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Cancer is something that each and every one of us has heard about. It may ring home for some of us more than others, particularly if it’s devastating effects have affected our friends and loved ones. I have recently been fascinated by this disease, specifically some of the research coming to light about nutrition and cancer. This article will discuss, very generally, what cancer is, how cancer has a ravenous appetite for carbohydrates, and ultimately how one could go about reducing the effects or prevalence of cancer within themselves with nutritional/dietary interventions based on some very interesting research on ketogenic diets.

What is cancer?

Very simply put, cancer is a disease that develops as a result of faulty/damaged/abnormal cells within our body growing in an uncontrolled manner.

Usually, if a cell is operating improperly, or has been damaged beyond reasonable repair, it is destroyed (a process known as ”apoptosis”) and its remaining pieces are recycled for use in the body’s other cells and tissues. Cancerous cells ignore this checks and balances system, and continue to divide at a very rapid rate with reckless abandon. As they continue to grow, they become tumors. These tumors have the ability to spread into and damage surrounding healthy tissues.

Cancerous cells usually develop as a result of a malfunction within the individual cell’s DNA, and thus the rapid, uncontrolled growth begins.

How to we find most cancers?

Through the use of a PET scan. PET (positron emission tomography) scans are performed though the use of a glucose dye and diagnostic imaging. The dye is injected intravenously and circulates throughout the body. The dye moves throughout the blood stream and contains a radioactive tracer that allows it to easily be tracked through the use of diagnostic imaging. These molecules allow for a doctor to view blood flow, glucose metabolism (cellular use of carbohydrates/sugars) and oxygen utilization throughout the body’s tissues.

The areas that are VERY active relative to normal tissues display brightly on PET scan images, and are likely tumerous/cancerous.

The below image from a PET scan shows the “more colorful” areas as cancerous within a man’s brain:

Brain Tumor

The scale along the right side notes that yellow/orange/red areas are using glucose at a much higher rate than the rest of the brain, which is blue and green.

 

Cancer Cells, Glucose and the Potential Benefits of High Fat/Low Carb/Ketogenic Diets.

A detailed and informative article authored by Rainer J Klement, outlines how glucose is consumed at an incredibly heightened rate in cancer cells relative to normal cells.

I am by no means a doctor, nor do I claim to be one on the internets, but here are my conclusions based on this article:

  • Cancer cells want to grow, and they want to grow fast.
  • Due to their damaged DNA, their mitochondria (structures within the cell responsible for creating energy/ATP that are essentially “power plants” that keep the lights on) are damaged and faulty as well.
  • These damaged mitochondria are unable to use fat as a source of energy production.
  • They are very good at using carbohydrates as a source of energy production
    • The cancer cells know what they are good at, and what they are not good at, so they become more and more able to increase their rate of glucose metabolism/use for energy.
    • Cancer cells require a huge amount of energy to grow as rapidly as they do.
      • They almost exclusively utilize glucose (carbs/sugars) to promote this growth.
    • Preliminary studies (a few here: 1, 2, 3) have shown that fasting and low-carbohydrate diets are effective at significantly reducing insulin and blood glucose levels (obviously, but the idea is that cancer cells would “starve” as a result of this), which significantly decreased the rate of growth and proliferation of cancer cells, as they are low on fuel.
    • Cancer related cachexia (muscle loss due to cancer, and quality of life loss as a result) was reduced in subjects, and in some cases on the verge of being reversed
    • The effects of the low-carbohydrate/ketogenic diets seemed to be synergistic with, and improve the effectiveness of, chemotherapy treatments
      • It also reduced the side effects associated with chemotherapy

I find this to be fascinating. Could high fat, low-carbohydrate diets actually drive cancers into remission via starving the cancer cells, and be beneficial in cancer treatments? Although I have no formal education on this matter, the data seem promising. What are the ramifications for simply trying an acute high-fat/ketogenic diet such as the ones utilized in the few studies above? My immediate answer is that the potential pros vastly outnumber the potential cons.

One could even say that cancer is a metabolic disease, and survival could be highly dependent on the diet of the individual affected. I know this is speculative, but I hope it at least makes you think.

Until next time.

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I am about to undergo some self experimentation with running barefoot to see if I can once and for all eliminate the nagging heel and foot pain that I have been experiencing for some time now. Following the recommendations from this article by Ben Greenfield (fitness, diet and nutrition expert), I will begin the transition today.

We live in a modern society in which our feet are coddled and protected by excessively cushioned footwear, which leads to the ability to run like a jackass and get away with poor technique whilst running (heel striking, overpronating etc.). My goal is to restore the strength to the small, intrinsic muscles within my feet and re-establish the natural biomechanical efficiency that should be present within the human foot.

More details to come, but I must be patient, as muscular adaptations to training take 4-8 weeks on average.

I will start with advice from the first article I mentioned:

“For the next 2 weeks, begin to run barefoot for very small distances on soft surfaces, like a few laps around a park or any easy jog several blocks around a soft track, just 2-3 times per week, and no more than 1 mile. Each week, gradually increase this volume, adding no more than 10% per week. After 8 weeks, if your feet are pain-free and you feel comfortable on soft surfaces, you can start experimenting with harder surfaces, paying very close attention to how your feet feel and whether or not anything hurts (which is a good clue that your feet aren’t quite strong enough yet for longer distances or hard surfaces).”barefoot

This is going to be awesome.

Until next time.

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Static Stretching Part 1

Static stretching is something that has been around for decades, and has been toted as a way to reduce injury prevention before exercise. Before I step onto a soap box and begin explaining some of the issues that I have with this common misconception, it is important to define static stretching.

I read a simple definition in which I have come to appreciate a few months ago from a thesis written by Cassandre Bernhart from Liberty University

“It occurs when an individual moves his/her body in such a way that a muscle is slowly elongated and then held in that position for a period of time. For example, to statically stretch the hamstrings a seated person with legs straight can bend at the waist and reach for the toes. The individual holds the position for a length of time, usually between 15 and 60 seconds. ”

Defined well, and an example given. Bravo, Cassandre.

Now, Cassandre went on to review all forms of stretching: Static, Dynamic, Ballistic and PNF. I will be focusing on her review of static stretching, and adding some of my own research in to the mix as well.

The biggest failure of modern exercisers is to attribute acute static stretching (that is, static stretching immediately prior to exercise) to a reduction in injury risk. When did this start, and why is it complete bullshit? I am so glad you asked.

In the early 90’s, a RCT (Randomized Control Trial, or the “gold standard” experimental design for a study) on static stretching was administered to 421 active recreational male runners (6-20 miles/week). This study coupled static stretching WITH a warm-up and cool-down, and educational seminars on how to properly warm-up and cool-down in the intervention group, and the control group just ran each week and recorded their mileage without any sort of standardized warm-up/cool-down/static stretching/education.

23 injuries occurred in the control group and 26 in the intervention group. The authors were 100% correct when they stated that:

“The intervention was not effective in reducing the number of running injuries; but it proved significantly effective in improving specific knowledge of warm-up and cool-down techniques in the intervention group. This positive change can perhaps be regarded as a first step on the way to a change of behavior, which may eventually lead to a reduction of running injuries.”

The last sentence that is in bold is what many fitness enthusiasts at the time picked up and ran with. The author legitimately said that both groups experienced an equal amount of injuries whether they performed the intervention or not, but that the intervention group was now more informed than the control group about how to properly warm-up and cool-down. Of course they were. They were forced to go to educational seminars on how to warm-up and cool-down, and the control group was not. Just because they are now better informed has no bearing on the fact that the intervention did not reduce injury risk.

But this got a good amount of media attention for some odd reason, and since static stretching was incorporated into the warm-up, everyone started doing it. Blindly. For no reason, because the article said that nothing was different between the two groups when it came to injury prevention.

More and more research was conducted on acute static stretching as years went on, and the consensus is as follows:Stretching

We mistakenly associate “being looser” with “being less prone to injury”.

I will address the previous statement in my next blog post, which will explain why being more flexible is not always a good thing.

Until next time, please do not perform static stretching immediately before you exercise. Many thanks.

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What Exactly Is Overtraining?

The idea of overtraining gets thrown around quite often, and in my opinion, is poorly defined. Textbook definitions typically associate overtraining with symptoms that are predominantly psychological initially, and end up affecting performance if they persist, but there is no real issues that have been traditionally defined outside of the athlete basically saying “I’m getting bored of exercising and I am tired all the damn time.”

I came across an absolutely perfect article for defining, assessing and tackling overtraining that is very concise and clearly outlined. It was written by Dr. Phil Maffetone who is an internationally renowned clinician, researcher and wealth of knowledge in the fields of nutrition, exercise and sport performance.

 

 

The article itself begins by stratifying overtraining into 3 stages in ascending order of severity.

Stage 1: Essentially “Overreaching”, which is a common short-term goal of athletes attempting to improve fitness by progressively overloading with volume (reps/miles/frequency etc.) and intensity (pace/heartrate/load/watts etc.).

This stage, as I mentioned, is common, and it is also functional in the sense that it actually serves a purpose: Progressively overloading the systems commonly worked in order to achieve improvements in performance and fitness.

I very much enjoy the statement he makes that says: “Stage 1 overtraining may be synonymous with overreaching, which has been shown in studies to boost performance but often turns into more obvious overtraining—it’s a fine line between optimal preparedness and the beginning of athletic decline.”

Definitely explore the article to look at some of the finer points of this stage, as MANY recreational type A exercisers are probably in the midst of Stage 1 Overtraining Syndrome.

Stage 2: Maffetone terms it “Sympathetic Overtraining” in reference to the neural/hormonal component that is associated with chronic stress.

He discusses a few things that can simply be measured to catch overtraining in this stage before it becomes more severe:

  • Increased resting heart rate
  • Elevated cortisol levels which lead to:Overtraining
    • Reduced testosterone and DHEA (aid in muscle recovery)
    • Increased insulin levels
    • Reduced hand-eye coordination as a result of these hormonal dysfunctions

These are bad things. Particularly if they are left unchecked for extended periods of time.

He goes on to mention that lifestyle, nutritional and training schedule adjustments are simple and basic variables that can be tweaked to remedy this stage.

Stage 3: Parasympathetic Overtraining. It has essentially become a chronic condition in which several different aspects of one’s physiology are influenced negatively, and your endocrine (hormones) and nervous systems have essentially thrown in the towel. This one is less common, but again explore the article further for information on this stage.

His website is full of so much useful information regarding exercise, fitness and nutrition. I highly recommend giving it a look.

Regarding this brief summary of his work: Overtraining is a common syndrome to which avid exercise enthusiasts can easily fall victim. Pay close attention to your energy levels, food cravings, mood and interest in your exercise of choice. If you notice these variables changing for the worse, take a day off, or simply pursue some “non-exercise related activity” such as a brisk walk, easy swim, or being active around your home.

Monitor your resting heart rate as well. This can simply be done with apps like Instant Heart Rate by Azumio each morning. Establish a baseline by taking HR each morning upon waking, and track any drastic changes in either direction.

In closing, I will leave you with a bit of simplicity from the article I am referencing:

Training = Workout + Recovery.

DO NOT skimp on recovery. Sleep well, and be okay with taking time off.

Until next time.

References:

http://philmaffetone.com/the-overtraining-syndrome/

http://www.azumio.com/s/instantheartrate/index.html

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Food For Thought

stoplightI came across an interesting article this past week regarding consumer food choices. There has been a strong push by the government to get restaurants to disclose information regarding the calorie content of their foods. The current study aimed to address the following questions: if consumers know how many calories are in a food product, does it influence their food choices? Is there something other than a number value that can positively influence a consumer’s food choice?

The study design was as follows:

Group 1 within the study simply had the number of calories disclosed to them within the foods that they could choose.

Group 2 within the study simply had one of three colors attributed to the caloric density of the food in the form of a stoplight: Green (low calorie), Yellow (moderate amount of calories), Red (high calorie).

Group 3 was a combination of group 1 and 2 interventions.

The results demonstrated that disclosing the number of calories or associating the stoplight with the food based on the number of calories it contained had the same effect: A reduction in overall calorie intake by an average of 10% for all 3 groups.

That’s impressive. They didn’t even attach a numerical calorie value to the food. They just placed a color on it and it worked just as well. Red is bad. Yellow isn’t that bad. Green is good. Oh, the benefits of simplicity.

I think the stop light approach has a very real application to the general population. More often than not, people have a poor understanding of caloric intake. Number of calories in a food may have no bearing on their decision between eating a large pepperoni pizza or a mixed greens salad, but if you slap a big red stop light on the pizza and associate it with being a “high calorie” food, they may opt into the salad. This could serve as a useful tool, even if it simply makes the decision a tough one for the regular pizza consumer.
People may start becoming more conscious of their food choices and tip the energy balance equation 10% in favor of weight loss.

Until next time.

References:

Eric M. VanEpps, Julie S. Downs, George Loewenstein. Calorie Label Formats: Using Numbers or Traffic Lights to Reduce Lunch Calories. Journal of Public Policy & Marketing, 2015; 150702153813007 DOI: 10.1509/jppm.14.112

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A question I get on a very regular basis from both advanced exercisers and beginners alike is “How often do you think I should do (insert exercise/fitness intervention here)?” I personally like the idea of doing everything in moderation (with the exception of drinking coffee), and a very recent study published in the Journal of the American College of Cardiology drives home this idea in regards to jogging.

The study followed a large cohort of individuals (1300 or so subjects) in Copenhagen for roughly 15 years. The purpose was to investigate the relationship between jogging and long-term all-cause mortality, or an easier way to understand that would be: Are joggers less likely to die than non-joggers? If so, what kind of volume/intensity/duration/pace of jogging is best suited for extending one’s life?

Their observations showed that “light” jogging had the greatest effect on reducing all-cause mortality (decreasing one’s risk of death by 30% relative to sedentary counterparts). What does “light jogging” entail, you might ask?

Volume: 1-2.5 hours per weekjogger

Frequency: 2-3 days per week (preferably not back to back)

Intensity: About 6 METs (5 mph or so) equates to “light” jogging

 

Application of the results could be as simple as:

Jogging at 5 mph for 20 minutes on Monday/Wednesday/Friday.

Taking it to an even simpler form of exercise: Treadmill walking.

Walking at 4.0 mph/2% incline is the same metabolic cost as the “6 METs” of intensity that they recommend in this study. Could be a stretch, but the equivalency of METs does add up.

For more on METs, and other activities that could replace the above mentioned jogging intensity, read through this article at your leisure. (For example, snow shoveling equates to working at 6 METs, which bodes well for northerners).

 

Interestingly enough, the effectiveness of jogging beyond the above mentioned volume/frequency/intensity had a point of diminishing return, all the way to the point that risk of death increased more and more as volume, frequency and intensity continued to increase.  There even came a certain point in which the obsessive exercisers had the same risk of death as the sedentary individuals. Jogging too much/too hard led to a risk of death that was EQUAL TO NOT EXERCISING AT ALL.

Holy smokes.

The general understanding of exercise is that more is always better. The above mentioned study demonstrates some interesting data in favor of moderation, although the sample size of the obsessive exercisers was very small, which warrants further investigation. Specifically, they should do a follow up study following hard-charging, type A exercisers and the effects it may have on early death.

 

It is important to understand that the only variable that was measured was incidence of death.

If you jog at the amount and intensity prescribed by this article, odds are that you are less likely to die 15 years from now than someone who does not jog (unless you are obsessively exercising as I just mentioned). It does not discuss any specific biometrics such as body fat, muscle mass, blood pressure, insulin sensitivity, etc. etc.

But, my two cents: incidence of death is a pretty damn important variable. Who cares what your body fat percentage is if you are dead. This information is very promising to sedentary individuals looking to elongate their lifespan and become generally more fit.

Until next time.

References: http://www.ncbi.nlm.nih.gov/pubmed/25660917

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I made a bold claim by making the title of this article what it is, but I am not the only one. A recent literature review (a type of study that summarizes several current studies and compiles their results) about resistance training conducted by the Department of Exercise Science at Quincy College in Massachusetts put together a wonderful list of the medicinal benefits of picking up heavy stuff repeatedly.

Here is the laundry list of benefits pertaining to 10 weeks of resistance training:

  • Increased total lean mass (i.e. muscle mass) by an average of 1.4 kg (3 lbs of muscle)
  • Increased metabolic rate by 7% (more calories expended at rest, helping with weight control that tends to get out of hand with aging/being sedentary)
  • Reduced total fat mass by an average of 1.8 kg (4 lbs of fat)
  • Increased “functional independence” (particularly of interest to aging populations keen on being able to live on their own)
  • Increased walking speed (an ability that is often overlooked as an individual ages)
  • Improved balance and movement control (prevention of falls as an individual ages)
  • Improved cognitive ability (it even makes you smarter)
  • Prevention/management of type 2 diabetes via:
    • improving insulin sensitivity (making your tissues more responsive to insulin, the opposite of insulin resistance which usually precedes full blown type 2 diabetes)
    • improving skeletal muscle uptake of blood glucose, thus playing a role in blood sugar regulation
    • decreasing visceral/abdominal fat
    • reducing hbA1c blood markers (a risk factor associated with type 2 diabetes, which is a running average of your blood sugar levels over a 3 month period)
  • Enhancement of cardiovascular health via:
    • Reduction in resting blood pressure measures (particularly systolic BP)
    • Reduction in LDL cholesterol, or commonly referred to as “bad” cholesterol
    • Increasing HDL cholesterol, or commonly referred to as “good” cholesterol
    • Reduction in blood triglycerides
  • Improvements in bone density by up to 3%, which can aid in prevention of osteoporosis
  • Reduction in lower back pain
  • Reduction in pain associated with osteoarthritis and fibromyalgia

 

Goodness gracious. Ladies and gentlemen. Boys and girls. Start lifting.
Here is the protocol that is prescribed in the article for getting started with resistance training:

(Westcott, Wayne L. Current Sports Medicine Reports. 11(4):209-216, July/August 2012. doi: 10.1249/JSR.0b013e31825dabb8)

ResistanceTrainingTable

(Westcott, Wayne L. Current Sports Medicine Reports. 11(4):209-216, July/August 2012. doi: 10.1249/JSR.0b013e31825dabb8)

And that’s all folks. I cannot stress enough as to the importance of resistance training in our day and age with the advent of what we call “modern diseases” such as type 2 diabetes and cardiovascular disease. Make the years in your life unhindered by weakness and disease. A better way to put it: It’s not about the years within your life, but rather the life within your years.

Until next time.

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COFFEE.There is a large body of evidence behind the idea that “time of day” influences athletic performance, particularly higher intensity athletic performance, such as interval training, sprints, resistance training, or performance in any sort of intermittent field sport like soccer, lacrosse, basketball, tennis etc. where there are periods of high intensity activity coupled with periods of recovery.

Traditionally, peak anaerobic performance (high intensity performance) is strongly correlated with core body temperature (1). The general trend of core body temperature is that it is at it’s lowest around 4:00 am (prior to waking) and at it’s highest between 4:00-6:00 in the evening (1). Putting two and two together, several studies have demonstrated that time and time again, athletes tend to perform about 5-10% better in the afternoon/evening than they do in the morning (1,2,3) in regards to strength and power performance, which, again, is predominantly anaerobic in nature.

Summarizing the paragraphs above: All things remaining equal, you are able to run faster and pick up heavy things better when it’s after 4:00 PM relative to earlier in the day. What about the early riser/morning exercise enthusiast?

So is it possible to get around this if you’re an early riser? According to a recent study by Ricardo et al (link here), the answer is yes.

What’s do he and his colleagues say is the solution? Caffeine. Wonderful.

Although this study targeted “highly resistance trained men”, it bodes well for the frequent exerciser, regardless of gender, if their focus is some form of HIIT (high intensity interval training) or resistance/power training in the early morning.

The dosage utilized within the study I just referenced is: 3mg per kg of bodyweight.

So, for example I personally weigh 188lbs, which equals 85kg, and thus 255mg of caffeine.

Equation: (Your bodyweight in pounds/2.2)(x3) = mg of caffeine per kg needed to reproduce the effects of the study.

Let’s put that into perspective: One Tall (12 fl oz) brewed coffee from starbucks contains approx. 260mg of caffeine (Source here).

Brews of coffee do vary in caffeination based on the roast/type of bean etc. Use the google to help you identify the caffeine content of your preferred type of coffee bean/roast.

One minor limitation of the study is that the dosing was administered via oral administration of a pill. (These two articles will help to clear up the idea that coffee and capsules have very similar rates of absorption and bioavailability: Here and Here). Long story short: Coffee as a substitute is 100% fine.

In closing, my advice, if you do not have a pre-existing heart condition, are not morally against caffeinating, typically exercise earlier in the day:

TRY IT.  

Sprint with reckless abandon whilst witnessing the sunrise. Hulk smash some new personal bests in your favorite lift, regardless of the time of day.

Until next time.

 

  1. Racinais S, Blonc S, Hue O (2005) Effects of active warm-up and diurnal increase in temperature on muscular power. Med Sci Sports Exerc 37(12): 2134–9.
  2. Racinais S, Blonc S, Jonville S, Hue O (2005) Time of day influences the environmental effects on muscle force and contractility. Med Sci Sports Exerc 37(2): 256–61.
  3. Taylor KJ, Cronin B, Gill N, Chapman DW, Sheppard JM (2011) Warm-up affects diurnal variation in power output. Int J Sports Med 32(3): 185–9.
  4. Mora-Rodríguez R, Pallarés JG, López-Samanes Á, Ortega JF, Fernández-Elías VE (2012) Caffeine Ingestion Reverses the Circadian Rhythm Effects on Neuromuscular Performance in Highly Resistance-Trained Men. PLoS ONE 7(4): e33807. doi:10.1371/journal.pone.0033807
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clockWhat is the most common reason individuals fail to adhere to a given exercise/physical activity regimen? They do not have enough time.

One potential solution to this excuse is High Intensity Interval Training (HIIT for short). Simply put, HIIT training is alternating between intervals of high intensity and intervals of low/moderate intensity. The high intensity intervals are somewhere between 30 seconds and 3 minutes, with low intensity/rest intervals varying in length relative to individual fitness levels.

A study in the early 2000s conducted by Gibala et al put the spotlight on HIIT training when it compared HIIT to traditional high-volume endurance training (commonly referred to as “cardio”). Subjects were placed in one of two groups:

3xweek for 12 weeks:

Group 1 performed 3x20sec ”all out”  cycling intervals with 2 min complete recovery. 

Group 2 performed 45 min sessions of “steady state cardio”  at roughly 70% of their maximum heart rate.

Both groups did a 2 min warm-up and a 3 min cool down.

The total time commitment for Group 1 was 6 hours over 12 weeks, and Group 2 was 30 hours over 12 weeks.

Both groups saw similar improvements in oxidative capacity in skeletal muscle (aerobic fitness), as well as skeletal muscle pH buffering capacity and glycogen content (anaerobic fitness).

Long story short:

Fitness increases were identical between both groups, and HIIT produced the results in 1/5 the time.

Gibala provided a quote when interviewed by ScienceDaily.com and stated that: “…no time to exercise is not an excuse now that HIT can be tailored for the average adult…while still a demanding form of training,” Gibala adds, “the exercise protocol we used should be possible to do by the general public and you don’t need more than an average exercise bike.”

To put things in perspective:

The HIIT group subjects did 3×20 second all out sprints, 3 times per week over the course of 12 weeks, which equates to an average of 10 minutes of work/session.

The traditional cardio group subjects did 50 mins of “steady state” cardio 3 times per week over the course of 12 weeks, which equates to an average of 50 minutes of work/session.

 

No big deal.

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