EP. 51: Best of The Endurance Experience Podcast Vol. 5

Taking a look back at clips from 5 of the most downloaded episodes in Season 5 with updated commentary.

8:18: Matt Fitzgerald, – The Racing Weight Question | @mattfitwriter| Full Podcast https://bit.ly/3qcgScE

23:43: Carol Irwin, Phd – Factors Impacting Swimming Participation and Competence | @usaswimming | Full Podcast https://bit.ly/3MDUalf

48:34: Graham Stuart, MSc – The Endurance Enthusiast’s Heart | @ag_stuart| Full Podcast https://bit.ly/3WBUrK4

1:09:03: Nick B. Tiller, PhD – The Pseudoscience of Sport, Health & Fitness | @NBtiller | Full Podcast https://bit.ly/3oC3XQY

1:26:55: Susan Sotir, PhD – Coaching the Endurance Athlete | @spsotir | Full Podcast https://bit.ly/3MGkQlc


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Episode Transcript

(00:00):
The intersection of endurance, sports,health, fitness, and life, challenging
conventional ideas and empowering people with thescience of self propelled motion. This is
The Endurance Experience Podcast hosted by TonyRage. Hello everyone, I am back

(00:21):
coach Tony Rich here and welcome toanother episode of The Endurance Experience. And
this is the best of the EnduranceExperience Podcast, Volume five. It's hard
to believe another season has come tothe and but before I get into all

(00:43):
that, just want to apologize.I've been away for a little bit.
The busiest time while one of thebusiest times of my season is during the
spring as marathon and triathlon season startsto kick up, and a litany of
my kicks off with Event and Horizondot TV in order to help athletes prepare

(01:03):
for the upcoming training and racing season. So check us out to on Event,
Horizon dot tv on all social mediaplatforms. And so I've been away
from the microphone. But also Iam preparing for my next season and that

(01:27):
will be season six of The EnduranceExperience, and so I've been planning for
that talking with guests or potential guests, and I have a good understanding of
what the lineup is be will beand then I will start recording soon and

(01:51):
it's looking like it's going to bea pretty great season if I can nail
down some of the guests that I'vebeen talking with and I want your some
of your ideas. This is atime where I solicit ideas. You can

(02:13):
send ideas to contact at event Horizondot TV. Some of your ideas actually
turned into guests for last this pastseason. And it's getting very competitive out
there. There are a lot ofpodcasts out there now. Depending upon which

(02:35):
number you believe, there may beany upwards of two million total podcasts out
there now, and there's lots ofcompetition. Everyone is starting to launch their
own so I'm looking for ideas aswell on how to differentiate. So if

(02:57):
you have some ideas on, youknow, some of the best elements of
some of the other podcasts that youare listening to or watching, let me
know I'm interested. I have gottenfeedback that people love the podcast and they
love the conversations, but they justwant more consistency. I'm working on that.
That's a challenge, especially with someonelike myself being pulled in different ways.

(03:22):
But I think in my next seasonI will consistently attempt to try to
get one to two podcasts out consistentlyevery month. And remember it really helps
the podcasts. If you go outon Apple podcasts in your phone and rate
and place a comment, it reallydoes help out the show and the algorithm

(03:46):
much appreciate it. So if youremember some of the best of episodes in
the past, this is where Itake a sample from the five most downloaded
and listen to podcasts of the season. I take from that from those episodes
and then provide updated commentary on them, and so new listeners can get a

(04:10):
nice little sampling of what the podcastis all about. And if you've already
listened to those podcasts, you canget my updated commentary. I want you
to get a flavor for the scienceand evidence based approach of the podcast,
in the discussions, in the questions, and in the guests, the type

(04:33):
of guests that we invite onto thepodcast. And then you know, you
can go back into the show notesfind the links, and then you can
listen to those podcasts. If youhaven't already or if you've already listened to
them, you can go listen toit again. In the end, you'll
have a nice jumping off point forseason six, which I will start briefly

(04:58):
thereafter this eppisod so, so withoutfurther delay, let's see what were the
five most downloaded and listened to podcastsof season five. Here they are in
the order in which they occurred.Episode forty two The Racing Weight Question with

(05:19):
coach, nutritionist and author Matt Fitzgerald. I knew that was going to be
a popular podcasts. Matt is avery popular coach, well known, and
that is highly discussed topic. Andthen there was episode forty three, Factors

(05:42):
Impacting swimming participation in Competence with doctorCarol Irwin. She has been one of
the lead researchers on swimming and whywe see less swimming competence in underrepresented communities,
Black communities, Hispanic communities and such, and she talked about the research

(06:08):
there. Episode forty five The EnduranceEnthusiast's Heart with Professor Graham Stewart, another
popular topic about endurance athletes and theimpact of training and racing on the endurance

(06:30):
athletes heart. I think many athleteshad some interest in that topic and so
many people tuned in and listened tothat. Then there was episode forty seven
the Pseudoscience of Sport health and Fitnesswith doctor Nick Tiller. He has a
book out which I highly recommend,The Skeptic The Skeptics Guide to Sport Science.

(06:58):
And we had a great conversation,and so that's very popular because I
think people like, people like thecontroversy of things that are being promoted on
social media that may not have empiricalunderpinnings. Let's just say so, we

(07:18):
had a great conversation. And thenepisode forty nine Coaching the Endurance Athlete with
doctor Susan Sautier. We had agreat conversation about a lot of topics,
but particularly with the one that seemedto get a lot of traction was with

(07:44):
some of the audiograms that I postedout on social media was our conversation about
coaching female athletes, and so thatgot a lot of activity. So those
were the fives that were the mostdownloaded and listen to in season five,
and so I'm going to go througha clip from each one, starting with

(08:09):
my conversation with Matt Fitzgerald on theracing weight question. Matt wrote a book
called Racing Weight, and I readit over a decade ago, and it
was a great book that took meinto new direction when trying to really figure
out the science of things like nutrition, racing performance, body composition, and

(08:35):
so I brought him on to talkabout that work. And so in this
clip we talk about timing effects andhow athletes should handle timing effects at the
latest, nutrition and the science underpinningbody composition for particularly running. I was

(09:01):
an endurance athlete, endurance coach,a sports nutritionist, and you know what
I saw, um at that timewas, you know, it's just it's
simply, you know, an obviousfact that, um, if you're pursuing
performance as an endurance athlete, optimizing, you know, your body composition and

(09:24):
body weight is one piece of thatpuzzling. It's only one among many pieces.
You know there are there are literallydozens, um. But but it
you know, to deny the factthat that you know, body weight and
body composition uh impact endurance performance isis foolish. And you know I was
aware of this, uh you know, the the you know, the athletes

(09:46):
I coached and trained with were awareof this. So there was a lot
of conversation about it. Was interesting, you know, um, I I
joke, I half jokingly referred toracing weight as the diet book for skinny
people, you know, because wehad you know, we weren't folks who
just wanted to look good in themirror naked like we were. We wanted

(10:07):
to to pr and qualify for Bostonand qualify for for Kona. And what
I saw was that athletes who werewho were looking to optimize their performance through
you know, improvements and body compositionand body weight, we're we're actually like
choosing the popular fad diets like likeyou know, like you know, triathletes
were going on the South Beach Diet, which was not written by it or

(10:31):
four indurance athletes, you know,for the sake of improving their indurnance performance.
And my thought was that's no good, right, you know, like
that there are there are there aregood and bad ways to go about this.
And so I wanted to you know, you said, you come up
with ideas for for books and don'twrite them because I've written them already.
Well, you know, I'm notthat different, you know. My thought

(10:52):
was, like, you know,there there needs to be like a credible
authoritative, you know, empirical resourcethat that shows athletes, you know,
the right way to go about optimizingtheir body composition of body body weight four
and durance performance. I looked aroundthat resource didn't exist, so I wrote
it with respected timing and timing.You're nutrition to step five? How do

(11:16):
you how do you recommend employing that? Do you mean? For instance,
someone has a big training weekend,a big training block coming up, and
perhaps uh, they take a tacticalapproach to fueling on say, you know,
Friday or Thursday coming up leading upto that big training BLOCKA how do
you recommend timing? Yeah, youknow, you know, the you know,

(11:39):
the basic point is that you know, when you eat matters almost as
much as what you eat, right, um, and and then you you
know, then you get down tothe details and specifics from there, um,
you know, in terms of youknow, you know, in tactical

(12:01):
terms, Yeah, calorie intake shouldbe contround, concentrated around periods of heightened
calorie expenditure. Right, so thatfor athletes, you know, you know,
you know, the most um intensiveperiods of caloric expenditure are our workouts

(12:22):
and races. So you know,fueling up before, fueling during as appropriate,
and fueling up after for the recoveryperiod. You know, not only
will you tend to perform better inyour workouts and thereby get more out of
them and also recover better afterwards bydoing that. I wonder if you could

(12:43):
explain this to the listeners, thescientific basis behind this, behind why this
is true for the endurance athletes.If someone came up to you and said,
what's the what's the scientific undepending behindleaner bodies moving more efficiently? Uh

(13:03):
in an endurance event, how wouldyou answer the question? Yeah, you
know it's uh so it's a littlebit physics and a little bit physiology.
Um. So, you know,running is a good example because you know,
in running you're moving against gravity.Like you know, running is really
just controlled jumping, right, um, And so if you know your physics,

(13:26):
you know that the more mass youryour body contains, the more you
weigh, the more energy it takesto take a hop forward, you know,
from one foot to the next,as you do, you know,
repeatedly in running. If you runa marathon, that's fifty five thousand steps
each each and every one of themagainst gravity. So you know, the

(13:48):
more the more mass on your body, uh, you know, the more
energy it takes. And you onlyhave so much energy, so uh,
you know, you'll go, you'llcover that just it's a lot more quickly
if you have less mass, youknow, to carry over that distance.
Um. So that's the physics partof it. Uh, you know,

(14:09):
the physiology part of it is thatbody fat is dead weight. You know,
you know, most other tissues ofyour body actually contribute to forward motion,
muscles being the obvious example. Likeyou know, muscles weigh something.
So there's a there's a cost.You have to move your muscles just as
much as you have to move anyother tissue in your body. But your

(14:31):
muscles are actually doing the work ofmoving you. It's like the engine of
a car. So and so youdon't want to get rid of your muscle.
Um. But but you know,body fat makes no you know,
beyond the minimal amount that's required justto be healthy. And you know,
you know body body fat is activetissue. It's not completely deadweight. But

(14:54):
you know it's not the same asmuscle where you know it moves you forward.
It's a it's a serve energy source. Um. So you know you
need a certain amount of Like bodyfat is not bad. You you need
a certain amount to be healthy andto train and to get from point a
to point B. But beyond that, you know, any excess beyond that
just it doesn't contribute to forward motionand it adds to the cost of of

(15:18):
getting from point A to point B. So for those reasons, um,
you know, and like a sportlike swimming, um, there's no particular
cost to being heavier. But stillthe elite elites, elite swimmers tend to
be have a relatively low body uhfat percentage because, like you know,

(15:39):
the physics factor is a little differentthere, but the physiology factor is not.
So those are the two basic reasonsyou want to be lean and light.
The link in the show notes toepisode forty two, the Racing Weight
Question with Matt Fitzgerald. For athleteslooking for a rese source to maximize performance

(16:03):
in this area, I would highlyrecommend Matt's book Racing Weight. It is
the book that, as he saidin the clip, that needed to be
written, so he wrote it right. And so with all the new heightened
awareness around this topic, and we'veseen recently where this can go wrong,

(16:26):
where athletes and coaches employ extreme strategiesin order to try to hack this element
of training and ignore, like Mattsaid, the dozens of other variables that

(16:49):
you need to focus on in thetraining process. We've seen it go wrong
for sure, and I think whatMAT's book shows is you can highlight the
need for a science and evidence basedapproach to this so that athletes can find

(17:14):
the range of body compositions that maximizetheir performance. And it is a range,
it's not just one target number onthe scale. And I do mean
body composition in the pure sense ofthat word, not only what's on the
scale, but the functional strength anathlete needs to accomplish certain movements and tasks

(17:40):
as well as training and racing payloads. And you can employ a thoughtful strategy,
a process oriented strategy, into theother elements of your training and eventually,
with diligent and consistency, arrive atthe place that you need to in
order to maximize your performance and achieveyour goals. And of course, your

(18:06):
behaviors and strategies are going to scalewith the category of athlete. A recreational
athlete won't have the same behaviors andstrategies of an athlete trying to run a
sub three hour marathon or qualify forthe Ironman World Championship. So I think

(18:27):
what has happened with this issue isbecause all of the heightened awareness around extreme
nutrition strategies and abuse of these strategiesis what it has done, is it
has caused many coaches to swing completelyin the opposite direction, and many of

(18:49):
them are now so paralyzed with fearto even consider or discuss the topic of
you know, nutrition and body compositionas a as an element of maximizing their

(19:11):
their training. And that can't behelpful either, because coaches are hired to
get results. They're hired to getresults. They're hired to help athletes be
truthful to them and use science andevidence based approaches wherever they can. And

(19:32):
it really doesn't matter even what typeof athlete you are, whether you're a
defensive lineman, a swimmer, aboxer, or a racer of any stripe,
a thrower in any type of sport, athletes have to consider nutrition and

(19:57):
body composition in their array of variablesthat they can target and ideally maximize.
And the last thing to say aboutthis that athletes should remember is form follows
function. And I've heard Matt saythis, I think it was in his

(20:19):
books. Your form will follow yourfunction, right, So be process oriented,
train hard, have a strategy behindyour nutrition and your form will follow.

(20:41):
Don't get too wrapped up into gettingto some number on the scale.
Believe it or not, your bodyhas an amazing way of figuring out where
it needs to be to do thethings you're trying to make it do.
And genetics does play a pretty significantI think in my heyday, when I

(21:03):
was the fastest I've ever been,I was able to get close to the
three hour marathon mark. I couldnever really actually hit it or get to
some three hour marathon, and Irealized that because of my muscular frame and
my genetics built like a sprinter,that that would be a little bit out

(21:23):
of reach for me. And Iwas fine with that. And sometimes you
need to say, you know,maybe I just do the best that I
can with the attributes that I haveand be fine with that. And sometimes
you just have to you just haveto do that. I recently coached an
athlete named Chris, and you know, he came to me wanted to do

(21:47):
his first Iron Man, and Chrishad some pretty powerful genetic attributes that I
realized from the start. Many ofyou are familiar with the three somatypes.
Somatypes are basically body composition types mesomorph, endomorph, and ectomorph. And Chris

(22:15):
came to me as a classic ectomorph, very tall, very lean, probably
slow twitch muscle fiber long slow twitchmuscle fiber disposition. And immediately I told
him, I said, you're gonnaYou're gonna do well in this sport.

(22:37):
And he ended up in his firstiron Man, qualified for the Ironman World
Championship. He wasn't trying to dothat, he just did it. And
then he came back in a fewweeks after that, just a few weeks
after that and ran his first BostonMarathon and ran a sub three hour Boston

(23:00):
Marathon, first Boston Marathon, andso I knew that, you know,
don't get me wrong. I hadhim trained diligently for sure, but it
was because that he had such afavorable predisposition. His factory settings gave him

(23:22):
such a favorable predisposition to do that. So do the best you can with
the attributes you have. Have asystematic, process oriented approach. Don't get
too wrapped around the axle about thescale. Train hard, and let your
form follow your function Onto the nextclip. So, my episode forty three

(23:47):
was on factors impacting swimming participation,in competence with doctor Carol Irwin, and
she was a part of a teamof researchers including her husband, who researched
this issue for several USA swimming researchstudies. The aim is to try to

(24:11):
figure out why we see such lowswimming proficiency in underserved populations, particularly African
American populations. North of two thirdsof African Americans show low or no swimming
ability. In this clip, doctorIrwin and I are discussing some of the

(24:33):
findings of the May twenty twenty QualitativeReport Factors impacting swimming participation and Competence.
This was a very popular podcast andone of the most downloaded, So let's
listen. In not only a generalas a general issue, I mean generally

(24:56):
we see that pep adults don't knowhow to swim, and particularly if they
if they didn't grow up swimming,and but it's almost a much more pervasive
case in the instance of minority swimming. And just this summer in the Northeast,

(25:18):
we had a we had a ayoung kid drowned and then a police
officer drowned trying to save the youngkid. H and the uh, well,
the police officer I think was hispanicpolice officer. So in the UM,
let's start right in and talking aboutthe research, and if you can

(25:42):
talk about how you UH formulated tostudy, maybe talk about the problem statement
that you and your fellow researchers tookon and UH factors impacting swimming participation and
what are some of the key statisticsthat will drive home the understanding of the

(26:04):
problem to the listeners. Sure.Originally, back in two thousand and eight
and twenty and ten, we kindof uncovered a few major issues. We
entered into this research with, youknow, the general kind of like,
well, I know why African Americansdon't learn how to swim, It's because

(26:25):
of X or Y or Z.And it's like, well, you know
that's fine, and you know,we'll ask a bunch of other people to
make sure that that's a pretty solidpossibility. And so we included a lot
of those maybe this is an issuekind of situation in the two thousand and
eight survey. And what we cameup with out of the two thousand and

(26:49):
eight and then verified it with thetwo thousand and ten study was that really
the major problem was fear of drowning, and especially with the underserved communities.
Underserved children, and that became afactor because their parents told them to stay

(27:11):
away from water because their parents didn'tknow how to swim. Yeah, and
that is something that as a WSI, I remember watching great fear of parents
sitting in the bleachers watching their kidslearning to swim because they were helpless.
They couldn't if they saw their childgo underwater, there was you know,

(27:33):
probably no way they could save thatchild because number one, they couldn't swim
and they wouldn't get there in time. So it was a there's a big
fear factor with drowning an injury,especially in the underserved Black communities, Hispanic
communities, and it's really just apervasive legacy of fear. Yeah, I

(27:59):
can tested that and just in myown experience and you know, as I
say and equals one, I'm justone observation. But there's there's a cultural
component for sure, absolutely. Andyou know, as a as a youth,
it never even dawned on me thatswimming would be something fun to do

(28:23):
as a black kid growing up.It was I was concerned with basketball,
and I was concerned with football.You know, these are the things that
we did because we were good atit well, and it was fun.
It's fun yeah, and um,where as swimming it can be fun too,
but it's also I think a lifeskill. I think every every child

(28:45):
should learn how to swim, verymuch like every child should learn how to
cross the street, right exactly.Yeah and yeah, And then there's that
cultural component, so sure, um, and the other thing is and well,
we can talk about it later abouthow money comes into play, time

(29:10):
comes into play, right because lifeRed Cross has a program, YMCA has
a program, but those programs arenot free. And then how how how
does that play into it? SoI want to get into that at some
point. Um, But before that, Uh, let's talk about the the
research in the May twenty twenty study. How did how did you build off

(29:37):
of all of the previous work thatwas done in two thousand and eight,
twenty ten? Uh, and um, what was the aim and and how
did this qualitative report build off ofthe previous work? And then if you
can comment on what are the limitationsif there are any? Sure the twenty

(30:00):
seventeen study was USA Swimming came tous and said we want to check,
we want to check to see howunderserved and at risk youth are dealing with.
Uh, you know, the informationthat was gleaned in twenty ten and
plus on top of it, USASwimming wanted to check their own programming.
You know that they had put alot of money in from donors to teach

(30:25):
um, you know, kids thatneeded to to learn how to swim.
So that was one part of it, but they also said, we want
to check also middle income rather thanjust low income. We want to check
to see how they are learning howto swim. That group is handling the
situation. And it was very fascinating, uh to compare the middle income or

(30:48):
upper income there was it was alittle bit above what median income was was
our groups that we were able toget and compare them to the lower income.
And you know, they were takingtheir babies into the water and dunking
them and you know, getting themto learn how to swim at a very

(31:11):
very young age and trying to matriculatethem into a swim team. So their
pathway into learning how to swim werea lot different than others. So it
was kind of fascinating. And tobe honest with you, that's how I
taught my children to learn how toswim. I took them into the pool

(31:33):
when they were infants and blew ontheir faces and dunked them down underneath the
water. So but that that's becauseI was a WSI and I had learned,
you know, other kind of techniquesto teach very young kids. So
so obviously kids middle income and up, we're learning how to swim. So

(31:53):
there was a huge income factor thatwe kind of uncovered with that situation.
Situation in regards to comparison, weknew there was an income issue from the
twenty and ten but just talking topeople in focus groups, it was the
truth comes out in focus groups andit was just completely revealing, so that

(32:19):
it was a good check. Andwhich cities were involved in the focus groups.
The cities in twenty seventeen were Houston, Las Vegas, Jacksonville, and
Memphis. We had a little bitof Los Angeles, but they kind of
backed out towards the end. Wehad some surveys that the focus groups were

(32:39):
those four cities Houston, Las Vegas, Jacksonville, and Memphis and okay,
and so then you have a setof questions that and then you and you
posed those surveys to do did theyknow what the this study was about?

(33:01):
For instance, is it blind tothat or is you do you did you
talk to the the survey participants onwhat the study was about. Right.
What we did is we would goto each city and we would train YMCA
UM staff to do the survey distributionand collection on their own. So we

(33:25):
told them to go ahead and tellthem it's we're trying to learn more about
swimming and um what people go throughand do they continue swimming and so they
were very honest about it, UMand they were very good about it too,
and we trained them in regards toif someone feels like some of these

(33:47):
questions are too sensitive, to justsay skip that question or if you want
to stop, you can stop um. So, and really the only sensitive
part on the surveys were basically designatingwhat racial category you fell into. But
we also gave them options to notcheck the box but then describe, you

(34:13):
know, what your racial description ison your own part if you want to.
So we had we ended up with, um, let me see,
I think about fourteen hundred surveys fromjust those four cities, which was amazing.
The YMCA staff did a great jobof being able to get as many

(34:35):
as they could, which is great, right, And so you have the
scale here and so imagine a youknow, a sort of what they call
a a Liard scale. You know, so on one end of the scale
you have I avoid getting near slashin water other than to bathe, and

(35:00):
and all the way at the endof the scale is I can swim many
lengths without stopping on a swim teamor could be on a team, or
could be on a swim team,and then there are many points in between.
So that I think is a helpfulway to do it because oftentimes when

(35:20):
you ask, so when can theyswim? Their definition of swim is different
from yours, right right? Iremember vividly in Houston in the two thousand
and eight study Houston, we didrerid did I'm sorry, were repeated Houston,
just to kind of check too,to see if it was similar,
which it was, which was good. But in the two thousand and eight

(35:44):
study, I can remember going intoan after school care and a middle school
that the YMCA ran, and thestaff member we just kind of sat in
the back and the staff member said, Okay, we're gonna do it about
swimming. How many if y'all canswim? And everybody raised their hands,

(36:06):
and she did a great job.She said I know you can't swim.
I know you can't swer. Shestarted pointing out at all these people that
had raised their hand, and shesaid, there's there is a breakdown of
levels of swimming in this and youhave to be honest. You have to
promise me that you will be honeston this and tell the truth on this

(36:27):
survey. So, yes, you'reright, everybody thinks they can swim,
even if it's just splashing around inthe shallow land. Yeah. What what's
some of the other limitations in this? I can't think of many, but
if you have a swimming scale forthem to gauge themselves, and I think

(36:50):
the other only you mentioned it,they there's some questions that someone may prefer
not to answer. I can't seemany many other additional limitations. Yeah,
there, it was pretty easy.It was survey research UM. And like
I said, we were very opento like, you don't want to answer

(37:13):
that question, don't answer it,but we encourage you to keep going UM
and finish up the rest of it. UM. And we tried to encourage
them about how there there's an umyou know, overabundance of drownings that occur
in certain communities and especially communities ofcolor, and we want to stop that.

(37:37):
We want to figure out how torespond to that by you know,
getting kids to learn how to swimrather than just never learning how to swim
and be at risk. So,um, we tried to you know,
get the staff as well as wedid. We did a lot of surveys
in Memphis in a few other places. Um, so we tried real hard

(37:59):
to make sure that we just wantto find out, you know, how
you feel about swimming truthfully. Justhave to be truthful, right, So
it says in your report. Overthe years, most swimming performance results change
for the better. Including all participants, approximately sixty one point four reported no

(38:20):
or low swimming skill level. Intwenty ten, results from the most recent
studies showed that forty nine point threepercent of the sample indicated they had no
or low swimming level. So thatdropped overall, which is good. But
then when you look at specific racialor ethnic groups. In twenty ten,

(38:43):
the no or swimming levels for AfricanAmerican children or a sixty eight point nine
percent as compared to sixty six pointfive percent from the twenty seventeen sample.
There wasn't improvement there there exactly,So not much improved. That means that
over two thirds, uh, approximatelyclose to two thirds of of African American

(39:12):
children report low or no swimming ability. And that is a staggering number.
It is. And um, youknow, I was happy to see that
it improved it, you know,compared to the two thousand ten study.
But um, and it improved onalmost all categories, which we told USA
swimming, this is good. Yourprograms are working. You know, you

(39:35):
just have to be patient. Andum, you know we work in other
you know, other communities that needhelp too, So UM, they were
pretty happy with that. But you'reright, you think that every child should
learn how to swim, you know, in the UM make Believe world.
I guess right, But have vanuagesgot to keep working towards That link is

(40:04):
in the show notes to that fullepisode. I wasn't surprised at that episode
with doctor when received a lot ofattention. I think this question of why
we don't see black swimmers is asmaller subset of a larger conversation happening about

(40:34):
disparities and the reason that the disparitiesexists. As doctor Irwin said at the
beginning of the clip, when wedo empirical evaluation and scientific study. We
try to stay away from the beliefsof Oh I know for a fact why

(41:00):
this is the case. It's becauseof, as she said, X,
Y, and Z, this highlyspeculative pull towards feelings and beliefs, and
those can be helpful too. Allscience starts with some form of hypothesis,

(41:22):
and as she said, we definitelywant to look and evaluate those hypotheses.
But then we come to how dowe understand better where the issues lie?
And to do that we take afundamental empirical approach in order to try to
evaluate and quantify what we can inorder to draw conclusions. And in my

(41:49):
empirical and science centered mind, that'sthe best way to go about trying to
understand it and perhaps trying to comeup with actionable ways that you can turn
the disparity around. So I'll tellyou a story I once got it.

(42:10):
A few years ago. I gotinto a conversation with a fellow swim coach
in a social media swim coach group, and the guy, a white guy,
basically said, well, I knowwhy this disparity exists. It exists

(42:35):
because back in the forties and thefifties, in that era, black people
weren't allowed in swimming pools, andso that created a sort of reverberation that
exists all the way to today.And he was speaking with such brazen confidence,
which, by the way, hisclaim is is a true claim.

(42:59):
We can go verify this claim,but the claim doesn't say much when black
people were prohibited from doing quite alot of things, including playing basketball,
baseball, and football. So,needless to say, I'm highly skeptical at

(43:22):
broadbrush, widespread, catch all claimsthat basically just appeal to emotion. So
I did challenge his assertion and caveatedwith you can't exclude the possibility that was
factor. I mean, all thingsare usually multi factorial. But this is

(43:45):
the error that we are in.We're in an error of speculation, appeal
to emotion, appeal to even controversy. What doctor Irwin and her fellow researchers
have showed us with they're highly evaluativeand empirical approach. Over more than a

(44:06):
decade researching this issue. What itshows is that it's much more complicated.
It has to do with cultural preferences, beliefs about swimming fear, it has
to do with there's a monetary Absolutely, there is a monetary component, So
you can absolutely make some quantifiable justificationsthat might lead to some socioeconomic underpinnings.

(44:35):
And like I said, I canoverlay all of the empirical research with my
admitted and equals one personal anecdotal experiencejust by growing up as a black kid
in a black community. I hadno interest at all in swimming. My
sports were basketball, football, andtrack and field. I did them because

(45:00):
I wanted to, they were fun, I was good at them, or
I thought I was good at them. But those were also the cheap things
that cost nothing to go to thecourt and play basketball, or to run
or to throw a football around.So there was absolutely in some form of
economic factors when you don't have money. Now, if my mother, say,

(45:23):
was an avid swimmer or grew upas an avid swimmer, yeah,
maybe perhaps that may have rubbed offon me. Doctor Irwin's research and survey
results I definitely think supports this.I just think we cannot discount the power
of cultural preferences, whether it's basketball, hockey, football, lacrosse, or

(45:49):
figure skating. And again I toldmy story on this podcast. I started
swimming somewhere around the age of thirtyand I started swimming just because I wanted
to do something called the Ironman triathlon, walked into a local YMCA and start
taking lessons. And that's the sameYMCA that I ended up going back and

(46:15):
setting a Guinness World Record for theindoor iron Man. I became a master
swim coach and lifeguard, waterfront lifeguard, water safety instructor, all certified with
the Red Cross. So the lessonthat I draw from this is first thing,
if you didn't grow up swimming,it's not a lifetime swimming death sentence.

(46:42):
You have enough time to become areally good swimmer. Second, for
non swimmers, just walk into alocal YMCA and take a beginner swim course
and learn how to swim. It'sa life skill. Even if you're not
training for a triathlon. I thinkyou should learn. And I'm talking about
real swimming, talking about horizontal bodyin the water, face in the water,

(47:07):
rotary breathing, consistent kick and strokingfor fifty two one hundred and fifty
yards without stopping. That's swimming,not the stuff that you do at the
beach. And finally, get yourkids into swimming early lifeguards you start at

(47:30):
age sixteen. If you get yourkids into swimming early they can become lifeguards
as a side job. Early andYMCA Red Cross both have programs that start
as early as six months all theway up until swim team, and then

(47:52):
even if you don't have the financialmeans, there are grants and scholarships from
YMCA and Red Cross. I willcontinue to look at whether or not new
empirical evidence from doctor Irwin's team ofresearchers and other researchers shed any more light

(48:15):
on this and see if the statisticsare turning around because the drownings and underserved
populations young and old have to improve. Let's go on to the next clip,
Episode forty five, The Endurance Enthusiast'sHeart. The conversation with Professor Graham

(48:42):
Stewart. He's a congenital heart cardiologist, and we had a conversation, broad
conversation about a number of different things, including what's happening with the endurance athlete's
heart during an actual endurance event.That was an interesting description. But this

(49:07):
clip here is from our discussion aboutthe impact of consistent endurance training and racing
on an endurance athlete over a longtime. Every couple of years some article
comes out about this, so Iasked him about that, and I asked

(49:30):
him about sudden deaths in endurance events. A few times a year an athlete
will die in the triathlon, usuallyin the swim, and I asked him
about that, the underpinnings of someof the research behind why it happens.
And he even offers his expert adviceon some of the wearable technology that detects

(49:57):
things like atrial fibrillation. So let'stalk now about the long term effects of
training endurance exercise like marathons, Ironmanjust to triathlons, and then the training
that comes with it. In everycouple of years, I see some articles

(50:20):
from you know, different cardiology departmentsabout the adverse effects. So I'm wondering
now the has the evidence changed.What is the collective body of knowledge from
cardiology saying about the long term effects? And can we can we understand any

(50:44):
sort of threshold of lifetime training thatis either good or bad. Well,
I mean, the first point tomake, Tony, is that there's absolutely
no doubt that taking part in exerciseis good for your health. So it's
easy to carry away with the downside. And there are some downside, but

(51:06):
by and large they're overwhelmingly swamped bythe benefits. So you reduce your lighthood
of bull cancer, breast cancer,you reduce your light of heart attack,
you reduce your lighthood of dementia,a whole host of prove your mental health,
a whole host of things that areactually very very good. The question

(51:28):
I suppose is, first of all, what does exercise do well. It's
there's a specific effect in the heart, but it also affects other areas of
the body. So from the cardioof ascar standpoint, there's the heart itself,
there's the blood vessels, and there'sthe skeletal muscles. And the skeletal
muscles become more efficient if you exercise. So there's the little energy producing organs

(51:52):
called mitochondria and the skatal muscles,and if you exercise, they become bigger
and they become more numerous, andso research a lot of that is people
whose hearts are maybe two chambered ratherthan four chambered, they're not going to
get better, but if they gettheir scratal muscles more efficient, they'll be
able to do more with the sameheart. So big scratal muscle benefits,

(52:14):
blood vessel benefits, and when yougo up, run up the stairs,
your hands and feet get warm.That's because the blood vessels dilate, and
by regular exercising they get better atdilating that the vessels are less stiff.
Now all our blood vessels get stifferas we get older, So exercise can
preserve the youthfulness of your blood vesselsif you like, which is a really

(52:37):
good thing. From the heart itself, one of the things you'll notice for
people, particularly doing in endurance exercise, they tend to a slower heart rate.
And the reason there's several reasons,really, but the output of the
heart is calculated by looking at theheart rate and looking at what's called the
stroke volume, which is the amountof blood pumped out for every heartbeat.

(52:59):
And there's the heart gets bigger,it doesn't need to pump out so frequently.
It slows, and it does thatthrough a couple of mechanisms, one
of which is increasing vegal tone,which is the vegas nerve that slows the
heart rate. So if you geta whole bunch of endurance athletes to sit
down, you give them a lecture, get them all to stand up,

(53:20):
quite a few will feel dizzy,and that's a very very common phenomenon in
endurance athletes, and that's because theheart rate takes a while to get speedback
up again, and that's mostly vegaltone. But also we've learned a lot
recently that there's a thing called downregulation of the funny channels of the heart,
the IKF channels, and that's whysome extreme endurance athletes, maybe the

(53:45):
Tour de France cyclists, may haveheart rates in the high twenties or low
thirties, and that's down regulation ofthe of the IKF channels. So these
are the main consequences of normal physicallogical consequences of training. In terms of
adverse effects, one of the fewadverse effects and endurance exercise is an increased

(54:07):
risk of a rhythm called at realfibrillation, and that's where the top chambers
of the heart goint are very rapidirregular rhythm. And that's four or five
fold increased in long term endurance athletes. Wow, it's it's a it's a
very common rhythm. As you gettold er anyway, it was something one

(54:29):
percent two percent of sixty year olds, you know, five percent of sixty
five year olds, ten percent ofseventy year olds have this sort of rhythm,
but it's higher in endurance athletes.And there's many, many potential explanations
for this, but it's it's certainlyis true. It's the case that is
that translate into something actionable for theendurance athlete as far as its first training,

(54:57):
it's concerned. Right, So youknow, average recreational athlete or even
slightly competitive athlete, Yeah, youmight train. If you're training for an
iron man, you might. Youmight train, you know, in a
week, you might you might trainmaybe an hour a day, or maybe

(55:21):
a couple of hours a day ifyou're really competitive. Is there any sort
of upper upper limit to training.A professional athlete might do several hours a
day. So but then I guessalso it might come down to time,
right, if you're a professional athlete, you might only do that for maybe

(55:45):
six years, six to ten years. I'm trying to figure out the magnitude
of training to where it might becomemore adverse than than not. Well,
there is a sweet spot in termsof cardiovascular mortality or all cause mortality.

(56:07):
The sweet spot is round about tenor eleven hours a week, So there's
a U shaped mortality curve. Soif you're doing nothing, then your mortality
is right up there. As youdo more and more exercise, it keeps
falling until you're doing round about tenor eleven hours a week. Once you
go past that, it starts toclimb again slowly, so by the time

(56:30):
you're doing twenty one hours, it'snowhere near as high as if you were
completely sedentary, but it's higher thanif you're doing ten or eleven hours.
And again the reasons for this arenot entirely clear. That's an observation,
an epidemiological observation, but atrofibrillation mightbe one component of that, and the

(56:52):
way they're an etrofibrillation. Usually it'ssomething that affects middle aged and athletes rather
than younger athletes. It's rare andyoung athletes. It affects particularly the bigger
athletes. There's a relationship with bodysize, so the taller you are in
more like you are to get atrofibrillation. And there's also a genetic element.
If both your parents have had itand you're an endurance athlete, you have

(57:15):
a significantly higher chance of getting it. And a lot of the you know,
things like the Apple Watch and theSAMs I watched, the ECG watches,
one of their modalities is to pickup atrofibrillation. Yeah and so yeah,
so apple Watch has this. There'sone called Cardia that I that I

(57:37):
use in the outside. It willdetect different rhythmias, something called Brady cardia
and Techer cardia. So do youthink that these are effective effective tools from
a cardiology at standpoint? A yeah, I mean there's some If it costs

(57:57):
you thirty pounds, you get itfrom the internet. It will not work.
The ones like Cardia You've mentioned theApple Watch, as Samsunger's Fitbit,
they all have a they use verysimilar technology and they work. You've got
to be careful in the interpretation thatthey will give you automatically. So,

(58:19):
I mean I use them a lotwith athletes, and quite often I'll recommend
athletes get them. You if somebody'shaving intermittent flutters of the heart rate and
it's only when exercising, one ofthe best ways of documenting that is to
have a Apple Watch charge five bandthat that monitors atrofibrillation and then you can

(58:42):
actually store a PDF of the rhythm, not not just the heart rate,
but the actual rhythm and send itto your cardiologists and they can confirm it
but so I test all these deviceswhen they come out to see if they
work, because when athletes come tome with it, I like to see
what the accuracy is. And soI am currently using the Charge five and

(59:04):
it's automatically an analysis of my rhythmalways says inconclusive. And that's because it's
below fifty a minute because I've donelong term durance exercise. That doesn't mean
it's abnormal. You just see inconclusive. So an I think that relies solely
on the algorithm to know what itmeans. May think they've got an abnormal
rhythm, but as that would bean entirely normal rhythm for somebody doing a

(59:27):
lot of exercise, right, Okay, So yeah, that's a good sign
that these this arrible technology is working. It's giving at least good information that
you can supplant with actual doctors recommendations. And so how about we talked now

(59:49):
about so periodically interesting you know,whether it be triathlon or marathon events,
we will see athletes will suddenly diein an event, and triathlon it's usually
during the swim. But it's nota lot. It's not a lot.
We're not talking about big numbers peryears have been looked at the numbers lately,

(01:00:14):
but periodically you'll hear about it.And when when this happens, do
we know generally what the cause isit? Maybe it's adverse reaction from atrial
fibrillation or some other pre pre existingconditions. Do we know generally when this

(01:00:38):
happens, why it happens? Yeah, I mean, first of all,
atrial fibrillation is unlikely to cause suddendeath, which is good news. It
can cause other things, the worstof which is strokes, but by and
large be unlikely in itself. Thevast majority of people who die suddenly in
that context have an undetected, unsuspectedunderlying heart problem. So it might be

(01:01:05):
an electrical problem, it might bea structural problem. There's so called cardiomyopathies.
Fancy doesn't work, but that's oneof the common causes. So that
and that is the rationale for doingpre participation screening. So it's certainly in
the United kindom every United footballer getsa professional contract will have an ECG and

(01:01:29):
an echo cardiogram, and the ideais to pick up the detectable conditions that
may prove dangerous on exercise. Theproblem with the pre participation screening is it
doesn't pick up everything. So lastweek we had a British football and the
card arrest on the football pitch andhe will have had several screens, so

(01:01:52):
it's not perfect, but usually it'sdue to an undetected underlying heart problem.
For the older athletes, heart attacksyour coronary archer disease are quite an important
cause. And there is genetics versusenvironment. And if you've got if your

(01:02:14):
father and your uncle had a heartattack at age forty two, even if
you're an unsmoker and you had yourchless or check, you are then at
increased risk of a heart attack.Exercise will reduce that risk, but it
won't necessarily you'll remove it completely.And James Fix the famous Injured's runner,

(01:02:34):
he tragically died of a heart attack. Yea being a long term marathon runner
and that can happen. Yeah,And it is it fair to say that
if you've done events many events,I mean athletes will have race histories where

(01:02:55):
they've done many marathons, many ironmen. Is it fair to say that
if you've done those you would haveexposed something if it were if there was
a problem. Okay, is thatnot a batually that's not always true.
So for example, I mean,if again, if I look at the

(01:03:16):
soccer world, you know, we'vehad famous soccer players who've had character ESTs
having played professionally for twenty years.Yeah, it's not always true. And
what's difficult sometimes is to tease outwhat it was specifically about a particular game,
a particular event that made it worse. There are some guidelines though,
So for example, if you arefeeling unwell, if you've a viral type

(01:03:40):
illness, if your muscles are achy, you should not go out training.
And that's because some of these virusesaffect the heart muscle and you won't be
aware of that, particularly the onesthat called stomach upsets, and so that's
why you shouldn't. You shouldn't trainwhen you run well. Um, there's
there's other actors. So for example, some of the stimulant drinks that are

(01:04:04):
marketed to improve endurance, you've gotto be very careful of them, particularly
if there's lots of caffeine because andthey're banned in some countries like Germany for
example. Appreciate an abnormal heart rhythm. This was a very popular podcast in
the season five. I would highlyrecommend you go check it. Out if

(01:04:27):
you haven't listened to it already.Professor Stewart was the perfect one to have
this conversation with. He has sucha broad research agenda in cardiology, but
also he himself is an endurance athlete, ironman, distance triathlete as well as
a runner, an accomplish a roweras well. So this is a topic

(01:04:50):
that you know, not only asa coach I'm interested in, but also
as an athlete. Right so,as you approach middle age and your race
count is climbing and climbing, youknow endurance athletes of all stripes who want
to continue to do these activities intolater ages should keep an eye on the

(01:05:16):
research and the technology in this space. At the same time, we don't
want to have too much of analarmist perspective. Like Professor Stewart said in
the clip, the benefits of exerciseover the long term far outweigh the risks

(01:05:38):
of endurance exercise over the long termand the likelihood of some pre existing condition
not being caught and someone has afatality fatality during a endurance event. Those
are minuscule numbers compared to the millions. Really tens of millions of people complete

(01:06:00):
these events every year and do themwell into their fifties, sixties, and
sometimes seventies and eighties. As theendurance events are getting very popular or have
gotten very popular over the last fewdecades, cardiologists now have big data sets

(01:06:25):
to look at and evaluate. Manypeople were captivated by Damar Hamlin, the
Buffalo Bill's safety who had to haveCPR done after suffering a cardiac arrest right
in the middle of a Monday nightfootball game on national TV, and so
that issue really duck with a lotof athletes of all stripes. People start

(01:06:49):
to say, yeah, well,maybe I should talk to my doctor and
just have some tests done just tomake sure. I have a primary care
physician that I had for probably overtwenty five years. In addition to her,
I also have a cardiologists and she'sone of the best cardiologists in the
country. And that's under the contextof there's absolutely nothing wrong. That's the

(01:07:13):
common misconception that there has to besomething quote unquote wrong for you to go
and get tests and check the story. Right, I have a marathon count
nearing a hundred already, and it'sjust something that you do as a precautionary
measure as you cross certain life thresholds. Recall what Professor Stewart said about the
U shaped mortality curve. As youstart to exercise, mortality rate begins to

(01:07:40):
drop, but then when it bottomsat ten to eleven hours, it starts
to creep back up again. Andsome people actually call it a J mortality
curve because the mortality never really climbsback up to levels where you were completely
sedentary. That's why some people callit a J mortality curve. And so

(01:08:02):
that's the value proposition of exercise generally, but it's something to keep an eye
on. I did get an AppleWatch, and I got one just because
of the feature where you can doan ECG and you know, these wearable
technologies will detect atrial fibrillation. Soon that note, I feel that it's

(01:08:25):
valuable to get. I still trainwith garment, but you know, some
of these new wearable technologies do havepotentially critical detection mechanisms. As you heard
from Professor Stewart. I mean,nothing can replace your primary care physician's advice
or your cardiologists advice. But ifthese tools can give even one small added

(01:08:53):
information benefit that you could share withyour doctor or cardiologists, hey, it's
worth the money. Okay, let'smove on to the next clip. Episode
forty seven The Pseudoscience of Sport,Health and Fitness with Professor Nick B.

(01:09:14):
Tiller. He's a senior researcher inexercise physiology at Harbor UCLA and the author
of The Skeptics Guide to Sports Science. This was a great episode. I
highly recommend you pick up Professor Tiller'sbook, and we talked about his book,

(01:09:39):
and it's one of those books thatI will continue to recommend and even
give as gifts. I told himon the podcasts, so we talk about
unproven claims that are pervasive in healthand wellness. He was the perfect person
to have this conversation with. Notonly is he a PhD an authority on

(01:10:01):
physiology and patho physiology, but he'salso an endurance enthusiast, an ultra marathoner
as well as an Ironman triathlete.So let me just play the clip.
It was hard to pick out justone clip, but this one was on
popular alternative therapies that athletes take up, like acupuncture, cupping, and so

(01:10:32):
on. Probably know a lot ofpeople in the endurance community. You tell
an endurance enthusiast that something will willwork or decrease their time by a minute
or two. They will, themoney will be burning a hole in their
pocket to pay for it. Andit doesn't have to have any evidence.

(01:10:54):
They just need to believe that it'sgoing to decrease their time by a minute
two minute, so it's going tohelp them recover faster, or so on
and so forth. And when thenthe Michael Phelps thing happened, when he
gets on you know, the onTV and international Olympic competition with the circle
the broken blood vessels in his back, I said, oh my goodness.

(01:11:16):
Well, and actually we did ananalysis of this and looked at the Wikipedia
page hits the traffic to the Wikipediaentry on cupping therapy, and before Phelps's
appearance at the twenty sixteen Games,it was kind of trucking along, maybe
fifteen hundred hits a day, andthe day after the Olympic finals it spiked

(01:11:40):
well over one hundred thousand. Everybodywanted to know what cupping therapy was all
about. And you know, you'dhave seen it yourself. It was feature
on the news in magazines. Whatare these big purple circles on Phelps's shoulders?
And now you see all sorts ofswimmers and different athletes trying this thing
despite the fact that it's not evidencebased, and it just goes to show
the people the the perception of somethingworking is more important than the evidence,

(01:12:04):
as long as it's good enough ofPhelps and it's good enough for everyone else.
Yeah, let's step into that now. Since it came up and the
talk about posebos, acupuncture, cupping, um, these are all cam compliment
what they call complimentary alternative medicine.Now, you can give me your thoughts

(01:12:30):
on where this came from. It. It's my understanding that the sort of
stem from the same idea of CHIor sort of an ancient pranac. Sure
help us unpack what what it isand some of some of the what you've
talked about, the harmful, potentiallyharmful parts or unethical parts of it.

(01:12:56):
Yeah. Sure. There are alsodifferent sort of subcategories of I guess the
umbrella term would be alternative. Iguess the umbrella term would be placebo medicine.
You have alternative medicine, complementary oralternative therapies, complementary and alternative medicine
you refer to energy medicine. Thisidea that there's some kind of energy that
ancient Chinese concept of chi, whichis energy flow, and a lot of

(01:13:19):
the complementary and alternative medicines or camsare based on this idea of energy medicine,
So acupuncture, for example, theoriginal incarnations were based on this idea
that there are meridians in the bodywhere energy flows, and if you get
some kind of ailment or saunas orpain, it's because one of these meridians

(01:13:39):
has been blocked. So you wouldput unity to the acupuncture site to help
the energy to continue to flow.Chiropractic is not an energy medicine. It's
not an ancient Chinese medicine. Isactually much more recent than that. It
was developed in the sort of midnineteen hundreds, and that is supposedly based

(01:13:59):
on more or modern thinking, butit's still it's still a sudis. It's
what we call a pseudoscience because it'sum it takes sort of it sounds scientific,
and it's it's sort of mimicking scientificprinciples and the scientific method, but
actually it doesn't hold up to scrutinywhen it's when it's explored in more detail

(01:14:21):
and other things like other energy medicines, for example, would be raiki or
healing hands, which is what misterMiyagi was very very good at in the
Karate Kid. You know, hewould put his hands together. Yeah,
and it's this is all based onsort of ancient Asian medicine. So there
are lots of different subcategories. Wecan't we wouldn't be able to cover them

(01:14:44):
all, but very broadly they canall be considered pseudosciences because they are subverting
normal practice. They are impersonating realscience, claiming to be evidence based,
but actually any scientist who is worthor her saults will know very quickly that
this stuff is not the real thing. Right, Yeah, that I see

(01:15:05):
this. I've seen this so muchover the years. Acupuncture, acupuncture,
dry dry needling. My response isalways it doesn't have any strong empirical evidence.
If you want to do it becauseyou think it feels like a massage
and it makes you feel good,maybe there's some second order effect like it

(01:15:27):
reduces stress hormone. Maybe, butI have to have to be honest and
say it might be speaking to athletesthat it doesn't have strong empirical foundation.
And an acupuncture is an interesting onebecause, as I said, the original
incarnations were based on energy medicine andblocked energy meridians. But it was decided

(01:15:49):
a little while ago that these theseprinciples are sort of outdated and don't really
conform to the modern world where youknow, we've got access to so much
information and people weren't so much interestedin energy medicine. So then they came
up with dry needling, which iswhich is acupuncture. Proponents attempts to basically

(01:16:10):
bring it into the new age,try and make it sound more sciency,
but essentially it's the same practice it'sand again the evidence for dry needling is
very weak. There are hundreds andhundreds of thousands of studies that have been
looking at the effect of acupuncture,and there's a lot of noise in the
data, but when you look atthe better, more well controlled study,

(01:16:31):
the effects are nondistinguishable from placebo.And people always come back with the idea,
well, it worked for me.I went and tried it, and
I felt better afterwards. Yeah,And this is a fallacy called post hoc
ergo prop to hearget. It's aninformal logical fallacy. It's that it's in
its base form and it's most basicmanifestation. It's you know, you have

(01:16:55):
an ancient tribe and it's and theygo out and they do a rain dance
around a fire, and then thenext day it rains. I assume that
the dance has caused the rain.Well, maybe it would have rained anyway.
So it's the assumption. The correlationis the same as causation. And
right again, it's it's about understandingbias and how how we're likely to commit
it, right, And I've seen, well two ways I've seen them test

(01:17:17):
acupuncture. One way is with asort of randomize where they put the needles
right, So so the so calledexpert will say these other where the meridians
are and say, okay, we'lldo a control where we'll just stick them

(01:17:38):
in random places. That's the controlbecause if if the meridians were true,
you would you would get something verydifferent, different results if you just randomize
and put them in any random place. That's one way they tested, and
that didn't really show any difference,right, So that's the control. The
other The other way was what it'scalled sham where the the it all sort

(01:18:00):
of retracts at the last minute,or the needle gives the indication that it
goes in, but it doesn't reallygo in. It just sort of retracts
at the last minute. And ifthat's the control So if if in fact
you saw something different or that controlgroup where the needle doesn't go in,
that would be very interesting. Butit also similarly there was no difference,

(01:18:24):
right, Yeah, And that's that'sthe essence of good science is if you
have these good placebo controlled studies,all they call them sham controlled, as
you just alluded to. And sothe listeners have to understand that it's very
easy to give a group of peopleacupuncture, ask them if they feel better,
and they say, yeah, Ifeel better because you're not controlling for

(01:18:44):
the placebo effects. Okay, well, if you get two groups of people,
you give one group acupuncture, yougive another group acupuncture, which is
exactly as you've said. It feelslike acupuncture, looks like it, but
actually it's the needles are placed inthe wrong place, or the needles are
attracted at the last second. Andin those better controlled, more high quality

(01:19:04):
studies, there's no difference between thetwo groups because you're accounting for the placebo
effects. And when you have anend of one, you have one individual
who's getting act function, they feelbetter you're not accounting for placebo, You're
not accounting for the expectation and belief. So that's why controlled scientific studies are
so important. Link in the shownotes to that full episode. We get

(01:19:28):
into some conversations about just about allof the most frequent myths of the health
and fitness industry. Now, ifyou take a look at social media these
days, the concophony of silliness that'sout there is just mind bending. The

(01:19:55):
frequency of all of the armchair expertsare just numerous, and much of it
from people with no qualifications or expertiseor real expertise. So this podcast was
just in the nick of time.So if you're an avid listener of this

(01:20:17):
podcast, I know I'm pushing atan open door. You all know that
I am scientifically centered. So I'vealways said that training, recovery, nutrition,
athletes, psychology, everything that youdo related to fitness, health and

(01:20:40):
wellness, all of it has tobe it should be grounded in the best
science available. Why, because weknow science works on average. The clip
underscores why it's necessary to do scientificresearch, empirical research to make sure that

(01:21:02):
what you're subscribing to has efficacy beyondplacebo. Effect, and the common retort,
well, I know that for afact that it worked for me.
Well, you're a sample size ofone, and so you can't really say

(01:21:24):
that you know at certainty that somethingworked. Something has to be put through
rigorous scientific study with samples large enough, with control groups, and the gold
standard is double blind, randomized,placebo controlled trials to get high quality understanding

(01:21:49):
of whether or not something has efficacy. So sometimes people say, look,
you know, what's the big deal. If it works, I think it
works for me, even if it'sa placebo effect. I go off and
then I get my placebo effect.No harm is done to anyone, perhaps,
But the flip side is people,because of this seducing down the pathway

(01:22:18):
to alternative medicine, they forego traditionaland potentially life saving medicine. We recently
mourned the death of Tina Turner,a world icon. She lived to be

(01:22:38):
eighty three years old, so shelived a pretty long life. But she
had an interview this March and essentiallyshe had to get a kidney transplant and
she was plagued with lifelong hypertension thatwas left untreated. Why is this relavent

(01:23:00):
to the topic, Well, you'regoing to find out very quickly when I
read People magazine article that came outafter she passed away on May twenty five,
twenty twenty three. This is TinaTurner talking in the interview. She
says, I can't remember ever gettingan explanation about what high blood pressure means

(01:23:21):
or how it affects the body.She said, I considered high blood pressure
my normal hints I didn't really tryto control it. With her condition left
untreated, Turner suffered a stroke intwenty thirteen, and that's when she learned
her kidneys didn't work that well anymore. She began taking prescription medigation to get

(01:23:45):
her hypertension under control, though thepills made her feel even worse. She
took matters into her own hands andwent to a homeopath doctor in France.
Later, during her next checkup,the results were shocking. I had not

(01:24:10):
known that uncontrolled hypertension would worsen myrenal disease and that I would kill my
kidneys by giving up on controlling myblood pressure. She said. I never
would have replaced my medication by thehomeopathic alternatives if I had had an idea

(01:24:31):
how much was at stake for methanks to my naivete. I had ended
up at the point where it wasabout life or death. She continued,
So this recent example, and thisis just one example of how one can

(01:24:51):
get seduced down the pathway and whythe answer to the question of hey,
what's the big deal is so important. She lived at b eighty three.
She lived a long life. Maybewe would have had her for another decade

(01:25:12):
or two. Maybe she would havelived a life with less suffering as a
result of the renal failure. Wedon't know, and we don't know why
she never got good advice about therisks lifelong risks of hypertension. But we

(01:25:34):
do know that somewhere along the wayshe was convinced that homeopathy alternative medicine was
a good idea when we know thathomeopathy is a scam. There is no

(01:25:55):
active ingredient in the homeopath remedy.If you listened long enough, you've heard
me say, I think alternative medicinethat's backed by strong empirical evidence has a
name. It's called medicine. It'sfunny. People never go to an alternative

(01:26:19):
car mechanic, or fly on theplane from an alternative pilot, or if
they're in legal trouble, go toan alternative lawyer. The scientific method is
the best tool ever devised for humanitybecause it works on average. Use it

(01:26:41):
and stay away from the concophony ofscams out on social media from armchair experts.
Okay, let's finish up with thelast clip, Episode forty nine.
Coaching the endurance athlete Doctor Susan Sortier. She's a endurance sports coach with Breakthrough

(01:27:06):
Performance Coaching. She has a PhDin sport physiology and exercise psychology. She's
also an assistant professor at Springfield College, former competitive college swimmer, ironman triathlete,

(01:27:26):
so she's got a wealth of notonly qualifications, but hands on experience.
The clip that I chose is aboutthe female athlete and the effects that
menstruation, menopause, and perimenopause haveon the female athlete in the training cycle,

(01:27:47):
as well as things like nutrition oreven things like race planning and race
scheduling. I put a brief audiogramof this exchange out on social media and
people were just drawn to it.So I'm going to play that clip and
then I'll come back with some comments. It's been over the last few years

(01:28:10):
heightened awareness around this show you know, there was a book written a few
years ago by sports physiologists Stacy Simms. She wrote a book Roar, and
it basically created sort of heightening awarenessaround a female athlete. So I think
her tagline is women are not smallmen. You know, women are different,

(01:28:32):
so they should be trained different,coach different. And behind that is
the sort of the idea that mostof the sports physiology research has been done
on men, and because of that, it's not representative, completely representative for
females. So I'm interested in yourthoughts on that. First, do you

(01:28:55):
think that is what do you thinkabout that that position about the sports physiology
researcher you think it is valid?And and are you doing anything specifically different
with female athletes, whether it bearound menstruation or female athlete triad awareness,
menopause, perimenopause, things like that. So she brought attention to something that

(01:29:23):
has been a conversation in the sportand exercise physiology world for a long time.
The biggest pool of available research subjectsin colleges are college aged students,
and because of that menstrual cycle andthe fluctuations of it, researchers didn't want

(01:29:47):
to have to figure out how towork with that. So college age men
primarily have made up the subjects forsport physiology research since they started doing sport
physiol to research. Stacy Simms dida phenomenal job not only writing that book,
but promoting that book and getting thatinformation out there and getting more people

(01:30:10):
to pick it up. Where wherethe nuance gets lost is that the research
studies that are cited in rare allof her information is accurate. Where it
fails to communicate nuance is that allof that information is based on averages.

(01:30:30):
So anytime we're talking about research findingsthat are summarized findings, we're talking about
averages. So the idea of theyou know the twenty eight day cycle,
well that's an average. Some peopleare some women are going to have a
much shorter cycle, some people aregoing to have a longer cycle, So
that cycle is much more variable.And the differences and distinctions between the sort

(01:30:59):
of physiological characteristics of the follicular stageversus the lydeal stage again are going to
be nuanced based on the individual.So kind of how we actually spent an
entire day on just talking about thistopic with our coaching staff. We do

(01:31:23):
a coaches education day fairly regularly,but we do it an ten hour day
at least once a year where wereally dive deep on something. And we
dove deep on this and how weframed it was all right, what are
the what factors affect endurance performance?And if we're talking about that, well,

(01:31:43):
it's your preparation, your training,your best sufficity, your adaptations,
your ability to maintain temperature, socooling, sweating, circulation, your fueling
including fuel availability, then elation,contractile proteins, all that sort of stuff,
execution of your work. So that'scomfort, psychological effects, confidence,

(01:32:11):
those pieces and then your equipment.And when you look at it through the
lens of where can the menstrual cyclehave an impact, well, really it's
pretty much everything but equipment. Andthen that means we have to actually work
with our athletes individually to understand whattheir effects actually are. There are some

(01:32:32):
people who are extremely impacted by ahigher onset temperature, higher temperature onset of
sweating in the felicular stage in thosedays before mensies start. Well, for
them, we need very specific coolingstrategies. We need pre cooling, we
need during race cooling, we needtemperature maintaining strategies for those folks. Other

(01:32:58):
folks it doesn't bother them. Soit's like, all right, well we're
not going to spend all your energydoing this. Let's spend your energy on
things that do bother you. Andthen when you're looking at fueling, same
thing, what can somebody tolerate?And I think one of the pieces that
Tasy Sims really highlighted in that bookwas as you get older, you have

(01:33:21):
more difficulties taking in your fuel asfluid, and it's easier for you to
take it in as food, andyou are also going to have more challenges
with fructos or fruit sugars. Well, okay, great, So if we
know this with somebody who is anathlete who's approaching menopause or empowerimenopause or in

(01:33:41):
menopause, well then we have tomake sure we give them a number of
trial runs at their fueling plan anddo it under stressful conditions, and make
sure they're fatigues going into it,make sure it's more really offering a number
of race rehearsals so that those piecescan be ironed out. And when we're

(01:34:09):
thinking about this topic, the otherpiece we have to really talk about is
the idea of birth control and hormonalversus non hormonal birth controls, because those
are typical cycles, so you're notgoing to have the same hormonal responses,
but you're going to have side effectspotentially from the type of birth control you're
on. So it has to bepart of the conversation. And what's really

(01:34:32):
interesting with the group I coach withis that there's nobody who coaches just one
sex. We all have athletes ofboth sexes, So we all have to
have be able to have conversations thatmaybe aren't our first instinctive comfortable conversation,

(01:34:58):
but if we're gonna if we're goingto prepare a person for something that they
are really striving for, then ourcomfort really has to not matter very much.
What matters is are they prepared,can they cool themselves, can they
fuel themselves, can they execute?And can they do it as well as
possible on the day that they're given. Great conversation with Susan Steer go to

(01:35:27):
the show notes you'll find the linkto the full conversation. We talk about
other things, psychology, swimming,things like that, but this topic is
particularly interesting because it's been in thenews over the last few years and there's
always something new. It's a recentsystematic review. The scientists involved in this

(01:35:54):
study Lauren Colenzel Simples, Stuart Phillips, Kristy Elliott's Sale. Some of the
questions they tackled, is there evidenceto support menstrual cycle based training? And
if there is evidence, how shouldtraining differ in different phases of the menstrual

(01:36:15):
cycle. They tackle the question oforal contraception and are these recommendations different for
women who use oral contraception? Theytackle tracking devices? How accurate are the
tracking devices? And so I won'tgo into all of the details here,

(01:36:36):
but you can definitely go look upthe study. Very interesting topic and I'm
always now more than ever looking tomake sure that I can intelligently articulate some

(01:36:57):
of the new research in space.And by the way, that study that
I mentioned is in Frontiers and SportActive Living, volume five twenty three.
I knew a bit about the topicgoing into the conversation. I think one
of the things that I got outof the exchange with doctor Sortier is much

(01:37:18):
of the question of what do youdo with female athletes and menstruation in the
training cycle in the race scheduling processshould be highly individualized. The other thing
that dawnedonomy with the exchange was thatpeople seem to systematically neglect the effects or

(01:37:45):
potential effects that menstruation has on femaleathletes. I mean, something as simple
as what happens when your period fallson your race ek or your race day
is something that male athletes just don'thave to contend with. We need to

(01:38:05):
do more just to simply acknowledge thisand also reduced all of the stigma around
it. I'll finish up with anotherreal world example that happened probably within the
last days. So there's a professionaltriathlete by the name of Emma palent Hope,

(01:38:30):
I'm pronouncing her name correctly, anda photographer posted a picture of her
in a triathlon I believe it wason Instagram. And let's say just say
the picture was a near full bodypicture, really stopped at her knee.

(01:38:55):
But you could see in the picture. You know, triathletes kits they call
the racing kids of especially with thepro triathletes and hot weather, they're very
revealing sometimes and you can see inthe picture that she is having her period.
And so someone commented on the onthe picture. I don't know who

(01:39:24):
posted it. Someone commented on thepicture and said, I'm reading it here
not the most flattering picture of EmmaPalent. Surely you can crop it a
bit better. Emma Palent sees thecomment and responds, and this is what

(01:39:44):
she says. She responds to theperson, thanks for caring, but definitely
something I'm not shy to talk aboutbecause it's the reality of females in sport.
My period comes over a month inbetween, and there will be one
day where it is super heavy.I pray it won't be race day,

(01:40:04):
but every now and then it is. No matter what tampon I have experimented
with for anything over three hours,it's too heavy. So just as someone
might get gut issues in a race, I have to suck it up and
give what I have and not beafraid to talk to women who have the

(01:40:26):
same problem. And she gives thetwo hands up emoji. All right.
So those were the top five mostlistened to and downloaded episodes of season five,
and it's about time that I wrapthis up. You can absolutely go
out and listen to some of theother ones. There were some other ones

(01:40:47):
that were pretty close and well downloadedas well. My episode with Dave mcgilvrey,
race director of the Boston Marathon thatwas in season five, had a
podcast with open water swimming olympian AlexMeyer. Had a podcast on nil and

(01:41:12):
Pay for Play and the Legacy ofTitle nine with doctor Jill Harris and doctor
Nola Aga. I had another podcaston hypnotism for athlete performance with Mike Mandel
and Chris Thompson. So I hopeI've given you some things that made you

(01:41:34):
think, and we're very interesting inthe sea of podcasts that are out there.
And I will follow up very soonwith the first episode of the Endurance

(01:41:57):
Experience podcast season six. It's comingreal soon and I got some great podcasts
lined up, so look for thatto follow pretty soon over the coming weeks.
Follow Event Horizon Endurance Sport on Facebook, Instagram, and Twitter for training

(01:42:21):
programs and services. To become amember of our Endurance Institute, or for
complete archival podcasts, low onto ourwebsite Event Horizon dot tv.