Blog ARCHIVES

Nov 28

We've all experienced the emotional power of certain words. Whether the negative bite of a sarcastic comment that hits too close to home or the positive boost we feel when someone we care about recognizes a job well done, something is amazing about how certain strings of letters can prime our actions and shape our behaviors. 

According to a research team from Virginia Tech, it starts with brain chemistry. In January, they found that certain words had the power to kickstart a wave of chemicals known to influence our mental health, regulate our emotions, and prompt us to act. They were the first to show that neurotransmitters like dopamine, serotonin, and norepinephrine are released in varying parts of the brain and in differing concentrations depending on the words used and whether they were positive, negative, or neutral (aka "valence"). While the list of tested words wasn't readily available, it did make me wonder if expressions of gratitude, something known to impact on the brain as discussed here, made the list. If so, it may further explain why the annual ritual that many of us participated in yesterday can be so much more than turkey and stuffing...

It's easy to think of "thank you" as a simple and often superficial gesture of politeness, something we might teach our kids to do by the age of 2 or 3 years. However, as has become popularized over the last several years, there's more to it than that. Inwardly, feelings of gratitude can impact a wide variety of personal health metrics and precursors. Interestingly, this 2020 review of research found even improved sleep quality made the list of benefits...but it doesn't have to end there.

A new review published in July suggested passing it on, that is, the moments when we allow our inward appreciation to overflow into a genuine outward expression toward someone deserving a "thanks", acting as a critical communication signal, greasing the cogs of trust between humans. Originally referred to as the "find-remind-bind" theory in 2012, expressions of thanks help us to identify the right people to connect with, keep them (and their positive traits) front of mind, and further solidify the strength of those relationships. They go on to say that when used in socially oriented settings like the workplace, outward expressions of gratitude not only benefit the members of the exchange but also those who witness the act, increasing the odds of positive contagion (social cascade) by priming others to join in (collective emergence). However, there is some fine print. The authors of the review point out that while gratitude as a practice can be powerful, gratitude as a "program" could be something closer to a tightrope walk. If it feels forced, fake, or otherwise phony, it's likely to backfire. 

In a world where chaos and calamity sell, there's never a bad time to have a moment to reflect, reset, and ready...in this case, for the final push of 2025. We hope you had the chance to do so and were able to both give and receive the brain boost that comes with expressed positivity. But just in case one more wouldn't hurt...on behalf of our entire team - thank you - we could never complete our mission without every single individual who strives to live a stronger and happier life. We hope you'll pass it on.

Have a great weekend,
Mike E.

Nov 14

When setting out to write this blog each week, I typically try to find a unifying theme worth relaying to clients, customers, staff, and friends. It starts with a headline that is interesting enough to dive into a little deeper and often sends me down the rabbit hole of review in hopes of determining whether the case is as strong as the headline claims. This week, however, things were a bit different. Instead of one generalizable headline, there were 3 that were interesting enough to share but perhaps applicable to a narrower few. Here they are in no particular order:

Coffee for Conduction - because it is a fan favorite (and because I love a good cup of coffee), we are always on the lookout for research that helps us answer whether coffee is "good for us". As we've mentioned plenty of times before, the general consensus leans "yes" when the dosage falls in a reasonable range and at a time of day unlikely to impact sleep. However, for some groups, such as those with heart rhythm disorders like atrial fibrillation (a-fib), things aren't quite as simple. Even though for at least 10 years observational studies have suggested a slight decrease in the risk of developing the condition for coffee drinkers, not everyone is convinced. This week, the case got even stronger as a randomized controlled trial showed that in a study of individuals who were treated for a-fib, those who consumed 1 cup per day had a 39% decreased risk of recurrence.

Rest for Runners - the second headline worth knowing about seemed intuitive, maybe to the point of obvious at first. Simply put, a research team showed that runners who trained on inadequate or low-quality sleep had a significantly higher risk of injury when compared to well-rested peers. OK, no surprise there. However, where things get interesting is the degree to which the risk was increased. Poorer sleepers - which was defined as low quality, low quantity, or trouble falling (and/or staying) asleep - had a whopping 78% increased risk of sustaining an injury in the 12-month assessment period as compared to peers who were steadier sleepers. Now, to be fair, this was not a super rigorous study, so we can't draw firm conclusions - but it lends support to the idea that recovery definitely matters, especially in those who are pushing themselves physically at work or at play.

More on Movement for Knee Pain - in something of an addendum to our October 24th blog on managing knee pain, a new study out this week added Tai Chi to the list. In a randomized controlled trial, individuals who participated in an unsupervised Tai Chi protocol had significantly greater relief of pain and increased function than participants who received education alone and not by a small margin. Compared to those who got an education alone, 55% more individuals in the movement-based intervention achieved clinically significant pain relief, and 38% more achieved clinically significant functional improvement

So there you have it - MOVE more, RECOVER well, and if you like the stuff, enjoy that cup of coffee...it's probably good for you, even your heart.

Have a great weekend,
Mike E.

Oct 31

Movement is a powerful health elixir. This is not new news. In one way or another, it's a song we have been singing for a very long time. Thankfully, it is also a message that many of the people we interface with understand, agree with, and, if our most recent client survey is accurate, are leveraging. We were excited to see that approximately 45% of respondents were in the low risk category for this ELEMENT, which is nearly double the average for American adults, where only 24% meet the full standard. However, we also know there is still work to be done as 35% of our respondents remained at high risk...they just haven't been able to turn the knowledge into action, which, of course, drives the results. Thankfully, we have a growing pile of research that provides strategies to bridge the gap.

One of the most critical bits to understand is that dosing matters. How often we move (Frequency), how hard we go about it (Intensity), how long (Time), and the mode we choose (Type) will all have an impact on our results...and therefore how close to achieving our goals we get. Exercise every day (F) at maximum effort (I) for hours (T) doing the exact same thing (T), like wind sprints, 7 days per week, and the combination is likely to produce such an overload that we could easily become injured. On the other extreme, sitting in a chair barely moving our thumbs enough to scroll, even for hours every day, is probably not enough to stimulate a healthy response. The good news is, just about everything in between, whether it be short bursts at higher intensities (aka "fitness snacks") or long slow walks, can be beneficial. The even better news, as new findings from a global research team showed this week, the greatest benefit, when dosing is dialed in, can be gained by those who are having a hard time getting the ball rolling.

More than "I" Alone

While so many studies have focused on intensity and there is fantastic research showing many great benefits of trading intensity for time (the stairwell is our friend!), this time, researchers wanted to understand if, at the lower end of the intensity spectrum, the tradeoff would still produce a benefit. They started by mapping the physical activity patterns of more than 30,000 generally healthy adults, but either had low levels of daily activity (5000-8000 steps per day) or were considered sedentary (defined as < 5000 steps per day). They then monitored health trajectories for the next several years to understand the connection between each pattern and the likelihood of developing heart disease or, worse yet, dying during follow-up. After nearly 8 years, the results were in, and the trade-off, in this case for slightly longer duration (Time), even at reasonably low effort (Intensity), worked.
 

Even though all movement patterns produced some benefit, individuals who got most of their steps in longer blocks (at least 10 minutes of continuous movement) were far less likely to die (about 1/5th as likely) as those who got their movement in bouts lasting less than 5 minutes, with the best result noted when activity bouts lasted longer than 15 minutes. The same basic trend was true for the development of heart disease. The group who got their steps in 15-minute blocks (or more) were more than 67% less likely to develop the disease as compared to those who achieved their movement in 5-minute blocks or less.

The takeaway on this one is simple enough: All movement matters and just about any "dose" can provide health benefits. While short bouts at higher intensities can do great things, even for individuals not quite ready for HIIT, carving out 15 minutes might just "FITT".

Let us know if we can help.

Happy Halloween - Have a great weekend,
Mike E.

Oct 17

Pain is a universal human experience and, at the most basic biological level, a critical warning system that lets us know when it's best to "stop everything" to avoid danger. Yet, as we've learned in greater detail over the last few decades, it isn't just a "local" danger radar, like the temperature sensors activated when we touch a hot stove, but rather, a finely tuned brain-integrated system which uses our past experiences to help predict our current and future risk. Unfortunately, there are times when our memory doesn't quite fade like it should and the system gets stuck in the "on" position, allowing our brain to send continuous full volume pain warnings long after healing has taken place or, as in cases of phantom limb pain (the experience of pain in a limb that has been amputated), the local signal has been turned off.

This can be just as confusing and frustrating as it sounds. While the initial pain might have been turned on locally with the onset of injury, it ultimately "lives" in the activated circuits of our brain. Therefore, what we experience as very real pain, often at the site of an old injury long after healing and even without any active harm present, is more likely to be a stuck brain switch. Referred to as persistent pain and impacting as many as 50 million Americans, this type of overreaction by our warning system can become a major impact on quality of life.

The good news is, as experts have helped us transition from dismissing something that we don't understand ("it's not real") to searching in the right places ("because it lives in the brain, it is both a mind and body phenomenon"), we have learned a ton. For example, while we know it is more likely to occur in individuals who experience chronic stress at a young age (especially those with adverse childhood experiences), we also know that lifestyle and health habits play an important role. For example, there is a known association between metabolic disease and persistent pain (possibly related to inflammation), and the emerging evidence shows that improving health factors can lower the odds of persistent pain. 

For example, in one study from earlier this year, individuals with knee pain who maintained a healthy lifestyle were significantly less likely to experience chronic pain than less health-focused counterparts over the two-year study period. Similarly, in a 2025 randomized trial, back pain sufferers who improved their health habits showed a greater recovery than those who performed more traditional (guideline-based) care without an emphasis on lifestyle habits. Now, in a very interesting development last week, we may be closer to understanding why.

As published in the journal Nature, a UPENN neuroscientist who had personally observed that being really hungry dampened chronic pain, found the root of this phenomenon. As it turns out, a bundle of nerves in the brain stem that plays an important role in driving the chronic pain experience also relates to other key survival circuits such as thirst and fear. The team went on to find a specific signaling molecule called Neuropeptide Y (NPY), which helps the brain juggle these competing needs and override pain in the face of more critical needs. 

“It’s like the brain has this built-in override switch. If you’re starving or facing a predator, you can’t afford to be overwhelmed by lingering pain. Neurons activated by these other threats release NPY, and NPY quiets the pain signal so that other survival needs take precedence”.

 While there's still plenty of work to be done to develop a treatment for this overactive circuit, the team has made it clear that they hope for more than a pill. “We’ve shown that this circuit is flexible; it can be dialed up or down, so the future isn’t just about designing a pill. It’s also about asking how behavior, training, and lifestyle can change the way these neurons encode pain”.

Pain that lasts for more than 90 days can be frustrating and confusing. The good news is, it doesn't always have to be. Reach out if we can help.

Have a great weekend,
Mike E.

Oct 3

Maybe you, too, grew up hearing the term "brain food". In our house, it usually referred to eating fish, which, whether consumed whole (e.g., low rates of depression per average pound consumed) or as a part (e.g., Omega 3 fatty acids and their connection to brain health and recovery), sometimes needed a little nudge at dinner time. There are of course others, many that we've talked about previously, and some outlined here, however, since then, the proof of the essential idea, that there are foods that are uniquely "good" for our brain and others that are not-so-good, has grown exponentially, which is getting us far closer to understanding why and how fast changes can start. 

First, in a series of studies, a research team from Purdue University demonstrated that the accumulation of fat in the brain disabled certain immune functions, which appear to be at the root of Alzheimer's disease. This represents a major shift in thinking away from "plaque" (b-Amyloid) as the root problem and toward viewing it as something closer to a contributing factor linked to inflammation that has been shown to drive a variety of brain diseases and disorders. 

 Lending support to this idea, another study published last week showed a clear connection between ultra processed food (UPF) consumption and whole-body inflammation in a large sample of Americans as measured by C-reactive protein. Individuals with a diet in which half or more of their calories came from UPF had significantly more inflammation, as much as double, when compared to those who consumed less than 40% of their calories this way.

However, perhaps the most show-stopping finding, also released last week, showed exactly how quickly this can all begin — at least in mice. Researchers from the University of North Carolina Medical School found that when they fed mice junk food, a diet that "resembles typical Western-style junk food rich in saturated fat -- like cheeseburgers and fries", there was evidence that critical brain structures, especially those related to memory, were negatively altered in as little as four days. Whoa. 

 Notably, the team found evidence that this dose of junky fat and the way the brain attempted to deal with it, which included altering the ability to access blood sugar, further connected the dots between metabolic efficiency (how well the body converts food into energy) and brain health. When they rebalanced blood sugar, brain activity showed signs of normalizing. While mouse models don't always translate perfectly to human models, this one, especially in light of growing evidence that suggests a connection between creatine supplementation (an important cellular energy component) and markers of future brain health, is worth keeping an eye on.

There's certainly more to come on this one, but for now, if, like many, you too are keeping future brain health front of mind, a spinach salad with avocado and/or salmon might be a great choice.

Have a great weekend,
Mike E.

Sep 19

I can't even remember the first time I heard the phrase. As a regular in physical therapy and orthopedic clinics - a quip often used by clinicians to describe the risk of crossing the line into "sedentary" - it is so commonplace that I just assumed the credit belonged to some legendary doctor somewhere. As I dove further in, I found that "if you rest, you rust" was actually attributed to a famous actress who, in addition to a massively productive career, also played an important role in the movement for healthy movement. I learned that Helen Hayes was not only the first female actress to win the "grand slam of American show business" (the Emmy, Grammy, Oscar, and Tony) as part of an 82-year career which started in childhood, she also became a major philanthropic force in the domain of rehabilitation. The hospital in West Haverstraw, NY, where she focused her energies, eventually became her namesake. Research this year has backed her up - we humans are built to MOVE and should do so often if we want to stay vibrant. Here are a few that I thought were particularly cool:

Pain & Injury

First, in February, a group compared the impact of traditional exercise and "exergaming", that is, video games which incorporate whole body movements, on chronic low back pain. Both approaches made a positive impact, and neither was definitively superior to the other, suggesting just about any movement can work to help those suffering longer-term back pain (typically defined as >90 days) feel better. Whether you prefer movement for its own sake or movement that feels more like fun and games, it all counts. Then, in the same journal (a study we mentioned a few months back), another team showed that when it came to pain severity, this time in older adults across 28 different countries, movement was the most important lifestyle factor for predicting severe pain. It showed a much stronger association than even well-known drivers like smoking, poor sleep, and poor diet. Those who reported low and very low rates of physical activity had more than 4X the odds of developing severe pain than those who were highly active. A few months later, in June, as reported in the Journal of the American Medical Association, the work of a team in Norway helped to quantify how much movement, in this case, total walking minutes, is required to prevent low back pain from becoming chronic in the first place. The answer was 100 total minutes per day with higher intensities, such as a faster pace, only slightly better than slow-paced walking. While some benefits began around 80 minutes, the greatest benefit appeared at 100 or more, where an additional 23% risk reduction was achieved. 

Illness & Disease

The story got even better last month when, in a huge new review of 57 studies that aimed to determine the "dosage" (in steps) of movement required to get meaningful risk reduction across a variety of diseases, the number 7,000 kept coming up. When researchers pooled the data and reanalyzed, they found that compared to a low-activity group (2,000 steps or less per day), individuals who got at least 7,000 steps daily had a significantly lower risk of getting (and/or dying from) a host of the most common diseases during the study period. In addition to a 47% decreased risk of dying from any cause (which ranged from 37% to 47% for cancer and cardiovascular disease respectively), those who averaged 7,000 steps per day also had a 38% lower risk of developing dementia, a 28% lower risk of falls, a 25% lower risk of developing cardiovascular disease, a 22% lower risk of experiencing depressive symptoms, a 14% lower risk of being diagnosed with diabetes type 2 and a 6% lower risk of being diagnosed with cancer. A powerful benefit from 1 simple habit.

Very few people work for 82 years or live to be 93, but if we can find a way to incorporate her first quote into our lives and minimize the rust with movement, we might be able to prove that she was also right when she said, "age is not important...unless you're a cheese." :)

Have a great weekend,
Mike E.

Sep 5

If you're an athlete, engaged sports fan, or have followed any of our communications, you've likely heard the term "load management" in one way or another. It's a simple concept - when we overload the body, it's more likely to bark back (or break down) - but until relatively recently, there wasn't really a common language around the idea or a reliable way of measuring it, and therefore it was more intuitive theory than hard science. Then, in the 20-teens, a researcher named Tim Gabbett planted his flag on the concept with some very interesting data, which helped spur a consensus statement and, in the process, something close to a revolution in the training and competition space. The talk of measuring physiological loads, primarily in athletics, became far more commonplace and started to ripple into conversations where injury and illness prevention in other athlete types (e.g., industrial, tactical, etc) was the goal. Fast forward 10 or more years since the idea first entered the conversation, and, like many trends, it has experienced backlash, revisitation, and refinement.

So how does it work?

The basic premise is reasonably simple. Whether high tech, through the use of wearables or monitors which might capture data like continuous heart rate to predict intensity, or low tech, such as a 0-10 "rating" of perceived exertion after a training session multiplied by the total time spent training, a training load can be calculated. For example, if yesterday's exercise session was rated a 7 out of 10 effort level for 30 minutes, it would score 210 "load points" (7 x 30). If we then compared that total to the rolling 1-week and 4-week averages for the same athlete, we would know, relative to both a short-term and long-term baseline, how hard that athlete had pushed. We could do the same thing for the intensity of a workday or training operation. 

Gabbett's research showed that if an athlete pushed significantly beyond their baseline average, such as more than a 30% increase in a week, their risk of injury went up. On the other hand, since the only way to reliably improve physical capacity (strength, power, etc) is to actually overload the system, so it can bounce back stronger, finding the sweet spot which allows for maximum gain with reasonable risk, has become a major focus for other research teams and coaches who have picked up the trail. 

One athlete type that is particularly attuned to this fine balance is runners. They are not only notorious for overloading (and therefore experiencing a high rate of injury), but they also tend to like gadgets, which means between their training device (usually a watch) and the app it pairs with, they have access to lots of training data. Knowing this, a research team from Australia sponsored by Garmin recruited more than 5,000 runners to analyze their training data and injury histories in hopes of determining with a greater level of understanding "how much is too much?". What they found, as reported late last week, is something worth knowing: in runners (and possibly other athletes who repeat movements in high volume), a single session overload (compared to baseline) presented significantly more risk than the same overload if it increased gradually over days or weeks and not by a small margin. Specifically, if a run was more than 10% longer than the longest recorded in the previous 30 days, the risk was 50-64% higher. If the spike was very high, such as double or more the longest session recorded in the previous 30 days, the risk more than doubled by 2.28X (228% increase). 

While we can't assume the change in risk is the same for those who are experiencing non-running-related spikes, such as seasonal workloads or intensive environmental conditions in tactical or industrial athletes, the principle makes sense - pushing ourselves beyond what we are used to all at once adds significant risk.

Humans can do amazing things. Our systems adapt to almost any stress we throw at them and get stronger most of the time...just not all at once. It's said that the original interpretation of the famous two-word inscription on the temple of Apollo, which reads "know thyself," was something close to "know your limits"...for the runners and all of us who grind out lots of repetitive motion at work, home, or play, perhaps that really means "know thy baseline".

Have a great weekend,
Mike E.

Aug 22

Most everyone believes that movement matters. That is, we humans are built to MOVE, should do so often and with reasonable intensity in order to prevent and reverse disease. Of course, as we always like to point out, it doesn't end there. We think clearly, feel better, and even get more out of social interactions when we are on the MOVE. However, when we explore the details of healthy and efficient movement, such as what it "should" look like, things get fuzzier. 

On one side of the spectrum, somewhere in the weeds, is a group that sees movement through a lens of mechanical precision; let's call them "the engineers". On the other end, zoomed way out as if hovering far above the weeds, lives a second group, which sees movement as an entirely unique expression, heavily influenced by our personal experience of the world; let's call them "the artists". The engineers tend to argue that there is a "right" way to move, something that is efficient, can be taught, and should be replicated by all, in order to minimize risk and promote thriving. The artists, while acknowledging the clear advantages of leveraging our, well, levers, as well as our fulcrum and pulley (aka musculoskeletal) system, point to the almost countless variations in even the highest performing humans as evidence that there really isn't a standard. As is usually the case, it's a bit more nuanced than either extreme, and we now have stronger proof. What started a decade or so ago with a team of biomechanists (i.e. "the engineers") who were studying one of the fundamental human movements - gait (that is, walking) and common changes associated with knee arthritis, has grown into a simple and powerful alternative for those who might want to stave off a surgical correction or replacement.

To provide context and in a wild oversimplification in hopes to save words, the inside (medial) portion of the knee, where the round thigh-bone (femur) sits on the flat-ish shin-bone (tibia), is a major load-bearing structure when we walk. The combination of compression and the requirement to bend under that load in order to walk makes the area susceptible to wear, especially in those with reduced leg strength or elevated body weight. While staying strong, reasonably limber, fueling for health, getting good sleep, and a variety of other health behaviors can significantly lower our odds of developing arthritis, even when a genetic risk is on board, the engineers theorized that improving the way a person moves could also help.

In the late twenty-teens the idea was put to the test. One group of researchers found that when individuals with knee arthritis were trained to "toe out" while walking, their biomechanics improved. Around the same time, a different group at Stanford's Performance Lab found that a more personalized change, having individuals either "toe in" or "toe out" based on their unique mechanics, produced better results. They found that a personalized approach more consistently lowered the pinch force on the inner side of the joint. The results were so promising that they expanded the study and, in 2022, reported continued positive results, some of which were discussed in a 10-minute video here. As it turns out, and as published last week, even under the most rigorous testing conditions (a randomized controlled trial), 6 weekly sessions to retrain participants to move differently, in a way that complemented their unique mechanics ("gait retraining"), resulted in not only pain reductions on par with those expected from medication but also a clear improvement in cartilage health on MRI over time.

 Said another way, both the engineers and the artists were right. Like a function-fingerprint, if you look close enough, our movement is uniquely ours. There is no "one perfect pattern" that works best for every human. However, exactly how we interface with the world through our movement can be optimized to lower risk, improve health, and ultimately maximize performance. If you think you could benefit from improving the way you move, let us know. We are happy to help.

Have a great weekend,
Mike E.

Aug 8

We dropped our youngest off at college this week. Although by the third repetition, it'd be reasonable to assume the process would be more routine and easier this time (that was, in fact, the hope), it certainly didn't feel easy.  Always a bit of an adventurer, Andrew's choice was the furthest from home and will start in a rigorous military environment. To complicate things, always fairly independent, he's probably the least likely to call home and tell us how everything is going. Combine all of this with the fact that those in charge describe this place as "the road less traveled" and even the locals referred to it as "in the middle of nowhere,"  and maybe it's no surprise that good sleep has been a little more elusive than usual this week. The upside, of course, is that it made deciding which avenue of health to explore for the blog a lot easier. :)

As an unapologetic sleep-geek, along with my Garmin, which, similar to their new sleep-focused product, calculates a daily sleep score, our usual go-to sleep hygiene tactics are already well-integrated in my life. However, for those who might be just starting or ready to take a second look, let's start with a wildly unscientific self-assessment of those key areas we know matter to set the stage:

Bedtime - My bedtime is as close to set-in-stone as it gets (25 of 25 points).

Long Runway - I try to ramp down a few hours before that time, first by stopping calorie intake (hours prior) and then by leaning on a cup of Sleepy-Time tea to reinforce my "habit loop". (20 of 25 points)

Environment - My bedroom is set up for something about as close to hibernation as possible with generous use of blackout shades and a temperature that is cool but not cold (25 of 25 points).

Physical & Mental Readiness - although not typically as part of a bedtime routine, my heavy reliance on to-do lists to stay organized (a known tactic to help swirling minds before bed) combined with the fact I usually cram enough into any given day to be physically tired, ensures that I am ready when my head hits the pillow (20 of 25 points).

Total = 90%

So what could possibly be left?

One recent study that caught my eye was on the use of Creatine, a supplement which is gaining attention for brain benefits, along with its more well-known benefits associated with physical training. The 2024 study showed that a single dose of creatine could combat the brain fog of sleep deprivation. While I wouldn't say I'm sleep deprived (yet), it's certainly one I'll keep looking at.

However, more recently, and as reported last month, certain exercise modes might be particularly beneficial for those who struggle with sleeplessness. When the research team reviewed the randomized controlled trials on the subject, they found that of the 13 different intervention types tested, exercise was most effective. In particular, yoga and Tai Chi had the greatest number of benefits (including reducing the time required to fall asleep by 25-30 minutes each), while moderate intensity rhythmic aerobic exercise (like walking and jogging) showed improvements in the general severity of sleeplessness.

While I suspect my bout of insomnia may be temporary and things will settle in now that I'm both back in my normal timezone and got a text that things were going reasonably well (especially now that he knows about the fire ants, oof!), sleep can be challenging at times. If you find yourself struggling and need some ideas or a place to start, reach out anytime. 

Have a great weekend,
Mike E.

July 25

If we work at something long enough, despite how distant the horizon, there's an occasional breakthrough to celebrate. A month ago it felt a little bit like that when the American Heart Association released a "scientific statement" which critically reviewed one of the oldest, most obvious, and yet still wildly polarizing concepts in health care - that since food quality has the power to restore health, professionals (including physicians) should prescribe it like a medication. While this seems like common sense to many who agree with the fundamentals of the idea, not everyone does. Whether the lack of formal training health professionals receive in the area of nutritional science, or the claim that eating healthy is inconvenient or costly compared to the "ease" of medication or even questions related to effectiveness, getting to a point where "food is medicine" has been a slog. However, over the last 5 years, things have begun to shift, and the idea is gaining steam. A growing number of people are realizing that trading the convenience of cheap ingredients enhanced with ultra-processed flavor profiles now for a hefty quality of life cost in the future is not a good bet, and since the microbes in our gut (microbiome) play an oversized role, they are worth learning to take care of.

Making sense of exactly how the many-trillion microbes on board actually drive our health is no small task. However, an exponential growth of studies in this area has helped. Before 2010 for example there were hundreds and even thousands of references on the topic depending on how far you go back, but in the last 15 years there have been hundreds OF thousands...and more than a quarter million since 2020, bringing far more clarity to the picture; and with it, a few themes that have become reasonably well established:

(1) Healthy bacteria feed on fiber and fermented plants, so consuming a wide variety and volume daily helps grow the population of "good guys". On the other hand, bacteria implicated in disease prefer an industrialized diet, heavy in sugar and highly processed, so limiting these whenever possible can help keep their population in check.

 (2) It's not only food that matters - other lifestyle factors like physical activity, sleep, and stress management can also play an important role and often have a bidirectional relationship with the microbes - they both drive each other.

(3) Supplementing or replacing colonies in order to restore health is an interesting but still mostly experimental idea, so our best chance to reset things may be to restore our diet to one which mimics a pattern far more common before the industrialization of food...a theory which was tested in Canadian adults.

 Researchers recruited and randomly assigned 30 people to consume a diet which they called the NiMe Diet (short for non-industrialized microbiome restore), an eating pattern of times gone by for most of the world. Typical of "ancestral" diets, this one was primarily plant-based, contained no dairy or wheat, and was low in process, which means it was low in sugar (as measured by glycemic index) and high in fiber. From a macronutrient perspective, it was 60% carbohydrate, 15% protein, and 25% fat, and the menu featured foods like beans, sweet potato, rice, cucumber, and cabbage as well as foods which were known to feed the particular bacteria they were hoping to grow, such as Jerusalem artichokes, peas, and onions. 

Following the intervention, their deep-dive analysis of participants' health showed impressive changes in only 3 weeks. The findings, published earlier this year, showed that participants had a significant change in the makeup of their microbiome, including growth of a particular bacteria found in tribes that still eat this way, like those in rural Papua New Guinea. They also had meaningful clinical changes, including significant reductions in cholesterol, blood sugar, and body weight, which paralleled a significant drop in health risk.

It seems less likely that the "Father of Western Medicine" is the one who said it, but whoever gets the credit for "let food be thy medicine and medicine thy food"...the data says they're right. I hope your garden is growing as fast as my lawn and you're benefiting greatly from feeding those microbes.

Have a great weekend,
Mike E.

July 11

Under the heading of "practice what you preach", I've been focusing on increasing my total exercise volume lately. Since I'd much prefer to be outdoors, I've found my way to a local rail-trail for a few jogging miles more regularly. While "easy and enjoyable" is not my typical default which is less surprising given new research on the links between personality type and exercise preference I suppose, on Tuesday I was reminded of how powerful an equalizer the heat & humidity of July can be; after two 15-ish minutes of jogging separated by a bout of walking, I was fried. My legs felt like they were made of lead, and I really just wanted to lie down, pretty clear signs that I had overloaded and possibly strained my system more than intended. 

Maybe this sounds like a bad thing. It certainly can be if not given the respect it deserves, but doesn't have to be. In fact, despite hype phrases like "you need to shock your system" that make it sound scarier than need be, unlocking the adaptations that make us stronger and healthier is, at its root, a conversation about controlled overstress. The better we are at staying on the right side of the fine line that separates "functional overreaching" (the good and stimulating stress)  and "over training" (the excessive overload which delays recovery or sets us up for injury), the more we can leverage the power of our physiology - we get stronger through stress. For most of us, that means if we dial in strategies that help us RECOVER, we can get stronger this summer.

Of course, this isn't exclusive to athletics, and it doesn't have to be all at once. Recent studies, such as this one and this one, have shown that allostatic overload, the more technical term for the accumulation of strain, is connected to overuse injuries and physical performance decline in tough environments like Officer Candidate School (OCS) with the US Marine Corps. Although the blood markers and survey data collected may not be practical in our daily lives, and three of the other five proven markers would require a blood draw, newer technology can provide a close approximation. Whether using a smartwatch or an app on the phone, most of us can easily and routinely measure heart rate and heart rate variability (HRV) if we want to. These two data points, which don't fluctuate all that much if measured in a true resting state (shown here) and therefore can tell us when our "engine is idling a bit high", have been effective in quantifying overload in higher stress occupational scenarios. For me, after the jog, those same data points suggested it might be the perfect opportunity to test a new recovery framework that had recently caught my eye - the 4Rs of Sports Nutrition: Rehydrate, Refuel, Repair, and Recuperate. 

It's a relatively simple idea - by accounting for current body mass and activity profile along with the symptoms I was feeling, I could leverage the latest in sports nutrition and focus on replacing the nutrients needed to bounce back quickly and fully. With the help of the web tool that accompanied the article, I was able to generate a plan for the next 24 hours. In truth, I didn't follow it to the letter, but instead used it as a guideline to help me be a bit more deliberate than I might typically be. I rehydrated more aggressively than usual and worked to make sure my next meal had the amount of carbohydrates and protein needed to restore quickly. The results were promising. While restless sleep or other signs of extended stress are not uncommon, the night after a heavy physical load, I slept like a log, my resting heart rate returned to within 2 beats of my baseline, and my overnight HRV was within my normal range...a good first test.

 The heat and humidity are likely here for another couple of months...that could mean risk , or it could mean more opportunities to test the 4Rs. Give it a try, and I'll let you know how it goes on my end.

Have a great weekend,
Mike E.

June 27

The list of "important things we should probably do for our health" is almost endless. Some of them are big foundational things that never seem to change (ELEMENTS). Others, like coffee consumption, are generally positive and seem to be gaining steam - for example, 3 new studies say it supports healthy aging in women, improves heart risk when taken "without", and may even flip a cellular stress switch. Yet others, like consuming seed oils (which have attracted a LOT of attention recently), are still probably in the "need more info" stage. Research from April, which said seed oils are a negative for cancer risk...in contrast to a recent talk at a nutrition conference earlier this month, which suggested they are possibly good for metabolic risk, only complicates things...stay tuned on that one.

However, in an otherwise busy life, trying to keep track of, or even more daunting, actually "execute" on the whole list is probably impossible. Ranking, prioritizing, and honing, therefore, is one of the most important things we can do in deciding where to place our limited (and possibly dwindling) attention. If we asked the American Heart Association which are the critical bits, they might suggest their Essential-8: be more active, quit tobacco usage, get better sleep, manage weight, cholesterol, blood sugar, and blood pressure. Research from this year, which shows better biological aging in those who do, appears to confirm the claim. If you ask us, we think those 8 (and a few others, perhaps) can be trimmed to 5 major headers: Move, Fuel, Recover, Endure, and Connect. But what if you had to pick just 1? Which is the most powerful?

It's a fun exercise, but context matters. The "most powerful to what end?". For example, when AHA number 4 (manage weight) is the priority, perhaps the old fitness idiom "you can't outrun a bad diet" applies. If so, Fuel might be the best starting point. For those who are trying to protect future brain health, a fascinating new theory that blends biology and physics suggests that our brain works best on the brink of chaos, which is primed while we sleep. If that's the goal, Recover (via sleep) should be near the top of the list. However, for the populations we often serve, those groups who push themselves physically as part of everyday life, often in stressful environments, which can leave bodies hurting, the answer may be Move.

This 2022 study showed for example that stress levels experienced by professional firefighters were cut in half when exercise was a regular part of their routine; a reduction of about 16% per 1 hour of exercise added per week and more recently, this small study (March 2025) showed moderate aerobic activity had a significant and positive impact on sleep quality. However, one of the more intriguing recent studies on the topic was completed by a team in Chile and published in January of this year. It showed overwhelmingly, in a population of nearly 30,000 older adults, that low physical activity loads increased the odds of experiencing severe pain. While all the usual culprits increased the odds of experiencing severe pain later in life - smoking by 21%, poor diet by 78% and poor sleep by 81% - physical activity was far and away the heaviest hitter, increasing the odds by a multiple of 4.35 (i.e., 435% increase). And, if this study on individuals with back pain is on the right, getting these loads in nature might be even better.

It's never a bad time to get moving. Start slow, keep it fun, and respect the heat.

Have a great weekend,
Mike E.

June 13

If you subscribe to the notion that "smarter is better than "harder", you probably love the idea of a shortcut. Truth be told, you're not alone - effort takes energy, which we humans try to conserve. While the thinking part of our brain understands for example that regular physical activity has the power to add years to our life AND life to our years, the part of our brain that controls our action is wired to stay put and opt-out, and so we often do. Brain-scan studies like this one from 2021 confirm this imbalance, providing support for the "Theory of Effort Minimization in Physical Activity", a fancy way of saying that it is neurologically more natural to sit on the couch than get up from it. Coupled with our equally powerful problem-solving circuits, we find ourselves on a quest to have it both ways - to get the benefit without all that pesky effort - a drive which has produced many innovations...as well as some unfortunate fallout. Whether it's moving walkways and e-scooters everywhere which make it easier to get around but also lower the odds we will hit a healthy number of steps per day (+/- 7K for most people) or any other number of conveniences, we have to make choices every day on when efficiency goes bad.

Dietary conveniences follow a similar pattern. Messaging on supplementation can feel like a game of chutes and ladders. Taking multivitamins, protein, omega 3s, vitamin D, or others can be an easier way to meet recommended daily units, however, the research on their health value is far from conclusive. While our thinking brain knows that getting enough healthy greens in our diet the old-fashioned way (by eating them!) is probably the way to go, the convenience of having something similar in a powder appeals to enough of us to generate $70 Million in sales each year...we're just not sure if it actually works.  On the other side of the spectrum given the known risks associated with consuming diets heavy in animal proteins and the generally positive story related to creatine supplementation which might help fill their gap, one might assume this switch would be well underway. A recent small study even showed it could improve our ability to think clearly when we are sleep deprived, an interesting gap-filler despite not making up for a good night's sleep. Of course, things get even more complicated as new threats emerge.

The trifecta of safe, effective, and convenient is becoming increasingly difficult to find.

The growing body of research on microplastics and their negative impact on health, for example, has certainly gotten me wondering about ways to limit exposure. Coffee consumption, which is generally in the "healthy" column (and something I look forward to each morning), could get murky if the way we prepare it needs to be drastically changed. While filtering coffee makes a major difference in limiting cholesterol-raising compounds that come along for the ride when coffee is brewed unfiltered, the trade-off of a steaming cup of plastics depending on what the filter is made of may need deeper consideration. Of course, unfiltered coffee steeped through a convenient tiny plastic cup might be especially problematic.

In a world where "time is money" and "no free lunch" can both be true, we are always trading something. With any luck it doesn't have to be our future health.

Have a great weekend,
Mike E.

May 30

Recovery is at the heart of prevention and health promotion this time of year. It's an easy time to get over-stressed, overdone, and maybe even run down to the point of injury or illness. Since, on one side of the (load) balance, work and life demands are often not under our full control, it tends to be the recovery side where we can gain the most ground. With that in mind, we are always on the lookout for ways to tip the scales. This week, a team in Switzerland opened a rabbit hole to a whole new idea, and it starts with the lining of our arteries.

Inside the muscular pipes known as our arteries are a layer of cells called the endothelium. This thin layer of specialized cells plays an oversized role in our health, acting as both a physical barrier between the arterial wall and the bloodstream, and is also critical in regulating blood flow, controlling some of our inflammatory responses, and repairing the vessels from the day-to-day wear of a busy life. Their ability to recover and repair is directly related to how and when our vessels begin to age. When the endothelial cells can no longer replicate but are still active, called senescence, the entire system slows down. It stands to reason then, that if we could influence this cellular switch, we might be able to keep our systems healthier for longer...and a research team in Switzerland may have just solved the puzzle.

They found that as our bodies break down certain foods they leave a key byproduct (aka metabolite) that in a high enough concentration, flips the cellular switch to prompt cardiovascular system aging. Determining how to counteract this byproduct, which accumulates over time and is related to the consumption of foods high in phenylalanine, such as red meat, dairy, and certain artificial sweeteners, could act as a fountain of youth. While the initial experiments used antibiotics to kill off the gut bacteria which produces the negative byproduct, they also found that adding in another more positive metabolite (acetate) can restore and rejuvenate the aging cells. While the concentration of good bacteria and therefore the capacity to rejuvenate seems to get lower with age, the researchers believe that diets rich in fiber and foods with antioxidant and anti-inflammatory properties could boost the body's own "fountain of youth", something they have begun testing.

This may explain why another recent study showed that a garlic supplement was linked to improved cardiovascular endurance in recreational athletes and a third study showed that curcumin helped control cellular stress before and after exercise.

We may not be able to limit the stress and strain we face this time of year, but we may be able to recover better and therefore age a little slower...and it starts in the gut.

Have a great weekend,
Mike E.

May 16

When it's on our own terms, we humans tend to change slowly. We think about it for a while, maybe first by imagining what it would look like. Then after we decide the vision is worth the effort, we might build a how-to plan and maybe even dabble for a bit before we actually go all in on the set of new actions that will lead to an adaptation. If the change we are looking for is a physiological one, such as a lifestyle change leading to a health-risk improvement like the effort of pushing heavy things around to gain strength or getting on a stationary bike to improve our heart health, it could be weeks, months or even years before we arrive at the intended outcome...the "change"....which can feel painfully slow.

It's not uncommon for the belief that "it takes forever" to add to the inertia required to get started. It can easily create a reevaluation doom loop ("Is this REALLY worth it?" over and over) which from the outside might even look like procrastination. But this isn't the whole truth on the speed of change, something we often try to highlight when we are asked to weigh in on the pros and cons for those considering one.

The deeper truth, if we zoom in far enough to see it, is that while long-lasting or permanent change, if there even is such a thing, is slow, the initial changes that lead to it are not slow at all. They happen immediately when we take on a new action, and in some cases even prior to the action as our systems anticipate the needs to fulfill the request. For example, this small (but super cool IMO) 2022 study showed that when subjects were told in advance how hard an exercise session would be, their bodies "readied" for the challenge by ramping up resources BEFORE they actually started the session, an effect that wasn't seen in those who weren't told the session parameters. Not unlike the heart-pumping excitement we might feel while we anticipate something jumping out at us in a horror movie, our bodies are ready to meet the ever-changing demands of our environment.

This of course can be a double-edged sword. On the not-so-wonderful side, another small study out this week showed that even after 3 days of short sleep (+/- 4 hours) the body reacted by ramping up inflammatory markers in and around the heart - signs of strain similar to those we see in cardiovascular disease. Interestingly, however, the same study showed that while definitely not the same, physical activity, even on short sleep, might blunt some of those negative changes. Given some of the natural load ramp up that accompanies the Summer season we talked about last week, going to bed early and maintaining physical activity habits this time of year could be a powerful combination to keep stress from becoming strain.

And while 30 minutes of cycling was the method they used to test individuals in the study above, when it comes to the speed of change from exercise, we should never forget that if dosed correctly, a little can go a very long way. While high-intensity efforts aren't best for everyone (check in if you're unsure), this 20-year-old classic is one of my favorites. Similar to the now famed Tabata protocol, It showed that 4-7 repetitions of max effort for 30 seconds (separated by 4 minutes of recovery) prompted significant change in the body in as little as 2 weeks. 

The key takeaway then is that although it may seem slow on the surface, change is also fast (deeper in) and always. If we know which combinations pair well, we can stay strong, enjoy the adventure and still arrive at our preferred outcome on-time.

Have a great weekend,
Mike E.

May 2

In 2022, the most recent year on record, heart disease once again claimed the ominous title of "the leading cause of death for Americans" accounting for more than seven hundred thousand cases. Cancer was next (608,000) and accidents, primarily falls, motor vehicle accidents, accidental poisonings (which include drug overdoses), and self-harm, were third on the list, accounting for 227,000 deaths. The math of it is staggering. 1.5 million friends, family members, and coworkers lost, a number which stays consistent for most years making it common but definitely not inevitable. It's not a stretch to say that most of these cases were preventable. So while we can't change the past, those of us who prefer to not repeat it can certainly manage, mitigate, and ultimately minimize the risks we face so as not to. We have many levers in our hands, some of the most powerful are shaped like tableware and what we allow ourselves to consume with it.

This is the essential message of a wide-reaching new study into a major (and growing) risk factor that we often talk about here on this blog; one which we mentioned again last week as an immediate threat to brain function - those easy-to-get consumables that tend to have ingredient lists which read more like a chemistry kit than food and are commonly referred to by their initials UPF, which of course stands for "ultra-processed foods". In 2024, a massive study published in the British Medical Journal linked regular consumption of UPF to 32 different diseases and disorders which ranged from heart disease to metabolic health disorders to poorer mental health and beyond. This month, this study put some numbers on it to illustrate exactly how big a threat it is.

A research team from across the globe analyzed historical data from 8 different countries including the United States and found that for every 10% increase in UPF consumption, there was a 3% increase in the risk of dying. In countries like the US where as much as 50% of daily calories consumed in the average diet are from UPF, this translates to 124,000 deaths in 2018 when the data was collected. To give some sense of how many that is, UPF would have been the 6th leading cause of death in the US that year, just ahead of Alzheimer's disease on the list of top causes. Still, other studies this year have shown that it harms our gut microbiome, harms our kidneys, and may be especially bad in males. Although probably inflammatory and possibly even insensitive to use terms like "poison", the outcomes are similar.

It's gardening season. Do yourself and your family a favor—get out in the dirt and cultivate health instead.

Have a great weekend,
Mike E.

Apr 18

If you ask some of the most well-known evolutionary biologists they might tell you running long distances is the human movement pattern that defines us. More than 20 years ago, that's essentially what the two in this article which reviews some of their research and theories essentially said. If running is such a natural and species-defining movement, why do approximately half of runners (with some reports approaching 80%) experience injury while (or from) performing it? The question is far simpler than the answer. However, at some level every time we get a step closer we learn more about how and why overused tissues break down, even those of us relying on the endurance to get through long days or stressful seasons who might never toe the starting line, can benefit.

There are a few relatively simple prevailing theories. Ramp-rate, the idea that the body can only "ramp up" so fast without becoming overextended beyond the capacity to recover, has been an intense focus over the last decade. Guidelines suggest that even seasoned athletes who increase loads (training intensity or volume for example) by more than 30% are at increased risk. Baseline fatigue is another. Knowing that our physiology fluctuates constantly in response to the complex demands (both internal and external) we face, should make it reasonably obvious that some days we will have a "fuller tank" than others. Running on empty from an energy perspective increases our odds of pushing too far. Lastly, changing conditions play a major role. Ask a group of runners what the perfect racing conditions are and they probably won't all say precisely the same thing. However, it's a reasonably safe bet that super cold, super hot, or quickly fluctuating between the two won't get many (if any) votes. Our physiology relies on prediction to adapt to changing conditions (called allostasis), therefore volatile or extreme conditions pose a challenge and eventually a threat. Yet these three ideas don't seem to capture all of the risk. Runners who follow a well-structured plan, monitor their physiology, and train in well-controlled conditions so they can more accurately predict when to push (or pull back) have better odds, but still aren't without risk. Something must be missing. As it turns out, a team from Australia thinks they may have discovered something that can help fill the gap and it starts with how we fill our bellies.

We know that FUEL plays a critical role in human performance. In longer triathlons, for example, it is often referred to as the "4th discipline" that gets tacked on to the more well-known first 3 of swim-bike-run. However, in this new review of nearly 6,000 runners, researchers were able to get a bit more specific. They found 3 interesting predictors of injuries that related to fueling strategies - the first two, calorie deficit and lower intake of fat, were specific to women and the third, low fiber consumption was generalizable across men and women. 

Specifically, they found that injured female runners consumed (on average) 450 fewer calories per day than uninjured runners. The fuller tank analogy above might track literally with running on empty. They also found that of the three macronutrients (protein, carbohydrates, and fat), there were no differences in protein and carbohydrates between those who sustained injuries and those who did not. There was however a difference in fat consumption with the injured runners not getting enough of it. Injured female runners tended to be at the lower end of the fat consumption spectrum (around 20% total calories) whereas uninjured runners tended to be in the middle of the healthy spectrum (27-29% where 35% is considered the high end of healthy).

The final risk which was noted in both men and women was dietary fiber intake. The authors pointed out that while both injured and uninjured runners tended to consume adequate amounts of fiber (while average consumers miss the mark), there was a distinct difference with injured runners falling on the lower end of the healthy spectrum and uninjured runners on the higher end. The authors pointed to potential causes we've discussed in the past when it comes to the relationship between fiber and injury, most notably the gut-promoting and inflammation-tempering benefits of a high-fiber diet.

If history is any indication of the future, our tissues are about to experience more stress. Loads tend to increase at both work and home, the conditions can fluctuate rapidly this time of year and it can be hard for our bodies to predict and possibly even keep up as life races by. In the next 30 days, many of our clients groups will have access to our version of a summer survival guide. Until then, do your moving parts a favor and consider your FUEL and whether you're eating enough of the right stuff...if the biologists are right, that's probably what we were running toward 4 million years ago anyway.

Have a great weekend,
Mike E.

Apr 4

Sometimes we run across a study that is just too big to ignore. The pool of data is so large and the findings are so impressive there's nothing else to do but just get into it. This study, led by a researcher in Australia and published in the British Journal of Sports Medicine is one of those studies.

The backstory, as laid out in this recent article and this review of a series of posts on X and BlueSky by the chief data reporter at the Financial Times, is a reasonably simple one - on the whole, a worldwide decline in language & math capability, which began in the 2010s (but was likely made worse during the pandemic), hasn't improved; by these measures, humans are getting less intelligent. One theory suggests that as we rely on other systems (algorithms, smarter machines, etc) to do the reading, summarizing, and possibly even thinking for us, we are getting worse at it.

 While it's probably not a capacity thing - clearly, we are capable of doing calculations, learning new things and thinking critically - it may be a distraction and, like atrophy, a disuse thing. Sadly, it seems "if you don't use it, you lose it" applies to cognition and since one of the greatest predictors of future brain health is current brain health as shown here when comparing our "brain age" vs the "actual age", if we don't challenge our brain to stay as strong as possible now, things will likely get even worse in the future.

If this leaves you wondering what can be done, you're not alone...that gets us back to our original story, a study of studies from an international research team that looked at a massive dataset of more than a quarter million subjects across the lifespan. They found conclusively that movement, of just about any type and intensity, when done consistently, improves cognitive function across every age. Simply put - they found that those who MOVE more can think better. However, where it gets really cool is when they dove deeper into specifics and subgroups.

 When it came to memory and executive function (decision-making and more), children and adolescents improved more than adults and older adults and individuals with attention-deficit/hyperactivity disorder (ADHD) exhibited greater improvement in executive function than other populations. 

 The lead author was quoted as saying: "For children and teens, exercise was especially beneficial for developing memory, while for people with ADHD, it helped improve focus, reduce impulsivity, and enhance executive function."

When it came to the preferred intensity, he went on to say "We also found that mind-body exercises, like Tai Chi and yoga, had the most significant impact on memory, while exergames -- such as Pokémon Go -- were highly effective for general cognition. This is an encouraging finding, suggesting that engaging, low-impact activities can offer real cognitive benefits."

To make things even better, the effect came on fast - with clear gains noted in 30-90 days.

There is no body-mind connection...it's all one thing. Find an excuse to MOVE...and drag everyone you care about with you.

Have a great weekend,
Mike E.

Mar 21

"Biological Aging" is a way of measuring the rate of change in our genetic material as compared to statistical norms. It has grown from an idea (circa 2013) to a more accurate way of predicting our health trajectory than chronological age (years alive) because it can account, at some level, for the variety of exposures to risk we have (or haven't) had through the years. To use a mechanical analogy, if our chronological age is our "model year", then our biological age is something closer to our odometer reading or multipoint inspection. Both are important, but the biological age may give us a better idea of how hard our years have been on us. "GrimAge" is one of the models that stands out for the accuracy of its predictions.

There are many factors known to influence our biological age. In 2025 alone, more than 100 studies have been published on the topic, with age accelerators ranging from environmental exposures to lifestyle patterns. Whether adverse childhood experiences, growing up around smokers and/or in economic stress, or exposure to heavy metals, it's clear that the environment we live in matters. Regular, unresolved stress takes its toll. However, our day-to-day choices also factor in significantly. Our movement patterns (or lack thereof driving muscular losses), our dietary patterns (especially fiber consumption), and our sleep patterns (especially as we age) all relate to our biological age about as we might expect. Trading movement for screen time, stepping back from sugar and opting for higher quality carbohydrates (defined as a better carb-to-fiber ratio), and working to develop good sleep habits all help. However, a study published by a team in Switzerland last month may be a help in understanding exactly how much benefit can be gained by making a few small changes.

As part of the "DO HEALTH" study, a multisite randomized controlled trial of more than 2,000 people truly in their golden years (that is, healthy and active at 70 years or older), researchers split the group in order to test two commonly advocated dietary supplements alone, combined together and in combination with a simple strength training regimen to determine whether, according to the biological aging score, they could slow the biological clock. In order to tease out the effects, they had to break the group into 8 subgroups:

Group 1 took Vitamin D and Omega 3 fatty acids and completed simple strength exercises

Group 2 took both supplements but didn't exercise

Group 3 took Vit-D + exercise

Group 4 took Omega 3s + exercise

Group 5 took Vit-D only

Group 6 took Omega 3s only

Group 7 took exercise only

Group 8 took a placebo

As it turns out, it worked. Omega 3s (sourced from algae) had the strongest stand-alone effect, slowing biological aging between 2.9 and 3.8 months over the 3-year lookback period, however, the effect was even stronger when Vitamin D and exercise were also on board. 

While we normally "spring ahead" this time of year, maybe 2025 is the year when we decide to slow time down a bit...at least on the biological clock. The "recipe" may be as simple as: (1) step away from the screen and (2) into moderate sunshine (Vit-D). Grab some tools and (3) turn over the garden until you break a sweat (exercise). (4) Plant and tend to some fresh stuff that's loaded with fiber and when your bounty is ready (5) try Algae Oil (Omega 3s) in your vinaigrette. (6) go to bed knowing you've just put a bit more gold into your golden years and, of course, (7) do it all again all Summer long.

Have a great weekend, and Happy Spring,

Mike E.

Mar 7

Saving for the future can be a tricky business. Most everyone believes it is important and that when it comes to answering "how much should I save?" there is a general guidance that is tried and true: "anything is always better than nothing, but more is probably better". This doesn't make it any easier. At some level, saving requires delaying (or deferring outright) what we want now for the promise of something better in the future. This is not only a self-discipline or mental-toughness challenge, it's a physiological one. Our brains have been honed over generations to look for, detect, and avoid short-term threats, but they are not as well-tuned to long-term forecasting. Combine this with our natural curiosity and the ultra-modern-double-edged-sword of having whatever information we want, in whatever format we want it, at our fingertips instantly, and the risk gets real. While social media scrolling (whether for laughs or on the slippery slope of doom) has often been implicated as making things worse, the speed of artificial intelligence, which makes life easier and faster, may come with strings attached. There's a brain-chemistry and plasticity thing going on here, and it's important.

If we consider for example the landmark "marshmallow studies" from Stanford published decades ago, which asked preschoolers in the 70's to delay eating a treat (now) in order to double their reward (later) and then showed that those who waited did better on a variety of measures years in the future including achievement and stress management as well as health measures, having a saver's brain could be powerful. If we compare those ideas to the results from studies like this one from 2023, which showed a negative impact on brain activity and development trajectory in American 12 year-olds who habitually checked social media platforms as compared to peers who didn't (including more activation in stress-centers of the brain in those who "checked"), there could definitely be a risk of trading away our future for the bliss of the now. While some more recent attempts to replicate the marshmallow studies have shown a less powerful effect, animal studies that required delay to increase rewards have shown a definite brain chemistry (dopamine specifically) change in those who "practiced" waiting. The most important question for our future selves and possibly our children might then be, "How do we start building the structures that lead to a saver's brain?".

One powerful answer might be - the same way we build most healthy structures - MOVE, FUEL, RECOVER. For example, this 2022 study showed a significant link between physical activity and fruit and veggie consumption and life satisfaction (happiness), using delayed gratification measures to show the contribution that doing so for a better tomorrow made. This 2024 study, which showed a powerful connection between sleep health and difficulty delaying (impulsivity), adds the third leg of the stool. But where should we start? A brand-new preliminary study out last month, which will be presented at the American Academy of Neurology in April, suggests the best first step might be, well, more steps.

When the research team looked at the data from more than 70,000 individuals who wore activity trackers they found something simple and powerful - those who moved more and sat less, even enough to burn only a few extra calories per day, were as much as 40% more likely to have healthier brains and better sleep than those who didn't. How much is a few extra? Well, as stated in the press release "The people who did not develop any of the diseases had an average daily moderate to vigorous physical activity energy expenditure of 1.22 kilojoules per kilogram, compared to 0.85 for the people who developed dementia, 0.95 for those who developed sleep disorders, 1.02 for stroke, 1.08 for depression and 1.10 for anxiety.". To put this in terms most of us understand, 1.22 kilojoules is about .3 calories, so for a 200 lb (90 Kg) body, that's expending enough energy to burn about 27 calories per day...which can be done in 2-3 minutes of cycling or 7-8 minutes of brisk walking.

If health is an asset, the time to start banking minutes of MOVE is now. It should be hard enough to break a sweat, but doesn't have to feel like torture. Even a few minutes invested now can produce meaningful savings in the future.

Have a great weekend,

Mike E.

Feb 21

I got a video this week of my nephew and Godson readying for one of the most daunting challenges an American 20-something can face, his final "haircut" before stepping into the legendary training that earns the very very few the right to say "yes" when the very very best, whether Sea, Air or Land, are called. It had him all smiles, but it conjured up another emotion for me, one that is filled, strangely, with both worry and pride. It's a mix that sort of short-circuits a parent's brain, which for me was in June of 2022 after a very formal, "you have 60 seconds to say goodbye", which still rings in my ears and pulls at my heart. It's an emotion I'm certain my sister and brother-in-law are wrestling with now. 

Little did I know that 3 years later (this past Wednesday), as part of my regular evidence search, I would find a study in which my child had taken part that looked at physiological and mindset variables that might predict injuries during the rigors of training. The researchers looked at physical factors (physical performance testing), mindset factors (self-efficacy, aka the extent a person is confident that they can succeed), injuries on-board (whether recovered fully or not), demographic differences (age, sex), anthropometrics (height, weight), athletics history (varsity athlete vs club athlete vs other) and personal goals of 781 cadets and tracked them throughout the initial phase of training. 

 In a previous (landmark) study from nearly 20 years ago, the psychological factor "grit", which is defined as "perseverance and passion for long-term goals" was shown to be a strong predictor of success in this setting, whether getting through the initial training or on the longer time horizon, such as graduation. In 2014 and again last year, grit was shown to be a strong predictor of success, suggesting that mindset and mental fortitude were some of the best tools we have to get through hard things. Interestingly, however, and perhaps a bit boring by comparison, which might explain its lack of headline attention, aerobic fitness & power was right there too...shown to be equally (or even more) powerful in predicting success. In study after study, including this most recent one from January, which looked at predictors of musculoskeletal injuries, cardio-respiratory fitness, in this case measured in a 2 mile run, was the strongest predictor after accounting for all variables. It doesn't take the worry away, but having talked with my nephew about some of the run, ruck, and swim fitness prep he has been doing in his lead-up to this next endeavor, based on the science of what predicts success, he is well prepared.

Most of us won't be training as an elite soldier this year, but any of us can choose to approach the challenges we face with the same physiological and psychological tools being used by those who are. March will be here soon and with it, the ramp up to hotter temps, heavier work, and the fatigue and injury risk that comes along for the ride. If you are not preparing already, now is a great time to start. If you need ideas, reach out anytime.

Have a great weekend,
Mike E.

Feb 7

It's been said that it takes 21 days to establish a new habit, a narrative many people have heard of. It has also been said that this is largely a myth originating in an old text that described in a very rough way, how long it took for a person to adjust to their "new look" after a serious plastic surgery, making it pretty far out of context regarding lifestyle change. One team which, more than a decade ago, actually put this idea to the test, found that the time required showed high variability (from 18 to 254 days), but that most people had achieved a level of automaticity by day 66. For us, now around day 25 of this 30-day effort to monitor, learn from, and ultimately better manage blood glucose, it is definitely getting easier, but not yet automatic. However, it's also getting easier to hyperfocus and perhaps even over-prioritize what we are seeing. I can't be sure the statement "what gets measured, gets done" is always true, but it seems to fit pretty well here.

This week, we implemented the final hack in our 4-hack protocol, a "savory" breakfast. Ultimately, this means shifting the profile of the first meal of the day to one that is lower in carbs and higher in protein, fats & fiber while still avoiding the trap of ultra-processed options, which might help the numbers or the narrative but lose the point of doing so to improve health. This took some creativity, especially for Lindsay, who, as a "mostly plant-based" eater (i.e. eats fish and occasional dairy-based cheese but otherwise no animal products), had fewer choices to work with than me (occasional meat, but will eat eggs for example). It really brought to light some of the complexities in using a dietary approach to improve health - getting the benefit of making a change in the right direction without letting convenience dictate the choice is not easy. We found ourselves making use of refried beans, which have a much more balanced carb-to-fiber ratio of 3 (less than 5 is generally "good") as well as higher fat and protein, along with veggies that pair well like peppers, onions, and baby spinach to make a tasty "skillet". This was definitely a shift from our more standard but still generally healthy fare - rough cut oats with berries, almonds, etc - but the difference was significant. There was almost no spike of blood glucose, and we each noticed we were less hungry for longer as the morning progressed.

As we compared notes and readings, it launched us into a conversation of whether this shift might tip the balance of our eating profile toward too much protein and fat, which can come with its own set of problems. It's reasonably easy to see how this could happen to anyone who loves a challenge or sees an improvement in the mirror, on the scale or in other metrics. Thankfully, we found that compared to general guidelines, our baseline protein intake was at the lower end of the healthy spectrum, so we were safe to bump it up a bit, and this might even be a good change to try to keep in order to stay closer to the ideal. We also found that, 25 days in, while these changes aren't automatic, it feels a lot less like we were limiting ourselves or missing something. It's possible that in line with this 2011 study (which we now know is likely related to gut microbiome changes) - our cravings do shift based on what we are eating and what bacteria we are fueling. After the initial period of missing them, it's gotten a lot easier because the simple-carb gremlins call less loudly. Lindsay, for example, has found the right snack combination in a green apple with peanut butter and some (no-sugar added) granola.

 Another super interesting finding this week for me has been in my internal dialog. I've known for a while about the Japanese idea of "Hara hachi bu" - which essentially is a tactic to avoid overeating, of striving to eat until no longer hungry (80% full), which of course is different than eating until 100% full. It's always sounded like a great idea and makes a ton of sense for those of us who could easily over-consume and suffer the health consequences of doing so regularly, but it also always felt unrealistic to me. I LOVE to eat, not only the experience of the meal, but in having a moment to share the table with people I care about. Family dinner, which doesn't always come to fruition in a busy life, is a sacred thing, and wanting to extend the time "at the table" makes it SUPER easy to eat and eat and eat. This week, I found myself more able to untangle that mental knot. During the experiment, I have found on multiple occasions that eating a "big meal" (even bigger portions of an otherwise healthy meal, unfortunately) was far more likely to cause a spike on the glucose monitor. Seeing that spike has given me the prompt to ask myself how I was feeling at that moment and take a few seconds required to think about my body's "answer". While normally I'd just ignore and push through those sensations to the next thing on my list, this week I found myself far more in tune with internal signals (interoception) and feelings of fatigue and even brain fog in those moments which made it a whole bunch easier to equate "not feeling full" with "feeling good" in my mind...and maybe it's working: compared to the 30 days "pre-experiment" my exercise minutes per day are up 2.5X, my step counts are up 1.3X, my number of good night's sleep (using Garmin Body Battery as a proxy) are up 1.7X and I'm closing in on 10 lbs of body weight lost.

What's the bottom line this week?

Learning about how food and movement are impacting our glucose has set us up for a solid exploration into habits, tendencies, and even internal dialogs. It hasn't been easy to zoom out in order to avoid too narrow a focus on only 1 (of many) health indicator(s), but in a time and place where excess sugar seems almost unavoidable, zooming in for a little while has had its benefits. While the data definitely isn't perfect and, therefore, I'd recommend working with your doctor to get a calibrated sensor for anyone who is at high risk (pre-diabetes, etc), it has definitely been enlightening. We're in the final stretch now; my sensor has 5 days left, and Lindsay's has closer to 10 (after the malfunction we talked about last week), and so now will be the time when we test a few other things that weren't squarely in the list of 4 hacks. We'll wrap it up next week - thanks for reading along.

Have a great weekend,
Mike E.

Jan 24

If last week was the "setup", this week we're "in the thick of things". To recap, Lindsay (my wife) and I have pledged to wear a continuous glucose monitor for 30 days and trial a handful of strategies (1 every 5 days) known to support better metabolic health. The hope is that by smoothing the spikes and drops of blood sugar that tend to be exaggerated when we consume highly processed and/or sugary foods, and therefore lead to both energy drain now and health and injury risk in the future, we will learn something, feel better and maybe see some beneficial outcomes. The first 5 days were to establish a baseline with the first "hack" - vinegar consumption before our biggest meal of the day, in our case dinner - added at day 5. All types of vinegar are known to blunt the sugar spike through a variety of mechanisms, but we chose apple cider vinegar in hopes it would taste a little better.

We've already learned a ton...but here are a few of our biggest takeaways so far:

1. Seeing Is Believing - Seeing the rapid rise and drop in blood sugar has made it MUCH easier to question, think about and ultimately change eating and snacking habits that aren't ideal. For me, it has meant quickly abandoning the honey in my cup of sleepytime tea before bed - a sleep hygiene habit I lean on to remind myself to slow down before trying to actually sleep. Now, to be honest, this one made me a little sad. As a beekeeper, I have grown to LOVE honey and as a health professional, I'm partial to the evidence that says it actually helps blood sugar control (among other great health benefits). However, the takeaway was timing. Having a sharp rise in blood glucose right before bed was not ideal...and so, while I still use and enjoy honey in tea, I just avoid it before bed. Anecdotally, my sleep quality according to my Garmin's sleep score and HRV, has trended in a positive direction since going to bed fully empty...always a welcome improvement.

Lindsay's take: "Using the monitor has definitely had an influence on food choices - I have altered what I eat because I want to avoid spiking or going above my upper threshold.".

2. It's Nuanced....and could easily be misleading. Metabolism is complex; we want it to be simple, straightforward, and maybe even easy to influence, but it isn't. Foods can be BOTH generally healthy AND still cause blood glucose to rise rapidly (certain types of fruit for example), while other foods that might generally be accepted as "less healthy" can actually blunt the sugar response. So there are definitely priorities to consider. For example, seeing the flattening of the curve or even drop in blood glucose after having a beer or glass of wine was surprising to me...even after being told to expect this exact phenomenon from a friend with experience in monitoring. While the mechanism isn't super well understood, the effect has been documented, especially when alcohol AND sugary meals are combined. Some suggest it is the liver effectively "slowing" its blood glucose functions in order to "switch on" and prioritize the alcohol processing function - not necessarily a good thing.  We had dinner out over the weekend and I had a black bean burger, fries, and a couple pints of Guinness...not a healthy meal per se, but certainly not the worst combo on that menu. And, you know, it's for science! Seeing the difference in my blood glucose overnight that night compared with my typical was a jolt. It was high (for me) all night long.

Lindsay's take: "I was surprised to see such a minor jump from a glass of wine. I guess I expected it to really spike my readings. However, seeing the delay, with a spike long after eating and even while sleeping has been super interesting and something I hope to understand better when this is all over."

3. Exercise is REALLY impressive - whether it's strength-oriented work which taxes and primes the muscles to "soak up" and use sugar or aerobic effort which quickly burns what is available, the effect has been strong and obvious. This is not meant to let the cat out of the bag on "hack 3" which is more about the deliberate timing of movement, it's been unmistakable even as part of our normal routine. I suppose it's not a huge surprise, the effect is well documented, especially when both strength and aerobic exercise are combined, but knowing that almost any routine movement can induce a blunting effect (even something as low intensity as stretching) is useful in the more wholistic effort of feeling energetic throughout the day and making a small investment in future health.

Lindsay's take: "I was surprised how strong the exercise effect really is. Strength exercise has been especially impressive for me, but even a light walk makes a notable difference in the shape of the curve."

4. Not the tastiest but still kind of cool - As expected the vinegar + water preload hack isn't particularly tasty. We've been using a ratio of 1 tablespoon of apple cider vinegar to 8-12 oz of water which waters it down just enough to be palatable and easy, but not something most would look forward to. The results however have been pretty cool to see. Instead of a rapid rise after eating, the blood glucose curve seems to either slowly climb in a gradual but steady pattern - as if it was giving a more sustained release effect - or bounce up and down a little if the meal was heavier in carbs.

Lindsay's take: "Kind of gross and it hasn't been as strong as exercise for me, but the effect is pretty consistent and easy enough to do".

We are now onto hack 2, which is to change the dinner preload to low glycemic veggies (fiber first!), and will move the vinegar to lunchtime so we can, at some level, compare. The devices are living up to daily life so far (they're estimated to last 15 days per) and, although I'm sure it'll be easy to slip backward when the data isn't staring us in the face, there are some early signs of health risk improvement (weight, body fat %, etc). Super interesting stuff so far. Stay tuned for more.

Have a great weekend,
Mike E.

Jan 10

It always feels so validating when a major news service points to the same essential message as we do here. This time, it was the New York Times in their New Year's series on health and wellness, which featured a couple of articles (here and here but unfortunately both behind their firewall) covering the topic of how to live healthier for longer, with both scientific evidence and interviews with experts. 

In one article they pointed to a really cool study from last year which looked at the health records of nearly 1M US service veterans' to determine the full potential of a healthy lifestyle. That is, they looked at the number of years of life gained (on average) in those who followed an "ELEMENTS+ Lifestyle" throughout adulthood and found that the investment paid off in about 2 decades of extra years of life. Said another way, those who did the hard work of Move, Fuel, Recover, Endure, Connect (and stayed clear of unhealthy add-ons like alcohol, tobacco, and drugs) on average gained 2-3 years per habit resulting in 20 extra years for men and up to 24 extra years for women. Said yet another way, and although NYT was careful to point out their belief that "super agers" (those who will live to 90's and beyond) likely have some genetic advantage, stacking all the same habits resulted in enough years gained to get the chance to meet another generation of the people we care about most - pretty amazing stuff.

For those interested in the specific behaviors that scored points the authors described it as "adhering to a whole-food, plant-predominant eating pattern, having regular consistent physical activity, managing negative stress, not smoking, having restorative sleep, no excessive alcohol consumption, no opioid use disorder, and having positive social connections". Specifics can be found on pages 128 & 129 of the study.

In the second article, they describe the "7 Keys to Longevity" which...although didn't use the same exact terms certainly got close: 

1. Move More

2. Eat more Fruits & Vegetables

3. Get enough sleep

4. Don't smoke and don't drink too much

5. Manage chronic conditions (blood pressure, blood sugar, etc)

6. Prioritize relationships

7. Cultivate a positive mindset

There's really no surprise here, the evidence on each is overwhelming. However, since just knowing something to be true doesn't make it easy to turn into a lifelong habit, the question remains - where should we start?

One doctor quoted in the article said "Do some version of physical activity...if you can't do that, then focus on being positive". Researchers at The University of Iowa Health Center might agree. They surveyed 7,000 patients on their movement habits, which they called the "Exercise Vital Sign" by asking 2 simple questions between 2017 and 2022.

1 - On average, how many days per week do you engage in moderate to vigorous exercise (like a brisk walk)?" (0-7 days)

2 - On average, how many minutes do you engage in exercise at this level?

They found that those who reported physical activity that achieved guidelines (about the same as the amount advocated above) had significantly lower odds of nearly 20 different diseases in the future. Amazing.

However, while getting "out there" for a walk might be inviting when the weather is gorgeous, it's easy to find reasons not to during a cold blast like the one we've been facing in many of our territories. What then?

Well, according to a research team who published findings showing substantial effects on the second target area for 2025 we identified last week, the microbiome and metabolic health, the answer might be Elderberry juice. 

In a randomized, placebo-controlled trial, drinking 12 ounces per day for a week significantly improved the gut and metabolic health of those studied. While, not nearly as well-studied as the more common but similarly low-sugar, nutrient-dense blueberry (perhaps because eating elderberries raw can be poisonous), the results showed a double-digit blood sugar reduction, a nearly double-digit insulin reduction, a significantly improved biome, and even some evidence which suggested a better ability to burn fat as fuel.

There are only 355 days left in 2025, the time to return to the groove is now.

Have a great weekend,
Mike E.

Feb 12

Being our best in the long term is really hard work. It takes a relentless drive to improve, a focus on the little things, and the ability to amass a vault of practice repetitions without extended setbacks from injury, burnout, or a variety of other obstacles. Maybe this is why there aren't many examples of people who've done it. Yet if we look back, even as far back as 8 decades, we might be surprised at how steady the fundamental formula has been.

Dive in to learn more.

________________________

The Rest of the Story

On the one hand, as a LONG suffering Miami Dolphins fan (last playoff win 20 yrs ago) who grew up spoiled watching Dan Marino do amazing things, it is VERY hard for me to type the next statement.....Tom Brady may actually be the greatest quarterback of all time. Winning a SEVENTH Superbowl at 43 years old, taking a team of mostly non-stars (1 pro bowl selection) who were on track for a good (but not great) season in terms of wins and losses at the midpoint and leading them to wins over multiple opponents who they had previously been beaten by and turning it into a Superbowl championship run is impressive work. Sure, he's only one person on a team of great athletes, coaches and staff, but on the other hand, as a person who is absolutely fascinated by top performing people who do it consistently over the long term, I find stories like Brady's, or Deena Kastor who set marathon records into her 40's, or Josh Waitzkin's who essentially did the same starting with chess (remember the movie?) and then in martial arts (really!), to be opportunities to learn from the few who seem to get better and better wherever they spend their time and effort.

So what does it take to defy the odds like Brady or Kastor or Waitzkin?

Well if you like history and you go back to one of the most well-known self improvement books of all time (originally published in 1937), you will very likely find some outdated ideas, word-choices and syntax. After all, the world has changed a bunch since then; but you might also find yourself intrigued by the staying power of some of the simple fundamentals like the "QQS" formula which boils down to: doing things right (Quality) as close to every time as possible (Quantity) which, when combined with a positive & growth oriented attitude (Spirit), yields amazing results.

Fast-forward 80 or so years and contemporary experts suggest some incredibly similar things:

1. Quantity - The idea of balancing "load" and "recovery" is not new; we talk about it a lot because it's the basic foundation of just about every growth activity for humans. When it comes to strength training, we overload the current capacity of our muscles to stimulate growth BUT THEN we back off and let a full recovery happen. If we don't overload a little? No growth. If we don't recover fully? Less growth. It's not just the hard push-forward, it's the pull back that lets us attain performance longevity. Just ask Kastor who is known for logging a massive number of miles in training - as many as 140 running miles PER WEEK! If that sounds intimidatingly huge, that's because it is. How'd she'd get there? She built up to it with ebbs and flows:  "She describes this system, visually, as a “roller coaster.” Her weekly mileage might go: 70, 80, 75, 90, 80, 100." - any of those weeks are intense, but maybe the most impressive thing is that if we give the body a chance to pull back, it can do impressive things.  

2. Quality - because quantity alone is never enough, doing the little things right matters. A few years ago (after winning the 2017 Superbowl), Brady said "When I was 25, I was hurting all the time, and I couldn't imagine playing as long as I did, just because, you know, if your arm hurts every day when you throw, how can you keep playing?". Maybe he has the perfect genetics for American Football... or maybe he's onto something in trying to put in a steady high quality effort at staying healthy. I'm admittedly skeptical about some of the specifics he adheres to, but the way he approaches it, deliberately with intense focus on improving, is almost definitely a big part of what's worked for him multiplying the effect of the volume of effort alone. After all, the often hyped 10,000 hour rule of mastery (if you read the some of the original work) was never only about the amount of time logged but the exacting nature of the practice itself....."how" it was being done, deliberately was the game changer.  

3. Spirit - How does a child prodigy in a mental game like chess become a champion athlete/coach in an entirely different (physical) game in one lifetime? Well if you ask Waitzkin who achieved both of these things before midlife - the answer is that winning is a learning process first. In his 2008 book on the subject, Waitzkin makes it clear that learning for him is about getting outside of his comfort zone.....which often means doing the hard things that he knows will ultimately improve his results: “Growth comes at the point of resistance. We learn by pushing ourselves and finding what really lies at the outer reaches of our abilities.” Ask Carol Dweck, one of the world's experts on achievement through mindset, and you'll find a remarkably similar concept.

Of course, Brady, Kastor, and Waitzkin are not experts in what it takes to be safe or healthy in all domains. Throwing a football, running a marathon and dominating a chessboard are not the same as dodging strain risk, working long hours in sometimes harsh conditions, or strategically navigating through the complexities faced when working with industrial grade tasks and risks, but the principles are remarkably similar... at home, at work, and in life.

Performance longevity is not easy. It takes a focus on quality, a willingness to endure large volumes of effort, and a mindset that seeks out continuous improvement.. Some measure it in championships or records set... others measure it in healthy and safe days, everyday, season by season... culminating in the "wins" of more time doing the things that matter with the people we love.

We are +/- 60% through the Winter. Keep growing.

Have a great weekend,

Mike E.

Jan 29

Are you a dog lover? If not, do you know someone who is? If so, you may have heard of the term "zoomies", or even seen it in action. It's those times average Fido morphs into Super-dog, bursting at the seams with energy - running around uncontrollably or wildly chasing its tail. Of course, the AKC tells us there's a technical term, Frenetic Random Activity Period (FRAP), but it's not nearly as fun as "zoomies". Entertaining as it might be to watch (if youtube videos over 1 million views can be used as evidence), the reason why dogs click into this behavior, to release energy and work through stress, is something we can learn from... which, as we wrap up January 2021, gets us to our final micro-resolution, number 5.

The Power of Zoom

As a social species, we are made up of bonded individuals (families, tribes, organizations, communities, etc). We're not exactly the same as the family pooch, yet in some ways we are remarkably similar. One of those ways is how we achieve the right balanced/rested state we need to thrive. Just like a lack of energy (fatigue) is not ideal for our overall performance and risk, too much energy (or too much of the wrong kind), is also not ideal. Our bodies are built with a variety of control mechanisms, some involuntarily happening in the background while others are triggered by things in our experience. The state of the world and the continued need for distancing make it easy to feel a bit disconnected - physically (solitude), mentally (lonely) or even spiritually (seeking greater purpose in a challenging world) which can leave us feeling out of balance - but, just like the dog who finds a way to get all that pent up energy off the system - there are things we can do.....even without running around in a frenzy.

With that in mind, here are a couple "human zoomies"- ways to add or release energy as we work toward building longer term healthy habits:

First Zoom Out - CONNECT with the world around us. How we internalize the world around us (which is at the root of whether we are energized or disengaged) starts with how we receive and filter the information coming in. Each of our senses matters here. What we see, hear, smell, taste, and touch informs our reality as information passes through the filter of our personal experiences. Excessive inward (self) focus tends to inhibit our performance as shown in a classic 30+ year old paper on public speaking. Practicing an outward focus - putting our attention on what is happening around us in a highly objective but non-judgmental way (facts only, no interpretation) takes focus and energy. If recent studies on the brain activity of highly skilled meditators are accurate, it may even remap the default "idle" setting of our nervous system. If you've got the chance to do so "out there" and enjoy some nature in the process, even better. Combining the health and well-being benefits of physically being in nature (aka forest bathing), even in the winter with the outward sensory focus is a potent combination.

Then Zoom In - CONNECT with ourselves. If you tried the Positive Affect Journaling (PAJ) exercise I profiled last week you may have noticed it takes a real effort to look inward and dive into the details of the day and how it all played out. For many of us it feels easier to get stuck on the negatives and threats. Without diving too deep into why this type of thinking may have been an imprint handed down from our ancestors, what we now know is that having a structured approach to work through those thoughts, see them for what they are but not more than they need to be, a process called cognitive restructuring, can have an impact. Using a "What am I thinking?" exercise, as found outlined in this document can be a benefit. You might be surprised how the technique can help us tackle a variety of challenges - like building an exercise habit - which, with some emphasis on core strength for the abdomen and lower back (as discovered in this fantastic 2016 study) can have an extra large and direct impact on our stress response.....bringing us full circle to resolution 1 - short bursts of MOVE.

There's a lot there.....but if instead you just want to follow the dog's lead, to "let go" and spin around in circles, we'd suggest a dance party (because it works!) or at the very least, making sure the area is safe.....of course, we'd also like to see the video :)

We are nearly 45% through the winter, keep moving strong! 

Have a great weekend,

Mike E.

Jan 15

We started off January as many do - with a focus on change.....not monumental change of the transformation variety, but little things, micro-resolutions, that have powerful evidence backing them up in hopes to march strongly through the winter and come out safe and healthy on the other side.

Week 1 we covered MOVE - and talked about how even 1 minute of stairs could make a difference.

Week 2 (last week) we dove into FUEL - and gave a hat-tip to "the most important meal of the day" with a special focus on the evidence related to oatmeal's ability to counteract cellular stress.

This of course gets us, right on track, to RECOVER and a micro-resolution that, with some boiling water and 10-15 minutes per day can have an impressive impact on several health markers. It starts with a flower that looks a lot like the common daisy. After a bit of drying and maybe some additions for flavor, it is steeped in hot water for up to 5 minutes to produce a pretty impressive (and widely available) cup of warmth known to all of us as "Chamomile Tea".

Maybe you've heard that Chamomile Tea has some medicinal properties - in fact, it does. There is some interesting evidence that it can be a help for those who may be struggling with type 2 diabetes when taken after meals. It also appears to have a calming effect when we are feeling stressed. In this study, which included multiple years of follow-up, using chamomile tea as a self-management strategy for generalized anxiety disorder made a difference. It's also been used for its antioxidant, anti-inflammatory and in some cases (topically) even pain control capacity. 

Q: So how can we get the most from this humble little tea as a micro-resolution?

A: Consider carving out 15 minutes per day to boil the water, steep the tea and mentally process your day.

There's no wrong way to inject a few minutes of calm, it can be done anytime, the key is being intentional about it. Rather than just consuming it, take the time to slow down and have that be the full focus of your time. If you really want to go all in, consider putting this in the time slot that is 30-60 minutes before bed as a reminder to cut back the bright lights/electronics/etc. - a really powerful way to ready the physiology for rest.

Next week I'll touch on a way to double up the habit with some techniques that are particularly good for those who may have a hard time getting to sleep.....but for now, just enjoy the tea.

We're +/- 30% through the winter - stay strong! 

Have a great weekend,

Mike E.

Dec 31

Maybe it's a yearly tradition for you. Maybe you never do but somehow this year has been enough of wildcard that you're going to dust the old concept off. Maybe it'll be the start of something entirely new. Who knows where it could take you.

Yes, of course I'm talking about New Year's resolutions. Not whether they work for everyone (spoiler, even though change was 11 times more likely stick when a resolution was made, resolutions work less than 1/2 the time) but rather as a tip of the cap to those who are going to make an effort.....and to give a few ideas to those who are on the fence. After all, sometimes the hardest step is the first one.

Resolution 1: Take the stairs, 4 times in a row

In 2018 an interesting finding was reported by a cardiologist in Spain. In more than 12,000 individuals tested and followed, those who did not have the fitness capacity to walk up 3 flights of stairs "very fast" or 4 flights of stairs "fast without stopping" were approximately 3 times more likely to die of heart disease or cancer in the following 5 years when compared to those who could.

The elegance of this finding is in its simplicity. Stairs are not specialized fitness equipment. The whole thing can be done in a minute or so. The pay off, although not surprising since fitness capacity has been connected to MANY risks, is pretty huge.

The drawback (and some of the criticism at the time) however was in quantifying what "very fast" or "fast without stopping" meant. This left people wondering - was their version of fast, fast enough?

Well, now, almost exactly 2 years later, the findings have been refined in a smaller subset of patients. As it turns out, the ability to climb by walking (but not breaking into a run) four flights of stairs (approximately 60 stairs) in less than 1 minute was an important risk-lowering threshold for cardiac issues, with 45 seconds or less the lowest risk. 

Health-geek-speak: I will achieve at least 8 METS of fitness capacity in 2021.

Resolution Translation: I will do at least 1 minute of stairs most days of the week, stopping for rest as needed, until I can do at least 60 stairs in under a minute without stopping.

_________

Need some additional help making it stick?  Here are some good tips on how to make the process work for you.  

We'll bring you another one next week!

Happy New Year, have a great weekend,

Mike E.

Dec 18

Well, it's here.....and unfortunately it's a bit ahead of schedule. If you're sitting anywhere near the eastern states you know that the winter weather arrived a week before the official, 12/21 kick off of winter itself. 2020 continues to keep us on our toes.....and, we all continue to work hard to stay on the right side of the risk curve with the near-term goal of winning the Winter season by staying healthy, safe and strong!

To do that, over the last couple weeks, I've tried to highlight some of the MOVE and FUEL strategies that can help us along the journey toward winter-ready. As a recap under the header of MOVE this means improve the efficiency of blood flow circulation throughout the body (fitness), improve the elasticity and responsiveness of working tissues (mobility/flexibility), ready our natural anti-fall tactics (stability) and work to monitor and manage fatigue during the 10-20 day acclimation phase. In the FUEL column this means minimize the negative performance effects of "drying out" with an eye toward hydration, eating foods that are known to help the body improve energy production efficiency (omega 3's impacting mitochondria) and lessen the workload on the engine whenever possible (beets, leafy greens and other sources of dietary nitrates) especially during the ramp up of acclimation.

But what about the 3rd leg of the ELEMENTS stool? Are there ways to RECOVER better to minimize the impact of the cold stress now and it's known link to pain/injury/disease even in the future? The short answer is YES.....but here are some of the specifics:

1 - Respect your sleep: This study showed a significant difference in the body's ability to tolerate cold after a period of sleep deprivation. Said another way, the participants who were required to stay awake for an extended period had notable blood flow changes in their hands. The authors concluded that this would open the door to risk of cold-related injury. Another study showed very similar findings in participants who were not fully deprived of sleep but had shortened sleep for a week.

2 - Warm-up to Cool-down? Over the years the use of warm-ups before work (priming) and cold (icing) after hard work has been commonplace. More recently, the use of heat after hard work or injury, especially for muscles, has been gaining traction. Although this is not always appropriate (e.g. heating muscles after working in the summer), under normal or cold conditions, this may speed recovery.....so after a hard day's work, especially when the working tissues were fatigued in the cold, a hot shower and/or proper use of a sauna may be a solid way to speed recovery along.

3 - Massage. There are MANY different ways to speed recovery along.....sometimes movement, for example in the opposite directions you've been working, or as a little bit of gentle stretching after a long day or even (gradually) adding more load to stimulate strength are all ways of nudging RECOVER. But that's not all. Here is some good news for the massage lovers.....although it has limitations and isn't perfect in every situation, when it comes to soreness, massage can be a solid choice.

The holiday season is here. In some places Winter arrived early......but the concepts stay the same - give your body what it needs and it will thrive. Let us know if you need more specifics.

Stay warm & safe. Have a great weekend,

Mike E. 

Dec 4

It was an early 90's mystery horror drama series. It's the jargon term for when an endurance athlete tries to have not 1 but 2 "bests" in one season. And, if yours includes a goal of health and safety through the end of this roller-coaster called 2020 into 2021 and beyond, it's the awareness that getting through this part of the journey and coming out strong on the other side is especially important. 

If you've been reading along, you may remember our focus on the summer months as a "peak" season; a critical time to ready ourselves for the extra risk that comes with extreme temperatures and the accelerated fatigue risk that comes with adapting to the season. Although clearly at the opposite end of the temperature spectrum, Winter is more of the same. It is the high-risk bridge between calendar years, the final peak of this year and the first challenge of next all wrapped up neatly into 90 days. Depending on your geography it can bring equally extreme temperatures and the extra fatigue risk (especially during the adaptation period) along with the "bonus" challenge of slippery surfaces and less natural light which adds risk in some of our most common tasks like walking, standing and driving. 

Although there's probably no practical way to perfectly prepare for the colder temps [insert image of Rocky punching sides of beef], there ARE a few things we can do to put the odds in our favor.....and, like it or not, with less than 20 days until we start climbing this peak, if we're going to be ready, now is the time to start. With that in mind and since we can't go wrong with the 3 legs of the healthy-action stool: MOVE, FUEL, RECOVER, we've decided to dedicate the next 3 prep-weeks to the most important levers.

Prep-Week 1: Start with MOVE

"Pre-winter" is a great time to reassess what body parts are a little stiff/sore, whether something that "should" be free and easy seems like more of a struggle than expected and when needed, to begin shifting focus back toward the components of a "solid base" that a successful 2021 can be built on. There's no wrong way to do this, but usually controlled-mobility, aerobic efficiency and whole body strength are near the top of the list. 

Look ma', no hands!

For most people a good starting point to assess controlled mobility is the ability to get to the floor and back up again with little or no use of hands (sitting-rise test). It's not perfect and it certainly has its critics, but on the whole, it's quick and repeatable for most people and with a little space and a soft surface can be done safely in the comfort of home. Can you do it?

Test the engine

When it comes to fitness the ability to cover a mile (walk/run) in 15 minutes or less (Rockport walking test calculator) is a solid gauge. Of course, faster is generally better with both maximum aerobic capacity and maximum walking speed well-studied indicators of overall health, but for most people the ability to achieve 10-15 metabolic equivalents of task (METs) tells a good story.

Ups, Ups and Away

With no consensus on a simple and effective test, strength can be a little tougher. For men (as it has only been published on a sample of men so far), the research on push-up capacity, a great snapshot of upper body strength (which says 40 is a major threshold), is compelling and a great starting point for change. For both men and women, hand grip and leg extension have been shown as strong predictors but in most protocols it requires a handgrip or leg extension torque assessment for accuracy. However, some research says determining the maximum single leg step up height a person can do is a good estimate of total leg strength.

The bottom line when it comes to MOVE - like always - know where you're at and start making small but consistent steps in the right direction to lower risk.

More next week.

Have a great weekend,

Justin B

Nov 13

There's a LOT you can draw from 30 years worth of data which looks at the health of the people around the world. Although COVID19 has made it abundantly clear that we can (and do) share many of the same risks as our peers around the world, the data compiled for the Global Burden of Disease study (visualization tool here, full study here) makes it clear that some of our experience is uniquely American.

If we care about living a long and healthy life, some of these trends represent clues on how best to do so. Below are, in my opinion, some of the most important trends in the US Health experience that we should all know about.  

The Top Condition

In the United States, heart disease was (1990) and remains (today) the number one most burdensome condition. This is true globally as well. During the 1990's it climbed from 3rd to 2nd (2001) and then grabbed the top spot in 2005. With as much as 80% of heart disease considered preventable (ref) there is work to be done.

30 Years Later, Unchanged

Lower back pain (ranked 2 in the US, 8th globally) and Diabetes type 2 (ranked 6 in the US and 7th globally) are the only other top conditions that have remained unchanged in the US during this period.

Dramatic Increases in Impact

Opioid Use Disorder was the fastest growing condition jumping from a ranking of 27th to 4th since 1990. With lower back pain as common and impactful as indicated above, there is a very real reason to lower personal risk of injury and pain syndromes as well as acting early to make corrections when needed.

Top conditions on the rise

The following 9 conditions have all become more burdensome since 1990: COPD (3rd), Other Musculoskeletal (7th), Falls (8th), Major Depression (9th), Age-related Hearing Loss (10th), Neck Pain (13th), Alzheimer's (14th), Anxiety (15th) and Endocrine/Metabolic/Blood/Immune disorders (18th). 

Top conditions improving

The following 6 conditions have improved since 1990 but remain in the top 20: Lung Cancer (5th), Migraine (11th), Stroke (12th), Colorectal Cancer (16ht), Motor Vehicle Injuries (17th) and Breast Cancer (20th). 

Almost Victorious

Three conditions that were on the top 20 list in 1990 have fallen off: Lower Respiratory Conditions (22nd), Neonatal Preterm Birth (26th) and HIV/AIDS (59th)

The Most Important Takeaway

By far the most important theme is the fact that ALL of the conditions in the US top 20 can be impacted if not prevented outright.

If there's something on this list that looks familiar and you're not sure where to start, let us know.

Have a great weekend,

Mike E.

Oct 29

"Time is more valuable than money. You can get more money. You can't get more time." 

Uttered by an American entrepreneur who went on to become a mentor and motivational speaker, Jim Rhon touched on a critically important concept that we all must eventually wrestle with. When Pink Floyd approached the topic, they did so with a song called "Time" where they painted a picture of people realizing time was fleeting as they aged. Zac Brown Band captures it in a lyric that says "it's funny how time can make you realize we're running out of it" and an amazingly wide variety of well known authors, poets and leaders - from Marcus Aurelius to Henry Wadsworth Longfellow - have quotes to this effect....because time represents how finite our lives are, something that can be easy to lose sight of in the daily hustle......but what if we could get a little back?

In the darkness before the dawn on a long and winding commute that included a 15-20 mile stretch of poorly lit county road I fought the glare of rain in the oncoming headlights and the extra awareness of a driver behind me who seemed to think driving closer and closer to my bumper would help speed up the cars in front of us, I too started thinking about time too. Of course for me, it was far more practical than the artistic examples above. I was simply thinking "when is the sun going to come up?", figuring if everyone could see a bit better perhaps the driving would get easier and safer.....even for those who were in more of a rush than me.

As it turns out, this question is a part of the ongoing debate that peaks this time of year - the debate on whether there is any real value in Daylight Savings Time (DST) which comes to an end this weekend as we turn clocks back. The concept, originally proposed by an insect scientist (entomologist) named George Hudson who realized he could collect more bugs if he had more (well-lit) hours in the day, took decades to gain traction but eventually became the norm in countries across the world, including most of the US.

Of course he (and others) could've never known about the ripple effects of such changes. Along with better bug collections (which history says his was STRONG) comes sleep disruption and therefore stress on the system which, in a now advanced (and over-tired) world, relates to a fairly big spike in heart attacks on the Monday after the change in Spring. In addition, because it can take a few days to fully settle from sleep disruption of any kind (as some researchers suggest), means how we use this new found time, for up to the WEEK after the Fall switch, can be really important......which ultimately means, now is the time....to think about time.....and what we will do with our time rebate this go around.

What if we actually use the hour to regain sleep - that is go to bed at the same time and wake up later? Well, it seems there IS something of a counterbalancing effect. On the Tuesday following the end of DST, heart-attacks appear to drop by 21% nearly offsetting the 24% jump in Spring - HERE.

On the other side of the coin, what if we use the hour as a free pass to stay out later on Saturday? Well....although not as conclusive.....some research suggests it's not a great idea. Similar to what my gut was saying on Wednesday morning, it turns out traffic accidents DO appear to be impacted. THIS STUDY reviewed fatal motor vehicle accidents during these critical periods and it turned out that Sunday night in the Fall, when DST was ending, saw an uptick.

Of course it's possible that for some people this year, with the various pandemic related process changes, RECOVER has actually improved because commutes have been changed (or eliminated) adding some sleep hours to the cycle. It's certainly a new wrinkle in the DST "natural experiment"; a silver lining that would be great to find. On the other hand, the full benefit (and then some) could be eliminated by the many new stressors of living a pandemic life. Only time will tell.

However, in the meantime, we can each pause and think about time itself; to be mindful of it - and this is a great time of year to do so. Not to worry about how short it is......but to give us a moment to work through the strategies that help us to live fully in the short amount we get....including being diligent and safe in the week following the ending of DST, a time when an hour gained means a routine changed.

Make the most of the hour gained.

Have a great weekend,

Mike E.

Oct 16

Sometimes I wonder if it's as much about the ritual as it is about the chemistry. Either way, a steaming cup of coffee is the first thing many people, including me, reach for in the morning and throughout the day. How many? Well, most......like 150 million adults in the US.....every single day.

Here's the good news for the coffee lovers - whether you call it Java or Joe or anything else - drinking a reasonable number of servings per day can be quite healthy. From Alzheimer's and Parkinsons, to diabetes and weight loss, people who drink coffee tend to do better. Dive into this 2018 post from the American Heart Association to learn a bit more. Of course, there is a bit of a caveat with how you take it; the more you add (milk, sugar, cream, etc) the less benefit you get. So if you want the max benefit, black coffee is the way to go.

But that's not all. WHEN you drink coffee, especially if it has caffeine, matters too. As discussed in one review - research has shown that, although on the long-term coffee is known to lower diabetes risk, in the short term caffeinated coffee temporarily impairs the body's ability to process blood sugar - which is generally not a good thing, a double-edged-sword of sorts. For example, in a small study of otherwise healthy men, caffeinated coffee paired with a typical breakfast impaired blood sugar processing, something that didn't happen with decaf.

And, as if that's not enough....Very recent research showed that it gets even more nuanced when poor sleep is in the mix.  Slated to appear in the November 2020 issue of the British Journal of Nutrition, this study showed that caffeinated coffee taken first thing after a night of interrupted sleep significantly threw off the body's ability to process sugar the next time the person ate......even though interrupted sleep alone (without coffee) did not.

So, as we roll into Fall, cooler temps and (perhaps) the urge for more coffee, tea, etc - what does this mean for us coffee drinkers?

1. Coffee can be a health food - best if you drink it black

2. Because of the caffeine on-board, WHEN you drink coffee matters. With as much as a 10+ hours to clear from the system entirely, avoiding late afternoon caffeine improves the odds of full restfulness of sleep.

3. For those who are less efficient with blood sugar processing (diabetes, pre-diabetes or a similar history), consider switching to decaf coffee or (likely a good practice for everyone) try separating meals from caffeinated coffee by an hour or more to allow for processing time. 

4. One possible solution is to change the order of the day - placing breakfast early/first and coffee a bit later or substituting a healthy breakfast (e.g. smoothie) especially after a night of interrupted or low quality sleep to get things back on track. 

The next time someone describes the taste of coffee as "complex" you'll know why!

Until then, I hope you'll get the most out of each sip.

Have a great weekend, 

Mike E.

Oct 2

It seemed like a good idea at the time. A great way to honor the memory of a friend's Dad. A perfect way to get some fitness time in the books and my schedule opened up just right to make it happen - what could possibly go wrong?

It was Thursday of last week and somehow I was going to be able to squeeze a quick workout into an already jammed schedule. But this was no ordinary workout, it was a tribute workout, designed by a friend to honor the memory of his Dad. I never met him but as I came to learn, Cole's Dad Bill was no ordinary guy. He was something of a legend in his world, racking up a resume that put him near the top of the "all-time" lists for college wrestling coaches....but more importantly, his sudden passing had left a hole for a friend, something that if I could help fill I wanted to.

It just so happened that the scheduling stars were aligning, something got switched and I had some "found time" in my schedule.....not really enough, but enough to try I thought. So I did. The first three exercises were pretty reasonable - a short run, some squats and some weighted rows. I was breathing heavy but doing ok.....and then came the hang cleans....56 of them.

The combination of me rushing a little (time-pressure condition) and being neither super well-skilled with this movement (type) nor entirely ready for this volume (number of repetitions) provided a fantastic example of being on the wrong side of strain-risk formula: Risk = (Load * Conditions) - capacity. More directly, since the repetitions made the total "load" high and the conditions were not ideal, my capacity was not able to offset.....and my body let me know. 

By Friday I was getting sore, but it wasn't terrible. Saturday I worked in the yard and didn't notice much discomfort during the actual work.....but by the end of the day my elbows both started to feel stiff. By Saturday night I was noting some difficulty fully straightening them. My family poked fun at me as I looked a bit like something out of an old Western movie - arms ready to draw my six-shooter at any moment. By Sunday morning it had gotten closer to pain and I noticed some swelling....and with the discomfort still lingering on Monday I had gotten to the point of needing to decide if this was "hurt" (just discomfort from overloading) or "harm" (actual injury from overuse).

Making this decision is not always easy.....which is why we'd rather you just call us to help......but to dig a little deeper into the how-to, here are some of the variables we consider to make this decision accurately:

1. Discomfort - There was moderate discomfort: my body telling me something was not quite right. This meant I needed to pause and take a closer look.

2. Signs of Harm - There was minor swelling (puffiness) but no bruising or notable harm: the muscles were there and working like they should, just really sore

3. Function - Functionally I was OK: I wasn't limited in my ability to "do" stuff. I could grasp, reach and even do the yard work.....my elbows were just barking back

4. Movement quality - Movement was pretty good and only sore at the very end range (fully extended elbow): even better, if I took it slow and let it warm-up, it seemed to improve

5. Baseline Health & Habits - My baseline is generally healthy: I don't have any baseline health conditions that would slow healing down and no other reason to believe I was at further risk

6. RECOVER Potential - My ability to rest was high: As a person that doesn't have a heavy upper body job I could choose to take it easy and rest it a bit and nothing would stop me from eating clean & getting solid hydration over the next few days

7. Ergonomics - I knew how to put the ergonomics on my side: there are many tactics from postures to grip position that can off-load the forearms

With 7 different factors at play here (and potentially others) there are MANY combinations of how this could present - in this case more than 5,000 - making every situation complex. However, after considering mine I was confident there was - "discomfort but no injury".......a solid reminder to "think twice before trying to cram that kind of body stress into too small a block of time.  

The good news? It followed the pattern as expected - by Tuesday (day 5) things were improving significantly and by Wed, all clear. 

There are many factors at play when it comes to movement-related discomfort. Some we can control, others we cannot. If we consider them all and make decisions accordingly, we can often prevent injury.....for me a bit more time between efforts to rest or a slightly lighter weight choice could have made all the difference. However, even in situations where we overstep the thin line between mild and moderate discomfort, with some deliberate analysis and the right self-care we can bounce back quickly and strong.

Have a good weekend,

Mike E.

Sept 18

For his 18th birthday my nephew decided he wanted to try parachuting. Since he lives on the other side of the US we couldn't really be there to see it firsthand, but, as captured with a few well-placed adventure cameras, we got the chance to relive it through video only a few hours later. It definitely looked intense. The tension as they waited for the plane to reach a high enough altitude seemed somewhere between excitement and fear. I imagined the first time jumpers were feeling a little churning in their guts....their bodies questioning whether overriding certain instincts was a great choice.....and still preparing all body systems to "go".

My mind wandered a bit as I thought about how landing a parachute was a bit like the reasoning & diagnostic approaches we use when determining what's driving someone's ache/pain and what the best strategy is to correct it.  I went on to watch a few videos of the US Navy Leap Frogs, including one when a handful of jumpers landed inside the University of Tennessee's football stadium as part of a pre-game ceremony. It was clear that (1) they had a target, (2) knew about their starting conditions (3) they communicated back and forth clearly and directly in order to guide them as they (4) made many small adjustments along the way. Very similar to the way we strategized some knee pain someone was experiencing this week.

(1) We knew our target - pain free function; freedom of movement and job-task.

(2) We knew about our starting conditions - some increasing discomfort but no signs of injury and no loss of function (despite some discomfort)

(3) We communicated back and forth clearly and directly - and in doing so determined that in addition to mobility/strength changes, baseline inflammation was likely playing a role (this person had put on some extra weight around the middle, was a smoker, had a history of high triglycerides and in general had been running a sleep deficit recently....all related to higher inflammatory risk).

And then we jumped.

On the way toward the target, we've made several small adjustments and it is getting us closer and closer to a safe landing. The first was to ease into the movement recommendations (3 times per day was a bit too much and swung the pendulum too far so we backed it down). The next was to make a few lifestyle recommendations - we focused extra emphasis on sleep and trying to add at least 1 "green" meal per day (as getting right after some of the heavy hitting inflammatory levers like smoking had to be in the "someday" column as it was going to be too difficult in the current conditions).....and last, we made a tweak in the plan that he was a little surprised to hear.....drink more brewed Green Tea.

When you're way up high above the target it seems strange to think that it could even matter....but just like the churning in the gut of the actual jumpers, the connection between gut, brain and the knee is getting clearer all the time in those with knee pain. And when you're close to the target, the details can be the difference. We reviewed this 2019 research which clearly showed certain gut bacteria could promote and (when neutralized) relieve knee pain associated with inflammatory factors known to add to the knee pain experience. Diving a little deeper, one of the interesting ways to neutralize the bacteria and rebalance the gut, especially for men, was through the healthy-consumption of green tea.

It's a small tweak in our flight plan but here's the key take-away: joint pain is common (32.5 million Americans) AND complex. There are many little risks, some that seem impossibly small, which add up to the difference between the pain and/or health "experience". In order to unravel pain and achieve health (and therefore prevention), we often need to find and pull the right combination of levers to ensure we land on the target.

Green tea is not likely going to solve all knee pain......by itself (without mobility, strength, etc) it may not solve any, but under the right conditions and in combination with the right approaches, it can help enough to make a difference.

Have a great weekend: stay strong,

Mike E.

Sept 4

8 months in the books. Labor Day weekend is here and there are only a few official weeks of Summer left. With any luck, we are through the heat waves and the devastating storms. With any luck we have been stretched but not torn, challenged but not beyond our limit.

A person's "ability to manage and positively adapt to adverse conditions", known as resilience, has been shown to support both physical and mental well-being as we go through life.....and it is one of the critical strengths we can hope for during periods of prolonged uncertainty like the kind 2020 has seen.

With that in mind, and with a holiday that celebrates hard-working-people providing a perfect backdrop, now may be a great time to reflect on where we stand in this category and make some adjustments if needed. 

So how do you know whether you're resilient? 

In truth there's probably no perfect way to know, but we can get close by rating ourselves on the following 14 statements on a scale of 1 (strongly disagree) to 7 (strongly agree):

1. I usually manage one way or another  

2. I feel proud that I have accomplished things in life

3. I usually take things in stride

4. I am friends with myself

5. I feel that I can handle many things at a time

6. I am determined

7. I can get through difficult times because I've experienced difficulty before

8. I have self-discipline

9. I keep interested in things

10. I can usually find something to laugh about

11. My belief in myself gets me through hard times