Human Locomotion and Injury-Free Running, by Thomas C. Michaud. Epic reads for anyone treating runners in a health care setting, by the illustrator for this book.
8 Steps to a Pain-Free Back, by Esther Gokhale. Relearn how to sit, stand, and walk.
Running and Being, by Dr. George Sheehan. A classic work by the original doctor/runner/philosopher/exercise authority.
Long Distance, by Bill McKibben. A great read on the principles of exercise physiology and the mind to endure.
Why We Run, by Bernd Heinrich. For the anthropologist in us all. How can birds fly for thousands of miles on minimal food? By burning efficient and tasty fat.
Lore of Running, by Dr. Tim Noakes. Explains the science of running in detail. The fourth edition is considered the bible of running.
Born to Run and Natural Born Heroes, by Christopher McDougall. The New York Times bestselling author tells the tale of an injured runner discovering the secrets of the legendary Tarahumara of Mexico and the secrets of the legendary citizen soldiers of Crete.
Spark: The Revolutionary New Science of Exercise and the Brain, by John Ratey. A groundbreaking and fascinating investigation of the transformative effects of exercise on the brain.
Play: How It Shapes the Brain, Opens the Imagination, and Invigorates the Soul, by Stuart Brown. An excellent book on the science of play and its essential role in a life of happiness and intelligence.
Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists, by Thomas Myers. This book will change the way you view the human body and how it moves. We all need to understand how to maintain our fascia, the vital web that integrates our body’s communication with its movement.
Fit Soul, Fit Body, by Brandt Segunda and Mark Allen. A six-time Ironman winner reflects on the essentials of sustainable activity and health. Discover the connection between mind, body, and soul.
The Nature Fix, by Florence Williams. Without vitamin “N,” it is rare for any positive health change to occur. An in-depth dive into the science of the outdoors, suitable for reading in the sunshine or in the shade of a tree.
And a few of my favorites on diet and nutrition:
The Overfat Pandemic, by Dr. Philip Maffetone. Emerging research shows that the overfat pandemic is alarmingly prevalent in developed countries, where up to 80 percent of adults and 50 percent of children suffer from this condition.
Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease, by Robert Lustig, M.D. An excellent overview and disquisition for anyone who wants to understand the science of food and obesity. This is required reading for our medical students.
Why We Get Fat and What to Do About It; Good Calories, Bad Calories; and The Case Against Sugar, by Gary Taubes. Three eye-opening, myth-shattering examinations of what makes us fat, from the acclaimed science writer.
Deep Nutrition, by Catherine Shanahan, M.D. Affectionately known as “Dr. Cate” to the Los Angeles Lakers and other professional sports teams, she was an innovator who connected healthy food to human performance in a transformative way, for those whose careers depend on it.
In Defense of Food and Food Rules, by Michael Pollan. This eloquent manifesto and follow-up handbook show how we can start making thoughtful food choices that will enrich our lives, enlarge our sense of what it means to be healthy, and bring pleasure back to eating.
Nutrition and Physical Degeneration, by Weston A. Price. A classic work from the 1930s on nutrition and its effects on health, based on Price’s studies of the healthiest places on earth.
Always Hungry?, by David Ludwig, M.D. From one of the world’s leading obesity clinicians and researchers. Overeating does not make you fat.
The Big Fat Surprise, by Nina Teicholz. Nina challenges the establishment. Ten years of work went into this impeccably researched challenge to those who suggest that dietary fat is the cause of obesity and disease.
Eat Fat, Get Thin, by Mark Hyman, M.D., of the Cleveland Clinic. More simple truth about what is wrong with nutrition science, and a simple way to start in a new direction.
Wired to Eat and The Paleo Solution, by Robb Wolf. Robb works with me to help Native Americans and first responders, and he dives into the science and ancestral health principles of food, and of how we live in the modern world.
The Art and Science of Low Carbohydrate Living and The Art and Science of Low Carbohydrate Performance, by Drs. Stephen Phinney and Jeff Volek. These two books are the scientific and practical references for a low-carb diet.
The Real Meal Revolution, vols. 1 and 2, by Tim Noakes and Jonno Proudfoot. Dr. Noakes is changing the world from South Africa, where “Banting” is becoming an everyday term for a healthy, low-carb way of eating.
The New Atkins for a New You, by Drs. Eric Westman, Stephen Phinney, and Jeff Volek. This book lends more science and refinement to the original Atkins Diet, by three of the top clinicians and researchers in the fields of obesity and metabolism.
Diabetes Unpacked, by Zoe Harcombe, Ph.D., and colleagues. The world’s leading researchers on diabetes and metabolism make the case for changing the government nutrition guidelines that are driving this chronic disease.
And for kids and youth:
The Youth and Teen Running Encyclopedia, by Mick Grant. This disciple of Arthur Lydiard presents the philosophy of fun first—so that kids want to come back to practice and never get hurt running.
Super Food for Superchildren, by Dr. Tim Noakes, Jonno Proudfoot, and Bridget Surtees. With childhood obesity at epidemic levels and no reversal of the trend in sight, we need to make food healthy and fun again, and teach families to cook meals that are free of added sugar and processed carbs.
Fat Head Kids, by Tom Naughton. Based on the humorous but startlingly real documentary Fat Head, this book demonstrates that much of the official advice about healthy eating is wrong, and has created a record number of overweight youth who can’t concentrate in school. This book makes getting healthy fun.
Just Let the Kids Play, by Bob Bigelow. A must-read for parents, this book singles out our elite focused youth sports programs as the cause of the problem, and offers practical ways to rebuild them so they better serve the physical and emotional needs of children.
Appendix V
THE TEN ESSENTIAL ELEMENTS OF HEALTHY RUNNING
IMAGINE MOVING PAIN-FREE FOR A LIFETIME. IT’S EASY IF YOU TRY.
1. Preassess yourself
If you have cardiac risk, a medical condition, are taking medications, or are injured, speak to a health professional you trust before you embark on or escalate physical activity.
2. Follow the general principles of natural and healthy running
Train the endurance engine, have fun, move your whole body, sprint a little, progress gradually, go barefoot or minimal with your footwear, and eat real food. Set the intention of doing that—often—for the rest of your life!
3. Give yourself positive affirmations
Activate the power of the mind through repetition of positive statements. (You can use “I” or “you.” I prefer “you.”) Create your own affirmations—those are the best—and repeat them daily. For example: You are powerful and springy. You love the hills.
4. Warm up
Give yourself ten minutes to warm up, at an easy, comfortable pace. Become springy and bouncy and loose. Listen to your body—it will tell you when you are ready.
5. Keep the movement going
Develop your personal daily mobility routine, and keep doing it. Mine takes five minutes every morning—the perfect launch pad for an energetic, productive day.
6. Prevent injury
Be aware of a tendency to build endurance prior to gaining structural strength in muscles, ligaments, bones, and tendons. The body will adapt to stresses, as long as the load is not greater than its capacity to adapt. So include strength and mobility in your endurance building.
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7. Recover
Balancing stress and allowing time for recovery is essential. Running should fit into the relaxing part of the day, not add to daily stress.
8. Monitor the signs of improving fitness and health
How are you feeling, and what do the simple measurements say? If your waistline, blood glucose level, and blood pressure are improving, and your level of vigor, too—you’re on the right track. And try a heart rate monitor—a form of biofeedback that helps in listening to your body. Learn the language of your physiology.
9. You can’t outrun a bad diet
Avoid eating crap. Junk food and excess sugar will sabotage every effort to become and remain healthy and stay young. Just say no to sweetened drinks.
10. Set a goal
Where are you now? Where do you want to be? Why have you set this goal? Once you achieve your short-term goals with comfort and confidence, work toward sustainable, longer-term goals.
Acknowledgments
This book represents the distilled essence of an adult lifetime—not merely of running but of exploring the function and physiology of the human body. Such a task couldn’t have been undertaken alone. I am indebted to my running and medical colleagues not only for sharing valuable knowledge and experience for this book, but for their guidance and friendship throughout my career: in particular, Dr. Ray McClanahan, who taught me about the foot, and Dr. Daniel Lieberman, the premier authority on evolutionary biology and health.
For helping me find my stride, and for sharing what we do with so many, I’d like to thank running education colleagues Ian Adamson, Jay Dicharry, Blaise Dubois, Dr. Lawrence van Lingen, Dr. Irene Davis, Dr. Trent Nessler, Dr. Ken Mierke, Lorraine Moller, Rod Dixon, Nobby Hashizume (Lydiard Foundation), Danny Dreyer, Chris McDougall, Lee Saxby, and Danny Abshire. To my nutrition colleagues Dr. Tim Noakes, Nina Teicholz, Gary Taubes, Dr. Eric Westman, Dr. Robert Lustig, Dr. Joseph Scherger, Dr. Robert Oh, Dr. Sarah Hallberg, Dr. Cate Shanahan, Dr. Stephen Phinney, Dr. Jeff Volek, Sami Inkinin, Dr. Jeff Gerber, Jimmy Moore—and many others who are now teaching and sharing the knowledge that patients can reverse metabolic illness. And, to West Virginia University colleagues Dr. KC Nau, Dr. Emma Eggleston, Dr. Clay Marsh, and Dr. Rosemarie Lorenzetti: thank you for your commitment to promoting food as medicine.
I’d especially like to thank running colleagues Jonathan Beverly, Brian Metzler, Amby Burfoot, Dr. Peter Snell, Keith Livingston, Roberto Ruiz, Chris Fall, Curt Munson, George Banker, Dave McGillivray, Dr. Nick Campitelli, Don Freeman, Scott Warr, Golden Harper, Dr. Casey Kerrigan, Tony Post, Steve Sashen, Sara Davidson, Kimberly Bachmeier, Elinor Fish, Sarah Young, Mick Grant, and Jerry Lee for your research, teaching, writing, podcasts, and innovation in the running realm.
In particular, I’d like to thank the late Bill Katovsky and Nicholas Pang for helping me create the Natural Running Center, and Jeff Vernon and Robin Desjardins for creating TrueForm runner training, which makes learning to run easier.
I’d also like to thank my local community, who have faithfully supported our mission at Two Rivers Treads and Freedom’s Run, and contributed stories and anecdotes for this book: Lois Turco, Holly Fry, Dr. Andro Barnett, Dr. Stacey Kendig, Katie Nolan Thompson, Morgan Wright, Candus Sutphin, Sarah Hodder, Diana Gorham, Dion Navarra, Erin Gaertner, Paul Koczera, Bill Susa, Jeff and Sheri Fiolek, Katherine Cobb, Kevin and Jennie Brakens, Susan Reichel, Bill Bondurant, James and Suzy Munnis, Jared Matlick, Fiona Harrison, James Hersick, Antonio Eppolito, Paul Encarnacion, Pat Schneble, Matt Knott, Mick Brown, Laura Bergman, Pat Fore, and Lara Foster.
Special thanks go to key contributors to this book, who have also been lifetime mentors to me and many others: Dr. Phil Maffetone, an internationally recognized coach and healer, and Dr. Tom Michaud—master of anatomy, clinician, inventor, and author. I am also proud to feature the professional photographic work of Joel Wolpert, a fellow West Virginian.
The critical partner in this book project was my writing collaborator, Broughton Coburn. Brot in turn would like to thank Dr. Tom Barrett and Dr. Polly Fabian, for their careful and informative technical review; Mari Siceloff for sharing her experience in coaching and running marathons; Susan Koskinen for library research; and his wife, Didi Thunder; daughter, Phoebe Coburn; and son, Tenzing Coburn, for their research assistance.
Finally, this could not have been done without the support of my family. My wife, Roberta, and children, Leo and Lily, have tolerated, with friendly humor, my barefoot-running and low-carb lifestyle, and the hours of work required to grow and shape this book. And unending thanks to my parents, Vincent and Nancy Cucuzzella, who gave my brothers and me the opportunity to go outside to run and play.
Notes
Inttroduction
How can we become healthier: With many thanks to my physical therapy colleague Jay Dicharry, author of Anatomy for Runners, who developed this construct.
CHAPTER 1 Our Bodies Are Older Than We Think
12,000 years as pastoralists and farmers: See the Genographic Project of the National Geographic Society: https://genographic.nationalgeographic.com/.
evolutionary adaptations in our anatomy: See, for instance, Dennis Bramble and Daniel Lieberman, “Endurance Running and the Evolution of Homo,” Nature 432, no. 7015 (2004): 345–52, and Daniel Lieberman et al., “Foot Strike Patterns and Collision Forces in Habitually Barefoot versus Shod Runners,” Nature 463, no. 7280 (2010): 531–36.
Despite all this medical attention: See “Life Expectancy Climbs Worldwide but People Spend More Years Living with Illness and Disability,” news release, Institute for Health Metrics and Evaluation, University of Washington, Seattle, 2013. Also GBD 2015 DALYs and HALE Collaborators, “Global, Regional, and National Disability-Adjusted Life-Years (DALYs) for 315 Diseases and Injuries and Healthy Life Expectancy (HALE), 1990–2015: A Systematic Analysis for the Global Burden of Disease Study 2015,” Lancet 388, no. 10053 (2016): 1603–58.
CHAPTER 2 Stand Up and Breathe
elevating the risk of metabolic diseases: Marc T. Hamilton, Deborah G. Hamilton, and Theodore W. Zderic, “Exercise Physiology versus Inactivity Physiology: An Essential Concept for Understanding Lipoprotein Lipase Regulation,” Exercise and Sport Sciences Reviews 32, no. 4 (2004): 161–66.
CHAPTER 8 Move More and “Exercise” Less
Emerging research that traces the roles: From T. W. Zderic and M. T. Hamilton, “Identification of Hemostatic Genes Expressed in Human and Rat Leg Muscles and a Novel Gene (LPP1/PAP2A) Suppressed During Prolonged Physical Inactivity (Sitting),” Lipids in Health and Disease 11, no. 137 (2015). “Physical inactivity is an established risk factor for some blood clotting disorders. The effects of inactivity during sitting are most alarming when a person develops the enigmatic condition in the legs called deep venous thrombosis (DVT) or ‘couch syndrome,’ caused in part by muscular inactivity…These findings suggest that skeletal muscle may play an important role in hemostasis and that muscular inactivity may contribute to hemostatic disorders not only because of the slowing of blood flow per se, but also potentially because of the contribution from genes expressed locally in muscles, such as LPP1.”
At home, I rarely sit in chairs: See Steve Chandler’s demonstration, “Sit Better to Move Better,” at breakingmuscle.com/fitness.
Gene expression, we’re learning: The PMC, or primary motor cortex, is where conscious thoughts are translated into movement. The central pattern generator (CPG), in the central cortex, controls “automatic,” reflexive actions. After three thousand to thirty thousand repetitions, a consciously controlled movement gets woven into the CPG. See K. Minassian et al., “The Human Central Pattern Generator for Locomotion,” Neuroscientist 23, no. 6 (2017): 649–63.
CHAPTER 9 Eating to Go the Distance
Essentially, fructose metabolism: Sam Z. Sun and Mark W. Empie, “Fructose Metabolism in Humans—What Isotopic Tracer Studies Tell Us,” Nutrition &
Metabolism 9, no. 89 (2012). “Glucose utilization can be regulated before cleavage, whereas fructose is less regulated. This initial difference has prompted some to hypothesize that, because fructose cleavage bypasses key feedback regulatory steps in the glucose metabolic pathway, this bypass may lead to increases of fatty acid synthesis, which may contribute to causes of obesity. This hypothesis relies on a simplified metabolic pathway analysis and on studies using pure fructose in comparison to pure glucose, a situation which rarely occurs in the American diet.” With thanks to Cate Shanahan for reviewing this section.
the prevalence of diabetes: S. Basu et al., “The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data,” PLoS ONE 8, no. 2 (2013).
The most likely suspect: James J. DiNicolantonio, Sean C. Lucan, and James H. O’Keefe, “The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease,” Progress in Cardiovascular Diseases 58, no. 5 (2016): 464–72.
The recent PURE (Prospective Urban Rural Epidemiology) study: Mahshid Dehghan et al., “Association of Fats and Carbohydrate Intake with Cardiovascular Disease and Mortality in 18 Countries from Five Continents (PURE): A Prospective Cohort Study,” The Lancet 390, no. 10107 (2017): 2050–62.
Now each of us consumes over 125 pounds of sugar: James J. DiNicolantonio and Amy Berger, “Added Sugars Drive Nutrient and Energy Deficit in Obesity: A New Paradigm,” Open Heart 3 (2016).
a high fructose load on the liver: Gianluca Perseghin, “Viewpoints on the Way to a Consensus Session: Where Does Insulin Resistance Start? The Liver,” Diabetes Care 32, no. 2 (2009): S164–S167.
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