Watching football can break your heart!

Watching football is bad for you?


This study, says that men with known coronary heart disease should be really really careful about watching a stressful football match.....it could finish them off!

Cardiovascular Events during World Cup Soccer

Background The Fédération Internationale de Football Association (FIFA) World Cup, held in Germany from June 9 to July 9, 2006, provided an opportunity to examine the relation between emotional stress and the incidence of cardiovascular events.

Methods Cardiovascular events occurring in patients in the greater Munich area were prospectively assessed by emergency physicians during the World Cup. We compared those events with events that occurred during the control period: May 1 to June 8 and July 10 to July 31, 2006, and May 1 to July 31 in 2003 and 2005.

Results Acute cardiovascular events were assessed in 4279 patients. On days of matches involving the German team, the incidence of cardiac emergencies was 2.66 times that during the control period (95% confidence interval [CI], 2.33 to 3.04; P<0.001); for men, the incidence was 3.26 times that during the control period (95% CI, 2.78 to 3.84; P<0.001), and for women, it was 1.82 times that during the control period (95% CI, 1.44 to 2.31; P<0.001). Among patients with coronary events on days when the German team played, the proportion with known coronary heart disease was 47.0%, as compared with 29.1% of patients with events during the control period. On those days, the highest average incidence of events was observed during the first 2 hours after the beginning of each match. A subanalysis of serious events during that period, as compared with the control period, showed an increase in the incidence of myocardial infarction with ST-segment elevation by a factor of 2.49 (95% CI, 1.47 to 4.23), of myocardial infarction without ST-segment elevation or unstable angina by a factor of 2.61 (95% CI, 2.22 to 3.08), and of cardiac arrhythmia causing major symptoms by a factor of 3.07 (95% CI, 2.32 to 4.06) (P<0.001 for all comparisons).

Conclusions Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event. In view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed.




Good research

NHS Choices do a nice analysis of this research. They are often quite sceptical about much research, but in this case they explain that this was a well constructed and well analysed piece of work:

Overall, this study provides good evidence that stressful events and emotions can trigger heart attacks and provides a warning for people who already know they have heart disease.

I think being healthy includes being psychologically "well". We often limit fitness to physical fitness, but your mind has big effects on your body too. You cannot be fit if your mind is not well! We need to get our stressors sorted out, to relax, to have good social interaction for example.

Stress and Heart Disease

One of the things I've written about before is stress. While I am a sceptic regarding the supposed danger of high cholesterol, I do find myself sympathetic to what Malcolm Kendrick hypothesises as a (maybe the?) major cause of heart disease - stress and its hormonal effects (primarily on the HPA axis) as he explains in this video:




If you don't want to watch it, the message is fairly simple - stress and HPA dysfunction are strongly associated with heart disease. (He explains a lot more - with lots of references in his book ) You get stressed and your hypothalamus, pituitary gland and adrenals start kicking out all these hormones which have a load of dodgy effects on your metabolism. Other things are important too - e.g. smoking, carb intake (not cholesterol), but stress is a problem. (I've just noticed that he plugs Taubes' book at the end of the video! Hope that doesn't upset anyone out there....)

Pullups - it is better if you are short!

Are you good at chins?



Here is a good one - following statistical analysis, this study indicates that short individuals are more likely to achieve maximum chin-up test scores. I am over 6 foot, so that is my excuse for being a bit rubbish at pullups. I can do singles with an extra 20kg, but with no added weight I struggle to get to 6.

Chin-up strength tests: does stature matter?


AIM: Many organizations place high value on employee physical fitness and use standardized physical fitness tests (PFT) to quantify it. The chin-up strength test is an example of such a test. Participants' anecdotal reports raise some concern that the latter is inherently biased against tall individuals. A demonstration that tall individuals are less likely than short individuals to achieve maximum score on a chin-up strength test, and modified scoring tables that equalize this likelihood across the stature range are sought.
METHODS: A statistical summary of 85 chin-up test outcomes is analyzed for likelihood of maximum scores as a function of stature. Scoring tables modified by reducing the number of chin-ups required for maximum score in a ratio inverse to a fixed power of the stature ratios are introduced.
RESULTS: Statistical analysis shows that short individuals are more likely to achieve maximum chin-up test scores (P<0.05). Stature adjusted scoring tables are shown to neutralize this trend.
CONCLUSION: Current scoring standards for chin-up strength tests favor short statures. Bias-free chin-up strength tests can be achieved by using stature-adjusted scoring tables. Similar bias problems may exist for other strength tests.

Eating Carbs after your workout reduces the fat burning effect?

If you want to maximise the fat burning effect of effect of exercise, what should you eat after a workout? This study - and the full paper is currently available here - seems to indicate that you should keep away from a carbohydrate rich meal. It is a really interesting paper to read and what I get from it is that having a carb rich meal after a workout blunts the fat burning effect generated by the exercise. Have a read - see what you think.

Devany gives another reason not to eat carbs after the workout

Does prior acute exercise affect postexercise substrate oxidation in response to a high carbohydrate meal?

BACKGROUND: Consumption of a mixed meal increases postprandial carbohydrate utilization and decreases fat oxidation. On the other hand, acute endurance exercise increases fat oxidation and decreases carbohydrate utilization during the post-exercise recovery period. It is possible that the resulting post-exercise increase in circulating nonesterified fatty acids could attenuate the ability of ingested carbohydrate to inhibit lipid oxidation. The purpose of this study was to determine whether prior exercise attenuates the usual meal-induced decline in lipid oxidation.
METHODS: Six healthy, physically active young subjects (x age = 26.3 years, 4 males, 2 females) completed three treatments in random order after a ~10 h fast: (a) Exercise/ Carbohydrate (Ex/CHO): subjects completed a bout of exercise at 70% VO2peak (targeted net energy cost of 400 kcals), followed by consumption of a carbohydrate-rich meal; (b) Exercise/Placebo (Ex/Placebo): subjects completed an identical bout of exercise followed by consumption of a placebo; and (c) No Exercise/Carbohydrate (NoEx/CHO): subjects sat quietly rather than exercising and then consumed the carbohydrate-rich meal. Blood samples were obtained before and during the postprandial period to determine plasma glucose, insulin, and non-esterified fatty acids (NEFA). Respiratory gas exchange measures were used to estimate rates of fat and carbohydrate oxidation.
RESULTS: Plasma NEFA were approximately two-fold higher immediately following the two exercise conditions compared to the no-exercise condition, while meal consumption significantly increased insulin and glucose in both Ex/CHO and NoEx/CHO. NEFA concentrations fell rapidly during the 2-h postprandial period, but remained higher compared to the NoEx/CHO treatment. Carbohydrate oxidation increased rapidly and fat oxidation decreased in response to the meal, with no differences in the rates of carbohydrate and fat oxidation during recovery between the Ex/CHO and NoEx/CHO conditions.
CONCLUSION: The plasma NEFA concentration is increased during the post exercise period, which is associated with elevated fat oxidation when no meal is consumed. However, when a mixed meal is consumed immediately following exercise, the initially elevated plasma NEFA concentration decreases rapidly, and postexercise fat oxidation during this 2-h postexercise, postprandial period is no higher than that of the 2-h postprandial period without prior exercise.

Cholesterol - lower is bad.....

Peter over at the Hyperlipid blog has put up a good post tracking through some recent papers showing again and again that scientists keep reporting that low cholesterol levels are associated with cancer and indeed "with all-cause mortality, showing significant associations with death through cancer, liver diseases, and mental diseases." Of course, the scientists really don't like to admit this.....

Check it out at Colorectal cancer and cholesterol

Metabolic Advantage again!

Richard has an excellent post on the whole "Is a Calorie just a Calorie" controversy!

180 Degree Errors

Read the whole thing, but his conclusion is worth repeating:

So I think we have a 180 degree error and Taubes is right: hyper caloric intake, in itself, does not cause us to be fat. Hyper insulin causes us to be fat, and that issues forth a whole cascade of problems (effects), one of which is hyper caloric intake. Repeat. And the effect of that cause is that very nearly everyone in the diet and nutrition establishment has been [conveniently] fooled.

Incidentally, Richard has arrived somewhere close to my current practice - low carb diet plus intermittent fasting.

Before anyone wades back in on this debate, take the time to watch Taubes lecture at Berkeley. You do not have to buy the book - he explains the key issues in the lecture.

Art Devany has also commented on Taubes: Energy Balance is Dynamic

This isn't really metabolic advantage, but Alwyn Cosgrove mentions also that the composition of your food is important simply due to what is called the Thermal Effect of Food (TEF):

The thermic effect of food (TEF)- or thermogenic effect - is a term used to describe the energy expended by our bodies in order to consume (bite, chew and swallow) and process (digest, transport, metabolize and store) food.

For most people this total number typically accounts for about 7-10% of calories consumed based on the Standard American Diet (SAD....)

Breaking it down ...Protein foods typically have a TEF of 25 -30%. Carbohydrate foods require about 5-10%. Fruits are around 15% Cruciferous vegetables are around 30% and fats are somewhere between 0 and 3%.

So you can see where I'm going with this ... if you just exchanged 100 calories of carbs for 100 calories of protein -- you'd actually in effect - burn off another 20-25 calories. If you swapped 100 calories of fat for 100 calories of vegetables -- you'd eat up an extra 27-30 calories.

Now I wouldn't necessarily agree with all of Cosgrove's conclusions with respect to diet (it looks low fat!), but it is another element to think about.

Primal Conditioning

Just a couple of videos today:

first off some bodyweight stuff:



then Ross Enamait demonstrates several movements with a pair of homemade ab wheels. A more detailed discussion (with pictures) is provided at the link here. Nice bit of Pantera on the soundtrack too!

Quick Update

Just a quick note of a number of things I've been reading in the last day or so:

Cholesterol - I'm still a sceptic

What’s Cholesterol Got to Do With It? - Gary Taubes looks at the recent news that the drug Vytorin had fared no better in clinical trials than the statin therapy it was meant to supplant.

Trial results forced out of drug company support the concept that cholesterol may not ’cause’ cardiovascular disease - Dr John Briffa comments on the same topic

Do Cholesterol Drugs Do Any Good? - Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated - similar article from Business Week

and on a different subject:

Cutting caffeine may help control diabetes - “We’re not sure what it is about caffeine that drives glucose levels up, but we have a couple of theories,” says Lane, who is the lead author of the study. “It could be that caffeine interferes with the process that moves glucose from the blood and into muscle and other cells in the body where it is used for fuel. It may also be that caffeine triggers the release of adrenaline – the ‘fight or flight” hormone that we know can also boost sugar levels.” I've mentioned coffee and blood sugar before

Gulp - Controversy!

Finally, prompted by Randy's comments on this post, I've been reading a little about the alleged so-called metabolic advantage of low carb diets. This is the idea that weight loss is not just about creating a calorie deficit, but that the composition of your diet can have an effect independent of the calories. Bluntly put it holds that not all calories are equal in their effect. I didn't realise quite how controversial this idea was.

In the post in question I didn't actually mention metabolic advantage, I merely pointed to an interesting article by Gary Taubes, who believes in this idea. Randy took me to task over this (!) and directed me to Anthony Colpo's book They are all MAD. Colpo's assertion is that in all the metabolic ward studies where they lock people up for a couple of months and feed them diets of known composition and quantity and control their activity, the only thing that mattered ultimately is the calorie - if you take in more than you burn you put on weight....He holds that low carb diets are still healthier than the alternatives, but they only help you lose weight because you end up eating fewer calories.

There is another side to this of course (there always is!) I'm not an expert and wouldn't want to be dogmatic about all this (so don't be too hard on me Randy!) but in addition to Colpo's book I've looked at Barry Groves comments (do calories really count), Michael Eades posts (here and here) and a couple of scientific papers (e.g. this and this)

Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: a meta-regression - Conclusion: Low-carbohydrate, high-protein diets favorably affect body mass and composition independent of energy intake, which in part supports the proposed metabolic advantage of these diets.

Low-carbohydrate nutrition and metabolism - This review article also discusses the proposed metabolic advantage


Anyway - this is a controversial topic that seems to get people really agitated. I just find all this stuff fascinating. This blog is just me gathering together bits and pieces that I find interesting. Feel free to disagree with me.

Recovery again

I recently posted about a study comparing active and passive recovery in football players. I'm still thinking about the paper and may write something more on it soon. In the meantime I wanted to record a couple of other papers that I came across about recovery or conversely under-recovery!

Firstly, one that indicates that three consecutive days of relatively moderate exercise (60% V O2peak) will lead to what I would call over-training - you get weaker, partly due to some systemic fatigue.....

Effects of consecutive days of exercise and recovery on muscle mechanical function.

Purpose: To investigate the effects of three consecutive days of prolonged exercise on muscle mechanical function, 12 volunteers (V[spacing dot above]O2peak = 44.8 +/- 2.0 mL[middle dot]kg-1[middle dot]min-1, mean +/- SE) cycled at approximately 60% V[spacing dot above]O2peak until fatigue.

Methods: Quadriceps muscle function was assessed before and after exercise on day 1 (E1) and day 3 (E3) and during three consecutive days of recovery (R1, R2, R3), using both voluntary and electrically induced contractions at various stimulation frequencies.

Results: Exercise on E1 and E3 resulted in a 40% (120 +/- 12 vs 72 +/- 10 N) and 35% (117 +/- 14 vs 78 +/- 8 N) deficit (P < 0.05) in force at 10 Hz, respectively, which remained depressed (P < 0.05) by 32-34% during R1-R3. At 100 Hz, force, although not altered by exercise at E1 or E3, was decreased (P < 0.05) by 12-16% during recovery. The maximal rate of relaxation (-dF/dtmax) at 10 Hz was reduced (P < 0.05) by 38% on E1, by 32% on E3, and remained depressed by 38% through R3. At 100 Hz, -dF/dtmax was only depressed (P < 0.05) during recovery. Maximal rate of force development (+dF/dtmax) at 10 Hz was reduced (P < 0.05) by exercise, but not in recovery. Maximal voluntary contraction force was depressed (P < 0.05) with exercise at both E1 and E3 and remained depressed (P < 0.05) throughout recovery. The reduction (P < 0.05) in motor unit activation assessed with the interpolated twitch technique, observed during recovery, suggests that part of the incomplete recovery (weakness) is central in origin.

Conclusions: These results demonstrate that three consecutive days of prolonged exercise result in a weakness that persists for at least 3 d, compromising force during both voluntary and induced contractions


Secondly - and this one is more related to the previous study about active vs passive recovery - there was this comparison between different recovery strategies. In this study, active recovery came out on top.....

Comparison of recovery strategies on muscle performance after fatiguing exercise.

OBJECTIVE: The objective of this study was to assess the influence of different relaxation modes: stretching (ST), active recovery (AR), and passive recovery (PR) on muscle relaxation after dynamic exercise of the quadriceps femoris.
DESIGN: Ten healthy male volunteers between 24 and 38 yrs of age participated in this study. After the warm-up, subjects performed three sets of dynamic leg extension and flexion (at an angle of 20-110 degrees) at 50% of previously determined maximal voluntary contraction (MVC), with 30 secs. of rest between sets. Immediately after completing the leg exercise, one of the relaxation methods was applied, in a randomized order (AR, PR, ST). Then, subjects performed isometric knee extension at 50% of MVC to the point of fatigue, and surface electromyogram (EMG) of the vastus lateralis muscle was measured.
RESULTS: After AR, the mean MVC was significantly (P <> 0.05). Total time of the effort during EMG measurement was significantly lower for all three recovery modes than at baseline. During the effort after both PR and ST, there was no significant increase in motor unit activation, but a significant increase was noted after AR (P <> 0.05).
CONCLUSION: The results of this study suggest that the most appropriate and effective recovery mode after dynamic muscle fatigue involves light, active exercises, such as cycling with minimal resistance.

Turkish Get Up - variation

A while ago I posted a couple of videos giving a tutorial for the Get up. Here is another utilising a slightly different technique that I am finding is a bit easier on my knees.

The myth of fruit and more Taubes

Just to highlight a couple of interesting bits from the newspapers this last week.

On Wednesday, the Guardian had a really thought provoking piece on fruit. Not low carb by any means, but certainly saying that the current focus on fruit in the diet is not necessarily healthy:

The myths of fruit

Fresh fruit is good for us, we believe - so much so that sales of prepared fruit have almost doubled in the UK in the past two years. But are all those ready-sliced apples, mango medleys and 'superfood' smoothies really such a healthy choice? Aida Edemariam investigates

Then the Daily Telegraph had an interview with Gary Taubes:

Big fat lie

For years doctors have held that the only way to lose weight is to eat less fat and take more exercise. But now an eminent science writer says they've got it wrong. So, asks Melissa Whitworth, could Atkins have been right all along?

I liked Taubes' realistic comment:

Gary Taubes: 'If I was writing about me, I’d assume that I am both wrong and a quack.'

And the conclusion of the article, which is pretty close to my current thinking (although I think there is still something about exercise and also fasting which can have interesting hormonal effects of their own):


Weight-loss the Taubes way

• Expending more energy than we consume – exercising more or eating less – does not make us lose weight. It makes us hungry
• Dietary fat is not a cause of obesity or heart disease. The problem is the carbohydrates in our diet, and their effect on the hormone insulin
• Insulin makes us store calories as fat. Simple carbohydrates – starches and sugars – raise insulin levels and so lead to excessive fat storage
• The smaller the amount of fattening carbs you eat, the leaner you’ll be
• Obseity is not a disorder of overeating – it’s a disorder of excess fat accumulation. We overeat because we are hormonally driven to grow fat; we don’t grow fat because we overeat

UPDATE

Seth Roberts has done a fantastic and wide ranging interview with Gary Taubes here:

Basically, the way we work, at least if you believe the biology that I describe, is that as we secrete insulin in response to the carbohydrates we consume and the insulin works, among other things, to facilitate the movement of glucose into the cells of your muscles and other lean tissues. But blood sugar is kind of toxic, so your muscle tissue doesn’t want the insulin pushing all this blood sugar in, and it becomes insulin resistant. Your fat tissue now remains insulin-resistant, because your body doesn’t like to waste fuel. So if you eat a high-carb diet, your lean tissue takes up some of the glucose for fuel, and the rest gets dumped in your fat tissue, and your fat tissue remains insulin-resistant for a long time --- far longer. Because once your fat tissue becomes insulin resistant, then you just become diabetic; you have no place to put the glucose. You just pee it out. That’s the last resort, because your body doesn’t want to waste fuel.