Blood, Sweat and Tears

A couple weeks ago, Bob, a friend of mine and practicing member of the Wellness Club, went for an after-work mountain bike ride. Nothing too technical, just a nice up and down loop to work up a sweat after sitting in front a a computer all day.

Nearing the top of an incline, he realized he didn't have enough momentum and decided to dismount and walk the last few feet. Coming to a stop, he went to put his right foot down, but his shoe cleat wouldn't separate from the pedal, and he fell over sideways before he could get it freed.

Anyone who has ridden trails on a mountain bike knows this happens all the time, and you usually get a scrape or bruise. But when Bob went down, he realized something was different about the fall and pain. He pulled himself up and could see blood spurting out the side of his leg. He looked down and realized he had impaled his leg on the jagged stump of a small tree. Using his cell phone, he called his wife, who was waiting in line at a health food store, and explained his situation. (Thanks to Bob for this picture - ouch!)

He managed to glide back down to the trail head, where his wife picked him up and got him to the emergency room just in time because he was starting to go into shock. After numbing him up and giving him a relaxant, the ER doc stuck his latex-covered finger into the wound all the way up to his knuckle, and then called a general surgeon for a consult. They decided to clean out the deep puncture wound as best they could and not sew him up in order to avoid infection by letting the wound heal from the inside out. They packed it with a ribbon of gauze and sent him home with a prescription for some narcotics to ease the pain.

Bob's healing well and getting off the pain meds, but he can't do much physical activity yet, and this is hard on him. Several years ago and headed towards 50, he decided to get rid of his beer belly by getting in really good shape. He watches what he eats and exercises hard every day, rain or snow. He's a great example of the benefits of eating the right foods and working out regularly. When people bring crap food to work, he avoids it. He's broken through to the fitness side.

When you become really fit, you form an addiction to exercise. If you don't do it, you miss it. You feel sluggish, tired, overweight, anxious, depressed. You crave exercise. That's where Bob probably is now, but won't be for long. He'll heal and be back out there soon.

If you exercise hard (do more than walking), there's always a risk of injury. Usually, it's something minor like a strain, sprain, or abrasion. When you push a little harder like Bob and most TOJs do, the risk goes up, especially if you're fatigued and try to do that one last rep or run a little faster than you ever have before. We all have a boundary that we shouldn't cross and, if we do, will get injured. Part of the challenge of getting fit is knowing where those boundaries are. And almost all people who exercise hard will get injured at one time or another.

The day Bob got hurt, he hadn't reached one of his physical boundaries. He had an accident out on a trail that really had nothing to do with fatigue or pushing beyond limits. Being fit and tough from falling other times helped him be able to get to a place he could get some help.

A couple days after he returned to work, he ran into one of his fellow workers, who's young and very overweight. She asked Bob why he was limping. After briefly describing what happened, she said, "THAT's why I don't exercise."

Over the long run, guess who's at most risk between the two of them? Emergency Rooms are no fun, but they beat the hell out of Intensive Care.

No Satisfaction

Today I heard on the news that Dunkin' Donuts is underway with a massive U.S. expansion. This is a tragic development for both the individuals who eat them and the health care system that will have to pay for their gluttony. Take a look at this graph:

If health care costs continue to rise at the same rate as they did in the last ten years, within another 10 -15 years, almost every dollar you earn will go to health care. Forget new running shoes or gym memberships.

Many Americans, rich and poor alike, feel they're hungry when, in fact, they are stuffed. One of the main reasons we eat too much is that we don't know when we're full because the hormones that regulate hunger and satiety are out of whack because of what we eat the most -- very high carb foods like donuts.

You've probably heard of insulin resistance -- when your muscle and fat cells no longer respond to insulin that signals cells to allow blood sugars to enter, so your pancreas produces even more insulin, a problem in itself. Then, when the sugars cannot be delivered to cells, they are returned to the liver where they will be converted to fatty acids that will morph into belly fat and very low density lipoproteins, which will eventually clog your arteries.

You may not of heard of leptin resistance, though leptin is directly connected to insulin levels. Under normal circumstances, leptin is a hormone that lets your brain know that you can stop eating because you have enough fat strored in your body to get you to the next meal in case of an emergency. (If you want to learn more about it, read "Mastering Leptin" by Byron Richards.) Leptin tells your brain, "I'm full now."

Ron Rosedale, M.D., describes the nightmarish cycle in his book, The Rosedale Diet:

" takes more and more leptin to tell the brain that it's satisfied. The brain, not hearing leptin, frantically signals for more and more fat to be stored. Since leptin is made by fat cells, you have to make more and more fat to produce enough leptin to finally get its message across to the brain to stop being hungry and stop storing fat. This creates a vicious cycle: you eat more because your brain doesn't know how to tell you to stop, and the only way you can stop is by producing more fat to make more leptin, which means that you keep getting fatter, and more insulin and leptin resistant, which just makes you want to keep eating more."

The best way to avoid this trap and restore hormonal balance is cheap and simple: eat mostly unprocessed foods (especially the deadly high sugar carbs) and exercise. Teach your family and friends do the same.

Once people are able to feel full again, the number of fast food joints like Dunkin' Donuts will go down. So will health care costs.

Shake Days

Food/diet purists had a twit that First Lady Michelle Obama, a champion for exercise and healthy eating, enjoyed a burger and milk shake (estimated at 1700 calories) last week at a popular burger joint in Washington, D.C. What they over-looked is that she gets up every day at 4:30 am to hit the weights and treadmill, and most days of the week she doesn't drink milk shakes. She's probably the fittest First Lady in history. She frequently wears sleeveless dresses; look at her well-defined arms. Shake days are rare.

We all have our equivalent of Michelle's "shake" days, when we consume cookies, cupcakes, beer, chips, donuts, pretzels, bagels, bread, milk shakes, pizza -- name the sweet, high carb food your brain craves. There's nothing wrong with a shake day now and then, even once a week, but our national problem is that, for many of us, shake day is everyday.

Our economy may not be growing, but our appetites are are, along with the fat riddling many parts of our bodies. A study from U. of North Carolina said that between the late 1970's and and mid-2000's, the average American adult increased caloric intake increased from 3 meals per day to the equivalent of 4.9 meals per day. Of course, we aren't doing this by sitting down for 1.9 extra meals on top of the 3 square meals we ate in the good old days. We're doing it by eating larger portions and snacking.

In the community health center where I work, we formed a Wellness Club. To become more aware of what we eat, many of us keep a food journal. In an inexpensive notebook, we write down what we eat at every meal, and for snacks. Everything we put in our mouths and swallow.

Right now we don't try to calculate volume and calories, though that would be useful. But even lacking these details, the food journal itself is revealing. Over time, each of us will discover a unique, day-in, day-out eating pattern, hopefully aligned with our health and fitness goals, though sometimes not at all. I can see already that I snack too much on high calorie nuts and chocolate. At least these foods have some  nutrient value -- nuts, especially, are calorie dense and nutrient dense.

The hard to swallow fact is that the snack foods most Americans eat too often are calorie rich, but nutritionally poor. Note that the U. of North Carolina also did an interesting experiment with rats. They fed one group of rats the typical snack foods that you can buy at the super market, and fed lard to the other group. The lard group actually stayed pretty healthy. However, the snack food rats got fat and developed metabolic syndrome and prediabetes.

Give Michelle Obama a break. A shake day here and there is no problem. What needs to be eliminated are the junk snack foods full of salt, sugar and fat.

TOJ Heaven

Just got back from a vacation in Oregon, the perfect setting for a TOJ.

After a slow, pre-4th of July car ride with traffic from Portland to Bend, we hugged family then headed to the Entrada Lodge, tucked in the trees along the road to Mt. Bachelor. It's located right along a running/hiking/biking trail system which parallels the Deschutes River. I pulled on my Montrails and took a 45 minute run in 80 degree temps under blue sky and sunshine. The trail was vintage eastern Oregon, covered with an inch of fine dust (which coated my shoes and legs) and lined with manzanita and sage highlighted with an Indian Paintbrush here and there.

The next day I rested and went to a lively concert by Ween, a talented band that plays an eclectic mix of rock mixed with humor and awesome guitar riffs.

Then, the next morning, my son and I went with my daughter for a workout at Empire Athletics, a CrossFit (XF) gym where she's a regular. Though I'm sorta fit for my age, I was a little wary about how it would go after having watched a CrossFit workout at another XF gym about a year ago, thinking it might be a little strenuous for a TOJ.

But my daughter promised the Saturday session we were going to participate in would be pretty low key and fun. I had to use my imagination with this statement because CrossFit is not what I usually associate with low key -- the workouts are very robust and demanding high intensity exercise. What's unique about XF is that the workouts change with each session so all the major muscle groups in your body are challenged in different ways for a significant number of reps. When you complete one set of exercises, you move to the next one with a minimal recovery time. (You definitely will not find people sitting on exercise bikes in their Spandex chewing bubble gum and reading People magazine.)

There's plenty of scientific evidence supporting the efficacy of the XF system for building strength and endurance, and, when combined with the Paleo Diet (widely followed by XFer's), reducing and controlling unwanted body fat. When you see XF athletes who've been at it for a while, you're struck by their leanness and muscle definition.

When you get to an XF gym, listed on a white board is the day's workout, which for us included pull ups, kettle bell swings, cleans with an Olympic barbell, sit ups, and box jumps. Because it was Saturday, the group was divided up into teams of four to do 150-200 reps combined for each exercise. My team had my daughter, fresh off a XF regional competition, and two other relatively new younger XFers, plus me, a total newbie. The fun for me was I could do fewer reps and let my daughter and younger team members make up the difference. :-)

The coach/trainer at Empire Athletics is a fit young guy named Mike Wild. I was curious to see how he'd deal with an old rookie like me. One concern you'll find on the Internet about CrossFit is that the intensity and speed of some of the exercises could cause injuries if a person is inexperienced or too fatigued. (Of course, anybody who's been around athletics knows that when you push your body there's always some risk of injury, no matter who you are.) If Empire is typical of certified Cross Fit facilities, this fear is totally groundless.

Mike, an experienced professional, minimized any risk by taking the time to demonstrate the proper technique prior to commencing the exercises, especially the lifts involving the back, and offering pointers during the exercises. I've done a fair amount of weight lifting and other resistance exercise through the years, but he still taught me a couple of valuable lessons on cleans and kipping during pull-ups. He also made sure to keep me on light weights/kettle bells to learn the right technique. I left Empire feeling great from head to toe.

Finally, early in the morning on the 4th of July, my wife, daughter, and son headed to downtown Bend to participate in a 5K run to raise money for a children's cardiac program sponsored by the local hospital. We joined a couple hundred other people to run a scenic course along the Deschutes River.

Sunshine, sweat, endorphins. What more could you ask for on a TOJ vacation?

Oh, yes, some ice cold Obsidian Stouts.