http://www.msnbc.msn.com/id/35242442/ns/health-fitness/?ns=health-fitness
"They initially identified, using a novel approach, a set of 29 genes that seemed to predict a person's ability to improve their VO2 max. Then, they examined the individual DNA sequence of those genes, looking for differences in the genetic code. They found a total of 11 DNA differences, or markers, which appeared to be predictive of a person's ability to get fitter. But these markers don't tell the whole story. Remember, heredity is only thought to account for 50 percent of a person's capacity to improve their fitness. Of this 50 percent, the newly identified genes can only explain about 23 percent of the variation in an individual's ability to be trained to improve VO2 max. "With this we can identify, with a reasonable degree of precision, who is a low responder [to exercise], an average responder, or a high responder," Bouchard said. "We can begin to rank order people for their ability to be trained before they are trained.""
While it is a BFO (blinding flash of the obvious) that genetics dictates athleticism in large measure, I think this is a hint of the future of fitness. If you could identify an athlete's athletic potential - for say strength, sprint speed, VO2 max, agility, coordination, etc - you could then evaluate in an entirely new way how various training modalities affected their development towards their maximum potential. Imagine when we can identify exactly what programming would get one athlete or another to their 90% point with the least training and the least time. Imagine what it would be like to know how fast you are getting to that 90% point as an athlete - and then could choose how much time to invest to get that last 10%, or not to chase it.
Tuesday, April 6, 2010
Monday, April 5, 2010
Ornish on Tierney
http://tierneylab.blogs.nytimes.com/2008/08/05/end-of-the-diet-wars/
Dr. Ornish responds to a question about "The Diet Wars." Near the end he states: "Where are areas of agreement? Choose foods that are more dense in nutrients (such as fruits, vegetables and whole grains) and less dense in calories (all fat has 9 calories per gram versus only 4 calories/gram for protein and carbohydrates). Have some good fats such as fish oil containing omega 3 fatty acids each day. Eat less salt and drink more tea. Eat mindfully. Calories count. Quality over quantity. Also, most experts agree that moderate exercise and stress management techniques are also beneficial ... it’s not low-fat versus low-carb. It’s the right types of fats and carbs as well as the right amounts of these and other nutrients. The diet wars are almost over. It’s about time."
There's nothing nutrient dense about whole grains (and they actually have about the same metabolic impact as refined grains - not to mention I don't know a lot of folk who don't pile high carb taste enhancers on top of their otherwise boring whole grain fare), but the reality is that unless one is going to eat a lot of fat, we have to use grains (or one of the other high density carbs - potatoes, rice, corn) in the diet for calories. If you take grains out of the food choices described above, but think you have to avoid fat, you'll be eating all day to get adequate caloric intake. I think that's an important connection - they have to advocate 'whole grains' no matter the significant negative issues, because rejection of grains means de facto advocacy of a higher fat intake.
I'm a little stunned that anyone with an IQ greater than room temperature quotes the "fat has nine calories per gram" nonsense any more. Are you eating food by weight? Do you diet by eating fewer grams of food? Do you have any idea at all how many grams of food you've eaten today? Is there any evidence to support the idea that we actually affect body fat loss by avoiding fat? I'd say the evidence is much stronger that by avoiding fat, we have reduced satiety and increased hunger - and that's before we consider what is used to replace the fat we should be eating (carbs - and thus insulin issues), the negative effect of low fat diets on fat soluable vitamins, and the necessity of fat for normal body functions (including and especially mental health). And let's face it, unless you mix sugar with fat (EG Oreos), it's hard to overeat fat - ever see a person sitting around eating lard? Ever know a depressed person pounding down the olive oil as comfort food? Perhaps fat deprivation makes Dr. O see this differently. I hate to even say that as I don't think badly of the Doc, but really - it's absurd to speak the way he does about fat and calories.
I don't think the 'diet wars' are over, for what that is worth. There's still every reason to believe that restricting carb intake to 100g/day or so is far better advice for most of us. There's little reason to think eating more carbs than that will benefit us.
That said, I prefer the new Dr. Ornish, the Spectrum advocate, to the old Dr. O who so doggedly advocated the super-low fat diets that I think are nonsense.
Dr. Ornish responds to a question about "The Diet Wars." Near the end he states: "Where are areas of agreement? Choose foods that are more dense in nutrients (such as fruits, vegetables and whole grains) and less dense in calories (all fat has 9 calories per gram versus only 4 calories/gram for protein and carbohydrates). Have some good fats such as fish oil containing omega 3 fatty acids each day. Eat less salt and drink more tea. Eat mindfully. Calories count. Quality over quantity. Also, most experts agree that moderate exercise and stress management techniques are also beneficial ... it’s not low-fat versus low-carb. It’s the right types of fats and carbs as well as the right amounts of these and other nutrients. The diet wars are almost over. It’s about time."
There's nothing nutrient dense about whole grains (and they actually have about the same metabolic impact as refined grains - not to mention I don't know a lot of folk who don't pile high carb taste enhancers on top of their otherwise boring whole grain fare), but the reality is that unless one is going to eat a lot of fat, we have to use grains (or one of the other high density carbs - potatoes, rice, corn) in the diet for calories. If you take grains out of the food choices described above, but think you have to avoid fat, you'll be eating all day to get adequate caloric intake. I think that's an important connection - they have to advocate 'whole grains' no matter the significant negative issues, because rejection of grains means de facto advocacy of a higher fat intake.
I'm a little stunned that anyone with an IQ greater than room temperature quotes the "fat has nine calories per gram" nonsense any more. Are you eating food by weight? Do you diet by eating fewer grams of food? Do you have any idea at all how many grams of food you've eaten today? Is there any evidence to support the idea that we actually affect body fat loss by avoiding fat? I'd say the evidence is much stronger that by avoiding fat, we have reduced satiety and increased hunger - and that's before we consider what is used to replace the fat we should be eating (carbs - and thus insulin issues), the negative effect of low fat diets on fat soluable vitamins, and the necessity of fat for normal body functions (including and especially mental health). And let's face it, unless you mix sugar with fat (EG Oreos), it's hard to overeat fat - ever see a person sitting around eating lard? Ever know a depressed person pounding down the olive oil as comfort food? Perhaps fat deprivation makes Dr. O see this differently. I hate to even say that as I don't think badly of the Doc, but really - it's absurd to speak the way he does about fat and calories.
I don't think the 'diet wars' are over, for what that is worth. There's still every reason to believe that restricting carb intake to 100g/day or so is far better advice for most of us. There's little reason to think eating more carbs than that will benefit us.
That said, I prefer the new Dr. Ornish, the Spectrum advocate, to the old Dr. O who so doggedly advocated the super-low fat diets that I think are nonsense.
Sunday, April 4, 2010
Adventure Race Highlights CrossFit (Men's Journal)
"To prepare for and finish the Speight’s Coast to Coast, a 151-mile adventure race down under, my relay partner (and wife) Mary and I faced two broad challenges and scores of little ones when it came to gear."
http://www.mensjournal.com/nzgear
The author consults CF Endurance helmsman, Brian McKenzie - www.crossfitendurance.com. The linked article is a run down of his gear for training and the race, but the story's in the paper version.
http://www.mensjournal.com/nzgear
The author consults CF Endurance helmsman, Brian McKenzie - www.crossfitendurance.com. The linked article is a run down of his gear for training and the race, but the story's in the paper version.
Saturday, April 3, 2010
Self Catheterization, Anyone?
Heart catheterization: Strange, but true
Really interesting tale from Dr. Davis about the origins of this procedure - stupid human tricks indeed!
Really interesting tale from Dr. Davis about the origins of this procedure - stupid human tricks indeed!
Friday, April 2, 2010
Wheat Belly Part Deux
Dr. Davis reports on the anecdotal information his clients report following when following his dietary advice (largely eliminating wheat and sugar). This is convincing enough to make someone at least want to try this zero cost health experiment.
http://heartscanblog.blogspot.com/2009/09/unexpected-effects-of-wheat-free-diet.html
"People also felt better, with flat tummies and more energy. But they also developed benefits I did not anticipate:
--Improved rheumatoid arthritis--I have seen this time and time again. Eliminate wheat and the painful thumbs, fingers, and other joints clear up dramatically. Many former rheumatoid sufferers people tell me that one cracker or pretzel will trigger a painful throbbing reminder that lasts a couple of hours.
--Improved ulcerative colitis--People incapacitated with pain, cramping, and diarrhea of ulcerative colitis (who are negative for the antibodies for celiac disease) can experience marked improvement. I've seen people be able to stop all their nasty colitis medications just by eliminating wheat.
--Reduction or elimination of irritable bowel syndrome
--Reduction or elimination of gastroesophageal reflux
--Better mood--Eliminating wheat makes you happier and experience more stable moods. Just as wheat is responsible for a subset of schizophrenia and bipolar illness (this is fact), and wheat elimination generates dramatic improvement, when you or I eliminate wheat, we also experience a "smoothing" of mood swings.
--Better libido--I'm not sure whether this is a consequence of losing a belly the size of a watermelon or improvement in sex hormones (esp. testosterone) or endothelial responses, but more interest in sex typically develops.
--Better complexion--I'm not entirely sure why, but various rashes will often dissipate, bags under the eyes are reduced, itching in funny places stops."
http://heartscanblog.blogspot.com/2009/09/unexpected-effects-of-wheat-free-diet.html
"People also felt better, with flat tummies and more energy. But they also developed benefits I did not anticipate:
--Improved rheumatoid arthritis--I have seen this time and time again. Eliminate wheat and the painful thumbs, fingers, and other joints clear up dramatically. Many former rheumatoid sufferers people tell me that one cracker or pretzel will trigger a painful throbbing reminder that lasts a couple of hours.
--Improved ulcerative colitis--People incapacitated with pain, cramping, and diarrhea of ulcerative colitis (who are negative for the antibodies for celiac disease) can experience marked improvement. I've seen people be able to stop all their nasty colitis medications just by eliminating wheat.
--Reduction or elimination of irritable bowel syndrome
--Reduction or elimination of gastroesophageal reflux
--Better mood--Eliminating wheat makes you happier and experience more stable moods. Just as wheat is responsible for a subset of schizophrenia and bipolar illness (this is fact), and wheat elimination generates dramatic improvement, when you or I eliminate wheat, we also experience a "smoothing" of mood swings.
--Better libido--I'm not sure whether this is a consequence of losing a belly the size of a watermelon or improvement in sex hormones (esp. testosterone) or endothelial responses, but more interest in sex typically develops.
--Better complexion--I'm not entirely sure why, but various rashes will often dissipate, bags under the eyes are reduced, itching in funny places stops."
Excellent Post from PaleoNu
This is a flawless summary of how I view Dr. Cordain's work. His fat and salt phobias I find to be disappointing. However, there are many, many redeeming qualities in his books, and I still recommend them highly. If you have not yet read them, you'll learn a lot and enjoy the books.
http://www.paleonu.com/panu-weblog/2010/3/28/the-only-reasonable-paleo-principle.html
"My new principle or "paleolithic" principle, was just that if foods contribute to disease, it is unlikely (but not impossible) that the bad foods are what we have been eating a long time, and much more likely that they are something relatively new. So, the way I thought of it, a food being evolutionarily novel was a likely condition for it being an agent of disease, but that novelty was neither necessary nor sufficient for agent of disease status."
It's one thing to look at any non-paleo food with a jaundiced eye, and another to pronounce it unfit for humans just on general principles (but lacking any direct evidence).
http://www.paleonu.com/panu-weblog/2010/3/28/the-only-reasonable-paleo-principle.html
"My new principle or "paleolithic" principle, was just that if foods contribute to disease, it is unlikely (but not impossible) that the bad foods are what we have been eating a long time, and much more likely that they are something relatively new. So, the way I thought of it, a food being evolutionarily novel was a likely condition for it being an agent of disease, but that novelty was neither necessary nor sufficient for agent of disease status."
It's one thing to look at any non-paleo food with a jaundiced eye, and another to pronounce it unfit for humans just on general principles (but lacking any direct evidence).
Review - The Great Cholesterol Con
http://www.proteinpower.com/drmike/statins/646/
BLUF: Dr. Mike Eades reviewing another MD's book giving the lie to the diet/heart hypothesis.
"I read Dr. Malcolm Kendrik’s book The Great Cholesterol Con in the UK-published edition several months ago... the UK publisher did a sorry job on what is a truly wonderful book. Dr. Kendrick’s writing style is accessible, humorous and to the point. He slashes and burns the diet/cholesterol/heart hypothesis in easy-to-understand terms and with great verve. I didn’t really find much in the first part of the book that I disagreed with except for one little throw away sentence about prions causing mad cow disease. I’m one of those folks who just don’t buy that entire premise, so Dr. Kendrick’s referring to it as established medical fact was a little jarring. Other than that one false note, I was completely engrossed in the book. As anyone who reads this blog knows, Dr. Kendrick was preaching to the choir with me, but the choir certainly enjoyed it. I’m going to excerpt a fairly long section for a couple of reasons, one of which is totally self serving. First, I want you to get the feel for Dr. Kendrick’s writing style, and second, I’ve been wanting to write a section on this blog about ad-hoc hypotheses for a while so that I could link back to it and not have to explain the term each time I write about it. Dr. Kendrick has done it perfectly, so I’ll simply link back to this post and let him do all the work. Here is Dr. Kendrick on the ad-hoc hypothesis:
"But there is no evidence that any of these three factors [he’s just been talking about how people claim that garlic, red wine, and lightly cooked vegetables are protective against heart disease] are actually protective.
"NONE. By evidence, I mean a randomized, controlled clinical study. Not epidemiology, meta-analysis, discussions with French wine producers or green-leaf tea growers, or a trawl through the Fortean Times. In reality, the only reason that these three factors appeared was to protect the diet-heart hypothesis. They are what Karl Popper would call ‘ad-hoc hypotheses,’ which are devices that scientists use to explain away apparent contradictions to much-loved hypotheses. Ad-hoc hypotheses work along the following lines. You find a population with a low-saturated-fat intake (and a few other classical risk factors for heart disease) – yet, annoyingly, they still have a very high rate of heart disease. One such population would be Emigrant Asian Indians in the UK. The ad-hoc hypothesis used to explain away their very high rate of heart disease is as follows. Emigrant Asian Indians are genetically predisposed to develop diabetes, which then leads to heart disease. Alakazoom! The paradox disappears. On the other hand, if you find a population with a high-saturated-fat intake, and a low rate of heart disease, e.g. the Inuit, you can always find something they do that explains why they are protected. In their case it was the high consumption of Omega 3 fatty acids from fish. Yes, indeedy, this is where that particular substance first found fame, and hasn’t it done well since? This particular game has no end. In 1981, a paper was published in Atherosclerosis (a crackling good read), outlining 246 factors that had been identified in various studies as having an influence in heart disease. Some were protective, some causal, some were both at the same time. If this exercise were done today I can guarantee you would find well over a thousand different factors implicated in some way. Recently, just to take one example, someone suggested that the much lower rate of heart disease in south-west France, compared to north-east France, was because the saturated fat they ate was different. In the south-west they ate more pork fat and less beef fat. So now it is no longer simply saturated fat that is deadly, it is the precise type of saturated fat, in precise proportions. Just how finely can one hypothesis be sliced before it becomes thin air? What this highlights, to me at least, is one simple fact. Once someone decided that saturated fat causes heart disease, then NOTHING will change their minds. There is no evidence that cannot be dismissed in one way or another. And there is also no end to the development of new ad-hoc hypotheses. You can just keep plucking them out of the air endlessly – no proof required. Genetic predisposition is one of the most commonly used ‘explain-all’ ad-hoc hypotheses, and it is a particular bug-bear of mine. Someone I knew quite well had a heart attack recently, aged 36. He was very fit, almost to international level at cycling. He was also extremely thin. His resting pulse was 50 a minute, his blood pressure was 120/70 (bang on normal). His total cholesterol level was 3.0 mmol/l, which is very low [116 mg/dL, very low indeed]. He was vegetarian and a non-smoker. I know what you’re thinking: he deserved it. Steady, he’s a nice bloke, actually, if a bit worthy. Now, you can go through all the risk factors tables produced by the American Heart Association, the European Society of Cardiology and the British Heart Foundation – and any other cardiology society you care to mention. According to the lot of them, he had no risk factors. Therefore, he should not have had a heart attack. However, it did emerge that his father had a heart attack aged 50. A-ha! He was genetically susceptible, then! Phew, there’s your answer. I beg to differ: if you think about this in any depth, it is a completely idiotic statement to make. If someone is genetically susceptible to heart disease, that susceptibility must operate through some identifiable mechanism. Or does a big finger suddenly appear from the sky and go: ‘Pow! Heart attack time, bad luck.’ Genetically susceptible people don’t need high LDL levels or high blood pressure. They don’t need to smoke or eat a high-fat diet. They don’t need to be overweight or have diabetes – or anything, actually. They are felled by a mysterious genetic force, operating in a way that no one can detect. Other people are killed by risk factors. But such factors count for nothing if you are genetically susceptible. I have one word to say to this – and it’s a word I’ve used before in a similar context. Balls."
The entire book is written in this engaging style and I found myself laughing out loud often. In fact as I was reading late one night I woke MD from a sound sleep with my laughter. The book is that funny in places. Funny, but accurate in its laying waste to the idea that fat in general and saturated fat in particular have anything to do with heart disease. Dr. Kendrick has pretty much the same take as I do on the statin issue. He has a chapter detailing all the hoopla the drug companies put out and the reality, which is that statins work only for a very few people. He even mentions our old friend Dr. John Reckless. The latter part of the book is an elaboration of what Dr. Kendrick believes is the driving force behind heart disease: stress. I hadn’t given stress a whole lot of thought until I read this book. Now I am reconsidering it as a major risk factor and working it in to my own ideas of what causes so much heart disease. I really can’t recommend this book strongly enough."
BLUF: Dr. Mike Eades reviewing another MD's book giving the lie to the diet/heart hypothesis.
"I read Dr. Malcolm Kendrik’s book The Great Cholesterol Con in the UK-published edition several months ago... the UK publisher did a sorry job on what is a truly wonderful book. Dr. Kendrick’s writing style is accessible, humorous and to the point. He slashes and burns the diet/cholesterol/heart hypothesis in easy-to-understand terms and with great verve. I didn’t really find much in the first part of the book that I disagreed with except for one little throw away sentence about prions causing mad cow disease. I’m one of those folks who just don’t buy that entire premise, so Dr. Kendrick’s referring to it as established medical fact was a little jarring. Other than that one false note, I was completely engrossed in the book. As anyone who reads this blog knows, Dr. Kendrick was preaching to the choir with me, but the choir certainly enjoyed it. I’m going to excerpt a fairly long section for a couple of reasons, one of which is totally self serving. First, I want you to get the feel for Dr. Kendrick’s writing style, and second, I’ve been wanting to write a section on this blog about ad-hoc hypotheses for a while so that I could link back to it and not have to explain the term each time I write about it. Dr. Kendrick has done it perfectly, so I’ll simply link back to this post and let him do all the work. Here is Dr. Kendrick on the ad-hoc hypothesis:
"But there is no evidence that any of these three factors [he’s just been talking about how people claim that garlic, red wine, and lightly cooked vegetables are protective against heart disease] are actually protective.
"NONE. By evidence, I mean a randomized, controlled clinical study. Not epidemiology, meta-analysis, discussions with French wine producers or green-leaf tea growers, or a trawl through the Fortean Times. In reality, the only reason that these three factors appeared was to protect the diet-heart hypothesis. They are what Karl Popper would call ‘ad-hoc hypotheses,’ which are devices that scientists use to explain away apparent contradictions to much-loved hypotheses. Ad-hoc hypotheses work along the following lines. You find a population with a low-saturated-fat intake (and a few other classical risk factors for heart disease) – yet, annoyingly, they still have a very high rate of heart disease. One such population would be Emigrant Asian Indians in the UK. The ad-hoc hypothesis used to explain away their very high rate of heart disease is as follows. Emigrant Asian Indians are genetically predisposed to develop diabetes, which then leads to heart disease. Alakazoom! The paradox disappears. On the other hand, if you find a population with a high-saturated-fat intake, and a low rate of heart disease, e.g. the Inuit, you can always find something they do that explains why they are protected. In their case it was the high consumption of Omega 3 fatty acids from fish. Yes, indeedy, this is where that particular substance first found fame, and hasn’t it done well since? This particular game has no end. In 1981, a paper was published in Atherosclerosis (a crackling good read), outlining 246 factors that had been identified in various studies as having an influence in heart disease. Some were protective, some causal, some were both at the same time. If this exercise were done today I can guarantee you would find well over a thousand different factors implicated in some way. Recently, just to take one example, someone suggested that the much lower rate of heart disease in south-west France, compared to north-east France, was because the saturated fat they ate was different. In the south-west they ate more pork fat and less beef fat. So now it is no longer simply saturated fat that is deadly, it is the precise type of saturated fat, in precise proportions. Just how finely can one hypothesis be sliced before it becomes thin air? What this highlights, to me at least, is one simple fact. Once someone decided that saturated fat causes heart disease, then NOTHING will change their minds. There is no evidence that cannot be dismissed in one way or another. And there is also no end to the development of new ad-hoc hypotheses. You can just keep plucking them out of the air endlessly – no proof required. Genetic predisposition is one of the most commonly used ‘explain-all’ ad-hoc hypotheses, and it is a particular bug-bear of mine. Someone I knew quite well had a heart attack recently, aged 36. He was very fit, almost to international level at cycling. He was also extremely thin. His resting pulse was 50 a minute, his blood pressure was 120/70 (bang on normal). His total cholesterol level was 3.0 mmol/l, which is very low [116 mg/dL, very low indeed]. He was vegetarian and a non-smoker. I know what you’re thinking: he deserved it. Steady, he’s a nice bloke, actually, if a bit worthy. Now, you can go through all the risk factors tables produced by the American Heart Association, the European Society of Cardiology and the British Heart Foundation – and any other cardiology society you care to mention. According to the lot of them, he had no risk factors. Therefore, he should not have had a heart attack. However, it did emerge that his father had a heart attack aged 50. A-ha! He was genetically susceptible, then! Phew, there’s your answer. I beg to differ: if you think about this in any depth, it is a completely idiotic statement to make. If someone is genetically susceptible to heart disease, that susceptibility must operate through some identifiable mechanism. Or does a big finger suddenly appear from the sky and go: ‘Pow! Heart attack time, bad luck.’ Genetically susceptible people don’t need high LDL levels or high blood pressure. They don’t need to smoke or eat a high-fat diet. They don’t need to be overweight or have diabetes – or anything, actually. They are felled by a mysterious genetic force, operating in a way that no one can detect. Other people are killed by risk factors. But such factors count for nothing if you are genetically susceptible. I have one word to say to this – and it’s a word I’ve used before in a similar context. Balls."
The entire book is written in this engaging style and I found myself laughing out loud often. In fact as I was reading late one night I woke MD from a sound sleep with my laughter. The book is that funny in places. Funny, but accurate in its laying waste to the idea that fat in general and saturated fat in particular have anything to do with heart disease. Dr. Kendrick has pretty much the same take as I do on the statin issue. He has a chapter detailing all the hoopla the drug companies put out and the reality, which is that statins work only for a very few people. He even mentions our old friend Dr. John Reckless. The latter part of the book is an elaboration of what Dr. Kendrick believes is the driving force behind heart disease: stress. I hadn’t given stress a whole lot of thought until I read this book. Now I am reconsidering it as a major risk factor and working it in to my own ideas of what causes so much heart disease. I really can’t recommend this book strongly enough."
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