Are treadmills just as good as running outdoors?

NY Times:

The most obvious difference with indoor exercise is a lack of wind resistance, Dr. Cavanagh said.

“The important variable here is speed relative to the air,” he said. For example, if you are running at 8 miles per hour into a 10-m.p.h. headwind, your speed relative to the air is 18 m.p.h. Dr. Cavanagh explained in an e-mail message: “Work done against air resistance can be extremely costly because the ‘drag force’ (force caused by air resistance) is proportional to the square of speed and the power required to overcome drag force is proportional to the cube of speed.”

One recent study, in fact, found that people can run 11.5 percent faster on treadmills than outdoors.

Many runners, including Dr. Thompson, set their treadmills at a 1 percent incline to make up for the lack of wind resistance. But that is not a complete solution because there are other aspects of outdoor running that a treadmill can’t mimic. For instance, the treadmill surface is just too smooth.

“If you run all the time on a smooth surface you are not training all muscles in your legs and feet that you need to run on the road,” Dr. Cavanagh said. “If you are going to race under certain conditions, you might as well train there.”

Safety may be the single best reason to opt for more treadmill training, particularly in the winter

Mr. Sell, an elite marathoner who ran in the 2008 Beijing Olympics, trains in Rochester, Mich. He bought a treadmill four years ago, after he had fallen a few times on icy roads, injuring himself so badly he could not train at all while he healed.

“I probably fall at least once a year here in Michigan,” he said. “My injuries ranged from a bruised hip to a pulled groin. That time it took three weeks to get back. I said, ‘If I was doing this on the treadmill, I wouldn’t have missed three weeks of training.’ ”

Mr. Sell continued, “If it’s really icy out or if it’s negative 10 degrees and you are doing an easy six-miler, it probably makes a lot more sense to do it on a treadmill than to risk hurting anything.”

Often I have worked out on treadmills when staying in neighborhoods characterized by pollution and traffic-congested streets.

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Elderberry highest in antioxidants?

I blogged about a study that showed that Elderberry could be as useful as Tamiflu in fighting H1N1 virus and other flu viruses. I just stumbled upon a table showing that the elderberry has almost the highest ORAC (Oxygen Radical Absorbance Capacity) value of any berry.

ORAC scores are for 100/grams (3.5 ounces).

• Aronia (15.8K ORAC)
• Elderberry (14.6K ORAC)
  
• Cranberries (9.5K ORAC)
• Black Currant (8K ORAC)
  
• Blueberries (6K ORAC)
• Blackberries (6K ORAC)
• Plums (6K ORAC)
• Glass of Cabernet Sauvignon (5K ORAC)
  
• Glass of red table wine or Chianti (3.8K ORAC)
• Red grape Juice (1.2K ORAC)

Also topping any overall list of antioxidant foods is cocoa.  Raw cocoa has an ORAC of 26,000 per 100/g; processed dark chocolate about half that (processing heat will reduce a food's antioxidant properties).

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Barefoot running and the fore-foot strike

J. Fallows, runner and journalist, blogs that according to a report in Nature, "fore-foot running, which also turns out to be the way people naturally run if they're barefoot, is fundamentally much easier on your joints and bones and therefore easier to bear over the years."

Good to know scientists are finally studying the question. I'm not a regular bare-foot runner yet -- though I have been won over to wearing lightweight running shoes.  

More on the question of the best footwear for running in a future post.

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Chondrolysis caused by pain pumps

Some medical stories make me furious. This is one of them. NY Times:

Chondrolysis has ended the athletic careers of dozens of high school and college students. In the most severe cases, it has required joint replacements. Many sufferers face lifetimes of pain and disability.

“I’ve lost so many hours of sleep over this, I can’t tell you,” said Dr. David S. Bailie, an orthopedic surgeon in Scottsdale, Ariz., who said he had seen dozens of cases of chondrolysis since 2005. “There’s nothing worse than a surgeon doing something that causes a problem, not fixes a problem.”

Although it is still unknown why chondrolysis develops, several medical studies have concluded that a likely culprit is a pain pump, a postsurgical medical device used to deliver local anesthetics to a specific area through a plastic tube.

What's really going on here?  Why are people being implanted with high-tech devices for the localized control of pain?   I've had more shoulder operations than anyone I know, and I'll tell you, shoulder pain goes away if you take demerol or morphine.  I've been prescribed these medicines on numerous occasions and they work. 

Kids are having these weird, untested, and dangerous devices put into their bodies because the medical establishment is adverse to prescribing ordinary pain killers to people in pain.   These medicines work and they are far safer than any high-tech alternatives.   Part of the interest in these devices might be lowering hospital costs because administering morphine requires an extended hospital stay.  Ultimately, a confluence of corporate interests -- manufacturers and the insurance companies -- are likely behind the interest in pushing these devices.  That's why mainly only American kids are being implanted with these high-tech devices.  

The article continues:

In late 2006, after a handful of studies indicated that the pain pumps might be causing chondrolysis, the I-Flow Corporation, the largest pump manufacturer, changed its directions in package inserts to advise doctors to avoid placing the pump catheters in joints. In 2007, I-Flow posted a bulletin on its Web site notifying physicians of the risk.

The first lawsuits against pain pump companies were filed about two years ago. It is difficult to know the exact number of suits, but I-Flow reported in November that it was a defendant in 191 chondrolysis cases involving 412 patients. Of those, the company said, 80 suits were dismissed. Kay Jackson, a spokeswoman for the Kimberly-Clark Corporation, which purchased I-Flow last year, declined to comment, citing the pending litigation.

I'm not a doctor, but over the years I've picked up a few basics of orthopedics.  First things: You don't go putting tubes into joints!   Certainly not to control pain. Any physician who would suggest doing this is an complete idiot.  (The risk of infection from the insertion of such a device is too great.  Pain-killing does not warrant such a risk.)  

These companies deserve to be sued.  The first maxim of medicine is DO NO HARM.  That means don't go experimenting with unproven techniques in order to relieve pain -- pain that has safely been controlled for many decades through the non-localized administration of low-cost prescription medication.

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Exercise quote

Dr. Robert Sallis, co-director of sports medicine at Fontana Medical Center in California:

"Exercise can be used like a vaccine to prevent disease and a medication to treat disease. If there were a drug with the same benefits as exercise, it would instantly be the standard of care."

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Oracea just expensive doxycycline?

I just saw a commercial for a product called Oracea.  Oracia is "a low-dose form of doxycycline" for the treatment of a skin condition known as rosacea.

Doxycycline ought to cost no more than $10 a month, but Oracea costs $200.    I did some checking on the Internet, and Oracea may be the poster-child for health-care costs run amok (h/t rosacea support):

KUNC: The Big Zit Rip-off, Marc Ringel
GREELEY, CO (2009-05-18) Most agree that something needs to be done to overhaul America’s healthcare system. But leave it to KUNC commentator Dr. Marc Ringel to illustrate the problem – through something as small and innocuous as a pimple.
Or you can buy Oracea, a brand-name doxycycline marketed by Galderma Laboratories. Oracea will set you back over $200 a month if you purchase it in this country or about $150 if you shop online and make your buy from a Canadian outfit. To be sure, the dosage of Oracea is 40mg, making it, like the baby bear’s porridge, just right.
…
I cannot imagine, though, how the extra 10 mg in a 50 mg generic doxycycline capsule could cause close to the distress that too-hot or too-cold porridge did to Goldilocks. Nor do I see how Oracea would work better than the plain vanilla generic except, perhaps, for an enhanced placebo effect generated by spending so much money on a product marketed especially to this affliction. A person might figure that such an exorbitantly expensive brand name would just have to work better.

Oracea is claimed to have this advantage over doxycycline:

Oracea is able to maintain a sustained release of the active ingredient doxycycline without venturing into anti-microbial territory. The advantage of a delayed release product is that Oracea can offer the `area under the concentration-by-time curve’ delivery, but at sub-antimicrobial dosage over 24 hours.

That is, Oracea can deliver a dosage of doxycycline that can give measurable results, but keep the concentration of doxycycline in your blood low enough to reduce potential problems associated with antibiotics.

If you are interested in researching this question further, the Rosacea support group website looks like a good place to start.

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Does Vitamin D prevent H1N1

Living in sunny Thailand, I noticed that there is no "winter flu season" like we have in northern countries. How could that be? Are the people of tropical countries getting something that those of us in living in the north lack?

In a paper,  J. J. Cannell explains how vitamin D intake -- obtainable either by way of sunshine or dietary supplement -- explains 14 observations about influenza:

1. Why the flu predictably occurs in the months following the winter solstice, when vitamin D levels are at their lowest,

2. Why it disappears in the months following the summer solstice,

3. Why influenza is more common in the tropics during the rainy season,

4. Why the cold and rainy weather associated with El Nino Southern Oscillation (ENSO), which drives people indoors and lowers vitamin D blood levels, is associated with influenza,

5. Why the incidence of influenza is inversely correlated with outdoor temperatures,

6. Why children exposed to sunlight are less likely to get colds,

7. Why cod liver oil (which contains vitamin D) reduces the incidence of viral respiratory infections,

8. Why Russian scientists found that vitamin D-producing UVB lamps reduced colds and flu in schoolchildren and factory workers,

9. Why Russian scientists found that volunteers, deliberately infected with a weakened flu virus - first in the summer and then again in the winter - show significantly different clinical courses in the different seasons,

10. Why the elderly who live in countries with high vitamin D consumption, like Norway, are less likely to die in the winter,

11. Why children with vitamin D deficiency and rickets suffer from frequent respiratory infections,

12. Why an observant physician (Rehman), who gave high doses of vitamin D to children who were constantly sick from colds and the flu, found the treated children were suddenly free from infection,

13. Why the elderly are so much more likely to die from heart attacks in the winter rather than in the summer,

14. Why African Americans, with their low vitamin D blood levels, are more likely to die from influenza and pneumonia than Whites are.

The whole article is worth reading.   A relatively safe and possibly effective alternative getting a flu shot this winter is to take 4,000 MG of Vitamin D daily.   That's what I'm doing.

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How to prevent prostate cancer

Gina Kola in the NY Times explains that drugs found to be very effective in preventing prostate cancer do exist, but have been ignored:

And, it turns out, there is a way to prevent many cases of prostate cancer. A large and rigorous study found that a generic drug, finasteride, costing about $2 a day, could prevent as many as 50,000 cases each year. Another study found that finasteride’s close cousin, dutasteride, about $3.50 a day, has the same effect.

Nevertheless, researchers say, the drugs that work are largely ignored. And supplements that have been shown to be not just ineffective but possibly harmful are taken by men hoping to protect themselves from prostate cancer.

As the nation’s war on cancer continues, with little change in the overall cancer mortality rate, many experts on cancer and public health say more attention should be paid to prevention.

Promising, but non-pharmaceutical means of preventing prostate cancer might include the anti-inflammatory herb curcumin/tumeric -- see this article.   A new study suggests exercise may play a role in the prevention of prostate cancer.

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How to prevent breast cancer

Gina Kola in the NY Times explains that effective preventive drugs for breast cancer exist, but have been ignored:

“If I had told you in 1990 that in 10 years I would have a pill that would cut the risk of breast cancer in half, you wouldn’t have believed me,” he said.

But, he said, to his shock, “The world said, So what?”

“We were met with shoulder shrugs and harrumphs,” Dr. Vogel said. Sales of tamoxifen, worldwide, “didn’t budge.”

Maybe, Dr. Vogel thought, the problem was that internists and gynecologists were not comfortable prescribing a drug used to treat cancer patients. Then, in 1999, he had a chance to do another breast cancer prevention trial, this time of an osteoporosis drug, raloxifene, or Evista, which did not have the cancer drug taint. It was to be compared with tamoxifen.

The $110 million study, involving 19,000 women, ended in 2006. The two drugs were found to be equally effective in preventing breast cancer, but with raloxifene there was no excess uterine cancer and the clotting risk was 30 percent less.

“It was a spectacular clinical trial,” Dr. Vogel said. But, he added, “Once again, the world met the result with a shrug and a harrumph.”

“Those were your tax dollars and mine,” he added. “You can’t do too many $110 million studies.”

He cannot understand why no one cares, but some doctors say they see a number of problems. It is usually not the cost; tamoxifen is about 30 cents a day and raloxifene $3.30 a day. It is doctors’ practices and women’s concerns.

Most doctors, said Dr. Therese B. Bevers, medical director of the Cancer Prevention Center at M. D. Anderson, do not take the first step — calculating a woman’s lifetime risk of getting breast cancer — in part because that can lead to the next step, spending an hour or so discussing cancer risk and drug risks and benefits.

Dr. Bevers suggests the drugs for women whose lifetime odds exceeds 20 percent. That could include, for example, a 55-year-old woman who began menstruating early (increasing the risk), had her first child late (again increasing the risk), and whose mother and sister got breast cancer. About half the time, though, women with that kind of risk turn down the drugs, Dr. Bevers said. “The No. 1 reason I hear is, ‘Oh, I just don’t like to take medications,’ ” she added.

Others, like Cecilia Anderson, who is 57 and lives in Houston, worry about side effects. “I felt like my quality of life was in question,” she said. “I am busy, I am out there. I totally love my life and don’t want it to be compromised.” Her lifetime risk of breast cancer is 20.5 percent, compared with an average risk of 9.8 percent for a woman her age. Ms. Anderson declined the drugs. “I live a different lifestyle,” she said. “I eat organic foods, I exercise. Through all of that comes a spiritual element as well. Mind, body, and spirit are all connected.”

Unfortunately, as is typical of the NY Times, the article fails to explore promising non-pharmaceutical measures that could reduce a woman's chance of getting breast cancer.

Other (non-patentable) substances that may help to prevent breast cancer include include melatonin, Vitamin D, molybdenum, and iodine. Exercise also seems to help.

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How important is Vitamin D in the prevention of cancer?

We've long known that people living in sunny climates -- or those who consume a lot of seafood -- don't get so many chronic diseases. Why? Evidence is mounting that it's the Vitamin D.

This video is remarkably well done:

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Tax junk food to pay cost of obesity

I think health care should be paid for largely by taxing unhealthy foods and behaviors.   The following would  be a good start (via CNN):

• Shift subsidies away from corn toward the production of fresh fruits and vegetables as well as organic farming, so healthier, more natural foods become as accessible as Happy Meals.
• Tax fast food, soft drinks, and packaged foods high in processed fats and sugars to decrease demand for unhealthy food. A study published recently in the New England Journal of Medicine recommends a tax on "sugar-sweetened beverages," projecting that for every 10 percent rise in price, consumption of soft drinks would decline a corresponding 8 to 10 percent, leading to weight loss and reduced health risks.
• Regulate youth nutrition marketing, preventing paradoxes like the teaming of "Cloudy with a Chance of Meatballs" -- despite its well-intentioned message -- with Burger King for a promotion heavily advertised on children's TV.

The above recommendations should be no-brainers.  Taxes aren't fun to pay, but the government has to collect money somewhere.  Better to tax wasteful or harmful activities than healthy ones.  Dubner cites a recent study (Freakonomics/NYT):

The prevalence of obesity rose 37 percent between 1998 and 2006, and medical costs climbed to about 9.1 percent of all U.S. medical costs, the researchers said.

More about the costs of obesity here.

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Health effects of sonic weapons

As you gain familiarity with the various ways the government has allowed corporations to poison the air you breath and the water you drink, you may decide to take to the streets in protest.

At the protest site, you may encounter police armed with "acoustic weapons." These were used against demonstrators -- Pennsylvania university students and other Americans -- during the Pittsburgh G20 summit. These weapons had apparently never before been used on a group of demonstrators in the United States (although the weapons may have been used against Hurricane Katrina victims in 2005).   Homeland Security has helped police departments around the US to acquire the weapons.

The question begs to be asked: What are the potential health effects of sound guns or sonic weaponry? Wikipedia notes:

Cavitation, which affects gas nuclei in human tissue, and heating can result from exposure to ultrasound and can cause damage to tissue and organs. Studies have found that exposure to high intensity ultrasound at frequencies from 700 kHz to 3.6 MHz can cause lung and intestinal damage in mice. Heart rate patterns following vibroacoustic stimulation has resulted in serious negative consequences such as arterial flutter and bradycardia. Researchers have concluded that generating pain through the auditory system using high intensity sound resulted in a high risk of permanent hearing damage. Organizations in a research program which included several institutions involved high intensity audible sound experiments on human subjects.

The extra-aural (unrelated to hearing) bioeffects on various internal organs and the central nervous system included auditory shifts, vibrotactile sensitivity change, muscle contraction, cardiovascular function change, central nervous system effects, vestibular (inner ear) effects, and chest wall/lung tissue effects. Researchers found that low frequency sonar exposure could result in significant cavitations, hypothermia, and tissue shearing. No follow on experiments were recommended. Tests performed on mice show the threshold for both lung and liver damage occurs at about 184 dB. Damage increases rapidly as intensity is increased.

Noise-induced neurologic disturbances in humans exposed to continuous low frequency tones for durations longer than 15 minutes involved development of immediate and long term problems affecting brain tissue. The symptoms resembled those of individuals who had suffered minor head injuries. One theory for a causal mechanism is that the prolonged sound exposure resulted in enough mechanical strain to brain tissue to induce an encephalopathy.[7]

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Segway: symbol of everything that is wrong with the American economy?

As the tech bubble was bursting, one of the cleverest inventors in the land, backed by A-list Silicon Valley investors, set out to produce a top secret device that would "change the world as we know it."

The result -- we now know -- was a machine that serves as a substitute for foot or bicycle as means of transportation.

Story continues here.

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Elderberry has antiviral properties against H1N1 flu virus

UPDATED
Reuters:

NAPLES, Fla., Sept. 10 /PRNewswire/ -- A recent research study has given new scientific evidence to the long-held empirical belief that elderberries possess antiviral activities. The research involved a specific, reproducible elderberry extract developed by HerbalScience Group LLC, and succeeded in identifying key chemical components of the extract that inhibited in vitro infection and were shown to bind directly to Human Influenza A (H1N1) virus particles. The binding blocked the ability of the viruses to enter host cells, and thereby effectively preventing H1N1 infection in vitro.

An article detailing the study, titled "Elderberry flavonoids bind to and prevent H1N1 infection in  vitro," has been published in the peer-review scientific journal Phytochemistry. . . .

The research results are notable not only because they identified and characterized two specific flavonoids (plant nutrients that are beneficial to health) that are the major contributors to the anti-influenza activity of the elderberry extract, but also verified how the flavonoids provide that benefit,  via direct binding to H1N1 virus particles and blocking the virus from infecting host cells.

This recent study provides scientific evidence in support of some of the traditional uses of elderberry:

Elderberries have been a folk remedy for centuries in North America, Europe, Western Asia, and North Africa, hence the medicinal benefits of elderberries are being investigated and rediscovered. Elderberry is used for its antioxidant activity, to lower cholesterol, to improve vision, to boost the immune system, to improve heart health and for coughs, colds, flu, bacterial and viral infections and tonsilitis. Bioflavonoids and other proteins in the juice destroy the ability of cold and flu viruses to infect a cell. People with the flu who took elderberry juice reported less severe symptoms and felt better much faster than those who did not. Elderberry juice was used to treat a flu epidemic in Panama in 1995.

UPDATE:  Move over Tamiflu! Here's an impressive quote from the abstract to the recent study.

The H1N1 inhibition activities of the elderberry flavonoids compare favorably to the known anti-influenza activities of Oseltamivir (Tamiflu; 0.32 microM) and Amantadine (27 microM).

The study was published in July 2009 in Phytochemistry "Elderberry flavonoids bind to and prevent H1N1 infection in vitro" by Roschek B Jr, Fink RC, McMichael MD, Li D, Alberte RS.

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Effects of intense interval training

NY Times:

A few years ago, researchers at the National Institute of Health and Nutrition in Japan put rats through a series of swim tests with surprising results. They had one group of rodents paddle in a small pool for six hours, this long workout broken into two sessions of three hours each. A second group of rats were made to stroke furiously through short, intense bouts of swimming, while carrying ballast to increase their workload. After 20 seconds, the weighted rats were scooped out of the water and allowed to rest for 10 seconds, before being placed back in the pool for another 20 seconds of exertion. The scientists had the rats repeat these brief, strenuous swims 14 times, for a total of about four-and-a-half minutes of swimming. Afterward, the researchers tested each rat’s muscle fibers and found that, as expected, the rats that had gone for the six-hour swim showed preliminary molecular changes that would increase endurance. But the second rodent group, which exercised for less than five minutes also showed the same molecular changes.

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