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Tips To Beat The Heat

Dehydrated, cramped, limping? on a bike. Road nationals 2010.

People who exercise outdoors face a new threat.

It’s unrelenting.



Perhaps, even more dangerous than distracted or mean motorists.

It’s the heat. Gosh, is it hot. If only I had a dollar for every time I heard someone say, “Doctor M, you aren’t riding in this heat; are you?”

Well…Other than the fortunate souls smart (or lucky) enough to live in cooler climates, most of us are facing an extreme wave of hotness. As a Kentuckian, I live in the epicenter of this summer’s cauldron. Louisville sits in a wind-protected valley alongside the heat sink that is the Ohio River. Think hot and steamy.

The excessive heat smacked me hard last evening. Normally, my highly-veined skin and northern European heritage serves me well in the heat. But last night, while riding in sight of our city’s skyline, it started: My mouth grew dry and my breathing labored. And why was that helmet feeling so tight? Next came the sensation of tingles—not the pleasant kind of tingles, like when your teenager hugs you. And then came the deal-breaker: chills. I stopped, swallowed my pride and called for a ride home. (Here’s an always for you all: When it’s ninety degrees out and you feel cold–stop exercising, immediately.)

After last night’s brush with heat exhaustion, I thought it reasonable to ramble on about the dangers of exercising in the heat. And of course, I will offer some nuggets of wisdom for beating the heat. Read more »

*This blog post was originally published at Dr John M*

Cyclist Asks: Is Sugar Abstinence Possible?

After spending an entire vacation reading stories, I would like to start tonight’s post with a tiny dose of fantasy. Can we try using a daydream to learn something about the challenge of making good nutrition choices?

The fantasy goes something like this…

You have just been sentenced to eternal life on a far-away sun-drenched island. This island has mountains, paved roads, wide bike lanes, and mountain bike trails. You get to take two bikes, a couple riding buddies and your family—if they’ll go. You also get to take one Apple product.

Sounds good so far.

The kicker is that you only get four food choices—and liquids count.

You are a cyclist, so after coffee and beer there are only two food choices remaining. Obviously, you will need a protein source. Smart choices here would include nuts, mercury-free fish or organically-fed animals. The protein isn’t the point, let’s keep moving.

Now we are down to the carbohydrate source.

Choose one of the following:

A.) Arugula
B.) Quinoa
C.) Cranberries
D.) Fruit Loops

Herein lies the primary hurdle that smart-nutrition advocates face: unhealthy simple sugars taste really good. Read more »

*This blog post was originally published at Dr John M*

Is Church Attendance A Risk Factor For Obesity?

For competitive cyclists, Sunday morning usually signifies a time for combining spirituality with calorie-burning. Whether we are immersed in the total focus of a hotly-contested bike race or meditating our way through a seemingly endless training ride, it’s a given that most cyclists use Sundays to churn out the kilo-joules.

This kind of Sunday-behavior differs significantly from many regular (normal) people, who like to sleep late, get up slowly, dress themselves nicely and amble off to church. It goes without saying that this kind of spiritual exercise doesn’t burn many calories. And it is also well known that worship and consuming high-calorie comfort food frequently go hand in hand.

In the hard-to-believe-that-people-study-this kind-of-thing category, comes a report that frequent churchgoing in young adulthood increases the risk of obesity in middle age. Really, I am not making this up. The story was reported prominently here, on the Read more »

*This blog post was originally published at Dr John M*

Physical Activity Versus Physical Fitness: It Could Mean The Difference Between Life And Death

My neighbor Ed was a thin man all his life. He maintained an ideal body weight by combining regular physical activity with a modest intake of calories. He was a “young” seventy year-old who looked the picture of heart health.

Ed regularly read the newspaper while walking on his treadmill, he hit a golf ball straighter and longer than his peers, and he wore the same size jeans now than he did in college 50 years ago. What’s more, he bragged about his low blood pressure, normal cholesterol level and perfect blood chemistries. He took no pills. I think he went to his primary care doctor each year just to show off his health.

The morning he woke with crushing chest pressure and shortness of air stunned him. “This couldn’t be a heart attack?” he thought. An hour later, minutes after his urgent heart catheterization showed severe blockages in all three of the main coronary arteries, a sternal saw provided a heart surgeon access to his dying heart.

Ed did well. The story had a happy ending. He still looks the picture of health, but now there’s a scar on his chest and a few pill bottles in his medicine cabinet.

How can a human who exudes heart health go to bed well and wake up with severe heart disease? What’s missing? What could Ed have done differently? Could his doctors have measured anything—over and above the traditional risk measures—that might have suggested his obviously higher cardiac risk? Read more »

*This blog post was originally published at Dr John M*

Don’t Treat The Number, Treat The Patient

In medicine we’re often reminded not to base our therapy solely on lab test results. Although it’s tempting to reduce patient care to a checklist of “normal” bloodwork targets, we all know that this is only a fraction of the total health picture. Today I made a mistake that brought this truism home: “Don’t treat the number, treat the patient.”

I’m turning 40 this year and decided to make an ambitious fitness goal for myself — to be in better shape at 40 than I was at 30. No small feat for a person who used to be in good form a decade ago (not so much now, ahem). So, I joined a gym owned by an affable triathlete and invited her to make me her project. Let’s just say that Meredith believes that one piece of sprouted grain bread is the breakfast of champions — and with that she has me doing many hours of cardio sprints and strength training every week. I’m still alive. Barely.

Today in my endurance spinning class (an unusual form of torture where you get yelled at — I mean encouraged — on a stationary bicycle for an hour and a half in a dark room filled with high-decibel rock music and sweaty co-sufferers), I was somewhat alarmed by my heart rate. I was taught in medical school that one’s maximum heart rate is 220 minus your age. So mine should be about 180. I assumed that anything higher than that was incompatible with life.

So when I saw my heart rate monitor rise to 185 on a steep climb at maximum speed, I wondered if I might be about to die. I certainly felt physically challenged, but not quite at death’s door, so I looked around sheepishly at my nearest peer’s monitor to see if she was handling the strain any better. Nope, she was also at 185. “Gee, what a coincidence,” I thought. “We must be exactly the same fitness level.” Read more »

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