Taking steps

In the last post I noted I had started cycling for fitness again in July 2012. This was very successful in terms of weight loss and by November 2013 I had got down to about 14 stone 7 lbs. It was then, partly because the weather was changing as winter approached, that I began to incorporate walking into my routine. This was reported in a post in my cycling blog Cycling, walking, hitting a ball in December 2013. I started doing specific walks round my immediate vicinity in the Aire Valley on the borders of Bradford with Leeds. Shortly after I began to use walking as an everyday form of transport often walking to Bradford centre and back for U3A meetings, or to Shipley and back for my U3A reading group meetings. Any trip of 3 miles or less is walked if I have the time or if longer and going by bus I will walk the first mile or so or the last bit of the journey. I try to walk every day that I don’t wither cycle or play racketball, even if it is only for 30 minutes or so although I usually manage up to an hour. The Garmin Vivofit I started using in December 2014, just over a year ago, has recorded about 2.5 million steps so far in 17 months.

Over the years I gradually put on weight and finally approached 18 stone about four years I still did some walking with my brother-in-law Kevin. The picture above was taken while on a walk along part of the Cleveland Way near Whitby in September 2012, when I was about 17 and a half stone. We didn’t do more than about 8 miles a day and, despite wonderful weather and scenery and some great evenings in pubs listening to live music and chatting with the locals, the trip was dominated by aching legs and sore feet more than anything else. This was deeply disappointing as I used to find walking a very enjoyable and rewarding activity. This greatly added to my motivation to get fit and lose weight for my retirement. Now Kevin and I are planning some longer walks. In fact last September 2015 we had a few days walking round Malham and part of the Pennine way covering, on one day, about 12 miles. By then I was down to about 13 stone so a very different story!


David Bowie

It is now the second day after the announced death of David Bowie at the age of 69 from liver cancer and the media and social media frenzy continues unabated, not surprising given his iconic status. Equally unsurprising there has been little if any reference to his flirtation with fascism in the mid 70s, none in the broadcast media a far as I can tell and only a passing reference in a couple of articles in the broadsheet press. But for my generation David Bowie had significant political impact in the 70s when he expressed the view that Hitler was the first rock star and Britain needed “an extreme right front come up and sweep everything off its feet and tidy everything up” in an interview with Playboy magazine (see article on this in the The Music Unions social history web site – David Bowie’s “Nazi” salute). It was this and the more virulent racist tirade of Eric Clapton that led to the Rock Against Racism movement and led to many of us getting involved in the Anti-Nazi League. Unlike Clapton, Bowie did distance himself from his remarks as early as 1977 claiming his flirtation with fascism was a result of his being “out of my mind, totally, completely crazed” at the time. Much more recently he has been praised for his anti-racism stance, for instance when he berated MTV for discrimination against black artists http://usuncut.com/…/bowie-remembered-legendary-music-effo…/ For over 40 years I have been a fan of his music but always a little ambivalent about the man. The dark days in the 70s of the National Front can’t be ignored. Hopefully Bowie’s legacy on the political front will not just be as an instigator of the the anti-Nazi moment but as an influential anti-racist.

Prostate cancer and excercise

There was a news item on the BBC Today programme Thursday last week on some research being done on any possible connection with exercise and the speed of development of prostate cancer in men that have been diagnosed with a Gleason score of 6 or 7 and on active surveillance. This is the PANTERA study. Details of the study and how to volunteer to be a subject can be found on the Cancer Research website. I fit the criteria to join the trial on every count except I already exercise beyond the maximum specified in advance of the study, more than 90 minutes per week of moderate intensity exercise. However, I was sufficiently interested to contact the lead researcher, Liam Bourke, by email. I asked if there if there is any information on the exercise regime required of the supervised group and whether they will be given any advice on nutrition. I was also interested in the conduct of the trial, in particular how if at all the ‘self-help’ group will be monitored for any level of activity they may decide to adopt in the light of the information pack you will be giving them and what that information pack consists of.

Dr. Bourke’s reply contained details of the exercise regime: Participants will be asked to attend two group-based supervised exercise sessions a week, comprising up to 45 minutes of aerobic exercise. Exercise intensity will be 65% to 85% of age predicted maximum heart rate or 12 to 17 on the Borg rating of perceived exertion scale, in episodes of 20-30 minutes of continuous exercise for the first 8 weeks, progressing up to 45 minutes per session thereafter. Gym based aerobic exercise training will be conducted using standard ergometers e.g. stationary cycles, rowing ergometers or treadmills. In addition, men are required to undertake self-directed two exercise episodes of up to 30 minutes per week, using an exercise log book and heart rate monitor to objectively record independent exercise behaviour and support adherence and compliance. They won’t be providing any nutrition interventions. The care pack for subjects in the group not undertaking regular supervised sessions is the standard Macmillan move more information pack, available free from McMillan Cancer Support. This comparison group’s exercise behaviour will be checked via standard questionnaires and any change in fitness by sub-maximal treadmill testing.
I have now joined the gym at my squash club and aim to replicate the 2 supervised sessions a week 20-30 minutes for 8 weeks and thereafter building to 45 minutes. I will not do the additional unsupervised sessions of 30 minutes per week as I think I will already be doing enough with cycling, walking and racketball!

Trust me, I’m a doctor

A few notes on the first in the new BBC series, broadcast tonight. It was of particular interest to me as it dealt with the effectiveness of whey protein as a muscle builder, how to slow down or even reverse muscle loss as you get older and what are the best times to exercise for weight loss with respect to eating. It also looked at the claims of taking fruit smoothies as a source of antioxidants. To summarise the findings:

Protein powders do not increase muscle growth providing you are getting sufficient protein in your diet. Any surplus is burnt as energy, is stored as fat, or is peed out of you system. The role of protein powder as part of a weight loss strategy was not considered in the programme. However, tests showed that protein supplements pass into your muscles in about 3 hours and the uptake is more in muscles that have been exercised.

Muscle loss starts in the over 40s at a rate of about 1% per year and after 50 at about 5% per decade. This is inevitable and is part of the normal ageing process – sarcopenia. This leads to loss of strength and power output as well as part of the reason balance deteriorates with age. The programme demonstrated how a few simple exercises done in the home without special equipment and generally without raising a sweat (so presumably not a cardiovascular workout) enabled a group of late middle aged and older subjects, over a 4 week period, have a 3% increase in muscle volume, a increase in strength of 12% and a power output increase of 13%. No special diet conditions were set.

The effects of exercise for fat burning were measured comparing subjects that exercised before eating in the morning and those who exercised after. Apparently the fat burning effect takes place in the hours after exercise and not so much during. This was not explained but it may be because the fat is used to replace carbohydrate energy stores in the blood. The effect was about 3% to 8% additional fat burn for men who exercised before eating and the same for women who exercised after eating. This is a new finding and may be explained by men having more muscle than women and the way the different sexes utilise energy.

Antioxidant drinks have no effect. If anything they produce an antioxidant spike that the body responds to by decreasing the amount of internally produced antioxidants so that the normal level is reduced and does not recover for 24 hours. So the supplements are counter productive. In any case, free radicals are necessary as they signal muscle damage has been done and repair mechanisms kick in. The balance between antioxidants and free radicals is managed by your body automatically.

The final snippet of information concerned looking at if being overweight was necessary a bad thing and whether fat loss was always something beneficial to strive for.  Fat round the bum and legs, hips generally, was not seen as particularly dangerous but round the stomach and abdomen definitely bad. BMI is still seen as a reliable measure of weight for mos normal human beings and under 25 is the recommended target. However, between 25 and 30 is OK for more elderly people, say over 65. Bearing in mind BMI is sensitive to the ratio between muscle and fat, in older people a highish BMI might be because muscle loss effects the ratio rather than just a matter of excess fat.

Finally there was advice about reheating food. Generally OK but be careful with rice because the bacteria present, although can be killed by thorough reheating, may have produce toxic spore that are immune to heat.

Trust me, I’m a doctor web site.


Prostate cancer update

I’ve decided to put any posts related to my condition here rather than were they are up until now in my cycling blog which from now on I will restrict to more directly related issues. This blog will be rather more eclectic and will cover a much bigger range of topics but still including stuff on health and lifestyle. Where it seems to be appropriate I will cross-post between the two blogs or at least refer to and summarise posts on the other blog. The two posts specifically about prostate cancer on the cycling blog are Prostate Cancer posted 15th August 2014 and Active surveillance posted 29th August. One thing I forgot to mention in the last post is that, on making a firm decision to opt for the active surveillance programme I was informed by Dr. Owen that this had been the interdisciplinary group’s recommendation. This is the first time I had heard this and I must say it gave me some confidence in my decision. I guess that was the point f not letting me know earlier  – let the patient make their own mind up since there was no sure-fire way of making the right one anyway.

Having opted for the AS regime this involves a 3 monthly PSA blood test, and initial MRI scan 3 months after going on the programme and, if necessary, further biopsies if changes in the prostate and tumours warrant them. I had a blood test early December 2015 which gave a result of 8 – a little higher than the last one, 7.9, but quite a lot lower than the highest taken while I was in hospital with the ruptured kidney of round 9. So the latest test may mean something or nothing – the usual problem with PSA tests. The initial MRI scan due at the same time (part of the AS protocol I was told) never happened but after chasing this up I have it booked for 28th January. I understand from others on this programme that test time is a particularly stressful period as you dread being told the tumour is on the move and surgery, etc. is now necessary. I can feel the tension mounting already even though the scan is 3 weeks away, in fact the day before my 70th birthday.

Rectum? It certainly didn't do them any good. (Thanks to several Carry On films for this)

Ouch! An ultrasound probe is inserted into the rectum to show where the tumor is. Then a needle is inserted through the rectum into the prostate to remove tissue. Apparently 1 in 10 men find the biopsies process too painful to tolerate so it is abandoned and rearranged under a general antithetic. I was one of the 9 out of 10 lucky ones.