All posts by Craig100

“No more effective than placebo”

The gold standard in scientific research is the randomized control trial, whereby subjects are randomly allocated to receive either an intervention, such as a medical treatment or a fitness programme, or a placebo. If the subjects in the intervention group change to a greater extent that those in the placebo group, then the intervention can be said to work. If the two groups are similar, then the intervention can be said to be “no more effective than placebo”. This is often taken to mean that the intervention doesn’t work, but of course, it doesn’t mean that.

 

Why? Because placebos can be effective. It’s well established in the medical research, particularly around pain, that placebos can exert some biological influence; indeed, around one-third of patients receiving a placebo report improvements in pain, which is essentially the same number of subjects who report that morphine does not reduce their pain. The mechanisms underpinning this relationship are both complex and, often, quite poorly understood, but as a lay summary placebos can work through a number of ways, including expectancy (you think something will help, so it does), and regression to the mean (the person would get better anyway, but providing a placebo makes them feel like they are doing something positive about it). Given the complex biopsychosocial nature of pain, in which stress and anxiety can exacerbate feelings of pain and disability, reducing this stress and anxiety in and of itself can reduce the pain; and this can be achieved readily through placebo. I can think of two anecdotes (which I’m aware are the lowest form of evidence) from my life that illustrate this. The first is that my back pain was always greatest on days when I had a competition. It seems unlikely that my underlying back issues were, for some reason, much worse of days when I was competing; instead, it seems more likely that I was more stressed and anxious on my competition days, and as a result interpreted the signals from my back as more threatening, which in turn increased my feelings of pain.

 

The second example is something that a researcher would struggle to get past an ethics board, such is the measure of deception and subterfuge used by the principle investigator – in this case, my mum. Early in my teenage years, I developed an entirely irrational fear of flying, and, in particular, turbulence. This made the flight from the UK to Florida for a family holiday somewhat unpleasant, both for me, and, I imagine, for my parents. Fortunately, whilst we were in Florida, my mum managed to track down some anti-anxiety medicine (don’t ask me how) that I could use on the plane; whenever I felt a bit scared, I could put a lozenge in my mouth an allow it to slowly dissolve, easing my anxiety. The lozenges themselves were very nice, which an aniseed flavor that, whilst not to everyone’s liking, is certainly to mine. As such, the long return flight how was an altogether calmer affair, which my anxiety been much lower, and I was very grateful that my mum had managed to locate these tablets which eased my anxiety. It turns out that these were just aniseed sweets she had bought at a sweet shop.

 

My point is two-fold – firstly, that many of our physical feelings have a psychological components, and, secondly, that by targeting this psychological component we can influence our physical sensations. And there is where placebos, and their close cousin expectancy, come in.

 

Let’s look at caffeine in sport. Caffeine is definitely performance enhancing for most people, in most sports, most of the time, to the point where around 75% of athletes consume it specifically as an ergogenic aid. Get a group of cyclists, tell them that they are being given caffeine, and their performance improves – even if you actually gave them a placebo. Conversely, if you consume caffeine but think that you haven’t, then your performance improves to a lesser extent than if you correctly determined you had consumed caffeine.

 

It’s clear, therefore, that both placebo and expectancy can have real-world impacts on a number of measures. Part of this is the theatre surrounding the treatment; in many of the studies utilizing placebos in medicine, the very act of seeing a well-qualified human being who (hopefully) takes our problems seriously is likely to have a positive impact in and of itself. Similarly, taking a substance you know will improve your performance will cause you to work harder, even if you haven’t actually taken the substance.

 

All of this brings me to my key point; when you see “no better than placebo” written in a study, don’t be tempted to assume that this means that the substance doesn’t work. Instead, understand that it might well work, but that its effect is likely related to other aspects outside of the particular interventions physiological impact. Secondly, whilst it’s unethical to deliberately deceive athletes, understand that their beliefs will impact their performance. They may well be utilizing something for which there is no evidence of effectiveness, but, if they believe in it, it may well be more effective that doing nothing. Obviously, you should prevent them from doing something harmful, but they key is not to try and move them away from behaviors for which is no/limited evidence, if they think it works. Because, if they think it works, it just might.

 

Caffeine, CYP1A2 genotype, and exercise performance: A role for timing?

 

A recent paper has made some quite significant waves, both in the science and lay communities, by exploring the effect of a polymorphism in a gene called CYP1A2 on the ergogenic effects of caffeine on performance. The paper (Caffeine, CYP1A2 genotype, and endurance performance in athletes) was published in Medicine and Science in Sports and Exercise, where the authors put 101 competitive male athletes through a 10km cycle ergometer time trial under three experimental conditions; no caffeine (i.e. placebo), 2mg/kg caffeine, and 4mg/kg caffeine. The main finding was that caffeine was ergogenic for subjects with the AA version of the gene, likely neutral for people with the AC version, and potentially ergolytic (i.e. harmful to performance) for those with the CC version of this gene in the 4mg/kg caffeine trial (and neutral in the 2mg/kg trial).

 

This is what I wrote about CYP1A2 in my 2017 paper on inter-individual variation in caffeine ergogenicity:

 

The gene CYP1A2 encodes cytochrome P450 1A2, an enzyme responsible for up to 95% of all caffeine metabolism [35]. A SNP within this gene, rs762551, affects the speed of caffeine metabolisation. AA homozygotes (“fast” metabolisers) tend to produce more of this enzyme, and therefore metabolise caffeine more quickly. Conversely, C allele carriers (“slow metabolisers”) tend to have slower caffeine clearance. The variable effects of this SNP are most well-established in regards to health, with myocardial infarction and hypertension risk increased in slow metabolisers consuming moderate (3-4 cups) amounts of coffee, whilst fast metabolisers exhibit a protective effect of moderate coffee consumption.

 

These earlier medical studies prompted research into how the CYP1A2 polymorphism might modify the ergogenic effects of caffeine. Womack et al. put thirty-five trained male cyclists through two 40-km cycle time trials, following consumption of either 6 mg/kg of caffeine or placebo 60-minutes beforehand. There was a significant effect of CYP1A2 genotype on the ergogenic effects of caffeine, with AA genotypes (fast metabolisers; 4.9% improvement) seeing a significantly greater performance improvement than C allele carriers (slow metabolisers; 1.8% improvement). Within AA genotypes, caffeine improved performance by at least one minute for 15 out of 16 subjects, whilst in C allele carriers only 10 of 19 subjects saw an improvement greater than one minute. These findings allowed the authors to conclude that caffeine has a greater ergogenic effect for CYP1A2 AA genotypes than C allele carriers.

 

Since this initial paper, a small number of subsequent studies have been published. The same group published a paper hampered by a lack of CC genotypes, putting 38 recreational cyclists through four 3km time trials under different experimental conditions; placebo mouth rinse + placebo ingestion, placebo mouth rinse + caffeine ingestion, caffeine mouth rinse + placebo ingestion, and caffeine mouth rinse + caffeine ingestion [40]. Both AC (4.1%) and AA (3.4%) genotypes saw performance improvements in the combined caffeine mouth rinse and ingestion trial, but only AC (6%) genotypes saw a performance improvement in the caffeine ingestion trial. The conclusion was that AC genotypes saw greater performance enhancement with caffeine ingestion, in contrast to Womack et al. One potential cofounder was the short exercise trial duration (c.5 minutes), as caffeine shows greater ergogenic effects in events of longer duration. A second potential cofounder is that Womack et al. utilised trained subjects, whilst Pataky et al. did not. Exercise appears to increase CYP1A2 expression, such that trained and untrained subjects may metabolise caffeine differently. Algrain et al. reported no modifying effect of the CYP1A2 polymorphism on the ergogenic effects of caffeine; however, they noted the small subject number (n=20), the untrained status of these subjects, and the lower caffeine dose (approximately 255mg). Klein et al. and Salinero et al. found no effect of the CYP1A2 polymorphism on the effects of caffeine on tennis and Wingate test performance respectively, although with modest sample sizes (n=16 and 21).”

 

So, given the highly equivocal results of the previous research, Guest and colleagues study is both timely and exciting. Of all the studies exploring CYP1A2, caffeine, and performance, it has by far the largest sample size, which is important in studies exploring genetics, as the effect sizes of each individual gene can be quite low – meaning that large numbers of people are required to determine a “true” effect. It’s also the first study (to my knowledge) to specifically show that caffeine is harmful for individuals with a certain property, in this case the CC genotype of CYP1A2. Prior to this, we knew some people didn’t find caffeine ergogenic, but we weren’t sure what they had in common.

 

Alongside Guest’s study was another one (The effect of CYP1A2 genotype on the ergogenic properties of caffeine during resistance exercise: a randomized, double-blind, placebo-controlled, crossover study) that focused on resistance training. Here, 30 resistance-trained males undertook 3 sets to failure at 85% of 1RM in four different exercises (bench press, leg press, seated cable row, and shoulder press). Those with the AA genotype could perform more reps compared to placebo when they had 6mg/kg of caffeine pre-test; whilst those with the C allele saw no performance improvement – but, crucially, also no performance decrement – when consuming caffeine. The results of this study got considerably less fanfare than Guest’s results, and I’m not sure why, but suffice to say we now have a decent idea that caffeine appears to not be ergogenic for CYP1A2 C allele carriers when it comes to both resistance and endurance training. Furthermore, it might even be harmful for those with the CC genotype, but, because very few people actually have the CC genotype (approximately 10%), most studies just group the CC and AC genotypes together into one group.

 

So, do we really believe that caffeine has no performance benefits for the ~50% of people who have at least one C allele? Personally, I don’t, in part because I have the AC genotype and I use caffeine to enhance my performance, and cognitive dissonance means I hope I am not wasting my money. To be clear, I don’t think Guest or Rahimi, or their co-authors, have committed scientific fraud by making up their results (and I think their studies are great), but I do think that there may be a way for caffeine to be ergogenic for these people. This is what I wrote in a letter to the Irish Journal of Medical Science on the topic:

 

The results, however, promote significant cognitive dissonance. As an AC genotype who used caffeine extensively as an ergogenic aid during my professional athletic career, do I really believe that caffeine had no performance benefits for me? It’s hard for me to reach such a conclusion, even though the results of both Rahimi and Guest and colleagues’ research suggest as much. I’m sure many other practitioners feel the same, and indeed perhaps worry that the standard caffeine recommendations are harmful, or at best neutral, for a significant proportion of the athletes they work with.

 

The mechanism proposed by Guest et al. is that, because C allele carriers metabolise caffeine at a slower rate than AA genotypes, they experience prolonged vasoconstriction, which is likely to be performance limiting in endurance events where the transfer of oxygen and nutrients to the working muscle is crucial. Additionally, Womack and colleagues speculated that the metabolites of caffeine – paraxanthine, theobromine, and theophylline – have additional ergogenic effects; in this case, the presence of these ergogenic substances would be lower in C allele carriers at a given time point due to the slower metabolization of caffeine, reducing caffeine’s performance benefits. This proposed mechanism was echoed by Rahimi.

 

If the above mechanisms are indeed correct, then there remains the possibility that caffeine can still be ergogenic for C allele carriers, but that such individuals need to consume it a greater amount of time prior to exercise. In the majority of studies – including Guest et al. and Rahimi – subjects consume caffeine ~60 minutes pre-exercise. However, for C allele carriers, could the ergogenic effects of caffeine be restored by utilizing a caffeine dose 90 or 120 minutes pre-exercise? Such an hypothesis is, of course, speculative, and requires testing – but it does represent a potential way by which caffeine can indeed be ergogenic for all. The resolution of whether caffeine is truly ergolytic or neutral for CYP1A2 C allele carriers, or if it merely necessitates a different caffeine strategy, represents an important step on the journey towards more personalized sports nutrition guidelines.”

 

The next step is obviously to test this under experimental conditions; watch this space!

 

What I Read in 2017

This year, I read 55 books, which compares well to previous years (here’s 2016’s book round up, and 2014). This year, I seemed to read less than ever about sport (directly at least), in part because I started to get serious in my study for a Professional Doctorate, which required me to read a lot of research papers, something I also do as part of my day job at DNAFit. As such, reading became more of a tool to wind down, relax, and be exposed to ideas outside of my usual domain.

 

The best book I read this year was The Sting, closely followed by Columbine. I don’t really enjoy fiction, and so narratives of real life events, which read like fiction, are my substitute. The Sting was incredible; the story has so many turns, and I don’t want to ruin it for you, so please just read it. My attention was initially drawn to it because the initial crime itself happened very close (in Australian terms) to where I now live. Columbine is an in-depth look at the eponymous school shooting, exploring the potential motives of the killers. Given that the shooting took place 18 years ago, the theory put forward by the author – that Eric was likely a psychopath, and Dylan just wanted to commit suicide – was completely new to me, and well argued.

 

After that, I also enjoyed For Queen & Currency, about a financial scandal that occurred in the Met Police’s Royal Protection group, which again read like a novel. That was much better than The Untouchables, by the same author, that looked at corruption in the police force, which hadso many characters, it was hard to keep track of all the goings on. Into the Black, the story of the first Space Shuttle flight, was much better, sending me into a Wikipedia black hole exploring various different threads. Painful Yarns by Lori Moseley was also excellent, and a great explanation of the concept of pain, particularly chronic pain.

 

I also read a decent number of books by Michael Lewis. The Undoing Project was as good as you’ve heard, exploring a number of different biases humans hold through the life story of Danny Kahneman and Amos Tversky. The Blind Side was also great, and I especially enjoyed the continuing thread of how a specific position had evolved over the years within football (not the real football, but Gridiron). The Big Short and Flash Boys are great examples of making a complex topic simple to the lay person, something that everyone involved in research should aim to improve within themselves. The concept underpinning Flash Boys was especially complex, but Lewis does a great job in explaining it. Moneyball got its own article. The New New Thing was probably the book of his I enjoyed the least, but I still read 200 pages of it in one go on a plane, so it can’t have been that bad.

 

Messy by Tim Harford and Behave by Robert Sapolsky were so good they got their own articles, both on HMMRMedia. Definitely read both books if you haven’t already. Fooled by Randomness was, sadly, a letdown, and I’m struggling to motivate myself to move onto The Black Swan, although I feel I must if only to finally be able to read Antifragile (and avoid being labelled an imbecile with no skin in the game). I also didn’t enjoy What Happened by Hillary Clinton as much as I thought I would, which is a shame. The Speechwriter was surprisingly good, and I enjoyed the constant tension between English graduate speechwriter and not-so-well-educated politician boss.

 

Tribe of Mentors was very Tim Ferriss-esque, promising to 100x my lifestyle by 8am through mindfulness and exogenous ketones. I found Tools of Titans much more interesting, although I suspect on second reading I’ll still pick up some useful tidbits (mostly book recommendations), although the repetitive nature of the same 11 questions might still wear thin. Speaking of book recommendations, via Tools of Titans I picked up House of Leaves (recommended by Amelia Boon), which I think is the worst book I’ve ever tried to read, and Tripping Over the Truth (recommended by Dom D’Agostino), which looks at the hypothesis that cancer is a metabolic disease; this was interesting, if a little left-field. Cancer: A Beginners Guide acted as a counter-balance, and, whilst well researched and informative, was perhaps a little dry.

 

Of the textbooks I read (yay!), the best two were Monitoring Training and Performance in Athletes – a hot topic in sports science at moment, and done justice by Mike McGuigan – and Molecular Exercise Physiology: An Introduction, which, as textbooks go, was all shades of excellent. Sticking to academic texts, Genomics and Personalized Medicine: What Everyone Needs to Know was a good introduction to many of the precision medicine technologies, along with a good discussion of some of the more contemporary issues around their use. Junk DNA was interesting, but also very complex. Caffeine for Sports Performance was a textbook masquerading as a popular science book, and it was wholly readable and very interesting; if you’re interested in caffeine and sport, like I am, it is required reading.

 

Sleep by Nick Littlehales was a timely reminder of the importance of sleep that I read in a jet lagged state, and, whilst I wouldn’t necessarily say it contained anything groundbreaking, it had a host of practical tips on improving our sleep, and I’d thoroughly recommend. Guests of the Ayatollah (the story of the US Embassy crisis in Iran), The Operator (the autobiography of the SEAL “who shot” Bin Laden), The Crash Detectives (an exploration of air crashes, just what a frequent flyer needs), The Nowhere Men (the story of football scouts), and Lethal Force (the autobiography of a Police Marksman) all deserve honorable mentions and were enjoyable reads.

 

To finish the year, I’m reading The Angry Chef, which got off to a great start by exploding myths regarding foods and eating, slowed down a bit with an explanation of how myths develop and quackery, and then picked up again with an excellent discussion on relative risk. It’s like the food version of Bad Science, and well worth checking out.

 

Last year, I said I was going to aim to read most of the highly recommended books from Tools of Titans. I didn’t. Perhaps next year.

The Legacy of Prior Events

 

The other day, whilst walking from my car to the gym, I was attacked by a bird. I imagine that it thought I was trying to get to its nest or something (I wasn’t), and it swooped down continuously, aiming for my head, until I bid a swifty retreat.

Today, whilst at the track, a bird of the same variety (hopefully not the same one) landed next to me whilst I was stretching. I immediately became a bit anxious, expecting it to attack at any point. I had to move to the other end of the track to continue my warm up, and even then I kept a weary eye on the bird, just in case it attempted to sneak up on me.

Prior to the attack outside the gym, I barely gave birds a second thought. I certainly wasn’t scared of them, and I hardly noticed them. Since the attack, however, I am more anxious around them, even though the attack was a one-time event over my thirty year life.

One prior event has therefore impacted my behaviour, at least acutely. The event itself was pretty benign; I wasn’t hurt or anything. But my brain now reacts to the presence of birds in a different manner to the past. Instead of interpreting them as a winged creature that has no interest in me, now I (or my brain) interprets them as something which could do me harm. And this perception then drives physiological changes, such as the release of stress hormones, which manifest as feelings of anxiety. The legacy of my prior experience drives my current and future behaviours.

From an evolutionary perspective, this is sensible. The first time humans saw fire, they would have been curious. Getting burned by it would have illustrated to them that fire can be harmful, and the feelings of anxiety associated with being around fire would have resulted in a healthy respect of its effects, like burning down your shelter when left unattended.

My experience has a very minimal effect on my life, except for making me more likely to look a bit weird running away from birds at the track. But for people who have experienced serious trauma, such as an assault or a car crash, the effects can be much more serious, making them scared to enter situations similar to the initial incident.

How does this affect athletes? Well, how about if I pull my hamstring during maximum velocity sprinting? During my rehabilitation period, I’m going to become fearful of maximum velocity sprinting, which will affect my performance and more than likely my running technique. Over time, as I accumulate more maximal velocity sprinting without injury, my brain will learn that it is no longer a threat, and the stress response will disappear.

As a real life example of this, after I had back surgery, the only day my back really hurt was race day. This was partly due to the increased anxiety and stress regarding the competition causing a heightened alertness towards threatening symptoms. Had I not known this was going to happen pre-race, I could have become unnerved by the increased sensation of pain in my back, and not been able to compete.

Pulling all these strands together, humans are clearly very complex creatures, and we are all unique in both our experiences and how these experiences affect us. Whilst two people might get exposed to the same stressful experience, the extent to which their behaviour is modified, if at all, will vary. Similarly, two people might get exposed to the same stimulus, but interpret it very differently – in part due to their previous experiences – and therefore have vastly different stress responses. Being aware of this, as athletes, coaches, and people, is crucial; and being mindful of why you might behave the way you do could be due to events in your history, you can attempt to resolve your response to a perceived stressor.

Which is why the next time I’m going to the track, I’m taking a water pistol.

 

If you found this article somewhat interesting, you might find this one , where I take a look at Robert Sapolsky’s most recent book, and what it can teach us about why certain behaviours happen, similarly enthralling

 

 

Enter Shikari, Felix Baumgartner, & The Sub-2H Project

Towards the end of 2006, I was in a record store in Bath when a simple cardboard sleeve caught my eye, emblazoned with the words Enter Shikari. The name made me curious, so I bought the single (it was only £2.99), and put it into my CD player. As the first guitar sounds from “Sorry You’re Not a Winner” came out, I was sure I had found my new favourite band. A month later, I saw them live at a bar in Bristol, and they were amazing. I bought everything I could from them (“Mothership” is still my favourite song), and spent all my time listening to them.

 

And then they got famous. They were everywhere – on the covers of magazines, at festivals. You couldn’t move for people who were Enter Shikari fans. And this annoyed me, because they were MY band. I had discovered them before they were cool and slightly mainstream, and I didn’t like the fact that everyone else had now discovered them for themselves. They were even on Radio One. Never mind that they had been slaving away for years looking for their break.

 

This bitterness inside of me is difficult to explain; I still really liked Enter Shikari, but I was cynical about everyone else’s motives for liking them. They were just jumping on the bandwagon, surely.

 

What does this have to do with Nike’s sub-2 hour marathon project? Well, since it’s been announced, there has been a lot of criticism regarding it. And this criticism mainly comes from well established runners and running journalists, who see it as a fake. They feel like it will make a mockery of marathon running. The sub-2 hour project is taking marathon running mainstream, which you can see from the amount of attention given to it in the papers, magazines, and online message boards. To hard core runners, the sub-2 project is bad because it’s taking their secret, something they loved before it was cool, and making it more accessible and interesting.

 

And it is definitely driving interest. Do you want to know how many marathons I’ve watched in my life? It is precisely zero. Any coverage I have seen of the marathon is the most important bit; the last 100m (because 100m is the only distance that matters) before the runners cross the finish line. And yet since the sub-2 project has been announced, I’ve devoured all the information I can on the subject. I read Ed Caesar’s great book, “Two Hours”. Next up is Phil Maffetone’s “01:59”. I’ve even started to read Tim Noakes’ “The Lore of Running”, which is 952 pages in length.

 

But that’s not all; I’ve also started to run, admittedly very slowly. Why am I doing this? Because the sub-2h project has captured my imagination. I’ve never cared about VO2max, lactate threshold, or running economy before. Now I’m training to see how these variables are affected by training, to use my own body to improve my knowledge in this area. I’m reading about fatigue, the impact of different pacing strategies on performance, and the psychological constructs that govern endurance performance. I’m curious about heat adaptation (running in the Queensland summer is difficult), and fats versus carbohydrates for fuel. These are all things I’ve only ever had a passing interest in previously, and yet now I’m getting all the information I can, and putting it to use on myself.

 

So why this sudden change? Because this project is incredibly exciting to me. The athletes and scientists involved are looking to innovate and drive forward performance. The only other time I’ve been excited like this is when, for the first and only time in my life, I watched someone parachute to Earth. The Red Bull Stratos project also gripped me; they wanted someone to jump from what was effectively space, break the sound barrier in freefall, and safely land. The thought of that is mental, and so I had to watch it. I read books about this too, including “Freefall” by a former SAS soldier who had previously tried to break the record. And so, on Sunday 14th October 2012, I watched a balloon travel far up into the atmosphere, transfixed. I watched Felix come back down, and there may even have been a little tear in my eye when he landed. Because life is about pushing the boundaries, and I am in awe of people like that.

 

The only disappointing thing for me about the Stratos project is that there wasn’t a whole lot of insight into the training and planning that went into the mission. This is where the sub-2h project should be different. Ed Cesar and Alex Hutchinson, two great journalists (check out Alex’s book) are going to be able to take us into the action, and afterwards, hopefully, give us some ideas into the science that went into it all, which will be fascinating.

 

So, cynics and running hipsters, my question to you is – what’s the worst that can happen? Nike can throw all their effort into this, and fail; in which case you’ll be vindicated and you can act all smug. Or they’ll do it, and even more people will become interested in running. This means better equipment for you, utilising whatever new technologies these projects unearth. It might mean a better understanding of the psychological aspects that impact endurance performance – which will enable you to run faster yourself. I’m struggling to see a downside.

 

Let’s bring this full circle, and end with Enter Shikari. They came to play a show in Bath a few months later, which had a capacity about 6 times that of the show I had seen previously in Bristol. It sold out; I had a ticket, but I wasn’t sure if I should go – it would be full of people who hadn’t liked the band, MY band, for as long as me; they didn’t appreciate them like I did. Anyway, I went, I met Rory C (I didn’t ask him what his thesis was) and it was far and away the best gig I have ever been too. As a result of their success, they made more money, and more albums, increasing my enjoyment from their music. Their becoming more recognised was a blessing in disguise for me. The sub-2h marathon project might be the same for runners.

What I Read in 2016

It’s that time of the year again, where people tend to look back at what they achieved, and what they are looking to improve on in the future. My 2016 was pretty solid – I got married, travelled extensively – both for work and on holiday, was a named author on a published paper (my first), and started a Professional Doctorate, which I’m really enjoying. Those of you that know me will be aware that I very much enjoy reading, and so in the hope that I’m somewhat relevant (and also to allow me to revisit some of the books I’ve read), I’ve put together a list of the best or most important books I read in 2016.

 

My 2016 Reading List

 

  1. How Bad Do You Want It? Mastering the Psychology of Mind Over Muscle by Matt Fitzgerald – 5/5

 

This was the first book I read in 2016, and it is outstanding. It examines the interplay between the brain and endurance performance through individual stories that keep you gripped. It’s a great example of scientific communication, and it’s also a subject matter that all coaches should become au fait with. Please read this book.

 

  1. Strength and Conditioning: Biological Principles and Practical Applications by Marco Cardinale (Ed) – 4/5

 

This is a textbook, and as such isn’t a typical bedtime read – I dedicated an hour a day to work through it and make notes. It’s very technical, but also rewarding, because you really do get an understanding of the scientific principles that underpin sports performance. If you haven’t gone through a textbook before, a better start point might be “High Performance Training for Sport”, which is a bit more practical, but if you want the theory this is the place to go.

 

  1. The Skeleton Cupboard: Stories from a clinical psychologist by Tanya Byron – 5/5

 

Sometimes it’s good to read for escapism, as opposed to learning. This book definitely achieved that for me; I read it cover to cover on a four-hour flight, which made the time fly by. The book is an autobiographical account of key cases from a clinical psychologist, and it’s a fascinating read.

 

  1. How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease by Michael Greger – 3/5

 

The main premise of this book is that consuming meat is unhealthy, and we should consume a plant-based diet. I eat a lot of meat, which obviously caused plenty of cognitive dissonance when reading this book. I found it interesting, and here are my main thoughts:

  • I remain unconvinced that eating meat, in and of itself, is unhealthy
  • The evidence cited in this book tends to compare meat eaters to vegetarians, which methodologically is flawed; meat eaters tend to eat fewer vegetables (sounds obvious), and are more likely to drink and smoke. So what happens if you eat meat, but also exercise, don’t smoke or drink (much) and eat a lot of vegetables? It’s not clear.
  • It’s definitely a good idea to eat plenty of vegetables and fruits, but I still think that meat can form part of your diet – provided that the meat doesn’t replace the vegetables you consume.

That said, it’s a good idea to read books that challenge your beliefs, and this book was an engaging read.

 

  1. Wicked Beyond Belief: The Hunt for the Yorkshire Ripper by Michael Bilton – 4/5

 

I’m a big fan of true crime, and have had a passing curiosity in the Yorkshire Ripper case for a number of years – especially as I grew up there. This book is probably the definitive account, and it covers the story from the first murder, through to Sutcliffe’s capture and subsequent appeals. It also looks at why Sutcliffe got away with it for so long; he was interviewed multiple times, but due to filing errors (this was before computers) he managed to slip through the net each time. As the senior policemen became more tired over the years, they made more mistakes which compounded these filing errors, resulting in more women being killed. Overall, a great read.

 

  1. Outrage: The Five Reasons Why O.J. Simpson Got Away With Murder by Vincent Bugliosi (4/5) and Without a Doubt by Marcia Clark (4/5)

 

Like the Yorkshire Ripper case, I’ve long held an interest in the OJ Simpson case, and given that this year there were two brilliant TV series looking at it, I thought I better do some reading up on it. Bugliosi is the prosecutor who got Charles Manson imprisoned, and he examines the OJ case and why he managed to be acquitted – looking at the mistakes of the prosecution. Marcia Clark was the lead prosecutor in the OJ case, so it gives a different perspective on things. Overall, this case is a good example of how emotions can triumph over facts (see Brexit later on), and how an inability to adequately portray these key facts to a lay audience can contribute to failure.

 

  1. How to Support a Champion by Steve Ingham – 5/5

 

Steve was kind enough to let me read an advanced copy of this book. You can read my full review here, but in summary, it’s great.

 

  1. The Pressure Principle: Handle Stress, Harness Energy, and Perform When it Counts by Dave Alred – 5/5

 

This book is so good, I wrote a full review about it here. Probably the best book I read this year.

 

  1. Simple Rules: How to Thrive in a Complex World by Kathy Eisenhardt and Donald Sull – 2/5

 

The key message from this book is to create simple rules that can be easily followed, which means that you don’t waste time or overthink. That’s useful information, but the authors pad out the book with such a huge number of examples that don’t add to the story – so much so, in fact, that I got bored and stopped reading; hence the low score. This presentation explains the key points really well.

 

  1. The Diet Myth: The Real Science Behind What We Eat by Tim Spector – 4/5

 

I really enjoyed this book, which looks primarily at the effect the microbiome can have on health – a subject that I’m becoming more interested in. The key take away, for me, was to eat a varied diet lower in sugary products and red meat. Spector also does a good job of debunking a number of other dietary myths, again just underlining the need for an uncomplicated approach to eating.

 

  1. When Breath Becomes Air by Paul Kalanithi – 4/5

 

Again, this book was pure escapism, and again I read it cover to cover on a flight. It’s the story of a surgeon who gets terminal cancer, and decides to write a book about his life and experiences; the book is unfinished as the author passed away during the writing. It’s a very emotional book, and it takes you inside the psyche of someone who knows they are dying, and as a doctor fully understands that – which only makes it sadder. Not necessary a feel good read, although it will make you appreciate what you have.

 

  1. Eleven Rings: The Soul of Success by Phil Jackson – 5/5

 

Phil Jackson was coach of the Chicago Bulls and LA Lakers during their sustained periods of success, and worked with Michael Jordan, Kobe Bryant and Shaquille O’Neill. This book provides an insight into the dynamics of these teams, and the interplay between coach and superstar athletes. It’s a very good book, and Jackson comes across as someone who can get the best out of people without having to raise his voice – giving responsibility to his players and watching them grow because of it.

 

  1. The Cure for Everything: Untangling Twisted Messages about Health, Fitness, and Happiness by Tim Caulfield – 4/5

 

I like Timothy Caulfield, the author of this book, who appears to have made it his life’s mission to debunk celebrity fitness advice and champion evidence based approaches to fitness and health – a very worthwhile endeavour. This book represents his journey through a myriad of complex health and fitness information, the outcome basically being that the simple, evidence based approach works, despite that not being “sexy”. It’s all useful information and well written – I’d guess my one criticism (not really a criticism, but more my own interpretation) is that, a) absence of evidence does not mean that something is ineffective, and Tim has a very high bar for evidence (this isn’t necessarily bad, but each person needs their own bar height), b) the placebo effect can have huge effects, especially in high level sports people, and c) sometimes spending money on a shiny gadget can increase motivation and adherence, at least in the short term.

 

  1. Why Everyone (Else) is a Hypocrite: Evolution and the Modular Mind by Robert Kurzban – 2/5

 

Another example of “great idea, terrible execution” (see “Simple Rules”). If I’ve understood this book correctly, the human brain evolved at different rates, and has created a somewhat modular system. Our ability to communicate, through speech, is controlled by one aspect of the brain, and the ability of other areas to communicate with the speech area impacts how well we can explain our feelings. Our subconscious can make decisions for us, but we can’t communicate why we have made these decisions, leading to us appearing to have hypocritical behaviour (although, of course, we don’t view ourselves as hypocrites). This was useful for me to get my head around, because it helps when involved in discussions with people – sometimes their behaviour seems irrational, but this model helps to explain that. The book is, in my opinion, poorly written and hard going – so perhaps watch the authors presentations instead.

 

  1. Them: Adventures with Extremists (5/5) and The Elephant in the Room (4/5) by Jon Ronson

 

Ronson is a great author, so for entertaining reading just pick up any of his books. Even better are the audiobook versions, which Ronson narrates himself; he has a very funny way of telling his stories. Great for relaxing and taking your mind off more serious things.

 

  1. The Sense of Style: The Thinking Person’s Guide to Writing in the 21st Century by Steven Pinker (4/5)

 

The biggest challenge I find with writing is successfully communicating my thoughts to a reader. Given that I write a fair amount of articles that deal with reasonably complex sports science issues, being able to do this properly is important. My Prof Doc supervisor recommended that I check out some of Steven Pinker’s work, as a way to make myself better at scientific communication, and as a result I came across this book. It was really useful, and essentially the key take homes are to try to avoid technical jargon, and instead try to take a more conversational tone. Authors of scientific papers would do well to take this advice, given how difficult some of them can be to understand.

 

  1. All Out War: The Full Story of How Brexit Sank Britain’s Political Class by Tim Shipman (4/5) and Game Change: Obama and the Clintons, McCain and Palin, and the Race of a Lifetime by John Hilemann (5/5)

 

I’m not usually one for political books, but this year was a bit different. The first is the story of Brexit, which I was eager to read because I was so certain the UK would vote to stay in the EU, so Brexit itself was a shock. I enjoyed “All Out War”, and it gives you a feel for how politics really works. The second, “Game Change”, was recommend by my sister in law (shout out to Lynn); it’s an account of the 2008 US Presidential race that reads like a novel. I highly recommend it.

 

  1. Deep Work: Rules for Focused Success in a Distracted World by Cal Newport (3/5)

 

The key message from this book is that knowledge workers (of which I am one), tend to spend too much time doing “surface” work – emails, travel, phone calls, etc., and not enough time doing “deep” work – learning, research, producing work. This is something that I’ve been frustrated with in my own daily life; I can often feel like I don’t have time to do good work because of my own surface work demands. Since reading this book, however, I’ve made a change. I try to schedule two blocks of deep work, free from distraction, per day, for between 90 minutes and three hours at a time – and I try to do this three days per week. As the name suggests, deep work allows you to go deep into a subject matter, which for me often involves reading and understanding scientific papers, and then pulling together various strands into one consensus that I can use, be that for work or my studies. So far, it’s been a revelation and has massively increased both my productivity and knowledge. So why the low-ish score for this book? It’s another of those simple ideas that gets pulled out over the length of a book, when really it could be covered it a few pages.

 

  1. Two Hours: The Quest to Run the Impossible Marathon by Ed Caesar (5/5)

 

Given how much attention, both positive and negative, the recent announcement of Nike’s sub-2-hour marathon project got recently, I though it worthwhile to get myself up to speed to read this book. I read it in a day, sat by the pool in Vanuatu, and thoroughly enjoyed it. It doesn’t delve deeply into the science behind what would be required to run a sub-2h marathon (although certain aspects are mentioned, including genetics) but instead covers the history of marathon running, looks in depth at Kenyan marathon runners, and looks at a bit of context regarding a two-hour marathon attempt. Enough to further excite me about the prospect of a sub-2h attempt!

 

  1. Tools of Titans by Tim Ferriss

 

Tim Ferriss is like crack; I know he’s bad for me, and yet I buy all his books on release day. I found the Four-Hour Body to just be full of pseudoscience, and the same is true for a lot of his podcasts; and yet you can always find good bits of information or book recommendations from them (and the Four-Hour Chef is honestly a masterpiece). This book is comprised of the key messages from Tim’s podcasts over the past few years; it’s an easy read, full of recommendations, but probably best to take it with a pinch of salt.

 

 

Summing Up

 

When I look at my complete list on Goodreads, it’s clear to see the impact of Amazon’s Kindle Unlimited, which I signed up for this year. Whilst you can get some good books in there, a lot of them are click-bait-esque titles, which of course I fall for. This means that I seem to spend a lot of time reading in a procrastination fashion – choosing easier reads as opposed to more in-depth ones – which is something I want to work on for next year.  In 2017, I’m aiming to read some big hitters from a list published on Tim Ferriss’ website on books most recommended by successful people. I also bought myself Taleb’s Icerto box-set for Christmas, so I’m hoping to work through those too. I’m also keen to hear your recommendations, so let me know!

How to Support a Champion – A Review

Love it or hate it (and I personally love it), sports science is becoming a big part of sport – and not just at the elite level. It isn’t uncommon for even recreational athletes to have a VO2max test these days, and even personal trainers utilise sports science principles when it comes to training absolute beginners in the gym. We have taken great leaps forward in the last few years, with the study of sports science at university moving from something sports people did to get a degree, to an actual real recognised science.

 

But what makes a good sports scientist? Well, clearly, you have to have a good grasp on the actual science of it. But that is only part of the battle. No matter how smart you are, if you turn up and work with a coach or an athlete and immediately tell them everything they’re doing is wrong, you won’t be working with them for very long. Similarly, your knowledge of the science might be correct, but your application might be wrong – you might know what the athletes’ blood lactate reading is, but can you turn that into usable information?

 

There are an ever increasing number of sports science students graduating from university every year. Many of them dream of working in professional sport, but don’t know where to start. My course at university dealt with physiology, biomechanics, psychology, and research methods; I left with lab skills and some knowledge, but no practice in applying this to the real world. The same is true for many budding sports scientists – how can you become better at what you do? There isn’t a textbook that tells you this, and indeed it probably isn’t something you can learn from a textbook. That’s why I was excited when I heard that Steve Ingham, Director of Science & Technical Development at the EIS, had written a book, called “How To Support A Champion”.

 

Even the smallest amount of interaction with the sports science team can have a big impact on athletes. This was illustrated to me really nicely at the 2007 World Championships –  every morning I would bring the sports science team a small container of my urine, step on some scales, and fill out a questionnaire. At those championships, I suffered horrifically with jet lag; most nights I got about 4 hours sleep. As a result, I ran pretty poorly in the 100m, and didn’t fulfill my potential. I was determined to learn from this, and improve on the whole process for the Olympics the following year, which had the same initial time change. Fortunately, the sports science team had the same idea, and used the holding camp at those 2007 Championships to monitor how we were responding to the time change. Using information on our hydration, weight changes, and response to questionnaires, they could plot on a graph how we were dealing with the jet-lag, and make recommendations to us individually on what to change. I took on board these recommendations, and then in 2008 at the Olympic holding camp, when I continued to provide the sports science team with a bottle of my urine, morning weight and questionnaire scores, he could give me real time on feedback on how I was adapting. This information was used to determine training intensity and load, among with lifestyle interventions. The end result was that I performed much better at Beijing in the 100m (not the relay, obviously).

 

The above illustrates really nicely the impact a sports scientist can have on an athlete. They collected data, presented that data, made recommendations, and then supported the implementation of those recommendations as part of a team. It had a big impact on my performance in 2008, and as such I remember it well. Steve was part of this team, but probably doesn’t remember it quite as well, as it doesn’t make his book, although that might just be because I’m not famous enough. It turns out that Steve has worked closely with a fair few incredibly high performing athletes; Steve Redgrave, Matt Pinsent, and a host of other incredibly successful Olympic rowers; Jessica Ennis and Kelly Sotherton, and World Class middle-distance athletes Hayley Tullet and Mike East. Throughout the first part of this book, Steve describes his journey with them; lessons he learned and mistakes he made. He gives examples of how he had to deal with athletes failing (and how he wishes he did a better job of it), his own shortcomings, and things he did incorrectly, but also what he did right; how he built rapport with athletes and coaches, getting them to buy into his ideas.

 

In the second part of this book, Steve gives practical tips on how to grow as a sports scientist, and how to truly support a champion. The last chapter is especially useful, as the lessons learned throughout the journey are condensed into smaller, take away sections, with bits of “homework” to do – including a reading recommendation for each section.

 

Overall, for me the book was very interesting. I expected a textbook, but it isn’t that at all, and I think rightly so. A textbook would have felt too dry and clinical, whereas instead here we actually get a feel of what it’s like to be part of a team as a sports scientist, with practical implementation strategies as opposed to theory. I very much enjoyed reading it, and would thoroughly recommend it.

 

Who might find this book interesting? Well, sports scientists for a start, but that’s obvious. The fact is that today the line between sports scientist and coach is blurry; its expected that a coach should have good knowledge of sports science principles, and be able to apply them correctly to their athletes. There is also a lot in this book that isn’t just sports science based, but instead deals with how to work with elite athletes (we’re an odd bunch), and also how to work within a high performance team and build trust and buy-in within that team. As such, anyone involved in sport, including sports scientists, or coaching in general, would probably find something useful from this book.

 

Full disclosure – I received a review copy of this book. Whether you think this impacted my review is down to you, but there was no expectation of a positive review from Steve. I have no financial incentive to promote this book.

Correction (9th May) – I initially thought that Steve was the Sports Science team member who collected my urine at the 2007 WC and 2008 OG, but my memory failed me. It was Marco Cardinale, another great sports scientist. Sorry Marco! You can check out his blog at marcocardinale.blogspot.com.au and his own book here, which again I would recommend!

Sharapova

In case you missed it, and you almost certainly didn’t, Maria Sharapova was suspended by the World Tennis Association this week for using the banned substance meldonium. Sharapova claims that she was taking this medication for years to combat a number of health reasons, including an irregular heartbeat.

 

Let’s cut right to the chase. I would bet my life savings that Sharapova was taking this medication because of it’s purported performance enhancing effects. The same reason as a number of other athletes, including the 2013 World Champion over 1500m Abeba Aregawi, were taking it, and now have positive tests to their name.

 

Here’s the thing though – I don’t care if she was taking it for the performance enhancing effects. For the vast majority of the time that Sharpova was taking the drug, the substance wasn’t banned. It has only been banned since January 1st, a period of two and half months. If it isn’t banned, then athletes are allowed to take it.

 

Athletes take all manner of things to improve their performance. Take caffeine, for example. Caffeine definitely improves performance. It’s not banned, though it used to be. How about nicotine? Perfectly legal, and likely improves performance. I know for a fact a number of athletes use nicotine pre-race, and I guarantee they’re not doing it to try to quit smoking.

 

Athletes do plenty of other things that aren’t banned to improve their performance. Like training, for example. They hire a coach to tell them the best type of training to do. Countries and athletes with the most money can hire the best coaches, creating an uneven playing field. What about altitude training? If you’re lucky enough to live in a country with altitude, you’ve won the cosmic lottery. Or you can pay for yourself to go and train at altitude. I guarantee British Athletics don’t send athlete to Font Romeu because they like the view.

 

Athletes are always going to push the boundaries in order to have a chance at success. That is what happens when you introduce competition. But if it isn’t banned, then it isn’t cheating, and to say otherwise is incorrect. The athlete doesn’t set the rules of the sport, they just have to abide by them. Each athlete has to face their own moral and ethical decisions about whether they should or shouldn’t take a legal substance. Personally, I wouldn’t take meldonium, but I don’t despise the athletes that did before January 1st. As an athlete, you have to do everything in your power to stack the deck in your favour, to increase your chances of winning. That’s why we train, follow a strict diet, sleep, and sometimes take supplements. Every professional athlete has to look at themselves in the mirror and ask themselves if they have done everything within the rules to win.

 

Recently, I took part in an 8km obstacle race in Australia. 100kgs of body mass rather overheats over that distance, so I used paracetamol to bring it down and enable me to exercise for longer. I definitely did not have a headache. I was using a substance to improve my performance in a race. Paracetamol is not banned. Am I a dirty drugs cheat?

 

Would everyone have been furious if on December 31st 2015, Sharapova revealed that she had been taking a legal substance for 10 years to enhance her performance?

 

So, my point is – don’t judge Sharapova for taking this substance before January 1st 2016. However, you can absolutely judge her for taking it afterwards. The fact that she didn’t check the email from WADA is absolutely ludicrous. I cannot imagine doing this myself. Furthermore, WADA would have been constantly re-enforcing this rule change through official communications to the athletes.

 

Do I think that she deliberately took the medication after January 1st in order to cheat? No, I don’t. I do genuinely believe that she was unaware of the rule change, as stupid as that is. You simply would not continue to take a substance that you know will be tested for, at an event where you know you are very likely to get drug tested at. That would just be asking to get caught.

 

So, go easy when you’re moralising against Sharapova. This isn’t doping to the same extent as Lance Armstrong. In my opinion, it is not a deliberate and organised long term implementation of a doping programme; it’s just an athlete taking something that was legal, and then not following the rules closely enough. She absolutely deserves whatever ban comes her way, however, simply because of the complete unprofessionalism she has shown towards the anti-doping process.