2006 - Passover as a new vegan and Eggplant and Matzo Meal Pancakes and Matza Pasta
Gold the Greyhound likes matzah!
Monday, March 24, 2014
Passover is Coming!!!
Often a holiday of culinary decadence with eggs, meat, cream, butter, matzah and constipation, I like to take a healthy spin on Pesach. Here are several years of Passover seders, dishes, and exploration. The older posts are some of my more rudimentary attempts at vegan Pesach dishes. The more recent posts, particularly my three seders 2011-2013, represent a far more polished effort.
Tuesday, March 18, 2014
Stuff Vegans Ask Me
One day last week, I had three plant-based vegan patients on my schedule. As a managed-care employed cardiologist, that's a lot!!
And, my vegan patients tend to have very interesting questions. So in my next few posts, I'm going to address a few of them.
First question: "Caldwell Esselstyn doesn't permit nuts in his diet. Do you eat nuts?"
Short answer: Yes.
Longer answer: Dr. Caldwell Esselstyn, in his book Prevent and Reverse Heart Disease, put his patients on plant-based diets with no oil and no nuts. Through that diet, he demonstrated reversal of coronary disease and a lack of cardiovascular events over the course of five years.
I tell my patients, "I don't tell you to do anything I don't do. When I tell you to exercise, I am exercising almost every day. And a plant-based diet, I follow that." But, I do eat nuts, in moderation. As a young woman who exercises 10-15 hours per week, and does not have coronary artery disease, I don't need to restrict my consumption of nuts, other than to make sure that I don't consume too many calories. Nuts are an excellent source of protein, fiber, and many different vitamins and minerals. But they also have a lot of calories and fat, so in any diet, they should not be consumed in large quantities.
And, my vegan patients tend to have very interesting questions. So in my next few posts, I'm going to address a few of them.
First question: "Caldwell Esselstyn doesn't permit nuts in his diet. Do you eat nuts?"
source: nutstop.com
Short answer: Yes.
Longer answer: Dr. Caldwell Esselstyn, in his book Prevent and Reverse Heart Disease, put his patients on plant-based diets with no oil and no nuts. Through that diet, he demonstrated reversal of coronary disease and a lack of cardiovascular events over the course of five years.
I tell my patients, "I don't tell you to do anything I don't do. When I tell you to exercise, I am exercising almost every day. And a plant-based diet, I follow that." But, I do eat nuts, in moderation. As a young woman who exercises 10-15 hours per week, and does not have coronary artery disease, I don't need to restrict my consumption of nuts, other than to make sure that I don't consume too many calories. Nuts are an excellent source of protein, fiber, and many different vitamins and minerals. But they also have a lot of calories and fat, so in any diet, they should not be consumed in large quantities.
Sunday, March 09, 2014
Rethink Food
I wrote a chapter for this book, Rethink Food. It is available on Amazon for purchase!
"
Featuring over 100 doctors, 8 renowned nutritionists, and 8 elite athletes from around the world, Rethink Food empowers you with a tastefully simple solution for a healthier, stronger, and smarter you! The misinformation regarding our health is one of today’s greatest injustices. We have been led to believe that meat and dairy are the foundation of good health. This is a myth and the science can no longer be ignored. From the Ivy Leagues of Harvard, Princeton, Yale, and Cornell to the UK, India, Germany, Italy, Brazil, Mexico, and New Zealand, ReThink Food’s experts explain how we can reverse heart disease and diabetes, eliminate food allergens and autoimmune diseases, live pain- free from arthritis, prevent Alzheimer’s, even bring cancer into remission and much more by completely removing all animal products from our plates. In the history of disease we have never before faced such rampant levels of illnesses. We are turning to prescriptions for answers, but they do not address the root cause of diseases. The truth is our health is not completely dictated by our genes. Our meat and dairy diets are the primary cause of our alarming rise in chronic health problems and disease. Rethink Food’s doctors conclusively prove that we have the power to reverse and prevent today’s leading health problems simply by choosing a whole food plant-based diet! Plus as Rethink Food’s top professional athletes show, achieving peak performance and winning gold depends on being powered by plants. We were inspired to write ReThink Food after watching family and friends struggle with today’s most common diseases for years and then completely rid themselves of the debilitating symptoms and re-gain their health and vitality within months by fully adopting a whole foods plant-based diet. As these doctors attest, there is a powerful connection between disease and wellness that is strongly associated with our dietary choices. Changing what we eat has the power to change our lives. It all begins with the courage to rethink food. Join us!"
Featuring over 100 doctors, 8 renowned nutritionists, and 8 elite athletes from around the world, Rethink Food empowers you with a tastefully simple solution for a healthier, stronger, and smarter you! The misinformation regarding our health is one of today’s greatest injustices. We have been led to believe that meat and dairy are the foundation of good health. This is a myth and the science can no longer be ignored. From the Ivy Leagues of Harvard, Princeton, Yale, and Cornell to the UK, India, Germany, Italy, Brazil, Mexico, and New Zealand, ReThink Food’s experts explain how we can reverse heart disease and diabetes, eliminate food allergens and autoimmune diseases, live pain- free from arthritis, prevent Alzheimer’s, even bring cancer into remission and much more by completely removing all animal products from our plates. In the history of disease we have never before faced such rampant levels of illnesses. We are turning to prescriptions for answers, but they do not address the root cause of diseases. The truth is our health is not completely dictated by our genes. Our meat and dairy diets are the primary cause of our alarming rise in chronic health problems and disease. Rethink Food’s doctors conclusively prove that we have the power to reverse and prevent today’s leading health problems simply by choosing a whole food plant-based diet! Plus as Rethink Food’s top professional athletes show, achieving peak performance and winning gold depends on being powered by plants. We were inspired to write ReThink Food after watching family and friends struggle with today’s most common diseases for years and then completely rid themselves of the debilitating symptoms and re-gain their health and vitality within months by fully adopting a whole foods plant-based diet. As these doctors attest, there is a powerful connection between disease and wellness that is strongly associated with our dietary choices. Changing what we eat has the power to change our lives. It all begins with the courage to rethink food. Join us!"
Wednesday, March 05, 2014
Running again... and a return to Barry's
It's been three months since my right foot 5th metatarsal fracture.
My fracture is almost, but not completely, healed. The orthopedic surgeon has cleared me to do "light running," which apparently means I can run on dirt, trails, and treadmills, but not on pavement.
So, for the past 3 weeks, I've been running a few days a week. At first my right foot would practically slap down on the ground and I feared flexing the foot, so my running gait was pretty awkward. But gradually it's gotten better. Physical therapy, as well as gaining some confidence as I continued running, helped. In fact, I was just discharged from physical therapy, in that I'm recovering well on my own, with the caveat that I need to try to "duplicate" with my right foot what my left foot is doing.
On Sunday I ran nearly six miles of trails over the course of an hour and I felt fabulous.
Today I decided on the real test -- Barry's Boot Camp. Now, Barry's is one of my favorite workouts. 30 minutes treadmill and 30 minutes fast-paced weights. And, being the competitive person I am, I try to get on a treadmill next to someone who I think will be pretty fast to inspire me to run fast. And I look around and see how fast people around me are running.
It's not only my speed that I've lost. As I changed out of my work scrubs and into my workout clothes, I thought to myself, the last time I was here at Barry's, I had better shaped legs, and a little less padding around my abs. So I was a little self-conscious too.
Today, I knew I had to put the competitive me aside. After three months of recovery from a fractured foot, just getting to Barry's today is a victory. I warmed up and decided I would just stick with the "beginner" speeds; before my fracture, I would do the intermediate speeds, which would put me faster than most girls in the class and up there and faster than several of the guys. But today, getting back into things, I would be a beginner.
Then our instructor Erik started calling out the speeds: "4.0 beginner, 5.0 intermediate, 6.0 advanced" to start. And something came over me. I wasn't a beginner. Maybe I'm not an intermediate, but let me push this a bit. So I ran at speeds exactly between beginner and intermediate. When beginners ran at 9.0, I ran at 9.5.
I accomplished some cool feats. I ran at 9.5 miles per hour for 90 seconds, and then sprinted at 10.1 miles per hour for 45 seconds. I didn't think I would be able to do that today.
I surprised myself. I could have pushed harder, but since I haven't sprinted on a treadmill in 3 months, I didn't want to go all out. I looked around at the end of class, and again, I was running faster than most of the girls, and the guy to my left, even on my first trip back to Barry's.
I feel pretty awesome. Maybe I haven't lost as much fitness as I thought. And my shape, I'll get that back.
My fracture is almost, but not completely, healed. The orthopedic surgeon has cleared me to do "light running," which apparently means I can run on dirt, trails, and treadmills, but not on pavement.
So, for the past 3 weeks, I've been running a few days a week. At first my right foot would practically slap down on the ground and I feared flexing the foot, so my running gait was pretty awkward. But gradually it's gotten better. Physical therapy, as well as gaining some confidence as I continued running, helped. In fact, I was just discharged from physical therapy, in that I'm recovering well on my own, with the caveat that I need to try to "duplicate" with my right foot what my left foot is doing.
On Sunday I ran nearly six miles of trails over the course of an hour and I felt fabulous.
Today I decided on the real test -- Barry's Boot Camp. Now, Barry's is one of my favorite workouts. 30 minutes treadmill and 30 minutes fast-paced weights. And, being the competitive person I am, I try to get on a treadmill next to someone who I think will be pretty fast to inspire me to run fast. And I look around and see how fast people around me are running.
Today, I knew I had to put the competitive me aside. After three months of recovery from a fractured foot, just getting to Barry's today is a victory. I warmed up and decided I would just stick with the "beginner" speeds; before my fracture, I would do the intermediate speeds, which would put me faster than most girls in the class and up there and faster than several of the guys. But today, getting back into things, I would be a beginner.
Then our instructor Erik started calling out the speeds: "4.0 beginner, 5.0 intermediate, 6.0 advanced" to start. And something came over me. I wasn't a beginner. Maybe I'm not an intermediate, but let me push this a bit. So I ran at speeds exactly between beginner and intermediate. When beginners ran at 9.0, I ran at 9.5.
I accomplished some cool feats. I ran at 9.5 miles per hour for 90 seconds, and then sprinted at 10.1 miles per hour for 45 seconds. I didn't think I would be able to do that today.
I surprised myself. I could have pushed harder, but since I haven't sprinted on a treadmill in 3 months, I didn't want to go all out. I looked around at the end of class, and again, I was running faster than most of the girls, and the guy to my left, even on my first trip back to Barry's.
I feel pretty awesome. Maybe I haven't lost as much fitness as I thought. And my shape, I'll get that back.
Monday, February 17, 2014
Do patients really *do* this?
I'll be the first to admit, the majority of my patients aren't vegans. And, I'm okay with that.
My goal as a cardiologist is to provide my patients with the best information on how to improve their heart health and reduce their risk of cardiovascular events. What they do with that information is up to them.
On one end of the spectrum, one of my long-term patients with coronary artery disease and a history of bypass surgery followed up earlier this week. We have our usual conversation, where I tell him that he would be well served to eat better, exercise, and lose weight. And as usual, he laughs and smiles, and says that he's not about to change. He has remained otherwise stable on his medicines for blood pressure and his statin, and I'll see him again in six months.
On the other hand, I have patients who take on lifestyle change with vigor. They adopt a plant-based and start exercising. And without much effort, excess weight seems to come off. They tend to feel better as well. Of those motivated patients, I have not seen a single one of them have a recurrent cardiac event -- not one has needed another stent or another bypass surgery.
My goal as a cardiologist is to provide my patients with the best information on how to improve their heart health and reduce their risk of cardiovascular events. What they do with that information is up to them.
On one end of the spectrum, one of my long-term patients with coronary artery disease and a history of bypass surgery followed up earlier this week. We have our usual conversation, where I tell him that he would be well served to eat better, exercise, and lose weight. And as usual, he laughs and smiles, and says that he's not about to change. He has remained otherwise stable on his medicines for blood pressure and his statin, and I'll see him again in six months.
On the other hand, I have patients who take on lifestyle change with vigor. They adopt a plant-based and start exercising. And without much effort, excess weight seems to come off. They tend to feel better as well. Of those motivated patients, I have not seen a single one of them have a recurrent cardiac event -- not one has needed another stent or another bypass surgery.
Thursday, January 16, 2014
After the Boot
I fractured my fifth metatarsal of my right foot about 6 1/2 weeks ago. I wore an orthopedic boot for nearly six weeks, and now I am back in two shoes.
I thought a lot about what I would do for six weeks in the boot. And I feel like I was successful -- I stayed active within my limits, remained fit, and did not gain weight. In fact, I dropped a couple of pounds.
For some reason, I thought the boot would come off, my fracture would be magically healed, and after a couple days of walking, I would be back to running. Such is not the case.
Unfortunately, the fracture hasn't fully healed. It's definitely better, but the two pieces of my fifth metatarsal bone have not completely fused. My orthopedist has told me that there is no running permitted for the next four weeks, at which point we will perform another x-ray to evaluate. In response to my shock, he responded that running prematurely could lead to nonunion of the fracture, which would then require surgery.
I hadn't truly thought out the consequences of my foot being immobilized in a boot for six weeks either. My calf muscle and the muscles at the ball of my foot are all tight from not being used, and in fact there's probably some muscle atrophy as well. I have been walking this week with quite an interesting limp.
With all my difficulty walking, it is ironic that the only place where I have felt like a normal person is on a spin bike or in a pool, because the mechanics of stationary cycling and swimming are not much affected by the condition of my foot.
I had a physical therapy session yesterday, where a few things were pointed out to me. My hip strength is off, and in fact my right hip is weaker than the left. And, since the muscles at the bottom of my foot are tight and atrophied, I am taking a much smaller step with the left foot than with the right.
I have some exercises from physical therapy, and with a bit of stretching and attention to my gait, particularly making sure to take a larger step forward with my left foot, I am feeling a bit better today. In fact, on my lunch break, I went for a thirty minute walk. In my athletic life prior to this fracture, I would roll my eyes at even considering that to be a workout. The toes of my right foot ached with each step, but I know I need to build and stretch those muscles so I kept going.
I thought a lot about what I would do for six weeks in the boot. And I feel like I was successful -- I stayed active within my limits, remained fit, and did not gain weight. In fact, I dropped a couple of pounds.
For some reason, I thought the boot would come off, my fracture would be magically healed, and after a couple days of walking, I would be back to running. Such is not the case.
My foot in all its x-rayed glory. And proof that a car window can indeed serve as an x-ray light box.
Unfortunately, the fracture hasn't fully healed. It's definitely better, but the two pieces of my fifth metatarsal bone have not completely fused. My orthopedist has told me that there is no running permitted for the next four weeks, at which point we will perform another x-ray to evaluate. In response to my shock, he responded that running prematurely could lead to nonunion of the fracture, which would then require surgery.
I hadn't truly thought out the consequences of my foot being immobilized in a boot for six weeks either. My calf muscle and the muscles at the ball of my foot are all tight from not being used, and in fact there's probably some muscle atrophy as well. I have been walking this week with quite an interesting limp.
This is what happens when one leg is immobilized in an orthopedic boot for six weeks. The muscle atrophy on the right is pretty apparent.
With all my difficulty walking, it is ironic that the only place where I have felt like a normal person is on a spin bike or in a pool, because the mechanics of stationary cycling and swimming are not much affected by the condition of my foot.
I had a physical therapy session yesterday, where a few things were pointed out to me. My hip strength is off, and in fact my right hip is weaker than the left. And, since the muscles at the bottom of my foot are tight and atrophied, I am taking a much smaller step with the left foot than with the right.
I have some exercises from physical therapy, and with a bit of stretching and attention to my gait, particularly making sure to take a larger step forward with my left foot, I am feeling a bit better today. In fact, on my lunch break, I went for a thirty minute walk. In my athletic life prior to this fracture, I would roll my eyes at even considering that to be a workout. The toes of my right foot ached with each step, but I know I need to build and stretch those muscles so I kept going.
This weekend, I look forward to my first outdoor bike ride since my fracture. And I look forward to developing stronger hip flexors, and walking like a normal person.
I thought I would be recovered by now, but I'm not quite there. In due time, I will be.
Monday, January 13, 2014
Motivation for Change
I talk about lifestyle change with my patients daily.
One of those conversations occurred last weekend. A previously healthy woman had a major health scare -- chest pain, followed by a cardiac arrest. She was resuscitated and I performed an emergency angioplasty on her in the middle of the night to open a completely occluded left anterior descending coronary artery.
Luckily, she recovered quite well in the hospital, and I had a conversation with her and her husband about diet and lifestyle. She was hesitant about changing her diet, saying that she felt that this would be very hard for her.
Her husband said, "Honey, you almost died. You have to do this. Or you will have another heart attack."
Fear is a big motivator. But it doesn't do well to lead to permanent changes. Fear eases as the acute event becomes more distant. Positive reinforcement is a better motivator to make change.
I love how Dean Ornish says it: "...re-framing the reason for changing from fear of dying to joy of living."
Because, living a healthy lifestyle makes you FEEL good. Eating clean and exercising gives you more energy, more vitality, better mood.
Lifestyle change is hard. But, in the long run, when you live cleaner, you live happier. And that's how I want to frame the conversation with my patients -- good habits aren't punishment, they are changes that will lead to a happier, healthier, and longer life.
One of those conversations occurred last weekend. A previously healthy woman had a major health scare -- chest pain, followed by a cardiac arrest. She was resuscitated and I performed an emergency angioplasty on her in the middle of the night to open a completely occluded left anterior descending coronary artery.
Luckily, she recovered quite well in the hospital, and I had a conversation with her and her husband about diet and lifestyle. She was hesitant about changing her diet, saying that she felt that this would be very hard for her.
Her husband said, "Honey, you almost died. You have to do this. Or you will have another heart attack."
Fear is a big motivator. But it doesn't do well to lead to permanent changes. Fear eases as the acute event becomes more distant. Positive reinforcement is a better motivator to make change.
I love how Dean Ornish says it: "...re-framing the reason for changing from fear of dying to joy of living."
Because, living a healthy lifestyle makes you FEEL good. Eating clean and exercising gives you more energy, more vitality, better mood.
Lifestyle change is hard. But, in the long run, when you live cleaner, you live happier. And that's how I want to frame the conversation with my patients -- good habits aren't punishment, they are changes that will lead to a happier, healthier, and longer life.
Monday, December 23, 2013
Three Weeks in a Boot
I fractured my 5th metatarsal and sprained my right ankle three weeks ago with a clumsy misstep in the middle of the night down the stairs. Today was my three week checkup.
According to my orthopod, this is an improvement from the initial x-ray. As I'm not having much pain, he's pleased with my progress. In another three weeks, I will have another check-up and presumably at that time if all is well, I'll be out of the boot.
My mental state through all of this has definitely improved. I'm swimming, riding a stationary bicycle and doing spin classes, weight training, and even doing a little yoga. My goal is to maintain my fitness and improve my eating a bit. Because I thrive on structure, I've asked my coach to continue to give me a "schedule" of activities, like when I'm training. It's just that the focus of my training is a little different.
A week after my injury, I headed back to the pool. I can't kick, but I can swim with a pull buoy supporting my legs. I've noticed that a full swim workout with a pull buoy tires me out slightly more than a standard swim workout. Getting in the water, I have the chance to flex and extend my ankle a bit more, which is good because with the boot I feel like I have less range of motion. The pull buoy forces me to rotate my torso, something my coach Gerardo has been telling me I need to do more when I swim but I really haven't truly understood until now. Last week I swam six times.
I can ride a stationary bike, and can even do a spin class. I just can't stand on the bike, which is fine by me, because I think that standing on a bike in spin class is a little silly because I don't spend much time standing on my bike when I'm riding on roads.
Sometimes selfies are fun. That's me getting on a stationary bike a little over a week after my foot fracture. I felt determined to get in a good workout, no matter what my limitations were. A lot of people who get on the bikes at the gym aren't necessarily pedaling very fast, and often they seem more interested in looking at their smartphone than working out. I'm not sure if I got more strange looks because I was the only one on a stationary bike pedaling fast, or because of the boot. Regardless, after that workout, I felt the best I had since my fall.
I'm doing more strength training, some with my personal trainer Corey, some on my own. Corey comes up with some good workouts, like step-ups on a bench, hopping in sand on one foot, and the usual upper-body challenges like push-ups, pull-ups, and tough core work. And, when I'm not training with him, I'm doing some strength workout on my own a couple more days a week. I have decided to challenge myself with exercises like one-legged burpees, which is a tough cardiovascular and strength workout, and as you might imagine yielded a few odd looks.
I've used my injury to my advantage in counseling patients, and perhaps it helps me empathize. When a patient tells me he or she cannot exercise due to back pain, knee pain, or whatever issue they have, I can point out my own injury (because it's hard to hide a large orthopedic boot) and talk about how I am finding ways to exercise in spite of it, and encourage them to try to do the same.
I miss running more than you can imagine. But I'm not focusing on that. Fractures heal. This is known. I will be back to running in a few more weeks, maybe 3 weeks, maybe a little longer. And in the meantime, I'm going to stay fit, and positive.
My mental state through all of this has definitely improved. I'm swimming, riding a stationary bicycle and doing spin classes, weight training, and even doing a little yoga. My goal is to maintain my fitness and improve my eating a bit. Because I thrive on structure, I've asked my coach to continue to give me a "schedule" of activities, like when I'm training. It's just that the focus of my training is a little different.
At poolside, about to do my first post-injury swim workout.
A week after my injury, I headed back to the pool. I can't kick, but I can swim with a pull buoy supporting my legs. I've noticed that a full swim workout with a pull buoy tires me out slightly more than a standard swim workout. Getting in the water, I have the chance to flex and extend my ankle a bit more, which is good because with the boot I feel like I have less range of motion. The pull buoy forces me to rotate my torso, something my coach Gerardo has been telling me I need to do more when I swim but I really haven't truly understood until now. Last week I swam six times.
I can ride a stationary bike, and can even do a spin class. I just can't stand on the bike, which is fine by me, because I think that standing on a bike in spin class is a little silly because I don't spend much time standing on my bike when I'm riding on roads.
I'm doing more strength training, some with my personal trainer Corey, some on my own. Corey comes up with some good workouts, like step-ups on a bench, hopping in sand on one foot, and the usual upper-body challenges like push-ups, pull-ups, and tough core work. And, when I'm not training with him, I'm doing some strength workout on my own a couple more days a week. I have decided to challenge myself with exercises like one-legged burpees, which is a tough cardiovascular and strength workout, and as you might imagine yielded a few odd looks.
I've used my injury to my advantage in counseling patients, and perhaps it helps me empathize. When a patient tells me he or she cannot exercise due to back pain, knee pain, or whatever issue they have, I can point out my own injury (because it's hard to hide a large orthopedic boot) and talk about how I am finding ways to exercise in spite of it, and encourage them to try to do the same.
I miss running more than you can imagine. But I'm not focusing on that. Fractures heal. This is known. I will be back to running in a few more weeks, maybe 3 weeks, maybe a little longer. And in the meantime, I'm going to stay fit, and positive.
Thursday, December 19, 2013
New Cholesterol Guidelines
Recent updated guidelines have been released regarding treatment of cholesterol. Specifically, this statement suggests who should and should not be on cholesterol-lowering statin medication.
There has been a lot of controversy regarding this document. And, as a cardiologist, I don't necessarily agree with its conclusions.
What's new -- new research? New studies? No. This is just a group of experts coming together to give their opinion.
The recommendation that patients with known significant arterial disease -- including anyone who has had a heart attack or stroke -- should receive statins is definitely supported by clinical studies.
But, the guidelines also suggest that many patients who do not have disease should receive statins. They present a new risk calculator, and if the risk of the patient is greater than 7.5% for a cardiovascular event (heart attack or stroke) that the patient should receive statins. That would mean millions more patients on statins.
The major problem that I see with the guidelines is the suggestion of statins for primary prevention. But, the literature on that topic does not suggest a strong benefit. To prevent one heart attack or stroke over the course of five years, one would have to treat about 150 patients with a statin pill every single day. So, when looking at a huge population, yes you see a reduction in the number of heart attacks and strokes. But, odds are, if you are one of those 150 people being treated with a statin, there is a 149/150 chance that taking a pill every single day for five years will not prevent any type of event.
Further, there have been meta-analyses, which are studies pooling data from several other studies, that demonstrate that amongst the primary prevention population, there is no reduction in mortality. In other words, a statin won't prolong your life.
There's a great editorial from John Abramson and Rita Redburg in the New York Times on the new guidelines, similarly skeptical of expanding the use of statins.
So, if you feel good, why should you take a statin, which is a pill that has a decent chance of causing muscle aches and is known to slightly increase the risk of diabetes, has a less than 1% chance of preventing a heart attack or stroke in the next 5 years, and won't prolong your life? It's a good question. Can you get the same benefit from improving your lifestyle?
YES! In fact, lifestyle will give you even more benefit than a statin pill! Daily cardiovascular exercise for at least 30 minutes, but preferably an hour, will help you feel better, lose weight, drop the cholesterol numbers, and reduce your risk of a heart attack or stroke. Diet is potent too -- and, a whole-food plant-based diet will make you practically heart-attack-proof.
I'm not a big proponent of statins for primary prevention because the data to support them just isn't that strong. While the guidelines do support lifestyle, I think that we as a profession and society need to do more to encourage people to be more active, eat better, manage stress, and maintain a healthy weight. And that is how we will prevent heart attacks and strokes, not by feeding everyone a statin.
There has been a lot of controversy regarding this document. And, as a cardiologist, I don't necessarily agree with its conclusions.
What's new -- new research? New studies? No. This is just a group of experts coming together to give their opinion.
The recommendation that patients with known significant arterial disease -- including anyone who has had a heart attack or stroke -- should receive statins is definitely supported by clinical studies.
But, the guidelines also suggest that many patients who do not have disease should receive statins. They present a new risk calculator, and if the risk of the patient is greater than 7.5% for a cardiovascular event (heart attack or stroke) that the patient should receive statins. That would mean millions more patients on statins.
The major problem that I see with the guidelines is the suggestion of statins for primary prevention. But, the literature on that topic does not suggest a strong benefit. To prevent one heart attack or stroke over the course of five years, one would have to treat about 150 patients with a statin pill every single day. So, when looking at a huge population, yes you see a reduction in the number of heart attacks and strokes. But, odds are, if you are one of those 150 people being treated with a statin, there is a 149/150 chance that taking a pill every single day for five years will not prevent any type of event.
Further, there have been meta-analyses, which are studies pooling data from several other studies, that demonstrate that amongst the primary prevention population, there is no reduction in mortality. In other words, a statin won't prolong your life.
There's a great editorial from John Abramson and Rita Redburg in the New York Times on the new guidelines, similarly skeptical of expanding the use of statins.
So, if you feel good, why should you take a statin, which is a pill that has a decent chance of causing muscle aches and is known to slightly increase the risk of diabetes, has a less than 1% chance of preventing a heart attack or stroke in the next 5 years, and won't prolong your life? It's a good question. Can you get the same benefit from improving your lifestyle?
YES! In fact, lifestyle will give you even more benefit than a statin pill! Daily cardiovascular exercise for at least 30 minutes, but preferably an hour, will help you feel better, lose weight, drop the cholesterol numbers, and reduce your risk of a heart attack or stroke. Diet is potent too -- and, a whole-food plant-based diet will make you practically heart-attack-proof.
I'm not a big proponent of statins for primary prevention because the data to support them just isn't that strong. While the guidelines do support lifestyle, I think that we as a profession and society need to do more to encourage people to be more active, eat better, manage stress, and maintain a healthy weight. And that is how we will prevent heart attacks and strokes, not by feeding everyone a statin.
Sunday, December 08, 2013
From athlete to gimp
With one clumsy misstep on the stairs, and the snap of a metatarsal bone, I went from athlete to gimp.
It's been tough. I am in an orthopedic boot. I can walk short distances in the boot, but anything longer and I use my crutches, because I've found that walking too much leads to quite a bit of pain. I am taking ibuprofen 800 mg three times a day, and an occasional Percocet. My foot is still swollen, but it's not quite the blue swollen mess with five sausage-like toes as of just a few days ago.
Other than a short weight training session, I have not been exercising. I'd love to do some nonweightbearing exercises with the boot on, but even shaking around the foot with the boot in place gets to be uncomfortable. And I am afraid to get in the pool to swim for fear that my unprotected foot will hit a wall, the lane marker, or even my other foot. Even the slightest touch to the foot can be uncomfortable.
It's been six days. I feel different. I definitely feel more tired. I have a lot more free time. I'm trying to free time to good use by reading. I'm also getting more sleep than I did on my typical two workout days.
Then there's the emotional impact of all of this. I envy my friends and teammates who are racing. I wish I could be out running swimming and biking with them. I fear what will happen to my body without exercise. I worked so hard earlier this year to get into the good shape that I am in and I don't want to lose it. I am trying so hard to eat less so that I don't gain weight.
I am so fortunate to be surrounded by good friends, family, and an incredibly supportive boyfriend. From coming over and bringing me dinner to taking out my trash cans, or hanging out and watching a redbox movie or just being a sympathetic ear, I couldn't ask to be surrounded by better people.
It takes only six weeks for this fracture to heal, but it feels like an eternity. And I am trying to be positive. But it's tough.
It's been tough. I am in an orthopedic boot. I can walk short distances in the boot, but anything longer and I use my crutches, because I've found that walking too much leads to quite a bit of pain. I am taking ibuprofen 800 mg three times a day, and an occasional Percocet. My foot is still swollen, but it's not quite the blue swollen mess with five sausage-like toes as of just a few days ago.
Other than a short weight training session, I have not been exercising. I'd love to do some nonweightbearing exercises with the boot on, but even shaking around the foot with the boot in place gets to be uncomfortable. And I am afraid to get in the pool to swim for fear that my unprotected foot will hit a wall, the lane marker, or even my other foot. Even the slightest touch to the foot can be uncomfortable.
It's been six days. I feel different. I definitely feel more tired. I have a lot more free time. I'm trying to free time to good use by reading. I'm also getting more sleep than I did on my typical two workout days.
Then there's the emotional impact of all of this. I envy my friends and teammates who are racing. I wish I could be out running swimming and biking with them. I fear what will happen to my body without exercise. I worked so hard earlier this year to get into the good shape that I am in and I don't want to lose it. I am trying so hard to eat less so that I don't gain weight.
I am so fortunate to be surrounded by good friends, family, and an incredibly supportive boyfriend. From coming over and bringing me dinner to taking out my trash cans, or hanging out and watching a redbox movie or just being a sympathetic ear, I couldn't ask to be surrounded by better people.
It takes only six weeks for this fracture to heal, but it feels like an eternity. And I am trying to be positive. But it's tough.
Tuesday, December 03, 2013
When life gives you lemons, make lemonade.
Life has handed me lemons.
My dogs started whining in the middle of the night. I came downstairs to let them out. Half asleep, I thought I was stepping my right foot on the floor, when in fact there were a couple more steps. I landed on the outside of the foot and fell to the floor, fracturing my 5th metatarsal bone.
I am in an orthopedic boot for the next six weeks. While I am permitted to bear weight on the foot, I am using crutches because bearing weight on the foot is simply too painful.
Needless to say, I cannot run, and I will not be running the Carlsbad Marathon on January 19 as I had planned.
I suppose I could throw myself a little pity party. And I'll be honest, as I lay in the emergency room this morning while my foot was x-rayed and splinted, I cried. No honestly I sobbed. Not from the pain, but rather because my running is being taken away from me.
I choose to be more positive. I am going to take a few days off from exercising. Then I can swim. I can't push off the wall with my right foot, but I can get in a good workout. I can lift some weights. I can aqua jog. And I'm sure my personal trainer Corey will come up with some fun stuff like one-legged burpees to keep me in shape.
As much as I'd love to become the one-legged fitness wonder, Coach Gerardo asked me to take the rest of the week off from training. That is to keep me from doing more damage. He suggests that one can take up to 2 weeks off from training and not lose fitness.
This will be a challenge but I will get through it. Maybe my body could use the rest. The last time I was in an orthopedic boot and couldn't run was 8 years ago. It was during that time that I began swimming and riding my bike. Ultimately, when my foot healed, I put it all together and became.... a triathlete. Which I am to this day.
I will take on this new challenge of not running. I will listen to my coach. I will rest as I should. And, in the next six weeks, I am going to become an awesome swimmer.
I am in an orthopedic boot for the next six weeks. While I am permitted to bear weight on the foot, I am using crutches because bearing weight on the foot is simply too painful.
Needless to say, I cannot run, and I will not be running the Carlsbad Marathon on January 19 as I had planned.
I suppose I could throw myself a little pity party. And I'll be honest, as I lay in the emergency room this morning while my foot was x-rayed and splinted, I cried. No honestly I sobbed. Not from the pain, but rather because my running is being taken away from me.
I choose to be more positive. I am going to take a few days off from exercising. Then I can swim. I can't push off the wall with my right foot, but I can get in a good workout. I can lift some weights. I can aqua jog. And I'm sure my personal trainer Corey will come up with some fun stuff like one-legged burpees to keep me in shape.
As much as I'd love to become the one-legged fitness wonder, Coach Gerardo asked me to take the rest of the week off from training. That is to keep me from doing more damage. He suggests that one can take up to 2 weeks off from training and not lose fitness.
This will be a challenge but I will get through it. Maybe my body could use the rest. The last time I was in an orthopedic boot and couldn't run was 8 years ago. It was during that time that I began swimming and riding my bike. Ultimately, when my foot healed, I put it all together and became.... a triathlete. Which I am to this day.
I will take on this new challenge of not running. I will listen to my coach. I will rest as I should. And, in the next six weeks, I am going to become an awesome swimmer.
Monday, November 11, 2013
Fitter and Faster
Something you may have noticed.... I'm smaller.
Back in February, in order to change up my routine with the hopes of becoming a better athlete, I hired personal trainer Corey Enman of Fitamorphosis. Upon signing on with him, I was measured and weighed. At 5'10", I weighed 159 lbs, with 24% body fat. While 24% body fat is a normal body size, it's a bit more than what a competitive female athlete should carry.
In about four months, that became 137 pounds and 18% body fat. Though, in truth, I've gained about 3-4 pounds of that back, and I'm hovering around 140-141 pounds.
As you well know, the exercise was already there, with the usual swimming, biking, and running prescribed by Coach Gerardo of Fortius Racing, and two personal-training weight session per week. But, with Corey, I've changed that up. A once weekly session with Corey consists of high-intensity body weight and free weight exercises to burn fat and build muscle. These may consist of running a mile in a 20-lb weighted vest while carrying two ten-pound dumbbells, burpees on a single leg, frog jumps, pushing a tire across a gym floor, amongst other challenging exercises done back-to-back-to-back. Then, I'll usually add in one day a week of Barry's Boot Camp. So that is two days of solid high-intensity strength training in addition to my cardio.
However, I would credit a better diet with my results. I don't deprive myself. I eat around 2000 calories per day. Breakfast is a soy latte, oatmeal with fruit, and usually a smoothie or another piece of fruit later in the morning. Lunch is typically a salad with tofu or tempha (a brown rice protein) and tons of veggies, and sometimes some quinoa and avocado. Dinner is usually a stir-fry. Snacks are fruit, or veggies and hummus, or trail mix. And I've curtailed my nighttime noshing.
Key to the diet is logging all my food into MyFitnessPal, a free application, to keep me accountable, and to allow Corey to know what I'm eating.
Initially, my smaller body size didn't transform into much speed. But, in the ensuing months, I am faster. In fact, in the past three weeks, I have set new personal bests at the half marathon (1:48:34), 5k (23:01), and 10k (49:04). Hopefully, that means that the Carlsbad Marathon in January will also be a personal best.
I wouldn't suggest my previous weight was unhealthy -- it was healthy. But, my lower weight helps me to move faster.
There's no shortcuts to health or speed -- it's hard work. If you want the support you need to get your fittest and healthiest body, take Corey's FitCamp classes. Click Here.
Back in February, in order to change up my routine with the hopes of becoming a better athlete, I hired personal trainer Corey Enman of Fitamorphosis. Upon signing on with him, I was measured and weighed. At 5'10", I weighed 159 lbs, with 24% body fat. While 24% body fat is a normal body size, it's a bit more than what a competitive female athlete should carry.
In about four months, that became 137 pounds and 18% body fat. Though, in truth, I've gained about 3-4 pounds of that back, and I'm hovering around 140-141 pounds.
On the left, me in December 2011 at 159 lbs. On the right, a slimmer and faster me.
As you well know, the exercise was already there, with the usual swimming, biking, and running prescribed by Coach Gerardo of Fortius Racing, and two personal-training weight session per week. But, with Corey, I've changed that up. A once weekly session with Corey consists of high-intensity body weight and free weight exercises to burn fat and build muscle. These may consist of running a mile in a 20-lb weighted vest while carrying two ten-pound dumbbells, burpees on a single leg, frog jumps, pushing a tire across a gym floor, amongst other challenging exercises done back-to-back-to-back. Then, I'll usually add in one day a week of Barry's Boot Camp. So that is two days of solid high-intensity strength training in addition to my cardio.
However, I would credit a better diet with my results. I don't deprive myself. I eat around 2000 calories per day. Breakfast is a soy latte, oatmeal with fruit, and usually a smoothie or another piece of fruit later in the morning. Lunch is typically a salad with tofu or tempha (a brown rice protein) and tons of veggies, and sometimes some quinoa and avocado. Dinner is usually a stir-fry. Snacks are fruit, or veggies and hummus, or trail mix. And I've curtailed my nighttime noshing.
Key to the diet is logging all my food into MyFitnessPal, a free application, to keep me accountable, and to allow Corey to know what I'm eating.
Initially, my smaller body size didn't transform into much speed. But, in the ensuing months, I am faster. In fact, in the past three weeks, I have set new personal bests at the half marathon (1:48:34), 5k (23:01), and 10k (49:04). Hopefully, that means that the Carlsbad Marathon in January will also be a personal best.
Before the Hard Rock Los Angeles 5K on November 2.
I wouldn't suggest my previous weight was unhealthy -- it was healthy. But, my lower weight helps me to move faster.
There's no shortcuts to health or speed -- it's hard work. If you want the support you need to get your fittest and healthiest body, take Corey's FitCamp classes. Click Here.
Wednesday, September 25, 2013
Confessions of a New Vegan Coffee Drinker
I've told you that I've started drinking coffee.
It began in Israel in July, where I was competing in the Maccabiah Games. Our first event was the Bike Time Trial. This involved a commute from Tel Aviv up to a kibbutz in the Golan Heights, in the north of the country. For a race start at 7:30 am, this required us to meet up in the lobby of the hotel at 2:30 am to drop off our bikes. I had miraculously gotten to bed at 8 pm, so I had some rest. But I was tired. We discovered that the hotel was kind enough to open up the coffee cart to provide complimentary drinks.
On a whim, I tried a soy latte. And I was surprised, it tasted quite good. And there I was, wide awake, probably the only one awake for the entire two hour bus trip up north! Shortly thereafter, I got on my bike and had an incredible race, or at least good for me, averaging over twenty miles per hour on a hilly time trial course.
So I figured, if I had a good bike time trial on some coffee, why not try it before other workouts? And so, I had my daily latte for the rest of the trip. I noticed that my morning runs were faster on coffee.
Then I got home. Starbucks around the corner from me got to know that "Doctor Heather is on her way to go swimming." Yes, my soy lattes fueled my morning swims far better than any green smoothie.
So then it made sense -- why give all my money to Starbucks when I can make my own soy lattes at home? My parents were kind enough to give me a Breville Automatic Espresso Machine as a birthday present. And now, in five minutes, I can make my own latte, and it's as good as anything I get at Starbucks, but it's not $3.55 (because Starbucks charges extra for soy milk... grrrr!)
A few things I've discovered as a new coffee drinker --
--Non-dairy creamer isn't soy creamer. It has palm oil and other artificial crap in it... including casein, which is a dairy product.
--Soy milk seems to work just as well as soy creamer in black coffee. At least for me.
--Why don't more places offer soy creamer or soy milk instead of that "non-dairy creamer" crap?
Oh and one last thing... I'm addicted. I need my morning coffee. At least it's a relatively healthy addiction.
It began in Israel in July, where I was competing in the Maccabiah Games. Our first event was the Bike Time Trial. This involved a commute from Tel Aviv up to a kibbutz in the Golan Heights, in the north of the country. For a race start at 7:30 am, this required us to meet up in the lobby of the hotel at 2:30 am to drop off our bikes. I had miraculously gotten to bed at 8 pm, so I had some rest. But I was tired. We discovered that the hotel was kind enough to open up the coffee cart to provide complimentary drinks.
On a whim, I tried a soy latte. And I was surprised, it tasted quite good. And there I was, wide awake, probably the only one awake for the entire two hour bus trip up north! Shortly thereafter, I got on my bike and had an incredible race, or at least good for me, averaging over twenty miles per hour on a hilly time trial course.
So I figured, if I had a good bike time trial on some coffee, why not try it before other workouts? And so, I had my daily latte for the rest of the trip. I noticed that my morning runs were faster on coffee.
Then I got home. Starbucks around the corner from me got to know that "Doctor Heather is on her way to go swimming." Yes, my soy lattes fueled my morning swims far better than any green smoothie.
So then it made sense -- why give all my money to Starbucks when I can make my own soy lattes at home? My parents were kind enough to give me a Breville Automatic Espresso Machine as a birthday present. And now, in five minutes, I can make my own latte, and it's as good as anything I get at Starbucks, but it's not $3.55 (because Starbucks charges extra for soy milk... grrrr!)
A few things I've discovered as a new coffee drinker --
--Non-dairy creamer isn't soy creamer. It has palm oil and other artificial crap in it... including casein, which is a dairy product.
--Soy milk seems to work just as well as soy creamer in black coffee. At least for me.
--Why don't more places offer soy creamer or soy milk instead of that "non-dairy creamer" crap?
Oh and one last thing... I'm addicted. I need my morning coffee. At least it's a relatively healthy addiction.
Sunday, September 15, 2013
Coffee -- Not so bad, actually can be good!
There was a great review article in JACC (Journal of the American College of Cardiology) this week on the health benefits and risks of coffee. I read it because after 38 years on this earth, I have finally become a coffee drinker.
A lot of patients seem to think that when they hear the bad effects on the heart due to meat, dairy, cigarettes, eggs, added sugar, oil, and salt, that somehow coffee is another substance of harm.
Actually, to the contrary. Coffee drinkers seem to have a decreased risk of heart attack, stroke, diabetes, and abnormal heart rhythms. These benefits can be seen in moderate coffee consumption of up to 4 cups of coffee per day. These benefits may be due to the caffeine in coffee, but there are other chemicals in coffee that may contribute to these health benefits.
The down side, of course, is that some people feel tremulous or anxious with consumption of caffeine.
So, drink up!
A lot of patients seem to think that when they hear the bad effects on the heart due to meat, dairy, cigarettes, eggs, added sugar, oil, and salt, that somehow coffee is another substance of harm.
Actually, to the contrary. Coffee drinkers seem to have a decreased risk of heart attack, stroke, diabetes, and abnormal heart rhythms. These benefits can be seen in moderate coffee consumption of up to 4 cups of coffee per day. These benefits may be due to the caffeine in coffee, but there are other chemicals in coffee that may contribute to these health benefits.
The down side, of course, is that some people feel tremulous or anxious with consumption of caffeine.
So, drink up!
Monday, September 09, 2013
Shabbat Shalom!
Last Friday night, I had a vegan potluck Shabbat at my home. Most attendees were not vegans.
I baked a challah from a recipe for Post-Punk Kitchen.
We had lots of options - matzo ball soup (see my passover post from March for links to that recipe). We had a couscous salad, a big kale and tahini salad, lentils, vegan hot dogs, hummus and an Israeli salad. For dessert we had homemade chocolate coconut ice cream, cookies, and plenty of fruit.
Saturday, August 03, 2013
Maccabi Triathlon
It's been a week since the race, but what better time than ever to post a race report???
In terms of my own performance, I had a pretty good race. But in terms of management by the race organizers, this was the most poorly run triathlon I have ever participated in. I will share my thoughts on that at the end of this post.
Early start
The weather in Tiberias is hot and humid and the temperature is 90° and upward on any given day this week. We arrived at the transition area just before 4:30 AM, ready for a start just before 6 AM.
Swim start
This was a large group that included all Olympic distance triathletes under the age of 39 and those aged 55 and higher. An interesting combination of swimmers, the elite young and the extreme old, all in one wave. I started toward the back of the group because I knew there were some spectacular athletes and swimmers who are far faster than I. I think this was probably one of the most violent swim starts that I have ever experienced. I felt like there were people all around me, in front of me, to my side and behind me. I took a few breast strokes just to get my rhythm and let a few people move ahead of me. Then, things were okay.
From what I'm told, there are a number of athletes who cut across the course and did not swim all the way to the buoys for the Olympic course. Instead, they turned at the sprint course buoys. I don't know if this was intentional but to me it was quite clear where we were supposed to swim and I followed the rules. I'm sure several of them had very short swim times recorded.
Unfortunately I ended up off a bit off course. It was difficult to sight some of the buoys.
This is the TrainingPeaks file mapping my swim. This was an out and back, starting from the green and ending at the red circle. You can see just how far off course I ended up.
At the end of the swim, I did more of a crab walk on hands and feet to get out of the water because there were a lot of rocks. The Australian coach, who has become a friend this week, was yelling at me to get up faster, but the last thing I wanted to do was injure my feet.
Transition
There was a long run from the water to transition. I banged through, helmet on, shoes on, sunglasses on, grab a gel and go.
Bike
The bike was an out and back course, repeated twice. The course had been shortened to 36 kilometers. I felt really good here. This is the first time that I have ever done a triathlon and no woman has passed me on the bike course.
Credit is due either to my coach Gerardo who had me working hard on my bike before this race, or to my brand-new Hed disc wheels. Regardless, I had a hell of a bike leg.
Run
The run course was literally out and back four times along the same 1.25 kilometer stretch of road. But this made sense given the hot humid weather. There was an aid station midway along that stretch, so we would pass the aid station eight times. I took a water bottle every time I passed and dumped it on my head and then had a sip or two. I felt very good on the run, didn't start too fast. Garmin was acting up so I don't know exact pace.
The Israeli Triathlon Association like this picture of me enough to feature it on their Facebook page. It's my game I play with the photogs on the course -- I see what the goofiest gesture is I can make for the camera, without the photog getting mad and putting down the camera. Here I am pretending I'm an airplane. And below here I am throwing my hands up like a goofball:
During the run, I passed more people than people who passed me. The temp was getting hot, from what I hear it was 100 degrees, and in fact at about 3 1/2 hours after the race began, the course was closed and anyone still racing pulled off the course because it was too hot.
My total time: 2 hours 44 minutes. Oddly enough, my bike was my best ranked of the three splits, followed by the swim, and then the run. Usually I'm the opposite. I guess it reflects my hard work on the bike.
I placed fourth out of seven in my age group. The top three were all Israelis with very fast swim splits, and none of them were entered in the Maccabi Man/Woman competition. Regardless, I'm happy with my performance.
That said.....
Organization of the Race
Worst organized race ever. Particularly for something that is an international event as part of the Maccabiah Games, and supposedly an ITU-sanctioned event. We didn't find out about the opportunity to swim on the course until after the fact at the pre-race meeting, when the race director said, "You all had the chance to swim on the race course from 3-5 pm." Ummm, no we didn't, at least those of us who weren't Israelis, we didn't have that chance, thank you, giving the Israelis yet another advantage over the rest of us. Then we were told that we needed to bring our own swim caps. Several of my team members didn't have swim caps with them, but fortunately there were a few of us who had extras to go around. We were also told that we needed to body mark OURSELVES -- really? Very strange. And at packet pick-up, we were notified that we had to put down a 50 shekel deposit to get our race chip, something we had not been told in advance. The race course had a guy at the finish turn-off who spoke no English and wasn't paying attention, so several people missed where they were supposed to go to finish. And, the supposedly "closed" bike course was not closed, with people walking back and forth, and unfortunately one woman stepping off the curb and getting hit by a cyclist who flew over his handlebars, and yet fortunately was not severely injured.
For an international event, this race was an absolute embarrassment.
Regardless, I had fun and had a good race. But, next time around, they really need to shape up.
In terms of my own performance, I had a pretty good race. But in terms of management by the race organizers, this was the most poorly run triathlon I have ever participated in. I will share my thoughts on that at the end of this post.
Early start
The weather in Tiberias is hot and humid and the temperature is 90° and upward on any given day this week. We arrived at the transition area just before 4:30 AM, ready for a start just before 6 AM.
Swim start
This was a large group that included all Olympic distance triathletes under the age of 39 and those aged 55 and higher. An interesting combination of swimmers, the elite young and the extreme old, all in one wave. I started toward the back of the group because I knew there were some spectacular athletes and swimmers who are far faster than I. I think this was probably one of the most violent swim starts that I have ever experienced. I felt like there were people all around me, in front of me, to my side and behind me. I took a few breast strokes just to get my rhythm and let a few people move ahead of me. Then, things were okay.
From what I'm told, there are a number of athletes who cut across the course and did not swim all the way to the buoys for the Olympic course. Instead, they turned at the sprint course buoys. I don't know if this was intentional but to me it was quite clear where we were supposed to swim and I followed the rules. I'm sure several of them had very short swim times recorded.
Unfortunately I ended up off a bit off course. It was difficult to sight some of the buoys.
At the end of the swim, I did more of a crab walk on hands and feet to get out of the water because there were a lot of rocks. The Australian coach, who has become a friend this week, was yelling at me to get up faster, but the last thing I wanted to do was injure my feet.
Transition
There was a long run from the water to transition. I banged through, helmet on, shoes on, sunglasses on, grab a gel and go.
Bike
The bike was an out and back course, repeated twice. The course had been shortened to 36 kilometers. I felt really good here. This is the first time that I have ever done a triathlon and no woman has passed me on the bike course.
Credit is due either to my coach Gerardo who had me working hard on my bike before this race, or to my brand-new Hed disc wheels. Regardless, I had a hell of a bike leg.
Run
The run course was literally out and back four times along the same 1.25 kilometer stretch of road. But this made sense given the hot humid weather. There was an aid station midway along that stretch, so we would pass the aid station eight times. I took a water bottle every time I passed and dumped it on my head and then had a sip or two. I felt very good on the run, didn't start too fast. Garmin was acting up so I don't know exact pace.
The Israeli Triathlon Association like this picture of me enough to feature it on their Facebook page. It's my game I play with the photogs on the course -- I see what the goofiest gesture is I can make for the camera, without the photog getting mad and putting down the camera. Here I am pretending I'm an airplane. And below here I am throwing my hands up like a goofball:
During the run, I passed more people than people who passed me. The temp was getting hot, from what I hear it was 100 degrees, and in fact at about 3 1/2 hours after the race began, the course was closed and anyone still racing pulled off the course because it was too hot.
My total time: 2 hours 44 minutes. Oddly enough, my bike was my best ranked of the three splits, followed by the swim, and then the run. Usually I'm the opposite. I guess it reflects my hard work on the bike.
I placed fourth out of seven in my age group. The top three were all Israelis with very fast swim splits, and none of them were entered in the Maccabi Man/Woman competition. Regardless, I'm happy with my performance.
That said.....
Organization of the Race
Worst organized race ever. Particularly for something that is an international event as part of the Maccabiah Games, and supposedly an ITU-sanctioned event. We didn't find out about the opportunity to swim on the course until after the fact at the pre-race meeting, when the race director said, "You all had the chance to swim on the race course from 3-5 pm." Ummm, no we didn't, at least those of us who weren't Israelis, we didn't have that chance, thank you, giving the Israelis yet another advantage over the rest of us. Then we were told that we needed to bring our own swim caps. Several of my team members didn't have swim caps with them, but fortunately there were a few of us who had extras to go around. We were also told that we needed to body mark OURSELVES -- really? Very strange. And at packet pick-up, we were notified that we had to put down a 50 shekel deposit to get our race chip, something we had not been told in advance. The race course had a guy at the finish turn-off who spoke no English and wasn't paying attention, so several people missed where they were supposed to go to finish. And, the supposedly "closed" bike course was not closed, with people walking back and forth, and unfortunately one woman stepping off the curb and getting hit by a cyclist who flew over his handlebars, and yet fortunately was not severely injured.
For an international event, this race was an absolute embarrassment.
Regardless, I had fun and had a good race. But, next time around, they really need to shape up.
Sunday, July 28, 2013
I am Maccabi Woman!
I earned a bronze medal!!! I took third place out of 11 competitors ages 36+! This was based on total time for four events in eight days, a 26 km bike time trial, a half marathon, an Olympic distance triathlon, and a 5 kilometer swim. I feel great about my performance at all four events. More later, I just wanted to share my awesome news!!!
Tuesday, July 23, 2013
Maccabi Man and Woman Half Marathon
This is one of the toughest races. And, as I am participating in a four race competition, with a triathlon less than 60 hours later, I knew I had to run this race smart.
I knew this race would be hot and humid -- at race start it was about 76 degrees and at least 80% humidity. And there were some hills. And it started at 9:30 pm, an unusual race time.
The start was absolute chaos. Not only were there 70 of us doing the maccabi man and woman competition, but there were another 1,300 Israelis in he general public who were running. The running corral was crowded and people were shoving to get to the front. I really feared I would be trampled. Those of us with Maccabi were supposed to start at the front with the general public following in 5 minutes behind. Instead, everyone started at once. As I was at the front and not with the abilities to run with the lead pack, this means a lot of people blew past me. I guess I am lucky I didn't get knocked over.
With all the fast runners around me, it took quite a bit of restraint to hold back. And I knew that holding back would be important. If I went too hard I would risk sacrificing my triathlon on Friday. I held my heart rate to zones 3 and perhaps a bit of zone 4.
Aid stations had plastic bottles of water, a little different from what I am accustomed to at races in the USA. We were also told that there would be "isotonic" fluids at two aid stations, in other words, an electrolyte solution. I wasn't sure how far out I would have to wait on the course for that, or what "isotonic" fluids in Israel consisted of, so I actually ran with a bottle of my own usual fluid, Ultima Replenisher. It's a good thing, because the isotonic solution was not available until 10k and was warm and not very palatable.
So, I had my own fluids to drink. To combat the humidity, I used the water bottles to dump over my head and keep my core temperature cool.
What I loved about the course was the crowds. They yelled "hol ha kavod" which I guess is the equivalent of "great job!" There were lots of little kids along the way and I high-fived a bunch of them. Around mile 6 I was done with the high fives and focused on my race.
My initial strategy was to run 9:00 per mile. But given the humidity, I knew I would need to adjust my strategy. I kept my heart rate in my appropriate zones, and whatever my pace was so be it.
I finished in 2:04. That's about 9:25 per mile. The important lesson - be ready to adjust your goal for unexpected conditions. I ran consistently, the second half about the same pace as the first. This was a successful day and I think I have enough energy to do well on Friday.
Monday, July 22, 2013
Maccabi Update
(I put together a post with pictures. It will not upload). Sadly I am having issues that I hope will resolve soon. )
Greetings from Israel!
And here I am with triathlon teammates Ryan Landy, Brad Scher, and Howard Sklar:
Here I am in the park in Tel Aviv for an easy morning taper ride:
And there I am climbing the hill to the finish.
I really felt like I had a great race. I finished the 26 kilometer (16.1 mile) race in 46:57. As the bike is my weakest of the three sports, I was not planning on winning, but rather giving my best effort.
This is the Carmel open market, with awesome produce. I bought some bananas, plums, and nectarines, and enjoyed a juice made from fresh beets, carrots, apple, and ginger. Yum!
Tomorrow is the half marathon, which starts at 9:30 pm! The late start is to avoid the hot weather of the day. Since my triathlon is only three days later, this will not be a hard effort. I will start at 8:45-9:00 per mile, and at mile 6 if I feel good I will pick up the pace, though keeping my heart rate in zone 3, or under 168 beats per minute. If the weather is hotter or more humid, I will alter my plan and run a bit slower.
Greetings from Israel!
As I told you in previous posts, I am the captain of the USA Masters Triathlon Team and am competing in something called the Maccabi Man and Woman Competition. This entails four events over the course of eight days -- a bike time trial of 26 kilometers (16.1 miles), a half marathon, an Olympic distance triathlon, and a 5 kilometer swim.
I am staying in Tel Aviv. The seaside is a beautiful backdrop for a morning run:
The Mediterranean Sea and the old city of Jaffa are behind me.
The opening ceremonies were an absolutely amazing experience! Over 9,000 athletes paraded into Teddy Stadium in Jerusalem. Here I am as I walked with Team USA around the oval:
And here I am with triathlon teammates Ryan Landy, Brad Scher, and Howard Sklar:
Here I am at the Wingate Pool in Netanya for a practice swim:
Here I am in the park in Tel Aviv for an easy morning taper ride:
Yesterday was my first event, the bike time trial:
Coming off the start ramp, we headed down a nice hill. Racers started a minute apart on this out-and-back course. and then halfway through we encountered a nice big hill to climb. The out and back course had us climbing the same hill we coasted down at the start.
I knew I was well-trained for this race. Coach Gerardo has really had me focus on the bike with a lot of workouts with time trial simulation at the end. And I had a new aero helmet and race wheels.
And there I am climbing the hill to the finish.
This put me in 11th place out of 19 women in my age group. That's pretty solid for this type of international competition.
Today is a rest day since I will be running a half marathon tomorrow.
And then I rested (and blogged!) from the beach.
Tomorrow is the half marathon, which starts at 9:30 pm! The late start is to avoid the hot weather of the day. Since my triathlon is only three days later, this will not be a hard effort. I will start at 8:45-9:00 per mile, and at mile 6 if I feel good I will pick up the pace, though keeping my heart rate in zone 3, or under 168 beats per minute. If the weather is hotter or more humid, I will alter my plan and run a bit slower.
More to come after tomorrow's marathon.
Monday, July 08, 2013
Subscribe to:
Posts (Atom)
