Wednesday, February 22, 2017

Want to Try CrossFit? Here’s What You Need to Know

With the CrossFit Open kicking off later today (woohoo!), I wanted to share some of the posts I’ve written about the “Sport of Fitness” over the years. I figured having them all in one place would be useful for those of you thinking about trying CrossFit in the future. I hope you find them helpful! And GOOD LUCK to those of you participating in the Open this year!

5 CrossFit Tips for Beginners: Ready to try CrossFit? Here are five tips that will help you get started!

How to Balance CrossFit and Running: Probably the most common question I receive!

My 8-Week Half Marathon Training Plan (with CrossFit Workouts included): If there’s a will, there’s a way! Spoiler: Not over-training is key!

My Pregnancy Modifications for CrossFit: These modifications worked for me during my pregnancy. If you’re pregnant, or thinking about it soon, you might find these modifications helpful to your CF workouts.

Diet, CrossFit & Running: What Really Changed My Body: I received so many questions about these things from readers, I finally wrote a blog post.

What to Pack for a CrossFit Competition: Here’s a post all about what I packed for my first CrossFit competition.

My Experience at the CrossFit Level 1 Trainer Course: A summary of my experience at the two-day CrossFit Level 1 Trainer Course and my thoughts about the instruction, workouts, exam, etc.

CrossFit Q & A: This post answers questions regarding class structure (i.e. Is the workout really just 5 minutes long?), how many calories you burn at a typical class, what shoes to wear, how to find a gym in your area, how to justify the cost of CrossFit, what to expect at your first class/intro session, and more!

CrossFit Q & A II: This post answers questions regarding being fit enough to try CrossFit (trust me, YOU ARE!), what’s up with the Paleo diet, doing CrossFit at home (check out my CrossFit-inspired workouts on Pinterest for a TON of ideas), and more!

CrossFit Home Gym Essentials: Thinking about building a gym at your home? Here’s a post about what we selected for our home gym.

How My Body Changed After Starting CrossFit: I wrote this post about a year after doing CrossFit on a regular basis.

What NOT to Wear to a CrossFit Class: Starting Crossfit, like any new fitness regimen, can seem overwhelming if you’re not prepared. Take some of the uncertainty out of your first workout by knowing what to wear or better yet, what NOT to wear.

Tips for Kipping Pull-Up Success: Here are a few tips and cues that helped me learn how to do kipping pull-ups.

Discouraged By Lack of Strength: A reader question and my reply. Spoiler: Don’t compare yourself to others!

My Favorite CrossFit-Inspired Workouts: Lots and lots and LOTS of workouts to try! 🙂

Question of the Day

Are you participating in the CrossFit Open this year? If so, any guesses for what we’ll see in the first workout?

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Long Fasts: Worth the Risk?

Inline_Long-Term_FastingIntermittent fasting, schmittermittent schmasting. The hot new trend is the extended fast—eating nothing and drinking only non-caloric beverages for no less than three days and often as many as 30-40 days. A mere compressed eating window this isn’t.

If fasting for more than three days sounds riskier than just skipping breakfast, you’re right. Long fasts can get you into trouble. They’re a big commitment. You shouldn’t just stumble into one because it sounds interesting or some guy on your Twitter feed wrote about it.

Skipping a meal or even an entire day of food makes evolutionary sense. We weren’t always successful on the hunt or with foraging. We couldn’t head down to the Trader Joe’s for shrink-wrapped steak, sacks of apples, and jars of honey. Reaching the fed state wasn’t a sure thing. Intermittent fasting—going out of your way to not eat, even though food is available—is a modern contrivance meant to replicate the ancestral metabolic environment.

But long fasts seem more evolutionarily aberrant. The evidence from extant hunter-gatherers, many of whom live on land far more impoverished and limited than our hunter-gatherer ancestors, indicates that outright famine is rare. The Hadza may not eat honey and wildebeest every day, but there’s usually plenty of something to eat.

Are there benefits to the longer fast, though? What’s the purported reasoning behind not eating for days on end?

The Logic of Long-Term Fasting

Weight loss

Back in the 1960s, obesity researchers were quite open to the notion that not eating for long periods of time could combat the results of overeating for long periods of time. The most famous case was of the Scotsman, an obese 27-year-old man clocking in at 456 pounds who, upon asking his doctor for help losing weight, was told to stop eating for a few days. He did it for a week, lost five pounds, and decided to continue the experiment for a total of 382 days. He didn’t do this willy-nilly. He took potassium, sodium, and various vitamins each day. He was under medical supervision for the duration, getting checkups each week.

It worked. After 382 days, he was 180 pounds, having lost 276 pounds. At the five-year checkup, he’d only regained 16. He might have been a bit stocky for the times, but by all accounts this long fast was a huge success. Most dieters nowadays eventually regain most or all of their lost weight.

In another study from the 1960s, 46 obese adults fasted for two weeks. No food, just water and vitamins.

On the good side, they all lost weight—an average of 17.2 pounds (from 7.7 to 31.9 pounds). At the two-year followup, half of them had either kept it all off or regained some of the weight they’d lost. The patients with diabetes enjoyed normal glucose levels throughout the fast and continued to have better glucose control after it had ended.

The bad news is that the other half regained every pound they’d lost or were so embarrassed at their progress that they failed to respond to the followup calls at the two-year mark.

Cancer

Cancer patients typically lose their appetite, and oncologists often prescribe anti-nausea meds to restore it. What if low appetite is adaptive?According to Valter Longo, a cancer researcher from USC, “normal cells” go into survival mode during starvation and display “extreme resistance to stresses” like chemotherapy. If this is the case, extended fasting could improve normal cells’ resistance to harsh cancer treatments. 

In one of Longo’s more recent studies, fasting for 3 days improved cancer patients’ resistance to chemotherapy. Leukocytes in those fasting for 48 hours before chemotherapy followed by another 24 after had less DNA damage than those who fasted for just 24 hours. saw less evidence of breaks in their leukocyte DNA. The result is preliminary but promising.

In an older case study (also authored by Longo), a woman with breast cancer underwent four rounds of chemo. The first round came during a six day fast. Other than dry mouth, fatigue, and hiccups, she felt well enough to continue working. For the second and third rounds of chemo, she didn’t fast. She felt awful the entire time, couldn’t work, and complained of severe nausea, fatigue, and pain. She decided to fast for the fourth and final round, which went as well as the first round. Fasting also improved her biomarkers, including white blood cell, platelet, and neutrophil counts.

There’s even a recent case study suggesting that fasting itself might combat cancer directly. In a woman with stage IIIa low-grade follicular lymphoma (non-Hodgkin’s), a 21-day water fast greatly reduced lymph size. She followed a plant-based whole foods diet immediately after, and by month 9 her lymph nodes were still of normal size.

If you’ve got cancer and are interested in long fasts, clear everything with your doctor first.

Immunity

In 2014, researchers used a 3-day fast to protect against damage to the immune system and induce total systemic regeneration of the immune system in mice. Fasting actually triggered the mice’s stem cells to begin production of new blood and immune cells.

A recent report on 6 autoimmune case studies sounds quite promising.

Case 1, rheumatoid arthritis: Symptoms included constant pain in all extremities, extreme fatigue, headaches, and occasional autoimmune conjunctivitis (pink eye). A month after stopping RA meds, the patient fasted for 17 days. Two days in, joint pain had subsided. A week in, all pain was gone and mobility was restored. Electrolytes were stable, and he maintained his progress at follow-up visits.

Case 2, mixed connective tissue disease: Symptoms included severe joint pain, chills, facial edema, weakness, fatigue, myalgia, photosensitivity, and tachycardia. She weaned herself off meds before fasting for 21 days. The first week was rough, but by day 10 she felt better. By 21 days, she had no complaints and remained off her meds. Electrolytes remained stable.

Case 3, fibromyalgia: Symptoms were pain, poor sleep, inability to sustain activity for more than an hour. A 24-day fast cleared them up. Electrolytes were stable.

Case 4, systemic lupus erythematosis: Symptoms were joint pain and skin rashes. Two weeks before the fast, she had weaned completely off her meds. On day 3, she was sleeping poorly and feeling nauseated, but on day 4 she began improving. Joint pain was gone. She cut the fast short after 7 days due to weakness and mild tachycardia, but that was enough—she remained symptom free at one year post-fast.

Cases 5 and 6, rheumatoid arthritis: 12- and 24-day respective fasts fixed symptoms for two patients with RA.

Hypertension

A 2001 study involving 174 patients with hypertension found that a 10-11 day water-only fast led to an average blood pressure reduction of 37 mm HG systolic and 13 mm HG diastolic. Those with severe hypertension (180+ mm HG/110+ mm HG) saw even bigger improvements—a 60/17 mm HG reduction on average.

You might have noticed that many of the cited studies were case studies of single individuals. While it’d be great to have RCTs with placebos and control groups and double-blinding, it’s hard and expensive to get a huge group of people together to fast for 21 days, monitor their vital signs, keep them honest, and ensure their safety. You couldn’t conduct a free-living long fasting study because you’d lose too many to McDonald’s-based attrition. You have to keep people in the facility. That takes a lot of money and manpower.

What Are the Risks?

Loss of lean mass

Any weight loss diet will lead to the loss of lean mass in addition to fat mass. The goal is to minimize the former and maximize the latter. Remember: when most people talk about weight loss, they really mean “fat loss.”

When a slightly overweight, otherwise healthy man drank only water for 44 days, he lost 25.5% of his body mass. A quarter to a third of the loss was body fat, the rest lean mass—mostly muscle.

Nutrient deficiencies

 Nothing’s coming in. You’re going to run out of stuff.

  • In the 44-day fasting study, the subject also developed deficiencies in thiamine, riboflavin, and vitamin K.
  • A man with non-Hodgkin’s lymphoma fasted for 53 days (he intended 60 days, but couldn’t make it) and ended up with a dangerous neurological condition called Wernicke encephalopathy caused by severe thiamine deficiency. 
  • A woman admitted herself to the hospital after a 40-day water-only fast. She had severe sodium deficiency upon admittance and developed severe deficiencies in magnesium, phosphorus, and potassium upon eating.

Refeeding syndrome

Nutrient requirements drop during a fast. Your body isn’t doing nearly as much as it does when you’re fed, so you can get away with less. Serum levels of basic minerals like magnesium, potassium, and phosphorus remain normal, while intracellular levels drop. But upon refeeding, the situation reverses. Your insulin spikes in response to incoming food. You’re suddenly having to store fat, make and store glycogen, and conduct various other metabolic processes that increase intracellular nutrient requirements. To meet the need, electrolytes move from serum to cells, creating a deficiency on the serum level that can be quite dangerous.

Increased susceptibility to infections

A study in famine victims found that starvation increased susceptibility to infections, particularly malaria. Sometimes the infections were suppressed during the fast and only manifested upon refeeding. Fasting isn’t famine, but it’s similar enough that we should heed the story.                 

Tips for doing it safely…

Drink green tea during the fast. Purists will scoff at you for ingesting anything but water. Forget them. A 2003 rat study found that green tea protects against the fasting-induced damage to the intestinal lining during a 3-day fast. Remember: these were rat days. In human days, those 3 days are more like 90.

Take MCTs. Tim Ferriss recommends taking medium chain triglyceride oil in the first couple days as a tool to ease your way into a long fast. If you’re already on a ketogenic diet or count yourself as a fat-burning beast with robust fat-burning mitochondria, you can probably skip this.

Take magnesium, calcium, potassium, and sodium. Long fasts seriously perturb electrolyte homeostasis. I vastly prefer getting my electrolytes through a tall glass of Gerolsteiner mineral water (magnesium and calcium) spiked with sea salt (sodium) and lime juice (potassium).

Take thiamine/B-complex. Many studies indicate that fasting depletes thiamine and other vitamins, so stay on top of that. The Scotsman I discussed earlier took a nutritional yeast tab each day, probably for the B vitamin content.

Take vitamin K. A week of fasting depletes vitamin K, which is incredibly problematic if you’re fasting before major surgery. It’s also not great for general health.

Make mineral bone broth. With all the fat strained out, bone broth is quite low in calories and will have a negligible impact on your fast. Throw in a big handful of leafy greens with the stems. I like collards and beet greens, personally. You can either remove the veggies (all the minerals will have gone into the broth) or eat them.

Refeed with a light, low-carb meal. Don’t come off a week-long fast and immediately tuck into a platter of ribs. Don’t refeed with high-carbs. Large meals are difficult to handle after a long fast, and high-carb meals may lead to dangerous levels of fluid retention.

Take two or three days to ease yourself back into your normal routine. Eat smaller, lighter meals. Don’t train too hard. Refeeding syndrome is a real threat.

Have a good reason for doing it. Long fasts are serious, and you should have a serious reason for embarking on one.

Obese? Sure, a long fast with medical supervision and electrolyte and vitamin supplements can work.

Got non-Hodgkin’s lymphoma? If your doctor is on board, a 10-15 day fast might really improve survivability.

Got rheumatoid arthritis or some other autoimmune disease that just doesn’t respond to anything you’ve tried? Maybe a week-long fast will help.

Got invited to a silent meditation/fasting retreat? Go for it.

Does your spiritual practice or religion call for a four day fast? If your faith is important to you and completing this fast is integral to it, you should fast.

But:

If you’re trying to reveal the bottom half of the six-pack you just know is lurking beneath your gut, long fasting is not the answer.

If you’re hoping to shed the last of your baby weight, don’t try a long fast.

If you’re sleeping five hours a night, working twelve hour days, and walk around a frazzled ball of stress, don’t not eat for a week straight.

If you’re fairly healthy and happy and everything’s going well, I’m not sure. Don’t make it a habit. Treat it like a marathon, maybe. A once in a blue moon event you pursue purely for the novelty.

By now, you should have a better grasp of the potential benefits and drawbacks of long fasts. They’re not for everyone or every situation—and I think shorter fasts or compressed eating windows make more sense for most people—but the long fast is an intriguing option that can be safely done if you take the right precautions.

Do you think you’ll try one? Have you tried one? How’d it go?

Let’s hear from you down below. Thanks for reading, everyone.

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The Ultimate Shopping Question & Stitch Fix Review

^^YUP.

It’s been a while since I shared a Stitch Fix box! Over the years, I have bought some pieces from Stitch Fix that I love and wear over and over and over, and a few things that I thought I would love but don’t wear that much (or at all, gulp). Plus, in an effort to work on my curated, functional wardrobe, I’m trying to be really picky about what I let into my closet.

When shopping, I used to ask myself, “Do I like it and does it fit well?”

Now I am asking myself this question: “Thinking back on the past year, where would I have worn this and would I have liked this more than what I did wear.”

This mentality really forces me not only to imagine myself wearing the clothing in public to an event, but it also makes me consider what I might already have that I would choose to wear instead. I tend to wear favorites over and over again, and they often win over something that I like, but like just a little less for whatever reason (comfort is one of the biggest reasons!).

So here’s what came in my latest Stitch Fix box, and what I decided to keep and what I sent back! (And next time I promise to have a friend take some better photos in natural light! My closet is no fun for photography. Also my apologies as I don’t have the names of the clothes anymore!)

First up, this beautiful purse! I loved the rosey pink, the soft leather, and the interior pattern, BUT I have a coral purse – which I got from Stitch Fix a year ago – that I love and use, so I considered this a duplicate to something I already own (although it really is quite different in style.)

Very cute though! Matched my Apple Watch ; )

These jeans are by Liverpool, who made one of my favorite pairs of jeans that I got from SF a while ago. The ones I have are high waisted, so I love that they don’t sag down. These jeans fit me like I glove on first try, but I have learned that with jeans you really have to dance around the room and move in them to know if they are going to stay put. I can’t stand sagging jeans that need to be pulled up by the belt loops each time I stand up, and, ultimately, that’s what these did. They were just a little too stretchy! A bummer, because once in place I loved the fit. Sent ’em on back. Can anyone recommend some jeans that stay put? I think I just need to steer away from stretchy jeans to find them.

This top was flowy and cute, but I wasn’t wild about the maroon color. I also thought it made me look pregnant because it poofed out in just that spot, and I don’t want those kinds of rumors starting now, do I!

This dress – the Renay Cold Shoulder Dress – was the one piece I kept! It met my criteria of practical (long sleeves that went all the way down so winter-appropriate), comfortable, and cute.

I loved the split sleeves, and that I could dress it up or make it more casual as well.

This black top is an old Stitch Fix purchase. I love the little sheer criss-cross ruffle on the bottom. My necklace is Stella and Dot, the New Moon Necklace.

And finally, this dress was cute in hand and I liked the lace detail, but its shape did nothing for my figure. Sent ‘er back.

I just wrote this note to my stylist for my next fix: “I am on the hunt for super comfortable sweatshirts, tunics, fleece-lined things, and sweaters!” LOL – winter much?!

She should write back, “Now Kath, we are not in the sweatpants and fleece market. We are here to get you out of those!”

But I did get a few more keepers in my next box –

This tunic and the LEGGINGS! These are smooth, compressiony leggings, and they are my new favorites to wear under clothes (not to the gym).

This dress just seemed like such a classic, all-around solid piece. And I love me some black.

And this cardigan came in the same box and looked great with the dress! Love the lace detail, length, and that it’s pretty fitted on my body. I always need cardigans to keep warm in the spring and fall.

What has been your favorite Stitch Fix piece to date? Mine is either the purse that I mentioned above, my navy blue cargo jacket, or one of my two favorite pairs of jeans.

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Pandas, Celiac and Fecal Transplants!

In my last blog post I put forward the Discordance Theory of disease (specifically modern degenerative diseases such as type 2 diabetes, neurodegeneration and cardiovascular disease) and introduced a rough timeline of change that humans have faced over the past 10,000 years. These changes are wide reaching and affect every element of the Four Pillars of health (Sleep/photoperiod, food, movement, community). It’s fascinating to me that many people find the Discordance Theory and associated concept of Ancestral Health to be incredibly informative and helpful for everything from orienting research to making clinical decisions, while other people dismiss both concepts out of hand and find no value in anything other than reductionist, symptom-based medicine. I’m of the opinion that we will not untangle chronic degenerative disease without some nod towards the Ancestral Health template. I might be wrong about that, perhaps there is a magic bullet waiting that can “fix” poor sleep+bad food+inactivity+inadequate social interactions….but I both think that is unlikely AND I’m not waiting around for that fairy tale to come to reality.

I’ve thought about this Discordance subject a lot and I have to admit: it’s a more nuanced topic than what I’d first thought or suggested. In the early days of the Paleo Diet movement, anything that was considered “non-paleo” was held as suspect. Salt, coffee, tea (to name a few items) have all been dismissed as “non-paleo” by the few folks who have turned paleo into a religion. Unfortunately these same folks seem to have missed all the research indicating reasonable amounts of the aforementioned substances are likely beneficial. So, we seem to have a few different competing concepts here:

1-The Discordance theory suggests that too rapid a change may produce deleterious health effects.

2-Some people interpret the above as meaning ANYTHING that is “evolutionarily novel” is inherently bad, somehow ignoring “the rest of science” (coffee for example).  

3-Some of the people who dislike the Ancestral Health concept rightfully point out that some not insignificant genetic change has happened to humans since the paleolithic.

4-Despite point #3, we still see far more degenerative disease than what I think anyone would like. And as I mentioned in the previous post, those metabolic changes are of sufficient severity that the associated diseases (type 2 diabetes, CVD, neurodegeneration, certain cancers)  are poised to cripple our economy and overwhelm our medical systems.

The trite advice of “eat less move more” and “everything in moderation” (the singular message we seem to receive from the medical world, particularly mainstream dietitians) is, let’s face it, an epic failure. My wild suggestion, dripping in nefarious ulterior motives, is that we really do need to think about modern, degenerative disease from the perspective of the Discordance Model, but we can’t turn the implications of that theory into religious doctrine like the Orthodox Paleoites have done. We need a governing theory to direct our inquiry, but this must be coupled with good clinical outcome based medicine and the studies these clinical outcomes inevitably generate.

So, we are about 500 words into this mess and you may be wondering “Hey Robb, this is all nice, but the title of the article is about pandas and poo…what gives?” This build-up is likely attributable to equal parts senility and a borderline obsessive need to provide Framework and ContextI want to look at a critter we are all likely a bit familiar with, the Giant Panda, as this cute, iconic Ursid is actually an interesting example case study of the Discordance Theory but with some interesting subtleties. Giant Pandas evolved from ancestors which were, like most bears, omnivores. For as yet unknown reasons panda ancestors likely started eating some amount of bamboo as part of their mixed diet, eventually shifting to a diet almost completely composed of bamboo. Estimates of this transition range from 2-5 million years ago, which is a decent period when considering evolutionary change. What this would suggest is pandas should be quite well adapted to their new dietary approach and in some ways they are. Pandas have evolved a kind of false thumb (derived from a wrist bone of all things) which helps pandas to grasp and pull down bamboo.

But recent research looked at panda digestion and the findings were fairly surprising as they suggest that pandas are not that well adapted to their current diet of bamboo. Whether in the wild or captivity, pandas display a remarkable amount of GI problems. They are almost the IBS poster animal given how many problems they have. The GI physiology of the panda is quite close to that of a carnivore, with none of the specialized GI structure we see in animals that digest cellulose (fibrous plant material). Some cellulosic fermentors use multiple stomachs, some use a larger cecum to provide more time to ferment this plant material, coupled with more surface area to absorb the short chain fatty acids produced by cellulose fermentation. Most of these animals have a symbiotic relationship with certain strains of bacteria which possess the enzymes to degrade cellulose, yet pandas are interesting in that they seem to still, after 2 million years of mainly consuming bamboo, possess a gut microbiome that looks virtually identical to that of a carnivore. The panda is a potentially confusing critter! As interesting as all this might (or might not) be, what does it mean for you?

1-Despite 2 million years of evolution on it’s current diet, the giant panda still has serious digestive problems. Problems which are sufficiently severe as to limit panda reproductive success.

2-Even though the gut microbiome of pandas looks a lot like that of a carnivore, there MUST be something more to this story. Although the efficiency of converting bamboo cellulose to energy appears to be rather low (compared to the efficiency of say a cow converting grass to usable energy) clearly the panda is getting SOMETHING out of the bamboo. It may be that they are relying more on the protein and fat content of bamboo to make their living. It’s also possible that although the microbes they harbor are not typically associated with cellulose fermenters, that does not mean these bugs have not acquired the genes to do so. Bacteria are remarkably promiscuous little bugars and they appear to be able to swap genes at a rate that until only a few years ago was thought to be impossible.

3-Given point #1, if we see a chronic disease (in humans, pandas or sand flies) it might be helpful to start asking questions using the Discordance Theory as a means of orienting our thinking. This is not the end of that investigative process but may prove to be a critical beginning. 

4-Given point #2, we need to be cautious in how we interpret and promulgate the Discordance Theory. Of particular note I think we need to be very careful in how we treat the topic of the human microbiome. Despite a relatively short period for evolution to occur on the human genome (10,00 years since “the paleolithic”), there is a remarkable amount of time available (in bacterial terms) for a symbiotic organism to develop or obtain the genes necessary to help it’s host organism (that’d be us). We are in the absolute infancy of understanding this story, so I think we need equal parts caution and optimism in how we approach this material. In my next blog post I’ll look at some human symbiotic bacteria which have proven to be remarkably helpful for a very pesky condition.

I am one of the folks that really went whole-hog into the Discordance Theory and unfortunately did not see the details and caveats to make that model work better. Time and pain have been good instructors and have hopefully moved me a bit down the Dunning Kruger graph.  In my second book Wired to Eat (available for pre-order everywhere books are sold, release date March 21) I do my best to talk about these subtleties and to provide a path for you to find your own truth with regards to health. I lean heavily on the Discordance model as so far it has provided what appears to be an unfair advantage in unraveling complex degenerative disease. I do however try to temper that message with an honest appraisal of what we do and do not know, what we can only discover via self experimentation.

ALSO!! If you pre-order Wired To Eat I have several fantastic bonuses here.

 



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