Thursday, July 25, 2013

Making the best of it when things don't go your way: NJ State Triathlon race report

I didn't sleep particularly well the night before. In true endurance athlete fashion, I was up a few times during the night to go to the bathroom. The entire week leading up to the NJ State Triathlon was in the upper 90's with extreme humidity (not fun!). Of course the natural thing to do is to make sure to sip on enough water to "stay hydrated." Turns out, I overdid it.

Unlike my stress-fueled trip to the Philly Triathlon, the pre-race motions this time around were a lot less eventful (the stress came the next day...).

Race morning came, and I went through the routine. However, this time was ever-so-slightly different. I took a page out of the Andy Potts playbook (he says he tries one new thing every race - only one) and had a small cup of coffee before heading to the race. I generally don't consume coffee or caffeine before a race despite there being some ergogenic effect. On this day, it made no difference.

I parked my car and was unloading the car when the first bike issue came up. I had some issues with my front derailleur (the part on the bike the enables your chain to move between the front chain rings) the week leading up to the race. A trip to the bike mechanic and then myself also needing to adjust the limit screws, it finally felt dialed in. I pulled my bike out of the car and ran through the gears to make sure everything was working. SNAP. Shifting from the small to big front ring, the front derailleur cable came loose. "You've gotta be kidding me."

"Stay calm, plenty of time." This was one of those mornings I was grateful that I like to arrive early! I grabbed my bike tool and quickly got to work. I was able to reattached the cable fairly quickly and then ran through the gears again. It wasn't perfect, but it was sufficient.

Off to transition.

I laid out all my stuff and checked my tired pressure. A little low, so I tried to pump them up. Nothing was happening. "You've gotta be kidding me." I walked around transition asking anyone I saw if they had an extra pump. Most people leave them in their cars because they take up too much space in transition. But of course I wasn't thinking entirely clearly after my little issue, so forgot to pump up my tires in the parking lot.

One person had a hand pump (which are notoriously ineffective), so I tried it. Ssssss. There goes a bunch of air from my front tire. Piece of junk didn't work. No one else had a pump. I had one other option - make a mad dash for the bike mechanic tent over in the finish line area (a few minute walk away). I only had 10 minutes before transition closed.

I grabbed my bike and ran as fast as I could (thank you carbon fiber for being so light). The guys hooked me up and filled my tires. Ran back to transition, racked my bike, grabbed my goggles and swim cap, and then off to the swim start. Two minutes to spare.

"Ok, calm down." Now the fun part.

Well, that's if you think swimming in an 89 degree lake is fun. I've never been in lake water so hot. It was a relief during the recovery part of every stroke when my arm came out of the water. The air temperature was about 15 degrees cooler.

I had a decent swim. The first half was a lot better than the second half. I think the warm water started to get to me and my form suffered a little bit. 

It never felt so good to be out of water. Checked my watch - 27 minutes. Eh, not bad, but not great. Swimming is my weakest discipline (which I have significantly improved over the past year), so I couldn't wait to make up a little time on the bike, especially since the bike course was fast and flat.

Ok, time to make up a little time. Out of T1 and onto the first loop of the bike course. It was a double loop on mostly flat roads. I ticked them off, passing a fair number of people. Each time I passed someone I glanced down at their left calf - ok, my age group; nope, not my age group.

As I came around for the second loop I spotted my family (who I can't thank enough for being so supportive). A quick waive to my little cousin Callan and back into the aero position.

 I felt good coming into T2. A solid one hour bike split. Let's close it out.

But, the humidity was starting to get to me. The warm lake water definitely took a bit out of me as well. I took a chance on the bike only carrying one water bottle too.

It caught up with me. I was holding on the first few miles of the run, but at the halfway point, I started to struggle. My legs felt heavy.

At every aid station I grabbed for as much water as possible to dump on my head. Being from Washington, DC I'm fairly used to pretty bad humidity, but I don't know what it was. I couldn't get my head in a positive place. I kept thinking about how much I wanted to stop.

Nonetheless, I pushed as hard as I could. I knew my pace wasn't as fast as what it usually is (my run split was about 50 seconds per mile slower than my PR), or what it was just a couple weeks ago when I had a solid brick session for that matter (had a solid 5 mile tempo at around 6:20 pace off a 25 mile bike ride). But, I tried to dismiss my discouragement and focus on my form. When it all heads south, the one thing I know I can control is my form.

And that's what brought me to the finish line. Around the corning I could see the red carpet and the finish chute. It looked incredible! I gave that last quarter-mile everything I had.

Finished in 2 hours 17 minutes - good for 16th in my age group. A bit shy of my goal, but not bad for the race that also doubled as the regional championship (on the bright side, I punched my ticket for next year's Age Group National Championships).

I was particularly happy with how I persevered through the run (I was also really pleased with my bike split, which was a PR). It wasn't my best run performance and it took everything I had to dig deep and keep going. After crossing the finish line, when I staggered through the finishers' area trying to regain my balance, I knew I did everything I could. I had nothing left.

Sunday, July 14, 2013

My recipe to swim faster

Swimming never really came naturally to me. I grew up running around the soccer field, not cranking out laps at the local pool. Since the age of four all the way through my sophomore year of college, my goals were always around building soccer-specific skill, strength, and fitness.

That's not to say I didn't know how to swim growing up. I took swim lessons when I was young. I could hold my breath underwater for a pretty long time. I even spent a summer life-guarding at my neighborhood pool, which of course required me to pass a swim test.

My first few years of running were a natural extension of my years of soccer. It was what I knew best - running, endurance, and cardiovascular fitness.

So it shouldn't come as a surprise that transitioning to triathlon from running has taken a lot of work, particularly on the technical side. And of the three disciplines, none is more technical than swimming.

What I’ve found over the past few years after getting back into swimming is that, above all, technique matters! You can be the strongest guy or gal lining up at the swim start (or on the start blocks), but if you produce a ton of drag, you don’t stand a chance at swimming fast or economically.

Since taking up triathlon a few years ago, I've managed to cut my 100 meter time in the pool by about 45 seconds. Compared to last year, I improved my swim time at the Philly triathlon by 8 minutes - that's a little more than 30 seconds every 100 meters.

Here's my 3-F recipe that made it happen:

1. Frequency - I've talked about this before in previous posts, but for a novice swimmer it's all about developing a feel for the water. The solution isn't really rocket science - swim more often. I shortened my swim workouts, but increased their frequency to about five times per week. This approach is all about quality over quantity. It doesn't make much sense to develop endurance in the pool and do these massive sets if your stroke is inefficient. You're simply perpetuating bad habits. That leads me to my next point.

2. Form - This means drills, drills, and more drills. Improving technique helps efficiency, particularly to reduce drag (so you're expending less energy). This is a big part of swimming faster! For me, at least one workout per week is exclusively for drills, and I often incorporate drills into as many as three or four workouts each week. During the past winter I basically did a six week block where I more or less did nothing but drills in the pool. One of my favorites (which I continue to incorporate regularly into my sessions) is a drill called Unco - short for uncoordinated. The drill helps improve rhythm and timing of your stroke.

Here's a quick breakdown, but check out the fantastic site Swim Smooth for more detail. While using fins (unless you have a really good kick) perform a full stroke with one arm, breathe to the opposite side, and keep the opposite arm at your side -- essentially a one arm stroke. For example if you start with your right arm, you'd breathe to the left side. Do the drill for 25 meters or yards and then switch sides.

Photo credit:

3.  Flexibility -Strong ankles help stabilize during your foot strike while running. Unfortunately, this doesn't really help you in the pool. Strong ankles are often inflexible ankles; and inflexible ankles produce a lot of drag. Take a look at the picture (again from Swim Smooth). With inflexible ankles, your toes essentially point straight down towards the bottom of the pool, resulting in water being pushed in the wrong direction. This obviously slows you down.

Photo credit:
Two easy things I've done to increase flexibility in my ankles: 1) use fins, especially during kicking drills; and 2) ankle stretches. Stretching out the ankles is pretty easy. Here's a quick stretch I've tried to do on almost a daily basis.

My final point is about consistency. These are things I've incorporated over months and improvement will take some time. But invest the time and you'll be a better, more efficient swimmer.

Happy training.

Sunday, July 7, 2013

Obesity the disease: Is it really about health?

The media and blogosphere lit up after the recent American Medical Association annual meeting.


The prestigious, 165 year-old organization of 225,000 doctors voted to recognize obesity as a "disease." Yup, let me say it again, according to the AMA, obesity is now considered a disease.

Now, of course, there are fairly convincing arguments on both sides of the spectrum (here is an interesting compilation of arguments from members of the Obesity Society). The popular obesity blog Weighty Matters lays out a pretty good listing of reasons against obesity as a disease. Interestingly, the article starts off by applying the common definition of disease, and seeing if obesity fits - "A particular quality, habit, or disposition regarded as adversely affecting a person or group of people."

At first glance this seems to make a lot of sense. Obesity is a quality or disposition that adversely affects an individual and society (a prime example being the health care costs associated with obesity).

This is the argument taken by Lee Kaplan, director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital, associate professor of Medicine at Harvard Medical School, and chairman emeritus of the Campaign to End Obesity:
"The simple fact is that obesity is a disease, a chronic, frequently progressive, and rarely remitting disorder that triggers an additional 65 or more other conditions ranging from arthritis and sleep apnea to many forms of cancer."

On the other hand, will the AMA's announcement simply medicalize the issue rather than addresses the miriad of factors that influence it. Public health expert David Katz makes this point when illustrating the irony of the AMA’s announcement and the recent introduction of the first FDA-approved obesity drug into the market. This obviously begs the question of who really stands to benefit: those who suffer from obesity or big pharma? Dr. William Davis, the preventive cardiologist and best-selling author, answers in pretty simple terms:
"To the system, you are worth more obese than slender. You are worth more diabetic than non-diabetic. And you are worth more as a wheat-eater than as a non-wheat eater."
One might go as far as to say that this is a classic example of "disease mongering" - a phenomenon described by Lynn Payer as the ability to control the destinction between health and disease, thereby allowing drug companies to determine the size of their own markets. From the enlightening book The Bottom Line or Public Health,
"Since disease is such a fluid and political concept, the providers can essentially create their own demand by broadening the definition of diseases in such a way as to include the greatest number of people, and by spinning out new disease."
It wasn't long after the AMA's announcement that its implications were already being seen. Only a few days later, Members of Congress introduced the Treat and Reduce Obesity Act (H.R. 2415/S.1184), a bill that would  allow Medicare coverage of prescription weight-loss drugs.


The Wall Street Journal importantly points out that even if obesity is characterized as a disease, there is still a pretty big grey area in terms of how to actually measure and track obesity trends. Traditional "diagnosis" of obesity has been using the imprecise Body Mass Index, which is simply weight divided by height. One can easily guess why this can be a challenge -  just think of a fairly fit athlete with good dose of lean muscle mass. Unfortunately, BMI doesn't distinguish between fat mass or muscle mass, which, of course has some severe limitations. Other research has shown (see here) waist circumference to be a much better predictor of obesity-related health risk and subsequent health costs (see here).


Might characterizing obesity as a disease actually be counterproductive to prevention efforts? A new study released a few weeks ago found that if parents discuss weight issues with their children they are in turn more likely to diet, use unhealthy weight-control behaviors, and engage in binge eating. By classifying obesity as a disease, won't doctors be more apt to discuss it in terms of "treatment" options for their condition - i.e. in the context of weight (remember how obesity is classically measured - BMI = weight/height)? And, my fear, is that by framing conversations between health providers and children/adolescents and their parents in terms of weight alone, children and teens might turn to some of the same negative dietary behaviors mentioned in the study.

The current President of the AMA doesn't think so, and recently defended the organization's decision.
She makes the argument, "Recognizing obesity as a disease will encourage a dialogue between patients and physicians to determine which behavioral, medicinal or surgical options may be right for them." But an honest dialogue between physicians and patients about options is only as useful as doctors are informed and able to accurately communicate the range of options.

Take for example nutrition.

Now, I think doctors are good at a lot of things, but offering nutrition advice (i.e. behavioral option) is not one of them. And medical schools themselves agree with this statement. A 2010 survey found that among 105 accredited U.S. medical schools, only 26 (25%) required a dedicated nutrition course! In other words, medical students (or our nation's future doctors) from three out of four U.S. medical schools received ZERO training on nutrition. The average contact hours of nutrition instruction medical school students received was 19.5 hours, and this was about 3 hours LESS than the average time from 2004.


My biggest fear, however, is that by placing the emphasis on obesity we neglect the underlying physiological processes contributing to weight-gain in the first place. Some research has already suggested that the link between obesity and shorter life expectancy may not be as clear cut as we once thought (i.e. being obese might not be the real issue. More on this below). The research was published earlier this year in the Journal of the American Medical Association and found that "Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality." (Yes, this is pretty ironic coming from the academic journal of the same professional organization that just a few months later deemed obesity as a disease.)

Dr. Peter Attia made a strong and eloquent case at this year's TEDMED conference about why obesity might not be the real issue. What if we have the causality backwards? What if obesity doesn't lead to issues of diabetes and metabolic syndrome, but the real issue (and whether our body stores or burns fat) has everything to do with insulin - i.e. the hormone at the crux of diabetes and metabolic syndrome? What if obesity is just a by-product of the metabolic firestorm caused by chronically consuming excessive sugar, starches, and refined carbohydrates?

What do you think - was the AMA's announcement beneficial or harmful?