Does This Absolve Shoeless Joe?

Who's laughing at my smurfy hobbit footwear now? (Ok, everyone, but still....)

Business Travel

When I order crappy room service from the hotel I'm in, the bill to sign does not make a big deal of it, but upon careful review, I notice they charge 20% for "service" and a $3 "delivery" charge. I'm not sure what service is happening aside from the delivery. Even worse, they then leave a blank line for "tip" and total.

I really miss my family, my butcher, and double cream. Usually in that order.

HDTV? Looks really, really good. When I get home, I'll wonder what's wrong with my TV for a week, before I forget what HD looked like.

Likewise with shower pressure. I always think our shower is broken when I first get home.

The hotel laundry service charges more to wash my t-shirts than I paid for them.

I really miss the per diem model, as opposed to expense limits. The daily limit expense policy doesn't work well for me if I eat a lot one day, over the expense limit, and very little the next day, well under the expense limit. It would be easier to administer if the company could simply figure the average daily spend for the past year's worth of business trips, and specify a per diem slightly lower than that. This would keep spending in check and make everyone happier (and be easier to administer).

"returning no value to the world"

Uh-oh, more people are catching on. Wall Street might want to drop the righteous indignation and just lay low for a while. Don't worry, the jig is not up yet.

Carbs Getting Mention On Room Service Menu

Staying at a Marriott and I've noticed the room service menu is flagging various items as meeting some dietary criteria or other. The designations include "low carb", "high protein", "carb conscious", "low fat", and "low cholesterol", plus various combinations of those. It's actually good to see indications that low-carb is going mainstream. I'm not fully clear what these designations are supposed to mean. I like the sound of "carb conscious", but I can't figure out how it's different than "low carb". Grilled fish gets the "carb conscious" label, while grilled steak gets upgraded to "high protein - carb conscious". Steak & eggs gets only "high protein", not sure why it doesn't also qualify either for low carbness or carb consciousness, and I feel a bit bad for it, whereas a shrimp cocktail gets "low carb, low fat", which means it must also be high protein (unless it pulls off the trick usually reserved only for acaloric items of being low-everything). And some things -- e.g. some of the salads -- have no labels, despite surely being carb contentious or low protein or something.

I wish they'd define the terms then apply them to everything that fits each term, but it's still good to see.


P.S. The only term I find objectionable is "low cholesterol". It's been about 25 years since even one of the most fervent anti-cholesterol crusaders admitted that dietary cholesterol has nothing to do with serum cholesterol. Even if you believe that high serum cholesterol is bad for you, you should know that dietary cholesterol has SFA to do with serum cholesterol. Why do egg beaters still exist? Why are egg-white omelets legal? It seems to me the anti-fat brigade who have known that the cholesterol you eat has nothing to do with anything have not done anything to correct the common belief that it does matter, because they secretly wish it really did.

P.P.S. I had the steak & eggs for breakfast, and it was surprisingly good. It came with mushrooms cooked with tomatoes & bacon. After that, I went 12 hours without eating. The only objection to it was that I found the canary-yellow egg yolks a bit shocking & disconcerting.

"the Americans"

Flying out of Heathrow earlier today, to New York. Our departure was delayed by about 90 minutes because every single passenger was getting frisked before boarding, and every carryon was getting opened and searched. I asked why they were doing this and what all the fuss was about. To his credit, the frisker was very polite and apologetic when I asked (in the US you tend to get nothing but attitude and aggressive posturing if you ask questions like that). His response? "The Americans". He kind of sighed and looked truly regretful as he explained since the underpants bomber, the US is demanding that all passengers and carryons be searched prior to boarding. We are a very, very difficult country to like sometimes.

ATM Card Skimming

Looking at an example such as this, I wonder if a simple measure to make this more difficult would be to have each ATM show a photograph of itself, as it was installed/meant to be, on the display prior to card insertion, so you can compare vs. what you are actually looking at.

Robert Llewellyn

Although I've never seen Red Dwarf, I'm a big fan of his. I adored Scrapheap Challenge (apparently there was a predictably horrendous US version, but the original UK version was charming and thoroughly enjoyable). He's been up to quite a bit, including a regular video podcast series, Car Pool, in which he interviews people while giving them a lift somewhere. His last two interviews were with Patrick Stewart, which was great, and Ben Goldacre, which I've not gotten to watch yet but am looking forward to.

Nutrition Info Shortlist

My shortlist of blogs I recommend is already over to the left there, but here are some highlights for nutrition & health related content.

if you only read one book
make it the Gary Taubes' book (btw, there was a recent review of the book in the British Medical Journal, the unedited version of which is available here)

if you only watch one lecture
watch one of Taubes' lectures on obesity

if you only read one blog
read Stephan Guyenet's Whole Health Source
(don't worry, he's not a low-carb nutter like most of the other bloggers I like)

best lecture of 2009
Dr. Lustig's lecture on fructose
Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, has a great lecture on fructose. He's especially passionate since he's been involved in treating obese children. I have 2 quibbles with this lecture. One is that I think he overrates glucose. The second is that he gives Ancel Keys way too much credit. He faults Keys for performing a fundamentally flawed regression analysis, but misses Keys' far worse sin of collecting data from 22 nations but publishing a "7 nations" study by choosing only the seven that best fit the curve he wanted to see. Faulty regression analysis is dumb, burying more than 2/3 of your data is dishonest. But none of this has any bearing on the message or impact of Lustig's lecture, which is a must watch for anyone who thinks fruit juice is "healthy".

best "paleo" blog/best new blog of 2009
No contest: Dr. Kurt Harris's PaNu blog
Don't worry, this is not about paleo re-enactment or some crap about "what would grok do". As an added bonus, he's a midwesterner.

best article on healthcare in the US
Atul Gawande's now-classic 2009 article on costs. There was a nice little followup a few weeks later as well.



some noteworthy blog posts from 2009
A fantastic summary of diet ("what I learned last year") from inflammation researcher Dr. Art Ayers. His blog gets fairly detailed and technical on inflammation, but occasionally he writes concise and accessible posts on diet.

Hyperlipid's excellent challenge to ketosis

Stephan's great series on eicosanoids and heart disease -- part I, part II, and a concise summary for those who don't want to read parts I & II (I have to confess I like saying "eicosanoid signalling" out loud, frequently, so that may be the basis for my fondness for the subject)

A wonderful dissection of some observational studies by Prof. David Colquhoun on his "Improbable Science" blog.

Dilbert

Dilbert was a lot funnier years ago when Scott Adams still had a job. I don't read it religiously because it's often pretty dull now, but when I do I'm struck by what a sanctimonious prick he comes across as. Anyone else notice that Dilbert is pretty much an asshole? Or does this mean my metamorphosis into a PHB is complete?

Oxford Scientists Discover Freddy Mercury

If I were an academic researcher, this is exactly the kind of thing I'd be getting to as well: coming up with projects and publications to extoll the virtues of round bottoms and shapely thighs.

Label The Pink Slime

In the excellent Fast Food Nation by Eric Schlosser, there's a section on shit in the meat, and radiation treatment. [Food irradiation is one of those practices that I oppose yet I find many who also oppose it to be idiots.] As Schlossers argues, the reason beef processors would like to irradiate at the end of their lines is so they can crank up the speed of processing, spray shit everywhere, but have the safeguard of killing all the [literal] crap that makes it in.

If we're not going to irradiate the shit out ground beef, what else can we do to it? How about inject some ammonia into it? A processing company had the genius idea of taking the "pink slime" that would normally be relegated to pet food or industrial by-product status, injecting it with ammonia to kill colonizing pathogens, and mixing it into their ground beef, making it cheaper. Not that different than shovelling the scrapings off the factory floor into the sausage-mixing barrels.

The USDA approved this practice. Naturally, they approved it by accepting the company's own study that the process is effective. That's not the really bad part. The inexcusable part is this: they don't have to mention on the label that they've injected the pink slime with ammonia and stuck that in your burger. 'Federal officials agreed to the company’s request that the ammonia be classified as a “processing agent” and not an ingredient that would be listed on labels.' The company asked the feds to not make them list ammonia as an ingredient, and the feds complied. The government is not acting in the public interest. Who is your government working for? Not for you, clearly.

Top Gear vs. Mythbusters

I begrudgingly appreciate mythbusters, although I generally find it tedious and that Jamie guy totally winds me up. Yesterday we were watching a bit that the vastly more likeable 'B' team were working on that involved underwater explosions and trying to surf the resulting waves. One of the things that bugs me about the show is how overly cautious they are about everything. They constructed a robotic paddler on a surfboard to not expose anyone to the possible dangers of the detonations, while they stood very far away, wearing hearing protection. We got to talking about how much better this would be if Top Gear were doing the same test. They'd have Richard Hammond out on the surfboard. He'd be complaining the whole time. James and Jeremy would likely put more explosives in than required, and would lie about how deep it would be submerged, all in a good-natured effort to kill their cohost. The detonation would happen, Richard would get tossed about, or possibly critically injured, and they'd all be pleased as punch.

the blip of the recording artist

Technopop got me thinking again about paying for music. What if the latter half of the 20th century was a blip, not a shift? That is, for thousands of years performing artists [attempted to] earn livings by performing. Then, for a few decades, it was possible to make a living by selling recordings rather than by performing per se. Having grown up with the latter, it seems perfectly natural and something we assume we should sustain. But of course this model is rapidly eroding. There's lots of worry about how to save it, but it may just end up reverting to the performing artist compensation model -- sponsorship & performance-based pay -- of hundreds of generations prior?

Blackberry

Improbably, I'd managed to avoid having to use a blackberry despite years of my white collar peers being tethered to them. A few years ago a survey at a former employer showed that remote access (being able to access work from a home computer) was roundly viewed as very positive for "work-life balance", whereas blackberrys were voted to be overwhelmingly negative. Remote access lets you reach out to work on your terms, whereas blackberrys let work reach out to you.

Sadly, my blackberry-free days ended this past week. I am shocked at how ugly these things are, despite several generations of iterations. Utilitarian is no excuse. What a cloddy piece of kit. Even the icons are bad. Horrid little pieces of shit, aren't they?

Weight Training

As I said in my health review a couple days ago, I'm a big believer in resistance training for anti-aging and all-around health effects. Whether it's pushups & chinups & dips at home, or hitting the barbells with Mark Rippetoe, or joining the crossfitologists, some kind of weight training is recommended for everyone, regardless of age or gender. I'm on week 6 of a new weight-training program. Since I'd previously been impressed with the research of Jeff Volek, I decided to give "tnt" a try. So far, I love it. Seems right up my alley. The diet advice in the book was old hat, but useful if you've never seen it before. I especially like the differentiated approaches based on starting state and goals -- very helpful. The actual exercise selection seems very thoughtful and part of a coherent plan. I also enjoy the nutritional timing suggestions.

Coffee w/ Cream

My one-man crusade to get cream back on the menus at cafes is going pretty well. Almost every place I've asked has been able to dig out some honest cream for my coffee, except the one coffee stand at which the barista looked at me as if I'd asked for a bowl of live grubs to spoon into the brew. Cream in coffee??!? Craziest request ever. This being the UK, a lot of places have cream about for desserts, which is a civilized practice if ever there was one.

It used to be that cream was the norm, then "half & half", aiming to be a blend of whole milk and cream, was added for a "lighter" option. Then the set got downgraded to half & half and milk, and so on, until now if you have two choices they are usually between semi-skimmed and skimmed.

Here there's a wonderful thing known as double cream. Yes, it's what you'd think. Delicious stuff. Ordered some as usual but the online grocer substituted, shockingly, with something branded "Elmlea double", boasting that it's "light". It is a horrendous product. Nevermind that I can't figure out who this product is for (I always thought that lower-fat cream is something that I like to call "milk"), check out the ingredients: it's a blend of buttermilk and trans-fats! Want some hydrogenated veg oil in your coffee?

Remember When The Simpsons Used To Be Good?

It used to be funny because it was true.
Mayor Quimby: "Are these morons getting dumber, or just louder?"

Health Review 2009

Interesting year, 2009, personally, professionally, health-wise. After dabbling in low carb in prior years, with good results, I went whole hog. Lost nearly forty pounds during the year: started at 219 and flirting with 180 in recent weeks. Lean mass seems to have gone up, too. I've lost 6" from my waist, down to 34" for the first time in a couple decades. "Gratifying" would be a huge understatement. My BMI, fwiw, went from over 30 to 26. It might never get to the "optimal" range of under 25. (BMI is more useful as a population tracking metric than as an individual measure.) According to the magic scale my bodyfat percentage went from over 30% to under 19%. I don't put much stock in that, since it varies so widely day-to-day, but for trend tracking it's still useful. The mirror and clothing make for better measures.

It will be interesting to see how my thinking evolves over the next year.

Diet
After years of assuming low-fat, "complex" carbs was the way to go for health, and dismissing low-carb as a bunk, I finally started coming around by looking into it over the past couple of years. Gary Taubes' book, of course, was hugely influential in my thinking. (Seriously, the guy is an awesome science journalist. Even if you don't give a damn about diet, try one of his earlier books on bad physicists.) But I've gone beyond that, read other studies, articles, papers, blogs, watched lectures, and, most importantly, experimented on myself. If it didn't work, I wouldn't keep doing it. And it did work, brilliantly.

I generally stick to low-carb, aiming for very low-carb most days. Occasionally I carpet-bomb my liver with crap, just to keep it on its toes. Can't let it get too complacent. Current thinking: low-carb (i.e. high fat) is the best way to lose weight. I don't think constant ketogenesis is necessary for weight loss, but being adapted to it and near enough to drift in and out with ease is a good goal. As far as carbs go, avoid especially sugar and grains. For sugar, fructose is by far the worst, so anything with sucrose or HFCS should be avoided. Likewise fruit juice. If you want carbs, best to still avoid gluten grains (no wheat!) and sugar. Get carbs from vegetables. Avoid starch and starchy veg, but if you must, tubers and rice are much better than wheat and other gluten grains. Nuts are generally fine. Fruit in moderation if you like carbs. For a carb-heavy diet, low GI is good, low GL (glycemic load) is better, except wheat elimination should be a goal regardles. Fibre I'm undecided on. Studies are mixed on the issue. It looks better observationally than interventionally, and there are good arguments against overloading yourself with fibre supplements. Fats are a contentious issue. The best general rule is to try to get the omega-6/omega-3 ratio as low as possible. (Unless you move to Greenland and eat a strict diet of seal blubber and coldwater fish, you won't be in danger of getting the ratio "too" low.) Lots of interesting results follow from this simple rule, including choosing grass-fed meat over grain fed, eggs from pasture-raised chickens rather than from battery hens, and eating fish. The biggest thing to avoid is vegetable oil. Industrial seed oils, especially corn and soybean, are awful for you. Rapeseed/canola/safflower, and sunflower are really not much better. Even now that hydrogenated oils ("trans fats") have been shamed, the ubiquitous veg oils are still terribly bad. Olive oil is ok, although the cheaper heat-refined stuff is not that great. Cold-pressed is good. Some nut oils are good. Coconut oil I'm undecided on. Butter, lard, goose fat, I clearly like. I like dairy. Milk I avoid because of the sugars, but cream and cheese (and sometimes yogurt, full fat, unsweetened) I love. I avoid artificially sweetened foods for the most part. I think it's much better to keep my palate dialed down to a much lower sweetness calibration.

Plan for 2010 is to keep it up. I've got a nice layer of fat around my middle that could stand some further reduction. I'll stick with generall low-carb approach unless I have reason to change.

Exercise
To be clear, I lost most of the weight without any exercise. It was pretty much all diet. That said, I think exercise is wonderful and the benefits of getting some, regularly, are numerous and varied. The biggest mistake is thinking that exercise is the key to losing weight, and being disappointed if it doesn't have an impact in that regard, while ignoring the many real benefits. Exercise, have fun, and feel good.

After a decent fitness level in 2007, 2008 was a write-off. I started running again, back at square 1, at the end of April in 2009. First run was 20 minutes, with having to walk several times. By the end of the year, I'd gone over 13 miles in a training run and crushed my old personal record in 10k race. Faster, on the ground, than I've ever been at any point in life. I picked up swimming again in the last few months. Not tearing up the lanes, but got some fitness back. The biggest addition has been weight training, which I've added in the past six weeks or so. I've never been a big lifter, but have dabbled a couple times in the last decade. Last time was in 2004, though, for just a few weeks. I did a bit of weight training, on machines, back in the early 80s in my high school swimming days. Now I'm starting on free weights and I love it.

My current thinking is that resistance training of some form is the best for health, if you only do one thing. But really, whatever exercise you enjoy is better than none. For non-resistance training, some sort of weight-bearing relatively unintense activity (hiking is perfect), interspersed with occasional sprints (bursts of high-intensity) is ideal for health and longevity. Resistance-training is important for anti-aging. There are many kinds. Again, finding the right fit is more important than finding the optimal program. The "body by science" or "slow burn" approaches seem useful for people who prefer a truly minimal time investment (but potentially needing hands-on management). A lot of people love Crossfit. Seems a bit cultish to me at its worst, but for fitness it looks great if the approach resonates with you. At a minimum, everyone should dabble in at least a bit of bodyweight exercises (e.g. pushups). Military-style training seems to be popular here. Lots of intensity and bodyweight stuff, and the fun of a group. Looks a bit like crossfit without the weights.

For 2010, I'm going to continue with the weights. I will probably ease back on the running. Swimming I'll continue a little bit. Swimming's hard because it takes so much time. Like cycling in some ways, but a lot more overhead. Not sure if I'll do any more running races this year, or maybe get back into triathlon, or possibly look into cyclocross in the fall. Skiing, definitely. Fitness definitely helps there.

Supplements, Vitamins, Etc.
I've tried a variety of supplements this year. I've toned it down the last few months. Some thoughts.
Vitamin D (D3, in oil/gelcap form): almost everyone should take this
Magnesium (in citrate): I like tap water, but ours has no magnesium. Good idea for anyone to consider supplementation, variety of benefits.
Those are what I consider the most important. The others:
omega-3, in fish oil capsules: another thing worth considering for general use. I was on a fairly high dose, of 3g of EPA+DHA per day, and have now reduced to 900-1200 mg omega-3 per day. Anti-inflammatory, good for the heart.
Potassium (in citrate): I tried this to help with nighttime lower leg cramping. Not sure it helped at all. But it's a very small dose and I still take some when I think of it. Serum potassium levels were good last time I was tested.
iodine (in kelp tablets): single kelp tablet, containing 150mcg of iodine, just to keep the ol' thyroid happy. Tiny dose, cheap, harmless.
CoQ10: tried 90mg in divided doses to help lower blood pressure. Not sure it had any effect. Weight loss and exercise both have more impact. By my observations, my blood pressure tracks with stress, not diet or supplements. No reason to continue this once the jar runs out.
l-arginine: started for blood pressure lowering impact (did seem to have a modest effect) and to help normalize endothelial function. Have a bit left, which I use mornings before weight workouts, but won't continue when it's gone.
Vitamin-C: tried this for a while but seems pointless or possibly counterproductive, so stopped.
vitamin-B complex: occasional use, generally after drinking or for an energy boost before a big exercise day
melatonin: small dose, sublingual, very occasional use to help with sleep, especially during or after international travel to try to get onto or back onto schedule

Plan for 2010: continue with vitamin D, definitely. Also magnesium. Probably kelp (iodine) and sometimes potassium, but not religiously. Will continue with lower dose of fish oil as well. I'd like to try creatine as I get more into the weights program.

Bloodwork & Other Metrics
The bad news: high LDL. I haven't decided how much I care. I can't get a particle count here. My LDL-C is most likely vastly overstated (it's calculated, and does not do well for people with low triglycerides and high HDL, which is what I have, which is good, nor does it do well for people with a preponderonce of large LDL, which is what I have, which is better than having small LDL). My trigs are down to 62, which is great (using "american" units here), and my HDL is up to 97, also excellent. My calculated LDL-C is 217. Even overshot, this is pretty high. Nonstandard calculators suggest something on the order of 180 might be more accurate. Honestly, I'd still rather that was lower, but I'm not willing to go on the statins. Very low trigs and high HDL are both good news. The good news with LDL is that the subfractions profile is good:
LDL I 58.2%
LDL IIa 17.7%
LDL IIb 12.3%
LDL IIIa 7.1%
LDL IIIb 2.3%
LDL IVa 1.9%
LDL IVb 0.6%
That means is pretty much all large LDL and almost no small, dense LDL. Does that matter? Maybe I'll find out someday.

The other bad news: I have a nonzero calcium score (CAC), a measure of coronary arterial hard plaque. In absolute terms, the score is low, 43, but in percentile terms for my age group, it's not good. I've got family history going against me here, which is why it was good to get a scan early.

The rest, in addition to low trigs, very high HDL, is all good news. My liver function tests (e.g. ALP, AST, ALT) are excellent. They had always been good in prior years, but now I'm getting the best measures ever. Kidney function excellent. Vitamin D levels normalized to 63, very good. Fasting glucose (last time I checked, was 83), fasting insuling, hsCRP, all good. HbA1c good, at 5.5, but I'd like to see that keep coming down.

Blood pressure has come down as well. In terms of change over the year, LDL is the only risk measure that moved in the "wrong" direction. Everything else -- blood pressure, HDL, triglycerides, various lipid ratios, weight, waist size, etc. -- has been moving in the "right" direction. I'd prefer perfection, but I'm pretty happy regardless.

Plan for 2010: I'd like to get an LDL particle count at some point, and check back on HbA1C. Definitely going to get another heart scan, at the 18-month mark from the first one. The extent to which it's changed in that time will tell me more than the absolute score in isolation. That will be far more interesting than any lipid profiles. I'll break out the finger sticks from time to time to check the blood glucose. Depending on the results of the next heart scan, I may decide to make changes to my diet.

Should be an interesting year all-around.

Fueled By Fat: 10K PR

Just ran a 10k race this morning and shattered by old personal record (47:30) with an official time of 44:17. Unofficially (i.e. by my watch, starting not at the gun but when I actually crossed the start line), I finished in 43:59. So I'm declaring victory and saying that I've run my age (43). Had steak for dinner last night, and a few carbs at new years eve parties. Being out until 1:30 was not ideal race prep, but oh well. Just a very little bit of protein this morning and some coffee. No oatmeal, no pasta, no carbo-loading, no sugar-water. I negative split, out in 22:48, back closer to 21. Fast race, nice runners, with entries limited to keep the field from being huge. I finished 101st out of 458 finishers, 19th out of 56 in my age group. (Before I get too full of myself, let me check the winners' times.... 33:59 in my age group, 30:23 overall.) Was a beautiful race in Hyde park, very well organized. Very cold (right at freezing), but sunny. Lovely.

update: the nice people at the Serpentine Running Club published the chip-to-chip times in addition to the official gun-to-chip times, confirming my 43:59 time :-)