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Running on empty

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Jun 082010

Ultramarathons are increasingly popular. But do they also pose a health risk?

This Sunday in New York, a small knot of runners will start running around the block. They will resemble any other running club although they might look a little slow. They will run one lap of the 0.5488-mile block. Then they will do it another 5,649 times.

: Image via Wikipedia

The 3100 Transcendental Race is the longest certified foot race in the world. Every day for the next six to eight weeks, the entrants will race from 6am until midnight – averaging 75 miles a day. For no payment or prize.

While few subject themselves to the lunacy of the 3,100 mile race, ultramarathons (anything longer than a marathon) are becoming increasingly popular, with races popping up all over the world. Keith Godden, editor of ultramarathonrunning.com, says there are already more than 100 such established races every year in the UK; with, he estimates, “a couple of thousand” British ultramarathon runners. “The sport now offers a great variety of very different challenges,” he says, “whether it’s 32 miles on the roads across Dartmoor, 24 continuous hours going around in circles on a running track in London, 145 miles non-stop alongside the Grand Union Canal in less than two days, or a marathon per day for three days along the Jurassic coast.”

Just finishing one of these punishing events is an achievement – but may come at a price. Personal trainer Rob Blakeman, who has trained boxers Ricky Hatton and Mike Tyson, explains: “We’re very specific organisms, with very specific requirements and very specific limitations. More training is not necessarily better training. If you do a really tough workout, the next day you often feel as though you have the flu. It’s a systemic stress. If you don’t allow that systemic stress to subside before you go back to the gym, you break the cycle of improvement.”

These flu-like symptoms, says Geraint Florida-James, senior lecturer in sport and exercise sciences at Edinburgh Napier University, are explained by the “open-window theory” which suggests that a prolonged bout of running weakens the immune system, leaving the window open for infections to attack the body. “Any stress that you come across, whether physical or psychological, will cause a response in the immune system. If you saw any of the interviews before the London marathon, everybody’s carrying a bit of a niggle, or they’ve got an illness. People trying to do ultra endurance events are taking it to a further extreme level.” If you keep on pushing yourself, disaster can strike. “If they go into overtraining syndrome, it can take years to recover from. We’re not sure, long-term, with an ultramarathon runner, how much damage they may be doing.”

Worryingly, ultramarathons could affect athletes’ hearts, says Florida-James. “Research has looked at cardiac damage within ultramarathon runners, and has shown that there are some temporary changes in terms of the functionality of the heart.”

One of Britain’s most celebrated ultramarathon runners, Geoff Oliver, president of the 100km Association, seems to bear this out when he says of the days following a long race: “I feel very weak. My heart rate is normally 48-52, and it goes down to 40-42 for a few days – I certainly feel more tired. The body is not functioning properly. It also affects my liver and my kidney sometimes. There may be blood either in my urine or out of the other end. Usually within four days I’m back to normal.”

He confesses that this has caused him to question whether he’s pushing himself too hard, but says “I’ve spoken to other runners and it’s quite common. It never lasts long.” And it’s clear that Oliver is in remarkably good shape – he recently ran the London marathon in “a disappointing 3:45.” He’s 76.

Florida-James is quick to point out that, with the proper preparation, ultramarathon running need not be unhealthy. Many people can run 100 miles without damaging themselves. That means adequate training, but also sufficient recovery time. “Everybody is different, and it will affect some people more than others.”

So why do some thrive under these harshest of regimes, while others simply crumble under the physiological stress? This, it seems, is the area that fascinates scientists and athletes alike. “I do it out of sheer interest. What can the human body cope with?” says Oliver. “I’ve always had this nice little mantra, an Alexander Pope couplet: “Know then thyself, presume not God to scan; The proper study of mankind is man.”

Five tips for ultramarathon runners

1. Go for long runs, on consecutive days, bookended by two days of total rest.

2. Splice running with periods of walking. That’s how you’re likely to complete the event.

3. If you’re finding the going tougher, the instinct is to push harder, when you should ease off.

4. Eat and drink on your runs. You should take on 400-500 calories per hour.

5. Taper off training three weeks before the race. In the last week, do almost none.

Benjie Goodhart

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Checking your blood glucose

BMJ Group, Diabetes Information, Diabetes, type 2, Diet and Nutrition, Editorial, Health & wellbeing, Health and Fitness News No Responses »

May 312010

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To control your diabetes, you need to get a good balance among the treatments you take (insulin, tablets or both), the food you eat and your physical activity.

Your doctor may suggest you check your blood glucose regularly, to see if it’s in the right range. Regular checks will also tell you if your blood glucose is dropping too low (hypoglycaemia or hypo) or climbing too high (hyperglycaemia). Both of these can be dangerous.

For example, if you’re about to do some exercise and you find that your blood glucose level is quite low, you need to eat something before you exercise. If you don’t eat anything, exercising could lower your blood glucose level even more. You could have a hypo.

Testing your blood glucose is most important if you use insulin. People with type 2 diabetes who use insulin need to be sure that they don’t have a dangerous hypo. But we don’t know whether testing your blood glucose yourself is helpful if you have type 2 diabetes but don’t use insulin.

Testing kits

There are kits to help you test your blood glucose. The kits make testing simple. Here’s what you do. You can test your own blood glucose level regularly using a simple kit.

First, take some of your blood, usually one or two drops from your finger or your forearm. To get blood for the test, most people use a special needle that springs out when they press a button. You put this needle on your finger. When you press the button, the needle makes a prick that gives you exactly the right amount of blood.
When you have a drop of blood on your finger, you touch the drop to a test strip. The test strip is usually held in place on a meter.
There are many types of meters. But they all do the same thing. The meter analyses your blood. Then it tells you how much glucose is in it. The number usually shows on a little screen on the meter.

Your doctor will help you decide how often to test your blood. You also need to decide when you will do the test. Some people need just one test a day. Others need to do it before they take their insulin therapy (three or four times a day).

You also need to get used to adjusting your insulin dose or your activities based on what you find in your test. You will get used to this over time. But if you’re not sure what to do, ask your diabetes nurse or your doctor for advice.

If you are having a treatment called peritoneal dialysis because your kidneys aren’t working or if you are getting injections called immune globulin to boost your immune system, check with your doctor. Some blood glucose meters might not give you a reliable reading. Your blood glucose might read high when it isn’t. It is very important to have a reliable reading to avoid getting low blood glucose.[2]

It’s a good idea to keep track of your blood glucose level over a period of time. This will help your doctor see how you’re controlling your diabetes. You can carry a notebook with you to write this down. Or you can plot your blood glucose levels right onto a graph. This will help you see how your levels change.

Also, most modern meters have an internal memory. This means that you don’t have to keep a record yourself. You can simply show the meter to your doctor.

Keeping a record of your blood glucose level helps your doctor decide if you need to change your treatment, change to a different kind of insulin or change when you give yourself insulin (this is called your dosing schedule). For example, when you go to bed, you might find that your blood glucose is always a little bit higher than it should be. If this happens, your doctor may advise you to take more insulin before your evening meal.[1]

Haemoglobin A1c test

Another test you’ll get used to is the test for haemoglobin A1c (HbA1c for short). Haemoglobin A1c is a chemical found in your blood. You might hear it called glycated haemoglobin, glycosylated haemoglobin or glycohaemoglobin.

Your haemoglobin A1c level gives your doctor an idea of what your glucose level has been over time. It is kind of an average of your blood glucose level over the previous weeks. If your blood glucose level is often higher than normal, you will also have a high haemoglobin A1c level. So this test is useful for seeing how well you’re keeping your diabetes under control. Most people with diabetes should have their haemoglobin A1c checked every three months to six months.

The result of this test is given as a percentage. A good result is 7 percent. Your ideal result depends on your own situation, but it should usually be between 6.5 percent and 7.5 percent.[3] The higher the number, the greater your chance of getting complications from your diabetes. But most likely it would have to stay high for many years before you got problems.

Driving

If you take insulin, you must inform the Driver and Vehicle Licensing Agency (DVLA) about your diabetes. You must also tell the DVLA if you control your diabetes with tablets or diet and you have a complication that could affect your driving, such as a problem with your eyes.

You need to be especially careful about checking your blood glucose level when you’re driving. If it drops too low when you’re at the wheel, you could have a hypo and black out. To reduce your chances of getting hypo while driving, check your blood glucose level just before you get into the car.[4] If it is low, have a snack and check again before you set off. Try to always have some sugary drinks or sweets in the car. If you feel you’re going into a hypo, you can stop and have a drink or sweet, to boost your blood glucose.

If you feel you’re going into a hypo while you’re driving:[4]

Stop the vehicle in a safe place
Switch off the engine
Have a sweet drink or snack, such as a sweet or glucose tablet. Wait until you feel better before setting off. This can take 15 minutes
It’s a good idea to check your blood again before driving.

References

Williams G, Pickup JC. Handbook of Diabetes. Blackwell Science, Oxford, UK; 1992.

U.S. Food and Drug Administration. 2005 safety alerts for drugs, biologics, medical devices, and dietary supplements: parenteral maltose/parenteral galactose/oral xylose-containing products. November 2005. Available at http://www.fda.gov (accessed on 18 November 2009).

National Institute for Clinical Excellence. NICE issues national guidelines for the management of blood glucose levels in people with type 2 diabetes. September 2002. Available at http://www.nice.org.uk/36734 (accessed on 18 November 2009).

British National Formulary. Insulins. Section 6.1.1. British Medical Association and Royal Pharmaceutical Society of Great Britain. Also available at http://bnf.org (accessed on 18 November 2009).

Glossary

kidney

Your kidneys are organs that filter your blood to make urine. You have two kidneys, on either side of your body. They are underneath your ribcage, near your back.

immune system

Your immune system is made up of the parts of your body that fight infection. When bacteria or viruses get into your body, it’s your immune system that kills them. Antibodies and white blood cells are part of your immune system. They travel in your blood and attack bacteria, viruses and other things that could damage your body.

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Weight Loss – You can’t afford not to.

Diet and Nutrition, Health and Fitness News, Loosing Weight 2 Responses »

May 032010

Many of you interested in health and fitness probably follow TV shows like “The Biggest Loser” and the new one with Jamie Oliver’s “Food Revolution”. What you don’t probably see is what is going on in the background. Obesity and the costs of it are becoming more and more talked about. Our policy makers, you know the guys and gals that just got you “free” medical insurance, are looking at the costs of a society that continues to struggle with weight issues.

: Image by SavaTheAggie via Flickr

I came across this article Jamie Oliver Trims the Fiscal Fat that you might find a good read. It shows a growing trend (pun intended) that when it comes time to trim some budgets obesity will be one of the areas that is looked at very closely. The article in fact mentions that obesity related illness in this country costs us over 90 Billion a year. Now if you have been following the deficit numbers you will know that curbing that spending could easily become a priority.

Having felt the stigma of obesity I can tell you now is the time to rethink your comfort level with being overweight. You can look in the mirror all you want and be happy with yourself. I in fact hope that you are. The question is with all this information coming out about costs of obesity, will an employer looking at you, just be looking at your qualifications or will they take into consideration your health and costs to the company.

Another number included in the article was a estimate at what obesity costs an individual (that would be your costs) for obesity over a lifetime. It was $29,000 in added health care costs. So I ask you do you think it is time to take notice? Is it time to take this issue and do something about it? I have seen obesity when it was mostly a non-issue cost people their jobs as well as their health. I don’t think our planners that feel like they are responsible to “take care” of us will let this one slide much longer.

The Guardian’s health editor introduces our health factfile – and the full dataset behind it
• Get the data
• Tomorrow: politics

Health, as the work of Professor Sir Michael Marmot most recently eloquently demonstrated, is in no small part a function of where and to whom you were born. The most deprived communities, where jobs are low-paid if not scarce and those who make it to university are a talking point rather than the norm, are also those where cancer rates, heart disease and strokes are high. One government after another has been uncomfortably aware of this and made promises to do something about it. It has always defeated them.

But while the health inequality gap persists, the UK’s health overall has been getting better. Comprehensive childhood immunisation programmes have virtually wiped out some diseases. Smoking has become the number one public health target, and although we still struggle to get certain groups – young women and people in those deprived areas particularly – to quit, the public smoking ban, high taxes and campaigns have had an impact that must show up in lower rates of lung and other cancers and reduced heart disease. Diagnosis and treatment of cancer has improved – even if we still trail much of Europe in death rates. The politicians (and the drug companies) argue that is because we don’t buy the newest, most expensive cancer drugs. The cancer tsar, Professor Mike Richards, will tell you it is because we are slow to diagnose the disease, especially in those deprived areas (again) where men and women do not stride into the GP’s surgery demanding attention.

In recent years, the health gap has become visible, manifesting itself in obesity, which is often most rife among those with less money and less education, who are more likely to buy affordable and filling pie and chips than a smoked salmon bagel. Obesity puts people at risk of heart disease, diabetes and cancer – the big killers of our age.

To make a momentous improvement in the health of the nation today, those social inequalities have to be addressed. Yes – we are all living longer but, to misquote George Orwell, one of our greatest critics of social inequality, some of us are living longer than others.

Sarah Boseley

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Drinking water effects both exercise and weight loss

Diet and Nutrition, Exercise Help, Health and Fitness News, Loosing Weight 1 Response »

Apr 172010

When working with clients for weight loss I often hear: I can’t drink that much water!

Image via Wikipedia

My advice to them is do drink half their body weight in ounces. So a 200 lb man would or should drink 100 ounces a day of water. Often they will argue with me and many won’t do it. However those that do often see faster and more consistent weight loss. take that for what is is worth, many experts agree that proper hydration not only helps in weight loss but also maintaining that weight loss.

Today I ran across this information on water and exercise that I thought might help a few of you as well:

Drinking plenty of water is important, particularly among people who exercise vigorously.

The American Council on Fitness offers these recommendations for how much to drink:

Two or three hours before you start to exercise, drink 17-to-20 ounces of water.

Twenty to 30 minutes prior to exercise, or while you’re warming up, drink another eight ounces.

While you’re exercising, drink seven-to-10 ounces every 10 minutes to 20 minutes.

Within 30 minutes of completing your workout, make sure you drink another eight ounces

So for a 60 minute workout you would drink somewhere around 66 ounces of water when combined with before and after workout. Now that 100 ounces doesn’t look like so much water when planed throughout the day.

Combining proper hydration with diet and exercise your body will be more ready to eliminate the toxins and wastes released into your system. It will also make it easier to break down the fat tissues and process them for energy. If you have difficulty drinking plain water then add some lemon juice or some sugar free water flavoring. I believe as you develop the habit of drinking water periodically every day you will find it gets easier. It will also help to relieve soreness after training and cut down on inflammation.

Why Be a Health Coach – Part 3 Who to Coach

Athletics and Sports, Diet and Nutrition, Health and Fitness News, Inspiration, Loosing Weight No Responses »

Apr 142010

To continue the series I want to address the people who you will want to coach. If you are reading this series as a possible client you may see yourself in one of the categories mentioned.

First Timers

This is a group of folks that have decided for the first time in their life to really take on their health. They are ready to take an honest look or have been motivated recently to take care of themselves. Often one would associate this with age, but I see a trend that it is about awareness of their personal health condition. They may have recently visited their doctor, taken an honest look in the mirror, or even heard someone say something when they thought they weren’t listening. Something has them thinking about needing to make a change without any knowledge of how to get started, more or less to finish the journey successfully. They need someone with the expertise to do it right and teach them how to make it stick!

: Image by Getty Images via Daylife

Yo-Yo’s

I was one of these so I have particular affection for them. This person is someone that tries to lose weight, in fact often has tried many times. They may have had some measure of success. The hard thing for them is the ability to find it inside to try one more thing. Why would they think this diet would work for them, everything else failed at some point, why this one? They don’t understand why and they don’t know about metabolism and diet, they just know they have really tried and failed. They need someone that understands they are serious about it, they just struggle with something that keeps them from succeeding. Often they are the hardest to get to try again. They need an uplifting coach to believe in them and motivate them to give it effort and determination that this time they will succeed.

The Expert

SYDNEY, AUSTRALIA - FEBRUARY 04: A client str...

Image by Getty Images via Daylife

This bunch is a hard bunch to even get to work with. They know it all. They have read every book. They have tried everything, and yet they have not reached optimal health. Another version of these wonderful people show up at trade fairs and run when they see a weight loss booth. They know nothing will work for them. I was also part of this group. I was convinced that nothing would ever work and that somehow I had messed up my body so bad that I would never be able to lose weight. I knew that there was no magic pill, no patch, no abs system, and it seemed like there was nothing that would work. If there was certainly I would have found it already, after all wasn’t I the real expert on what would work for me. This group has one question to ask them: Are you happy with the results you are getting now? If the answer is yes, they automatically become un-coachable. To be coach you have to be willing to admit you don’t have all the answers.

Growing Your Own and Losing Weight

Exercise Help, Health and Fitness News, Inspiration, Loosing Weight No Responses »

Apr 022010

No this is not an article on how to raise pot and lose weight, it is about growing your own food and getting some exercise while doing. An added benefit has been some quality time with both my wife and son as we work together to completely redo our backyard.

For the last 4 nights (with many more to follow) we have been working on moving what would be a dump truck load of dirt around the yard. Because our back yard was part of the Boise river many, many years ago, it is full of rock of various sizes. We have to shift the rocks out as we prepare it to go into some raised beds we are doing square-foot gardening with this year. There is also the digging out of spots to put the new sifted dirt into the raised bed area.

: Image via Wikipedia

Come to find out the approximate calories per hour for a 150 pound person (not me) is 350 calories per hour. For me it is closer to 460 but we will use the 350 number to illustrate a point. One hour of digging would then equate to the following food intake to put things into perspective: The numbers on the right under the Cals column are the calories per serving.

These numbers from Calorie Count at About.com

Quantity	Description	Cals
1.3	Grande Starbucks Caffe Latte – Made with whole milk	272
0.5	McDonald’s Big Mac – With cheese	704
4.3	Glasses of wine (3.5 fl oz)	79
1.2	Snickers Bar	273
1.6	Cans of Coca-Cola	207
11.3	Carrots	30

Translated, it means that it would take a 150 person two hours of shoveling to burn off a Big Mac or 1.3 cups of a Grande from Starbucks. We wonder why 15 mins on a treadmill and a few other exercises don’t cut it for weight loss. It all depends on energy in versus energy out. I tease my wife that each night I have earned the right for a donut. Truth is donuts are once in a while treats these days and figured into the total for that day. Unlike in the past where it was nothing for me to eat 6 or more in one sitting and eat the rest of my meals that day.

Lesson for the day, it takes a whole lot more effort to burn off calorie dense food than it does the few minutes that it takes to eat it.

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