Early studies:

London Transportation: The Cohort Studies (1947-1972)

The annual rate of CHD for drivers was 2.7 per 1,000, and 1.9 per 1,000 for conductors.More important, the disease is not so severe in physically active workers, tending to present first in them as angina pectoris and other relatively benign forms, and to have a smaller early case-fatality and a lower early mortality-rate.”

http://www.epi.umn.edu/cvdepi/study-synopsis/london-transport-workers-study/

Possible confounders:

sleep and stress: http://archives.sethroberts.net/blog/2009/09/28/exercise-and-its-confounds-the-london-bus-study/

Weaknesses of the study were based on the characteristics of the cohort at entry, thus early selection into active occupations, and selection out with age and illness. Employees of the London Transport Executive also could retire early if they developed CHD, making follow-up after an initial coronary incident difficult

Paffenbarger: Harvard Alumni Study

In the 1993 survey, 2,135 subjects had experienced coronary heart disease (87.1% response rate). In this analysis, the researchers found increased physical activity level was associated with lower coronary heart disease risk when considered singly (RR for those who burned more than 8400 kilojoules per week= 0.73, 95% CI= 0.63-0.84, p <.001). [2] When considered along with age, BMI, alcohol intake, hypertension, diabetes, smoking status and early parental death, higher levels of physical activity were also apparently protective (RR for those who burn more than 4200 kilojoules per week= 0.81, 95% CI: 0.71-0.92, p= .003) [2].

http://www.epi.umn.edu/cvdepi/study-synopsis/harvard-alumni-study/

 All cause mortality and dose response of exercise:

http://www.onlinejacc.org/content/accj/64/5/472.full.pdf

 https://www.researchgate.net/publication/11912487_Lee_I-M_Skerrett_PJ_Physical_activity_and_all-cause_mortality_what_is_the_dose-response_relation_Med_Sci_Sports_Exerc_33_S459-S471

With respect to maximal aerobic capacity:

https://jamanetwork.com/journals/jama/fullarticle/1108396

 

 Large Cross-Sectional Studies

The Lancet:
Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

 

The Evil Three

Sugar

http://healthland.time.com/2012/02/02/should-sugar-be-regulated-like-alcohol-and-tobacco/
https://www.nytimes.com/2019/07/10/well/eat/sugary-drinks-linked-to-cancer-onset.html
https://www.nytimes.com/2019/07/22/well/eat/the-downside-of-having-a-sweet-tooth.html?rref=collection%2Fsectioncollection%2Fwell
https://www.menshealth.com/nutrition/a28277408/giving-up-all-sugar/
https://www.sciencedaily.com/releases/2019/09/190905090929.htm
https://www.ama-assn.org/press-center/press-release/ama-adopts-policy-reduce-consumption-sugar-sweetened-beverages

Sugar Addiction
https://bjsm.bmj.com/content/52/14/910
https://www.nytimes.com/2019/03/14/health/big-tobacco-kool-aid-sugar-obesity.html

Fat

High-fat diets affect your brain, not just your physical appearance
https://www.sciencedaily.com/releases/2019/09/190909121234.htm

Salt

 

Nutrition

Processed Foods

It's Not Just Salt, Sugar, Fat: Study Finds Ultra-Processed Foods Drive Weight Gain
https://www.npr.org/sections/thesalt/2019/05/16/723693839/its-not-just-salt-sugar-fat-study-finds-ultra-processed-foods-drive-weight-gain
https://www.ama-assn.org/delivering-care/public-health/limit-junk-food-ads-contribute-childhood-obesity

Crazy Diets

Intermittent Fasting
https://www.sciencedaily.com/releases/2018/05/180520090903.htm

Vegan
https://www.sciencedaily.com/releases/2019/09/190916185819.htm

 Addiction

https://academic.oup.com/jn/article/139/3/623/4670401

 

Exercise As Medicine

Mortality and Morbidity

https://www.medicalnewstoday.com/articles/245025.php
https://www.medicalnewstoday.com/articles/244388.php

H.I.I.T.

https://www.telegraph.co.uk/news/health/news/8730084/Dont-just-plod-if-you-want-a-longer-life-say-heart-experts.html

Creating and maintaining an energy deficit reduces cancer risk:
http://www.economist.com/news/science-and-technology/21693419-active-life-protects-against-cancer-researchers-now-understand-why-run-day

Obesity
https://www.cdc.gov/obesity/data/adult.html

The effects of exercise on fat storage:
https://www.medpagetoday.org/meetingcoverage/ada/40038?vpass=1

Elevated Temperature
https://www.sciencedaily.com/releases/2018/05/180521095606.htm

Societal Impact

http://cdn.missionreadiness.org/NATEE1109.pdf

 Gain Muscle, Loose Fat

http://ajcn.nutrition.org/content/103/3/738
https://www.sciencedaily.com/releases/2016/01/160127132741.htm
https://www.google.com/search?q=gain+muscle+lose+fat+diet&ie=utf-8&oe=utf-8

https://www.washingtonpost.com/lifestyle/wellness/the-fat-burning-heart-rate-zone-is-a-myth-how-exercise-and-weight-loss-really-work/2018/12/17/548ea93a-fc8e-11e8-83c0-b06139e540e5_story.html?noredirect=on

Abdominal Fat

https://www.nytimes.com/2018/06/11/well/live/belly-fat-health-visceral-fat-waist-cancer.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health®ion=rank&module=package&version=highlights&contentPlacement=6&pgtype=sectionfront

Obesity

You can grow fat cells at any age and the fuller they become the better the body gets at making them:
http://www.scq.ubc.ca/america-and-adipocytes-why-liposuction-is-not-the-answer/

But once they're made, they almost never go away....
http://www.nature.com/nature/journal/v453/n7196/full/nature06902.html

Evolution

Human genetic change since the Paleolith:
https://www.washingtonpost.com/news/wonk/wp/2016/02/17/what-actual-caveman-dna-says-about-the-paleo-movement/

We did not evolve with shoes on our feet:
https://www.nytimes.com/2019/07/17/well/move/born-to-walk-barefoot.html?rref=collection%2Fsectioncollection%2Fwell

 The evolutionary reason why we are lazy:
https://slate.com/technology/2013/06/daniel-lieberman-long-distance-running-we-evolved-endurance-and-dislike-of-running.html

Ultrarunning:

http://www.huffingtonpost.com/jodi-weiss/what-i-have-learned-from-_5_b_8795088.html

No upper limits:
https://www.outsideonline.com/2358586/dont-worry-about-exercising-too-much

 

Documentaries

https://mic.com/articles/89183/11-powerful-netflix-documentaries-that-will-change-how-you-think-about-food#.pQV8cpLGM

 

General Running Topics

The 2 things that have helped my plantar fasciitis, both backed by research:

tissue specific stretching:
https://www.ncbi.nlm.nih.gov/pubmed/16882901
http://nesportandspine.com/sites/default/files/plantarfasciitisteachingsheet.pdf?fbclid=IwAR2egcYaV9MQgoYW64UBiRBGwlUnNEzocUA93w19tluq_B7SYDN_ea3Ymno

high load heel raises:
https://well.blogs.nytimes.com/2014/09/15/heel-pain-treatment/?fbclid=IwAR2bek7-hZddcsvTLiA0q4XClJfFGjAQgUJYuJ-mGHbIive0-0w5MyEcBXg
https://onlinelibrary.wiley.com/doi/full/10.1111/sms.12313

Calories burned running and walking:
http://fellrnr.com/wiki/Calories_burned_running_and_walking

https://static.nytimes.com/email-content/RU_8032.html?nlid=56151896

Getting Old

https://www.sciencedaily.com/releases/2019/09/190909193211.htm

https://www.sciencedaily.com/releases/2019/09/190917193639.htm

Stress

https://www.sciencedaily.com/releases/2019/09/190909134912.htm

With exercise we discipline and perfect our body; with study we discipline and perfect our intellect; with meditation we discipline and perfect our desire.

boo

"No one can say that Sparta was vulgar."

When I watched the previous generation begin to pass on, it occurred to me that this was preparation for when my generation would begin to decline and die. The grieving we experience and the choices we make for our parents are preludes to the time when we will take the same path. 

I had a feeling that time was upon me last year when Micah True died. He was an accomplished utlra-runner who disappeared while on a relatively short 12-mile run last year in the Gila Wilderness. He died while sitting on the side of a stream, soaking his feet. He was only 58. He was killed by an undiagnosed congenital heart condition. Micah did not have medical care, and given his excellent physical condition, he was unaware of his condition. I struggle to believe that he would have restricted his running even if he had known of his condition. 

I see my colleges at work decline. One can barely walk because of chronic joint pain. Another is over-weight and repeatedly crushes her arches. She now wears shoes that are so supportive that there is no possibility that the muscles, tendons, and ligaments in her feet and legs will ever get strong enough to support her. Several sleep with breathing devices to reduce their obesity-induced sleep apnea. One is so overweight that he has a handicapped parking pass that deposits him within 20 feet of our building's entrance. Another 20 feet past Security, he has a little electric cart that ships him around the office. He minimizes the one thing that would do him therapeutic good. Of these, several have often predicted the end of my running when I inevitably succumb to running-induced arthritis. Yet it never seems to occur any of them how avoidable, how unnatural their current lives are. Despite massive numbers of peer reviewed studies establishing the connection between health and low rates of morbidity with large volumes of exercise, they remain convinced of the utter uselessness of periodically pushing one's body to its limits. One male college my age, with no apparent health problems aside from a sedentary life, has recently had a stroke. 

My wife has just been informed that one of her close relatives, someone also my age, has fairly advanced esophageal cancer. This alarmed her and she was screened for this cancer also, despite that she shares none of the lifestyle conditions that predispose one to this condition. Nonetheless, disease and death seem to creep inexorably closer in this cycle of our lives.

I do not assert that physical and mental decline are not inevitable. But I have the strong belief, substantiated by the way I live my own life, that the decline I am witnessing in my peers is not only avoidable, but unnatural. Humans are not structured to be sedentary. When we are sedentary, we decline at an extraordinary rate, particularly as we age. This truth seems more obvious to me every day as I sprint up the 4 stories to my office while co-workers half my age take the elevator, then get winded walking down the hallway.

An acquaintance emailed me birthday wishes, remarking that she would always be three days older than me. I replied with a resigned, "Yeah, we're old!". She replied resolutely that we're not.

Now, as I approach 60, the challenge has evolved. Running and an athleticism have become part of my life style, part of my world view. I have moved to the point where people remark that I must have the genetics for fitness, or that it must easy for me because I'm so trim, or that I have been doing this all my life. But I manage the growing aches and pains each morning getting up. I am learning the compromises one has to make with age, that injury comes more easily and recovery comes more slowly. Conscious form, correct and deliberate execution, and more judicious use of intensity all become vitally important to avoid injury. The fitness momentum carries me into my older years, but the aches and pains of effort are beginning to grow. The dull ache in my hips in the morning are not an excuse to do nothing, they are an ugly harbinger of what life would be like if I stopped what I am doing. I was recently asked why I run. I blurted, "Because the alternative is too terrible to contemplate." The reply came thoughtlessly; but its truth is obvious to me upon reflection.

With each passing year, many of us justify the growing sloth and its resulting frailty and weakness with excuses that we're too old, that we don't have the right genetics, that it is natural to become impotent and frail as we age, or, insidiously, that "we deserve a break today". Even now, 10 years after the herculean effort it took to re-adopt athleticism, I have refocus daily on the absolute necessity of keeping a strong mind in a strong body, defying the cultural current all around me that tells me that its ok to degrade.

Saying that 59 is not old is lying to oneself. I am old, but I redefine it with growing strength and resolve. To say that 59 is not old is to deny the magnitude of this achievement to myself and to all others who chose this way.

98% of the atoms in the human body are replaced every year (1). The body is an ever changing stream. Nothing about it is constant.

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