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Should we be prescribing fruits & veggies?

Why?

Across the globe we’re experiencing rising healthcare costs and spending are increasing at an alarming rate. Diet-related conditions (diabetes, obesity, etc.) are a major contributor to that cost. An interesting idea, and something that has actually been implemented on a small scale, is “prescriptions” or incentives for eating more fruits and vegetables. The authors aimed to evaluate the implications of healthy food prescriptions in healthcare.

What?

As a part of the Food Policy Review and Intervention Cost-Effectiveness (Food-PRICE) Project (www.food-price.org), they estimated the health and economic impacts of healthy food prescriptions in the largest providers of insurance, Medicare and Medicaid.

Shockingly, over a lifetime, the fruits and vegetable incentive would potentially prevent almost 2 million cardiovascular disease (CVD) events and roughly 0.4 million CVD deaths. Which ultimately means massive savings in of an estimated $40 billion in healthcare costs.

A broader reaching, healthy food incentive would increase those numbers considerably with an estimated 3.3 million CVD cases, 0.6 million CVD deaths, and 0.1 million diabetes cases prevented and save a whapping $100 billion in healthcare costs.

Of course, cost for programs like this are naturally going to be a major concern. However, Lee et al, found that from a healthcare perspective that it’s surprisingly cost-effective.

Significance?

So, what’s the deal? The take home is this, by implementing healthy food incentives or prescriptions within large government healthcare programs we could promote healthier eating which in turn would result in increased health gains at a relatively low cost.

Also don’t forget to eat your fruits in vegetables! 

Some fun figures:

Table 2. Lifetime health gains, costs, and cost-effectiveness of 30% F&V incentive and healthy food incentive programs through Medicare and Medicaid from a healthcare perspective.

Fig 2.

Estimated reductions in total (A) CVD events averted, (B) diabetes cases averted, (C) QALYs, (D) healthcare savings, (E) net costs, and (F) ICER of the 30% healthy food incentive program through Medicare and Medicaid by insurance type over 5, 10, and 20 years and lifetime. Values are shown from a healthcare perspective. Numbers indicate the values for lifetime analysis. ICERs were calculated as the change in net costs (policy costs minus healthcare savings) divided by the net change in QALYs. CVD, cardiovascular disease; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life year.

Citation: Lee Y, Mozaffarian D, Sy S, Huang Y, Liu J, Wilde PE, et al. (2019) Cost-effectiveness of financial incentives for improving diet and health through Medicare and Medicaid: A microsimulation study. PLoS Med 16(3): e1002761. https://doi.org/10.1371/journal.pmed.1002761

[shadassa]

What’s lurking in tattoo ink?

If you’re like me then you probably find tattoos pretty awesome, but you might be concerned about the health implications of inking your precious body. Are there serious concerns lurking in those mysterious liquids that imbue skin with a myriad of colors that give life that dumb idea or incredible piece of artwork that adorn many bodies?

Well there’s bad and good news. Let’s start with the bad. As tattooing has become more prevalent and popular, there’s been an increase in adverse effects caused using different tattoo inks. Inks contain a mixture of particles and compositionally are varied, often containing different amounts and types of metals and compounds that may be toxic.

Most poor reactions that people may encounter are hygiene related and are caused by the introduction of bacteria. However, there is evidence that the compounds in the ink are associated with cytotoxicity (essentially being toxic to a cell). Researchers hypothesize that it is due to azo pigments that create stress on a cellular level. And it appears, that certain colors of inks are potentially more toxic than others. A group of researchers found that blue, green, and red inks were more toxic than black. More specifically, the worst of the three were green and red which demonstrated increased toxicity and contained those dreaded azo compounds.

Black ink was, in terms of toxicity the lowest. Which makes sense, black inks are predominantly carbon based and do not contain metal or azo compounds which are used in colored inks. So the good news is perhaps embrace the black and grey tattoo style if you’re considering getting inked.

 Highlights from “Tattoo inks: Characterization and in vivo and in vitro toxicological evaluation”:

Tattoo inks contain nanoparticles.

Blue and green inks contain high levels of metals.

The metal fraction of tattoo inks is not proportional to the toxicity.

The black ink was found to be the safest toxicologically.

The higher toxicity of red and green inks may be related to pigments containing azo compounds.

Source: (Arl, et al., 2019)

If it were me, I’d appreciate colored tattoos on other people and commit to the black and grey style. I mean look at some of these amazingly talented artists. Besides, black is timeless and is good for any occasion. Just check out some of this incredible art on Instagram. 😉

Source: Instagram, @Lilbtattoo

Source: Instagram, @juncha​

Source: Instagram, @Kiljun

[shadassa]

All about that bacon

So I’ve continued to read public health related books since graduating from my masters program, and the most recent being Spillover: Animal Infections and the Next Human Pandemic by David Quammen. As the title implies, this book is all about zoonotic disease that occurs typically in animals but can spillover and infect humans. For instance, swine flu which is a virus common in pig populations, and while rare, can infect humans.

As a growing public health professional, I find diseases to be fascinating, and this book gives a great overview of some of the recent and potentially threatening zoonotic concerns of our day. Mr. Quammen is a traveling writer for National Geographic, who has a penchant for tracking down and writing about diseases, wherever they’re found.

He is thorough, he visits the locations and interviews the people who were there which ultimately paints a vivid picture of the location and steps taken in identifying and controlling or trying to control the spread of things like Hendra virus, Ebola, or AIDS. I personally haven’t read the Hot Zone yet, but I’ve heard that comparatively this book is much better in its realism. Quammen jokingly points out that people don’t actually dissolve from the inside out when they contract Ebola. This is important to me, books about public health crises shouldn’t help fan the flames of fear.

Reading Quammen is sort of like reading the epidemiological version of Indian Jones, it’s half travel and science mingled with a dose of adventure writing. The best part is that it is factually based in science and research, and so by default you learn a lot about diseases. He presents a wide range of material and builds up from the microscopic level to the broad reaching social impacts that disease can play out on the global scale.

He comes at it with a balanced approach, and you appreciate the horrifying nature of some of these diseases like Ebola, but it’s not blown out of proportion. In reality, the risks of contracting a disease like Ebola is pretty slim. However, there are other more pressing public health concerns of diseases that could make a resurgence.

If you’re interested in disease, public health, or science writing. I’d definitely give this book a read.

[shadassa]

Vaccines are safe!

Given the recent outbreaks, I think this is critical and very appropriate timing. Not that we needed more evidence, but this decade-long study of half a million people was just published. Spoiler alert, they found no link between autism and the measles vaccine!

Annals of Internal Medicine: 

https://annals.org/aim/fullarticle/2727726/measles-mumps-rubella-vaccination-autism-nationwide-cohort-study

There has been a growing movement of parents and conspiracy groups pushing dangerous ideas that vaccines are harmful. They’re not. 

It’s incredibly frustrating to me that, literally, the greatest medical advances in preventative medicine might lose ground. Measles outbreaks are on the rise and this year alone we’ve seen them occur in Washington and Oregon in communities with low vaccination rates.  

As a scientist I can’t say vaccines are 100% safe, and unfortunately we can’t make it as black and white as we may want to. However, vaccines are not high risk interventions, and the benefits of vaccination far, FAR outweigh any mild side effects.

There are some side effects that are more moderate or severe, but again they're EXTREMELY uncommon. For instance, febrile seizures only happen in about 1 out of 3,000 doses of MMR. Definitely scary but not life threatening like the diseases that MMR prevents. Additionally, there is no link between febrile seizures caused by vaccines and any lasting problems.

The most severe side effects, including severe allergic reactions are incredibly rare less than 1 out of a million doses, and are often completely treatable.

I'll just repeat that there are risks (usually very minor), but again you have to think about population safety and risk management. Child mortality before vaccines was high, really high. For example, in 1900, 21,064 smallpox cases were reported, and 894 patients died (Fenner et al). In 1920, 469,924 measles cases were reported, and 7575 patients died; 147,991 diphtheria cases were reported, and 13,170 patients died. In 1922, 107,473 pertussis cases were reported, and 5099 patients died (US Department of Health, Education, and Welfare). Smallpox has since been eradicated (thanks vaccines!). In the last decade there have less than 5 cases of  diphtheria in the US and pertussis cases have dramatically fallen (thanks again to vaccines!).

The diseases that vaccines prevent are much more dangerous than the mild and rare risks associated with vaccines.

A friend sent me this article which I think is both fascinating and terrifying, and is an important reminder about the way that we use technology and how these platforms shape our realities. 

https://www.wired.com/story/amazon-and-the-spread-of-health-misinformation/

[shadassa]

I think I might be a scientist

So this exciting thing happened, I’m officially a published scientific author! 

For as long as I can remember, I have had a deep interest in how we interact with our environment; especially the way in which we react to environmental changes. During my undergraduate studies in biology I developed a passion for the biological sciences, chemistry, and environmental influences. The culmination of this degree was my senior capstone thesis, which focused on creating a baseline for water quality and riparian disturbances in the Cascade-Siskiyou National Monument. 

While doing my graduate program in public health at Emory University, I was very interested in water and health. The Centers for Disease Control and Prevention (CDC) estimates there are 780 million without access to clean water. The CDC also suggests that half of the developing world lacks access to appropriate sanitation. To enhance the health of developing nations, it is imperative that water supplies are clean and accessible.  I wanted to do a project during my studies that focused on something that would combine an environmental health and epidemiological perspective. 

And while my career path has taken an interesting diversion from water and health as a primary focus, I was able to work with some great colleagues and get a piece published that looked at arsenic and fasting blood glucose in Bangladesh.  

If you’re interested, feel free to download the article: 

https://authors.elsevier.com/a/1YdbO3Ao5niuG

[shadassa]

We should all be concerned.

In 2017 the National Safety Council analyzed preventable injuries and deaths and discovered the odds of dying by accidental opioid overdose was 1 in 96 compared the odds of a motor vehicle crash 1 in 103. That’s a pretty shocking statistic. It’s so extreme that there is evidence that opioid deaths is causing life expectancy to drop in the US.  

This is an area of research that I recently began to work in, and one that is as fascinating as it tragic. Long before the opioid epidemic erupted into the spotlight as a major public health emergency there was a rather surprisingly important blip written back in 1980 by Dr. Hershel Jick and Jane Porter. This little letter to the editor to the New England Journal of Medicine suggesting  “that despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction.”

This op-ed pretty much remained in obscurity, until around 1986, when it was cited in the journal of the American Pain Society. That essentially started a snowball of scholars that began to cite “Porter and Jick” as some seminal and rigorous study, journals and researchers alike were referring to it as an “extensive study” and a “landmark study.” The Porter and Jick paragraph was exaggerated and its conclusions clearly taken out of context. Remember, that this was not a rigorous study but a simple opinion piece to a journal.

Coincidentally, the New England Journal of Medicine didn’t put its full archives online until 2010, literally the only way to track it down was to find a physical copy in the stacks!

Around the same time that this “idea” that opiates weren’t particularly addictive was being pushed there was a movement to aggressively treat pain. In the 90s the VA hospital system developed a perspective that pain, while not a traditional vital sign nor disease, should be treated as a “5th vital sign.” This became standard practice in 2001 by the Joint Commission. The general thought was that pain was being under treated and needed to be rigorously targeted during each patient visit.

As this idea grabbed hold in the medical community, there was a growing movement being pushed by pharmaceutical companies that Oxycontin was not as addictive as its predecessors due to its timed release mechanism. They were essentially giving the green light for doctors to prescribe as much of it as they wanted to treat pain. And they did.

There is a lot more to the story of how opiates became widespread across America, how manufacturers like Purdue Pharmaceuticals changed the game, and the impact it all had on opioid prescriptions being written. There is also another important component to the opioid epidemic, the sale of black tar heroin. If it’s something that interests you I highly recommend reading Dreamland by Sam Quinones.

Some closing thoughts. We as communities need to be better about how we treat the opioid epidemic and implement local changes to curb the amounts that are entering the streets. Safe disposal of unused opiates is important, changes in prescription quantities needs to be evaluated. However, the answer is not to ban opiates entirely. They are a useful tool in the medical toolbox and have their place for treating patient’s pain.

[shadassa]

2nd Big Race: Publix Marathon

I’ve been lackadaisical, and busy with the end of my graduate program, regardless I felt the urge to do a quick write up about my most recent Atlanta Publix Marathon. I have to say, I’m pretty proud of this race. 

I’m just going to jump right in and perhaps pop-corn around. I was able to take some lessons from my first marathon into my second. Namely, my nutrition game was stronger and I found the gel that is the least repulsive to me (I recommend the Cliff Mocha flavor). Secondly, I got some good training runs in doing a few long runs back to back to train my body to run on tired legs. 

The race temperature was great. I was a little concerned leading up to this race since the weather reports were ranging from rainy to sunny, but it turned it to be literally perfect. A little on the chilly side to start, and never got too hot.

The course overall was good. I’ve never loved running through cities, it’s just a lot of asphalt, but we started in downtown Atlanta and then meandered through all of the major neighborhoods. While city running is not my passion, it can still be enjoyable and running through the streets of a major city without fear of being run over is fun.

Over the 26.2 miles, we went up and down a good amount. I actually really loved this part of the race. It always kept me engaged mentally and physically and I never found it so exhausting or fatiguing. However, it definitely does add some challenge so if you’re considering this race or one similar make sure to do some hill work.

It’s always a struggle no matter where your fitness is. But it’s all worth it at the end when you’re cross that finish line and get to reward yourself with some well earned beer! 

[shadassa]

Saying Goodbye!

This is old news, but Pearl Izumi discontinued their running line. It was such a sad day when I found out the news, and once I heard I immediately squirreled away a few of their N2 trail and road shoes to get me through the dark times.

 Saying goodbye to a pair of shoes that are no longer made is analogous to ending a relationship.

 A little bit about me and my feet. I’m pretty flat footed, and over pronate (meaning the inside of my foot collapses inward), I’m 5’9” and weigh about 158lbs. Pearl Izumi’s worked great for me, and I trusted that they could get me through whatever lay before me. 5K, 10K, 10 milers, half and a full marathon were no problem for my faithful sneaks.

If you don’t know anything about your gait/foot-strike, I highly recommend going to a local running shop and having a gait analysis done. It’ll do wonders for helping to determine a good fit and shoe, and pay off in the long-run. 

However, the day has come to switch out the old for the new! I feel like I should have a farewell ceremony and pyre for my old trusted Pearls.

 I spent many hours reading about shoes, trying shoes on, and pestering numerous running store employees about the nitty gritty of their shoes. Fingers crossed it will pay off, if not I’ll be exploring more brands to come.

 I landed on purchasing two pairs of Saucony shoes. The Freedom iso road shoe, and their Peregrine 7 trail shoe. Here were some key factors for me. Pearl Izumi’s are typically a 4mm drop (meaning that the heel to toe drops approximately 4mm). Both of these Saucony shoes are also 4mm drops. I considered trying out some zero drop shoes, but ultimately let the age old “if it ain’t broke, don’t fix it” mentality persuade me from changing too much. The other thing that really persuaded me was their overall fit, felt similar to my old Pearls.

Saucony Peregrine 7 (grey/green) 

The Peregrine 7s felt great in the store, and I’ll be testing out them out this weekend during a little Storm the Watershed 15k trail run, but I have high hopes for these shoes. The lugs felt great, and I think I’ll get plenty of traction their (fingers crossed on a variety of surfaces), it had a carbon fiber footplate for protection, and the upper felt very durable. My only real concern was the uppers material felt a little plastic-esque which I imagine may trap in heat. The other thing I noticed was the tongue is very short which could be an issue depending on how it fits/rides for some. 

Saucony Freedom iso (blue)

The Freedom iso also had a very comfortable upper that feels like kind of like a sock locking my foot in but allowing for some stretch and flex. So far so good, though I feel like lateral movements in this shoe will not be ideal. However, for my inaugural run with this shoe it felt really, really great.

I’m excited to put some serious miles on these puppies and see how they hold up! Hopefully, I’ll have found my next workhorses but if not… What are your favorite shoes?

[shadassa]

Portland Marathon 2017

My journey to finishing my first marathon ever was a success, and I can happily say that I learned a great deal from the entire process.

 It’s always fun to feel the race day nerves, maybe it’s just being around hundreds of people that are equally as excited and amped about what’s about to happen, I don’t know. I do know that racing is never about getting first place for me, I’ll leave that to the professional racers, for me race day is about realizing a goal. About stepping forward, setting an intention, and trying to achieve it. Running is a personal accomplishment.

 My first goal while training was to simply finish. I thought “heck, this is my first marathon. I should be happy just to finish the damn thing.” However, as I really started to dig into my training and my fitness and speed started to progress I realized that not finishing was out of the question, and that an under 4 hour finishing time was my goal. Then I did a 20-mile training run that felt great, and I realized that I might be able to get closer to a 3:30 finishing time. This idea got me pretty excited as I realized I was in better shape than I anticipated.

 Regardless, I kept the under 4-hour goal as something I’d be happy with and said to myself that the best-case scenario would be right around 3:30. I mean, friends were saying that the real marathon doesn’t start until mile 22.

 Portland must have known that I was flying in from Atlanta to attend this race, because the weather was pretty ideal. The prediction was cloudy with temperature right around 60 with no anticipated rain. Great running conditions.

 The race started at 7am, and ran along the Portland waterfront. Looped up into what looked like some industrial areas of Portland and then crossed St. Johns Bridge around mile 9, and then into some north Portland neighborhoods along the Willamette River. Every mile or so had bands playing live music, and aid stations offering water/electrolyte drinks, as well as some gummi bear/pretzel stations.

 My plan was to start out relatively slow, get my body warmed up, and then start to crank it up around the half way point. I typically don’t eat energy gel or shot-blocks while I ran, so didn’t bring any of that with me. I planned on rotating water/electrolytes at each aid station. Things started out great. My first 3 miles were done at around 8:30min, around mile 6 I had sped up a little bit, at the halfway point my average pace was around 8min miles. I was on target for a 3:30 finish! I kept up this pace up until mile 22.

At mile 22 I realized that I was crashing. My legs were starting to cramp up a little and all the pounding of the asphalt was beginning to creep into my knees. My pace was starting to plummet, and I decided to stop at the next aid station and eat some gummi bears. It was too little too late though, and my last 4 miles were rough. I was average pace slowed down to around 9:45 min miles. My legs were feeling super heavy, my muscles were slightly cramping, and I just couldn’t get my legs to move faster. It was a strange feeling; my cardiovascular system was in great shape. I wasn’t breathing super heavily, I had plenty of breath, but I couldn’t get my legs to cooperate. I quickly realized that my 3:30 finishing time was out the window, but refused to let my desire to walk overtake me. When people say that the real marathon starts at 22-miles, they’re literally telling the you the truth. Running on legs that were that tired was pretty painful, and my stride went to shit, I felt like I was hobbling the last 4 miles to the finish line.

Crossing the finish line was glorious. I definitely felt a little zombie-esque, but it was none the less an amazing feeling. I was also perhaps a little delirious and let myself just be corralled by all the race volunteers that just sort of move you along. I felt like I was shuffling through a gauntlet of people just handing me stuff. Finishers T, I’ll take it. Finisher medal? Yep! Commemorative coin, why not? Here’s a necklace to remember the event. An Atlas cedar seedling to be planted? I’ll take it. A Rose, a bag of bread? Sure.

Once they’d successfully burdened me down it was time to hit the feeding trough, which was awesome! There were mountains of apples, oranges, bananas, yogurt, soda, water… All great things. However, I delicately sampled some fruit and yogurt as I wasn’t sure yet how things would settle in my stomach.

 The race ended with a beer and a burger! Though the day held plenty more beers and food to be consumed!  

 Lessons learned:

While I may not need nutrition on training runs, I think I’ll try it for anything over 20 miles. My game plan for next time is to eat a gel or something around mile 15, and have something in my system for the last push.

Train harder, and have a few runs on tired legs. Running on tired legs was much, much harder than I expected and I don’t think there’s any good way to prepare for it except to just do it.

This will not be my last marathon. 

[shadassa]

Eating Well is Critical

Good nutrition is critical for success:

I was lucky to have parents that firmly believed in the phrase “you are what you eat.” From a young age, I remember how my parents believed in buying whole foods and preparing them simply and well. Our house was always stocked full of fresh produce, organic dairy, fruits, legumes, and tasty pastas, you get the idea it was your typical health food store offerings with little processed food in the pantry. However, I don’t think I realized how much an impact it would have on how I think about nutrition and what I want to eat. A great rule of thumb is to simply eliminate processed foods, if the ingredient list is a novel, avoid eating it. 

Nutrition though is more complex, and it also depends on what your goals are. If you’re a bodybuilder trying to bulk up like Arnold Schwarzenegger then your nutritional requirements/strategy will be quite different and you’ll probably be focused on certain macros (protein, fats, and carbs). The academy of Nutrition and Dietetics reports that bodybuilders need roughly 0.63 to 0.77 grams of protein per pound of body weight each day and that you’ll probably need around 1.4 to 1.8 grams of protein to build 2 pounds of muscle mass. For me personally, that means I need to consume over 120 grams of protein a day to maintain and build body mass.

However, I’m not a body builder nor do I want to be in the Arnold camp. I’m more of a Bruce Lee fan, a lean, tone, and functionally fit body that is centered around a healthy lifestyle is my objective. Running, climbing, and being outdoors is a central part of my life and being bulky and weighed down by excessive muscles doesn’t sound awesome. 

Regardless of which camp you’re in it’s also important to recognize that there is a limit to how much protein the body can use to synthesize muscle at a given time. There is evidence that 30 grams of protein per meal is sufficient to stimulate muscle repair and growth. It’s also likely that to maximize repair and growth, protein should be consumed over the day as opposed to eating one large protein rich meal at dinner.

Enter healthy snacking. I typically pack all my meals since I’m pretty active and want to be eating throughout the day. Additionally, I want the extra control over my diet and don’t want to be at the mercy of whatever restaurant or junk food is closest. I don’t believe that all calories are created equal, a calorie from sugar is worse than a calorie from a carrot or an apple. I’m a huge fan of having almonds, walnuts, and sunflower seeds handy at all times. They’re a great source of quick protein, great natural fats, as well as fiber and other nutrients. I’ll probably bring this up in the future again, but limit your sugar intake. Sugar is literally the devil, sugar from whole fruits is fine as it also comes with healthy fiber and carbs. However, refined sugar is the worst and essentially gets turned into fat.

Sugar is processed in your body as a carbohydrate. Once it enters your digestive tract, sugar is broken down into fructose and glucose. Glucose starts out as a carbohydrate, but is quickly stored as a fat. Fructose is absorbed through your liver, and is mostly turned into fat as well. A problem with sugar in our society is that it’s literally everywhere, and in almost anything processed, which means your average American consumes WAY too much of this nasty, white refined, devil’s powder. My advice to any friend is to cut out processed sugar as much as possible, kick that soda habit to the curb! Buy a water bottle and drink that delicious life-giving fluid instead!

The major concept here that I’m getting at is not so much about eating less food, but eating better foods.

To illustrate the idea here is a table that represents an average day and what I consume. Also feel free to check out my Instagram (bibble.time) for ideas, and visuals of how I eat. 

[shadassa]

Let’s Talk Training

About seven months ago I realized that I was experiencing depression. I had overwhelmed myself with moving to a brand-new city, isolated myself by working remotely and not really getting “out there,” and I’d recently started a graduate program. All of these things, and more, made me push aside the things that I love, namely adventure, trying new things, and staying active.

 It isn’t always easy to objectively tell when things are wrong, and this realization crept up on me slowly. However, eventually the water was boiling and I noticed that I was getting cooked alive. A change needed to happen.

 I decided to start really running again, it was a “fake it till you make it” strategy. I knew running made me feel good from the natural endorphins released. So, I set out daily to get that runners high, but it didn’t stop there. I signed up for a yoga membership, started avidly climbing again and decided it was time to mix back in some lifting movements. My first goal was simple, start getting back out there to feel better. It’s not always easy, but sometimes the best thing to do, is just doing it.

 However, my first goal was quickly achieved and I wanted more motivation and I wanted to test my personal abilities to overcome obstacles. I decided it was time to finally mark off a marathon. Below is how I’ve been training and my philosophy on overall health and functional fitness.

 Running:

My main philosophy when it comes to running is three shorter runs during the week, that are anywhere from three to six miles, followed by a long run on a weekend day. This leaves three days a week for recovery or cross training. My long runs waffled on weekends, for example if I ran 12 miles one weekend, the next weekend I’d likely run 10 miles before going beyond 12. I also typically double on days that I do short runs (i.e. run 3 miles in the morning, plus a shorter lifting session either after or in the evening).

Here is an example chart of my training, including some cross training. This isn’t a from the couch to marathon kind of thing, I had a relatively good base of fitness to start with. After the longest run for me (20 miles) I’m giving myself two to three weeks to taper. Tapering for me means reducing my mileage considerably, I’m stilling running three to four times a week but for shorter distances (three to six miles). During the taper, I will do some 8 mile runs on the weekends but at a leisurely pace. The idea here is to give your body plenty of time to recovery and replenish before the marathon.

Quick philosophy between weekday vs weekend runs. I’m a believer that when going for endurance quantity definitely matters. However, I also believe that quality runs are just as important. My weekday runs, especially those that are short, are a time to focus on form and speed. My goal is to always be striking the forefront of my foot and gently rolling back a little that my heel gently touches the ground before exploding forward. These short runs are additionally a time for me to push my speeds. You should be uncomfortable during the short runs, and unable to really be chatting.

My weekend long runs are a different story. I typically start out slow, hit my stride in the middle or end of the long run, and then slow back down for the last mile or two. Long runs for me are about building endurance and spending time pounding the trail/pavement.

Lifting:

When it comes to lifting there are many dogmas. For me personally I’m not trying to bulk up and be a beef cake, instead I want to be lean and functionally fit. Long distance running has a tendency to lean a person out, during those long runs and elevated heart rates our bodies will metabolize protein (muscles) into energy. A result of this is that long distance runners are often pretty lean. As a climber and overall athletic individual I want to be lean and strong and functional in a variety of activities. To help counteract my body metabolizing my muscles I lift. My lifting routines usually incorporate a lot of full body motions and body weight exercises (dead lifts, squats, bench press, pull-ups, bar dips, etc.), furthermore it’s important to vary your lifting days. I like to rotate between upper body and leg days to give different muscle groups important rest days.

Sample 12 weeks of training.

Fitness is an ever changing thing and as my goals have changed so has my training and activities. Stay tuned for more. 

[shadassa]

Silver Comet Trail, Georgia

Silver Comet Trail, a leisurely rest day! 

In an attempt to give my legs a needed rest day from last weekends 20 mile long run, a friend and I decided to take a nice 30mile bike ride along the Silver Comet Trail. 

I think we had high hopes of actually crossing into Alabama, and while that didn’t happen it was none the less an epic ride. It’s been years since I’ve really been on a bike ride and it was an exhilarating feeling to be, in comparison to running, flying at phenomenal speeds along a well groomed “trail.” 

To my horror, I managed to pick up a few rogue hitchhikers that happened to be dangling to low from the surrounding canopy. I do pretty well with creepy crawly things, maybe it’s the biologist in me but snakes, salamanders, etc. have never really bothered me. However, my kryptonite is spiders. So I wasn’t pleased with my hitchhiker friend that decided to jump onto my helmet as a careened by at a zooming 13.5 MPH. Naturally, I slammed on my breaks to investigate what had just happened. I didn’t find anything, but my buddy did mention that there was a large spider that had been trailing behind in my slip stream. I can only imagine how startled and probably stoked he was to be experiencing the miracle of flight, unbeknownst to him though his voyage caused some small amount of panic to his transportation. 

To my excitement though today’s ride reinvigorated me to get back into the biking game. I pulled the trigger on ordering some bike shorts (absolutely necessary), lights, and will be visiting REI stat to pick up some panniers (saddlebags) to begin bike commuting when possible. I’m a solid believer in cross training and if you’re legs need a break, like mine did, try something low impact like biking or swimming! Everything in moderation, including marathon training. 

[shadassa]

I did a thing today. This will be my first marathon, and hopefully not my last. My running journey started in 2014 after coming home from the Peace Corps. I had landed a job working for a mental health organization, and a new colleague and soon to be friend, Joe, gave me a half marathon finisher t-shirt. Naturally, I couldn’t in good conscience wear the shirt without running the damn thing. So I signed up for that years race. 

The thing about this half marathon (it’s actually 13.3), is that it’s essentially all up hill, 13.3 miles long, one mile up. Or as the back of my shirt read “what could possibly go wrong.” It wasn’t a pretty or illustrious start to what would become one of my favorite hobbies and lead to the best shape of my life. I’ve always been in fairly decent shape, but running wasn’t a regular part of my exercise routine. I identified as a climber, even better someone who preferred bouldering. Short bursts of intense explosive power and then kicking back on a crash pad with a beer in my hand was more my MO. 

Needless to say, pounding the trails for long periods of time was not my forte, but damnit, Joe gave me that shirt and I’d be damned if I didn’t earn the right to wear that stupid thing. So I journeyed three to four times a week, aided by some patient friends, to put in some miles. I completed that half marathon, it was not easy and I remember that the last 0.2 miles were an incredibly steep scramble to the finish. My legs were cramping, and every step I took my quads would seize up but I managed to finish with around a whopping 3:49:00 time. Nothing amazing about it, I probably crossed that finish line looking more like a zombie than a runner. 

Fast forward 3 years, I came back in this year to run that Hillclimb all over again. I was nervous, I’ve been training but I was no longer training in the hills of Oregon but instead putting in miles in the humid south. However, I managed to improve my time considerably. I finished this year 2:49:00, shaving a clean hour off my previous time, and that is something that I’m damn proud of. 

       Tastefully shirtless, and happy. I didn’t look nearly as good at the end of the 2017 Mt. Ashland Hillclimb ;)

My eyes are on you Portland Marathon, and I’m excited to see what happens and where my next fitness challenge will take me. 

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Welcome to shadassa.com. Take your coat off, stay awhile.

[shadassa]

Stomp Guinea

This last year of my Peace Corps service is wrapping up and hopefully I will be flying home at the end of July! Most of my time is spent teaching which often makes me feel useless, ineffective, frustrated, and a slew of other negative emotions. Luckily the school year is almost over which amazingly enough sometimes makes me a little sad. However, this post isn’t about teaching in Guinea instead it’s about an ever present threat to those that live in this beautiful country: malaria.

The World Malaria Report of 2013 indicates that 100% of the population lives in a high transmission area. This kind high-risk situation means that almost all Guineans are affected, at some point in their lives, by this disease. A huge issue is education from the basics of understanding the disease, and how it is passed, to proper diagnoses and treatment, and of course prevention.

Guinea’s number one public health issue is malaria, and to help change this situation Peace Corps Guinea participates in a huge amount of malaria education activities. Right now we find ourselves in the middle of a “Malaria Month Competition” where the three regions (Basse Cote, Fouta, and Haute) of PC Guinea volunteers compete to do the most malaria related projects.

We’ve been doing a huge amount of work all over the country holding soccer games dedicated to malaria awareness. Training host country nationals to go out into their communities and sensitize their neighbors. Doing volunteer bike tours visiting multiple villages and setting up information stands. Using multimedia (videos, radio-spots, posters, murals, etc.) to promote malaria awareness. All these great projects and PCV collaboration makes me proud to be a PC volunteer serving in Guinea. 

One project that I made is a short video of my community highlighting the malaria situation there. I live in a very small rural village with a population around 500. Last year, 2013, there were 204 documented cases of malaria at my health center that’s around 40% of our communities’ population that contracts malaria. This has a huge socio-economic cost to my village and to Guinea. 

[shadassa]

I Can't Wait

So maybe you know and maybe you don’t but here, in Guinea, I’m a teacher. That’s right I get to shape the minds of young adults that will hopefully go on to shape the future of this beautiful country. You might ask what subject I teach and I’d humbly reply chemistry. Chemistry the study of matter and a fascinating subject is made almost worthless by the designated program that I have to teach in order to prepare my students for their exit exams. Recently I taught my 7th grade class, according to program, about a volatile gas; butane. Naturally at the end of a lesson we teachers try to evaluate student comprehension by giving tests. What follows is a translated test that I gave my class following the butane lesson. All my classes and tests are of course given in French, which is the administrative language in Guinea.

Now your instinct might be to say that such poor responses reflect poorly on the teacher, and I’ll be the first to admit that I’m not what one might call a natural teacher. But remember that this kid as been in school for 7 years, maybe more if he was held back a grade which happens often.

  I try to present the information that I have to in a clear and engaging fashion with lots of demonstrations, and examples as well as in class practice. The real problem here is not my teaching style but sadly the education system in Guinea and more specifically language comprehension. The administrative language is French, yet the population at large speaks a variety of local languages and the literacy rate is terrible around 40% of the population can read and write. The majority of my 7th grade students simply don’t understand French. My 7th grade class has 60 students of which 5 can actually formulate and think in French. To the rest of my class I must look like a very bizarre white man jumping around and making things explode while speaking in a hilarious accent. Hopefully they will learn something from my classes though I doubt it will be related to chemistry. I can’t wait to be done teaching.

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To help combat malaria in Guinea Tess Palmer helped her community hang up over 300 nets. I used the pictures she took during the process to create a short video to motivate volunteers!