Supplements: To Take or Not to Take?
There are a large number of vitamins and other supplements that are purported to improve metabolic health, cardiovascular risk and perhaps have anti-aging effects. The idea is that is that these products do things like lower blood pressure, improve blood lipids, and reduce the risk of diabetes. The consumer market for these products is huge with about 27 billion dollars spent in the U.S. during 2009.
Do They Work?
There are a couple of ways to answer the do they work question. The first way is to survey the population and see what the health of users and non-users looks like. When this was done in about 300 multiple supplement compared to about 600 non-users, the supplement users came out ahead for many variables associated with better long term health.
Dietary supplements consumed on a daily basis by more than 50% of Multiple Supplement users included a multivitamin/mineral, B-complex, vitamin C, carotenoids, vitamin E, calcium with vitamin D, omega-3 fatty acids, flavonoids, lecithin, alfalfa, coenzyme Q10 with resveratrol, glucosamine, and a herbal immune supplement. The majority of women also consumed gamma linolenic acid and a probiotic supplement, whereas men also consumed zinc, garlic, saw palmetto, and a soy protein supplement……After adjustment for age, gender, income, education and body mass index, greater degree of supplement use was associated with more favorable concentrations of serum homocysteine, C-reactive protein, high-density lipoprotein cholesterol, and triglycerides, as well as lower risk of prevalent elevated blood pressure and diabetes.
Pretty convincing, except who knows what other health behaviors the supplement users were engaging in. For example, they might have been exercising more or eating a generally healthier diet than non-users.
So, what happens to the blood pressure, lipids and glucose levels to matched groups of people given multiple supplements prospectively? Do they make a difference? When about 60 generally healthy middle aged men and women were randomized to receiving either a standard multivitamin or a multivitamin and supplement cocktail containing resveratrol, quercetin, carnitine, alpha-lipoic acid, curcumin, pomegranate extract, fish oil, cinnamon bark, green/white/black tea complex and sesamin:
“The main outcome measures were arterial stiffness, endothelial function, biomarkers of inflammation and oxidative stress, and cardiometabolic risk factors. Twenty-four weeks of daily supplementation with 10 dietary supplements did not affect arterial stiffness or endothelial function in nonobese individuals. These compounds also did not alter body fat measured by DEXA, blood pressure, plasma lipids, glucose, insulin, IGF-1, and markers of inflammation and oxidative stress. In summary, supplementation with a combination of popular dietary supplements has no cardiovascular or metabolic effects in non-obese relatively healthy individuals.”
What About Vitamins?
The data on vitamins is generally worse. At least one analysis that has evaluated all of the studies on vitamin E supplementation suggests that relatively high doses might increase all-cause mortality. Others have concluded that there is likely no effect. There might also be issues with vitamin A. When the effects of vitamin C and vitamin E on longevity and lifespan are evaluated in “model organisms” like fruit flies and rodents, the data is all over the place. Here is a summary for the vitamin E studies:
Twenty-four studies were included in the final analysis. While some studies suggest an increase in lifespan due to vitamin E, other studies did not observe any vitamin E-mediated changes in lifespan in model organisms. Furthermore there are several studies reporting a decrease in lifespan in response to vitamin E supplementation. Different outcomes between studies may be partly related to species-specific differences, differences in vitamin E concentrations and the vitamin E congeners administered. The findings of our literature review suggest that there is no consistent beneficial effect of vitamin E on lifespan in model organisms which is consistent with reports in human intervention studies.
To Take or Not To Take?
Based on the summaries above, it is hard to make a convincing argument that anyone without evidences of a primary vitamin deficiency should be taking vitamins. This is especially true if your diet is high in fruits, veggies, “good fat” and you are physically active. Pretty much everything vitamins and supplements are supposed to fix can be optimized with a reasonable diet and plenty of exercise.
Negative Splits
Like a lot of people, I get regular e-mail updates from my alma mater and last week I learned that Rick DeMont had been named head swimming coach at the University of Arizona. In addition to being a great coach, DeMont was a superb swimmer and is an accomplished painter, but what struck me was the following statement in the press release:
“…..DeMont also pioneered negative split swimming, which utilizes the strategy of swimming a faster second half of a race than the first.”
I have also been reading a new comprehensive biography of the late UCLA coach John Wooden by Seth Davis. The book describes in detail how Wooden adopted the full court press at the suggestion of his assistant coach Jerry Norman. The goal was not so much to create steals and easy baskets; the goal was to control the tempo of the game, and frequently UCLA simply exhausted the other team and pulled ahead during the second half. Sort of a negative split approach to basketball.
The concept of negative splits might also be applied to other things and developing a “negative split mindset” is maybe one way to think about managing your effort to optimize performance. In endurance sports negative splitting can be learned by engaging in specific training sessions designed to develop a sense of pace, rhythm, effort and controlled fatigue. The classic way to do this is via something called a descending set of intervals. For example a runner might run a set of 4x1200m with a 400m jog between the 1200s. In other words the three laps of a standard 400m track fast with 1 lap of jogging between. The idea would be to run each of the 1200s a bit faster. In addition to the time targets, the real goal is be in control throughout and sort of sneak up on a maximum but relaxed and purposeful effort during the final fast 1200. This general scheme can also be adapted to almost any kind of structured physical activity or exercise training. Your imagination is the only limitation.
Can negative splitting also apply to your work day, your work week and perhaps other elements of your life? Is it possible to learn to slowly improve over time by managing your effort? Can consistency level out the inevitable valleys in life but at the same time serve as a platform for more frequent peaks? The concepts of rhythm, balance and tempo are all essential elements of high level swimming and basketball. They also apply to music and other performing arts, and I would argue that by learning how to negative split via exercise training you can develop a skill set that carries over to other things. Learn to control your pace so it does not end up controlling you.
Is The Super Bowl Dangerous?
Super Bowl Sunday is about to land on us again. I will leave to others to analyze the football, advertising, TV viewership and economic impact statistics associated with the game. I want to cover the potential health related effects of the big game – on fans – not the players. So here is a list of some of the main risk of mass spectator sporting events.
1. Heart Attacks
The risk of heart attack during and after the game goes up especially in people (middle aged and older men) who have multiple risk factors and are passionate fans of team that loses. There is also some interesting data from Germany showing a 2-3 fold increase in emergency room admissions for cardiovascular events when Germany was playing. This study concluded that:
“Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event. In view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed.”
Here is a chart from that study, the 2006 data is from the World Cup year, the 2003 and 2005 is data from years with no World Cup:
My advice for passionate fans who know they have heart issues to make sure they take their medicine the day of the game. These folks also need to remember that no matter who wins or loses, the sun will come up in the morning and the key is to make sure they do too.
2. Terrorism & Stampedes
The idea that the Super Bowl or some other major sporting event might be the target for a terrorist attack is nothing new. However, as I searched for information on this topic the issues of fan stampedes at major public events popped up. This is a particular problem in the developing world but events have occurred all over and one of the most notorious is the Hillsborough disaster in the UK. It appears that the risk of stampedes can be reduced considerably via a combination of effective crowd control and better stadium design. The authorities responsible for Super Bowl XLVIII should be able to prepare for either of these possibilities and hopefully they will have a bit of luck too.
3. Riots & Hormones?
Riots in one of the participating cities (Seattle or Denver) are a possibility. What is interesting is that rioting in the city of the winning team is not unusual. There are all sorts of theories about what triggers these riots, but one idea is that there is a hormonal surge especially in the young men who are passionate fans via the sociology of “basking in reflected glory”.
“Basking in reflected glory, in which individuals increase their self-esteem by identifying with successful others, is usually regarded as a cognitive process that can affect behavior. It may also involve physiological processes, including changes in the production of endocrine hormones. The present research involved two studies of changes in testosterone levels among fans watching their favorite sports teams win or lose. In the first study, participants were eight male fans attending a basketball game between traditional college rivals. In the second study, participants were 21 male fans watching a televised World Cup soccer match between traditional international rivals. Participants provided saliva samples for testosterone assay before and after the contest. In both studies, mean testosterone level increased in the fans of winning teams and decreased in the fans of losing teams. These findings suggest that watching one’s heroes win or lose has physiological consequences that extend beyond changes in mood and self-esteem.”
These surges might then drive violent or territorial behavior after the game and some people think that the mere presence of the police trying to keep a victory celebration in line might actually contribute to the problem. These sorts of data drive all sorts of speculation about the evolutionary biology of behavior for other hormones like cortisol which can also rise in fans:
“The cortisol data from this study are in line with social self-preservation theory, as higher cortisol secretion among young and greater soccer fans suggests that especially they perceived that a negative outcome of the match would threaten their own social esteem.”
Win Drink & Be Violent?
There is also all sorts of evidence that excessive fan drinking can contribute to most of the problems outlined above and winning may amplify the urge to drink and perhaps feed into some of the effects of hormones on “bad” postgame behavior here is the summary from a study on Rugby fans:
“…..team success but not failure may increase aggression among supporters, and…..aggression, not celebration, drives post-match alcohol consumption. Losing and drawing decreased happiness but winning did not increase it. Better understanding of pathways to violence in these circumstances will pave the way for more effective prevention and management strategies.”
Beyond drinking there is also some evidence that illicit drug use in the host cities goes up as well.
What to Do?
The take home messages from the data above are pretty clear cut. If you have known cardiac issues make sure you take you meds and be aware that simply watching the game on TV is not risk free. If you are watching the game with folks who might have health issues and they develop chest pain, shortness of breath or an irregular heartbeat, call 911. If you are out in a crowd of revelers, pay attention to your surroundings and avoid situations where you could be trapped with no escape route. Finally, how much do you really need to drink? Have a few but not a few too many.
Hayden Smith Before & After
Here are a couple of vintage pictures of Hayden Smith who I mentioned earlier in the week. These shots give you some idea about how his body changed as he made the ten pound transition from a speed/strength/power “fast-twitch” athlete in the middle 1970s to a 2:26 marathoner by the late 1970s. His comments about the pictures are instructive.
Tucson Marathon 1975
“After the race I coached at the regional wrestling tournament for 8 hours. Now I need a nap after a 5 miler.”
Eugene Marathon 1979
“Little did I know Stoney (Dennis Stonehocker) had just missed qualifying (for the Olympic Trials) that day. Blair (Johnson) was 2:16 or 2:17, Tom (Rotkis) was 2:23. I spent the final 100 looking at the clock ticking in the 2:20’s. Finally under 2:30:00! I didn’t bother to kick (like the day we raced to the finish in the parking lot in Tucson).”
Denis Stonehocker and Tom Rotkis were part of our group of “sub-elite” marathoners in Tucson from that era.
10,000 hours: The Saga of Hayden Smith
I want to do a final post on the idea that 10,000 hours of deliberate practice can make anyone world class at anything. This follows the recent posts on the general topic of talent and some of the nuances or even urban legends about the so-called 10,000 hour rule. To do this I want to tell you the story of Hayden Smith who is the cross country coach at Albion College.
Hayden Smith 1.0
The first version of Hayden happened in the late 1960s when he competed for Albion. He was a 5’8”, 145 pound sprinter/jumper who could run the 100 yard dash in 10.2, long jump 23 feet and high jump 6’5”. In an e-mail he told me his best time for the 220 yard dash was:
“23.1……always faded because it was too far!”
Hayden graduated from Albion in 1970.
Hayden Smith 2.0
The second version of Hayden emerged in the early 1970s when he began to teach and coach at Flowing Wells High School in Tucson, Arizona. For some reason he decided to start running long distances. In 1974 Hayden ran his first marathon. Here is the progression of his personal bests along with some notes about his body weight over that time.
Date PR Weight (lbs) Site
12-01-74 3:14:30 142 Culver City
02-15-75 3:01:54 142 Tucson
06-14-75 2:56:13 140 Palos Verdes
12-20-75 2:49:43 138 Fiesta Bowl
06-20-76 2:47:05 138 Toledo
12-11-76 2:40:26 138 Fiesta Bowl
12-10-77 2:38:20 136 Fiesta Bowl
02-18-78 2:32:30 135 Tucson
12-02-78 2:31:44 135 Fiesta Bowl
04-16-79 2:30:37 135 Boston
09-09-79 2:26:28 133 Eugene
12-01-79 2:26:10 134 Fiesta Bowl
While Hayden was getting better and better over the years he was part of an informal group of about 10 people in Tucson who all had personal bests for the marathon under 2:30. The group lasted until the early 1980s when people either started running less, moved away or got into other sports. From time to time true elites with times near 2:10 like Ed Mendoza, Thom Hunt and Don Janicki would train with us. More frequently Blair Johnson and Nick Martin, who both had personal bests of around 2:15, ran with us.
Most members of the group had a history in endurance sports and broke 3 hours the first time they ran a marathon, frequently off minimal training. They then got better quickly and in a year or two were running near 2:30 or faster. By contrast Hayden showed a slower start and a five year progression to a sub 2:30 time. During those years he was averaging between 80-100 miles per week of running or more, doing hard core interval training, and long runs in the mountain trails around Tucson on Sundays. In other words Hayden was training the way elite runners were at the time and still do! He was also regularly running shorter road races. Hayden continued to train at this level through most of the 1980s and ultimately he broke 3 hours 55 times. However, his personal best is from 1979.
If there is anyone in the world who has spent 10,000 hours of deliberate practice at anything it is Hayden Smith.
Hayden vs. 10,000 hours?
Hayden is a great example of both the power and limitations of the 10,000 hour concept. First, he became a truly accomplished distance runner in spite of the fact that he started out in what might be called “fast twitch” sports where he was also way above average but not great. So, Hayden got good at distance running even though it was probably not exactly where his “natural talent” lied. Second, no matter how much he trained his upper limit was still a long way away from world class. That was true for all of the other members in the group as well. Everyone found a talent barrier somewhere in the 2:20 to 2:30 range no matter how hard any of us trained.
So, when anyone tells you that talent doesn’t matter don’t believe them. And, when anyone tells you the practice doesn’t matter don’t believe them.
Talent & Achievement: Beyond 10,000 Hours!
In my last post I summarized an ongoing e-mail exchange I was having with David Epstein, Terry Laughlin and Amby Burfoot. The focus of our exchange was on talent in general and the idea the champions are either born and then made or simply made via intense and deliberate practice. When this topic comes up the first thing that pops into many people’s mind is the “10,000” hour rule as popularized by Malcolm Gladwell. The basic idea is that practice beats talent and that with enough of it “anyone can become world class”.
The conversation is continuing and David got Jonathan Wai involved. Jonathan is one of the world’s leading experts on the nuances of intellectual and creative talent, and it has been fun to get his perspectives. It is also interesting to see how ideas about talent, practice and achievement in academic and creative fields are the same or different than for sports. So what have I learned in the last 10 days as the exchange continues?
Dr. Ericsson I Presume?
At least some of the ideas associated with what Terry Laughlin described in our exchange as the “10,000 brand” come from K. Anders Ericsson, a psychologist at Florida State University. Ericsson is now either back tracking from some of his original ideas or perhaps they were misinterpreted and oversimplified to begin with. Here are a few caveats to think about:
- Many of the groups used to make the 10,000 hour argument are elite or nearly elite to begin with. So perhaps among the most talented people, more practice makes a difference.
- The distribution of practice times to “elitehood” is highly variable and reflects potentially complex interactions between talent, exposure, and what might be called trainability. Average values rarely tell the whole story.
- There are obvious talents like body size, which trump all sorts of things. You will never find small shot putters or big gymnasts.
- For academic and creative efforts there are many parallels with sport. That having been said kids who do really, really, really well on early tests of academic ability end up (on average) with higher levels of academic and professional achievement later in life in comparison to the merely seriously above average. Practice and motivation matter but so does talent.
Rage to Master!
One of the more interesting topics that came up is the so-called “rage to master” concept. The idea is that a very few people are both gifted in a given domain and also develop an early interest in pursuing it like their “hair is on fire”. There are some great examples from the visual art world that include people who draw well early. There are also well known examples like Picasso. The image below is the “First Communion” that Picasso painted when he was about 15. I am not an art historian, but it is pretty clear that he had mastered what might be called classic 19th century European painting at an early age before moving on to his later innovations.
The other interesting thing about highly precocious highly motivated kids is that they seem to “pull” their environment as opposed to being pushed by parents; again their hair is on fire. David Epstein sees Tiger Woods as a classic example of pull that went along with any physical talent he had plus the early exposure. It is also easy to see how under the right circumstances all of these factors can amplify each other with success leading to more motivation, more practice, and then more success……..
Go For Broke!
Tiger Woods (at least the Tiger of old) also conjures up what might be described as the “go for broke” mindset. Amby Burfoot wonders if that is part of the success of the E. Africans in distance running. They go out hard and push the pace. Many crash and burn in big races, but if someone is really on that day, and conditions are right then the odds of a breakthrough time improve. As I thought more about this it occurred to me that one of the reasons Tiger Woods is not as dominant as he once was is that the wave of golfers just behind him (the 20 somethings) saw him go for broke and now all do it. Thus, on any given day at least someone almost as good as Tiger gets hot and is there to challenge him.
Practice, Practice, Practice
Terry is a very effective advocate of deliberate practice and he has shown repeatedly that technique and skill matter in swimming, and that it is way more than getting in the pool and mindlessly working out. He sent a link about the 17 year old Ski phenomenon Mikaela Schiffrin. The story reinforces many of the ideas we have been e-mailing about:
- She obviously has some ability and is the perfect size. The picture in article shows what appear to be powerful legs and a low center of gravity.
- She got intensive early exposure but also developed well-rounded athletic skills like juggling while riding a unicycle.
- She seems to have the “rage to master” and by master I mean focusing on flawless and efficient technique.
Where to Leave It?
The conversation is continuing, but where to leave it for now? There are all sorts of pieces of advice that might flow for our discussion but one thing that is for sure is that we have at least some control over our effort and how well we practice. The story of Mikaela Schiffrin juggling and riding a unicycle along with the observations in last week’s post on “sample early and focus “ make me think that focusing on general motor and intellectual skills and that mastering a few fundamentals at any age has a lot of merit. That having been said, here is something about Vince Lombardi explaining his basic plays in 1965 to center Bill Curry. Curry was a rookie and Lombardi used nothing more than a yellow legal pad and a pencil:
“Our system is complete, simple, and comprehensive,” he went on. “We can attack the whole field. We have very little trickery. We really don’t need it. We win with execution. Something works, not because it’s a brilliant piece of strategic or tactical thinking, but because our team has practiced the same plays, the same movements, and the same fundamentals over and over and over again.”
How great a teacher was Vince Lombardi? The best way to answer that is to tell you that, 43 years later, I remember each one of the plays he outlined for me that day. I can draw each assignment, make the calls, and teach their installation. I remember the coaching points for the guards, tackles, and tight ends. I remember it all, as if it were yesterday. “
In sports the fundamentals include superior technique, foot work, balance, timing, and conditioning. Together they are tough to beat. They can make the gifted elite and permit the rest of us mere mortals to develop high levels of skill and immense personal satisfaction.
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