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Cycling Wednesday: New Year’s resolution

It’s January 2nd. It’s past time for resolve.

Since one of the themes of this blog is healthy living through good choices, it would seem self-evident that I would resolve to eat better, rest more and exercise smarter. Given my slow-twitch make-up, smarter exercise means more strength and flexibility work.

These would be the easy resolutions. They would, however, be completely devoid of nuance. I aim for more nuance. Like cowbells.

A slightly more subtle resolution would be to live more in the moment. The present is where it’s at. Be the moment. The burn terminates the arrhythmia; the middle-aged cyclist makes the log-crossing; the watt meter says 350 watts for ten-minutes; the grand-daughter looks into your face. These are all moments to cherish more. The coolest thing about being in the moment is the lack of worry about the future.

Every day in the office I see worried faces, worried spouses and worried kids. Worry is everywhere. It’s heavy. An admission: I, too, succumb to worry. I’m human. I worry too much.

So all these things would be worthy topics for resolve.

But that’s not where I’m going.

I want to point you to my favorite New Year’s resolution post:

From Runner’s World: Resolved: Eat the Damn Cookie.

You might think this is crazy. How could a health blogger suggest such?

In 2013, I aim to set a lighter tone. I don’t have all the answers. Writing about health topics is a challenge. Today, I read this Columbia Journalism critique of health reporting. The gist of the long post was that well-meaning, well-read and well-cited science writers can find support of opposite viewpoints. That it’s normal for reporters to lean towards what makes sense to them. But when you look hard at the science, the real answer is not known. And since people care about health, they may act on specific advice. In other words, it matters what we write.

The thing about health reporting these days is the huge number of stories. The specifics get confusing.  But for me, the big picture of health is still clear.

Here’s a short quote from the Columbia review that captures the essence of how I feel about health: (emphasis mine)

… most experts have insisted for some time now that successful, long-term weight loss requires permanent, sustainable, satisfying lifestyle changes…

Eating one cookie, once in a while, is not inconsistent with this theme. A cookie isn’t the problem. Eating the whole bag is. Same with pizza, coke and ice cream.

Permanent, sustainable and satisfying.

I have learned from patients that have lost weight and kept it off over the long-term. None did with a diet or a scheme or a pill. They did it with normal life.

Savor the damn cookie.

Eat just one.

Go for a run or ride or walk or swim.

Then don’t worry about it.

Happy New Year Friends.


2 replies on “Cycling Wednesday: New Year’s resolution”

As I am now 4 weeks away from my half marathon competition (Surf City Half Marathon, on Super Bowl Sunday, in Huntington Beach CA), I’ve been giving a lot of thought to the health risks of distance running. You keep talking about “inflammation.” This issue is this: does general, muscle inflammation cause heart disease? We know that inflammatory markers go up in heart disease, what causes this? It seems to be some interaction between oxidized pathogenic lipids and the coronary artery endothelial cells. This produces both calcification and inflammation. Could the inflammation be secondary to the calcification, as opposed to inflammation causing calcification? Certainly it could. The mechanisms of both inflammation and calcification are not well understood.

So you’ve got one of those classic old fashioned medical school multiple choice test questions. “Answer A if true/true and related. Answer B if true/true unrelated. Answer C if true/false. Answer D if false/false. Answer E if false/true. I think that this is one of those things which is true/true unrelated.

True enough, hard athletic training causes muscle inflammation. True, inflammatory markers go up in coronary artery disease. But these are entirely unrelated phenomena. Muscle inflammation doesn’t cause coronary artery disease. I can’t conceive of a plausible mechanism.

Now, left atrial enlargement and atrial fibrillation is a different story. But the issue to be resolved is whether the heart enlargement of training produces a higher incidence of atrial fibrillation in the absence of coronary vascular disease. I think that athletes may be at higher risk for coronary artery disease (adjusted for other risk factors), simply because they burn more calories, eat more, and therefore have a higher daily load of oxidized pathogenic lipids. Unless they exercise very strict control over the heart healthy quality of the foods they eat.

I would be interested in a study showing risk of atrial fibrillation in distance runners stratified according to presence or absence of coronary calcification.

In the meantime, the bargain I’ve made with myself is that I’m going to do the Super Bowl Sunday race (in the 65-69 age division – hoping to win this division) and then go on sabbatical from very heavy training for another 5 years, until I age up to the next division (70-74).

I like your blog.

– Larry Weisenthal/Huntington Beach CA

Good questions.

One mechanism for calcification in the coronaries of marathoners is the pounding-induced calcium leaching from bones. There are not as many CAD calcium studies in non-running endurance athletes.

As far as the atrium goes, it’s well known and agreed upon that long-time endurance athletes develop AF at higher rates than non-exercisers. Why this occurs is debated. Atrial stretch is one mechanism, so is Vagal tone and unremitting inflammation–lack of macro and micro studies, among others.

Good luck in your race.

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