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Category Archives: Medical Research

Alexander Dale Oen 1985-2012

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Alexander Dale Oen jokingly told me that he´d happily have my calf muscles to improve his starts, even though they may cause some drag in the water. I was telling him how his physique would suit kettlebell sport, more specifically the snatch, with his long arms and explosive hips. After the Olympics in London, he said, I could teach him more about kettlebells, but until then his coaches wouldn´t be too happy. I explained some of the movements and could tell he was genuinely interested.

Dale Oen had recently returned from Shanghai where he was crowned 100m breaststroke world champion. We occasionally met at my local gym, shared stories, joked and had a mutual appreciation of the science behind training. When I last spoke to Oen, we briefly mentioned London 2012, where he offered to try and sort me out tickets to the aquatic centre. I´d followed his progress from a shoulder injury and he seemed quietly confident he would be back in top shape come July. Sadly, just last week on April 30th, Alex suffered a suspected cardiac arrest whilst at a national team training camp in the US, and died, aged 26.

For a small nation like Norway, Oen´s death came as a massive shock. Few athletes have made it to the top of genuine world sports, and his humility and humble roots made for an extra outpouring of grief. He had, the nation well remembers, dedicated his world title last year to the victims and families of the terrible tragedies tat struck Oslo and Utøya on 22 July. In Bergen, the town he was born in and raised close by, the feeling was one of losing its most illustrious son.

As one who has dabbled in sports psychology, I had a particular fascination with the mindset of those elite athletes who seemed to handle the enormous pressures of training and competition to make it to the very top. I once shared a coffee with Alex after training, having recently returned from Solomon Islands where I had been working with elite footballers. There were many ways those players handled pressures, and I was interested in finding common threads, using previous studies of elite rugby league players in New Zealand as further comparison.

Dale Oen spoke of his continuous search for movement patterns that could make him swim faster. Training hard was something he had always been used to, and enjoyed. But his recent rise to the top of world swimming was due to new discoveries which he was sure put him at an advantage over his competitors. I had heard elite athletes talking about “that something extra” before, and even though few had given me a clear definition of what that was, I assumed it was connected to an unconscious pattern of moving beyond conscious and habitual performance. The skills elite athletes posses are often expressed in effortless ways, almost as a transcendence of the self. I had pondered a lot on this so-called “zone”, and never wanted to bore or confuse the athletes I´d spent time with all the literature. I was simply interested in what the “feel” was like.

With slight, but continual changes in his training and technique, Oen told me that on certain occasions (usually in training) he felt so effortlessly fast. This wasn´t the case when he won the world title surprisingly. “Not the perfect race by any means”, he said. I asked him what was unique about world champions, and I sensed his typical modesty when he explained that some athletes simply had a better capacity to eliminate inhibiting movement and interference that would slow them down, at the same time as they had found an optimal balance of training technique, volume and ability to fire at a very important moment. Hard work, he added, was a necessity even for those with supreme natural abilities.

ImageWe spoke about other sports and joked about my experiences in Norway, and my lack of swimming ability. Could I become a world class swimmer without shaving my body, I asked?. “I know a good waxer in Oslo”, Alex replied. But what about my chunky legs?, I said. “Just enter the 50m, jump from the blocks so hard that you reach the end in one breath!”.

I sensed Dale Oen had reached the top not only because of his natural talent, work ethic, and top coaching apparatus, but also his open mind when it came to learning how to possibly go faster. “I´ve met swimmers from all over the world, and listened to the way they talk about training and preparation. There is no single way to train, or do anything well. You just have to keep thinking, keep doing things, and learn when things go wrong”.

Dale Oen was optimistic and excited about London 2012, just as he was about getting some food after our chat, and finding out about my ´secret´calf-training methods. We parted ways, and said we´d keep in touch. Sadly, it was the last I saw of Alex. I will remember him as a champion not just of the swimming pool, but of the human spirt. He possessed qualities of warmth, humor, humbleness and humility and was fiercely proud of his birthplace and nation. He will be sorely missed by all who were lucky enough to be touched by his presence, but whose legacy will last for generations to come.

 

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Sexual selection (part 1)

Sexual selection: It does all seem to get over analyzed, with the general confusing over how much the social/external influence directs our evolutionary makeup. Less than we realize I reckon. This post** outlines how some of this confusion has got us through to today´s uncertain times regarding mate selection. In anthropology, 20th century theory was dominated by forms of functionalist thinking which saw social behavior reflecting or sustaining social order or collectivity, with less weight (understanding) placed upon legitimate biological practicalities of evolution.

Two competing, yet comparative instincts humans have evolved through their increased complexity are the sexual instincts that drive copulation (finding a partner to mate with) and the way we create, expose and decorate our bodies to apparently achieve such results. Both factors (one, we could crudely call biological, the other social) are part of sexual selection and, whilst not mutually inclusive, are fundamental to understanding the modern commercial preoccupation for “the ideal body” (whatever that is…I just heard about this reading high-end lit. in the dentists waiting room last week).

For the male, I think it is unquestionable that evolution has favored toughness those with hard to hide expressions of physical condition. Size, energy, loudness etc have been selected ahead of feebleness. But for the female, physical signs have not been allowed such scope of outward diversity due to the demanding task of pregnancy and motherhood. It would make sense to think that a female with a large arse and thighs (vs. skinny one) would indicate too much processed food breeding potential and proficiency as carrying potential genes forward. But then again, not all females are like that, so there are other factors. One that has become popular with evolutionary psychologists is the idea of “developmental stability”. Not just the arse then. This relates to the ability to change outward expression of fertility and health by aiming for symmetry in appearance, even if the genes and environment select against this. This is related to these odd studies you read about whereby people look at faces of all sorts of individuals and pick the ones they are most/least attracted to based upon nose/cheek/eye/chin lines etc.

Bodily symmetry has of course been a major factor in aesthetical expression of the human form throughout our history. But whatever the size and shape, these factors are biologically important to mate selection. So the question may be asked for today´s male or female out to find a partner or a one night liaison:

  • “What are these developmental symmetries that can help me out here?!”
  • “Never mind your evolutionary ranting, I just want to know how to get laid, and whether or not it is the bodily characteristics me or her I should be concerned about!”

Well, if I knew the answer, I would be like Tucker Max pretends to be. There is no answer of course, other than the fact that sexual selection a mutual choice (mostly). And that mutual choice is based upon a hugely broad variation of indicators of what fitness entails. It can be be boiled down to the level of tradeoff one places upon a certain category versus the other, which again is vastly diverse. If sexual fitness was biologically determined to favour certain factors like breast size, hip width or height, then we would all be the same. We are not, which is an indicator that humans get what they can use strategic selection based upon whatever they can get  a combination of socially and biologically influenced understandings of fertility and health. Big, or perhaps solid and meaty arses have long been a feature of the developmental success of our species, and the trend today towards stripping away the flesh to reveal bony, flat rumps is in fact more of a reversal of the evolutionary path back to our tree-dwelling days (minus all the hair). As far as breasts go, size has usually been linked to nutritional wellbeing in terms of fat reserves being stored there, but also as an indicator of fertility. In this sense, we would expect large breasts in affluent societies but the huge variation in size is perhaps an indicator of too much pointless aerobic exercise of other more influential factors in male selection, like brains.

The human body has successfully evolved to survive. We don´t have to worry too much about selecting a mate who may not have the capacity to survive, with few exceptions. Sexual selection has become more complex as our brains have developed, and as our societies have expanded. No longer do we have to make do with the odd new mate appearing on the horizon, unless we live in the Arctic. No longer do we have to use violence. No longer do we have to grunt better than the other hairy dude living in the next cave. We have language, we have the cognitive skills and intuition to make wrong choices and get divorced make the selective process a lottery more nuanced, more interesting and broader than that of our ancestors. But we still focus on tits ´n arses, girls still check out the shoulders, arms and hips. What´s up then?. The more we are told that aesthetic composition is the key to successful mating, the less we seem to adhere to the factors that have played a pivotal role over the course of our life histories.

Humans get sexually aroused rather quickly, and this is our downfall usually precedes the time it takes for emotional connection, which, in most cases is the determinant factor in (long-term) mate selection. How many times do you hear, see or think “he´s in it for the body” or “that has to be to suit the image”?. Like it or not, we are rather plastic beneath our cloak of egalitarianism and humility. We wish society well, and believe personality is the key to harmonious relations and coherence in life, yet still we are genetically programmed to display our (perceived) sexual prowess and select mates who fill these desires. Be truthful now!. Science does not usually lie, it is as objective as we allow ourselves to believe it ahead of the subjectivity that allows our ideological meandering to think we are an advanced monogamous species.

So, what the hell has this to do with modern consumer society trying desperately how to change our genetic tendencies?. We are perhaps guided by moralities and try our best to adhere to principles of good faith, family bonds and unity. But we find our modern complexities in constant flux regarding social, psychological, biological and physical frailties and the need to place more or less weight on the factors (they say, we say, we feel etc) that initiate our selection choice for partners.

It is only the media and commercial interests that profit from telling us how we need to manipulate our bodies and buy shit we don´t need through diet and exercise in order to make ourselves more attractive. Save yourself time and think of “being healthy” not as some aspect of social conformity, but as a possibility we have to fulfill our evolutionary potential. Mates will come and go, hearts will be broken, that is just my human nature. The less we stress about it the better. If we think of selection like we think of an episode of Seinfeld, then we understand the blurred nature of reality and entertainment. Just how we “know” what we are attracted to and why is part of our epistemological evolution that is in constant flux, and in constant battle with the pressures we allow ourselves to be influenced by in modern society.

Intelligence, warmth, compassion, humility, humor and lifting kettlebells so on are all parts of physical attractiveness. These qualities are displayed in various ways and will forever be debated through trial and error. Body image through the media and social commentary is part of the objectification of self that is so pervasive in today´s society. But we are reflexive in our mind´s appearance and habituate a body every day in many ways, thus have a capacity to act in non-cognitive ways. Our bodies are in constant motion and move freely beyond the boundaries prescribed by the the subject-object dichotomy that causes so much self-doubt about body image. It is the space we occupy and interact with that determines our consciousness wellbeing, not a static time zone. Sexual selection has many forces at play, but still, take it as a compliment if someone tells you you´ve got a nice arse. I´m sure it´s well meant.

**based upon years of trial and error and the realization that George was smarter than Jerry and Elaine

 

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Manipulating causality: Medical journals and the pharmaceutical industry fraud

“Medical journals are an extension of the marketing arm of pharmaceutical companies”

Richard Smith

This is a safe life

We are never far from captivating headlines telling us how our path to eventual death may be even closer should we consider squatting below 90, consuming a double espresso, eating bacon and eggs, or god forbid, challenging state health authority recommendations for diet and exercise. For most, avoiding doing anything remotely controversial when it comes to lifestyle changes is a scary option. And people do not like to get scared. People prefer to stay inside the wheel like a mouse, going nowhere in particular, eating birdseed, and wondering if what you did yesterday was what you will do tomorrow, and the day after. But of course being content that even if you never get around to doing something, you´ll not face fear. Society tells us a lot about fear, let´s just exist.

But some seek to understand their shortcomings, and move beyond page 3 of the tabloid newspapers whilst subliminally wondering what life on the road with Shakira would be like (this is the alter ego speaking, they confused image with reality). Some seek the science behind the myth, the clinical evidence that makes us convinced cholesterol is bad, fat loss is a genetic thing, and 60% carbohydrate intake is optimal for health performance. We go to the journals.

I´ve always liked journals, not so much for their up-to-dateness, but for the constant variation and stimulation provided on a regular basis, and the thought provoking material that one can either add to the pile in the office shelf or keep open and develop further knowledge. Much like relationships to a woman or a dip bar, journals can be a challenge, and thoroughly rewarding if approached methodically at the correct time in a focussed way, but can provide confusing feedback that may require extended periods of self-reflection. If I appear slightly Freudian, I can explain. And I love the dip bar.

Richard Smith was editor in chief of the British Medical Journal and CEO of the BMJ Publishing Group for 13 years between 1991-2004. His article “Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies” is based on a lecture at the Medical Society of London in October 2004 when receiving the HealthWatch Award. The article overlaps to a small extent with an article published in the BMJ in 2003. He later published a book in 2006 entitled “The Trouble with Medical Journals” which further expands upon this topic. Now what struck me as interesting, was the levels of collusion that must be systematically inherent in the medical journal industry that allows for randomised controlled clinal trials to be the basis of cause and effect “evidence” that ends up as published papers, which are force fed to the medical industry, state health authorities and eventually to all the mice on treadmills living the life of existence in the uncivilized and brainwashed modern society. Sorry about the long sentence, I´ve been reading too many medical journals and drinking coffee, so that MUST be the effect.

The pharmaceutical industry is big. The biggest company Pfizer had global revenues in 2008 of USD$68billion, so sponsoring journals and clinical trials and no doubt unethical medical practitioners/peer reviewers to promote its drugs is well worth it. The World Health Organization (WHO) recently issued a fact sheet warning about the corrupt and unethical practices that are endemic to every step of the pharmaceuticals business. This is probably not so new to many, as is usually the case with multi-billion dollar industries, corruption and malpractice is the norm rather than the exception; “Join the ride and keep your trap shut, or stand up against it, quit the industry and take up life as a poor, but morally sound social scientist instead” type gig. An extract:

  • Corruption in the pharmaceutical sector occurs throughout all stages of the medicine chain, from research and development to dispensing and promotion,” the fact sheet reads.The medicine chain refers to each step involved in getting drugs into the hands of patients, including drug creation, regulation, management and consumption. The WHO notes that corruption is so widespread in part because medicines pass through a large number of intermediaries before they reach the patients who need them. Each extra step provides an opportunity for corruption to take place, ultimately driving up the cost of the medicine or diverting it toward the wrong recipients.

So we see the journals being published by professional societies (e.g. British Medical Association), the pharmaceutical companies that provide the funds for gaining the results they want and the academics/medical professionals who provide the writing, reviewing, and promotion of the results to the students/patients/media. Talk about symbiosis. Reading through PubMed to gain some knowledge about type II diabetes, hormone regulation, fat metabolism etc is like a discovering a fetish for handbags, and sitting down with a decade´s supply of Woman´s Weekly magazines to work out what has been in fashion. Take cholesterol research for example.

You got it Homer!

Statins (lipoprotein reducing medicine) are the best selling medicines in the history of modern pharmaceuticals. It is a billion dollar drug range, and these companies will do anything to keep up the myth of cholesterol being bad for us and linking it to disease. But recent research, often coming from the internet/blog driven independent health research field, is telling us that this is little more than a scam on a massive scale. Still, one cannot help but feel sorry for the confusing advice that not only is “bad” cholesterol actually “bad”, because “new insights” tell us so, but some “good” cholesterol is actually “bad”, or can go “bad”. Even statins that reduce “bad” cholesterol, also reduce the risk of certain cancer. And again here. Or we could just relax, eat well, rest well and not worry about it at all. What methods to these companies adopt to get the results from clinical trials they look for?. Back to Dr. Smith´s article (2005)

  • Conduct a trial of your drug against a treatment known to be inferior.
  • Trial your drugs against too low a dose of a competitor drug.
  • Conduct a trial of your drug against too high a dose of a competitor drug (making your drug seem less toxic).
  • Conduct trials that are too small to show differences from competitor drugs.
  • Use multiple endpoints in the trial and select for publication those that give favourable results.
  • Do multicentre trials and select for publication results from centres that are favourable.
  • Conduct subgroup analyses and select for publication those that are favourable.
  • Present results that are most likely to impress—for example, reduction in relative rather than absolute risk.
The problem seems inextricably bound up in economics. As long as drug companies continue to fund research and be complicit in directing every step along the way, then the public will not get the preventative treatment that could be developed if, for example, state funding agencies began to sponsor trials based upon the types of broad-ranging interdisciplinary research that are beginning to uncover so many of the myths of modern medicine. It seems a long way off however. I cannot see even the state providing funding for a decade-long study looking at the effects of a lower carbohydrate/sugar intake on mental and physical health, without having to admit the fallacy of their advice over the past decades to consume a low-fat, high carbohydrate diet. Another suggestion would be to regulate the medical journal industry, making them somehow independent of the drug companies, and adopting a critical approach to existing research, instead of continuing to publish results from clinical trials that quite obviously seek to prove an effect from a pre-framed cause. This too, seems a long way off.
In the meantime, we can continue to discuss informally some of the benefits that a social science orientated methodological approach can provide to some of the natural sciences that seem steeped in a reductionist-type methodological orientation. We need to look closely at ideas taken from biocultural anthropology and evolutionary psychology and merge the holistic understandings about human physiological development to forge a new health paradigm for the current millennium that is not a slave to corrupt commercial interests, but actually has the wellbeing of humanity at its core.
 

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