FUEL: 11/6/15 Meat as a Carcinogen - Relative Risk & Total Exposure

Relative Risk and Total Exposure

In case you haven't heard (maybe you went off the grid?) - processed meat has recently been classified as a carcinogen by the World Health Organization (WHO).....and what a story it has become.  Some cheered, some groaned and many put up the caution flag.  Now, if you've been reading these blog posts for a while you know that we are pretty big proponents of the simple dietary advice to "eat more plants".  After all, many different studies have shown that total plant consumption is linked to better health.  Whether it be the beneficial connection with prevention of vessel disease or the growing evidence that foods which trigger inflammation (including processed meat) are tied to diabetes or even the connections made between things like poor quality diet and anxiety/depression, it shouldn't be ignored.  In fact, a recent study showed that participants, especially women, who consumed the greatest number of fruits and veggies per day when they were young (9 servings had the most powerful effect) had the lowest levels of calcified plaque on tests done even 20 years later.

So why then was there so much backlash in the media when the WHO said that sufficient evidence existed to classify processed meat as a carcinogen?  In short, because, for many reasons, there probably should be.  In absolute terms, their statement is correct.....the evidence IS there, but it's a bit more nuanced than that.

For most folks, since we are exposed to many different risks every day, it's a question of relative risk and total exposure. For example, since the evidence of a link is strong enough to be considered causal (as per the experts who evaluated the research), it is accurate to say that processed meat consumption is a cause of cancer, the definition of a carcinogen.  Of course, the same can be said for smoking.....making it accurate to say they are the same.....they are both carcinogens.  However, and equally true, when compared to smoking, under typical exposures, smoking has a stronger link and is therefore a much higher RELATIVE risk. So, on a spectrum of known carcinogens, smoking would rank much higher....making it accurate to say that they are not the same....since the result largely depends on the exposure to the known risk.

Take for example the risk of an asteroid impact with earth:  Officially it IS a risk (with odds of about 75 million to 1) and so, by definition, it is the same as exposure to forces of nature (which sits at about 200,000 to 1) and heart disease (467 to 1). Yet, clearly, with such wildly different odds, the likelihood is very different.

So, even though smoking (leading to estimated 1 million cancer deaths per year) is a far riskier behavior than eating processed meat (leading to an estimated 34,000 cancer deaths per year) they are both carcinogens. In relative terms however, even though it is possible that with enough exposure, such as a person who eats low quality processed meat several times a day, compared to a person who had 1 puff of cigar to celebrate the birth of a friend's baby (not sure if that tradition still exists), it is a less potent risk.

Although I'm sure there will be continued developments in this and similar stories, with any luck the WHO classification story had the effect that any controversial topic can....it got us thinking and talking about it; because the more we do of that, the more likely we are to use evidence to formulate personal strategies to minimize the risks we face.

So although you won't hear us saying it's time to trade in that bacon for a smoking habit, you also won't hear us recommend you ignore the risks we face -- Low risk doesn't mean no risk -- with enough exposure, even low risk activities can generate big problems.  This is true in safety, this is true in health and, as unfortunate as it may seem for the bacon lovers.....it's true for food choices. The body is not a weak machine, if we give it what it needs (MOVE, FUEL, RECOVER,ENDURE, CONNECT), it will work well for many years......

ENDURE: 10/23/15 Aging Well

What does it mean to be age well?

 

Spoiler Summary: If loading the body is what stimulates growth and adaptation - how much is enough?

October is national physical therapy month....a time when PTs from all over the country take a moment to recognize the amazing power of the body to perform and recover as well as be recognized for their effort in preventing and treating injuries and disease.  Although I'm not sure it ranks up there with some of the other national months and days (I heard there is a "National Blueberry Popsicle day" in September - is that real?), I always do find it interesting to hear about some of the stories of amazing performance against all odds or amazing comebacks.  This year, the American Physical Therapy Association decided it would focus its efforts on the concept of being well as we age.  They started using the hashtag #AgeWell in social media and pushed a few stories out about people who have done just that....and show the kind of future payoff that is possible for people who invest in the healthy life now.

This got me thinking a bit about what it really means to age well.  Is it simply attaining a certain number of years or is it more than that? For example, does the average life-expectancy in America (78.6) define "old"?  Does attaining an age greater than that average constitute a success?  Some groups use the terms "young-old" for people 65-74, "old" for people 74-84 and "oldest old" for people 85+.  But is it just a chronological thing?  I'm of the mindset that there's more to it than that.  To me there is a big difference between a person who is vibrant (at any age) and a person who is not.....maybe that's the difference between "old" and "aging well".  Age represents a number, but aging well means being able to enjoy it fully and using the wisdom gained along the way.

With that in mind, I searched a little more deeply into the question....what I found was both disheartening in some cases and amazing in others.  The disheartening part was that despite paying a whole-awful-lot on healthcare, essentially our attempts to stay well in age, US citizens NOT leading the world in longevity....worse yet, they are also not enjoying the best quality of life in those years.....by some rankings we are as low as 7th.  

However, on the heartening side....I found THIS - an amazing story about someone who is "oldest-old" and still doing what he loves with a body that is able to....something we should all strive for as we "kids" (by his standards) grow up.

Unfortunately aging well won't happen automatically, despite some work to create an exercise pill, however it can be done.  Let us know if you have questions.

MOVE: 10/16/15 Only Enough is Truly Enough

(Only) Enough is truly enough.

 

Spoiler Summary: If loading the body is what stimulates growth and adaptation - how much is enough?

_________________

Q: "You OK?"

A. "Humbled and hurting...but pride makes everything hurt more I think"

Q. "Ugh! What happened?"

A. "Had and engine built for 16 and tried to run 26.2 -- not advisable".

__________________

That was the text exchange between my wife and I when I picked up my phone after completing the Chicago marathon last Sunday.  It was a long morning and she was making sure the drop off in my mile spits she had (virtually) witnessed were not due to injury.  To be specific, the morning was anywhere from 11 to 20 minutes too long.  Now, I realize that for most folks 11 to 20 minutes doesn't sound like that long.....but when it's all tacked on in the last third of an already long race, it makes for a less than ideal experience.  Like most things however, there's always a great opportunity to learn tucked into these events and for the extra minutes of pain and frustration, there was a great silver lining this time - race wisdom at its finest.

About 7 months ago, I decided to train for a marathon with a few of the guys who run for the same club as I do.  2 are older than me, 1 (my brother) is younger.  2 are steadily faster than me and with the other I was essentially even.  All three started with a training plan (like me) and kept on track for the better part of the 7 month window (not like me)....2 set new personal bests, the third well enough to place in the top 15 in his age group.....

And then there was me:  not able to train as consistently as I had hoped but with an already-paid-for trip, I was in for the duration -- just the kind of test I love...and hate.  What could possibly go wrong? A lot, but why?

Why, after only 1 year ago (when I posted a time 7% faster and a personal best) was I not able to repeat or do better this time?  Was it a longer or harder course? Not really.  Was it worse weather? No.  Was it at elevation? No.  Was I that much older? Not really.  Was I significantly slower? No.  Was I injured? No.

The answer, in its simplicity, is also the frustration - I just wasn't ready.  I had invested time and effort, but not ENOUGH time and effort.  I had logged miles, but not ENOUGH miles.  I could run a fast mile but not ENOUGH fast miles.  The dose of training was just not enough to match the response from it that I was looking for. I was able to squeak 19 miles out, but by mile twenty my left knee was barking and it was time to give into the fact that 7 miles was too many to push through; that unless I was willing to risk injury (I was not) I'd have to back off.  It was not the result I was looking for....but another one of those great lessons that come with experience and a renewed respect for exactly how long 26.2 miles really is.

Right before I checked my phone and as I got back to the hotel, I gave my brother a hug. I was exceptionally proud of him for meeting his goal - a new personal best.  And in that moment the moral of the Chicago story became exceptionally clear:  it's much more fun at the finish line when you've prepared enough to go the distance.  

___________________

May life be a marathon not a sprint - and may we all train accordingly!

Have a great weekend,

Mike E.

RECOVER: 10/9/15 Dose & Response

More on Load: Dose, Response

Spoiler summary - "enough" to prevent one thing and "not too much" to prevent another

Greetings!

There's just so much going on in the world it can be hard to keep track of it all....and, with all the "negative" that seems to make headlines, sometimes you may wonder if it's healthy to even try.  Yet, amongst the tragedies and the presidential politics, two really important scientific studies (and 1 cool video) were making news and they both related to the concept of "balanced load".  

Now, for purposes of recall, I'm not referring to balancing a load that you're carrying to avoid straining something -- which makes a ton of sense in its own right -- rather, I'm referring to the idea that for the body to thrive, it needs to be under enough load; that even though too much load can lead to strain, a body that is completely unloaded gets weak and health suffers.  I used astronauts as an example and talked about how much can go wrong when the body doesn't experience load - check out this video to see how NASA is wrestling with the problem on the trip to Mars. 

So if you were searching what you would've found was this:

1. Not enough load (in this case exercise load, about 4x what's previously been recommended) is linked to a greater risk of heart failure and

2. Too much load ( in this case inflammatory load from tobacco products) is linked to sharp rise in risk for diabetes.....and although this risk can be reversed by quitting, it takes a while.

What does this tell us?  The human "machine" is not weak....but it does require care, in the right amount.  We can't beat it up and expect it will bounce back forever....and at the same time, there appears to be some truth to the old saying "if you rest.....you rust".

ENDURE: 10/2/15 Load it up - building resilience

Load it up - building resilience

Spoiler Summary: As we brace for the storm and hope for the best, we take a look at how similar the storms we face really are.

Greetings!

So here we are again.  Faced with the potential of a major storm impacting us.  Will it turn into us?  If so, where will it hit? And how hard?  How many will be impacted?  What did we learn from the last storm? Are we ready for this one?

There are so many parallels between storms and the disease process. Not unlike disease, storms are not usually something people look forward to; everyone knows they can happen (risk) and that there are situations that increase the risk (certain seasons and conditions), but still, most hope they pass by or fizzle out entirely.  Likewise, most people know at some level if they are at risk for a health issue (family history, certain health behaviors) and they know that certain combinations can increase or decrease the risk....but they still hope to avoid dealing with it if at all possible.

If storms parallel disease, then storm-preparedness parallelsprevention. Those who are diligent and invest (time/money/energy/effort) to lower risk and exposure put themselves in a position to lessen damage and harm when the storms come.  It seems easy....it's definitely not....but it is possible....and worth it.

How?  Well, since I'm no expert on "storm hardening" I'll leave that to the pros, but when it comes to building resilience to disease and injury ("health hardening"?) it's about testing the current systems to see where they're at and then challenging them to do more where needed. It's about the improvements we gain from graded exposure, and resilience which results in loading the system.

Loading the body -- that is, progressively increasing the challenges it faces through more force or reps or working time, etc -- assuming adequate rest/recovery -- stimulates growth as we work to meet the challenge. For example, if we load the joints in a graded and progressive way and then let them recover, they will get more accustomed to greater forces and get stronger as a result.  This is one of the reasons why running actually LOWERS the risk of knee arthritis  (assuming you have good form) - because as the runners in the study loaded their knees and then rested, the body repaired and became more resilient.  On the flip side, in cases where increased load is present without the ability to get sufficient rest (e.g. the effect of increased body weight on the knees) or when load is progressively decreased (e.g. a person stops exercising) the tissues weaken over time.

This is the case in almost all body areas but is especially true for the "working parts" - which we call the MOVEment system.  People who progressively load the movement system have lower blood pressure, better blood values and are more resilient to heart disease, diabetes and cancer (3 of the top 10 killers in the US)....but that's not all.  They also have better strength, less pain and improved quality of life as they age.  If that same person puts in the right FUEL and gives the body adequate time to RECOVER s/he will be more resilient when the storms of life come....s/he will ENDURE. 

However, loading is not arbitrary and it should never be a guessing game.  It has to be done with the balance of knowledge and care.  After all the risks are considered and the goals are reviewed there is a "right" amount....quite literally, a proper dose.  Want to know more?  CONNECT with us any time - it doesn't have to be complicated.

Wishing everyone a healthy and safe weekend - especially to those who find themselves in the storm's path or working to deal with its aftermath.