Friday, May 31, 2013

Why I ask for your support and your money (it may surprise you)

Why Do I Ask You For Money?
For the last six years, I've been asking you for money. And giving my own away too, in support of the American Diabetes Association, mostly. And you've responded with enthusiasm! Over that time span, together, we've raised over $10,000!

This year - 2013 - is no different from the past few years. I'm asking you for money in support of my Tour de Cure campaign. I ride, you give. 100 miles, every one of them backed by your dollars. And they matter. But maybe not just the way you think they do.

Tomorrow I'll be once again asking for your support. One final big crazy event before this year's TdC on June 15th. Before that 100 mile ride, I'm going to ride 100 miles, going nowhere, on a stationary trainer in front of Denny's Central Park Bikes in Okemos, MI.

Inevitably, folks ask me: why? why do such long rides? why be so public about it? Here are a few good reasons:

1. I *feel* your support, every bit of it, with every pedal stroke. It sustains me and keeps me pedaling when I think about all the people out there who've chosen to lend a little confidence in me by giving away some of their hard-earned cash. It is the way I maintain my behavior changes.

To put it another way, I create a public account of this journey to get and stay healthy. And by creating that account, I am account-able. You see it. I know it. And hopefully you create accounts of your own. Maybe lighthearted, but I hope also inspiring. These accounts could change your life. Or someone else's. For the better.

2. Clinically, since May of 2007, I don't *have* diabetes anymore. My risk factors are in check and my blood glucose values are in the normal range. So are my cardiac risk factors.

But this doesn't mean I am back to the way I was. I don't *have* diabetes because I *do* diabetes. That includes being mindful about eating and exercising. It includes, for me, riding a bike. Those things make me healthy. They have made a big, big difference in my life. One that I can prove with evidence from my medical chart, from my health care expenditures, and from my overall quality of life.
3. I *do diabetes* publicly to inspire others. And it really has done that. I know because people tell me. They write with questions about how to start riding a bike. They write to ask what to do differently when they have a new diagnosis. Or to ask how to help a loved one who has one.

I am happy and proud to show to the world what, to some, might be embarrassing. Before and After.
I do this because for me, the change was real. And I believe it can be real for many others too.

So why do I ask you for money? It is a symbol of your commitment. An invitation to join the team. To help me and others - especially those you love - *do diabetes* so fewer of us *have* it.

Your dollar is a beginning. I'd rather have you beside me on a bike going down the road, or better yet, I'd like to have your own account to keep the account-ability going. There is real research to show that this sort of group dynamic really works to keep people healthy. I won't bore you with it here. But let me ask one more time:

Support my campaign here:

Then make a further investment in a change. For you or someone you love.

Thank you!

Friday, May 24, 2013

And I would ride 100 miles, and I would ride 100 more...

June is going to be a busy month on the bike! I've got four - count 'em - four centuries on the calendar. And I'm looking forward to every one of them. Here's the list, just so we can keep it all straight.

June 1st - 2013 100 Miles of Nowhere Ride

The first big ride is coming up on June 1st and is my second consecutive 100 Miles of Nowhere. This year, I'll be on a stationary trainer in front of a local bike shop. My registration fee for that ride supports a Cancer charity fundraiser sponsored by Elden Nelson, aka, Fat Cyclist.

June 6th - 2013 Ride2CW (Ride to Computers & Writing)
This is an annual fundraising ride supporting the Computers & Writing Graduate Research Network Travel Scholarship fund. The fund pays travel stipends for grad students and fixed-term faculty to attend the annual pre-C&W network forum and the conference. It is a great cause! Click the link above to donate! My ride this year will take me from just outside Pittsburgh, PA to Frostburg, MD which is the site of this year's C&W conference, at just over 100 miles along the Great Allegheny Passage.

June 15th - 2013 Tour de Cure Michigan

My main fundraising event each year, this will be my 7th consecutive ride in support of the American Diabetes Association. My 2013 campaign is going along well - we've raised nearly $1500 so far and have about three weeks left as of this writing. The ride is a lovely 100 mile route. That takes me through Hell, MI, among other truly beautiful places. Watch this space for more about that ride. And run, walk, or ride over to my donation page to support the campaign!

June 23rd - 2013 5th Annual Allegrina 100 

Last, but by no means least, is the best little century around! The Allegrina 100 benefits the John Allegrina scholarship foundation and is, without question, a wonderful event organized and ridden with fabulous people! I strongly encourage all riders of all levels to check this event out. It is organized as a series of successive loops, which makes it ideal for riders doing their first event or doing the event with family members. Folks can do one or all of the loops, start early, start late, etc. There will be great food and fine, fine beverages at the start/finish area, the historic Felt mansion in Holland, MI. Best of can still register! 

I'm also sneaking in at least one road race on foot, the Dexter-Ann Arbor Run 5k, on June 2.It's going to be a great June! Hope to see many of you out on the roads and trails!

Friday, May 17, 2013

Hack Your Metabolism, Part III: Sending the Right Messages

Note: this post is part three of a three part series. If you like it, consider contributing to a fundraiser called the Tour de Cure. If this helps you or someone you love, please consider clicking here to see more and donate to support my campaign on behalf of the American Diabetes Association. Thank you!

In the first part of my "Hack Your Metabolism" series, I talked about mindful eating and in the second installment I talked about what role exercise plays in regulating blood glucose and, ultimately, in losing or maintaining body weight.

In this final segment of the Hack Your Metabolism series, I want to talk about something that the two other discussion have in common. In my experience it is not obvious to most people, nor even to experts. And so it is the closet thing to "a secret" if not the secret behind making metabolic changes that improve your health in a measurable way. Including controlling body weight.

Here it is: mindful eating and the kind of exercise "dosing" I discussed both trigger long-term changes to the messages your body sends to regulate your metabolism. Insulin signaling is one of these types of messages, and an important one, for regulating the way your body uses energy.  What's counterintuitive about this is that we don't often think about changing eating habits or doing exercise as anything but direct interventions. That is, we think: eat less, gain less weight! Exercise more, burn more calories!

But our bodies are more complicated than that. And they are really, really good at adapting to external conditions that effect the most fundamental functions: eating, drinking, breathing, etc. It's that homeostasis thing again.

What I'm arguing here is that we should think of changes in our eating habits as a way to re-wire the circuits and change the messaging patterns that resulted in an increase in health risk. And we should adjust our expectations to how (and how long it takes for) the changes to take effect accordingly. This is a bit tough to get, I know. It took me a long while. So let's think through the example that most people care about a lot: losing weight.

Losing Weight: The Secret Is, There Is No Secret...Right?
On the surface it is simple. To lose weight you have to use more energy than you take in over some period of time. Right? Well...yes. Kind of. Not always, and not exactly.

Dieting - as an intervention in eating habits - is the most common way people pursue weight loss. But as my mindful eating post hopefully made clear, not all food is treated the same way in the body and the processes that signal your body to break down fat to use for energy may not happen if you eat too little of something (like carbs) or only something else (like proteins). So the first thing to ask when you are considering whether a new way of eating is appropriate as an intervention for you is to ask: what kinds of messages am I trying to re-program by eating in this new way?

Let's talk Paleo for a second. It may be the current hot diet. As with others, it is shrouded in controversy. And as with others, it has some elements that have been shown to work. In particular, it has been shown in at least one small-N study to improve insulin tolerance (though not a rate much different than doing those short, quick bursts of exercise I wrote about in part II). That same study showed that, over 12 weeks, it had no effect on weight loss or waist size, however.

All of this makes perfect sense to me. Why? Because the change in eating habits implied by the Paleo diet would have the most immediate impact on messaging related to blood sugar. Why? Less dietary carbohydrates means that the body would need to get better at using the blood glucose available and would initiate some changes to do this. This may or may not include a metabolic state called "ketosis," a condition that is sometimes portrayed as a desirable end goal for folks on the Paleo diet. But ketosis is not best understood as an end state. It is, rather, an indication of both the metabolic functions and messaging going on in the body. Specifically, it refers to the presence of elevated levels of ketone bodies in the bloodstream, something that happens when liver glycogen stores (remember those? the bodies' mid-term storage medium for blood glucose) are depleted.

Endurance athletes are familiar with ketosis, even if they don't know it by name. We have to train our bodies to switch to a different form of fuel during long efforts (lasting more than 45 minutes). And the better trained we are, the smoother this transition goes so that it is easier to maintain a given level of intensity even after our more immediate sources of fuel - carbohydrates - are depleted.

I bring up endurance athletes because this is a group that explicitly understands their exercise and eating habits to be in the service of causing specific kinds of metabolic changes: those that increase athletic performance in their sport. They (ok, we) can get a bit obsessive about it, in fact. And so in this group we have some interesting examples of what happens over time when we induce something like ketosis. I'll give you the short answer: the body can adapt. Even in extreme conditions, human bodies can learn to use other forms of fuel - in the case of Paleo, fat and proteins - to get what it needs. And, just as importantly, our bodies will continue to adapt to make these new processes more efficient. Eventually, we'll see a new set of metabolic rules in place that keep the body in a homeostatic state...all regulated by a new set of messaging pathways.

Habits Are What matter
The paleo diet isn't magic. And its efficacy in any one human body likely has little or nothing to do with the fact that some strain of ancient humans that you may or may not share ancestral DNA with ate in particular ways. If it works for you it is because it rewires your metabolism in a certain way, for a certain amount of time, to cause changes that reverse negative outcomes.

Your body adapts and changes constantly. It's trying to keep you alive and healthy, but it is rigorously biased to attend to immediate, basic needs. It will fulfill those needs in the short term to keep you alive at the expense of longer term health risks. So it is up to your conscious self to keep those longer term risks in check while complying with your greedy brain's need for fat.

The good news is that almost any sustained change in eating habits can cause signaling changes. So can almost any level of exercise. For how long? well that depends. And what changes does it cause? well that depends too. But what this all means is that there are no perfect diets and no perfect exercise routines. There are only habits that cause changes - harmful or helpful. And that word - habits - is important. One time doing anything is not likely to cause *any* signaling changes at all! So eat a piece of cake. Once. It's fine. Run once, if you feel like it, but it won't magically make you healthy.

What we are aiming for when we hack our metabolism are durable adaptations. These happen when we apply a new level of adaptive stress, which is a fancy way to say "habits."

Like what you read? Feel free to share, make comments or ask questions below. Also check out my Tour de Cure fundraiser here and consider a donation! Thanks!

Monday, May 13, 2013

2013 100 Miles of Nowhere Preview: Now with 100% more juggling!

So last year, I did this crazy thing where I rode around my circle driveway (almost) 3000 times...

It was all for not one, but two really great causes. First, it was part of Fat Cyclist's fundraiser that he does each year, which is a thumb in the eye of cancer. And second, I posted and tweeted about my exploits and raised some money for *my* campaign for the American Diabetes Association Tour de Cure. My 2013 Campaign is underway. You can support it here!

This year, I'm doing it again. I'm registered for Fatty's 2013 event, which will raise money for Camp Kessem, a place where kids who've lost loved ones to cancer can meet others and do a little healing. I'm planning an equally absurd day in the saddle this year for 2013, and with similar hopes of a good day of raising awareness and raising funds.

Here's how it will go down. On Saturday June 1, I'll ride 100 simulated miles on a stationary trainer in front of my local bike shop: Denny's Central Park Bicycles. They've agreed to lend me a chunk of their front sidewalk so I can pedal my way to, well, nowhere. How did I come to this plan you ask? Well, I asked you! (or at least some of you...). I posted a poll. People voted. And the winner was a true 100 Miles of Nowhere. On one of these:
Here's an action shot:

I also took some suggestions. One of which was that I spend some of my time riding to nowhere while also juggling. This seems like a fine idea to me. And I am happy to consider others as well. Because you see the whole point is to make a spectacle of myself so that we might have more people paying attention to the ways that riding a bike can make you healthy! And we all know I'm not above making a spectacle of myself...

So feel free to make some additional suggestions in the comments section below about what I might do while riding my bike on Saturday June 1st. If you are in the area, drop by and ring a cowbell and support Denny's shop. I'll invite you all to support my Tour de Cure Campaign for 2013 too, of course, where we've already raised over $1000!


Tuesday, May 7, 2013

Hack Your Metabolism, Part II: What is Exercise For?

Note: this post is part two of a three part series. If you like what you've read, consider contributing to  a fundraiser called the Tour de Cure. If this helps you or someone you love, please consider clicking here to see more donate to support my campaign on behalf of the American Diabetes Association. Thank you!

In the first part of my "Hack Your Metabolism" series, I talked about eating and how to pay attention to what you eat and what that does to your blood glucose (BG). I made the case that even if you weren't watching your blood glucose due to risks associated with diabetes, it is worthwhile to pay attention to it anyway. Why? because it helps you to monitor the amount of energy you take on board. Too much energy coming in means that the body has to deal with a "rich mix" in the bloodstream: high blood glucose. Over time if this rich mix condition persists, metabolic changes start to happen. One that concerns most people is that you accumulate fat. Why? Because that is one way the body stores excess fuel it hasn't an immediate need for.

What Exercise is NOT For
This second installment of "Hack Your Metabolism" isn't precisely about fat, though. I bring up the subject because I want to address a misconception that many people have about the role of exercise in staying healthy, losing weight, and controlling BG. That misconception is that exercise is for using up the energy you took on board from eating a recent meal. Like earlier that day. Or even earlier that week. You hear this kind of thing all the time: "I have to work out later because I ate like a pig yesterday!" Or this: "I ran today, so I'm going to treat myself to a Triple Venti Frappucino with Whip..."

Yeah, no. That's not what exercise is for.

For one thing, it is difficult for most people to exercise long enough and with enough intensity necessary to make up for any "extra" eating they do measured in calories alone. That Frappucino? 510 calories. I'd have to run more than 20 miles at 10 min/mile pace to burn that many calories! But recall our little discussion about mindful eating. Did we talk about calories there? No. We talked about carb units. That little post-workout treat at Starbucks would be worth almost six of them (84g). And a big spike in your BG levels to go with it. Even if you worked out really hard and for a really long time - with a few little exceptions limited to the first 30-45 minutes after exercise - your body reacts the same way to that big cup o' carbs no matter what!

So What *is* Exercise For?
Adaptive stress.

Engaging in exercise presents a challenge to your metabolism causing adaptation. Ideally. Where there is no challenge, there is no change. This idea is consistent with our discussion of mindful eating. Recall that the body is amazing at mobilizing regulatory systems to achieve and maintain a sense of "business as usual." You might recall the scientific name for this: homeostasis. New stress on the system - whether it comes from lifting weights, pedaling a bicycle, or doing yoga - may present new energy needs to muscle groups as they are challenged. The body responds to these challenges not only in the short term (burning calories during a workout), but also by preparing for the next similar challenge. These longer-term changes are signaled and initiated during exercise, but take place long after the workout is done while the body is recovering from the effort.

So the point of a workout is the change that results when your body is at rest afterward. This includes an array of changes to your metabolic systems that regulate energy, its storage and its use. Your body is constantly adapting to the conditions it finds itself in, in fact, whether you are working out or not. It is always trying to achieve homeostasis. This is a moving target. When you are more sedentary, for instance, the body adapts to that too. Adaptations to chronic high BG, a condition that can happen when your intake of carbs keeps that "rich mix" flowing, put stress on the mechanisms associated with insulin response. The body usually adapts to these stresses in ways that maintain homeostasis, until it cannot anymore. This is a condition related to Type II diabetes (T2DM), but it is life-threatening on its own even when some of the T2DM symptoms are in check. It goes by another name: Syndrome X or Metaboblic Syndrome. I wrote about that in a post titled Rx:Bike. Some of the thoughts in that piece helped shape this one. Check it out. And then go ride a bike. But first, I have just a few more things to say about exercise and adaptive stress.

What Kinds of Exercise Produce Good Metabolic Changes?
I have great news in response to the question that I get asked a lot: "what kind of exercise should I do?" Answer: any kind! All kinds! Whatever feels fun to you. Whatever makes you smile and lifts your mood. Me, I like bikes the best. And running, well, it's complicated. But I do it. I've learned to like yoga. I hate push ups, but I like the core workout stuff ok. I love to play sports like basketball, softball. I even juggle. It's all good. No really.

It *is* all good because, depending on my fitness level and the kind of activity I choose, it can all apply a "dose" of adaptive stress that will produce positive metabolic changes (among others). The more sedentary you are, the more likely it is that any amount or any level of physical activity will kick off some positive adaptations. As you get more fit - that is, as your body re-models itself internally and externally to better handle the heightened needs for energy, strength, and endurance that your new activity level requires - the "dose" of adaptive stress will have to change in order to produce positive results. So you run a bit longer or a bit faster, lift a heavier weight, or maybe add some Zumba classes to your your twice-a-week water aerobics schedule.

It's all good. Potentially. But it is not all good for the same thing. Different kinds of workouts produce different kinds of changes, of course. But let's keep things simple and talk just about varying two factors of exercise that apply to almost every activity you can think of: duration or length of the workout and intensity or how much effort the workout requires.

Two Categories of Adaptations that Enhance Metabolism (And How to Cause Them)
As with my advice in Part I, the information I am presenting here is a mix of things that are well known if not always well followed and relatively new knowledge produced, in some cases, by some recent science. Some of it is quite surprising. I won't explain all of that here. But if you want a very engaging overview, check out The Truth About Exercise with Michael Mosely. What I will do instead is break down two kinds of changes to metabolism that seem to be related to different kinds of exercise. This, in turn, may help you exercise a bit more mindfully.

1. How to Enhance Your Insulin Response to Regulate BG More Efficiently

This one is easy and fast, if not painless: short, maximum-intensity intervals of exercise. This is sometimes called HIIT, or high intensity interval training. An interval is a timed unit. And an intense interval, in this case, means that you should be working at your full potential for a very short burst of time. A work interval is done at max effort for 15, 20, maybe eventually 30 seconds at a time. This is followed by a recovery interval that is at least as long if not longer. Just a few of those intervals - 3 or 4 to start and then maybe 5 or 6 later on - twice a week is all most of us need to see a measurable improvement in insulin response. The reason is not quite yet well known, but it is thought to be related to building and strengthening the neural pathways associated with insulin signaling. This effects the way the body uses insulin, and so this adaptation is not tied exclusively (or perhaps very strongly at all) to the way the body makes insulin (the science here is early days, but really interesting). So even if you get your insulin from somewhere other than your body, these kinds of exercises may help. And for those whose bodies make insulin, including those with T2DM, HIIT works.

As with all exercise, the adaptations we see from HIIT will begin to fade if the length and intensity of "the dose" is too consistent. So as you get more fit, you might throw some intervals into the middle of another, longer workout rather than just doing three 15 second bursts. Or you might vary the length, or the recovery period between. But the essential idea - quick, high energy bursts - remains the same.

How you achieve these matters very little in terms of the end result at the metabolic level, except that you have to put your whole body to work including your cardiovascular system. And so how you do them *does* matter in the real, macro world of your whole body and your life. Running is one way to do HIIT. But running even in short bursts at maximum effort is hard or impossible for some folks. It is a little easier on a hill. But with running, the biomechanics of the activity put limits on getting to that "maximum effort" level. I find it hard to do with swimming too, because my stroke is so sloppy I simply can't keep a short intense interval going (maybe I should swim with sharks?). I think a bike - and especially a stationary bike - is best for these exercises. A regular bike works too, though you need a spot where you can go all out with little risk. Up a hill is good for this because all out doesn't necessarily mean high speed. Weight lifting usually doesn't do it, but "circuit training" routines where you quickly move from one exercise to another with no breaks can certainly get you there. 

2. How to Get Your Body Using Stored Energy from Fat All Day, Every Day

Do long, steady, exercise that builds lean muscle and endurance. The opposite of HIIT in many ways, exercise that gets your body in a rhythm of converting glycogen stored in the liver to blood glucose and converting fat into glycogen to replenish those stores is slow, steady, and long. Like walking. More walking, more often, will apply a kind of stress that asks your body to use its energy system in a consistent way. I think of it as calibrating the "thermostat." Instead of lighting a fire to heat the house and then putting it out or opening the window when it gets too hot, we set a thermostat to cycle the furnace or boiler on in our house to keep the temperature steady and comfortable.

To work well - by which I mean to produce the effective adaptation - this type of exercise should not be too intense. Why? because that shifts the body to a different energy use method. Intense exercise produces a different, though no less desirable adaptation that we talked about above with HIIT.

For athletes and others training for reasons related to performance - i.e. racing or other forms of competition - it can be a tremendous challenge to slow down enough to let this kind of adaptation happen. It is also challenging for normal people like you and me for a different reason: time. Slow is slow. And if we only have so much time to spend working out, then we tend to want to "get the most out of it" and so we amp up the intensity. And that can be beneficial. But that might not be all we need.

The secret to doing this kind of exercise, then, is not to think about it as exercise at all. But rather to make small adjustments in everyday life to increase the amount (time spent) doing low-intensity activity. Instead of parking close to the mall entrance, park far away and walk. Take the stairs instead of the elevator. Get a fitbit or another pedometer and count your steps. Have standing meetings or walking meetings when you can. Walk to work. Ride your bike to pick up a few groceries at the store.

Putting It All Together: Applying the Minimal Effective Dose
I know not everyone enjoys exercising. I happen to. I like to find where my limits are and see if I can extend them. But testing your limits in a race or a crazy-long endurance event like a marathon is not necessary in order to hack your metabolism and get healthier. All you need to do at any given moment is apply the minimal, effective dose of adaptive stress. (I know this guy uses that term, and on this he's right.)

Exercise smarter, and yes sometimes that means *harder* and sometimes it means *longer*, but it doesn't mean go out and run a marathon or, maybe not even a mile. It means do what will challenge your body to adapt, today, in the way that will produce a better "normal" state tomorrow. That might mean doubling your steps per day and doing two HIIT sessions a week several days apart. It might mean a two hour walk on Sunday and run around the yard with the dog on Tuesday and Friday. You get the idea. What it means for you will change as your body changes. You'll be able to do more, do it faster, and do it for a longer time. As you change, your minimal effective dose will change. But if you apply it consistently, you'll not only change. You'll get better.

Like what you read? Feel free to share, make comments or ask questions below. Also check out my Tour de Cure fundraiser here and consider a donation! Thanks!