Monday, December 24, 2012

It's that time of the year: 2012 Reflections

It's that time of the year. Temperatures are dropping. Days are shorter. We're in the middle of the holiday season. Which means one thing...

It's time to recharge the batteries, take stock, and plan for next year.

I love the holiday season. Yes, it's cliche and the saying is often over-used, but it's nice to be with family and friends. Many of them (and mostly my wife) graciously support my individual pursuits in triathlon and running. She selflessly puts up with my early morning swim workouts; my not being around when she wakes up in the morning; my need to get a good nice sleep to do it all again tomorrow; my structured diet. For 11 out of 12 months of the year, it's seemingly all about me.

There is a lot of sacrifice that goes into it all. And that's why that one month a year (or two) - during the holidays - is so important. It's not about whether I swim 3000 meters that morning. It's not about making sure I get in four bike workouts that week. It's not about going to bed at a decent time knowing I need to be at the pool at 6am the next morning. For one month out of the year, it's not about me. It's a time to sleep in a little on the weekend. It's a time to spend the afternoon at the cafe with my wife sipping coffee and chatting. It's a time to share a bottle of wine with some friends. It's a time to let go of the pressure of "I need to train today."

But, as much as the end of the season is about reconnecting on the other important aspects of life, it's also time to reflect back on 2012 (the good and the bad), and start setting specific goals for 2013. This is the fun part. To look at the entire body of work for the year, analyze where things went well, where they didn't, and find small nuggets of information to help lay the foundation for next season's training. The big thing is to identify very specific aspects, whether nutritionally, biomechanically, or otherwise, and dedicate a solid training block to improving those deficiencies (more on this in my next post).

What I'll remember about 2012 

 

I would be lying if I said I wasn't thrilled with qualifying for Boston. But, I'm also proud that I made a number of very solid advancements in my training over the past year. Here are three things I'll remember about 2012:

1. The mental game. Five years of marathon running and 18 months of triathlon, I'm finally figuring out the mental game; even enjoying the mental game. Whether you say 50% or 75%, what goes on between your ears has a lot to do with what happens in your chest, arms and legs. Researchers are figuring out there is a closer link between the heart and brain than previously thought, and things like sleep and stress play a major role. Tim Noakes has long expressed the idea of a "central governor," or essentially the idea that exercise is neurally-mediated. The brain calculates a safe pace for the body, and limits exertion and endurance by the number of muscle fibers recruited.

But forget all the scientific stuff, mile 25 of a marathon or mile 95 of a century bike ride is all about the decision to endure pain and keep going, or pack it in and stop. The biggest mental adaptation for me over the year is one of perception. How much can I really endure? As I discussed in previous posts, I've focused a lot on improving my lactate threshold with high intensity interval work. Yes, it has a lot of physiological advantages, but the mental component of the training is equally as important. Run 2 minutes as fast as you can along slightly rolling hills. Rest for 30 seconds. Then do it again another 10 times. By the eighth or ninth interval your legs are screaming; you're hearts pounding out of your chest; you can taste the lactic acid building up. Then you have to decide if you're going to bang out this last interval (and how hard you're going to go), or if you're going to cut it short, and pack it in for the day. This is the same game you play at mile 25 or mile 95.

2. Recovery. If there is one thing I've learned since taking up endurance sports, it's that it's all about recovery. Doing those hill repeats or swim drills seems like the work part, but it's really afterwards when your body gets to work. Recovery is when your body goes about fixing all the damage created during exercise - and then rebuilding. But in order to rebuild, the body, of course, needs the right tools. These come in the form of quality amino acids for muscle repair; or antioxidants for all the free radicals produced during exercise; or dark leafy vegetables to alkalize the body's pH after it became acidic during a hard workout; or cold therapy and compression to reduce inflammation. Bottom line, I've seen my best performance improvements when I'm recovering properly. Not to mention, mastering the art of recovery is also critical when taking a high-intensity-interval-based training approach. Doing the right things between workouts ensures I'm able to maximize performance during workouts.

3. My first coaching experience. On the day before I ran the Philadelphia Marathon, about 2,000 people lined up for the Rothman Institute 8k, including my wife and me. This was her first time running anything more than a 5k. She was definitely nervous. Yes, I was a little conscious of not "over-doing it" with a marathon the next day, but these were nerves of "coach" rather than "athlete." It was a tough task: how to help Stephanie prepare for her first 8k and structure a useful program within her busy schedule of attending law school, serving on law review, and holding down a job. Not to mention, trying to carve out time for her training separate from my own. But in the end she was great - a minute under her goal minute/mile pace and she ran the entire thing. More than anything, it was something we did together, and that's what made it so enjoyable.


She even beat me to the finish line...

Now, she's talking about doing another...maybe a 10k or half marathon...who knows what the limit is...

***

2012 was a good year. Not only am I happy with my race results (my next post I'll talk about one triathlon-specific achievement that's shaping my training approach for 2013), but I also dedicated a lot of attention to mastering many of the "non-race" things, like nutrition, sleep, recovery, etc. Many of these things, of course, have a carry-over effect with performance, but I'm most pleased with how I've optimized all the different variables for overall health and well-being.

But 2013 is another year, and another opportunity to recalibrate and find ways of doing things even better. 2013 will be filled with a new set of goals, challenges, achievements and setbacks. That's all part of the journey...

Stay tuned for my next post where I go into a bit more detail on how I identified some weaknesses from my 2012 season, and what I'm doing to improve them in preparation for next year's races.

But for now, it's time to relax and enjoy the downtime.

Happy Holidays!

Thursday, December 13, 2012

"Pink" 5-hour ENERGY Drink: Inherent contradiction to public health?

 Some facts on energy drinks...
  • Energy drinks are consumed by an estimated 30% to 50% of adolescents and young adults, but some experts suggest this number is even higher.
  • A recent review of the health effects of energy drinks on children, adolescents, and young adults concludes, "for most children, adolescents, and young adults, safe levels of consumption have not been established."
  • Energy drinks are not regulated by the U.S. Food and Drug Administration because they are marketed as nutritional or dietary supplements (see the bottom left of any 5-hour Energy bottle).
  • According to a recent New York Times investigation, 13 deaths over the last four years have cited the possible involvement of 5-Hour Energy.

 

Behind non-melanoma skin cancer, breast cancer is the leading cause of death among women in the U.S. Breast cancer is also the most common cancer among women worldwide. In this regard, I am all for raising awareness about breast cancer. I also recognize the very specific role caffeine can play in exercise performance (this is of course within limits). 


With this all in mind, is this a fundamental contradiction to public health?


Sunday, December 9, 2012

Challenging Nutrition Dogma: Is it really all about calories?

Along with cholesterol, there may not be a more misunderstood nutrition concept than fat. Is it bad? Is it good? What kinds are good? What's the difference between triglycerides and fatty acids? Why do I hear so much about omega-3s? Why do people say saturated fat is bad?

I recently finished reading Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health, by science writer Gary Taubes. More so than many other nutrition books out there, Good Calories, Bad Calories puts into perspective current nutritional guidance with what the evidence shows - and I mean all the evidence. The book is several years old (published in 2007), and Taubes has since written another book on similar issues called Why We Get Fat (which is much more accessible for the less technical audience), but for anyone truly interested in nutrition, food policy, and health, this is a must-read.

Coming from a science writer, I expected a fairly thorough presentation of the research. At the same time, though, journalists and the media don't necessarily have the best record when it comes to accurately and objectively writing about health and medical studies (but that's an issue for another article). But, taking one look at the 44 pages of notes and the book's 66-page bibliography, there's an immediate appreciation for the full picture Taubes attempts to paint.
 
The essential thesis of the book is that "obesity is caused by a defect in the regulation of fat metabolism." In other words, "obesity is a disorder of fat accumulation NOT a disorder of overeating."

To better understand what this exactly means, lets consider several important points.

First, Taubes argues that energy expenditure and energy intake are independent variables. This essentially turns the classic "calories in/calories out" paradigm on its head, which assumes energy intake and expenditure are dependent. In the classic "caloric balance" model, the assumption is that energy change (or fat accumulation), and therefore obesity, is the result of (or dependent upon) overeating (energy intake) or physical inactivity (energy expenditure). 

Taking a little detour back to physics, energy is neither created nor destroyed. So, the change in energy (or change in fat mass) is the difference in energy consumed and energy expended. But, this equation says nothing of causality. Is fat accumulation caused by increased food intake, or does increased fat accumulation cause increased food intake?

This is a good time to introduce a major piece to this entire puzzle -- hormones. In the book, Taubes gives a very illustrative example about why hormones play such an important role in fat metabolism. Think about growing children. The energy balance is obviously positive, which is why children grow. But, children aren't growing more because they eat more. Instead, the causality is reversed, and children eat more because they are growing. "They require the excess calories to satisfy the requirements of growth; the result is positive energy balance. The growth is induced by hormones and, in particular, growth hormone."

One could think of a similar example with pregnant women. Weight gain during pregnancy is the result of hormonal changes. "This hormonal drive induces hunger and lethargy as a result. In the context of evolution, these expanded fat stores would assure the availability of the necessary calories to nurse the infants after birth and assure the viability of the offspring." In essence, fat metabolism, including the distribution of fat, is a hormonal issue. And its these hormonal changes that influence energy consumption.

In terms of fat metabolism, there may not be a more important hormone than insulin. Insulin is produced in the pancreas, and is said to be the "principal regulator of fat metabolism," which has been known since the 1960's. How does it work? Essentially, if fatty acids are to be mobilized from inside fat cells (and burned as fuel), insulin levels must be low (Quick distinction on terminology: fat is stored as triglycerides - the reason being triglycerides are three fatty acid molecules held together with a glycerol making it too big to cross the cell membrane. Fatty acids are burned as fuel. Fat enters/exits the cell as fatty acids, a smaller molecule). Conversely, when insulin levels are high, fatty acids are shuttled into fat cells and stored rather than burned as fuel. This happens when glucose (when burned as the primary source of fuel) produces something called glycerol phosphate, which assembles fatty acids into triglycerides in fat cells. (A good overview can be seen in this series of video clips.)

Basically, the accumulation of fat in fat cells is regulated by the availability of glycerol phosphate, and the production of glycerol phosphate is directly related to the amount of glucose available. Conversely, "when blood sugar levels decrease, fatty-acid levels rise," and therefore become the predominantly energy source. As Taubes puts it, "the one fundamental requirement to increase the flow of fatty acids out of adipose tissue...and so decrease the amount of fat in our fat tissue, is to lower the concentration of insulin the bloodstream."

Taubes recounts early experiments on insulin from the 1920's (just after insulin was discovered) that demonstrated the role of insulin as a "fattening hormone." These studies showed that "when insulin was injected into diabetic dogs in the laboratory, or diabetic human patients in the clinic, they put on weight and body fat. As early as 1923, clinicians were reporting that they had successfully used insulin to fatten chronically underweight children...and to increase their appetite in the process."

Now what causes high levels of insulin? In short, carbohydrates (insulin is also released when eating protein, but a much smaller amount), and most commonly refined carbohydrates and sugar (fructose has a particularly unique effect, which Dr. Robert Lustig discusses in great detail in this now popular lecture 'Sugar: The Bitter Truth'). "The more carbohydrate flooding the circulation after a meal, the more will be converted to triglycerides and stored as fat for future use."

Taubes goes into a bunch of other related issues, such as issues of hunger, satiety, diabetes, and the like (all of which are extremely interesting and thoroughly researched), but here are two basic take-aways:

All calories are NOT created equal. One hundred calories of bread has a distinct physiological and hormonal response compared to 100 calories of salmon. And it's this hormonal response - principally the high levels of insulin - that drives fat metabolism, not necessarily the number of calories.

Fat isn't a bad thing. Two quick examples: Fat is fundamental to the many cells that make up our body. Without fat, there would be no cell membrane to maintain the cell's integrity. Second, without fat, nerve cells would not have something called myelin, which is essential for cell signalling (or how our nervous system communicates, or 'tells' our body to do certain things). This article on fat consumption in children and depression reinforces the close link between fat and cognitive functioning. 

***

Nutrition science isn't clear-cut. It's littered with studies that claim "associations" and "links," but few point to causality. More so than anything, Taubes reminds us of this in his book. Just because obesity may be associated with something, doesn't mean that it is caused by it. It is this short-coming by which much of current nutrition and dietary guidelines are based. And if for no other reason, this book is worth the read because it firmly puts into context current dogma, and underscores the need for rigorous science to better inform nutrition policy, guidelines, and the general public's understanding of the issue.