April 13, 2023

April 13

When the going gets tough, the tough recite mantras

I sometimes quip that no one can actually run 26 miles. It’s way more than the mind and body can handle. The only way to get there is to run 1 mile 26 times.

During those 26 “intervals,” different runners use a variety of tricks to help them stay in the game: mantras and mental tougheners. Here are 6 evidence-based ways to stay mentally tough, including “Reframe your pain” and “Smile like you mean it.” More at Substack/Ashley Mateo.

Mantras seem cheesy. Heck, let’s just say it: They are cheesy. But they can also be very effective. In a marathon, you could recite the Gettysburg Address for motivation. Or you could keep repeating something short and punchy like, “Yes, I can.” The latter will serve you better. More at RunStreet.

Results from a race between minimalist shoes vs traditional shoes

A group of Swiss researchers used 16 experienced runners to investigate the economy of minimalist shoes vs traditional cushioned shoes during a 45-minute treadmill run. All runners became less economical toward the end of their runs, as you would expect, because they were getting tired. 

However, there was essentially no difference between the two shoe types. Also, muscle activation around the ankles did not differ between the two shoes.

In minimalist shoes, the runners appeared to make better use of their legs’ natural elastic energy. But they also took more steps and performed more total mechanical work. These two effects canceled each other out.

Therefore, the decreased running economy after 45 minutes was not related to shoe differences “but likely due to physiological modifications with exercise duration.” More at Nature/Scientific Reports (free full text).

What you need to know about alcohol & sugar consumption

Two nutrition-health stories made headlines around the world recently. The first was the biggest ever study of alcohol consumption and mortality. The second looked at the health effects of added sugars. Here are brief summaries along with links to the original journal articles.

The alcohol report, a systematic review and meta analysis, looked at 107 papers that included 4.8 million subjects. It was trying to determine if low-to-moderate alcohol consumption had a protective effect on mortality risk, as so many of us have believed for so long. It found no such association. 

That doesn’t mean that low/moderate drinking will kill you. But it won’t help you live longer. And higher levels of alcohol consumption are definitely a bad thing. “There was a significantly increased risk of all-cause mortality among female drinkers who drank 25 or more grams [about two drinks] per day and among male drinkers who drank 45 or more grams per day.” More at JAMA Network Open (free full text).

The sugar research reviewed 8601 articles that investigated possible links between “dietary sugar consumption” and various health outcomes. It uncovered “significant harmful associations between dietary sugar consumption and 18 endocrine/metabolic outcomes,10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental, hepatic, osteal, and allergic).” Whew! Pass the unsweetened salad dressing.

High sugar consumers (vs low consumers) had higher body weight, more belly fat, and more coronary heart disease. Conclusion: “High dietary sugar consumption is generally more harmful than beneficial for health, especially in cardiometabolic disease.” A good goal: Reduce daily sugar intake to below 6 teaspoons per day, and limit sugary drinks to less than one per week. More at British Medical Journal (free full text).

What to believe--and not--about “dry needling” for muscle strains

I had a modest groin strain two weeks ago--I actually DNF’d three easy runs in one 7-day stretch--so you better believe I clicked through quickly to this article on recovery from muscle strains. It presents a good assortment of reasonable advice, but doesn’t mention the trick that worked for me. I visited a local PT (and sub-3-hour marathon runner), and he more or less cured me with one session of “dry needling.”

So of course I checked the best, most recent research I could find on dry needling. A number of reports quote the “low quality” of dry needling studies. The most recent systematic review and meta analysis (2021) acknowledged the low quality issue, and concluded that “Dry needling performed by physical therapists was more effective than no treatment, sham DN, and other therapies for reducing pain.” More at Physical Therapy & Rehabilitation Journal (free full text).

How to stay “young” and fast as you get older

Jess Piasecki is not old by any standard, but she set her marathon PR last year (2:22:25) at age 32, so she’s getting older and faster at the same time. She’s also a PhD lecturer in exercise physiology at Nottingham Trent University in Great Britain with a particular interest in aging athletes.

Here she answers 6 questions about how masters athletes can maintain (and sometimes improve) their best performances. She seems particularly interested in two arenas. First, nutrition; then, new training solutions.

For example, Piasecki believes senior runners should “ingest greater amounts of protein in older age.” They should also “implement cross training modalities to support the volumes of training but also reduce the load.” Another smart idea: Using training cycles that are longer than the usual 7-day week. This allows you to fit in several key workouts while also taking enough time for recovery. 

Her observations are particularly powerful when it comes to maintaining health, fitness, and vitality with age. “Our research has continually demonstrated that masters athletes live with an improved health into older age,” she says. It’s not that exercise can prevent aging, but it does delay the inevitable decline. More at SportSmith.

Do you need protein with your post-workout carbs?

It seems to me that we’ve been batting this question around for a long time, but apparently it’s worth more investigation. Here, one study says: no difference. Another says: It’s best to get both to enhance immunity.

The first paper (randomized, controlled, crossed-over) investigated highly fit and competitive cyclists who completed a hard morning workout followed by a recovery drink that was carbs only or carbs + whey protein. Both contained the same number of calories. Five hours later, subjects completed a hard time trial.  

Result: Subject performance in the time trial was the same after both drinks, and no subjects showed any signs of “negative nitrogen balance” (ie, protein deficiency). More at Scandinavian J of Medicine & Science in Sports.

In a different but somewhat similar study, subjects used a carb-only or carb-protein drink during 10 weeks of hard training. This was a randomized, controlled trial, but one that looked into immunity markers, not performance. Conclusion: “Ingesting a post-workout protein–carbohydrate combined beverage promoted a more favourable immune status than carbohydrate-only ingestion by attenuating cellular inflammation over a 10 week training period in endurance male athletes.” More at European J of Applied Physiology.

The reality--and limitations--of foam rolling

Foam rolling is probably the warmup and recovery exercise of choice for many runners, Also, several studies have indicated it “showed more favorable effects compared to stretching on performance parameters,” at least in certain circumstances. 

However, a new meta analysis and systematic review that includes RCTs doesn’t support that outcome. It concluded that foam rolling “showed no significant changes in performance when FR training is applied for several weeks.” 

The paper also noted a possible Catch 22. “Although a decrease in muscle stiffness has the potential to decrease injury prevalence, such a decrease might also accompany a decrease in force production”--that is, your ability to train and race fast. More at International J of Environmental Research & Public Health.

A similar report reviewed foam rolling for its effect on “myofascial tissue stiffness and muscle strength.” After assessing 20 studies that investigated this question, the researchers found mixed evidence for foam rolling. It “increased knee extensor concentric torque, but it did not acutely change the myofascial tissue stiffness and isometric muscle strength.”

The quality of many studies was low. Conclusion: “Both qualitative and quantitative analyses showed no effects of FR on isometric muscle strength, eccentric torque [except at the knee], and rate of force development.” More at J of Strength & Conditioning Research.

Why the Boston Marathon should accept more senior runners

Several physician friends recently asked me to coauthor a short Opinion piece for a medical journal. Of course, I agreed. That said--Bob Johnstone and David Rutlen--did most of the research and writing. All three of us are active marathon runners over the age of 75.

Here we argue that America’s public and individual health would be improved if more physicians would encourage their “senior” patients to do more exercise--including more running. Older runners aren’t fast, but they have excellent endurance, particularly if they adopt an appropriate run-walk program. 

We believe that “Running may be the best endurance exercise,” in good part because it is so simple and accessible, requiring “fewer resources than swimming, cycling, skiing, gym machine workouts, or other common exercises.” It also takes less time to log a productive workout.

A couple of other good ideas: “Commercial insurers and Medicare should pay some road race entry fees,” and the Boston Marathon should adjust its qualifying times for runners over 65. This would add only modest numbers to the start field, since there are so few of us. 

But it would highlight what runners over 65 can still achieve, and inspire others to follow in their footsteps. After all, Clarence DeMar and “Old John” A. Kelley are two of Boston’s most fabled champions precisely because they ran the race so many times, so well, and at advanced ages.

By the way, have you heard of Joan Benoit Samuelson? She hit 65 last year. More at Medicine & Clinical Science (free full text).

SHORT STUFF you don’t want to miss

>>> Easy does it: How to run with lower back pain

>>> See it, believe it: 6 ways to visualize success in your running

>>> Good carbs vs bad: Know the difference to reduce heart and stroke risks

GREAT QUOTES make great training partners

“It’s not about the legs; it’s about the heart and the mind.”

--Eliud Kipchoge

That’s all for now. Thanks for reading. See you in two weeks. AMBY

April 6, 2023

Use downhill running to boost leg strength & performance

Many runners dislike downhill running. It can be uncomfortable and perhaps cause injuries. But it can also lead to rapid muscle adaptations that improve your running, especially if you’re headed to the Boston Marathon this month.

Here,10 subjects did 10 modest downhill workouts over a 4 week period. Result: The downhill training “promoted neuromuscular adaptations typically observed after high-intensity eccentric resistance training.”

The researchers observed no change in vo2 max, and didn’t conduct other performance testing. Still, they concluded: “These novel results suggest that short-term, moderate-intensity DR training is an effective method of promoting rapid gains in knee-extensor muscle strength, size and structure.” 

And there’s no doubt that you want strong muscles around the knees for efficient running. Or as the investigators stated: “The chronic use of downhill running can stimulate muscle hypertrophy of the main locomotor muscles, i.e. quadriceps femoris.” More at European Journal of Applied Physiology (free full text).

How to exercise more without eating more (and gaining weight)

Many experts in the weight-loss field are confident that exercise doesn’t do much. They believe that eating less should be the primary goal.

One reason why: Exercisers tend to “compensate” after a workout. They reach for a bar or a smoothie or some form of processed food that quickly adds more calories to their daily energy balance than the calories burned by their workout. 

However, most studies have been conducted in a laboratory setting. Recently, an Australian group decided to retest the compensation hypothesis in a “naturalistic” manner. They followed a group of moderate exercisers (2 to 5 workouts per week) to determine what and how much they ate on exercise days vs non-exercise days.

Result: On exercise days, the subjects did not eat more unhealthy foods than on non-exercise days. In fact, they ate better foods. The exercise seemed to provide a reinforcing diet stimulus rather than a junk-foody “compensation” pattern.

However, subjects did eat more on exercise days. Perhaps the exercise stimulated their appetite. The results seem to indicate that you should pay more attention to meal size and total calorie intake on exercise days. More at PLOS ONE (free full text).

Sara Hall’s 6 steps to coming back from a long term injury

Sara Hall, now 39, is known for her longevity in the sport. In high school she won the national cross-country championship, and she has run a number of top marathons past age 35. But last year was a tough one, as an IT band injury sidelined her for 8 months. Last week wasn’t great either; she had Covid. 

So what did she do over the weekend? She took the top American spot in the 50th annual Cherry Blossom 10 mile--a rite of spring in Washington, D.C.

And in another 10 days she’ll be running the Boston Marathon. Here, Hall shares her advice on how to bounce back from a long term injury like her IT band issue. A unique tip: Hall takes an inquisitive approach, applying curiosity to the process. She enjoys digging into “the back story” of her running career to figure out what went wrong, and what she has to do to correct it. More at Runner’s World.

Do running shoes prevent injuries?

Sara Hall didn’t bother looking for a new pair of shoes to cope with her injury, and there are good reasons why. The same reasons that running shoe companies generally don’t claim their shoes will prevent injuries. 1) There’s little to no evidence for this. And 2) A decade ago Vibram paid several million dollars to settle a lawsuit based on the injury-prevention claims of its Five Fingers running shoe. (Vibram didn’t admit guilt; it just settled.)

This excellent article doesn’t mention the Vibram suit. Nor does it look at an emerging belief that more minimalist shoes could help with some knee pains, while high-rearfoot cushioned shoes could reduce Achilles and calf problems. But it references good research (especially this Cochrane Review), interviews appropriate experts, and reaches a consensus conclusion. You should read it for a solid update. More at the NYTimes.

“Social fitness:” A surprising new way to boost your running

We’ve all read about a million articles on the importance of relationships in a happy fulfilled life. No doubt we should glance up from the smartphone every once in a while to, oh, I dunno, maybe have a conversation with a spouse, child, friend, or other. Even better if we join a nonprofit volunteer group.

Now this idea has entered the fitness world as “social fitness.” I like it. “Not exercising your social fitness is hazardous to your health,” says Robert Waldinger, a professor of psychiatry at Harvard Medical School and author of a new book, The Good Life, with lessons from the world’s longest scientific study of happiness

It’s possible that we can only maximize our vo2, running economy, etc, when we also focus on our social fitness. After all, a lonely runner who’s feeling unsupported isn’t likely to race strong.

In a similar manner, Army research has shown that “social fitness exercises such as doing someone a favor or practicing conflict resolution reduced loneliness and boosted well-being in soldiers.” More at Outside Online.

Here are four great suggestions straight from Wadlinger and his work. Try to practice: 1) Generosity; 2) Radical curiosity; 3) Communicating back to others; 4) Regular relationship check-ins. More at TED.com.

Maybe 90 is the new 50

Antonio Rao, 90, finished last month’s Rome Marathon in an age-record 6:14--beating the old record by more than 30 minutes. He also improved his own time from last year by 6 minutes. Rao, who still trains about 15 miles/week, said he enjoys running because: “When I run, I don’t think about problems. I feel free.” He reports that he has been running regularly since 14--that’s 76 years. More at Canadian Running.

In a new review article, senior author and exercise-heart specialist Ben Levine begins with an unusual title: “Exercise in Octogenarians: How Much is Too Little?” The paper notes that cardio fitness can remain quite high until age 70, but then begins to drop off more substantially.

What to do? That’s easy. Keep exercising, no matter how much you slow down. Why? Because: “Recent studies have provided compelling evidence that reinforces the favorable effects of prolonged and vigorous endurance exercise training and competition on the exercise performance of men and women in their late eighth to tenth decades of life.”

The ideal exercise program is one that you follow from your teens onward. But even if you don’t begin exercising until mid life, you get a significant late life payoff. It’s the decline in late-year exercise that must be avoided. In fact, that’s when you need it the most. More at Annual Reviews (free full text). Infographic and conclusion. 

Didn’t see this one coming: Exercise reduces risk of bad sleep

With more than 92,000 subjects whose daily activity was objectively measured with accelerometers, here’s a sleep study with more oomph than most. I don’t think anyone was surprised that sleeping less or more than optimal (about 7 hours) was “associated with higher risk for all-cause mortality.”

The twist in this study was a new question: Does your daily movement amount change the mortality risk? Answer: Yes! More total activity, or more moderate-to-vigorous activity (ie, exercise), lowered “the excessive mortality risks associated with short or long sleep duration.”

In other words, exercise is so good for you that it somewhat offsets the harms of a major lifestyle problem like poor sleep. More at European J of Preventive Cardiology. Here’s a nice graphic summarizing the study results.

Another accelerometer study measured daily step counts of more than 3000 adults around age 50.

In a 10-year followup period, those taking at least 8000 steps on 1-2 days a week, were 14.9 percent less likely to die than those never reaching 8000 steps. Those taking 8000 steps on 3-7 days/week were 16.5 percent less likely to die. The results were interpreted as good news for “weekend warrior” types who can only find exercise time several days a week. More at JAMA Network Open (free full text).

An accompanying editorial added: “It is important to note that these data merit replication and likely miss other important dimensions of health, such as neurologic health. Recent evidence indicated that higher thresholds (eg, 9800 steps per day) and higher intensities may be important for higher-order benefits, including reductions in incident dementia.”

Big article but no evidence to support diaphragmatic breathing

Even the NYTimes is guilty of overhyping articles from time to time. Like this one: “Power Your Run With Better Breathing.” That implies that you’ll get a big payoff if only you breathe right.” Ahh, nope. The reporter is more honest: “While there is not a lot of research on how diaphragmatic (or “belly”) breathing directly improves running….” The article doesn’t present any convincing evidence. More at the NY Times.

But I get it. Everyone finds their breathing gets difficult (labored) at some point, usually when they speed up. And we naturally wonder if there’s a right or better way to breathe. Some advocate for nasal breathing (seems unlikely to help). Some believe in synchronizing breaths and strides at a certain ratio. Maybe. But not likely.

Here’s a twist on synchronization. In the first ever Boston Marathon-funded research project, investigators at Boston this year will be looking at heart rates and stride rates. Do they match up to some degree? If so, is this good or bad?

It’s a novel but interesting idea, because when you think about it, a 40-year-old runner has a max heart rate around 180 and is also told by many to aim for a stride rate near 180. Hmmm. More at BAA.

SHORT STUFF you don’t want to miss

>>> Going too far: Do ultra runners have more mental-health problems?

>>> Seeing the light: Exercise protects against retinal disease.

>>> Not guilty: Coffee/caffeine don’t cause problematic heart contractions  contractions.

GREAT QUOTES make great training partners

“It’s hard at first to understand that it’s not about beating other runners. The competition is against the little voice inside you that wants to quit.” 

--George Sheehan

That’s it for now. Thanks for reading. See you again next week. Amby