My Fuel

We all have those products that we rely on for performance. Here are mine:

PureFit Bars

These bars are amazing!  They have anywhere from 200-240 calories, 18 grams of protein, and less than two grams of saturated fat per bar.  They are perfect fuel in the middle of my afternoon.  Today I ate one to refuel as I was losing steam on a tough hill climb on my bike -- it worked!!!  PureFit bars are vegan, kosher certified, and gluten-free.  I just ordered six boxes online -- http://www.purefit.com/

Vega Sport Performance Protein

This stuff is fabulous for refueling after a tough workout.  One scoop has 110 calories and 20 grams of protein, including branch chain amino acids.  The instructions on the package say to mix one scoop with a cup of water.  I prefer to mix it with water and a splash of orange juice, or better yet with a soy yogurt.

Clif Shot Bloks

On a long run or bike ride, it's critical to take in fuel and electrolytes.  Clif Bloks are easy to ingest.  Three blocks contains 100 calories, 70 mg sodium, 20 mg potassium, and 24 grams of carbohydrates.  I love the fact that the blocks are not messy like gels.  And, they're tasty, kind of like gummi bears!

Firecracker 10k

Up until this weekend, I hadn't raced in about six weeks.  But, there were two great races this weekend, the Race on the Base triathlon (see post below), and the Firecracker 10k today. 

The Firecracker 10k was held in Chinatown.  It's the hilliest race I've ever run.  The first 3/4 of a mile is a gradual incline.  Then until mile 3 it's a climb, and some of it is quite steep.  The scenery in Elysian Park was beautiful, followed by the course winding along Dodger Stadium, and ending downtown. 

I finished in 54:52, a time that I'm quite proud of given the hills on the course.  The last standalone 10k (as in not part of a triathlon) that I ran was eight years ago back in Detroit, and my time was twelve minutes slower on a flat course.  It's good to know that even though I am getting older I'm still faster :)

Race on the Base

Today was my first triathlon of the season.  It was also my first reverse tri -- run-bike-swim, instead of the traditional swim-bike-run. 

I had a rude awakening -- even though I am 34, I am no longer a 30-34 year old, I'm now a 35-39 year old!!  Since I turn 35 this year, I aged up to the older group.

I realized this was not a hard-core race.  I saw a lot of mountain bikes and even a beach cruiser!  I like these kinds of races, where many participants get their first taste of what a triathlon is like.

The weather was not the most agreeable.  We started our run in rain, and as the race progressed, the rain only poured down harder and the wind blew hard.  I put my head down and ran as hard as I could.

My run was good -- I kept a pace of about 7:50 per mile for the three mile run.  That's about my usual 5k pace.  I was worried that I might not have the steam for the bike and swim. 

Coming into transition at the end of the run, I saw a full rack of bikes -- this is a good sign, meaning that I'm ahead of most of my age group.  I pulled off my wet shoes and socks, which took a few extra seconds of transition time, put on my bike shoes, grabbed my bike and headed out.  The flat bike course, which consisted of three loops of the runway, had plenty of puddles, so my bike and I got soaked. 

Since I knew I had a good run, I didn't want to give up my lead, which I knew was quite possible since running is my best event and I am not a strong cyclist.  Only two women passed me on the bike, and neither was in my age group.

Running to the pool was interesting.  As I ran, I tried to put on my swim cap, which was quite awkward.  The swim consisted of four lengths of a 50-meter pool.  The pool was crowded, and swimming after a run and bike is more challenging than swimming at the beginning of the race.  At the end of the swim, there were lifeguards to help lift us out of the water and the finish mat was just a couple feet away.

The medal was pretty cool -- a dog tag:

For me, it was a great race.  I was fourth place in my age group out of 56 women.  That was less than a minute and a half behind the third place winner, in other words thirty seconds off my first transition time and a minute off my bike.  But I'm still really happy with my performance.  It's a great start for my season!

Is Soy Dangerous?

Many myths exist about soy not being safe -- that it can increase risk of breast cancer, cause hypothyroidism, and increase sterility in men.

Neal Barnard, M.D. wrote an editorial for The Huffington Post that dispels these myths.

Image from gobblegreen.com

There are many benefits of soy, including reducing risk of cancer, decreasing LDL cholesterol, reducing the risk of uterine fibroids, and lessening the risk of fractures.

Read on here.

Recovery Hike

The view from my morning recovery hike to the Hollywood Reservoir, taken by my cell phone camera.
After running 20 miles this weekend, today is a rest day.

Forks Over Knives

Many diseases, including coronary artery disease, hypertension, diabetes, and obesity can be treated and prevented by a plant-based diet.  This is a belief that I am passionate about and have seen in my daily work as a cardiologist.

The movie Forks Over Knives, which is coming out this summer, is based on the premise of diet as a treatment for disease.  It traces the lives of two important pioneers, T. Colin Campbell PhD of Cornell University and Caldwell Esselstyn MD of The Cleveland Clinic.  Both come from animal farming backgrounds, and yet both are strong proponents of plant-based diets.

View the trailer here

For Foodies

I love eating, and I loooove trying new restaurants!

One of my favorite blogs is quarrygirl.com.  When I think I've tried out just about every veg-friendly restaurant in LA, I go to her site and see all the neat places that I have yet to check out.

This is a great site if you want to eat vegetarian but aren't sure where to go. 

I love LA -- it's a great place to be a vegan!!!

Vinh Loi Tofu

There's a lot of Asian vegan food in Los Angeles.  But, Vinh Loi Tofu is unique -- the tofu and mock meats are made fresh on the premises every day.  In addition, owner Kevin Tran is a runner, training to run the LA Marathon next month, and will be doing his first triathlon later this year at Malibu.

Here are some of my favorite dishes:

Ham Spring Rolls -- my sister-in-law says they actually taste like ham.  I don't know about that because I've never eaten ham in my life, but they are delicious.

Curry Udon with Chicken

House Soup -- big enough for a small meal by itself, or great to share:

Tucked away in a strip mall in Reseda, you'd never expect to find a place like this -- but, as it's become well known, there's always a crowd. 

Vinh Loi Tofu
18625 Sherman Way, Reseda
818-996-9779

Lifestyle Change Works!

A study from the February 1, 2010 issue of the American Journal of Cardiology demonstrates the benefits of making lifestyle changes with diet and exercise.

A group of patients with heart disease or risk factors for heart disease were asked to follow a vegetarian diet with less than ten percent of their calories from fat, get at least three hours of exercise per week, and practice stress management for one hour per day.  Another group received the usual standard care.

The patients who followed the vegetarian diet, exercised, and meditated had improved endothelial function or function of the lining of their arteries.  They also decreased their C-reactive protein and interleukin-6 levels, which are markers of inflammation which have been shown to be linked to heart disease.

Source:  Dod HS, Bhardwaj R, Sajja V, et al. Effect of intensive lifestyle changes on endothelia function on inflammatory markers of atherosclerosis. Am J Cardiol. 2010;105:362-367.

Farmers Market Lunch

Sweet potato, whole wheat pita with black bean hummus and garlic hummus, and a salad with Korean tempeh.

Morning Run Misadventures

I woke up early to get in a run, thinking it would be about 4 or 5 miles, mostly flat.

Just after 5:30 am, I headed out the door, with my Garmin GPS on my wrist and my IPod on my arm.  I felt slow, but that was okay -- it was my first run in about a week as I was resting from a shin splint injury -- but I felt good.  I ran up the hill to the Hollywood Reservoir to run the flat, scenic roads around the reservoir.  Unfortunately, the gate was locked, possibly due to the rain, or possibly because the sun was not up yet.

I turned around and ran back down the hill, not sure where I would go.  I ended up taking a few twists and turns up and down some small hills, then ended up on the main street.  I felt energized -- instead of my short loop up and down the hill, I 'd do my longer loop.

But, I had never done my longer loop backwards, which is what I would be attempting to do.  It was still dark out, and I was just over two miles into my run.  I started up one of the canyon hills, on the sidewalk, when I tripped on a piece of uneven sidewalk, scraped one of my knees and both of my hands.  I rested for a moment, hoping I didn't tear my favorite running pants, got up and continued up the hill on the road instead of the sidewalk.

Running uphill felt good.  And I kept going, and going, and missed my turnoff.  I realized that I was not where I should be when I looked down on what I thought would be the canyon and saw a beautiful sunrise over downtown Los Angeles.

I kept running, now five miles in.  I didn't know exactly where I was, but if I kept running in the direction that I was running, I would eventually hit a street that I knew.  And I did. 

But then I took another wrong turn, which led me to Mullholland Highway, which I had never knew how to get to.  Somehow, I managed to trip AGAIN!  I scraped both my knees and hands and hit my left shoulder.  This one hurt even more than the first fall.  Now, keep in mind, I maybe trip on a run once a year, and now I've tripped twice in a single run! 

As I get up, my knees are sore and blood is dripping from both hands.  But I keep going -- I have to get home so that I can get to work in a reasonable amount of time, and somehow in spite of the pain I still feel good!  I don't know quite where I'm running, but I find another road that I've never run on, with a sign that reads "Scenic Road 1/4 mile".  I looked down, and wow, what an amazing view across the canyon!  And just above me is the Hollywood sign.  It was just amazing.

Nonetheless, it was a wrong turn, and after I again figured out where I was, my bloodied and bruised self was home.  Instead of my flat 4-5 mile run, I had run nearly eight miles of hills!

As it was far later than I had anticipated, I very rapidly showered, rinsed off my bloodied palms and kneecaps, and headed to work as quickly as possible.

I still feel great -- a good long run, and some new sights to see!
Image from visitingdc.com

Sports Nutrition

Just because I'm the VeganHeartDoc doesn't mean I have it all figured out when it comes to my own nutrition.

I'm not perfect in my own eating habits, but I think I do better than most.  I get my fruits and veggies. I eat whole grains instead of refined grains.  I don't eat a lot of junk, and though that big chocolate chip cookie from Follow Your Heart after lunch was delicious, it certainly wasn't necessary.  I'm also not perfect with portion control either, and I do love to snack throughout the day.

I've been thinking hard about my own nutrition and what changes I need to make.  Perhaps part of it is the extra five pounds of padding that I've acquired in the off-season.  But, more importantly, I'm about to take on the most daunting physical challenge that I've ever encountered:  The Ironman.  2.4 miles of swimming, 112 miles of bicycling, and 26.2 miles of running, all in the same day.  My training weeks will consist of anywhere between 10 and 18 hours of cardiovascular exercise in a week.

I've recently talked to a nutritionist, and I've discussed nutrition with my new personal trainer.  The consensus is that I need more protein in my diet.  Now, the average person needs no more than ten percent of their calories from protein, and when left to my own devices, that's about how much protein I consume.  But, as an endurance athlete, my requirements are higher so that I don't catabolize too much muscle.  From what I've read, I need about 1.3 to 1.5 grams per kilogram body weight of protein per day, which for me is about 90-100 grams of protein per day.

I've been thinking of ways to get that protein -- veggie chili, soy yogurt, Chicken-Free Chicken, Luna bars, tofu, Kashi Go Lean (which is my favorite cereal already), and protein smoothies.

My personal trainer did bring up a good point -- I would benefit from a rapidly digestable protein.  Whey protein is digested rapidly, but as a vegan, I do not consume dairy.  I am looking into a good source of rapidly digestable vegan protein.  So far, I have come up empty.  If anyone has thoughts on this, feel free to share!

Back to Training

I like having a goal.  And I like structure.  And competition.

That's why I'm a triathlete.

I've enjoyed the past three months of working out for the sake of working out, with no schedule and no coach to report to.  But, I'm ready to start training again.  I'm even ready to start swimming again.

Ironman Lake Placid training starts February 1.

Southern California Half Marathon

It is still my off-season, but I've been keeping up with my running, staying at 20-30 miles per week, much of it hills because I'm really beginning to love running in my neighborhood.

A friend wanted to do a half marathon this weekend, and I agreed to join her.

The weather today was perfect for a race -- at the 8 am start time, it was in the low 60's, and warmed up slightly during the race.

As I haven't been specifically training for a half marathon, I hadn't thought too much about pacing myself.  I have wanted to run a half marathon in under two hours.  Toward that goal, I decided that I should aim for 9:00-9:15 per mile, and if I felt good at the halfway mark to pick up the pace.

The start was crowded.  With thousands of us lined up, and no indication of where walkers, slower runners, and faster runners should start within the crowd, the first mile was crowded.  I probably spent too much time and energy dashing between people.  My first mile was 9:09. 

I had a little bit of an ache in my left ankle, which I've ignored this week thinking it was a big nothing, but during the race, it did nothing more than just ache.  I was more bothered by a blister in my left arch.  After the race, that was a different story, as I sit here typing with a bag of frozen corn on my right ankle.

Back to the race:  The course was on major roads and along canal paths, and it was mostly flat.  I had consistent mile splits, averaging about 9:10 per mile, so by mile seven, as I high-fived a guy announcing the race and wandering the course with a microphone, I decided to pick up the pace a bit, and the last half was done at an average pace of 9:00 per mile.

There were lots of enthusiastic volunteers on the course directing us, which I loved!  But, the fluid stations were horribly understaffed.  I couldn't get anything to drink at several stations because there weren't enough volunteers, the volunteers were not spread out and were too clustered together, leading to too much crowding to effectively grab fluids.  One station had only one volunteer with Powerade and about a dozen other volunteers holding water.  Another station ran out of Powerade by the time I got there; that shouldn't have been the case -- I was definitely in the faster half of runners so there was no reason to run out.  I think that the race could have done well with fewer volunteers with direction signs and more volunteers at the aid stations.

I wasn't sure that going sub-2 hours for the race was doable, since my training has been pretty free-form -- I run when I want and as far as I want.  But, when I hit the ten-mile marker and saw that my time was 1:30, I realized I could do it.  As long as I kept sub-10 minute miles, I knew I could do it.

So, I pushed the last few miles, and coming around the corner to the finish line, I knew I had it.  My finishing time was 1:58:58, my best half marathon time by four minutes.  24 out of 126 women in my age group.  202 out of over 1700 women.  896 out of over 3800 runners.

Cravings

Think about the foods you crave.  What are they?  Pizza?  Nachos?  Candy?  Or maybe fruit?  Salad?

Fruit?!?!?!?

I was thinking about this while talking to one of my patients today.  She is someone who has made some major changes -- she now follows a low-fat, mostly vegetarian diet.  She also now exercises regularly.  Her cholesterol numbers, as a result, look fabulous -- her total cholesterol dropped from 239 to 139, and her LDL (the so-called bad cholesterol) plummeted from 168 to 71.

She tells me that she feels better eating lighter, and she doesn't crave a lot of the heavier foods that she used to eat.  She was surprised to find herself craving healthier items.

I can understand that from my own experience.  While I once craved fast food, I now crave things like apples, strawberries, carrots with hummus, oatmeal, and even salad.  Granted, I still enjoy a little bit of chocolate or ice cream occasionally.  But those aren't regular staples of my diet.

If you are thinking about making changes to your diet, keep this in mind:  As you make positive changes to your diet, you will feel good, and your body will crave the healthy foods that make you feel good.

Pumpkin Pudding

So I'll be honest -- the only reason I have a can of pumpkin in my kitchen cabinet is because I was afraid I might mess up the pumpkin pie that I made for Thanksgiving.  I came up with this recipe, and I'm proud of the results.

Ingredients:
One can of pumpkin, 15 oz
Silken tofu, seven ounces
Agaven nectar, three tablespoons
One half teaspoon of nutmeg
One half teaspoon of allspice

Put all ingredients in a blender and puree until well mixed and smooth.  Refrigerate in individual dishes.

Makes four servings.

Nutritional information per serving:
120 calories
1.5 grams of fat
5 grams of protein

Dinner for my parents

In honor of my parents' visit to Southern California, I cooked for them:

Squash, carrots, and sweet onion stir-fried in a tiny amount of oil and teriyaki sauce.

Whole wheat pasta spirals

Mashed cauliflower, mixed with a little soy milk and pepper.

Field Roast -- a great source of protein, but high in sodium.  If you want a low-sodium option, grill some tofu steaks.

Staying Fit on Vacation

I just returned from a relaxing trip to the Bahamas.

A lot of people see vacation as a time to throw caution to the wind, become sedentary, and eat obscene quantities of food.  I see things differently.

To me, vacation is a time to unwind.  But, because exercise makes me feel good, I keep it up.  I tone down my routine, but I still exercise in some way on most days of a vacation. 

I do a lot of running on a vacation.  I find that running is a great way to explore the local sights.  Another favorite workout is running barefoot on wet sand.  I go barefoot, and I run along the beach just where the waves touch the sand.  It's a little more challenging than running on trails and works different muscles.

I found another triathlete physician, and he put me through the paces of his own workout.  It was fun for me, because I always love a challenge.  We did intervals of ten minutes alternating on the bike and on the treadmill, and did a total of six intervals, followed by a brief swim (yes, me, voluntarily swimming in the off-season) in the ocean.

On vacation, the bottom line to exercising is to keep it fun.

Happy New Year!

2009 was a good year.

Professionally, I joined Valley Cardiovascular Specialists and moved into my office in West Hills.  I've been fortunate to work with wonderful people, including Ashley, my receptionist, and Keely, my medical assistant.  I have had the opportunity to get to know and take care of some terrific patients.

Athletically, it was a challenging year, and yet one of great accomplishments.  I DNF'ed a marathon and came back to complete a marathon two weeks later to prove I could do it.  I learned what it was like to be a cardiac patient with my arrhythmia and ablation.  I completed two half Ironman-distance triathlons, one of which was a personal record for me, and the other is considred the second-hardest triathlon course in North America.  I even learned to not take myself so seriously by running a marathon in costume.

My most proud athletic accomplishment of this year: taking forty-five minutes off of my marathon time from 2008, getting down to 4 hours and 12 minutes for a marathon.

I'm looking forward to the upcoming year of challenges, of meeting and caring for new patients.  I'm excited to finally be able to call myself an Ironman (or Ironwoman, which is it?) once I complete Ironman Lake Placid in July.

Happy New Year... and may your 2010 be filled with health and accomplishment!

Losing a Patient

I take care of patients with complicated medical illnesses.  Unfortunately, that means that occasionally my patients pass away.

One of my patients died a few mornings ago.

I met him in February.  He was an engineer and inventor, one of the brightest people I've ever met.  He had right heart failure, and was one of the few patients who knew why I look so closely at a patient's neck.

"How's my angle of Louis?" he would often ask as I looked at his neck veins to assess his right heart pressure.

He was one of my more talkative patients.  He would talk about science, research, often things that were a bit over my head.  He was dutifully compliant with his medications and kept meticulous records, though he occasionally indulged in foods higher in salt, which led to occasional decompensation of his heart failure.

He read my blog, because he'd ask me about my races and comment on my posts.  In particular, I remember him being very curious about my experience with supraventricular tachycardia and my ablation earlier this year.  I think he even posted an anonymous comment about my "ablative cardioversion".

I was also fortunate to have the connection of my medical school advisor being one of his closest friends.  He invited me to his home for lunch, which gave me the opportunity to reunite with my former advisor.  Seeing his home gave me more insight into who he was as a person and as an inventor.

But, it was ultimately other health issues that took their toll.  A compression fracture caused terrible back pain.  Cognitively, I could see him declining as he became less intellectual and less talkative at his more recent visits.  Most recently, swallowing became difficult for him and he was hospitalized due to aspiration into his lungs.

He was discharged home and passed away two days later.

He's a unique man who definitely left an impression.

Athlete Cookies

My friend Gail competed as part of a relay team for the San Diego Triathlon, to benefit the Challenged Athletes Foundation. She offered to make cookies for anyone who sponsored her $100. I took her up on the offer, and challenged her to make vegan cookies. Here they are, and they are very funny!!

From left to right, these are in honor of my best 5K race, my best marathon, and my most recent marathon which I ran in costume.

Clockwise from the top, these commemorate Santa Barbara Long Course triathlon with its chilly ocean swim, California International Marathon, and the New Moon Century ride.

These cookies are for Wildflower Long Course triathlon and Vineman 70.3, the two half-ironman distance races that I completed this year.

Running as Supergirl

I thought seriously about whether to post my marathon pictures on the blog. As a cardiologist, I have a certain image to maintain.

But, the more I thought about it, the more I thought that being Supergirl for a race was something I wanted to share. Fitness has to be fun, and I think that this experience reflects that. If exercise was always serious and always hard-core, we would burn out, a lesson that I've learned over the past few months of training.

So here are a few pictures from my race. Through the wind and cold, I had much more fun running as a superhero than I would have otherwise.

CIM Marathon

Today was the CIM Marathon in Sacramento.  I've been doing more cross training and a lot less running, and I wasn't sure what to expect from my legs or how long it would take me to finish.

I chose to run with the 4 hour and 15 minute goal time group.  My last marathon seven weeks ago, that I was far better trained for, was a 4:12 finishing time.

But, for the first time ever, I ran the marathon in costume, as Supergirl.  Complete with a cape.  The day was cold and windy, so the long sleeves of the costume and the cape worked well to keep me warm.

Self-portrait with my camera.  Better picture coming soon, hopefully.

At the start of the race, it was 29 degrees and maybe by the end the temperature was in the mid-40's. I started with the 4:15 pace group. Our leaders, Lisa and Mike, definitely made the running eperience unique. They had us shaking out our arms and fingers every couple of miles. It seemed silly, but they kept saying, "You'll thank us at mile 20", and yes they were right, it kept our upper body loose. They instructed us to take the tight turns on the course so that we limited the distance that we were running.

I felt good at mile 4, so I broke away from the group and went ahead. A few miles later, I stopped to use the restroom and the group caught up with me around mile 8.

The winds were strong and made running far more challenging. Our pace leaders told us to "tuck in" and run closer together to try to shield the wind. It helped a bit, but the cold and the wind definitely took their toll. With wind, there is more fluid loss, so I was mindful to drink as much as possible.

I pulled ahead of the pace group again at mile 12, and they caught me at mile 14. Lisa, one of the pace leaders said, "We caught up with Supergirl!" Part of me thought she was taunting me for thinking I could pull ahead.

I stayed with the group through mile 21 I needed that group support, positive energy, and shielding from the wind. It took everything in my being to keep up with them and not drop off.

At the water stop at mile 21, I choked on my cup of water, and as I choked, the group ran by. I tried to keep them in sight, but they kept getting farther and farther away.

Dressing as Supergirl definitely has its advantage in crowd support. Lots of people yelled, "Go Superwoman!" "Go Supergirl!" It really helped push me forward. But, my mile splits dropped below ten minutes. I felt tired. But I kept going. Three miles left. Two miles left. One mile. And then a strong finish. Even the announcer yelled for Supergirl!

My finish time:  4 hours, 16 minutes, thirty seconds.  That's about three and a half minutes slower than my time seven weeks ago at Long Beach, when I was training harder.  I'm proud of my time, and I had fun along the way.

Does work count as exercise?

I ask all my patients if they exercise.  It's an important question since exercise is so important for cardiovascular health.

A common answer:  "I exercise at work."

Unless you are a bicycle delivery person who covers large distances or a valet car attendant who spends most of your shift running to retrieve cars, it doesn't count.  Construction and manual labor don't really count either, since those jobs involve short bursts of lifting or exertion as opposed to a sustained effort.

Granted, a job that has you moving on your feet is far better than a desk job in terms of promoting heart health.  However, for true cardiovascular benefit, you should be doing something outside of your daily work that involves a sustained effort, preferably for at least thirty minutes on most days of the week.

Tofu Pumpkin Pie

I baked this from a recipe from Vegweb.  It's a whole wheat crust, which I bought from the store, and a filling made from pumpkin puree, maple syrup, cornstarch, silken tofu, nutmeg, and cinnamon.  I'll be serving it up with Soyatoo whipped cream.

Happy Thanksgiving!!!

Teriyaki Bake

This is a similar, easy recipe to the one from a week earlier.

Chop up some veggies and extra-firm tofu.  The veggies in here are eggplant, carrots, squash, sweet potato, and onions.  Add teriyaki sauce.  Mix it up, cover with foil, and bake for 40 minutes at 400 degrees.

Cranberry Sauce

A less sugary, lower-calorie, easy version of a Thanksgiving favorite.  I concocted this on my own to make sure it tasted good before subjecting my family to my cooking.

1 bag of cranberries, 1/2 cup of orange juice, 1 large sliced apple, and 1 1/2 tablespoons of agave nectar.  Heat it in a saucepan for about thirty minutes, until the cranberries all burst.

Where I'm At

I've been coach-less for three weeks and doing mostly what I want for exercise.

Needless to say, I didn't qualify for Boston.  However, I am proud to say that in the course of eighteen months that I cut my marathon time down from 4:57 to 4:12.  I'm proud to say that through much effort and good coaching that I'm a better runner.  One day I'll qualify for Boston, it just won't be this year, or likely next year since I'll be shifting my focus to Ironman training.

However, I decided to run the CIM Marathon after all.  I'm already signed up and I love doing long training runs, so I'm going to just do it.

I have only been running three days a week.  Last week, I ran 4 miles on Monday, six miles of hills on Friday morning, then twenty miles on Saturday morning.  Perhaps the six miles of hills on Friday made Saturday's run more painful than it needed to be.  Nonetheless, I finished the long run.

Another thing I've noticed with less exercise is that I can't get away with eating quite as much.  In peak training for my 70.3 (half-Ironman distance) races, I could easily maintain my weight on 2700-2800 calories per day.  Now, doing only about an hour of cardio 5-6 days per week and two days of weights, it's more like 2400 calories per day.

I feel great.  Relaxed.  Eager to start Ironman base training in January.

Dr. Shenkman Goes to Washington

I spent a few days in Washington DC last week.  As you can see, it was quite rainy and cold, not at all resembling the weather that we are accustomed to here in Los Angeles.

I traveled with a Young Leadership group from the Jewish Federation of Los Angeles.  We went to the White House, Capitol, Supreme Court, State Department, Holocaust Museum, and US Treasury Department.

We also had the opportunity to meet with representatives of our members of Congress to discuss a couple of important issues:  hunger in Los Angeles and Iran.

In Los Angeles, one in eight people face hunger every day.  That's a very sad statistic for a wealthy country like ours.  As I discussed in an earlier post, this is the role of the Jewish Federation's Fed Up With Hunger campaign -- to bring attention to hunger locally and to raise funds to combat it.

As a cardiologist, I had the opportunity to give my perspective on hunger:  Those who face hunger are poor and as a result eat unhealthy foods that are high in calories, fat, and sugar, and hence obesity is becoming more and more prevalent, especially amongst the poor.  Obesity leads to high blood pressure, diabetes, abnormal cholesterol, and as a result to heart disease.

Diseases like hypertension and dyslipidemia that once were thought to occur in middle age are being seen in younger and younger people.  I took care of a 25 year-old man with a heart attack and have a handful of patients who are younger than me who have suffered heart attacks.  I see teenagers with high blood pressure, diabetes, and dyslipidemia.

To help to combat obesity, we need to fight hunger by providing healthy options to cheap junk food.

Veggie and Tempeh Bake

I chopped up some yellow squash, sweet potatoes, a green pepper, red onion, and coconut-flavored tempeh mixed it with some Liquid Bragg's and a little agave nectar and sprinkled with pepper.  I baked this at 400 degrees for about 35 minutes and served it over whole wheat pasta.

Low Carb Diets Won't Make You Happy

A study in this week's Archives in Internal Medicine (Nov 9, 2009, Vol 169, No 20) looked at the effect on mood and cognition of a low-fat versus a low-carb diet.  Patients on both diets lost the same amount of weight, 14 kilograms.  However, those on the low-fat diet had greater improvements in mood compared to those following a low-carb high-fat diet.

Interestingly, the "low fat" group got 30% of its calories from fat.  I'd call that more of a moderate fat diet, but clearly that diet has less protein and fat than the "low carb" diet.

Why the difference in mood?  Serotonin may be suppressed by a low carbohydrate diet, while it may be upregulated by a lower fat diet.

Thee bottom line:  It doesn't matter what you eat to lose weight.  But, what you do eat in your weight loss obviously has an impact on how you feel.

What I'm Reading

Caldwell Esseltsyn Jr. is a cardiovascular surgeon at the Cleveland Clinic who asked twenty-four patients with severe coronary disease to make radical changes to their diets and follow a low-fat plant-based vegan diet.

The results are incredible.  Through diet alone, these patients were able to halt the progression of their heart disease and save their lives.  It also includes several very simple recipes for low-fat heart-healthy meals and snacks.

As this book demonstrates, diet is so important in heart disease.  This is why I discuss food at just about every patient encounter.

If you're not sure whether you can change your diet to improve your heart health and change your life, read this book!!!

New Adventures

On my first day of exercising for fun, I ran.

On my second day of exercising for fun, I biked.

Sound like a broken record of a triathle's life?

But, when I went running, I didn't have my GPS or my heart rate monitor.  I just went out and ran up and down a few hills for fun.

And, for my bike ride, someone asked me, "How far are you going?"  Normally, I know exactly how far I need to ride that day.  My answer was, "I don't know, I'm just going up."  It ended up being a fun 15 mile round-trip ride from the LA Zoo up to the Griffith Park Observatory.

Yesterday I tried  a boxing boot camp class.  I hadn't been to a boxing class in a couple of years, so I was a bit rusty with the punches.  However, given my running and triathlon background, I had no trouble keeping up with the class physically. 

Unfortunately, since boxing uses muscles that we don't use to swim/bike/run, I am still pretty sore. Even taking a deep breath strains a few muscles!
I am enjoying my new exercise program, in spite of the soreness.
Image from blog.mtviggy.com

I Am Burned Out

I haven't been enjoying running lately.  While I love to run, as of late I absolutely dread getting on the treadmill.

Today I came to a realization:  I have been training for something for over two years.  A half marathon.  A marathon.  A half ironman.  Another triathlon.

I need a break.

I exercise and train beause I enjoy it.  I do it for me.  So, when it ceases to be a fun challenge, I think that means I need to take a break.

I am dropping out of the CIM Marathon that I signed up for on December 6.  For the next two months, I will be exercising for fun.  Though I may do a few short 5k or 10k races, there will be no big events to train for.  I'm going to do things that I haven't done in a while -- kickboxing, rollerblading, and spinning.  I may even try some new things, like pilates or yoga.

I hope to come back refreshed in two months and ready to start base training for Ironman Lake Placid in July 2010.

Fuze Tropical Punch

I love pop / soda, and not the diet variety -- the full-calorie drinks, and I love fruit juice.  However, they're empty calories, so it is best to drink as little of these beverages as possible.

Recently, I discovered Fuze. One bottle has ten calories. It's flavorful and has vitamin C. It doesn't even taste low-calorie!

Atkins

A patient once described to me his diet which included healthy meals, such as "good foods like steak."  He experienced initial success with the Atkins Diet in rapidly losing fifteen pounds, and then, unfortunately gained back all of the weight within months.

The Atkins Diet was popular early in this decade as an easy way to rapidly drop weight.  True, the diet will allow you to lose a large amount of weight at first, most of it in water.  But, in the long-term, it isn't successful.  How many people do you know who have lost weight, kept it off for several years, and attribute their success to the Atkins Diet?  I don't know a single one.

Ingesting a diet high in saturated animal fat and protein is not good for the body.  Diets high in saturated and animal fat have been shown time and time again to increase the risk of heart disease and cancer. 

The European Prospective Investigation into Cancer and Nutrition, a multi-national study of thousands of people, demostrated that high-protein, low-carb diets increase mortality risk.

A low-fat, vegetarian diet, with lots of fruits, vegetables, and whole grains, with lean protein, really is the best option for health and permanent weight loss.

New Moon Century -- 100 mile bike ride

Physically, I'm always looking for something tougher, something bigger to accomplish.  Yesterday I rode 100 miles, including 9000 feet of climbing.  This is the most I have ever ridden in one day.

As of late, my training has been focused on running.  Cycling has been reserved for recovery days.  My last 40+ mile ride was over a month and a half ago!  So, needless to say, I was a bit worried.

However, this event supported a good cause, the Jewish Federation's Fed Up With Hunger campaign to feed hungry people in Los Angeles.  It was also an all-vegan ride!

The ride started in the West Valley community of Oak Park, headed south to Agoura Hills, west toward Thousand Oaks, south to Pacific Coast Highway, PCH into Malibu, then up Mulholland and when I say up I mean up up up with some serious climbing.  We stopped for lunch at mile 56.  The last 44 miles were full of climbing -- on Mulholland and up Topanga, and then back to the start.

I felt okay at the start.  I went out with a group that seemed at my level.  A couple riders were a bit faster.  I ended up riding much of the way with one person, who was on a commuter bike, and when it started getting windy on Las Posas Road and at the westernmost edge of PCH near Poing Mugu, I drafted off of him.  I'm not sure he realized I was drafting him, but when I gained enough energy, I rode in front to give him the chance to draft off me, but I'm not sure he took advantage because I'd turn around and see him behind and to the left of me.  Is there shame in a man drafting off a woman cyclist?  I'm not sure.

Once we reached Mulholland, around mile 39, the ride really began -- in other words, the climbing!  I really surprised myself that I had it in me to climb those mountains given my lack of recent cycling, but I passed a few riders in our group.

I was so thrilled to get to mile 56 and enjoy some lunch.  Since all the food was vegan, it was easy -- I fixed myself a whole wheat Tofurky sandwich with avocado, tomato, and Vegenaise.  Yum!

The last 44 miles were rough.  I found a couple of men who were about my pace to ride the last 35 miles with.  When struggling to achieve a goal, it's great to be around others -- that's why I do my long training runs or track workouts with a group -- I get energy from being with other people with the same goal.  I'd say I "hit the wall" at mile 85, climbing on Mulholland heading west back to Las Virgines Road.  My legs were tired, my knees ached, and my energy was sapped.  One of my riding companions flatted at mile 90, which made for a good excuse to stop and wait for him to change his tire.

When we finally finished, it felt so good to be done!  I slept so well last night.  Yesterday's ride helped me gain the confidence that I need going into training for Ironman Lake Placid, knowing that I can complete a long hilly course.  Also, I got to practice staying fueled while training, with both electrolyte solution and food.

No more endurance races for me for a while... not until the California International Marathon on December 6.

Three Runners Die in Detroit Half Marathon

Sadly, three runners died at the Detroit Half Marathon today, as reported in The Detroit News.

Two runners collapsed and died around mile twelve, and the third shortly after finishing.  All three were men, ages 26, 36, and 65.  All received prompt medical attention and had defibrillators applied to them, all unsuccessfully.

In addition, a 23 year-old man died at the Baltimore Marathon last week, and two runners died at the San Jose Rock N Roll Half Marathon just a few weeks ago.

Why are apparently healthy athletes dying, and why is this a more common phenomenon recently?

A person can feel well, train for a race, but unknowingly may have heart disease.  In younger athletes, those under age 40, the most common cause of sudden death during a race is a structural abnormality of the heart, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, or arrhythmogenic right ventricular dysplasia.  The presence of those structural abnormalities of the heart, combined with the stress of a competitive athletic event, can trigger a deadly arrhythmia.  Amongst older participants, unknown coronary artery disease may be present, and could lead to a heart attack or arrhythmia that could then lead to death.

Statistically, the odds of dying while competing in a marathon range from 1 in 50,000 to 1 in 150,000.

What should an athlete do?  How can we find these things before someone dies?

This is a controversial question amongst the cardiology community.  I believe that everyone who wishes to compete in any type of endurance sports needs a full physical before participation.  This includes a physical examination, blood pressure check, full panel of blood work including fasting cholesterol levels, and an EKG.  A physician should also inquire as to whether there is family history of heart disease in any first-degree relatives.

In Italy, guidelines are even stricter.  All young competitive athletes have a complete echocardiogram, or ultrasound of the heart.  As you can imagine, the vast majority of these echocardiograms are normal, and thus this recommendation is quite controversial.

Despite the risk in participating in competitive athletics, I hope that these recent events will not scare people away from being active, because an active lifestyle, in spite of these risks, is far better than a sedentary lifestyle.

Dr. Oz -- Cowboy Goes Vegan to Save His Life

Rocco is a cowboy.  He's overweight, diabetic, and has a large amount of plaque in the arteries of his heart as demonstrated by a CT scan.  Dr. Oz challenges him to go vegan for 28 days with the goal of reversing his coronary disease and prolonging his life.

Watch the video here

Now, Rocco is similar to so many of my patients whom I see every day.  If he can become a vegan, then I'd say just about anyone with the right motivation can make important dietary changes to improve their health.

Long Beach Marathon

Today I ran the Long Beach Marathon.

I wasn't sure whether to run with the 4 hour pace group or go it alone.  As the gun went off and the 4 hour pace group dashed ahead, my choice was made for me and I started on my own.  I easily settled into a pace of 9:15-9:20 per mile.

I was nervous about being able to keep that pace, but for the first 13 miles it felt comfortable.  Then my legs felt heavier, and I slowed down, averaging 9:59/mile for the second half of the race.

Highlights of the race were running through Cal State Long Beach during miles 17-18 and all the enthusiasm of the students cheering us on, and the nursing home that brought their residents outside -- I've never seen a row of twenty elderly people in wheelchairs bundled up cheering at a marathon, it was awesome!

At mile 25, one of the stomach cramps that I have been plagued with came upon me.  I ended up slowing to a walk for about two minutes until it passed, and then I ran the rest.  The last mile felt so long, and it felt so good to finish!

My finishing time was 4 hours, 12 minutes, 55 seconds.  It's my personal best by almost six minutes over my San Diego Marathon.  But, I'm not that pleased.  I feel like I missed my goal, and could have gone faster.  Maybe I needed more longer runs.  Nonetheless, a personal best is a personal best, and I'll take it.

I think that before I race California International Marathon in Sacramento on December 6 that I will do a few things differently:  I hope to do more long runs, and I will take two Immodiums instead of my usual one.

Vegetarian Diets Reverse Diabetes

Improving control of your diabetes can be as simple as changing your diet.

In this interview from the Huffington Post, Kathy Freston talks to Dr. Neal Barnard, whose research has demonstrated that diabetes can be controlled and even reversed with a vegan diet.
Image from api.ning.com

Cooking Less... Eating Vegin' Out!!

Today I ran the Race for the Rescues 5K in 24:29, a new personal best for me, 1st in my age group and 6th woman overall.  I definitely have increased confidence going into next weekend's marathon.

With work, running, triathlon, and time with family and friends, it's tough to prepare healthy meals.  I don't feel like cooking when I get home.  And, living alone, fresh produce has a habit of going bad.

Veginout.com is a vegan home food delivery service.  They bring three different main dishes, four entrees, a soup, and five cookies.  It's enough food for eight or nine full meals, all for $110/week.

The food is healthy stuff, relatively low in oil and fat, and delicious.  I would love to see them provide calorie and nutrient information, but perhaps that's something they can provide in the future.

Check them out at http://www.veginout.com/.  And, if you sign up, tell them I referred you!

Taper

A Taper is a period of time during which we back down the amount of exercise that we are doing in preparation for an upcoming race.

I've never truly embraced the concept of a taper.  When I decrease the amount of exercise that I am doing, I feel sluggish.  Invariably, I gain a pound or two because I'm not as active.  But, when I stick with the taper plan and am rested before a race, I do well.

Last weekend's 18 miler went much better than the one before it.  I had some good runs this week.  This morning, I ran a total of 8 miles, six of those miles with the LA Leggers 9-minute per mile pace group, which is the first time that I have run with this faster group.  It was a challenge  running 8:20 per mile for eight minutes and then walking a minute, and keeping that pace while running up a couple of steep hills, but I was able to do it.

Tomorrow I'm doing a 5K race, just to get an idea of how much I've improved since July, when I had a personal best of 24:55.  I would love to break 24 minutes.  Then I'm going to go for an easy hour-long bike ride.

My strategy for Race Day at the Long Beach Marathon next Sunday:  Coach Jamie wants me to start at a 9:15/mile pace.  I think that's a little aggressive, but if I'm rested up enough, maybe I can keep that pace up for the race.  If around mile 7-8 I feel like that's a little too fast, I'll back it down.  My goal is to run in under 4 hours and 5 minutes.

Why I Do What I Do

This weekend, while rounding in the ICU, I looked up and saw a picture of one of my patients, smiling with his wife, standing next to two nurses who cared for him.

He was a previously healthy man in his early 30's.  A few days earlier, he had a fever, and then developed shortness of breath.  I had come in to the ER to see him at 1 am, saw that he had congestive heart failure and a weak left ventricle.  We stabilized him temporarily, but the next day, he was intubated, his blood pressure was dropping and he was requiring multiple medications to support his blood pressure.  This previously healthy man's life was in danger.  I cancelled half of my morning's patients to emergently place a central line to sort out what was going on.

In the days to come, he gradually improved, his heart function strengthened, and a week later he was discharged.

I see him in my office, and he's sitting on my exam table, smiling, and you'd think he'd never been ill.  He feels great.  He's back to work and back to playing basketball

And, I swear, when I saw that picture of him, smiling with the team who helped save his life, I smiled.

Got my Mojo Back

I was very disappointed after my long run this weekend.  Read below -- it was awful.  But I'm better now.

My coach was right.  I needed a few days off.  Monday was an hour of weights, Tuesday was a 30 minute run with a few accelerations, and today was a track workout.  We did 800's, and mine were all consistently between 3:34-3:37.

I think I'm back.

Burnout?

I'm trying to figure this out.....

I've been running 40 miles per week for several weeks.  Most of my runs have been on the treadmill because of the heat and because of my work schedule.  And, most of those runs have been great -- I had a personal best last Tuesday, where I was able to run 8 miles in 1 hr 11 minutes and 50 seconds on the treadmill, just under 9 minutes per mile.  I was thrilled!

And, I set the treadmill at a 1% incline, to best emulate running outdoors.  So, I felt like I was ready for my 18 miler on Sunday.

My goal was to run the 18 miles at 9:10 per mile.  The first three miles were at 9:30/mile.  I wasn't feeling fabulous, but I was chugging along.  At mile 5, I had an awful stomach cramp.  I stopped for a few minutes, rehydrated and slugged down a Hammer gel and kept going.  But, as the run progressed, I kept getting slower.  My legs felt heavy and I felt a bit tired.  By mile 14, I was just forcing myself to keep going, and my pace was down to 10:30 per mile.  I pushed to 16 miles and called it quits early.  There was no point in torturing myself to get the extra two miles out.

I've been agonizing over this not-so-stellar performance.  What went wrong?  Am I doing too much treadmill running?  Does this mean that the Long Beach Marathon is going to be a miserable experience too?  And my little Boston Marathon dream -- forget it!

I was so glad to talk to Coach Jamie today.  It was quite reassuring.  He thinks I'm overtrained, and has more confidence in me than I probably have in myself right now.

I'll have a day of easy running tomorrow, some track work on Wednesday, a 10K time trial on Friday, and an 18 mile run Sunday.  Coach Jamie thinks that if I can nail this 18 miler then I will be okay.  I've also vowed to do all of my running this week on the roads, not on a treadmill.  Maybe that will help.  I hope.....

Malibu Pictures

Pre-Race, in the transition area.

Running out of the ocean after the swim.  I may be smiling, but I am absolutely sucking wind!

On the podium at the Awards Ceremony --

Fourth Place Athena (since the first place girl started in the wrong wave, she was dq'ed)!!!!

Malibu Triathlon

Today I celebrated my 34th birthday by racing the Malibu Triathlon!!!

Me and April, a teammate, in the transition area before the race.

Half mile swim, 18 mile bike, 4 mile run.  Lots of celebrities.  I saw David Hasselhoff (looks far older in person), Mario Lopez (looks gorgeous even in a wetsuit and swimcap), and Jeremy Piven.

I did something different -- instead of racing as an age group athlete, I raced as an Athena, the category for women 150 pounds and higher.  My weight hovers between 148-150, and on the morning before the race, I was 150 so I decided to go for it.  Coach Jamie didn't agree with my decision -- he says I'm "competitive" and should "be fair", while another coach suggested I should use my size to my advantage and race in the Athena category.  While I admit that I am a normal weight for my height, being tall (5' 9 1/2") presents a definite disadvantage in triathlon, since long legs biomechanically are horrible levers on the bike and serve as somewhat of a disadvantage for running.

The swim was a bit choppy.  Some of the waves got some big swells, while ours didn't seem so bad.  I felt my swim was good, though I must admit I crashed into the third buoy before I went around it.  Yes, clutzy, but only cost me a couple seconds.  Even getting out of the water, it was a bit choppy.

I was pretty breathless getting out of the water, probably because of all the chop, and was having a heck of a time running through the sand to the transition area.  My bike ride was good, for me.  One benefit of being in a late wave is that I get to pass people on the bike, which isn't a common occurrence since the bike is my weakest leg of the race.  One girl on an archaic bike with no pedal clips kept passing me, and then I would pass her.  Every time she pulled up next to me, I laughed to myself, "I have a Cervelo!  Your bike isn't supposed to pass mine!"  But in the end, pride took over -- I wasn't going to let THAT bike beat me :) and I passed her for good.

I enjoyed the run.  Coach Jamie wanted me to run it in 8 minute splits.  I didn't quite hit that goal, but did run about 8:30/mile, and saw great friends and teammates on the course.  Best of all, my 4 year-old niece had just run the Tot Trot, and I saw my family near the finish line -- with about 200 feet to go, my brother yells, "Good job -- 2 more miles!"  I laughed, and dashed for the finish.

In the end, I finished in 2 hours and 3 minutes, five minutes faster than last year.  I placed fourth in the Athena category, which means I got to stand on the podium, which I have never had the chance to do at a large race.

I couldn't have had a more thrilling birthday!

No Soup For You! -- Watching out for Salt

There seems to be a common theme this week:  My patients love soup.

Unfortunately, soup is full of sodium.  Sodium causes fluid retention, which can lead to edema (swelling), increased blood pressure, and in those susceptible patients, congestive heart failure.

Some may believe that if the soup is homemade then it must be healthy and low in sodium -- not true.  A homemade chicken soup is made from the drippings of a chicken or another animal, which naturally are full of sodium.

Unless the broth is made with just water and vegetables, or is specifically labeled with a low sodium content, the soup is high in sodium, and if you have hypertension or congestive heart failure, then it is best to just stay away.
Image from static.howstuffworks.com

Spinach Dip

I love this spinach dip and will be bringing it with me to a Labor Day party this afternoon.  It's easy to make, healthier than a standard spinach dip, and tasty.

Here's the recipe:
3 pounds chopped frozen spinach, thawed and drained of extra water
1 small can of chopped water chestnuts
1/2 cup Vegenaise
2 tablespoons of imitation Chicken soup mix

Mix all ingredients in a bowl.  Refrigerate overnight.  Serve with chips.

Saturated Fats and Cholesterol

A common conversation that I have with my patients is how they've altered their diet once they have learned that they have elevated cholesterol.  Most will tell me that they've cut back on beef, but are eating more fish and chicken, and unfortunately, their cholesterol levels have not improved.

All animal foods contain cholesterol, because like us humans, their livers produce cholesterol.  In fact, beef and chicken and fish all have just as much cholesterol in them, so by switching to fish and chicken, dietary cholesterol consumption will not decrease.

More importantly, though, is saturated fat, which raises our bodies' cholesterol levels.  Interestingly, animal foods tend to be higher in saturated fat than plant foods.  These values are taken from the USDA National Nutrient Database:

Small Hamburger               3.56 grams saturated fat
Lean beef (1/8" fat trim)    1.38 grams
Large egg                          1.63 grams
Salmon, 3 oz                      1.63 grams
Roasted chicken breast       1.76 grams

However, here are the quantities of saturated fat for several vegetarian sources of protein:

Kidney beans, 1 cup            0.13 grams
Tofu, 1/4 pound                 0.69 grams
Veggie burger                     0.11 grams

Animal products tend to be high in both saturated fat and cholesterol.  So, if you have elevated cholesterol, it is especially important to limit your consumption of animal products.

Santa Barbara Triathlon -- In Action

A friend snapped this picture at the beginning of the bike course. I'm out of focus, which is ok, because you can see that the scenery along the bike course was really beautiful.

Santa Barbara Long Course Triathlon

My season was essentially over, with two small races to go. And then the e-mail two weeks ago from Jessica, with whom I travel to most of my races, which began...

"Feeling impulsive?"

Next thing I knew I was signed up for the Santa Barbara Long Course Triathlon. With less than two weeks until the race -- 1 mile swim, 34 mile hilly bike, and 10 mile run -- I knew I had the fitness base to do it, but also realized that this would not be an "A" race.

It is also late in the season. I find it harder and harder to get to the pool and go swim. So I haven't been to the pool lately, and my swim training has consisted of an ocean swim each week of no longer than one mile. Biking is always fun, and I've continued to ride hills. But as the fall approaches, I've focused more on my running to prepare for fall marathons. So my training for race day wasn't exactly ideal.

The swim was in ice-cold water. Halfway through, my hands and feet feeling like icicles, I just wanted to quit. I trudged through it and could not have been more glad to be running on the sand pulling my wetsuit off and heading to pick up my bike.

The bike was fairly hilly, but certainly not nearly as challenging as the hills of Wildflower earlier in the season. I dropped my bike chain about a mile into the ride. After what happened last year, there were a lot of people on the course cautioning us on the descents to be careful. My ride wasn't fabulous -- I got passed all over the place.

Lastly was the run. It was an out and back. The first two miles were flat, then miles 2-4 were all uphill. I love the run. For me it's the opposite of the bike. I get to pass people. On the entire run, I passed dozens of people, but only two passed me, and one was a man who I'll bet had a flat tire. My run time was pretty good -- 1 hr 31 min 30 seconds -- about 9:10 per mile.

My finishing time was 4 hours 31 min 31 seconds. 33 out of 47 in my age group.

One more triathlon, or maybe two, I may be racing with a friend who is doing his first triathlon.

Meat and Cancer

Consumption of meat increases the risk of cancer and heart disease.
This was reported on Good Morning America this morning. The suggestion is that parents should not be packing their kids' lunchboxes with slices of deli meat, since deli meat is high in sodium and saturated fat.

Alternatives suggested: Peanut butter and jelly on whole wheat. Or how about a sandwich with hummus and avocado? Or perhaps Tofurky?

Want more lunchbox ideas?
Vegan Lunch Box or Vegcooking are great resources.
Photo from abc.com.

Health Care Reform

I don't want to get political here. However, my experiences as a physician have shaped my opinion on this topic.

There are too many uninsured and underinsured in this country. They do not get the care they need for preventing diseases, and they present when it is too late, when their condition is out of control and the cost to treat it is far higher than what it would have cost to prevent the disease in the first place.

The rumors and scare tactics are absurd. One of my patients told me today that he, as an otherwise healthy elderly man in his 80's, with health care reform may not be treated for his hypertension, but instead would get "death counselling". Simply untrue.

The current health care system will bankrupt our country. There needs to be change. The melodrama and scare tactics need to stop and there needs to be intelligent discussion on this topic.

21-Day Kickstart to a Healthier Diet

Want to eat healthier but don't know where to start?

Have you thought about trying a vegan diet?

If so, then check out the PCRM 21-Day Vegan Kickstart. This looks like a great program!

Motivation to Exercise

I tell my patients to go exercise most days for at least 30 minutes. But what's to keep you going?

As I practice what I preach to my patients, I exercise just about every day. And there are days when my motivation is lacking. Sometimes when the alarm goes off at 4:30 am, I just want to roll over and go back to sleep. And, were I to be completely honest, every so often that's what I do. But, 99% of the time, I get up and go.

My goals keep me on track. In the next two months, I have two triathlons, and I want to perform my best. If I miss a workout, I fear that may impact how ready I am for my races.

Yesterday morning, on the treadmill at the gym, five miles into an eight mile tempo run, with my heart racing and sweat dripping on the treadmill, I was tired out. I thought, I can end this at six miles.

What kept me going was thinking of my long-term goals -- I want to qualify for the Boston Marathon for 2010. To do that, I need to get faster, and hard workouts like this have made me a faster runner and a better athlete.

Somehow I got a second wind and finished off my 8 miles with a sense of true accomplishment.

Goals are important for keeping us on track. If I didn't have goals for myself, I don't think I'd be able to wake up early and exercise.

A goal can be as simple as wanting to finish a 5K race. Another great goal is having the stamina to keep up with active grandchildren.

Whatever it is, find a reason to get out the door and exercise.
Image from media.photobucket.com

My Interview

This past Thursday, July 30, I was interviewed on the Simon Gowen Show on LA Talk Radio. I discussed the heart and exercise and my own triathlon experiences.
Listen here.

I'm going to be an IronWoman!

I decided to take the plunge..... I just registered for Ironman Lake Placid 2010, on July 25, 2010.

I had signed up for an ironman-distance race last year, but I wasn't feeling ready to put in the training. With my heart not being in it, I decided to drop out and wait until my heart was really in it.

In this sport, and really in anything in life, there's always bigger and better. When I started this sport and was doing sprint races, I thought one day I might do an olympic distance race. Now having completed four half-ironman distance races, I'm ready and excited to take the next big step.