Please Close Your Mouth When You Run Past My House!

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What is wrong with this picture? Yes, yes, they all have blurred faces. I have done that to protect the guilty!

The problem is that they all have their mouths open while they are running. Is that a problem? It is not that they have bad breath as they run past my house on the bi-annual “Griseløb” . No, they are possibly causing immense damage to their bodies.

Why? Each and everyone of them is hyperventilating. They are expelling all of their carbon dioxide. I hear you say “That is a good thing, isn’t it? – Isn’t respiration  about getting oxygen in and CO2 out?”. Wrong – that is a bad thing. And yes, getting oxygen in is correct. How would we otherwise stay alive? But where do you need the oxygen when you are running? In the muscles, the cells and the organs.

If you are not retaining some of the carbon dioxide in your bloodstream (the “Bohr Effect“), you are not releasing the oxygen from the haemoglobin. Moreover, it is lowering the PH value of your cells (“acidosis”) and their are some enlightened doctors and researchers who say that this creates conditions for cancer.

How do you counter this? Learn to breathe in and out through your nose only. It is called Buteyko breathing and has long been used to cure asthma. Another good reason to breathe through your nose is that the nose extracts the majority of the microbes we don’t want in our bodies, before they get to the lungs. It also warms and moistens the air that you inhale.

Misha Sakharoff has written an excellent piece on this “Asthma is common among Olympic athletes – but why?”

They knew about this in India a long time ago with Pranyamic breathing. As they say “The more you control your breathing, the longer you will you live”, and this is especially true when we are exercising heavily.

So at the next Griseløb, I may well stand outside with a big sign “Luk munden”, which means “close your mouth”!

Obsessed with my health? Moi?

My brother has a mantra: “Your health is your wealth”. It is probably the most profound thing a human can say, It does not matter how materially wealthy you are, unless you are in good health, it is difficult to enjoy life.

So why do we take it for granted? Why do we strive to get materially rich at the expense of our health? We rush here and there, never any time to reflect, get stressed, eat crap food, are too tired to exercise and then when the apparently incurable illness inevitably comes along, we cry “Why me?”

So today, I am going to tell you why my apparent obsession with my well-being is simply a case of taking responsibility for my life.

Why should I put my health in the hands of others? Because they have a long education? Because they only come into the picture when I am ill, and then only to treat the symptoms of the illness?

No. I am reasonably intelligent and I feel that I am in touch with my body. I am aware. I know what works for me and what does not. I use the Internet to research stuff.

Tools help, though. If only they are adapted away from the shibboleths of modern western health care – or should that be health-don’t-care?

I recently bought a new phone, the Android-based Samsung Galaxy S5. I did not need the S6, and this phone suits my needs. On the phone is an app, S Health, and I have started using it. You have to enter some data, in the absence of having further devices strapped to your chest, It has an in-built pedometer, which counts your steps. The goal is 10,000 steps per day, the recommended target for adults. I have a dog, so it is relatively easy to achieve.

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There is an in-built device at the back of the phone to measure one’s pulse.

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Mine seems to off the scale to the left, but that is not a bad thing. When you gather data over a number of days, you start to see a trend.

The next panel shows your stress level, which tracks the variation in your pulse rate. Is it accurate? I have no idea. I seem to be on the low end, again. By design, that is!

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Weight is an important factor with one’s health, and I was looking for the scales app on the phone, but alas, it does not have one! So you have to weigh yourself manually and add the data. No problem! I have also a BFI (Body Fat Index) calculator app and you can enter this data, too.

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I have just broken down through the 80kg barrier – haven’t been there for 25 years! My BFI is about 20%, in the middle of the range. The BMI (Body Mass Index) is calculated for me, based on my height which I entered in the set up.

If you want to track your blood pressure, then you will have to do it manually. Again, you can track the trend. I have a digital medical sphygmomanometer (wow! – that’s a mouthful). I don’t measure it every day – once a week should do.

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There is a good food tracking section, which allows one to record the food from a very comprehensive list. If the food that you consume is not on the list, you can add (but not edit) the item. The problem is that here it is only possible to record “portions”, but on the other hand you can have a fraction of a portion. Very importantly, the breakdown of carbohydrates, fat and protein are shown – for each item and each meal and the total for the day.

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This is a great feature, but for me personally it does not allow me to use the data in a sensible way. Why is that? Because I favour a low carbohydrate diet, and the raw numbers in weight do not reflect how much energy I am extracting from each group. To find this, multiply the carbs and protein weight by 4 and the fat times 9. I do this in an excel spreadsheet like this:

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You can see that the weights have been converted back into kcals per food type and then shown in their respective ratios. Extreme ketogenic diets are almost exclusively fat (for treating cancer), but my aim is around 70%, which is mildly ketogenic. That means that I (my liver, that is) will produce ketones (and glucose) as opposed to exclusively glucose. This seems to hold my carbohydrate intolerance at bay at the same time, I can still swim long distances without “bonking”, or running out of energy.

There are also various measurements of performance based mainly on running and cycling, but also a host of other sports, showing the calorie burn.

I am no expert on these apps, but it seems pretty sensible. To create awareness of your situation so that you can take some action, it is probably worthwhile tracking your performance and diet. Take responsibility, but do not become obsessed with it!

A longer life – at what price?

My Father died at the age of 76. Not bad for a man born in England in 1913. Better than average, one might say. He died of shortage of breath – literally, He was mowing the lawn and felt bad. He passed out on his bed, and died. His heart was not getting enough oxygen to function because his alveoli in his lungs no longer functioned.

If you thought that my Father suddenly “kicked the bucket”, you would be wrong. He suffered from what is now called Chronic obstructive pulmonary disease (COPD) for the last 8 years of his life. It was not pleasant to see him, as he was coughing up phlegm constantly and was on an atomiser machine most of the time. He blamed it on the fact that he delivered coal for 25 years, but ib fact, it was the roll-up unfiltered cigarettes that did it. But he would never accept that-

What is my point? That the last 10% of his life were miserable. He was also on steroids, which gave him uncontrollable diaorrhea occasionally, so he was never far away from a toilet.

Countries seem to tout life expectancy numbers as an indicator of how “healthy” the nation is. Also how “wealthy” a nation is – that is, how it can keep citizens alive for the longest time.

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Imagine that a country wanted to REALLY boast of its longevity. It could spend a fair proportion of its GDP on life support machines, and keep everyone going until they were 100. But what would be the point for the individuals?

Here is a fantastic animated graph which shows the development of life expectancy against GDP from 1800 to the present day. Between 1890 and 1955, there was a great increase in life expectancy from 47 to 72 years of age. This was for a 300% increase in GDP. But what else was happening? Pathological diseases were eradicated for one thing, by improving sanitation. Families got smaller which meant less infants dying. I am no anthropologist, but that is my speculation.

Between 1956 and now, we have seen an increase of just 8 years – in fact, for many years it was flat. This was for a 357% increase in GDP (at adjusted PPP).

Let’s try and put the numbers in perspective: Over a period of 65 years, life expectancy increased by 25 years with a wealth increase of 300%. A 53% increase over 65 years – 0.82% longer each year, which adjusted for the GDP increase is 0.27% per annum. Over a period of 58 years to the present date, life expectancy increased by 8 years with a wealth increase of 357%, which adjusted for GDP increase is 0,05%.

It would appear that we are living marginally longer as the GDP rises. But I would argue that part of the GDP is going to healthcare, indicating that we pay a heavy price to increase the life expectancy and that doing this increases GDP growth, thus providing the magic economic growth that is the mantra of politicians around the world.

According to the latest OECD numbers Denmark spends 11.1% of its GDP on healthcare (if you think that is a lot, then look at the US – 16%!). This is up from 8,7% in 2000, and it was probably a lot lower in 1955!. Denmark’s saving grace is that the amount spent on medicine has gone down, to 6.5%.

Incidentally, if you play with the control on the graph, you will see that in 1916, Denmark had the highest life expectancy at birth in the world. In 2013 Denmark was placed a paltry 29th. What happened?

There well be a natural upper limit to how long we can expect to live, but I believe that lifestyle is not only holding the number down in Denmark, it is causing many people to live a morbid lifestyle on medication for many years. Is this desirable? Is it feasible? In Greece, many older people on medication suddenly found that the medications were not being paid for by the state. I think we should all be careful – because in dire draconian states of austerity, expensive medication for the chronically sick is going to be the first thing to go.

The Diabetes Society in Denmark sponsored a study where they found out that treating diabetes 1 & 2 had massive costs. I reprint the abstract from the study here

Objective: The study aims to provide real world evidence on societal costs attributable to diabetes (SCAD) in Denmark evidenced by age, gender, education and complication progression. Method: All persons (PwD) (N=318,729, 2011) in the Danish National Diabetes Register were linked to national data from 5 health/social registers. Complication groups were defined through data from the Danish National Hospital Register. SCAD were measured as difference between resource consumption of PwD compared to the diabetes-free population. Results: SCAD were estimated to at least 31.8 billion DKK in 2011, corresponding to 107,000 DKK per patient-year distributed on 5.5 billion DKK for primary and secondary care, 1.1 billion DKK for pharmaceuticals, 6.4 billion DKK for nursing, 13.2 billion DKK in lost productivity and 5.6 for additional costs. Steep increasing costs with increasing complications are evidenced across all cost components: 12 times in the health care and 33 times for nursing services for persons’ with severe complications compared to persons’ with no complications. 25% of PwD consume nearly 60% of all resources. PwD received lower annual income than controls when controlling for highest educational level. Conclusion: Majority of costs are incurred among persons’ with severe complications pointing to importance of secondary preventive efforts among PwD.

31.8 billion kroner! and that is just diabetes. Note the conclusion. And what about the costs of all the other lifestyle diseases?

We need to rethink this.