Here are the 5 questions with Nadeem and his answers:

1) Biometric devices like heart rate monitors and accelerometers have been around since you began your journey into exploring health and wellness technology over a decade ago; what has changed in the last 12 months that has made biometric devices much more interesting than they have been in the last 12 years?

Technology is accelerating at an exponential rate, and so everything from batteries, to Bluetooth, to the smartphone ecosystem have become cheaper, faster, and smaller.  Also, the space is heating up, from cool start-ups and new entrants like Jawbone, Nike+ and others, increased awareness and technical talent,  and – very important – increased venture capital dollars are being allocated to our sector. We used to talk about “when” the mobile space would hit and now we are talking about how fast it is going to explode and then mature…

2) Biometric devices have not yet “crossed the chasm” but they seem to be getting close. In your opinion, what are the signs to look for that will indicate we are reaching the tipping point of mass adoption?

I really like that you’ve asked me “when” will mass adoption occur and not “if”. People like you know it is just  assumed, I love that. The signs will come from the press, evident on the wrists of Middle America like the white earphones of the iPod, and when mass amounts of “consumer” health data actually begin to influence healthcare in this country.

3) Do you believe this market will ever consolidate in a similar fashion to digital audio devices and smart phones? Or is the assortment of data available from our bodies large enough that there will always be a need for a large number of biometric device manufacturer types to focus and specialize in specific areas of interest (e.g. weight, movement, blood glucose, blood pressure, heart rate, etc.).

It has been my vision for almost a decade that, “in the end there can only be one.” I don’t mean just one company standing, as I believe there is a lot of space in this huge industry for strong competitors. I mean, that at the end of the day, humans are only going to want one biometric device strapped to their body.  I believe the wrist is the natural place for that device. This device will fit within an ecosystem of the smartphone, and the PC/TV, as these devices continue to learn how to interact with our bodies to give true meaning while entertaining us on the way to personal and social well-being.

4) Aside from your involvement with the BASIS device which is extremely exciting, what in the biometric space is on the horizon that excites you the most? In addition, where do you think the industry can do better?

The stuff that excites me the most, unfortunately, I really can’t talk about yet. But let’s just say that medical technology is advancing so fast, that invasive techniques are becoming more passive. But to give you an answer, I find it exciting that the day in which we have consumer devices that are truly medical grade, but possess a user experience that rivals Apple, is not that far away. I’m also very excited about the merger between mind and body and how new technologies will bring what has traditionally been known as ‘biofeedback’ into the mainstream.

It’s not so much what our industry could do better …  We are still in the early stages and we are just figuring out collaborations between great companies. Awesome organizations have emerged like Rock Health to foster entrepreneurship in this space and Steve Krein’s StartUp Health program that has been set up to not only foster friendships and synergistic relationships in this industry, but also to help grow the industry as a whole.  As a product of our industry’s lifecycle, we are working on what we can do better, and it’s exciting!

5) Borrowing from David Hansson, how do you plan to ‘put a dent in the universe’? When you are done leaving your footprint, how do you want to be remembered?

If there is one thing that I have learned from my father it is that you are never done, it only becomes grander, more enjoyable and relaxed as you get older.  I want to be remembered as a great father, leader, and philanthropist to those that knew me, and as a radical spark of change for those who did not. I want to help make a powerful impact on health and wellness in the world and will use fun and entertainment to do just that.

Here are my 5 questions with Alex and my summary of his answers:

1) One of the core value propositions behind your BitGym product line is to provide an exercise option to those that aren’t necessarily interested in traditional fitness. When was that “ah ha” moment that you were on to something (i.e. you had the solution to a problem)?

The initial idea to combine proper video games with exercise was first conceived during a conversation with a friend. Wanting to test it out as soon as possible and see what people thought, I had several of my nerdy and non-athletic friends over to my house. I had set up an exercise bike with a bunch of wires hanging off it leading to an Xbox 360 controller which itself was wirelessly connected to a racing game running on the screen in front of them. I told them their speed of their pedaling would accelerate the car and to steer they would simply use the controller like normal.

They all had a blast and were sweating in an uncharacteristic way. That’s when I first knew I was on to something.  Of course, my bike sensor didn’t actually work yet. Unbeknownst to my friends I had run some wires to a hand-held knob which was controlling the acceleration. As they sped up I would simply turn the nob a bit to match their effort. Active Theory has been a lean start-up from the very beginning!

2) It can be argued that some of the success of your technology relies on the content and engagement of the games you provide. Game play and game environments tend to uniquely match up to certain player attributes such as: gender, personality, and other psychographic characteristics. This is a problem that is outside the realm of designing for the general fitness user. What is your strategy to work with content owners and game developers to maximize your reach in the fitness market?

Our approach is to learn by observing the video game industry. One thing we know by watching Nintendo is that there are certain aesthetics and game play concepts that have wide appeal. For example the Zelda series has universal appeal among gamers and the Wii Sports series has universal appeal to, well, humans. The games we produce in-house will follow this tradition of non-offensive aesthetics and a focus on accessible game play.

We also observe that if you have a user base willing to pay money there are always game developers willing to create experiences for them. We see it as our job to get people excited about the idea of exercise video games while establishing that they will cost more than regular iPhone/iPad games. If we can accomplish those two things we can foster an ecosystem of developers working to build exercise game experiences for all types of people.

3) The United States Surgeon General and the Office of the National Coordinator for Health Information Technology have challenged technology developers to build apps that “empower users to engage in and enjoy healthy behavior” (United States Surgeon General’s Healthy Apps Challenge). You have uniquely positioned your company to influence non-fitness enthusiasts into a healthier lifestyle through mobile devices. Through the point of view of  Active Theory’s market vantage point, what role do you think mobile devices will play in helping people get healthier?

First of all I view these app challenges with skepticism. Building the app and winning the contest based on app quality and adherence to the contest rules is only step one. Actually getting it into people’s hands and getting people to use it – that’s the real challenge. However with that said, mobile devices (mobile phones and the coming wave of smart wearable technology) are clearly poised to bring about significant change in people’s health.

But specifically in diet and fitness, we’re not quite there yet. I would argue that right now what we have is only iteratively better than the analog tools we’ve had in the past. How many apps are simply replacements for a workout notebook, workout tapes, or a meal diary? These only help the people those analog tools would have helped… those with enough willpower to deploy the tools.

Unwilling or occasionally unwilling participants (most people) still find no help from diet/fitness apps and devices. But that will change soon. The next generation of mobile technology will be full of trickery – exploiting our impulses instead of trying to suppress them. And it will be very powerful.

4) Conceding that it requires critical mass first, how far do you think you’re away from the ability to offer a MMOG (massively multiplayer online game) version of one of your fitness games? For instance, is it in the realm of possibility to offer a virtual 10K race, or maybe even a virtual marathon, in the future?

Taking the analog concept of a marathon and making it digital is something we’ve kicked around a lot at BitGym. But before copying a thing you have to know the true essence of a thing. The essence of a marathon isn’t thousands of people running in the same place at the same time – the essence of a marathon is a hard schedule of self imposed training followed by a dated and well-understood certification of accomplishment.

So then let’s paint a picture of what a virtual marathon should have. It should have a concept of persistent identity. It should have schedule of challenging fitness tasks to accomplish. It should have a set end date (perhaps one every three months) so that people can experience it in sync with participating friends. It should have a standardized certification of achievement. All of this will be possible in BitGym mid to late 2012.

5) In building a platform to inspire people to workout, what is one thing you have learned about fitness in the process that you did not know before you started (that you wish you had)?

I wish that when I started I had a deeper appreciation for the difference between a fun cardiovascular experience and a sticky cardiovascular experience. From the day of my first Xbox prototype we knew how to make an exercise machine fun. But fun isn’t enough, and I know now we still have a lot of work on the behavior modification part of our product before we’ll really convert non-exercisers into exercisers.

Here are the 5 questions with Dr. Applegate and my summary of her answers:
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1) What are some good glycogen boosters for endurance athletes? And is it true with respect to glycogen boosters that effectiveness, regarding both type and dosage, is going to vary amongst different people?

People underestimate the power of training and what that does in terms of muscle adaptation.  So rather than discussing a particular supplement or food, let’s look at the body’s adaptation to exercise. Adaptation to exercise is dramatic adaptation – changes in different proteins occur, we increase our ability to store glycogen – all as a result of endurance training.

Also, there isn’t a consensus on the right way to influence glycogen efficiency. There are carbohydrate recovery products made for the purpose of promoting glycogen resynthesis and recovery. There is also another camp of researchers with fairly substantial evidence regarding the notion of “training low”. This means maintaining a low carbohydrate diet and training twice in a day, so that during training sessions you are exercising in a carbohydrate deficit. There is evidence that shows that one’s muscles respond and adapt with increased mitochondria and aerobic capacity in this state even better than those that maintain a carbohydrate rich diet during training. Talk to someone like Dr. Ed Howley, and he’ll tell you not to worry about carbohydrates and to, “train low, and compete high.”

My approach is to look at the athlete’s history and ask questions like, “How many hours are they training? What’s their mileage? What is the time spent doing aerobic exercise?” I then examine what their typical training diet consists of, how they are responding to their diet, and then make a judgment on what I see fit for them to change. I am not a proponent of a one-size-fits-all plan. With many of the athletes I see, the discipline is usually there with regards to strict regimen adherence and control, but they come to me a mess because the particular system that they prescribed themselves to does not work for them. This has a negative psychological and physiological impact, and as such their training sessions are not as productive. By the time they get to their event they are so beat up that they end up not doing very well.

So I start by looking at the hours one spends training, and come up with a formula to baseline carbohydrate intake and go from there. I am not a supplement person. In my opinion, the best legal ergogenic aid is caffeine. That aside, one has to eat real foods. I’m dealing with 20 year olds that want to take a supplement approach to their diet. So given this case I will probably, in reality, weed supplements out and replace them with real foods. So to truly answer your question when looking for “glycogen boosters” I will look at what carbohydrate foods a person likes, what foods they are missing in terms of micronutrients and phytonutrients that may be beneficial for muscle recovery and anti-inflammatory response, and I will try to implement those foods into their diet until I am satisfied with the carbohydrate availability based on the feedback and response to these changes.

2) Is the latest research on DNA dieting more hype than science (http://www.lvrj.com/news/dna-driven-diets-fitness-plans-catch-on-121485479.html)?

In general terms, these findings are very intriguing. I don’t know when it is going to happen, but in broad futurist terms I do think there is some appropriateness to the idea, and we are already seeing it in the most basic of recommendations. The United States Dietary Guidelines basically speak to a range of intakes that are meant to help prevent chronic diseases such as diabetes and heart disease. Again, there isn’t a one-size-fits-all diet and it is good we are recognizing that.

Should I sit down with a 28 year old who is now done with their cross-country career, their focus isn’t joining a national team, but they are still an avid elite runner… would I recommend this person go get their cheek swabbed? No, probably not, there just isn’t enough evidence yet. I think they, at least from what we know now and the current costs of these tests, are better off sticking with the diet that has gotten them this far and tweaking it where appropriate.

But I’m holding the hope that we’re going to be there soon. I was just at the Olympic Training Center earlier this week, and while they are not doing genetic testing on these athletes they certainly are doing very specific diet counseling based on that athlete’s sport. Periodization is being looked at not only in regards to training but with one’s diet now as well.  In other words, where is the athlete in their training schedule? For example, if they are in the pre-competition stage or in the competition stage of a 52 week cycle, I would ask, “how many weeks do they have away from their sport? How many weeks will they have in competition? How many for preparation and training?” And then you periodize their diet based on those demands… again, for any given athlete there isn’t a one-size-fits-all plan. So our field is already highly customizing athlete’s diets, just not based on a DNA test yet… because we just don’t have the research to back up that method.

However, there is a lot here. And to answer your question, I don’t think it is more hype than science.  I mean we’re always looking for the next great thing. There’s very intriguing science to back up the method… but as it relates to both sport performance and chronic diseases we simply have more to learn… and there’s more to come.

3) Does creatine supplementation provide any benefit to endurance athletes? And what is the deal about avoiding caffeine when supplementing with creatine, is there a valid concern?

To answer the first question, does creatine supplementation provide any benefit to endurance athletes, my answer to that is no. A majority of the research shows that it doesn’t support endurance performance and can be detrimental, even for athletes that might be anaerobic competitors (ex. swimmers) but train in an endurance format. For an endurance athlete you have to consider the weight gain and muscle hypertrophy that creatine promotes, and that’s not optimal for a lot of endurance athletes. I can tell you of the athletes I have seen, that have come in and come out of creatine supplementation, usually in the end they don’t really want to have anything to do with creatine.

Now, for some athletes, such as shorter distance track athletes at the 400 to 800 meter range, there are certainly some potential benefits there. However, you have to deal with the modification in body weight and what the implication is for a runner at that level.

In my experience, people that really track improvements see better results by asking questions like… how well do I sleep, how good is my training program, how consistent am I with my eating, and what diet works best for me… rather than looking to creatine or glutamine or any of these other type of things. So what I see is that the people who get into a supplement get right back out and realize it’s more the day to day consistency that fosters results.

Regarding your question about caffeine and creatine, actually when you look at the research, caffeine supplementation combined with creatine actually enhances anaerobic performance. I appreciate your question, and the fact that people try their best to fine-tune their effort but if an athlete came to me, that was a strength training athlete, and she or he was taking creatine would I suggest avoiding caffeine? No, I would not.

4) Can l-glutamine be effective at raising one’s growth hormone levels (http://www.ajcn.org/content/61/5/1058.short)?

In the mid-90s there was more of a push with glutamine in that regard, if you look at the research now it is really relating glutamine to possibly being an immune boosting amino acid. So to your question… do I view it as an effective growth hormone stimulant… my answer is no. That is not how athletes are using it these days. I remember going through that research a number of years ago but today glutamine just is not talked about in terms of performance boosting, but rather its effect on immune health.

Weight bearing exercise is a better option than supplementation. Take a look at the author Dr. Keith Baar. He is from UC Davis as well. He is a molecular biologist that looks at protein synthesis within the muscle and the factors that stimulate it in terms of nutrient timing, particularly with amino acids. If anything, the amino acid that people should be focusing on is glycine as far as enhancing and remasking. It has been shown repeatedly that one can get greater lean mass gains if, after exercise, they ingest a dose of protein which includes glycine – because glycine enhances the availability of protein in the body.

So I look at the glutamine story as more of an issue of immune health and the glycine story as directly impacting protein synthesis within the muscle fiber. So those readers interested in your question might want to look at the possible benefits of glycine instead.

5) Beer drinkers like me rejoiced after hearing that beer might be better than water after a race (http://www.foxnews.com/story/0,2933,307518,00.html).  In 2007, however after learning a little bit since then I’m under the impression your best bet is always to try and get a carbo\protein drink in right after a race. If alcohol retards glycogen uptake, should someone looking to recover from an endurance event wait awhile before grabbing a celebratory beer?

In June, I actually spoke to the researchers of a more recent publication on the subject (than the one you cited), their article is titled Non-Alcoholic Beer Reduces Inflammation and Incidence of Respiratory Tract Illness. Their participants drank a fair quantity, about a liter and a half every day, which you know… if you ask a person to do that, that’s a commitment! Of course it was non-alcoholic beer in the study and the concept was to look if the phenols and other compounds in beer are potentially beneficial in one’s immune response. What these researchers chose to look at was the immune response following the Munich Marathon. Lots of runners get sick following a big effort like a marathon, and in this study fewer of the runners got sick on the beer protocol than the control group. So the story is, okay who’s going to drink a liter and a half of non-alcoholic beer? Certainly not me.  So I don’t know if today we can translate the findings to regular beer. Especially considering that while alcohol is metabolized in the liver it can impair glycogen resynthesis, particularly after an overnight fast. So when you look at when beer is typically consumed, later in the day, this could be problematic for somebody who might be working out in the morning who really does want to have a good workout. One might say, “Oh I’ll drink beer and go glycogen depleted during my 10 mile run”. Well, there is a possibility you may be OK, but there is a chance you may feel so lousy during that 10 mile run that you train at a slower pace and the whole training benefit is impaired… it becomes a Catch 22.

To answer your question direct, if your goal is to optimize recovery so that you can workout the next day my answer would be a carbohydrate protein drink over beer. But if your goal is a set lifestyle – i.e. I’m doing these runs to be social as well as to be healthy – I would say pick the beer because we can’t be so concerned with every detail a hundred percent of the time. If you’ve trained hard then it’s fine to celebrate, but if you’re going to train the next day you want the product that’s going to offer you the nutrients that you need for recovery… plain and simple.

The Basics: Endurance athletes need to increase their access to available fuel. During event training the prevailing wisdom is that an endurance swimmer should get about ~60 percent of their daily calories from carbohydrates with an increase to ~85 percent three weeks prior to race day. If this protocol is followed, an athlete can expect to increase muscle glycogen stores by ~35 percent, which will allow you to swim longer before fatigue sets in.

Another good practice is to make sure to eat a pre-swim meal. This will protect you against low blood sugar by restocking your liver with one hundred grams of carbohydrates. By eating a pre-swim meal you maintain your blood sugar levels which will help improve your energy prior to your swim start.

Avoid complex and fibrous carbohydrates. This might seem counter intuitive but the last thing you want to think about on a long swim is clearing your bowels (you can read about the Ironman New Zealand race here, if you need a real world example).  Instead include ~ 25 grams of protein and/or ~ 20 grams of fat along with ~125 grams of carbohydrates two hours before the swim. This will help control your hunger and stabilize your blood sugar levels.

After one hour of moderate-to-intense swimming, blood sugars will result in fatigue and increase your risk of shivering and hypothermia – all of which can have a profound negative impact on performance. In an Ironman you will need to tough it out, but longer swimming distances of 10K and beyond generally take the trained swimmer two or more hours to complete. As such, feed zones are generally provided where coaches and support crews can help mediate calorie and fluid intake off of a floating pontoon, dock, pier, or anchored boat (for swims longer than 25K a team and escort boat are usually provided).

It is estimated that swimmers racing at moderate to high intensity will expend ~.065 calories per pound per minute, or on average 500 to 700 calories per hour. You will not be able to replace all of these calories during the race, but if possible take in approximately 150 to 200 calories via carbohydrate liquids or gels – along with implementation of small amounts of protein and fat, as well as some solid food if the race is extremely long.

In cases where aid stations are few and far between, or escort boats are not allowed, athletes may need to stuff gels into their suits (allowing two per hour in case a feeding is missed or one is lost during swimming). The gel packs should be prepared pre-swim by cutting a small incision to allow for easier access during the race. An alternative is to place several gels into a four-ounce gel flask, diluted down with water to allow for ease of exit, and stuff the flask into the suit or a pocket in the suit.

Sweat rates for swimmers average around 125 milliliters (four ounces) per kilometer swum; which means that during a 10K event, about 40 ounces of fluid (including a total of 500-1000 milligrams of electrolytes, specifically sodium) is generally needed for distribution.

Special Note:  As is with all endurance training, it is vital that you practice with any aids you plan to use on race day, as well as what you will do on race day, which can be broken down as follows:

1. Seek & Spot: Swimmers spot their coaches at the feeding station
2. Reach & Roll: Swimmers grab cups or bottles from coach/feeding stick and roll onto their backs to initiate feeding.
3. Gulp & Go: Swimmers swallow their nutrition quickly and continue swimming within two to three strokes.
4. Toss & Turn: Swimmers toss their cups/bottles and sight before turning over to continue swimming.

 This post was adapted by an old article from Kim Mueller, a Registered Dietitian & Exercise Physiologist who owns Fuel Factor Nutrition (www.Fuel-Factor.com). Karen has helped many athletes nutritionally prepare for swims, including English Channel swimmers.

Here are my 5 questions with Ellen and my summary of her answers:

1) The current chair of Exercise is Medicine^® Dr. Robert Sallis stated, “Regular physical activity, at the correct intensity, is so powerful in maintaining and improving health that it should be prescribed, just as a medicine or drug would be.” It is quite clear that empirical evidence backs this up. The government has recently come out with ChooseMyPlate to help influence dietary choices and Let’s Move! to help influence children to increase their physical activity. These are primarily passive programs. Why is it important that your doctor or primary medical provider take an active role in your fitness regimen?

There is a significant amount of research indicating that people who discuss exercise with their health care provider as an important part of their overall health and wellness are more likely to start routine physical activity. Exercise is Medicine rolls this into an actual prescription because getting and filling a doctor’s prescription is a familiar process for people. There are numerous studies indicating that people tend to engage and adhere to prescriptive exercise compared to self-started programs (Decision Making Versus Decision Implementation: An Action Control Approach to Exercise Adoption and Adherence), so empowering doctors to use the prescription referral process to assign exercise makes sense.

As you highlighted in the quote from Dr. Sallis, there is significant scientific data that shows one of the best ways to prevent and treat disease is to get at least 150 minutes of moderate-intensity physical activity each week. Our aim at Exercise is Medicine is to make this powerful concept a part of every discussion about health and well-being. With that in mind, it becomes essential that your doctor or primary medical provider plays an active role.

2) One of the many important areas that Exercise is Medicine is focusing on is benefit reimbursements and legislation initiatives related to health improvements through exercise. There are inflation-adjusted per capita health savings estimates as high as $544 per year (Costs and Benefits of Bicycling Investments in Portland, Oregon) for individuals that exercise regularly. Are there any ideas being executed that use this economic incentive to help with patient adherence?

It’s widely known that disease treatment is also an economic concern. As you’ve said, there are numerous studies that point to the economic benefit of disease prevention. We like to couple the discussion of physical activity with the discussion of fiscal responsibility. We are fortunate to live in a time where one’s life expectancy continues to increase. However, per capita health expenses continue to increase as well, and medical entitlements are a consistent part of the debate over national budget reform. We are working to influence national policy based on the evidence that exercise can reduce the cost of disease. We are also working with insurance companies and other health care associations to encourage referral reimbursements. This effort involves including exercise as part of one’s documented medical history, and we are seeing it documented more in people’s electronic medical records (EMRs). There are no pass-throughs yet (that reach the patient) in terms of economic gain, with the notable exception that the data shows they are likely to spend less on medical care in their lifetime if they adhere to the established federally mandated exercise guidelines.

3) With regard to the established federally mandated exercise guidelines, within the current Exercise is Medicine fact sheet it is stated that four out of every ten U.S. primary care doctors, and more than one third of U.S. medical students are failing to meet the minimum requirements. Further, physically inactive doctors are less likely to provide exercise counseling to patients and provide less credible role models for the adoption of healthy behaviors. What strategies are being used to help doctors understand that physical activity (at the right intensity) is a valuable prescription, for themselves and their patients?

We are employing several different strategies to improve these statistics. Our website features the Exercise is Medicine Health Care Providers’ Action Guide and also provide supplemental materials to tell physicians and health care providers about the evidence supporting exercise prescription. We also have developed strategic partnerships with health advocacy groups, such as The Institute of Lifestyle Medicine, who create training courses for health care providers and physicians.

We are also working to ensure that exercise education becomes part of the standardized curriculum at medical schools. Reaching doctors before they begin practicing is one of the most effective approaches to improving these statistics. It is critically important that doctors understand that they are role models and their behavior is proven to have an impact on patient outcomes. Therefore, it is important that doctors understand the role exercise plays in preventative medicine.

4) Exercise is Medicine’s approach seems to be focusing their effort on establishing a connection between medical practitioners and their patients. In an era where some people are choosing to have more personal influence over their own health care, are there strategies in place to help provide influential advice through information channels that cater to this segment of the population (ex. WebMD, Healthline, Wikipedia, etc.)?

We understand you do not need to talk with your doctor to know walking is good for you. Our focus at Exercise is Medicine is incorporating the idea that exercise is a medicinal tool, which needs to be properly addressed with health care providers and their patients. It is something that should start with the doctor, potentially get passed along to the engaged health-and-fitness professional, and ultimately adhered to by the patients themselves. We are quite aware that, for instance in pharmaceutical sales, direct-to-consumer marketing can influence patient behavior. To the extent that we can pass along information to consumers about the benefits of exercise, we will do that. Our overarching goal for all audiences is to  make physical activity an integral part of every discussion about the prevention and treatment of disease.

5) With innovations such as FitBit, BodyBugg, and BodyMedia there are ways of tracking physical activity and progress through technology, in turn providing positive feedback loops that can assist with patient adherence. To what extent do you see the importance of technology playing a role in achieving Exercise is Medicine’s mission?

We are always exploring ways to use technology effectively. We have partnered with Interactive Health Partners of PCE Fitness to create technology that improves the way patients connect with doctors and health care providers. The software lets doctors risk-stratify patients by determining their activity levels, and it assists them in providing personalized exercise prescriptions that are medically precise. It will also help doctors in the next step of the referral process by giving them access to a database of qualified health-and-fitness professionals. If the prescription can be self-monitored by the patient, the software will enable patients to log exercise results and track outcomes and other valuable metrics.

We are also currently redesigning our own website, which includes several micro-sites. There will be behavioral tools, ways to track physical activity online, and other applications to help users create positive feedback loops.

It is important to note however, that as great as technology is, not everyone has access to it or the inclination to use it. For many families, the gym, Internet service, and unfortunately even medical care, might be cost-prohibitive. We are cognizant that if we rely on technology too heavily, we could potentially exclude a segment of the population. In that regard, we are careful to make sure that we include initiatives that can cast the widest net and help everyone.

In my opinion, a departure from the food pyramid is a good thing because the previous imagery used by the USDA gave the misconception that a diet with a foundation in carbohydrates (any carbohydrates: cereal, muffins, bagels, etc.) was a healthy approach…

MyPlate still suggests eating carbohydrates but now has more of an emphasis on whole grains. In addition, the total area representing grain-based food (on the plate) is significantly less than the pyramid. It should be noted however that carbohydrates are hardly eliminated in the new USDA model. In fact, there is still an arguably large amount of carbohydrates on the plate via fruits and vegetables. It is assumed the rest of MyPlate accounts for protein requirements (apparently there is no room for fats, oils, or sweets anymore | just kidding).

The USDA has built the sub-site ChooseMyPlate to help encourage and educate parents and individuals on quality food sources and MyPlate in general. One admirable aspect of ChooseMyPlate that I like is it gives families ideas of healthy, yet economical dietary choices for those struggling to make the right decisions on a budget.

So the basic paradigm shift is that the food pyramid was founded on the premise that one should consume more of what was at the bottom (of the triangle) and eating less of those things found at the top. In contrast to MyPlate, the pyramid appeared to have more choice. However, the idea behind the design of MyPlate is to provide a simplistic and direct connection to the food we eat. At a rudimentary level, this makes sense.

I commend Michelle Obama’s Let’s Move initiative to a healthier lifestyle and to the degree that people had difficulty understanding the former food symbol, I think we are moving in the right direction.

As with all good science it is important to continue the debate, there are those that believe mixing and matching food groups with nutrients will confuse consumers… and of course, different industry players and experts which might be affected by the promotion of MyPlate have their own opinions about the government’s efforts. There are also people that have conflicting ideologies about food intake, like Paleolithic diet proponents, or the PCRM with their vegetarian Power Plate.

So does all of this guarantee a healthier America? No. I am not a dietitian but portion control is a no-brainer when addressing weight management so it isn’t surprising that dietitians are perplexed by the lack of emphasis on portion control. However, MyPlate is moving us in the right direction, is usable, and will be much more helpful to children than its triangular predecessor.

During high intensity effort, our bodies use energy stored in our muscles. During these short bursts of activity lactic acid is produced. This lactic acid in turn creates a burning sensation in our muscles letting our bodies know we are reaching failure. During this period our muscles are also getting starved of oxygen. When we switch to low intensity tasks our heart and lungs work together to recover oxygen and remove excess lactic acid from our muscles. Our bodies adapt from the stress of the intense interval portion by building new capillaries and in turn improving oxygen delivery. This improves our muscle’s tolerance to the upsurge of lactate and also strengthens our cardiovascular system resulting in improved performance.

In the study Two weeks of high-intensity aerobic interval training increases the capacity for fat oxidation during exercise in women, published in the Journal of Applied Physiology, Dr. Jason Talanian found that after just two weeks of interval training, 75% of participants doubled their endurance before getting exhausted. Further, that bursts of high intensity exercise not only improve cardiovascular fitness but also the body’s ability to burn fat faster. The amount of fat burned in an hour of continuous moderate cycling increased by 36% and cardiovascular fitness increased by 13%. Although this study was conducted with women the study provides precedent to suggest that aerobic and mitochondrial enzyme adaptation in well-trained individuals would be similar across both sexes.

Further studies such as Mark Rakobowchuk’s Sprint interval and traditional endurance training induce similar improvements in peripheral arterial stiffness and flow-mediated dilation in healthy humans suggest that short bursts of high intensity sprints can improve the function and structure of our blood vessels, in particular arteries that deliver blood to our muscles and heart. The research compared individuals who completed interval training using 30-second “all-out” sprints three days a week to a group who completed between 40 and 60 minutes of moderate-intensity cycling five days a week. The result showed that six weeks of intense sprint interval exercise training improved the structure and function of arteries in a comparable manner to that of extended endurance training, making interval training a “time-efficient strategy to elicit improvements in peripheral vascular structure”.

For runners with limited time to train (like myself), interval training isn’t just an economical way to increase aerobic threshold but running speed as well. Intuitively, we can train at higher speeds for shorter distances so interval training gives us the opportunity to test speeds outside of our comfort zone. However, because we are training in and out of anaerobic and aerobic conditions, one should also approach this type of training with caution and make sure that they are in a condition to put this type of stress on their body. Serious interval training is not for anyone that remotely thinks they might have biological system deficiencies, but in healthy individuals can be a great way to get great results in a minimum amount of time.

Christopher McDougall’s position is backed up by recent research out of Harvard. In the study published in Nature, Foot strike patterns and collision forces in habitually barefoot versus shod runners, evidence indicated running barefoot might have lower shock/impact on our overall leg structure. In the study, barefoot runners experienced shock of only 0.5 to 0.7 times their human body weight. The impact was two to three times more for runners who wore shoes. The main difference was observed on foot landing. Shod runners landed on the heel of their foot while barefoot runners landed flatfooted or on the ball of their foot. Running barefoot, scientists suggest in the study, causes more bend in the foot’s spring and calls for more foot and calf muscle participation which causes less shock on the rest of the body making for more comfortable running strides.

What is your opinion? Let us know in the comments section below.

The benefit of Volumetrics is that one can potentially lose weight without decreasing their food portions. This can help eliminate the feeling of hunger that accompanies certain types of diets. The premise is that a full stomach will limit feelings of hunger and make the regimen feel less like a diet than other alternatives potentially leading to adherence.

Accordingly the primary focus of this diet is changing one’s food choices as opposed to meal reduction. For example, calorie dense foods like butter, cookies, oil and candy are to be substituted with foods that have fewer calories by mass and volume. However, that doesn’t mean you can’t still indulge in old favorites. For instance, macaroni and cheese can be made healthier by replacing the usual ingredients with whole-wheat pasta, no-fat milk, low-fat cheese and margarine. Food preparation is also optimized in this dietary plan through boiling and grilling as opposed to any type of cooking that requires oil.

Because the body stays hydrated during the Volumetrics diet it probably won’t appeal to those looking to shed quick pounds through the diuretic effect of low carb diets. Don’t expect to lose more than two pounds a week on this diet. It is not a quick fix. Like any diet your results will depend on obedience to the plan and maintaining an exercise regimen. However it might be just what you are looking for if you are opposed to reducing portion size but are willing to make different food choices.

A great cookbook on the subject is available from the best-selling author and nutrition professor Dr. Barbara Rolls entitled The Volumetrics Eating Plan: Techniques and Recipes for Feeling Full on Fewer Calories (See all Healthy Diet Cooking Books). If you have had any luck (good or bad) with Volumetrics please let us know in the comments section below.

One important factor is mileage – one school of thought is to replace running shoes every 250 miles, where others recommend changing shoes after running 300-500 miles. So how should a runner gauge his mileage? This is where your training log comes in. Documenting your effort is the best gauge on getting a true sense of what is right for you.

Time is another factor – a generally accepted duration is 6 months. This has been calculated by assuming a regular weekly schedule of 3 to 5 mile runs / 4 days a week. A runner who follows that schedule would change shoes around the 300-500 mileage timeline. Logically, a runner who runs more miles would find it necessary to replace his/her shoe earlier than the general 6-month rule.

Other important factors include weight and running style. Clydesdale/Athena runners might find themselves changing shoes more often as carrying extra weight can break down shoes faster. Lightweight runners who are heavy footed or use unique running techniques will also burn through shoes quicker.

How can you tell if your shoes are showing signs of wear? Place your shoes at eyesight level and look at the back of your shoes. If the soles look worn out and appear uneven, there could be some damage to the midsole. The midsole is one of the more important parts of the shoe. However, finding a defect is not easy. If you feel tightness, fatigue, aches and pains while running, then it can be an indication of midsole damage. Try twisting your shoe, if it twists easily then it might have a damaged insole. Similarly you can check the other parts of the shoe — wear can affect the cushioning, back heel, arch point or the toe box of the shoe.

Knowing the condition of your shoes is important because neglecting them may lead to injury. A tip for longer shoe life, try rotating shoes during a training week. Not only will it reduce mileage on each pair, it is a great way to test different brands to determine which shoe is giving you the best performance.

Finding the right running shoe is not an exact science, it depends on the various factors mentioned above. You are the best person to determine what works. Log your training and keep notes about how you feel, and you will quickly be able to answer the question, “When should I replace my running shoes?” for yourself.