Friday, January 18, 2013

Book Interview From Germany

Here is an interview transcript from a few months ago in conjunction with the publication of the German edition of Fitness For Geeks. The interviewer is Alex Plaum of O'Reilly's office in Cologne, Germany.

AP: Hi Bruce, what did you have for breakfast today?

BP: I had two hardboiled eggs, an avocado, some berries, cheddar cheese, and half a banana. I waited about 15 hours between meals (6 PM last night), although I did have a whey protein smoothie while watching the Obama-Romney debate later on, so this doesn't count as a "full fledged" intermittent fast.

AP: When was the last time you worked out?

BP: Yesterday I had an interesting workout. We have a 10 kilometer stretch of open beach here north of Boston (Plum Island). It was low tide and the ocean was flat, not too many waves, so I did 6-7 100-meter dashes on the hard sand barefoot, maybe the last few all-out. Then I dived in the water. It was 9-10 degrees C., which I measured with a pool thermometer. Just a quick swim. Very refreshing (and healthy)! Cold-water swimming is a relatively new thing with me; it's remarkable how the body can adapt to it.

AP: Wow, not bad... There's a sentence in the "about the author" section of your book that made me a smirk. It says that even though you're back on track now fitnesswise, you had an "unguided youth". Can you elaborate on that - tell us a little about your past sins and the events that made you change your lifestyle? ;-)<

BP: That was mostly a play on words, considering that now I've done a few climbs with mountain guides in the Alps, and in the Western U.S. But I think I did some of the wrong things fitness-wise during my youth; mainly, I overtrained.

I was banged up from too many road races (running), then I jumped into an over-40 soccer league (your futbol) and almost wrecked my knee; then the triathlons were a little more forgiving due to the swimming, but I was still overtraining. Now I've eased back on the speedometer, and just do things with my son like ski, and one big effort in the mountains per year. I play with fitness apps. I get sick far less often than I used to.

AP: For "Fitness for Geeks" you've done quite a bit of research on nutrition, health, physical strength in general and body monitoring. What are your most important (and most surprising) insights in a nutshell?

BP: One insight was the pure breadth and depth of the health/fitness apps; tens of millions of users on EndoMondo, Strava, FitBit, Runtastic, and the like.

You can engineer your own weight loss and fitness gains, as software people are used to an engineering context, using these apps. Track the calories in your diet and your movement level throughout the day (and calories expended) with the FitBit, and connect these data with a Withings body-composition scale, and there you have it, all the data on the same screen, tracked over time so you can look for patterns.

These apps also have a tail-wagging-the-dog effect; they make people exercise more, when everything is being tracked.

I guess another insight that has evolved over the years is that we have been given a lot of "upside down" public-health advice: fats in the diet are bad; the sun is poison, so run around covering yourself with sunscreen all the time; and the more exercise the better (as if lots of marathoning was good for you).

Wrong on all three counts. It's sugar in the modern diet, as in refined sugar and fructose syrup, that's wreaking havoc metabolically (a little bad news there for dessert lovers :), not fat; the sun is healthy for generating the all-important secosteroid hormone vitamin D and for other reasons (some possibly not discovered yet), and "ultra" or excess exercise can damage the heart, suppress the immune system, and lead to some unhealthy outcomes.

"Mother nature does not make bad fats"; man makes bad fats, as in trans fat and rancid vegetable oils, and the like. Eat healthy fat and get control of your fasting blood sugar by eliminating refined sugar, exercising and moving a lot (particularly after eating), as well as fasting.

AP: The average western office worker spends something like 8 hours a day sitting on a chair and staring at a screen. Can riding your bike to work, running in the park during lunchbreak and having vegetable soup instead of french fries and chocolate pudding really compensate for all this passiveness?

BP: Yes. It's funny, sitting around a lot is the one thing everyone knows they do too much but it seems to be the hardest habit to break. They do a lot of studies on the effects of sitting and "screen life" (they should probably move on to something else important now, since we already know...:) and they find out at the very least that even relatively short bouts of sitting around will mess up your fasting blood sugar (which is supposed to be lower, not perpetually high).

Little things add up over the months and years; you lose bone mineral density and bone strength because of the lack of weight-bearing exercise and weightlifting. What happens to older people and muscle and bone deterioration is a case in point; they stop moving for years ("because I'm old") and the propensity to fall is the cause of so many problems, literally the straw that breaks the camel's back. It's tragic to see someone decline for these reasons, because it's preventable.

The upshot is that modern office people should put themselves in perpetual motion. It's not hard, right?

AP: I concur. That makes me think of something, b.t.w. Two of my colleagues have special high desks (where they can work standing up) because they recently had some back trouble. I think *everybody* should have a desk like this - to *prevent* any problems. How do I convince the German CEO? ;-)

BP: Stand-up workstations will be the norm. They undoubtedly are at some companies.

AP: Another question about "working out" in your free time: I love hiking... and rowing... and playing team sports. But weightlifting? Is it really necessary to go to the gym?

BP: Weightlifting is kind of an X factor, and I don't think these other activities, however fine they are, can substitute for it. Best to combine your endurance sports with muscle building: avoid injuries, avoid loss of lean mass which modern life accelerates; slow the ageing process, get positive gene expression; become stronger and faster. Hiking's wonderful, I do it a lot, but it doesn't make my legs or upper body appreciably stronger. By the way, you don't need a gym; you can get free weights for home or office, and do crossfit type routines like pullups, pushups, and burpees.

AP: Hanging on the couch, watching three sci-fi movies in a row while having a big cheese pizza and a lot of caffeinated soda is very popular with a lot of my friends. Is your book a danger to "traditional" geek culture?

BP: No. "Traditional" geek culture is evolving; some of the things "the software inclined" have liked to do, such as level up with video games, are now being adapted to exercise routines: see Fitocracy. It also depends on what geek cliche you're talking about. A geek is also an aficionado, a passionate devoted expert, as in bike geek or weightlifting geek. You can be a jock and a geek; believe me, if've worked with many of them.

AP: Anyway, it's been very interesting discussing "Fitness For Geeks" with you. Any final thoughts on your book and why people should read it?

BP: My book covers all the bases for anyone who wants to get started, including the plethora of apps available for analyzing nutrition and supporting your fitness routine. If you ever wanted to know what a GPS eXchange file was, my book has a section on that, as well as solid, well-researched health information on Paleo nutrition, fasting, weightlifting, interval training, and the like.

Wednesday, January 9, 2013

Health Geekery: Do It Yourself Testing

During a recent talk I gave in New York City at the interesting software company Cyrus Innovation, I mentioned that self-tracking and -testing will be disruptive of conventional health care. It already is. Doctors will have to get used to patients coming in with their own generated data, and they'll have to adapt, be open to, and embrace this development. This is all a movement in the right direction. Self-testing has a demystifying effect on your own attitude. With more and varied data comes more valid interpretations.

Times they are achangin' in the health field; see PrimalDocs for one.

It simply makes sense from a philosophical and practical standpoint. It's your body, right? And what doctor has the time and inclination to properly test various biomarkers over time, and within the proper contexts?

What to test?

You could obviously test a lot of biomarkers or indicators of your fitness and well-being. Three of the easiest and cheapest are:
  • Resting heart rate (RHR): How many times your heart beats in 60 seconds, at rest.
  • Weight and body composition (body fat percentage)
  • Blood pressure (BP)
Equipment

The initial investment for testing equipment might seem a little pricey, but pales in comparison with a typical doctor's visit, and all that prescription medication. A few hundred dollars at most (and less if you borrow, share, or buy the equipment used), will give you a:
  • Blood pressure cuff with a digital reading, including BP and RHR
  • A decent body composition scale
For the testing I'm doing today, I use the following devices: A Withings BC scale, which gives me weight and body-fat percentage; a pulse oximeter (PO) left over from my RestWise account, giving me my pulse and oxygen saturation; and a Homedics digital blood pressure cuff.

Protocol

You should test several times a day under different contexts (e.g., after waking up; during fast; after eating; after exercise; before bed, etc.). These devices are not infallible. One reading does not cut it. You will get different readings throughout the day as your body fluctuates through natural stages (i.e., your BP will be different during a fast than within an hour after eating, or after exercise).

More data is better

A great analyzer of baseball statistics used to say, "You can tell more about a hitter when he's gone 200 for 1,000 at-bats than if he's gone 2 for 10." More data means more valid conclusions. I'll be testing throughout the day today, but it will be better when I'm done doing it throughout the week.

Imagine you go to a doctor's office, and you get a "white coat" BP reading of 132/85. He says "hmm, you have a little hypertension." But you reply, "Dude, your office makes me a little edgy. I tested myself 100 times last month (wanna see the Excel file?) and it averages 115/75." Now who's in charge?

For example, here's what my data looked like early this morning (BCOF = before coffee; ACOF = after coffee):

7 AM:

Pulse oximeter (BCOF): 49/99; 44/98 (ACOF). Explanation: the first number is my resting heart rate (RHR); the second is a measure of how well oxygen is being diffused throughout my body (it goes up to 100).

Blood pressure (ACOF): 109/71; RHR 54. Explanation: caffienated coffee affects pulse and BP, generally increasing BP and lowering pulse.

Body composition (BCOF): 143 pounds; 9.8% body fat

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(A few hours later, ACOF + meal, breaking intermittent fast)

10 AM:

Blood pressure : 112/67, pulse rate 56

Pulse oximeter: 47/99

Body composition (BCOF): 143.4 pounds; 11.1% body fat

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...Now after a walk and a cat nap:

3 PM:

Blood pressure : 107/67, pulse rate 53

Pulse oximeter: 51/99

Body composition (BCOF): 143.1 pounds; 10.4% body fat

You can see how the data jumps around, depending on the circumstance, the context, the activities. Body composition does not change day to day (hardly week to week either), but the data spit out by your scale will. But now we're getting into some data, we have something to work with.

View Data In Context

One hundred BP readings would be good data, including knowing how food and sleep patterns were affecting it. A lot of data points will allow you to spot patterns (e.g., how does time of day, circadian and hormonal rhythms, affect your RHR and BP? What about the foods your eating and physical movement?).

I'll continue this throughout the week and then reproduce the results. You really should become kind of a stat geek and figure out the mean, mode, and standard deviations of the readings.