August 2019 WheelPeople

Articles
 

Message from the President

Larry Kernan
Message from the President
 
This will be a brief column this month as I’m on the road again -  doing the 7 day Tour de Cure New England Classic for the American Diabetes Association.  It’s a real monster of a ride — 550 miles and nearly 30,000 feet of climbing.  I’m taking notes on how they support their riders.
 
Tim Wilson, the executive director of the ride (and a CRW member) gave a wonderfully safety briefing.  His comment on potholes was priceless.  “In old England, the one across the Atlantic, they ride on the left side of the road.  Here in New England, we ride on what’s left of the road.”
 
On another topic, we did a huge mailing of 1,250 CRW name tags to all CRW members who had up to date addresses and emergency contact information in their CRW profile.  In addition to Mary and me, we had eight volunteers who helped print, punch, sort, stuff envelopes, stick on address labels, return address labels and stamps.  My thanks go out to Rich Taylor, Penny Leslie, Gene Ho, Dom Jorge, Ellen Dirgins, Glenn Pelrine, Patrick Brennan and Gardner (Sandy) Gray who put in a long evening to get this accomplished.
 
We’ll give members who haven’t yet received one the chance to update their CRW information and then do another production run.  After that, Linda Nelson volunteered to send each new member who joins CRW a name tag.
 
Finally, you have probably noticed that WheelPeople looks very different than it has in the past.  We are in transition.  Please be patient with us as we develop the new internet-based newsletter.
 
Get out and ride and stay hydrated!
 
 

The new Wheelpeople – and a request for volunteers

Lisa Najavits

 

You may notice that you’re seeing the August Wheelpeople in a new format. CRW will be sending Wheelpeople as an email newsletter going forward with clickable links rather than the former PDF (which was preceded by a mailed newsletter, which was preceded most likely by a horse-and-buggy or carrier pigeon method). 

The email newsletter will allow us to view metrics to understand what content is most of interest to members, such as what is clicked most often. So, click away and we will ‘hear’ you!

The newly formed Communications Committee (myself, Larry Kernan, Jack Donohue, Robyn Betts, and Kristi Carlson) is also working on some other fronts. We are:

  • Discussing ways to expand CRW social media options to help members engage with each other in new ways. 
  • Exploring the possibility of launching a member-initiated impromptu ride mechanism so that people can ride together beyond just the calendar-posted rides.
  • Planning to help new and existing members become more aware of already-existing communication methods such as the CRW listserv.
  • Considering creating a database in which members could post their locality, ride pace, and preferred ride times so they can locate others in the club with shared interests.
  • Planning to work on redesigning the club website.

 

In general, we are looking to create more interactivity via CRW media rather than it being primarily a one-way communication channel. We will also be addressing policies about what gets posted in the newsletter, such as ads and other events outside CRW.

Now here’s the ask--  we need some help. As you will see, the August newsletter will be functional but not as spiffy as we would like. We are looking to engage members to help with these projects, such as those who have a background in graphic design; social media; proofreading and formatting of the e-newsletter; and editor-level work such as writing and editing articles. Also, if you have ideas beyond what’s listed here that would enhance the club’s communications, send your ideas to me at lisa.najavits@treatment-innovations.org or via text (617-299-1620). 

Happy cycling!

 
 

WheelPeople Graphic Designer – David Cooper

Eli Post

 

It takes well over 100 volunteers to run CRW, and the tasks are not evenly divided. Some contribute more than was ever expected, and do so out of a commitment to the club, and in some cases a high sense of professional pride. One such volunteer is David Cooper who recently retired as the WheelPeople graphic designer. David started in the year 2000, and brought a high degree of professional quality to his work. WheelPeople went beyond what you would expect for a bike club newsletter. I speak from direct experience as I had the privilege of working with David where he created visually stunning articles from the text and photos I supplied. I suppose the highest compliment I can make is that David made me look good. He also never shirked from additional work when he was recruited to take on the design of CRW’s custom apparel. He handled the give and take with the Board with grace, and we were all grateful with the process and for the ultimate product.  Larry Kernan, President of CRW, commented, “On behalf of myself, the Board and the entire membership of CRW, it is hard to express sufficient gratitude for all of what David has done over the last 20 years.” We wish David well, and you may also extend thanks when you see him on a club ride.

 

 

Safety Corner

John Allen

Car Back, or Got Your Back?

by CRW Safety Coordinator John Allen

As long as I have been a CRW member, the call “car back” has resounded from riders at the rear of strings of cyclists. It has become almost reflexive. I have used it myself. If there’s a car behind, then someone near the rear of the group calls out “car back.” 

And what are riders ahead supposed to do then? Well, get over to the right and let the car pass. 

But, is this always the right thing to do?

Much of the time, certainly.  And, too often there is the one rider who obstreperously or cluelessly hangs out to the left of the group, despite repeated cries of “car back,” The car could have passed safely, and everyone could be happy, if only…

Or an aggressive or oblivious driver may pass anyway when it is risky. It is not always the right time to invite a motorist to blow through our rolling party. Moving over to the right is an invitation for a driver to pass.

Is there a better way? I think so. I tried it on one of Eli Post’s beginner rides recently. I was riding sweep. The group was of about ten people. Everyone except the leader and I were new to CRW rides, mind you. That may actually have made the group dynamics easier to manage. When I called out “car back,” people would move over and the car would pass. 

But when it was not safe for a car to pass, I tried something different: got your back. I wouldn’t say anything, but instead I’d ride in the middle of the lane and stick my left arm out straight, all fingers extended, palm of the hand facing the rear, warning the motorist not to pass. When it became safe, I’d call out “car back’ and move over to the right. 

It does help that I use a rear-view mirror so I can easily see a car approaching in time to decide what to do about it. But somewhat to my surprise, “got your back” was clearly much more comfortable not only for the group, but also for the car drivers.  The compliance rate was very high. 

Why less discomfort? I was sending clear and intentional messages. I wasn’t inviting drivers to do something they knew at some level was unsafe. I was being courteous and accommodating to the extent consistent with the safety of the group, but I was not being pathologically polite by inviting motorists to put me and the other members of the group at risk. 

CRW has been having more rides recently with a group leader and sweep: Eli’s intro rides; the Jack’s Abby rides; follow-the leader groups on the Centuries. Whenever there is a group of, say, twelve or fewer that stays together, “got your back” is easy to do. It works with slow intro ride or a fast paceline group. If the group gets too big, then it can split, but then it needs another sweep. 

The more usual CRW Sunday ride over decades has been the amorphous show-and-go ride where groups form and disperse more or less randomly depending on who is faster up hills, who had to wait at the traffic light, who had a flat tire, etc. etc.  This kind of ride is a great way to meet a variety of people (including the one who hangs out to the left of another rider to chat -- or maybe you are the one pulling up on the left). All well and good as long as you keep an eye on what is happening behind you. Unless you are in the middle of a group, and someone behind you calls out “car back” even though it is unsafe to pass, and being In the middle of the group, you are damned if you do and damned if you don’t move over. 

When a substantial percentage of the people on CRW rides know and practice “got your back,” then this doesn’t have to happen, but there is a learning curve and I’m not sure how soon we’ll get there as a club. It did work like a charm on the intro ride and if intro riders can do it…

With “got your back” group dynamics, it also is possible to make good choices about when to ride single- or double-file, but this article is getting long and maybe I’ll write about that next month.

 
 

The Athlete's Kitchen

The Athlete's Kitchen

Copyright: Nancy Clark MS RD CSSD   June 2019

 

Sports Nutrition Myths: Busted!

 

Keeping up with the latest science-based sports nutrition recommendations is a challenge. We are constantly bombarded with media messages touting the next miracle sports food or supplement that will enhance athletic performance, promote fat loss, build muscle, and help you be a super-athlete. At this year's Annual Meeting of the American College of Sports Medicine (www.acsm.org), a sports nutrition myth-busters session sponsored by the global network of Professionals In Nutrition for Exercise and Sport (www.PINESNutrition.org) featured experts who resolved confusion with science-based research.

 

MYTH: Protein supplements build bigger muscles.

Protein needs for a 150-pound (68 kg) athlete average about 110 to 150 grams of protein per day. (More precisely, 0.7 to 1.0 g pro/lb. body weight/day; 1.6 to 2.2 g pro/kg./day) Hungry athletes can easily consume this amount from standard meals. Yet, many athletes believe they need extra protein. They consume protein shakes and bars in addition to protein-laden meals. They are unlikely to see any additional benefits from this higher-than-needed protein intake. Resistance exercise is a far more potent way to increase muscle size and strength than any protein supplement. 

 

MYTH: Eating just before bedtime makes an athlete fat.  

While it is true the body responds differently to the same meal eaten at 9:00 a.m., 5:00 pm, or 1:00 a.m., an athlete will not "get fat" by eating at night. The main problem with nighttime eating relates to the ease of over-eating while lounging around and watching TV. When your brain is tired from having made endless decisions all day, you can easily decide to eat more food than required.

     That said, bedtime carbohydrates to refuel depleted muscles and bedtime protein to build and repair muscles can optimize recovery after a day of hard training or competing. For body builders and others who want to optimize muscle growth, eating about 40 grams of protein before bed provides an extended flow of amino acids needed to build muscle. (This bedtime snack has not been linked with fat gain). Cottage cheese, anyone?

 

MYTH: A gluten-free diet cures athletes' gut problems.  

If you have celiac disease (as verified by blood tests), your gut will indeed feel better if you avoid wheat and other gluten-containing foods. However, very few gut issues for non-celiac athletes are related to gluten. FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides and Polyols) are often the culprit. These are types of hard-for-some-people-to-digest carbohydrates found in commonly eaten foods such as wheat, apples, onion, garlic, and milk. For example, the di-saccharide lactose (a kind of sugar found in milk) creates gut turmoil in people who are lactose intolerant. The poorly digested and absorbed lactose creates gas, bloat and diarrhea. 

     For certain athletes, a low FODMAP diet two or three days before a competition or long training session can help curb intestinal distress. If you live in fear of undesired pit stops, a consultation with your sports dietitian to learn more about a short-term FODMAP reduction diet is worth considering.

 

MYTH: Athletes should avoid caffeine because of its diuretic effect

With caffeinated beverages, the diuretic effect might be 1.2 ml. excess fluid lost per mg. of caffeine. That means, if you were to drink a small mug  (7 oz./200 ml.) of coffee that contains 125 milligrams of caffeine, you might lose about 150 ml. water through excess urine loss. But you'd still have 50 ml. fluid to hydrate your body—and likely more if you drink coffee regularly. Athletes who regularly consume caffeine habituate and experience less of a diuretic effect. In general, most caffeinated beverages contribute to a positive fluid balance; avoiding them on the basis of their caffeine content is not justified.

 

MYTH: Athletes should be wary of creatine because it is bad for kidneys.

Creatine is sometimes used by athletes who want to bulk up. It allows muscles to recover faster from, let's say, lifting weights, so the athlete can do more reps and gain strength. A review of 21 studies that assessed kidney function with creatine doses ranging from 2 to 30 grams a day for up to five and a half years indicates creatine is safe for young healthy athletes as well as for elderly people. Even the most recent studies using sophisticated methods to assess renal function support creatine supplements as being well tolerated and not related to kidney dysfunction.

 

MYTH: The vegan diet fails to support optimal performance in athletes.

Without a doubt, vegan athletes can —and do—excel in sport. Just Google vegan athletes; you'll find an impressive list that includes Olympians and professional athletes from many sports (including football, basketball, tennis, rowing, snow boarding, running, soccer, plus more.) 

    The key to consuming an effective vegan sports diet is to include adequate leucine, the essential amino acid that triggers muscles to grow. The richest sources of leucine are found in animal foods, such as eggs, dairy, fish, and meats. If you swap animal proteins for plant proteins, you reduce your leucine intake by about 50%. For athletes, consuming 2.5 grams of leucine every 3 to 4 hours during the day optimizes muscular development. This means vegan athletes need to eat adequate nuts, soy foods, lentils, beans and other plant proteins regularly at every meal and snack. 

     Most athletes can consume adequate leucine, but some don't because they skip meals and fail to plan a balanced vegan menu. Vegan athletes who are restricting food intake to lose undesired body fat need to be particularly vigilant to consume an effective sports diet. Plan ahead!

 

Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). The newest 6th edition of her best selling Sports Nutrition Guidebook is being released in July 2019. For information about readymade handouts and PowerPoint presentations, visit www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

 
 

Dr Mirkin.com

 
 
New Studies on Fatty Liver
A liver full of fat can be caused by anything that damages the liver. Doctors used to separate liver damage into that caused by alcohol and that not caused by alcohol (non-alcoholic fatty liver disease or NAFLD). Now we know that a liver damaged by excess alcohol has the same harmful consequences as a liver damaged by anything else, such as obesity or excess sugar intake (Gastroenterology, May 31, 2019).
The most common cause of liver damage used to be alcohol, but today it is far more likely to be caused by eating a lot of sugar-added foods or drinking anything with sugar in it. A fatty liver is common even in people who never drink alcohol. Up to 12 percent of people with a fatty liver keep on adding fat to eventually develop Non-Alcoholic Steato-Hepatitis (NASH), which is liver inflammation and permanent liver damage, called cirrhosis, that can cause liver cancer (Gastroenterology, August 23, 2018).
Excess Belly Fat Increases Heart Attack Risk, Even If You are Not Overweight
Another report shows that post-menopausal women who store fat primarily in their bellies are at increased risk for having heart attacks, even if they are not overweight (Eur Heart, June 30, 2019). Researchers followed 161,808 healthy women, aged 50–79 for 17.9 years and found that 291 developed heart disease during that period. Women with the highest percentage of belly fat had double the risk for heart disease, compared to those with the lowest belly fat. Furthermore, those with the lowest percentage of hip fat and highest percentage of belly fat (apple shape) had three times the risk for heart disease than those with lowest percentage of belly fat and highest percentage of hip fat (pear shape). The researchers concluded that reducing the amount of belly fat by itself would help to reduce heart attack risk significantly, even if the amount of hip fat was not reduced.
A Fatty Liver can Lead to Diabetes
People who store fat primarily in the belly are most likely to also store a large amount of fat in the liver. You can often diagnose diabetes just by looking at a person. People who have a big belly and small buttocks are at very high risk for being diabetic and suffering heart attacks (JAMA, 2017;317(6):626-634). To prevent your blood sugar level from rising too high after you eat, your pancreas releases insulin which is supposed to lower high blood sugar levels by driving sugar from the bloodstream into the liver. However, if your liver is full of fat, the excess fat prevents the liver from accepting the sugar and blood sugar levels can rise even higher (Eur J Gastroenterol Hepatol, Dec 2016;28(12):1443-1449). A high rise in blood sugar causes high blood insulin levels that convert blood sugar to a type of fat called triglycerides. Then insulin drives triglycerides into your liver. Having high triglycerides and a fat belly are signs of high blood insulin levels, and high blood levels of insulin constrict arteries to cause heart attacks. Insulin also acts on the brain to make you eat more, and on your liver to manufacture more fat, and on the fat cells in your belly to store that fat.
Fatty Liver Disease and Diabetes
Non-alcoholic fatty liver disease occurs when excess fat is stored in your liver. The most common cause of liver disease used to be alcohol, but now it is far more likely to be caused by eating sugar-added foods and drinking anything with sugar in it. Up to 12 percent of people with fatty livers keep on adding fat to their livers to develop Non-Alcoholic Steato Hepatitis (NASH), which is liver inflammation and permanent liver damage called cirrhosis and can cause liver cancer (Gastroenterology, August 23, 2018). The simple sugar, fructose, is the most likely food component to end up as fat in your liver (Dig Dis Sci, May 2016;61(5):1282-93).
How Does Sugar Cause a Fatty Liver?
After you eat, your blood sugar level rises, which causes your pancreas to release insulin, which converts the sugar to a type of fat called triglycerides. To prevent your blood levels of triglycerides from rising too high, your good HDL cholesterol is used to carry triglycerides to your liver where they are stored to cause a fatty liver.
High levels of triglycerides (>150) predict diabetes and in diabetics, high triglycerides predict increased risk for premature death (Diabetes Care, 2017;40(4):529-537). The more fat you have in your liver, the higher the rise in blood triglycerides after you eat (Clin Sci (Lond), Sept 18, 2017). People who eat a lot of foods with added sugars have more than double the risk of heart disease than those who eat the least (Am J of Clin Nutr, April 7, 2010; Arch of Int Med, May 2010).
Why Sugared Drinks Cause Such High Rises in Blood Sugar
When you take in liquid sugar, you get a much higher rise in blood sugar than when you take in the same amount of sugar in a solid food. Solid foods stay in your stomach until they are converted into a liquid soup, while liquids can pass directly into your intestines, so sugared drinks cause the most rapid passage of sugar into your intestines and the highest immediate rises in blood sugar. Compared to sugar in food, sugar in drinks is more strongly associated with increased risk for excess belly fat (Circulation, January 11, 2016; Quart J Med. Apr 26, 2017), obesity (Nutr J, Aug, 2017;22;16(1):48), and diabetes (Am J Clin Nutr, Jun 28, 2017; Curr Opin Cardiol, Sept, 2017;32(5):572-579). All sugar-sweetened beverages are associated with a significantly increased risk for developing a fatty liver and metabolic syndrome, which is also called pre-diabetes (Int J Clin Pract, Jan 10, 2017)
How a Fatty Liver Causes Diabetes
Your blood sugar level is supposed to rise after you eat. To prevent your blood sugar level from rising too high, your pancreas releases insulin which is supposed to lower high blood sugar levels by driving sugar from the bloodstream into the liver. However, if your liver is full of fat, the excess fat prevents the liver from accepting the sugar and blood sugar levels can rise higher and higher. Many diabetics or prediabetics will have “normal” fasting blood sugar levels below 100 mg/dl (In Canada and UK, convert to the U.S. number by multiplying the Canadian or UK number by 18). The correct definition of diabetes is having a rise in blood sugar one hour after a meal to more than 140 mg/dl (Diabetes Care, 2001;24 (8):1448-1453).
How Can You Tell If You Have a Fatty Liver?
You are likely to be at high risk for a fatty liver and diabetes if you have a big belly and small hips. People who store their fat primarily in the belly are also prone to storing fat in the liver. Your doctor can do a liver sonogram to determine whether you have excess fat in your liver (Nutrition, Metabolism & Cardiovascular Diseases, Dec 30, 2015).
How Do You Get the Fat out of Your Liver?
Exercise: Exercise can markedly reduce the amount of fat in your liver (World J Gastroenterol, Jul 21, 2016;22(27):6318-27). It does so by lowering blood sugar which then lowers triglycerides, the fat that forms in your liver (J of Funct Morph and Kines, 2017;2(4):35). Resting muscles draw almost no sugar from your bloodstream and the little that they do draw requires insulin to do so. On the other hand, contracting muscles draw tremendous amounts of sugar from the bloodstream and don’t even need insulin. This effect that exercise has of rapidly drawing sugar from the bloodstream is maximal during exercise and for up to an hour after you finish exercising and rapidly tapers off after 17 hours. Then muscles can draw sugar only with insulin (Am J Clin Nutr, 2008(July);88(1):51-57). Exercise reduces liver fat even if a person does not lose weight (Metabolism, Mar 2017;68:119-132).
Diet: Avoid foods that cause a high rise in blood sugar, such as all sugar-added foods and all drinks with sugar, including fruit juices. Restrict other refined carbohydrates such as foods made from flour. Most people with a fatty liver are overweight and will need to lose weight to get the fat out. I recommend intermittent fasting.
Signs of a Fatty Liver
You can often tell if people have diabetes just by looking at them. A person with a big belly and small buttocks is at very high risk for being diabetic, because those who store fat primarily in the belly are most likely to also store a large amount of fat in the liver. Having excess fat in your liver markedly increases risk for diabetes and heart attacks (JAMA, 2017;317(6):626-634), and also increases all markers of inflammation that are associated with increased risk for heart attacks (Clinical Gastroenterology and Hepatology, February 28, 2019). You can reduce the amount of fat in your liver and the inflammation it causes by severely restricting sugared drinks, fruit juices and foods with added sugars (JAMA, Jan. 22, 2019).
How a Fatty Liver Leads to Diabetes
Your blood sugar level rises after you eat, but to prevent it from rising too high, your pancreas releases insulin which is supposed to lower high blood sugar levels by driving sugar from the bloodstream into the liver. However, if your liver is full of fat, the excess fat prevents the liver from accepting the sugar and blood sugar levels can rise even higher (Eur J Gastroenterol Hepatol, Dec 2016;28(12):1443-1449).
The leading cause of fatty liver used to be alcohol, but now it is far more commonly caused by drinking sugared drinks and eating sugar-added foods. The simple sugar, fructose, is the most likely food component to end up as fat in your liver (Dig Dis Sci, May 2016;61(5):1282-93). A fatty liver comes from:
• high rises in blood sugar, which cause
• high blood insulin levels that
• convert blood sugar to a type of fat called triglycerides, and
• insulin drives triglycerides primarily into the fat cells in your belly and its organs such as your liver.
Having high triglycerides and a fat belly are signs of high blood insulin levels, and having high blood levels of insulin increases risk for heart attacks. Insulin also acts on the brain to make you eat more, on your liver to manufacture more fat, and on the fat cells in your belly to store that fat. People who store fat primarily in the belly have higher blood insulin and blood sugar levels, which raise LDL (bad) cholesterol and lower HDL (good) cholesterol.
Having a normal fasting blood sugar level does not rule out diabetes. A high rise in blood sugar after meals can damage every cell in your body. If your blood sugar level one hour after eating is greater than 140, your cells are being damaged and your life is being shortened (Atherosclerosis, Jan 2017;256:15-20).
Why Sugared Drinks Cause the Highest Rises in Blood Sugar
When you take in liquid sugar, you get a much higher rise in blood sugar than when you take in the same amount of sugar in a solid food. Solid food is not allowed to pass into your intestines because when you eat, the pyloric muscle at the end of the stomach closes and allows only a liquid soup to pass into the intestines. Sugared drinks can pass right through into your intestines, so they cause the quickest rises in blood sugar. Compared to sugar in food, sugared drinks are more tightly associated with increased risk for excess belly fat (Circulation, January 11, 2016; Quart J Med, Apr 26, 2017).
All sugared drinks are associated with increased risk for developing a fatty liver, pre-diabetes (metabolic syndrome), diabetes, inflammation, abdominal obesity, high triglycerides, and increased waist circumference (Int J Clin Pract, Jan 10, 2017; J of the Acad of Nutr and Dietetics, Feb 2013;113(2):219-227; Am J of Clin Nutr, March 23, 2011).
What Can You Do About a Fatty Liver?
Your doctor can order a liver sonogram to see if you have excess fat in your liver (Nutrition, Metabolism & Cardiovascular Diseases, Dec 30, 2015).
Diabetes can be treated and often cured with a diet that removes fat from the liver (Diabetologia, 2011 Oct; 54(10): 2506-2514) and with exercise that removes excess fat from the liver and muscles (Scandinavian Journal of Medicine & Science in Sports, March 13, 2017;27(5)).
Diet: Avoid the foods that cause high rises in blood sugar, especially sugared drinks and sugar-added foods, and restrict other refined carbohydrates. Restrict red meat and processed meats, which block insulin receptors (JAMA Intern Med, 2013;173(14):1328-1335), and fried foods.
Exercise: Resting muscles draw almost no sugar from your bloodstream and the little that they draw requires insulin to do so. On the other hand, contracting muscles draw tremendous amounts of sugar from the bloodstream and don’t even need insulin to do so. This effect that exercise has of rapidly drawing sugar from the bloodstream is maximal during exercise and for up to an hour after you finish exercising, and rapidly tapers off for about 17 hours. Then the resting muscles can draw sugar only with insulin (Am J Clin Nutr, 2008(July);88(1):51-57). Exercise can reduce liver fat even if a person does not lose weight (Metabolism, Mar, 2017;68:119-132).
My Recommendations
• If you have a big belly or your blood sugar is greater than 140 one hour after a meal, I recommend that you lose weight (if overweight) with intermittent fasting; check with your doctor.
• Since most liver fat comes from sugar, avoid or severely restrict all sugared drinks and sugar-added foods.
• Restrict other refined carbohydrates such as foods made from flour (bakery products, pasta, many breakfast cereals and so forth).
• Restrict red meat, processed meat and fried foods.
• Eat plenty of vegetables, seeds and nuts which are rich sources of soluble fiber.
• Try to exercise every day.
Caution:Intense exercise can cause heart attacks in people who already have blocked arteries. Check with your doctor before starting an exercise program or increasing the intensity of your existing program.