On Exercise, Dietary Supplements and Doping

When I'm walking down the street, people often stop and ask me (not really): Do you take supplements?

All athletes, whether world class or TOJs, are always alert for anything that makes them stronger and faster, or enhances endurance, or speeds recovery. At the extreme ends of the spectrum, there are the notorious, professional athletes who used illegal substances to enhance performance, like Mark McGuire (baseball), Marion Jones (track), or Floyd Landis (biking).

But the truth is most of us are separated from them by a thinner line than we like to admit. We all have our manias, whether running a 10K in a certain time or living to be 100 years old. In North America, we spend $16.4 billion a year on vitamin/dietary supplements, which is amazing given so little is actually known about them regarding their effectiveness and long term effects.

Consider these questions about supplements that have incomplete answers:

  • Do supplements actually do what the companies marketing them claim they will do?

    Fact: Few supplements have been subject to the rigorous double-blind studies to which medicines are tested to make these determinations. Because most supplements are derived from bountiful, natural sources, they are not patentable, therefore not attractive as investments to Big Pharma.
  • If so, have the correct dosages of these supplements been determined based on weight, age, health and other factors?

    Fact: No, for the reason above, though they are marketed by health food stores or multi-level schemes whose marketing materials clearly imply they have medicinal or health-enhancing properties. They are able to do this because the supplement industry, using the political machinery in Washington (e.g., Orin Hatch, who represents Utah, home to large supplement manufacturers) to protect it, have managed to fight to keep supplements classified as foods rather than medicines and avoid FDA regulation.
  • Do the supplements you buy contain the actual ingredients listed on the labels of the bottle?

    Fact: http://www.consumerlab.com/, which provides actual laboratory analyses of vitamin and other widely marketed supplements for a minimal fee (note, however, for a limited number of brands) says it finds about one in four products do not contain what is claimed. More alarming, many of the ingredients are made in China (the prosecution rests).

The key unresolved question is if the chemical compounds in these supplements, assuming they can be helpful, are not best acquired by eating good food. However, the supplement industry, not completely without justification, claims that due to soils being over-worked and depleted by industrial agriculture through overuse of chemical fertilizers, pesticides, long refrigeration, etc., healthful levels of these vitamins and minerals are missing. Hence we need to pop pills.

In December 2008, I blogged about the challenges facing a TOJ trying to figure out what's best to eat/swallow. I recommended people interested in the topic of supplements to read Dan Hurley's Natural Causes: Death, Lies, and Politics in America's Vitamin and Herbal Supplement Industry. In the interest of self-disclosure, this TOJ is hostile towards the diet supplement segment of the industry because my family suffered a tragic loss from the unregulated use of ephedra.

All this said, athletes place unique stresses on their bones, lungs, hearts, muscles and immune systems. Some supplements do show promise to ameliorate the inflammation that follows hard workouts, and help the body to resume anabolic processes (cell building) and resist opportunistic viruses like colds and flu.

So, in answer to the question: Does this TOJ take supplements? Yes, a few. More later on which ones and why. I take them based on a formula of 20% faith and 20% science, mixed with a 60% dose of healthy skepticism.

Running, Shakespeare and Zen

Shakespeare wrote several hundred sonnets, a kind of poem composed of three quatrains (four lines) and a couplet (two lines). One of his most famous and revered is Sonnet 73. It's a sad poem about mortality. No surprise, I usually remember it around my birthday, a date when we all realize time is going by and we get a reminder of our own mortality. Sonnet 73 starts with:

That time of year thou mayest in me behold
When yellow leaves, or none, or few do hang

Upon those bows that shake against the cold,
Bare ruined choirs, where late the sweet bird sang.

He slips that first metaphor in like the master he was -- he's not talking about the fall season, but himself. He continues in the next two quatrains to compare himself to the onset of nightfall, then to a fading fire. With each new metaphor, you descend an emotional staircase with him, and with each step down, the mood becomes darker and starker -- we live and die and must separate from everything we love.

However, though the poem is beautifully written (so well the words have stuck with me for decades, ever since a nun made me memorize it in high schooI), maybe Bill sat too long hunkered over his desk, brooding too much on the Big Topics like life, love, and death. I wonder what his mood and writing would have been like if he had been a runner and got out a few times a week to pound the cobblestones under London's gloomy grey sky.

Many people who run continuously for more than 30 minutes have experienced the runner's high, a feeling of calm and well-being that is a pleasant side effect of aerobic exercise. It is a well-understood physical phenomenon that neurologists attribute it to the release of endorphins in the brain. When its there, you are very cognizant that you feel good, and the feeling can linger for hours after you finish a run.

If you want to read an interesting scientific explanation of the neuroscience of the runners high,, pick up a copy of Christoper Bergland's The Athlete's Way: Sweat and the Biology of Bliss (a fine book that deserves a wider audience). In fact, the exercise-induced high is so predictable that John Ratey, a psychiatrist at Harvard Medical School, believes that aerobic exercise can be considered an effective treatment for a range of mental and emotional disorders.

I get a runners high on many runs, sometimes more intensely than others. I've no doubt that this endorphin rush is addictive, and the reason Runner's World has so many subscribers and so many people of all sizes and shapes toe the starting line for races 10K and longer.

But every once in a while when I'm deep into a run, something very different occurs that is beyond a runners high. It has only happened a few times and is hard to describe in words, but suddenly you as a thinker goes away, and you are just running. There is no sense of time. The color of every bush, rock, and cloud is thrilling and vivid. There are breathing sounds and leg pains, but they don't belong to anybody. It's more than a high, it's an ecstatic absorption in the moment. It's short, intense, and very cool.

What I'm trying to describe is better said in an ancient story from Zen Buddhism. In the story, a man is dangling over a cliff, desperately clinging to a vine. Above him, two mice are chewing through the vine. Below, two tigers are circling, looking up, waiting for him to fall. As the man ponders his difficult situation, he looks right in front of him and sees a wild strawberry plant growing from a crack in the rocks. He reaches out, plucks the deep red fruit, and takes a bite. How sweet it tastes!

If I'd been around London in the early 1600's, this TOJ would have dropped by Shakespeare's place. I would have said, "Bill, put down the quill. You need to get off your butt and sweat a little. Let's go for a run. If we're lucky, maybe we'll find some strawberries."

The visit might have changed the entire course of English literature by taking the edge off all the drama and trauma in human events about which he obsessed so much. He might have stopped after the first quatrain of Sonnet 73 once he laced up his Sauconys and run along the Thames for a few miles because his melancholy would have vanished. The world's loss would have been his gain.

--This blog is dedicated to Tom Wayman, my favorite foreign poet

Exercising on the Edge

A couple weeks ago a strange and terrible thing happened: three runners died in the Detroit Half Marathon. The men, 26, 36, and 65, all died within sixteen minutes of each other. News of the tragedy gave pause (hopefully a short one) to endurance athletes everywhere.

In wake of the tragedy, the Internet buzzed with speculation as to what happened. One blogger was convinced that a demented person had poisoned the water at one of the rest stops. It will be interesting to see what the pathologists conclude, if made public.

Facts regarding each of the men's health and medical history are few. They were probably in pretty good shape based on what I've read. The death of the 65 year old was no great a surprise because, as every TOJ knows, odds of sudden death during exercise rise steadily as a function of age, and he reputedly had some lung problems. When young men die during exercise, it is usually attributed to an electrical conduction or other hidden heart defect.

The weekend after the Detroit event I received an email from Dr. Al Sears (http://www.alsearsmd.com/), who runs a wellness and longevity center in Florida, and is a strong opponent of aerobic training, especially running marathons. His email claims this type of exercise "shrinks your lungs and downsizes your heart's output." Further, studies have shown that blood samples taken from people who have completed marathons have exhibited the same enzymes that are present during a heart attack. Dr. Sears sells an program that is based on progressively short anaerobic bursts of exercise, which be believes are safer and help you live longer.

I forwarded his email to another TOJ who is a distance runner (had just finished the Humboldt County Marathon in California) and a physician. His reaction was illuminating. He said it might be true you live longer if you exclusively follow a short interval program like Dr. Sears, but there is no scientific evidence that it does. Furthermore, most distance runners use a variety of exercise, including intense progressive intervals.

This distance runner/physician's most important point was that how you exercise really depends on the outcome you seek. If you want to run a marathon, you have to train for it, which is true for any challenging physical endeavor. If your goal is just to live a long time, it might not be necessary to do many of the forms of physical exercise that a TOJ enjoys. Most TOJs exercise hard because it enhances the quality of their lives. Quantity, as measured in years, is just a secondary effect, and subject many other factors like genetics and environment.

My friend speculated that there might be subsets of people for whom distance running is good, and others for whom it is detrimental. But being able to identity who falls into which category waits future study. Right now, to use his words, we are still in the medical dark ages when it comes to long term effects of exercise.

For most of us, any exercise where you ramp up your heart rate -- whether in intense, sub-minute anaerobic bursts that leave leave you breathless or in long aerobic activities where you dwell minutes and hours at at the burning upper end of your aerobic capacity -- presents some risk. You don't know know where you reach a dangerous tipping point, and, luckily most of us never find out.

The men whose lives ended in Detroit did. While it is doubtless a tragedy for their family and friends, this TOJ admires that they were in the race.