Male Pattern Fitness :: An SB Nation blog about meat, muscle, and the minds of men

This story ran a couple of weeks ago in New York magazine, but I just got around to reading it today. The big idea:

Shoes are bad. I don't just mean stiletto heels, or cowboy boots, or tottering espadrilles, or any of the other fairly obvious foot-torture devices into which we wincingly jam our feet. I mean all shoes. Shoes hurt your feet. They change how you walk. In fact, your feet -- your poor, tender, abused, ignored, maligned, misunderstood feet -- are getting trounced in a war that's been raging for roughly a thousand years: the battle of shoes versus feet.

Last year, researchers at the University of the Witwatersrand in Johannesburg, South Africa, published a study titled "Shod Versus Unshod: The Emergence of Forefoot Pathology in Modern Humans?" in the podiatry journal The Foot. The study examined 180 modern humans from three different population groups (Sotho, Zulu, and European), comparing their feet to one another's, as well as to the feet of 2,000-year-old skeletons. The researchers concluded that, prior to the invention of shoes, people had healthier feet. Among the modern subjects, the Zulu population, which often goes barefoot, had the healthiest feet while the Europeans -- i.e., the habitual shoe-wearers -- had the unhealthiest. One of the lead researchers, Dr. Bernhard Zipfel, when commenting on his findings, lamented that the American Podiatric Medical Association does not "actively encourage outdoor barefoot walking for healthy individuals. This flies in the face of the increasing scientific evidence, including our study, that most of the commercially available footwear is not good for the feet." ...

"Natural gait is biomechanically impossible for any shoe-wearing person," wrote Dr. William A. Rossi in a 1999 article in Podiatry Management. "It took 4 million years to develop our unique human foot and our consequent distinctive form of gait, a remarkable feat of bioengineering. Yet, in only a few thousand years, and with one carelessly designed instrument, our shoes, we have warped the pure anatomical form of human gait, obstructing its engineering efficiency, afflicting it with strains and stresses and denying it its natural grace of form and ease of movement head to foot."

If we just accept the premise here -- and frankly, I can't think of any reason not to -- the big question is, what the hell can we do about it? The author, Adam Sternbergh, tried out some shoes that were designed to allow a completely natural gait. Here's his reaction to the Vivo Barefoot:

The Vivos are a totally different experience, since they're as close to going barefoot in the city as you can get. Barefoot walking should be easy to master, in theory, and Clark assured me that I won't need any special instruction. The first thing I noticed while wearing the Vivos is that each heel-strike on the pavement was painful. Soon, though, I naturally adjusted my stride to more of a mid-foot strike, so I was rolling flexibly through each step--but then I noticed my feet were getting really tired. My foot muscles weren't used to working this hard.

After wearing the Barefoots for a while, though, I found I really liked them, precisely because you can feel the ground -- you can tell if you're walking on cobblestones, asphalt, a manhole, or a subway grate. (Striding along that nubby yellow warning strip on the subway platform feels like a foot massage.) Of course, it's not often that you walk around New York, see something on the ground, and think, I wish I could feel that with my foot. But this kind of walking is a revelation. Not only does it change your step, but it changes your perceptions. As you stroll, your perception stops being so horizontal -- i.e., confined more or less to eye level -- and starts feeling vertical or, better yet, 360 degrees. You have a new sense of what's all around you, including underneath.

Later in the story, he points out that you can't wear shoes like this in the rain or snow. You'll get soaked or frozen. But I think there's another, simpler alternative: Keep wearing your worn-out sneaks.

Sternbergh mentions some research suggesting that runners' injury rates are much higher when they're wearing new shoes than when they're wearing older ones. I've mentioned this in a couple of the presentations I've given about how the media covers fitness-related issues. My big point was that magazines can't tell you about research like this because they get so much advertising revenue from Nike and Reebok. You, however, are a free agent; you don't have to do what magazines or shoe companies tell you to do.

I have a really old pair of cross-trainers that I wear to run sprints or play soccer with my kids. The rubber on the soles is worn down, and whatever padding it once had on the inside has been pounded into oblivion. And nothing ever hurts after I wear those, despite my lifelong history of foot, ankle, and knee pain.

I also have a pair of hiking boots that must be 15 years old now. I might wear them once a year. I went on a camping trip with my son's Boy Scout troop last weekend. We didn't do a hike, but there was a lot of walking and brush-clearing-type work. I was expecting to pay a price and be sore as hell by Sunday, but again, I had no foot, ankle, or knee pain.

So what's your experience? Have you tried any of the minimalist training shoes, like the Nike Free?

I haven't posted in a week because of yet another brutal slog to hit a deadline. (In this case, the goal was to turn the manuscript in a month before deadline, for reasons that aren't worth going into.) Now I get to breathe easy for about five minutes before I tackle two more projects that have to be finished by the end of the month.

I assume I missed out on some great blog meat over the past seven days, but I doubt if any of it was as meaty as this news:

Body fat found under the skin -- and particularly on the buttocks -- may help reduce the risk of developing type 2 diabetes, research suggests. The study contrasts this subcutaneous fat with visceral fat, which is wrapped around the organs, and raises the risk of ill health. ...

The researchers, who worked on mice, transplanted fat from one part of the animals' body to the other. When subcutaneous fat was moved to the abdominal area, there was a decrease in body weight, fat mass, and blood sugar levels.

The animals also became more responsive to the hormone insulin, which controls the way the body uses sugar. A lack of response to insulin is often the first stage on the path to type 2 diabetes.

In contrast, moving abdominal visceral fat to other parts of the body had no effect. Lead researcher Professor Ronald Khan said: "The surprising thing was that it wasn't where the fat was located, it was the kind of fat that was the most important variable. Even more surprising, it wasn't that abdominal fat was exerting negative effects, but that subcutaneous fat was producing a good effect."

So we've solved the diabetes problem, right? We'll just set up a bunch of clinics specializing in butt-fat transfer, and that'll be that.

Alas, I don't think it'll be that easy. According to this study, the problem isn't really with body fat:

Overeating, not the obesity it causes, is the actual cause of metabolic syndrome, suggests a study with mice by researchers at the University of Texas Southwestern Medical Center at Dallas. ...

This study was among the first to propose that weight gain is an early symptom, not a direct cause, of metabolic syndrome, the researchers said.

"Most people today think that obesity itself causes metabolic syndrome," senior author Dr. Roger Unger, professor of internal medicine, said in a prepared statement. "We're ingrained to think obesity is the cause of all health problems, when, in fact, it is the spillover of fat into organs other than fat cells that damages these organs, such as the heart and the liver. Depositing fatty molecules in fat cells where they belong actually delays that harmful spillover."

For pure entertainment value, I'm kind of hoping someone will transplant butt-fat cells into the brain. If it improves cognitive function, "talking out your ass" will no longer be an insult.

The 55 men in a drug doping study in Sweden were normal and healthy. And all agreed, for the sake of science, to be injected with testosterone and then undergo the standard urine test to screen for doping with the hormone.

The results were unambiguous: the test worked for most of the men, showing that they had taken the drug. But 17 of the men tested negative. Their urine seemed fine, with no excess testosterone even though the men clearly had taken the drug.

It was, researchers say, a striking demonstration of a genetic discovery. Those 17 men can build muscles with testosterone, they respond normally to the hormone, but they are missing both copies of a gene used to convert the testosterone into a form that dissolves in urine. The result is that they may be able to take testosterone with impunity. ...

Dr. Schulze learned from an earlier study that about two-thirds of Asian men are missing both copies of the gene, as are nearly 10 percent of Caucasians. The prevalence in other groups is not known.

The New York Times story by Gina Kolata notes that the missing genes aren't the only way athletes might get away with doping:

There may be more than a dozen testosterone-metabolizing enzymes, said Dr. Shalender Bhasin, a testosterone researcher at Boston University School of Medicine, and it may be necessary to examine all of them to see if gene variations affect test results. He added that there may be differences in the way men and women metabolize testosterone, so a separate study on women would be necessary to determine whether the gene deletion affects their testosterone tests the same way.

The reasonable response to news like this, I think, is to hope that the official anti-doping agencies find ways to use it to make the playing field as even as possible. That said, we all know that sports, like life, will never be completely fair. There's always someone who will get away with something, and there will always be innocent people who get swept up and cast off because of someone else's mistakes. Life sucks, shit happens, get a shovel, dig out, move on.

But, of course, there's always someone who draws the wrong conclusions from new information about doping. Today, that role is played by two Bloomberg sportswriters, who break out the specious comparison of doping to Lasik eye surgery:

Golfer Tiger Woods enhanced his vision to 20/15 with laser eye surgery. Football wide receiver Terrell Owens recovered more quickly from injuries by sleeping in a high-pressure chamber. And Olympic distance running hopeful Dan Browne extended his stamina by living in an altitude house that increased his oxygen-carrying red blood cells.

While athletes including the sprinter Marion Jones have lost gold medals, championships and eligibility for taking drugs, neither Woods nor Owens nor Browne was investigated by Congress or labeled a cheat by any U.S. sporting group. Their training and medical treatments are permitted under current rules.

Does anybody reading this really believe that Tiger Woods dominates golf because of his vision?

I just looked up some of his stats this morning: Woods ranks 54th on the PGA Tour in driving distance, 102nd in "total driving," first in "greens in regulation" (hitting the green with your tee shot on a par 3, with your second shot on a par 4, and your third shot on a par 5), 41st in putts per round, 10th in putting average.

Can anyone explain to me which of those stats has been affected by his laser eye surgery?

A new study in Archives of Internal Medicine attempts to answer the question of whether exercise counteracts the negative effects of being overweight or obese. The short answer is "not really," although the long answer is interesting for several reasons.

New research challenges the notion that you can be fat and fit, finding that being active can lower but not eliminate heart risks faced by heavy women. "It doesn't take away the risk entirely. Weight still matters," said Dr. Martha Gulati, a heart specialist at Northwestern Memorial Hospital. ...

The new study involving nearly 39,000 women helps sort out the combined effects of physical activity and body mass on women's chances of developing heart disease, said Gulati, who wasn't involved in the research. ...

Participants were women aged 54 on average who filled out a questionnaire at the study's start detailing their height, weight and amount of weekly physical activity in the past year, including walking, jogging, bicycling and swimming. They were then tracked for about 11 years. Overall 948 women developed heart disease. ...

Compared with normal-weight active women, the risk for developing heart disease was 54 percent higher in overweight active women and 87 percent higher in obese active women. By contrast, it was 88 percent higher in overweight inactive women; and 2 1/2 times greater in obese inactive women.

The first big limitation of the study is that it relied on self-reporting. (The MPF reader who gave me the heads-up flagged this; based on his experience in the health-care industry, he said, you always have to use caution with self-reported results.)

The second is that the definition of "exercise" leaves out strength training. Here's a direct quote from the paper:

Women were asked to estimate the average time per week spent during the past year on the following 8 groups of recreational activities: walking and hiking; jogging; running; bicycling; aerobic exercise, aerobic dance and exercise; swimming; tennis, squash, and racquetball; and lower-intensity exercise. The number of flights of stairs climbed daily was also reported.

The third problem is a near-total lack of consideration for the intensity of exercise. (There's one interesting exception, which I'll get to in a moment.)

Another problem arises from the way the story is reported. The headlines hone in on the "fit but fat" angle, but really, the researchers didn't measure fitness.

They assessed physical activity, which is different. There were no treadmill tests to measure maximal oxygen uptake (VO2max), or timed 1.5-mile runs, or any other measure of fitness or performance. (And, of course, there were no assessments of strength or muscular endurance either.)

That's why there's an apples-and-oranges disconnect with these quotes toward the end of the story:

University of South Carolina obesity expert Steven Blair, a leading proponent of the "fit and fat" theory, said the study is limited by relying on women's self-reporting their activity levels. That method is not as reliable as a more objective fitness evaluation including exercise treadmill tests, Blair said. These tests include heart-rate measures to see how the heart responds to and tolerates exercise.

In Blair's research, overweight people deemed 'fit' by treadmill tests did not face increased risks of dying from heart disease.

As I said, Blair's point refers to a separate issue, and I'm not sure if it's truly an important one. Since body size and VO2max are both strongly linked to one's genetics, someone could be born to be fat and fit. A treadmill test would only confirm that this unusual pairing of familial tendencies puts one at low risk of heart disease, despite appearances to the contrary.

Measuring physical activity strikes me as more democratic, since it's something an individual can actually control (to a point, I mean; I understand that some people are predisposed to be more active than others). Which brings me to a couple of interesting findings:

According to this article in The Guardian, a soccer team in the UK wants to give its players a genetic test to see if any of them have a propensity for greatness. The inspiration was research published by a professor at Aberdeen University:

Wackerhage prepared an academic paper earlier this year highlighting experiments that had produced enhanced physical performance in mice and rats, and the possibilities offered by gene doping and screening for enhanced athletic performance. He has since suggested that it might be possible to produce the human equivalent of a formula one car by using genetic mutations. His research was picked up by the unnamed club, which got in touch hoping to exploit nascent gene-screening technology, already freely available in Australia, which tests athletes for a number of genes considered indicative of top-level performance. ...

Australian company Genetic Technologies offers a ... test that claims to identify whether customers have the fast-twitch muscle function gene ACTN3, which is found in leading sprinters.

There are other genes associated with athletic ability including PPARdelta, which governs slow-twitch muscle growth; IGF-1, which controls human growth; and genes that regulate erythropoietin, a hormone that affects the production of red blood cells.

My first reaction was much like that of this soccer official quoted later in the story:

Huw Jennings, youth development manager at the FA Premier League, said screening could have a role to play in identifying athletic talent but was unlikely to establish whether youngsters would make the grade as professional footballers.

"While you may be able to identify athletic ability, the road from promising youngster to top professional is far from smooth, and it doesn't necessarily follow that talented athletes will become talented footballers," he said.

In European soccer, as in American baseball, players who reach the highest levels tend to be born in particular months. Those months, not surprisingly, are right after the cutoff dates for Little League or the equivalent. Let's say a league's cutoff date is July 31, with kids before that date assigned to one age group and kids born after it assigned to the next one down. Kids born in August will always be the oldest in their leagues, giving them an advantage. Kids born in July will always be the youngest in their leagues, putting them at a disadvantage.

You'd think that the advantage would eventually disappear, as the athletes mature physically and they compete in high school and college, where the age cutoffs are different. But it doesn't. Apparently, being the oldest and best players throughout childhood has an effect that continues into adulthood.

What does that have to do with genetics? Nothing, which of course is my point. It's all about circumstances that led to early advantages over their peers. Another type of advantage might be having your father as a coach, giving you more opportunities to play than other kids with similar skill sets. Yet another advantage might come from affluence -- better-off families can afford to send their kids to camps where they'll get better coaching and develop more advanced skills than their peers.

None of this is to say that physical prowess isn't, at least in part, determined by genetics. I could've been born in the best month for whatever sport I wanted to play and gotten all the best coaching in the world, and I still wouldn't have had the talent to take advantage of it. I still would've been slow, weak, nearsighted, and at best modestly coordinated.

But even among athletes who possess all the key attributes, there's still something else that produces athletic greatness, particularly in team sports. According to this article, some baseball teams are experimenting with a new way to evaluate talent:

[T]he Cardinals now have a sophisticated computer program that correlates results from a written test to actual performance.

"We had heard another club had done that and had some interesting results," Luhnow said.

If it works, it might prove to be baseball's equivalent of the NFL's Wonderlic tests, which measure players' intelligence.

But as much as the NFL values intelligence in its quarterbacks and offensive linemen, the players who take the test already have a long history of accomplishment at their positions. If a quarterback can't throw a football, and hasn't been a star in high school and college, he's not going to get offered the chance to redeem his career with an IQ test.

So put me on the side of those who doubt if there'll ever be a genetic test that predicts superstardom, at least in team sports. Success remains the best predictor of success.

When my daughters took classes at the Parkettes National Gymnastics Center here in Allentown, I was struck by how different the style of coaching was. In the sports I'd played in my youth, like baseball, the coaches actually showed you how to catch, throw, and hit. But in gymnastics, the coaches told kids how to do the various things gymnasts do, but never actually demonstrated.

One time, as I watched my daughter and a few other kids try and clumsily fail to do some kind of tumbling thing, I asked someone why the instructor didn't just show the kids how to do it. "That's not the way they teach gymnastics," she replied with a shrug.

At the time, I didn't think much of it. It was clear that whatever they were doing worked with elite athletes, since Parkettes is a world-class training facility. While my daughter and the other non-elite kids tried and failed to master the basics, some of the best gymnasts in the U.S. were working on their skills and routines on the other side of the building.

But until I read this interview with former Parkettes star Jennifer Sey, I didn't know this about some of those coaches:

Throughout the book, you make elliptical references to male coaches who are attracted to young girls and imply that your own personal coach, John, was one of them. What did you mean when you said that he was "lewd and lascivious" and "may have liked being near all the barely dressed teens, but ... never explicitly let on"?

He was never inappropriate with us, but he was a really flirty guy, and we all saw that. And sometimes the women he flirted with were very close to our age -- 18, 19 years old, and we were 15 or 16. There were a lot of things he did that made me feel weird -- he was a weird guy. The conditions of the sport are strange, and that was what I was trying to say. Most men that coach women gymnasts have never been gymnasts themselves. So I always wondered, even as a child: Why do these men want to coach little girls? In some instances, it's purely financial. But I think in the minority of cases, there are men who are interested in little girls.

Man, that's creepy. I wrote about another creepy aspect of Parkettes in this post from my old blog:

While watching [my daughter], I got into a conversation with the mother of a 12-year-old girl who is on that track. This girl is at level 9, which is two steps away from the "elite" designation. Elite gymnasts are the ones who compete internationally. But the level-10 gymnasts, the mother told me, are virtually guaranteed college scholarships. One recent level-10 gymnast at this club was offered 45 college scholarships, she said.

That's not a typo: one kid, 45 scholarship offers.

Of course, that got my attention, but then the conversation went a different direction, and we started talking about the type of commitment that gets a kid to that level.

She told me she home-schools her daughter, because the regional and national travel, on top of daily practice, makes a normal school schedule impossible. She didn't say how much all this costs. But when I told her I'd heard from a friend that it costs $1,000 a month to compete at that level, she said it wasn't that high, but implied that it wasn't a whole lot less.

So just when I was thinking that a few years of travel and training would negate any financial benefit of a college scholarship, the conversation took another turn:

Her daughter came over, with one foot bandaged. They had a quick back-and-forth, and then the daughter ran off to continue training.

I asked what was wrong with her daughter's foot. She said, "Oh, they think it's a stress fracture. But they don't want her to go see a doctor."

Why not?

"A doctor'll just tell her to stay off it. And then she'll have to quit training. If you see a doctor, you have to do what he says."

If I read this correctly, she was talking about legal liability; the club has none, as long as the kids don't see an actual doctor for their injuries. As soon as they see a doctor, it's game over. At that point, ignoring the doctor's advice could set up the gymnastics center for a lawsuit.

I then said what anyone who knows me would expect me to say: "If any coach tried to tell me whether or not I could take my kid to a doctor, there would be trouble."

She smiled. "Then your kids couldn't do this."

Apparently that policy regarding doctors is a new one. When Sey competed for Parkettes, in the mid-1980s, it went like this:

You portray the Parkettes team doctor, Dr. Dixon, as something of a charlatan, a man who deferred to your coaches about medical decisions and sent you back to the gym to train with a concussion in one instance, a freshly broken ankle in another.

The way he would probably present himself is that he aided you in getting back to your goal. It's easy to look back and say that as a doctor, he should have had my physical and mental health at heart, but he saw my best interests as getting me back into the gym so I could compete and win. I think that most orthopods and specialists who treat high-level athletes are probably very similar. If you talk to the doctor for the San Francisco 49ers, they probably send people into play who aren't 100 percent. What made the situation unique is that we were children.

The two passages I quoted from the Salon interview aren't even the worst parts of Sey's story, which I assume just scratches the surface of the details revealed in her new book, Chalked Up. The book's subhead offers some broad hints: "Inside Elite Gymnastics' Merciless Coaching, Overzealous Parents, Eating Disorders, and Elusive Olympic Dreams."

We all dream of our children achieving some level of excellence in their pursuits, but it's nice to think my daughters aren't the type of athletes who'd get caught up in that kind of madness. They're good at what they do, but we'll never have to worry about their talent forcing us to make choices that could ruin their chance for a normal, happy life.

Yesterday was Earth Day, an event I barely noticed because it happened to coincide with the Pennsylvania primary. I'm a big fan of the earth, in both its lowercase and uppercase permutations, and try to avoid screwing it up whenever possible.

The key word there is "possible." I'm not an all-or-nothing guy, which is why I'm not a vegan or a Ron Paul supporter. I like meat, and I don't want to return to the gold standard.

Earth Day and Election Day, unfortunately, tend to bring out the extremes in our species. Vegans tell us our meat eating is killing the planet, and political enthusiasts tell us the candidate they oppose will bring about the end of our republic as we know it. There's nothing in between, and whether we're talking about poultry or politics, the message is the same:

Repent, and ye shall be saved. Continue your life of sin, and ye shall damn us all to hell.

That brings me to Regina Wilshire, who writes a terrific blog called The Weight of the Evidence. Regina focuses on low-carb diets, and always manages to look beyond the headlines to find something interesting and incisive to add to the debate. Yesterday she outdid herself with this magnificent response to the anti-meat movement:

[I]s eating meat really an environmental problem? The answer really is a "yes" and "no."

Meat from livestock is an excellent source of complete protein, vitamins, minerals and fatty acids essential to human health.

The big problem isn't so much the meat, but the way we in the United States (and more and more countries around the world) raise livestock today -- intensive feedlot operations which demand huge amounts of "inputs" to fatten cattle quickly.

The various reports on the global impact of raising livestock are based on factory farming practices which are indeed damaging to the environment.

To understand how, we need to look at how livestock in the US, and in other parts of the world, is now routinely raised for food and how the messages about the "inputs" is virtually ignored by the popular and politically correct message to eat less meat. All of these "inputs," interestingly, are also required for growing the plant-based vegetarian/vegan diet being promoted as the way for us to save the plant ... but those promoting that message don't bother telling us that in their cries we must eat less meat.

Like I said, the problem isn't the meat -- it's the method used to produce the meat.

I recommend reading the entire post, including the comments. You'll see that she got hammered with responses from vegans, who do what extreme partisans always do in arguments: They shout slogans and pay no attention to any part of an argument that might suggest common ground, or at least a point at which reasonable people can disagree. It's all fire and brimstone -- if you don't agree with the environmental argument against eating meat, then you're just a murderer because you can't eat meat without killing something.

They win because they're anti-death. You lose because you're willing to acknowledge the necessity of killing something before eating it. You can support more humane ways to raise and eventually slaughter the animals, but there's really no getting around the fact that there will be blood.

Vegans, like Ron Paul supporters, seem to thrive on the unpopularity and impracticality of their positions. It's easy to be an uncompromising zealot when nobody takes you seriously enough to compromise with you. It's easy to oppose the killing of any animal for any reason when you know there's zero chance you'll wake up to find a herd of bison crapping on your earth-friendly composite flooring. It's easy to say "abolish the IRS and eliminate all entitlement programs" when you know your own grandparents won't end up living in your storage shed and raiding your medicine cabinets.

Coming up with practical solutions that people can accept and live with -- that's hard.

We all know that Americans live longer than ever before. We also know that life is unfair -- some live longer than others. What we didn't know, until today, is how much lifespan varies from one part of the country to the next.

It's starting to look at this map posted by USA Today and see the differences. The blue and dark blue areas of the map indicate the shortest lifespans. The light green and yellow show the longest lives.

While most Americans enjoyed a clear jump in life expectancy from 1960 to 2000, a startling number -- especially women -- living primarily in the Deep South and in Appalachia actually saw a drop in life spans beginning in 1983, says a study that came out Monday.

In sum, where you live makes a difference in how long you can expect to live.

Researchers at the Harvard School of Public Health and the University of Washington found that 4 percent of the male population and 19 percent of the female population experienced either declines or stagnation in their life expectancy in the '80s and '90s. The paper appears in the online non-profit journal The Public Library of Science.

Most counties with the worst downward swings were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas.

The male-female discrepancy is interesting. If you toggle back and forth on the USA Today map, you can see that in some parts of the country (Oregon and California jumped out at me) women are doing worse than men.

The reasons why life expectancy is falling back aren't particularly surprising. The researchers mention the usual suspects: obesity and smoking produce heart and lung disease, cancer, and diabetes.

From 1983 to 1999, the gap between men living in the best- and worst-off counties widened from nine to 11 years. The gap for women widened from 6.7 to 7.5 years.

"The worse off are getting worse," Ezzati says. "There's just more inequality."

Interestingly, inequality in health and longevity actually seems to favor one political party over the other. Almost all the states with dark-blue patches have voted for Republicans for president in recent elections. There's the Deep South, of course, but also Wyoming, Montana, South Dakota, Arizona, New Mexico.

But it doesn't follow that the states with the most yellow and light-green areas support Democrats. The Northeast, West Coast, and North Central U.S. have been solid for the Democratic Party the past few elections. Some other areas where people live longer, like Colorado and Iowa, are trending toward the Democrats. Virginia is trending Democratic as well, and those yellow and light-green pockets in the northern part of the state might explain why.

Conversely, people in Utah and Idaho are anomalies for having long lives and deeply conservative politics. Nebraska and Kansas also have lots of yellow and light green, but aren't likely to cast their electoral lot for a Democratic president in 2008. Alaska and Hawaii, two states with lots of light green, split their affiliations: Alaska is a stalwart Republican state (although that might change if every single elected Republican in the state ends up in legal trouble), while Hawaii goes for Democrats.

Earlier studies have shown a gap in life expectancies between black and white Americans, but this latest research found that in the counties where declines occurred, they occurred in whites as well as blacks. Race appears less a factor in health disparities than income.

The findings linking county of residence to health outcomes also mirror the results of other studies of health disparities within neighborhoods of individual counties. "We found the same thing in Alameda County [in Northern California]. Blacks in the flatlands live less long than blacks in the hills; whites in the flatlands live less long than whites in the hills," said Alameda County Health Officer Dr. Anthony Iton.

I had no idea, until I saw this report on 60 Minutes last night, that gastric-bypass surgery causes immediate remission of type 2 diabetes, stops sleep apnea, and may even reduce the incidence of obesity-related cancer.

The report makes a pretty strong argument for all those benefits, which kick in even before the main effect of the surgery, which is dramatic (and more or less sustained) weight loss.

A big reason the operation works is because it seems to suppress appetite. "If you listen to your patients, they come back and they say, 'Doctor, you put the fire out,'" Hutcher says. ...

Paul Delios of Saugus, Mass. has lost 90 pounds. He owns a doughnut shop with his siblings, but he's able to resist the cravings. "Before I'd have cravings for everything. Now I really don't," he told Stahl.

For most patients the cravings really do disappear. One theory is that's because the operation suppresses the levels of a stomach hormone called "grelin" that activates the sensation of hunger.

Studies confirm that about 80 percent of diabetics go into complete remission following the operation. Obesity is considered one of the major causes of type 2 diabetes, but here's something odd: when you have the gastric bypass operation, your diabetes goes away long before you lose the weight. ...

This spontaneous remission puzzled Italian surgeon Francesco Rubino, now at New York Presbyterian Weill Cornell Medical Center. "We wanted to know what is making diabetes remit. We thought it could have been something to do with the small bowel," Dr. Rubino says.

So he began performing the bypass on diabetic rats, and realized that when he disconnected the top of the small intestine, an area called the duodenum, the diabetes disappeared. Then, he reversed the operation. When he reattached it, the diabetes came back.

This was a pivotal discovery. By merely blocking food from traveling through the duodenum, Rubino sent diabetes into remission, proving the effect was independent from weight loss. This meant diabetes could essentially be removed with a scalpel.

Dr. Rubino argues that the surgery, which he now performs on humans with type 2 diabetes, is safe and effective. 60 Minutes notes that it's not legal in the U.S., since our regulations only allow bariatric surgery for people who're morbidly obese. Naturally, 60 Minutes argues that those guidelines -- written 19 years ago, long before anyone knew about the surgery's potential benefit for diabetics -- should be reversed.

Which brings me to the big question I have about all this: Just because we can reverse obesity-related disorders with a surgery, should we? One doctor, himself a successful bariatric-surgery patient, says he now is much more likely to recommend it for overweight patients:

The bypass operation costs an average of $25,000 and insurance companies don't always cover it; and despite the gains in safety, most doctors still consider the operation an option of last resort. That is no longer the case for Dr. Miller's patients.

"I look at 'em now and I'm handing out my surgeon's card right when I see 'em. I'm not waiting for the last resort now," Dr. Miller says, who lost 120 pounds after the surgery.

"Do you think most doctors are where you are?" Stahl asks.

"Probably not," he says. "They haven't walked the walk."

On the one hand, the surgery is more refined now, with less risk to patients. The death rate, according to 60 Minutes, has gone from 1 in 100 patients to 1 in 1,000. More surgeons have more cumulative experience with the operation than ever before. On the whole, the odds of the surgery improving the lives of patients seems to far outweigh the potential risks, assuming at this point that the only people getting the surgery are the ones who want it. (We may someday get to the point where people who don't want it are pressured into it, but I think that's still pretty far down the road.)

But, to use a financial-industry term, I wonder if making bariatric surgery too easy to get presents a risk of moral hazard. Here's the Wikipedia definition of the term:

Moral hazard is the prospect that a party insulated from risk may behave differently from the way it would behave if it were fully exposed to the risk. Moral hazard arises because an individual or institution does not bear the full consequences of its actions, and therefore has a tendency to act less carefully than it otherwise would, leaving another party to bear some responsibility for the consequences of those actions.

When the subprime-mortgage crisis hit, there was a lot of talk of moral hazard. If people on both ends of the crisis - lenders and borrowers -- can get relief from the bad choices they made, what message does that send? Here's Wikipedia again:

A moral hazard arises if lending institutions believe that they can make risky loans that will pay handsomely if the investment turns out well but they will not have to fully pay for losses if the investment turns out badly. Taxpayers, depositors, other creditors have often had to shoulder at least part of the burden of risky financial decisions made by lending institutions.

A moral hazard can also occur with borrowers. Borrowers may not act prudently (in the view of the lender) when they invest or spend funds recklessly. For example, credit card companies often limit the amount borrowers can spend using their cards, because without such limits those borrowers may spend borrowed funds recklessly, leading to default.

It's easy to apply that to obesity: If you know that surgery can reverse the impact of bad choices you've made in your diet and lifestyle, what's your incentive to change those behaviors? One of the surgery patients interviewed in the 60 Minutes story said he used to be "addicted to food." After the surgery he was not only cured of that addiction, he also became more active.

Which is great for him, but what message does it send to others? What if there was a surgery that cured alcoholism, for example? Would someone struggling with drinking problems have any incentive to change his behavior? Or would he get the message that he can keep on drinking, and if it becomes too problematic he can simply get an operation that turns him into a teetotaler overnight?

The libertarian in me wants people who want the surgery to be able to get it with as few roadblocks as possible. The part of me that's inherently skeptical about miracle cures wants to keep the gastric-bypass bandwagon in the slow lane. The part of me that's a realist acknowledges that nobody really chooses to be obese, that there's a powerful genetic component to obesity, and that modern life encourages overconsumption of everything, including food. Finally, the part of me that's a fitness professional wants people to have every incentive to exercise, eat a clean diet, and manage their lifestyle for maximum health and longevity.

A lot of women are intimidated in the gym by machines and free weights, but they should be using them, especially the weights, according to Lou Schuler, a strength training expert and author of the book, The New Rules of Lifting for Women.

First, Schuler wants to dispel the myth that strength training means building bulky muscles. He offers himself as living proof.

"I'm 51 years old. I started working out when I was 13, and I'm still waiting for the day when I look in the mirror and say, 'Gosh darn it, I'm so bulked up, I've got to stop lifting weights,'" said Schuler.

The interview was for the ABC affiliate in Philadelphia, and if you click around you can see the video clip. But I wanted to highlight that quote as proof to my friends and former colleagues that, yes, I really did say "gosh darn it" instead of the more typical expletives I'm known to use. My brain really does have an editing function, and on some occasions it actually works.

Speaking of former colleagues, Adam Campbell is helping Good Morning America's Chris Cuomo get in shape. The main ABC website has this story, written by Adam, called "Five Reasons You're Still Fat."

A new study suggests that a chemical known to regulate appetite can cause your body to act against its own best interests. The science, I confess, is over my head, but this BBC News report gamely attempts an explanation:

The fat that some people carry around their middles could be making them even fatter, researchers have said. The Canadian team found abdominal fat tissue produces a hormone called NPY -- which also prompts the development of cells that turn into fat.

The upshot is that a vicious cycle ensues once visceral fat starts producing neuropeptide Y: You get hungrier, you eat more, and you're more likely to store that excess food in these new fat cells accumulating in your midsection.

The news report concludes with hope for a new drug to slow down or reverse this process:

Dr. Yang added: "If you can detect NPY early and identify those at risk for abdominal obesity we can then target therapy to turn off NPY. It would be much easier to use drugs to prevent obesity than to treat the diseases caused by obesity."

I guess that's true. But what happens if you intervene even earlier, and use diet, exercise, and lifestyle changes to prevent that accumulation of abdominal fat in the first place? Wouldn't that nip the entire process in the bud?

John Coates, a former Wall Street trader, was intrigued by the aggressive, testosterone-fueled behavior he observed in his fellow money-makers. So when he changed careers and went into academia, he decided to study their hormonal attributes. Here's what he found:

In a new study he reports that traders who start the workday with high testosterone levels make more money on that day than their low-testosterone colleagues do. A hot day on the market sends their levels of the natural steroid up even more, Coates says; under the influence of their own hormones, they start to take bigger risks in hopes of bigger rewards.

Classical economic theory assumes that people make financial decisions in a rational way. But Coates's finding is part of a growing body of work explaining why, in reality, they often don't: they're at the mercy of their biology. This school of thought helps illustrate how economic trends can get out of control, ballooning until they burst. It also suggests one reason why central banking is so tricky: policymakers don't often take hormones into account. "[Former Federal Reserve chairman] Alan Greenspan spent his whole career trying to control economic bubbles," says Coates. "I don't think he realized he was up against steroids."

Eventually, it all backfires, which is how winning streaks end and spectacular profits turn into devastating losses:

In animals testosterone-fueled perpetual winners eventually get careless. "The hormone gets to a point where it starts to impair their judgment," he says. "They start going out in the open too much, they pick too many fights, they neglect their parenting duties. It turns into stupid risk-taking." In humans the desire for ever greater risks can destroy careers (we're looking at you, Eliot Spitzer) -- or even, when it catches on en masse, whole economies.

That's where the reverse of the winner effect -- call it the "loser effect" -- comes in. After a loss testosterone levels in males come right back down, and levels of cortisol surge instead. Cortisol, a stress hormone, is the brake to testosterone's gas pedal, and what sends it spiraling up is uncertainty -- just the kind of condition a trader would encounter in a suddenly volatile market. "If you have chronic exposure to cortisol, you start to recall bad memories more often and you see risk everywhere," says Coates. "This hormone may make traders dramatically risk-averse." Just as testosterone increases in an economic bubble, cortisol may rise in a recession. That, says Coates, is yet another reason that central-banking policies sometimes can't halt an economic downslide. "At some point, what people are responding to is more than price levels."

Given that, you may think that women make ideal traders. Their testosterone levels will rise with competition, but actually winning or losing won't affect their hormonal levels in any substantial way. Alas, it's not quite that simple.

According to game theory, winners win by being decisive, and sticking with their winning decisions. The context of this particular story is mating -- the man-woman thing -- but it seems to me that it could apply to investing as well:

[G]ame theory predicts, and empirical studies of auctions bear out, that auctions will often be won by "weak" bidders, who know that they can be outbid and so bid more aggressively, while the "strong" bidders will hold out for a really great deal. ... [W]ith a lot at stake in getting it right in one shot, it's the women who are confident that they are holding a strong hand who are likely to hold out and wait for the perfect prospect.

If we're talking about marriage, those who hold out because they know they're holding a strong hand -- they're beautiful, charming, brilliant, successful in their careers, or some combination -- sometimes find that the best marital prospects have already been snapped up by women who realized they were holding a weaker hand and were savvy and decisive enough to make the first move.

Now, getting back to business, the testosterone-fueled guys will get on winning streaks by finding underappreciated assets and bidding up their price until they become overpriced. Alas, because of their hormones, they'll keep trading those assets long after the point when they should've banked their profits and started looking for something else to trade. That's how we get bubbles, and why there's so much pain and suffering when they burst.

Game theory suggests that a "strong" trader -- someone who's a truly rational player -- might not be quite so willing to jump into undervalued assets, and thus would lose out on the really big profits to be made when those assets go from depressed to overvalued.

I guess that means the perfect trader would be someone who has the cajones to get in before others do, and to be decisive enough to pay what at first appears to be an irrationally high price for some types of investments. Then, when others jump into the market and bid the price up even higher out of fear that they'll miss a great investment opportunity, the perfect trader needs to be able to sell the assets at the inflated price, collect the well-earned profits, and start looking for the next great opportunity to make a killing.

In other words, the perfect trader would probably be male at the beginning of an economic cycle -- taking big risks on what he hopes are undervalued assets -- and female at the end of the cycle, making it easy to resist the urge to keep playing after the game is already won.

All of which should make us appreciate just how hard it is to be a successful investor.


	Male Pattern Fitness : An SB Nation blog about meat, muscle, and the minds of men

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