Individual performance varies, and this variation can be partly explained by genes. But lifestyle, diet, and behavior matter, too. A journalist named Adharanand Finn observed the strenuous, physically active lives of rural Kenyan children, many of whom chase goats and livestock at home, then run long distances to and from school. These children have little access to television or computers, and virtually all of them are barefoot. One Kenyan tribe in particular has consistently produced running champions—the Kalenjin. Their steely determination and active rural lifestyle appear to have converged to make them the fastest endurance runners in the world.
Similarly, the Tarahumara of Mexico are famous for covering extraordinary distances wearing sandals made of old tires and rope. When Tarahumara legend Arnulfo Quimare spoke at the 2016 Boston Marathon, a runner in the audience asked about his “training” regimen. Through a translator (who had to pause to find the suitable word), Arnulfo replied that his “training” consisted mostly of walking from village to village.
When it comes to running, there’s no evidence that the Tarahumara or the Kenyans are genetically superior to anyone else. Harvard evolutionary biologist Daniel Lieberman points out that people in these groups are prone, like all of us, to habits that can lead to illness and poor running technique, especially when they adopt Western diets and modern running shoes.
COMPETING EVOLUTIONARY INTENTIONS
We evolved to run, to walk, and to remain active. At the same time, we were born to conserve energy whenever possible—to rest and relax. In the calorie-shy world of our ancestors, the ability to reduce caloric expenditure, and to store that energy through periods of no food, conferred survival advantages. For modern humans, however, this genetic tendency to pack away calories has created something of an evolutionary dilemma. Researcher James H. O’Keefe and his colleagues describe a “millennia-old connection—the balance between energy expenditure, calorie ingestion, and appropriate hormonal responses.” In other words, the connection between our inner nature and the environment we live in has largely been severed. “Until a century or so ago,” O’Keefe says, “never before in history have humans been routinely exposed to high caloric, highly processed foods in excess of the calories needed to function.” (This may have been true for most, but not all. Dr. Michael Eades often speaks of the mummified evidence and artistic renditions of the farinaceous Egyptian culture. A high body weight may have been a sign of wealth and status, though it appears that a far smaller percentage of people were overweight in earlier times.)
We’re beginning to see that this inborn proclivity to take the path of least resistance and eat as much as we desire plays a major role in the health woes and rising health care costs beleaguering modern people. Obesity and high-sugar diets create fertile ground for a variety of modern diseases, especially type 2 diabetes. We’ll address this in the chapters on nutrition and diet.
Therein lies the inspiration for this book: the hope that we can become better, more functional, healthier humans—and restore and nurture our connection to who we are and to how we were meant to live. This doesn’t mean finding a place of stasis and comfort. It demands that we actively resist the inborn desire to remain on the couch and eat whatever is within reach.
We’re living in a unique time in human history, one in which we have a choice of lifestyles. Our bodies didn’t evolve to sit all day at a desk, though many of us do. Nor, admittedly, did we evolve to be ultra-marathon-running machines, though I have occasionally aspired to be such, and have enjoyed the adventure. Our goal should be to find a place in between, and to adopt a lifestyle that matches what our bodies were designed for. Homeostasis with hormesis as the path to excellence.
NEW OLD ROUTINES
The daily routines we have fallen into over the past several generations have perpetuated a number of habits that are harmful to our health. Not only have our diets, sleep patterns, and anxiety levels changed, but the ways we move our bodies (or don’t move them) have drifted from the natural, ergonomically efficient patterns of our ancestors. One example is sitting, which I discuss in chapter 3, on posture and walking. If we sit in a slumped position—head and shoulders forward, hips flexed, and glutes overstretched—we develop a muscle memory that disrupts our standing posture. We become misaligned, and all of our movements suffer.
Technological aids and interventions don’t help. Drugs, orthotics, gimmicks, supplements, and fads that promise to compensate for our declining mobility and health mainly serve to accelerate our bodies’ physiological drift. These expensive “fixes” seldom correct the underlying problems, which often originate in poor posture, incorrect movement, and unhealthy behavior. Many of the modern medical interventions, too, merely accommodate our ancient human bodies to a very different modern world. We end up with growing instances of what Dr. Lieberman has termed “mismatch diseases,” afflictions resulting from behavior, movement patterns, and diet that don’t match the physiology (and psychology) of the bodies and minds we inherited from our ancestors.
QUALITY OF LIFE: MORE IMPORTANT THAN QUANTITY
Despite all this medical attention, the disability-adjusted life expectancy (DALE) and the health-adjusted life expectancy (HALE) for Americans is only seventy years, which doesn’t even figure into the global top twenty. And if you discount only two developments of the last century—the significant reduction in infant mortality, and the singular lifesaving qualities of antibiotics—life spans today aren’t all that much longer than they were generations ago.
By some measures, average functional life spans in the United States have started to decline. This refers to the length of one’s healthy, active life, in contrast to the total number of years that one has been alive. In light of this, Orville Rogers, a one-hundred-year-old Masters record holder in the 200-meter run, quipped that our goal should be to “live long and die short.”
How do we do that? Researcher James O’Keefe points out that the daily physical activity pattern of hunter-gatherers forms an ideal template from which to design a modern exercise regimen—one that works to realign our daily movement with the archetype encoded within our genome. Indeed, the drills at the end of each chapter have premodern counterparts. For instance, endurance training (long, slow runs) was essential for persistence hunting; interval training (jogging punctuated with short sprints) corresponds to fighting and fleeing; strength training (such as lifting weights) replicates house building or handling large game; and mobility training (moving the body through its full range of motion) reproduces a variety of movements needed for survival. Rest and recovery is included front and center in this template: hunter-gatherers spent plenty of time relaxing, too.
I’m convinced that to avoid the tantalizing perils of the convenient modern age, we need to reclaim a bit of our evolutionary past—by eating simple, natural foods, and by regularly putting our bodies through a wide range of movements. Throughout, hopefully, we’ll also experience a sense of enjoyment and play. (In recent generations, this has been re-created in the context of sports.)
Fortunately, even low to moderate levels of exercise, sports, or exertion at your job can improve your health. This simple message isn’t always self-evident in a society that assumes more is better and faster is best. As a doctor attempting to reintroduce the concepts of simplicity, consistency, and modest effort, I sometimes feel “old school,” swimming against a tide of fads, assumptions, quick fixes, hacks, New Age remedies, and popular theories.
You’re about to learn more about the miracle of human mechanics and enjoy the art, the mechanics, and the plain old addictive pleasure of walking and running, which is ingrained in our DNA.
Let’s get started.
DRILLS
The preliminary drills in this chapter involve balance, which requires the integration of our eyes, inner ears, and receptors in our feet and throughout the body. Balance is the foundation—the prerequisite, really—for the other exercises and activities desc
ribed in this book. And good balance is the basis of healthy running’s single most important attribute: relaxation.
Once you have mastered the following drills, you can elevate the challenge and add a bit of fun by closing your eyes, or by standing on a cushion or folded yoga mat.
One-legged balance
Start barefoot on a firm surface. Keep a chair or a wall within reach.
Lift your knee and lower leg slightly. Then slowly lower and extend your thigh behind you, and extend it at the hip. Hold this position first with eyes open, then closed. Change up your position by placing your hands on your hips, by stretching your arms to the side, and by swinging them up and down (as if making “snow angels” in the air), with your thumbs pointed to the rear. Switch feet. Repeat this as often as you can during the day.
Leg swings
Stand on your right leg and raise the left leg a few inches off the floor. With arms at your sides, swing your left leg forward and back, then from side to side. Repeat with the other leg. Try not to allow your swinging foot to touch the ground.
One-legged squat
Plant your feet hip-width apart. Lift your right foot and extend it back just a bit. Now push your hips back and down into a partial, one-legged squat position. Your right knee is bent, chest upright, eyes forward, as your butt aims for an imaginary stool behind you. Use your glutes (butt muscles) to return to the starting position. Repeat with the other foot.
Golfer’s pickup (or single-leg dead lift)
As you hinge forward, maintain a straight line from your head to your outstretched foot. Keep your hips parallel to the floor, and maintain the natural lumbar curve of your back.
For repeated lifting from the floor of light objects (only!), the safest method is not to bend the knees and to keep the back erect. The “golfer’s pickup” is easier on the joints. As one leg rises behind (for counterbalance), the torso tilts forward over the stance leg, forming a fulcrum. No spine or knee bending occurs.
Simply balance on your left foot and hinge forward at the hips, while you reach toward the ground with your right hand as if to pick up a golf ball. Your knee and your back are straight but relaxed throughout. Tighten the buttocks as you return to the starting position.
Explore your feet
Our feet have two hundred thousand sensory receptors that are constantly, and unconsciously, apprising us of our position so that we can make microadjustments to our balance. With your shoes off, in the house or in the office, spend a bit of time each day walking on your heels, then on the balls of your feet, then on the outside edges of the feet, then on the inside edges.
Single-leg run (for the more advanced)
I do this several times a week at the end of a run, preferably on a soft (but not unstable) surface such as a grassy field. Balance on one leg, engage the muscles of your core, and hop with a running motion on one leg for five to ten hops. Switch to the other leg. Start with 10–20 meters, and work your way up to 50–100 meters. This requires active concentration on balance, and focusing on the foot and lower leg as a spring.
CHAPTER 2
Stand Up and Breathe
Eighty percent of young people have back pain. The other 20 percent have no computer.
—UNKNOWN
MYTH: Strength is the foundation of performance.
FACT: It all begins with posture.
I live in West Virginia, but when I run in Central Park, I pause at the “Imagine” mosaic that memorializes John Lennon, and I imagine peace in the world. I also imagine a world in which we are more at peace with our own bodies. It’s a world where there is no back pain, and no metabolic or degenerative illnesses.
That world exists today—for societies in which people avoid prolonged sitting. If you are in your early fifties or older, you may even remember that time—a pre-video-game childhood of summers when the only occasion you sat was at the table for dinner (and maybe on the floor for a board game or an episode of your favorite TV show).
Now we suffer through chronic back pain, poor posture, and incomplete breathing, much of it caused by too much sitting. The good news is that there are simple remedies for these, and they add time to your day, not take it away. All it requires is correcting your posture, spending more time on your feet, finding a bit of comfortable space on the floor, and working on “spine hygiene.”
As John Lennon sings, It’s easy if you try.
HOW SITTING IS KILLING US
Parking ourselves in chairs for extended periods results in a chronic shortening of the hip flexors, the muscles in front that connect the pelvis and lower spine to our legs. Sitting also overstretches and weakens the muscles in back, the glutes—the substantial butt muscles that support much of our movement. When we stand up after hours of being chair-bound, our pelvis and spine don’t immediately return to their balanced, “neutral” position. Our posture remains stooped (sometimes imperceptibly) and our full range of motion is impaired.
This new “default” posture sets off a series of other postural compensations. Without fully realizing it, we end up walking around just slightly “wonky,” with shoulders rolled forward, upper back rounded, and head carried in front of our center of gravity—as shown in the figure on this page. For every inch that your head is positioned forward, five to seven pounds of stress are added to the lower cervical spine. As we will learn in the chapter on feet, modern shoes (and elevated heels in particular) exacerbate this dysfunctional posture.
At left, head and shoulders are slumped forward in “texting position.” The spine is displaced from its natural, tall, straight architecture. Texting or desktop posture is hard on the joints and requires static muscle strength to maintain. On the right: straight, strong, and stable posture.
We simply spend too much time out of balance. When our posture is not tall, balanced, and relaxed, our efficiency of movement is reduced to the point that even standing becomes uncomfortable. This mild discomfort reinforces the desire to sit. As sitting becomes the easy, less painful option, it becomes habitual, and creates a sedentary feedback loop. As athlete and massage therapist Laura Bergman says, “How you stand is how you land.” Cycling—though unquestionably a healthful activity—doesn’t help with this, due to the cyclist’s bent-over, sitting position.
Kids who are confined to school desks for hours (typically followed by more hours on couches at home) quietly begin to suffer a shortening of the deep hip flexors—the psoas and iliacus muscles. Distressingly, the resulting bent-over posture and inefficient movement patterns are imprinted and passed on to adulthood.
The iliacus and psoas are dominant hip flexors.
These major muscles shorten with prolonged sitting.
Physical therapist Kelly Starrett noticed that pre-kindergarten children run naturally, with minimal exertion—sprinting, powering hard, running on the balls of their feet, “like miniature Kenyan marathon runners.” He also saw, as I have seen in my clinic, that by first grade half the kids start heel striking. And by second grade, most children’s running and movement patterns have become dysfunctional. In this case, practice doesn’t make perfect. It makes dysfunctionality permanent.
SITTING SENDS A SIGNAL: STORE UP THE CALORIES
In addition to the structural changes caused by sitting, the mere act of sitting down sends metabolic signals to store energy. As we’ll explore later, sitting and inactivity trigger a dramatic reduction of the enzyme that is essential for the metabolism of triglycerides in muscle mitochondria. Those triglycerides are then converted into fatty acids that accumulate in the liver and in adipose tissues (belly fat), elevating the risk of metabolic diseases. Studies show that prolonged sitting decreases the diameter of arteries, as well, and increases blood pressure and the risk of heart disease, type 2 diabetes, cancer, and early death.
The bigger picture is even scarier. A recent meta-analysis, extracted from multiple studies and pooled data, showed th
at even rigorous daily exercise doesn’t mitigate the negative health effects of sitting, even for those who exercise regularly and are physically active (including marathon runners). This “active couch potato syndrome” came as a surprise to me because, like many of us, I assumed that a daily thirty-minute run or other activity (as recommended in the Physical Activity Guidelines for Americans) would surely undo the harmful effects of a day of prolonged sitting.
As part of my Air Force flight doctor training, I spent one of the most physically challenging (and body-damaging) days of my life when I was subjected to repeated spins in a human centrifuge. I was taken up to six Gs (six times the force of gravity), then to nine Gs. I survived the test protocol, but the soreness I felt, which lasted several days, made a marathon seem like a Sunday stroll. Our bodies are simply not adapted to this kind of stress.
Joan Vernikos, former director of NASA’s Life Sciences Division and author of Sitting Kills, Moving Heals, has studied the effects of G forces and gravity—and also weightlessness—on the body. She learned that prolonged zero gravity (no G forces) is harder on the body than those excessive G forces. Even relatively short periods in a weightless environment accelerate aging and reduce bone mass and bone mineral density, and this elevates the risk of fracture.
Run for Your Life Page 3