A Journey of Mindfulness--the Remaking of Life in Midstream.

[IlliniDave]

I've messed up my shoulder with calisthenics while never had a problem over years of weight lifting. I would say it may be easier to hurt oneself with calisthenics, because with weight lifting you can finely adapt the weight to your current capabilities, while with calisthenics your body weights what it weights, so the only form of adaptation is basically switching to another exercise.

It might depend on the particular calisthenic. I do know the worst shoulder injury I ever had in terms of acute pain came from doing as many burpees as I could in 6 minutes as part of a competition. For some calisthenics like squats, you always have your body weight in addition to any weights. But something like a strict pushup, you're right--it's possible to say perform a bench press much less than the fraction of your body weight you push up, although there are several variations on pushups to mitigate that while initial strength is being developed.

[IlliniDave]

A note to tie up some things on my Spring 25 round of lab tests.

I finally got the balance of my Function Health test set. Mostly it was just all the lipid "fractionation" (I think that's the right word) stuff and the last couple standard lipid numbers. With the fractionation stuff, I'm still not ideal, but every parameter improved substantially. If one just looked at my standard TCL/HDL/LDL/VLDL/TGL numbers my lipid profile looked pretty darn good. The particle characteristics indicate I have room for improvement. My understanding is that aside from some uncommon genetic conditions, the undesired particle characteristics are usually described as "damaged" particles due to insulin resistance. Function Health provides a "clinician review" as part of the service. This time the clinician review was rather terse, but what stood out is that the person stated that my overall biomarker profile indicated that I'm producing too much insulin (without any discussion about the basis of that conclusion). All that seems to support my theory that I still have not unwound all of the IR built up in prior decades. I get decent (but not stellar) HOMA-IR and HbA1c numbers mostly through substantial moderation in carb intake. If I ate more "normally" those numbers would reflect more of a residual issue. So on the one hand I'm encouraged by the progress, but on the other hand winding down IR still remains one of my top nutritional/lifestyle priorities.

But there's a rub. 2.5 weeks after I went to the lab for the Function tests, I went to have blood drawn for my annual "well patient visit" with my primary doc. She only orders a basic lipid panel, no fractionation stuff, and those numbers came back "worse". Specifically my LDL was quite a bit higher, and therefore total cholesterol was higher. At the same time HDL was somewhat higher (over 60 for the first time ever!) and triglycerides were lower.

I had the actual appointment with her on Wednesday, and I have to say that I've now almost completely lost faith in her. When the lipid panel numbers came up I said in so many words that I wasn't thrilled about the LDL, but pointed out that the lab's assessment of the overall profile was that my cardiac risk was "below average". The primary marker I look at id TGL/HDL ration which was around 1.5 and puts me in the "low risk" category, and although it's considered not as good a marker as TGL/HDL, my LDL/HDL ratio fell in the "ideal" range with room to spare.

Her response was, "We don't pay any attention to that stuff anymore, we only look at bad cholesterol now". As a matter of fact, she wouldn't even say "LDL", only "bad cholesterol". So she was basically reading from the 1995 playbook with absolute certainty, which I found stunning because based on her appearance she may not have been born yet in 1995. And I do realize that some fraction of my LDL is of the undesirable type, but she hasn't seen those numbers and I'm trending sharply in the positive direction there. To her credit, she did note that I'd already proved to her that I can improve all that stuff through lifestyle and she was okay with giving me time and let me try to do the lifestyle thing even though the statin option was floated. I was just disappointed that she seemed so unaware of the growing nuance around the topic of LDL as gaping holes have been shot in the "science" of decades past that fingered LDL as the smoking gun for all that was amiss in the world.

Putting that aside, it does leave me with a fascinating question--why did my LDL jump so much in 17 days? (from memory it went from something like 112 to 168) with the fact that different labs performed the respective tests, especially while the companion markers HDL and triglycerides improved slightly. I didn't make any huge shifts in my nutritional macros in those in between days. And if anything my activity level increased slightly. I don't keep a food log, but I do save receipts for 2-3 months, so I've collected my March, April, and May-to-date receipts to take with me to the hideout to see if can reconstruct roughly what I ate for the 2.5 weeks leading to each test. I tend to shop for groceries 3-4 times per week to cover a window of a couple days rather than making big stock-up runs, so I should be able to put together a pretty good picture of any differences. I see this as a golden opportunity to learn something about my physiology.

If all goes well I'll be heading up to the end of the road Sunday, so all that will have to wait until next week. It'll be a good exercise in self discipline since I really want to drop everything and dig into that question.

[IlliniDave]

I had an unusual sleep last night. I had a busy day, blew through my active calorie burn goal without even thinking about doing any sort of workout--12,800 steps gathering, packing and loading. I was ready for bed at bedtime, 12 min latency, but only slept a paltry 5 hours. The odd thing was that I seem to have had only 1m deep sleep. I had 1h of REM which is another oddity for me--not so much the amount but that I had so much more REM than deep. The lack of deep sleep is noticeable--this one one of the extremely rare mornings that while fully awake. I feel like I'm dragging a little.

It's too early to get started on the balance of my packing so I'm typing in here to kill time before I get started. Looks like I'm clear to commence my annual migration in the morning although I'm monitoring a couple of fires in Superior National Forest. So far it doesn't appeal that they are imminently threatening my route. Down here in my part of Illinois it's been steamy, reached the mid 90s Thursday, well into the 80s yesterday, and last I checked snow is in the forecast tonight for the area around the hideout.

Each time I shove the yak up on the roof of my vehicle the chore gets easier. Some of that is skill, but it takes an amount of brute force to actualize skill. The thing's not super heavy, somewhere between 70 and 80 lbs, but at 12' length and 46" beam and nowhere to get a good hold, it officially qualifies as a PITA. I did tweak my bum shoulder in the process of that plus all the carrying, but it feels better this morning. Getting old is not for the faint of heart.

Once I get there I'll have about 2 weeks to finish off my present workout regimen before I transition into whatever I settle into for 6/25-5/26. My current regimen gave primacy to strength. This next 1 year period I want to strike more of a balance and pay more attention to VO2 max. It's easiest for me to divide the 12 months between June-Sept while at the hideout and Oct-May in the normal world. The natural activities at the hideout that would be more VO2-focused than strength-focused are my normal hiking and walking and paddling the kayak. I heard about a study conducted with a cohort of ~elderly Japanese participants that compared what was described as "tabata" walking with "normal" walking where the former appeared to have VO2 max benefits. I have tabata in quotes because I don't think they used the sort of interval duration/spacing I associate with tabata, it was more like 1-minute of power-walking followed by 3-5 minutes of easier walking. Hopefully I can track down the specifics but since I try to walk frequently for other reasons related to metabolism, if I can eke a little more out of the endeavor, I don't see any harm in it. I'll probably have to restrict it to roadside walking rather than hiking--the trails in the area are not suitable for anything close to power walking, way too much risk for injury.

One thing NE Minnesota is not short on is hills, so if I get to feeling sporty I might play around with running uphill and walking downhill. Running for me means jogging.

I'm going to experiment with doing the same thing while paddling. I goofed around with it a little last season but I'm going to try to make it a more regular thing. Paddling is more arm/shoulder/core-centric so it's tough to ramp heart rate up quickly which misses the modality I'm trying to hit (basically a REHIIT strategy).

I'm also going to be focused on my continued battle with insulin resistance, so I'm going to attempt making postprandial walking a habit. We'll see how that goes. I foresee it being a little inconvenient, but I've heard it repeated often enough that a 15-20 minute after dinner stroll does wonders for blood sugar regulation which in turn helps the unwinding of IR. I bought enough beans and pasta to have 2-3 "carb feast" meals per week. I did that prior to getting all the biomarker data back (which indicated I'd overestimated my progress on the IR front). Part of the motivation is to avoid my habits from prior seasons of gradually adding more crappy high carb food as the season progressed, thinking if I had some more reasonable carb choices, the odds of jelly-filled bismarks, cheesecakes, and frozen pizzas finding their way to the cabin would diminish. And I also hoped that a few more carbs would help me balance energy and even improve sleep while there. I don't want to waste the food, so the bargain I'm contemplating with myself is to at minimum make such a stroll mandatory any time I have a moderate-to-higher carb meal. Wish me luck on that one.

[Scott 2]

The impact of postprandial walking is extremely clear on a CGM, specifically after high carb meals. Movement cuts the peak right off the glucose curve. I think you're on track there. Some meals don't spike the glucose curve. Moving after them doesn't change much, in my experience.

For someone with an interest in their insulin response, a CGM remains my first suggestion. Oura just announced an integration with Dexcom even. Once one is eating stuff like frozen pizza, I think it's an essential tool. Some patterns can nearly level the glucose curve, while others lead to regular spikes of 50+ points.


I'm interested to see what a focus on v02 max does to your numbers.

[7Wannabe5]

How are you going to measure VO2 max? For my purposes, the results of the varying estimators will produce a very wide range.

[IlliniDave]

How are you going to measure VO2 max? For my purposes, the results of the varying estimators will produce a very wide range.

Over the summer the only real choice I have is to attempt the 6-minute walk test that Oura has built in. I did find one option for a sort of flat sort of straight course last summer. Another option is to wait until I get home and do the 2k row and punch the time into the calculator, but that's a truly sucky workout. In the longer-term I'm considering buying a fancy pants indoor bike that's whole purpose for existence is centered around VO2 max, and I think it gives you an estimate every time you use it. I'm torn on that one though. If I was faced with the choice of undergoing a medical treatment that came with a reasonable expectation of boosting my relative health over my last few years of life for $10x the cost of the bike I'd probably do it without much thought versus crossing my fingers and trying to DIY the same result. But spending $x on a piece of "gym equipment" is tough to warm up to.

[Ego]

A bike or treadmill VO2 Max lab test around here cost about $100-150. I have not done one since I was doing triathlons competitively at 21 or 22 but I've considered maybe doing an annual baseline test much like Dave's blood work.

[IlliniDave]

The impact of postprandial walking is extremely clear on a CGM, specifically after high carb meals. Movement cuts the peak right off the glucose curve. I think you're on track there. Some meals don't spike the glucose curve. Moving after them doesn't change much, in my experience.

For someone with an interest in their insulin response, a CGM remains my first suggestion. Oura just announced an integration with Dexcom even. Once one is eating stuff like frozen pizza, I think it's an essential tool. Some patterns can nearly level the glucose curve, while others lead to regular spikes of 50+ points.


I'm interested to see what a focus on v02 max does to your numbers.

I'm with you on the CGM, I'm apt to do that. I'd been thinking about trying Levels, in part because one of the founders has a shot at being the next Surgeon General. The reason I haven't acted yet is because, like I said, I got a little overconfident regarding my progress with IR.

Makes sense that a typical meal of mine wouldn't be the ideal use case for postprandial walking. I did some experiments with my Keto Mojo last spring and most often didn't register a glucose number above the "healthy" range for fasting glucose when taking measurements at down to 30-minute intervals. Even throwing in a half a sweet potato barely pushed me over 100.

[IlliniDave]

A bike or treadmill VO2 Max lab test around here cost about $100-150. I have not done one since I was doing triathlons competitively at 21 or 22 but I've considered maybe doing an annual baseline test much like Dave's blood work.

That sounds like a worthwhile idea. I haven't looked into that around here in detail, but a quick Google search came up with nothing within 80 miles or so. I ran into the same thing late last winter when I really, really wanted to get a DEXA scan done to get a baseline before I changed up nutrition and started the heavier resistance regimen. A couple of the places over near Chicago offer both VO2 max and DEXA. That might make it worth the drive assuming I could get both done within half a day or so.

[7Wannabe5]

Over the summer the only real choice I have is to attempt the 6-minute walk test that Oura has built in.

It would be interesting to know how they perform their estimation. The Jenkins regression on the 6 minute walk test offers a good example of why VO2 max and/or CRF estimation estimation metrics can produce fairly widely varying results:

Predictive equation for males: 6MWD(m) = 867 – (5.71 age, yrs) + (1.03 height, cm)
Predictive equation for females: 6MWD(m) = 525 – (2.86 age, yrs) + (2.71 height, cm) – (6.22 BMI).

As you can see, the Jenkins regression used to score the 6 minute walk result as a measure of CRF actually corrects for BMI for females, whereas VO2 max relative as a measure of CRF penalizes for adiposity. Obviously, this is because VO2 max relative is assuming a population of athletes of varying sizes, but similar lean/fat ratios, whereas the 6 Minute Walk Test is assuming a general population of older adults in which any adiposity seen in older men is likely to be central body vs. varying distributions for females, some of which would be likely to inhibit walking speed irrespective of CRF.

[Scott 2]

Levels stands out as the CGM solution for health optimizers. I didn't want to pay their premium, so got a device script from my doctor. With good Rx discount, 30 days of a dexcom was $180. 3 sensors, so I spread them out. Dexcom now offers an over the counter device. I haven't tried it.

I spent a lot of energy reading the Levels articles and manually interpreting my data. If I valued my time, paying for their product probably would have been worth it.

Casey Means is an interesting candidate for surgeon general. Much of her book Good Energy resonated with me. I do wonder how she'd navigate public policy, with the average American being so far removed from Medicine 3.0 strategies.


If I was going to add one piece to my home gym, it'd be an indoor bike. Low maintenance, small footprint, no impact. I'd probably splurge for magnetic resistance. The rowerg is more fun, but a bike is so easy to zone out on and accumulate zone 2 minutes. It's often my first choice even at the full gym.

[jacob]

If I was going to add one piece to my home gym, it'd be an indoor bike. Low maintenance, small footprint, no impact. I'd probably splurge for magnetic resistance. The rowerg is more fun, but a bike is so easy to zone out on and accumulate zone 2 minutes. It's often my first choice even at the full gym.

You can make a cheap stationary zone 2 bike by getting "whatever bike" on craigslist for $0 and up (you just need the saddle, handlebars, and pedals ... it doesn't matter what quality the bike is when you're stationary) and installing it on a trainer. Fluid>magnetic>friction. Fluid is worthwhile because the resistance feels closest to an actual bicycle at all speeds. Fluid trainers can be had for $200 on ebay.

Spacing out while pedaling is practically free. It'll even heat the home a bit (100-300W).
There are also some cycling programs available on DVD. I used to own a collection of Troy Jacobson training vids to keep things interesting. $10-20 per vid. Also free stuff on youtube like amateur roadracers wearing a gopro.
Next step would be something like Zwift. This is a $10-20/month subscription that turns consumers into reliable cashflows. To get the true cost of a monthly subscription, multiply by a factor of 400. This is already getting more expensive by a couple of orders of magnitude.
The latest offerings apparently attempt a lock-in by getting people to buy a very expensive stationary bike that is practically useless once one stops paying a high monthly fee. In terms of net present value, the market will now bear around $10,000 apparently. It emulates the "leasing a car"-model of financialization.

[Ego]

Next step would be something like Zwift. This is a $10-20/month subscription that turns consumers into reliable cashflows. To get the true cost of a monthly subscription, multiply by a factor of 400. This is already getting more expensive by a couple of orders of magnitude.

https://www.mywhoosh.com/ is the free competitor to Zwift. They have deep pocket funding from one of the sovereign wealth funds. I've never used it but I've heard good things.

[theanimal]

Over the summer the only real choice I have is to attempt the 6-minute walk test that Oura has built in. I did find one option for a sort of flat sort of straight course last summer. Another option is to wait until I get home and do the 2k row and punch the time into the calculator, but that's a truly sucky workout.

The Cooper test is another option and widely considered to be the closest match to a lab test. You run as far as you can for 12 min and note the distance. Punch the numbers the following formula and voila.

VO2 max= (Distance in meters-504.9)/44.73

Given that VO2 max is measuring maximum effort/capability, any test that moves further away from that is bound to be less accurate. In other words, it should feel truly sucky.

[IlliniDave]

It would be interesting to know how they perform their estimation. The Jenkins regression on the 6 minute walk test offers a good example of why VO2 max and/or CRF estimation estimation metrics can produce fairly widely varying results:



As you can see, the Jenkins regression used to score the 6 minute walk result as a measure of CRF actually corrects for BMI for females, whereas VO2 max relative as a measure of CRF penalizes for adiposity. Obviously, this is because VO2 max relative is assuming a population of athletes of varying sizes, but similar lean/fat ratios, whereas the 6 Minute Walk Test is assuming a general population of older adults in which any adiposity seen in older men is likely to be central body vs. varying distributions for females, some of which would be likely to inhibit walking speed irrespective of CRF.

It would be interesting to know their algorithm, but In a sense that doesn't matter to me at this juncture as long as they use the same algorithm each time I take the test. I'm only interested inthe competition of iDave(this month/year) versus iDave(last month/year). I detest endurance training and so I need continual feedback to keep myself motivated. That's also why REHIIT is so intriguing to me. If I can get better results doing less of something I hate, sign me up. That doesn't have any relevance to whatever calculations Oura decided to use in their app.

It would be nice if the number was fairly close to what would emerge in a laboratory, but I have no expectation it will. I saw a plot of the results of a study that compared 6-minute walk distance to laboratory measures and it was essentially a cloud. You could eyeball a positive correlation in the population but actual VO2 max at any given distance achieved varied significantly.

[IlliniDave]

The Cooper test is another option and widely considered to be the closest match to a lab test. You run as far as you can for 12 min and note the distance. Punch the numbers the following formula and voila.

VO2 max= (Distance in meters-504.9)/44.73

Given that VO2 max is measuring maximum effort/capability, any test that moves further away from that is bound to be less accurate. In other words, it should feel truly sucky.

Some of us are getting on in years and the 6-minute walking test was designed to be suitable for us more decrepit souls. If nothing else there's a lot of data out there and you can get a pretty good gauge of where you are relative to your age cohort. That can lead to a false sense of security since my cohort is largely overweight and sedentary and and suffering one or more variants of chronic disease. So in my case being above average isn't telling me much. The Cooper test is probably great for runners who are spend enough time at it that they know how to pace themselves to maximize a 10-minute run.

Sucky is definitely part of it, but when it comes to the ongoing training part of it, I'm pursuing the highest bang for the least suck. To get a good measure that can at least be translated to something like VO2 max reasonably definitely comes with a high suck factor, no doubt, especially if you want a precise estimate. I'm basically interested in improving for as long as I can then slow the inevitable decline. So knowing mL/(kg·min) is less important than knowing I got 10% better or whatever at some measure of CVF. It's fun to have an VO2 max number, but at my age and starting point knowing the truth is likely to just spike my cortisol.

[IlliniDave]

Casey Means is an interesting candidate for surgeon general. Much of her book Good Energy resonated with me. I do wonder how she'd navigate public policy, with the average American being so far removed from Medicine 3.0 strategies.

If I was going to add one piece to my home gym, it'd be an indoor bike. Low maintenance, small footprint, no impact. I'd probably splurge for magnetic resistance. The rowerg is more fun, but a bike is so easy to zone out on and accumulate zone 2 minutes. It's often my first choice even at the full gym.

I've been impressed with Casey since the first time I encountered her a couple years back. TBH, I couldn't tell you what a Surgeon General does or name a single person that's held the position in my lifetime. But she was out ahead of the pack in terms of empowering individuals to take charge of their own health, so I'm pleased to have a voice like hers in the mix. Her brother is a special advisor to the DHS secretary too, but I know less about him, except that at one time he was a lobbyist and so he knows the sordid underbelly of how commercial interests have corrupted the system.

There are two things that appeal to me about a bike. One is that the core time I'd be using it is in the winter, so weather wouldn't interfere with maintaining a schedule. The other is that they can apparently spike your heart rate in a hurry compared to something like a rower, which makes them more suitable for the modality I want to exploit.

[Scott 2]

The other is that they can apparently spike your heart rate in a hurry compared to something like a rower, which makes them more suitable for the modality I want to exploit.

Are you looking at something with arms, like an assault bike? Using one, I cannot stay in zone 2 at a reasonable rpm. It'd be great for HIIT style training. Huge cardio demand, no localized fatigue.

I personally find the HR ramp up on a standard exercise bike slower than a rower. Especially if my legs are sore. Even when they're not, localized fatigue is a limiter.

I tried to push my HR on the bike this morning. I tapped out in the mid 160's. My legs couldn't take it. I can reach the low to mid 170's on the rower. You can see the slow ramp up, relative to power output:



The bike has magnetic resistance, so jumping between levels is instant. But I don't think my knees would appreciate a sudden difficulty spike.

[jacob]

I personally find the HR ramp up on a standard exercise bike slower than a rower. Especially if my legs are sore. Even when they're not, localized fatigue is a limiter.

I tried to push my HR on the bike this morning. I tapped out in the mid 160's. My legs couldn't take it. I can reach the low to mid 170's on the rower. You can see the slow ramp up, relative to power output:

I think I see the problem here in terms of strategy. (BTW I'm not an expert on this, so this is the "physicist version", but hopefully it'll bring some clarity. Maybe @frugaldoc or one of the other bio people can correct me if I get the details wrong.)

All muscles utilize three different energy systems: phosphagen (which burns ATP directly), glycolytic (which makes ATP w/o needing oxygen, so it's anaerobic), and oxidative (which makes ATP out of oxygen + whatever fat, sugar, ... is available locally or from the bloodstream). Each do the same thing (ultimately supply ATP that allows muscles to contract) but they do it at different rates, efficiencies, and with different reserves. Therefore depending on "demand", they'll not be used in the same proportion.

Key point is that the phosphagen and glycolytic systems are supplied locally (in the muscle) whereas the oxidative system relies on the oxygen pump that is the cardiovascular system and so may be limited by that. No oxygen, no bueno.

Obviously, the larger the muscle or the more muscles are involved, the greater the ATP burn rate. This doesn't matter for the phosphagen or glycolytic systems (which are local) but it does mean that if you engage enough muscles (full body compound movements) or your muscles are large enough (the oak tree trunk legs of a dedicated cyclist), you can reach the cardiovascular limit of the oxidative system (which is global) once you run out of local ATP reserves or the local ability to generate it w/o oxygen.

On the flip side (not applicable here, but very relevant for HIIT type workouts), the size/strength of the muscle determines its capacity in terms of ATP reserves and lactid acid tolerance, so for a given demand (e.g. 10 pushups), it might be a case of simply knocking it out with the phosphagen system if you're strong. If you're not, it becomes a lactate problem or even worse: an oxydative problem. Thus if you're already deficient on oxygen and the muscles are not big enough to have enough ATP reserves, those pushups aren't going to happen even if you could easily do them if you had fresh reserves.

Instead the heart is now trying its hardest (BPM>175) to make the pushups happen via the oxidative system.

Thus, if you think in terms of what you have in reserves (size of muscle), rate-of-use (size of muscle), and rate-of-supply (cardiovascular capacity) for the three systems, it should be easier to hit/max out any of the particular energy systems.

Add: In terms of strategy, this is why it's better to do oxygen first, water second rather than the other way around when on limited breaks like in a Tabatha protocol. Ultimately, it's all about managing depleted systems/ensuring that at least one of them remains functional.

[Stasher]

I know you have said you hate running but if you want easy intensity that is the route to go. I trail run race and also do long distance gravel bike endurance races. The power usage in my legs has me reaching muscle fatigue much faster than I can get my heart rate up to the 160s whereas if I'm running I can easily push into threshold or tempo allowing me to hold sustained 160bpm efforts. The same PRE (perceived rate of exertion) on the bike would have me sitting somewhere around 140bpm.

Also, it is unfortunate that you don't like the endurance side of recreation/exercise as that is the low hanging super power of VO2max.

For age reference I am 51yrs old and only using my Apple Watch it says I'm currently at 45 for VO2max, I wear it 24/7 and for all my runs, rides and daily life activity including sleeping. It would be cool to see how my number looks in an actual lab test. But as you mentioned above, I compare how I feel and then only against my past self.