In recent news: Red meat & bad science!

How many of you saw the recent "Too much red meat may shorten lifespan" story? How many of you were as alarmed as I was? Not alarmed at the story itself, but really, the seriously bad science that surrounds the article? How many of you went to PubMed and looked up the published research article and tore it apart? I better a number of you who aren't science minded didn't see some of the glaringly obvious "bad science" mistakes these researchers made and didn't address in their conclusions. Or did you?

Let me first start by apologizing for the potential length of this post. As most of you know, I am overly passionate about science and nutrition; namely nutritional biochemistry...

Let's have fun with this. I'm going to do my best to make sense of the data and see what the article doesn't say that data is actually telling us.

At the outset we must highlight the error that this, and every similar study, makes. All that a study like this can even hope to achieve is to suggest a relationship between two things. To then leap from an observed association to causation or risk is ignorant and erroneous. This article makes this mistake – as has every other study I have reviewed demonising red or processed meat over the past year such as THIS or THIS.


The studies used in this article

There have been two large studies in America where people have been asked to record dietary intake, smoking, activity, weight and many other factors over a long period of time. The data from these two studies has been analysed retrospectively to look for patterns. This was not a study designed to review meat consumption over a period of time – some data just happens to be available and it has been reviewed to make headlines about meat consumption.

The two studies are the Health Professionals Follow-up Study (1986-2008) (abbreviated to HPFS) involving 49,934 men and the Nurses’ Health Study (1980-2008) (abbreviated to NHS) involving 92,468 women. A number of participants from these two studies were excluded in this meat review. After excluding people with cardiovascular disease (CVD) or cancer at the start of the study and excluding people whose dietary responses were incomplete, this article proceeded to review data from 37,698 men in the HPFS and 83,644 women in the NHS. Diet was assessed by validated food frequency questionnaires and updated every 4 years.

The dietary questionnaire offered 9 possible responses for meat consumption, ranging from “never or less than once per month” to “6 or more times per day.”

Unprocessed red meat was assumed to be “beef, pork, or lamb as main dish” (pork was queried separately beginning in 1990), “hamburger,” and “beef, pork, or lamb as a sandwich or mixed dish.” The standard serving size was 85 g (3 oz) for unprocessed red meat. As this was an American study, the great American hamburger has been included in unprocessed meat – it is of course as processed as meat can be. Hamburgers account for approximately half of American ‘beef’ consumption[i] and should be categorised as processed meat. If someone has had a beef sandwich or a pork kebab or a lamb curry – this has also been deemed unprocessed meat. Hardly what Paleo types would call real meat!

Processed red meat included “bacon” (2 slices, 13g), “hot dogs” (one, 45g), and “sausage, salami, bologna, and other processed red meats” (1 piece, 28g).

The Data – Table 1

Table 1 has the raw (baseline) data for the two studies separately categorised into quintiles for total red meat consumption (processed and unprocessed meat lumped together). The five quintiles take the lowest fifth consumption of red meat and then the next lowest and then the middle of the five groups then the second highest and then the highest. Table 1 is age standardised (to remove the impact of any age differentials between the different five groups of red & processed meat consumption) and it then lists other characteristics of the five groups.

Here is where the first problem emerges. As you can see for yourself in Table 1, Q1 is the lowest red & processed meat intake and Q5 is the highest. There are many other variables that correlate to the groups Q1 to Q5 – this is for the HPFS – the top part of Table 1:

- Physical activity, as measured by hours of metabolic equivalent tasks, falls from 27.5 in Q1 to 22.7 in Q2 to 20.2 in Q3 to 18.8 in Q4 to 17.2 in Q5. As red & processed meat consumption increases, so exercise falls. Could lack of exercise impact mortality?

- Body Mass Index – the average BMI for Q1 was 24.7; the average BMI for Q2 was 25.3; for Q3 it was 25.5; for Q4 it was 25.7 and for Q5 it was 26. As red & processed meat consumption increases, so does BMI. Could BMI impact mortality?

- Smoking – the percentage of people in Q1 who smoke was 5%; in Q2 it was 7.3%; in Q3 9.8%; in Q4 11.3% and 14.5% in Q5. As red & processed meat consumption increases, so does smoking – the top quintile virtually three times higher than the lowest. Could smoking impact mortality?

- Diabetes – the percentage of people in Q1 and Q2 with diabetes was 2%; in Q3 it was 2.2%; in Q4 2.4% and 3.5% in Q5. As red & processed meat consumption increases, so does diabetes. Could diabetes impact mortality?

- The interesting one was cholesterol. 14.8% of Q1 were recorded as having high cholesterol; 11.1% of Q2; 9.7% of Q3; 9% of Q4 and 7.9% of Q5. So, as red & processed meat consumption increases, cholesterol recorded as high fell. Could low cholesterol impact mortality? Given the protective nature of life vital cholesterol and the repair role that it plays in the body, it is highly likely that high cholesterol is protective against cancer and heart disease. Quite the opposite of what we have been led to believe in the interests of statin and plant-sterol-injected-low-fat spread profitability.

- Total calorie intake – the average daily calorie intake for Q1 was 1,659; the average daily calorie intake for Q2 was 1,752; for Q3 it was 1,886; for Q4 it was 2,091 and it was 2,396 for Q5. As red & processed meat consumption increases, so does calorie intake. Could calorie intake impact mortality?

- Alcohol intake – in Q1 an average 8.4 grams of alcohol were consumed daily; in Q2 this was 10.7; in Q3 it was 11.2; in Q4 it was 12.4 and 13.4 grams of alcohol were consumed daily in Q5. As red & processed meat consumption increases, so does alcohol intake. Could alcohol intake impact mortality?

The Nurses Health Study showed exactly the same correlations – the numbers were slightly different but the trends were the same. As red and processed meat consumption increased so exercise and high cholesterol fell; BMI, smoking, diabetes, calorie intake and alcohol intake all increased.

Table 2 looks at all mortality (I will stay at the all mortality level – the study does not stand up to scrutiny at this level so there is no point looking at cardiovascular (CVD) mortality vs. cancer mortality).

Table 2.  Table 2 presents mortality data per quintile. The high level numbers are that:

- The HPFS covered 758,524 person years and there were 8,926 deaths in total: 2,716 attributed to CVD and 3,073 to cancer.

- The NHS covered 2,199,892 person years and there were 15,000 deaths in total: 3,194 attributed to CVD and 6,391 to cancer.

- The two studies combined, therefore, covered 2,958,416 person years and there were 23,926 deaths in total: 5,910 attributed to CVD and 9,464 to cancer.

The first point to make, therefore, is that the overall death rate was very small:

- In the HPFS, in 758,524 person years the overall death rate was 1.18% and the CVD death rate was 0.36% and the cancer death rate was 0.41%. Over a 22 year period, just over one in a hundred members of the study died.

- In the NHS, in 2,199,892 person years the overall death rate was 0.68% and the CVD death rate was 0.15% and the cancer death rate was 0.29%. Over a 28 year period, approximately one out of 150 members of the study died.

- In the two studies combined, in 2,958,416 person years the overall death rate was 0.81% and the CVD death rate was 0.2% and the cancer death rate was 0.32%. In the combined studies, fewer than one person in one hundred died in a 28 year period.

Table 2 is then supposed to have adjusted for all the other factors noted under the analysis of Table 1. The article says that the multivariate analysis adjusted for energy intake, age, BMI, race, smoking, alcohol intake and physical activity level. However, I don’t see how this can have been done – certainly not satisfactorily.


In Table 2 the raw data for deaths per person years for each quintile is presented. I have done a raw ratio (marked Z) on these numbers to show the following:

Health Professionals Follow up Study

Above, I have simply taken the raw number of deaths for each quintile over person years and then calculated this as a ratio. The Multivariate line is the one presented in Table 2 of the article. It is the alleged comparison between the five quintiles – using quintile 1 as the base of 1.00 and relating the other quintiles to this base number. This multivariate line is supposed to have adjusted for the fact that exercise and cholesterol went down and BMI, smoking, diabetes, calorie intake and alcohol intake all increased alongside red and processed meat consumption. It is supposed to have removed all those correlations to isolate meat consumption alone.


My death rate line (Z) should therefore have all the other variables included and the multivariate line should have excluded all the other variables. The multivariate line should therefore be substantially below my death rate line (Z) for every quintile and it isn’t. Indeed the raw data for deaths per person years shows that the death rate was lower in Q2 and Q3 than Q1 for total meat, unprocessed meat and processed meat. Look at unprocessed meat (not withstanding that this includes hamburgers and other junk that it shouldn’t) – the death rate in quintile 3 (Q3) is 0.99 vs 1.23 for Q1. As meat consumption increases from Q1 to Q2 and Q1 to Q3, so the death rate falls. Only in Q4 and Q5 does this reverse and it is in these quintiles that we saw the highest levels of BMI, smoking, low activity, high calorie intake, high alcohol intake and so on and these have clearly not been adequately allowed for.

The nurses study shows exactly the same pattern. The death rate falls in Q2 and Q3 vs. Q1 in all cases. In fact even Q4 is lower than Q1 in all meat groups. Only Q5 is higher than Q1 on my ratio of raw data and this is with none of the smoking, exercise, weight, diabetes, alcohol having been allowed for.

Nurses Health Study

The headline of the article

The key passage in the press release that attracted all the headlines was this:

“Unprocessed and processed red meat intakes were associated with an increased risk of total, CVD, and cancer mortality in men and women in the age-adjusted and fully adjusted models. When treating red meat intake as a continuous variable, the elevated risk of total mortality in the pooled analysis for a 1-serving-per-day increase was 12% for total red meat, 13% for unprocessed red meat, and 20% for processed red meat.”

This is what led to the big news story: “adding an extra portion of unprocessed red meat to someone’s daily diet would increase the risk of death by 13%. The figures for processed meat were higher, 20% for overall mortality…”

These numbers come from the bottom lines in Table 2 in the article. The bottom three lines in Table 2 come from the authors of the article combining all deaths in both studies from the multivariate model. They state that, using Q1 as the base line (1.0), the relative results for the other quintiles are as follows and they have added in a final column claimed to be the risk factor for increasing consumption of total, unprocessed or processed meat by one serving a day:

The 13% at the end of the unprocessed line is where the 13% headline comes from and the 20% at the end of the processed line is where the 20% comes from. I don’t know precisely how they have come up with these numbers. The corresponding consumption for each quintile was 0.25, 0.61, 0.95, 1.36 and 2.07 servings per day (for the HPFS). I suspect that their model allows them to look at the data for 1 serving vs 2 or half a serving vs one and a half and to compare ratios in this way.


None of this, however, reflects the facts from the raw data that Q2 and Q3 have lower death rates than Q1 in both studies and Q2, Q3 and Q4 are lower than Q1 in the Nurses study.

In summary

There are numerous key problems with this study – I’ll share seven:

1) This study can at best suggest an observed relationship, or association. To make allegations about causation and risk is ignorant and erroneous.

2) The numbers are very small. The overall risk of dying was not even one person in a hundred over a 28 year study. If the death rate is very small, a possible slightly higher death rate in certain circumstances is still very small. It does not warrant a scare-tactic, 13% greater risk of dying headline – this is ‘science’ at its worst.

3) Several other critical variables showed correlation with death rates – lack of activity, low cholesterol, BMI, smoking, diabetes, calorie intake and alcohol intake. These have not been excluded to isolate meat consumption alone. The raw data actually shows deaths rates falling with increased meat consumption up to the third or fourth quintile – and this is before all the other variables have been allowed for. This would suggest that meat consumption has a protective effect while weight, alcohol, calorie intake, lack of exercise and so on are all taking their toll.

4) Several other critical variables were not measured, which would logically correlate with certain meat consumption. Unprocessed meat inexplicably included sandwiches, curries, hamburgers (which come in buns) – has the correlation with bread, margarine, white rice, egg fried rice, poppadoms, burger buns, ketchup, relish or even fizzy drinks been correlated with the death rates? Indeed, Frank Hu, one of the authors of this meat study, is also quoted in today’s paper saying that one soft drink a day raises the risk of heart attacks. It doesn’t of course – it is association at best, just as the meat article is – but one does wonder if that harmful soft drink was the one that just happened to be consumed with the hamburger or the bacon, lettuce and tomato sandwich ‘meal deal’?!

5) Hamburgers and pork sandwiches or lamb curries have been included as unprocessed meat. This is not a study of what real food devotees would consider unprocessed meat therefore. May I suggest that a study of consumers of grass fed ruminants would not deliver the desired headline? The lamb and beef grazing in the fields around me in Wales could not be further in health benefits from the hamburgers in buns and hot dogs in white rolls in fast food America.

6) We are all going to die. We have 100% risk of it in fact. We are not going to increase this risk by 13% or 20% if we have a hamburger and certainly not if we have a grass fed nutrient rich steak. This is headline grabbing egotistical academics doing their worst.

7) As I always consider conflict of interest, it would be remiss of me to end without noting that one of the authors (if not more) is known to be vegetarian and speaks at vegetarian conferences[ii] and the invited ‘peer’ review of the article has been done by none other than the man who claims the credit for having turned ex-President Clinton into a vegan – Dean Ornish.[iii]

All of this nonsense has given me an appetite, so I’m off to get my complete protein and essential fats plus the full range of B vitamins, ample fat soluble vitamins and lashings of iron, phosphorus, magnesium and zinc – also known as grass fed steak!

What Causes Heart Disease? Confession of a Heart Surgeon

Guest Blogger: Dr. Dwight Lundell, M.D.

We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong. As a heart surgeon with 25 years experience, having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact.

I trained for many years with other prominent physicians labelled "opinion makers." Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.

The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.

It Is Not Working!

These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.

The long-established dietary recommendations [of diets low in fat, high in carbohydrates; especially whole grains] have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.

Despite the fact that 25% of the population takes expensive statin medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.

Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.

Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.

Inflammation is not complicated -- it is quite simply your body's natural defence to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from these bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process [e.g. grains], a condition occurs called chronic inflammation [aka: "silent" inflammation]. Chronic inflammation is just as harmful as acute inflammation is beneficial.

What thoughtful person would willfully expose himself repeatedly to foods or other substances that are known to cause injury to the body? Well, smokers perhaps, but at least they made that choice willfully.

The rest of us have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity.

Let me repeat that: The injury and inflammation in our blood vessels is caused by the low fat diet recommended for years by mainstream medicine.

What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.

Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. you kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.

Regardless of where the inflammatory process occurs, externally or internally, it is the same. I have peered inside thousands upon thousands of arteries. A diseased artery looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing the body to respond continuously and appropriately with inflammation.

While we savor the tantalizing taste of a sweet roll, our bodies respond alarmingly as if a foreign invader arrived declaring war. Foods loaded with sugars and simple carbohydrates, or processed with omega-6 oils for long shelf life have been the mainstay of the American diet for six decades. These foods have been slowly poisoning everyone.

How does eating a simple sweet roll create a cascade of inflammation to make you sick?

Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works.

When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.

What does all this have to do with inflammation? Blood sugar is controlled in a very narrow range. Extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall sets off inflammation. When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels.

While you may not be able to see it, rest assured it is there. I saw it in over 5,000 surgical patients spanning 25 years who all shared one common denominator -- inflammation in their arteries.

Let's get back to the sweet roll. That innocent looking goody not only contains sugars, it is baked in one of many omega-6 oils such as soybean. Chips and fries are soaked in soybean oil; processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6's are essential -they are part of every cell membrane controlling what goes in and out of the cell -- they must be in the correct balance with omega-3's.

If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation.

Today's mainstream American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 in favor of omega-6. That's a tremendous amount of cytokines causing inflammation. In today's food environment, a 3:1 ratio would be optimal and healthy. [If you're a CrossFitter, like myself, then reaching the superior 2:1 ratio is easily achieved by following The Paleo Diet.]

To make matters worse, the excess weight you are carrying from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. The process that began with a sweet roll turns into a vicious cycle over time that creates heart disease, high blood pressure, diabetes and finally, Alzheimer's disease, as the inflammatory process continues unabated.

There is no escaping the fact that the more we consume prepared and processed foods, the more we trip the inflammation switch little by little each day. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils.

There is but one answer to quieting inflammation, and that is returning to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation-causing omega-6 fats like corn and soybean oil and the processed foods that are made from them.

One tablespoon of corn oil contains 7,280 mg of omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed cows.

Animal fats contain less than 20% omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labelled polyunsaturated. Forget the "science" that has been drummed into your head for decades. The science that saturated fat alone causes heart disease is non-existent. The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.

The cholesterol theory led to the no-fat, low-fat recommendations that in turn created the very foods now causing an epidemic of inflammation. Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats. We now have an epidemic of arterial inflammation leading to heart disease and other silent killers.

What you can do is choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients from fresh unprocessed food, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.

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Brief C/V of Dr. Dwight Lundell, M.D.
In 2003, Dr. Lundell left his successful thoracic and cardiovascular surgical practice after 25 years to open a clinic to test his theory that inflammation in the arteries was the cause of heart disease, a theory traditional medicine saw as heresy disputing the cholesterol theory.

Leaving surgery brought a freedom to refocus his career writing books and articles, presentations, interviews and speeches to educate on inflammation and how to prevent and reverse heart disease through nutrition and lifestyle changes.

Dr. Lundell’s clinical testing led to the development of a unique supplement designed to reduce inflammation, HeartShot™ developed by Asantae.

His position as Chief Medical Officer of Asantae allows him to travel the country speaking, educating and presenting information about inflammation and heart disease changing the health of America.

Cardiovascular and Thoracic Surgery. Certification by the American Board of Surgery, the American Board of Thoracic Surgery, and the Society of Thoracic Surgeons.

Pioneer in “Off-Pump” heart surgery reducing surgical complications and recovery times.

Beating Heart Hall of Fame.

Phoenix Magazine’s Top Doctors for 10 years and recognized by his peers as a leader.

Past Chief Resident, University of Arizona and Yale University Hospitals and later served as Chief of Staff and Chief of Surgery.

A founding partner of Lutheran Heart Hospital which became the second largest heart hospital in the US now owned by Banner Health

Dr. Lundell has consulted and advised for a variety of leading medical device manufacturers such as Cardio Thoracic Systems, Inc. before and after its acquisition by Guidant Corporation. He advised St. Jude Medical on tissue valve implantation and marketing. For A-Med, Inc., He consulted on and published the first clinical study on miniature pumps for heart support. He co-authored a clinical study validating key technology for Coalescent Surgical, which was subsequently acquired by Medtronic, Inc

Publications & Presentations

The Great Cholesterol Lie, March 2009

The Cure for Heart Disease: July 2007

A Miniature Right Heart Support System Improves Cardiac Output and Stroke Volume During Beating Heart Posterior/Lateral Coronary Artery Bypass Grafting, Heart Surgery Forum, 2003;6(5):302-6.

Clinical and Six-Month Angiographic Evaluation of Coronary Arterial Graft Interrupted Anastomoses by Use of a Self-Closing Clip Device: a Multi-center Prospective Clinical Trial, J. Thorac Cardiovasc Surg, 2003 Jul; 126(a):168-77, discussion 177-8.

The Interrelationship of Factors Controlling Cardiac Output, Med Hypothesis, 1983 Jan; 10(1):77-95.

Clinical Applications of the Intra-aortic Balloon Pump, Ariz Med, 1981 Jan;38(1):19-21.

Randomized Comparisons of the Modified Wire-Guided and Standard Intra-aortic Balloon Catheters, J. Thorac Cardiovasc Surg, 1981 Feb;81(2):297-301.

Combined Aortic Valve Replacement and Myocardial Revascularization, Connecticut Medicine, 1980 Jun;44(6):363-6.

The Importance of Myocardial Protection in Combined Aortic Valve Replacement and Myocardial Revascularization, Annual. Thorac Surg, 1979 Dec;28(6):501-8.

Leiomyoma of the Esophagus, Conn Med, 1979 Aug;43(8):483-5

Cold Chemical Cardioplegia, Presentation at the New England Surgical Society, May, 1979.

Doppler Ultrasound Diagnosis of Thoracic Outlet Syndrome, Presented at Connecticut Society of Board Surgeons, December 1978.

Hypoliquorreic Headache and Pneumoncephalus Caused by Thoracosub Arachnoid Fistula, Neurology 1977 Oct;27(10):993-995.

Guidelines for the Management of Lung Cancer, Ariz Med, 1977 Mar;34(3):176-82.

Cardiothoracic Surgery Resident, 1977-1978
University of Arizona, Arizona Health Sciences Center
Chief Resident, General Surgery, 1976-1977
University of Arizona, Arizona Health Sciences Center
Surgery Resident, 1971-1973, 1975-1977
University of Arizona, Arizona Health Sciences Center
General Surgery Intern, 1971-1972
University of Arizona
Doctor of Medicine, Charter Class of 1971

Programming vs Periodization

Doug Katona (DK) is a CAT-1 Cyclist and a Co-Founder of CrossFit Endurance with Brian MacKenzie. In this video, DK gives a very brief and concise explanation of the difference between “periodization” training—which the masses of endurance athletes use to train for their sport—versus the “programming” that my coaches at CrossFit Endurance (CFE) do for me and the rest of the CFE athletes.

Watch and learn!

A hard lesson learned, more is not beneficial

This lesson really came about as an accident. It was not my cognoscente intention to become nearly bedridden by rhabdomyolysis.

You see, as a triathlete, the thinking of such a person often goes unquestioned that a higher training volume is truly needed in order to do well in your races throughout the season. However, as a CrossFit Endurance (CFE) athlete, I have learned this is the biggest myth our triathlon community puts faith and stock into. You seriously need less volume than you’d think training within your disciplines of swimming, biking, and running. What should the core focus be then? Technique first, then INTENSITY. Intensity is where the magic happens. Intensity is where the results are. BUT—this is kind of a big but—you must be skilled in your movements first. Whether it be mountain biking, running, powerlifting, cycling, swimming (heavily technique focused), weight lifting, burpees, the dreaded thruster, or other CrossFit specific movements; your sole priority in training is mastering the techniques of movement and/or athletic discipline.

Once you are skilled mover and shaker, you can start cranking up the intensity. And unless you CrossFit, or do some type  of HIIT training, your idea and understanding of intensity is my idea of Long Slow Distance training (LSD). How do I mean? Well, get on a treadmill set at a 12% incline. Then crank up the speed to 30-seconds slower than your fastest mile pace. Then run attempt to do a Tabata workout of just 8 intervals at 20 secs running, 10 secs resting—stepping on the sides of the treadmill during your 10 secs of rest, and not stopping the belt at any point until the workout is complete. Once you do this, you’ll have a better idea of CrossFit’s intensity. Once completed, you should feel like you could shoot vomit 30-yards. Or you should feel similar to having your balls kicked in by an angry Clydesdale.

With that said, that’s the level of intensity that I work with daily in my training; sometimes for 8 minutes, sometimes for upwards of 30 minutes; this higher timeframe is rare though.

Let’s get back to teaching you my hard-learned lesson...

A few weeks ago I started a new career job. And prior to this, my off-season triathlon training (or 3S, CFE-lingo) had been reduced to CFE’s single sport program for a rower/crew member. Now that I am officially trained in my career and validated for the work that I do, I’ve been able to adapt my own work schedule to support my 3S training schedule. And as of two weeks ago Monday (20-FEB-2012) I dove back into my CFE prescription for 3S. Full bore. I never even stopped to consider if this was a bad idea. The thought never crossed my mind.

So that Monday, I rose at 0530, hit the pool by 0600, finished my swim WOD (workout of the day) by 0615—it was a Tabata swim: 20-sec ON, 10-sec OFF; as fast as possible—covering as much distance as possible. I went to work that day and did my CFE Strength work right after, and hit the CF WOD that was prescribed (Rx’d) for CFE. I hit PR’s across the board; everything was awesome. Great first day! The next day went pretty much the same, except no strength WOD; had the Tabata treadmill run in the morning and CF WOD after work. More PR’s. Fantastic. Wednesday, another PR. Thursday, REST DAY! Friday, the 2012 CrossFit Games Open WOD 12.1 was posted for the community to tackle. My CFE coaches and family strongly recommend I tackle The Open to try and qualify for Regionals (I want to go as a Team, not as an Individual—YAHTZEE!). So now I’m doing The Open. And returning to my 3S program. All in the same week. I seem to be handling it well...

This week starts off with another early swim. Tuesday brings an early spinning session, which I decide to skip because I’m surprisingly exhausted—my training log notes that my two cats kept waking me up every 90 minutes the night before. So I chalk-it-up my exhaustion to poor sleep. Tuesday night one of my favorite CrossFit benchmark WOD’s is posted at CrossFit Lincoln (CFL)—HELEN! Helen is 3 Rounds for time of 400m run, 21 kettlebell swings at 53#, 12 pullups. My PR is 7:05. And because of how my previous week of training went, I felt that another PR was up for grabs. In my mind, I thought I could shave at least 20-secs of my Helen time. Nope! Major fail. I added 3:00 to my Helen time. 10:05. WHAT THE WHAT?! This can’t be?! That night I was pretty upset with myself and I shared with my community and coaches what had happened.

Before I left the CFL training center that night, Coach Phil Kniep (a 2011 CF Games competitor & 36th Fittest Man in the World; picture below) suggested that my -3:00 Helen might be a result of too much volume. I sort of agreed with him. But my ego didn’t want to. “I’m a triathlete; and endurance freak; too much volume?! Bwwaaahhahahahahhaaaahhaha!!! You’re crazy, Phil!” That’s little rant of psycho-babble should’ve been a clear sign of under-recovery, but nope, the over-training-fog had me in full-hallucination mode.

JMac (John McBrien), one of my coaches at CFE sent me an email late that night that I had read early the next morning (Wednesday). It suggested the same thing: That I had increased my volume back to 3S too quickly. I had also deviated from the programming template. And I had failed to keep myself from under-recovering—something I pride myself on when coaching my endurance athletes. JMac basically agreed with Phil’s comment, but he did it gently; in such a way that I didn’t even feel betrayed.

Then Wednesday of this past week arrived with me feeling really achy and super tired that morning. I chose to sleep in again. And then I chose to reset my alarm...FIVE TIMES! This basically forced me to eat breakfast on the run. Going to McD’s and getting two the egg & sausage biscuits without the biscuits (Paleo!). And then Starbucks for 5 shots of espresso over ice. And of to work I went. I nearly crashed on my lab bench several times. After work, I drug my sore ass into CFL to do my Strength WOD; not an issue. Then the CF WOD for CFE was brutal: 3 Rounds, each for time, with a 2:00 rest between rounds of: 500m row, 15 thrusters at 95#, and 21 Kettlebell Swings at 70#. My first round was a little over 5:00. My 2nd was over 8:00. What?! Another +3:00 loss?! Sign? Symptom? Correlate? All of the above! During the 2nd round I nearly passed out from exhaustion while doing the thrusters. I stopped after the 2nd round and examined myself. Phil was right. JMac was right. BMack was right. Kaitlin was right.

I was severely under-recovered or as the greater community says, “over-trained!”

Rhabdo crept in. Unofficially, of course.

With our 3S volume for swimming, biking, running being so low for CFE most wouldn’t consider over-training or under-recovery to be an issue. However, it’s quite the opposite. And that’s because of the level of intensity we are working with. We are getting quicker results that are far more impressive than the standard way of triathlon training, by using the intensity of CrossFit and the programming of CFE. It’s this intensity that we work with on a daily basis that will cause you to over-train/under-recover faster than going long. As you saw with my 3S programming above, I didn’t ease into it. I just dove headlong back into the 3S program—adding in the extra sport specific WODs at the same intensity as everything else I had been adjusted to. Plus, we threw The Open WOD into the mix. And within just a 9 days of training, my ability to recover was shot dead. With the standard LSD training that the typical triathlete does who doesn’t use CF or CFE for conditioning, they could probably go a full month or longer before their lack of recovery would start to be felt.

And, coming from that mindset, I know their way of thinking to cure their recovery problem: It’s caused by lack of calories! We need to ADD MORE CARBS!

Now, that’s a whole other topic!

Watch and learn from The Coach who changed my life, Brian MacKenzie on “Overtraining” (ahem, Under-Recovery)

A Paleo Diet Exploration

If you can think back a few years, what differences between your diets then and now come to mind? For many and especially myself, I always broke even. That is, I always ate just enough bad foods to cancel out the hard work that I had put in to get rid them. Being a triathlete and not know how bad grains were for me, you could imagine the minefield I would cavalierly run through.

Plateauing during most of my triathlon career was probably the result of equally weighing bad eating and good eating. We don't want that. We want to create an imbalance where the right food choices always outnumber the wrong ones.

Last June, my coach introduced me to a new concept of diet and nutrition – The Paleo Diet. As most of us would guess, Paleo is short for Paleolithic age, the time period 2.5 million years ago when hominids lived by hunter-gatherer standards, as opposed to the advent of the Neolithic era when humans first learned how to farm crops and animals.

The Paleo Diet suggests eating as our ancestral cavemen did; we should stick to things that can be hunted, fished and gathered. Before you join the fad of calling this nutritional plan a fad, consider the rationale behind living as a modern person and eating as a Stone Age person. We humans have been evolving for the past two million years with Darwinian Fitness producing a seemingly final winning species in the form of Homo sapiens. Our DNA is inherently programmed to best handle "Stone-Age" food. It has only been 10,000 years since the dawn of agriculture and just over 100 years since the introduction of manufactured chemicals to expedite the farming process.

One might argue that life expectancy has risen to 70 years in most developed countries. Why would we want to eat like our ancestors who at the age of 40 were considered old? Remember that, aside from dieting, we have millions of technological gadgets all contributing to the increased life expectancy. Our genetics haven't changed to allow us to survive for 30 more years in the wilderness compared to someone from a million years ago.

Since evolution is an extremely tedious process based on trial and error, and while some scientists argue that humans have stopped evolving, the fact remains that time is on Paleo's side.

So what exactly does going "Paleo" imply?

The bottom line is to ditch the carbs and go for what you can hunt and gather in nature (but make sure it's edible by developed country standards). Meats, eggs, animal fat, fish and seafood are the obvious choices of protein, iron and essential fats.

Berries, fruits and plant derivatives have antioxidants, vitamins, phytonutrients and low-carb sugars. Nuts and seeds also provide protein and healthy fats. Mushrooms are one of the only sources of vitamin D in the produce aisle and have an amazing combination of vitamins, antioxidants and compounds that can help protect many kinds of cells and reduce the risk of different types of cancer. And, of course, vegetables are always just plain good for anyone.

Throw out grains, breads, pasta and even most or all dairy products. It may seem crazy, but the rationale behind Paleo makes a strong case as to why it's okay to give up all of the processed carbs we so heavily rely on today.

From an evolutionary standpoint, we love carbs because it has so much potential energy packed into such a small amount and our bodies can metabolize and store that energy very efficiently. But we no longer live in a world where the supermarket is going to disappear the next day.

We don't have to horde grains on the off chance that we might experience a famine every other week and our survival is at stake. So while it does taste delicious, you can surely find the fuel that a freshly baked baguette provides in other foods and still maintain a well-balanced diet.

A Paleo diet also in no way implies that you need to stop eating. It just cuts out the bottom of the all-too-skewed food pyramid that we learn about in elementary school.

In fact, because a Paleo diet includes everything but most grain-based products, it can be very tasty. Sashimi, bacon, steak and almonds all fall into the allowed category, and it may come as a pleasant surprise how different but equally tasty the meal of a cave man may play out to be.

Another way to look at Paleo is to consider it an advanced version of carb-cycling, the method of eating high, medium, low and no amount of carbs on different days to induce higher metabolism. If you can eat the right combination of fruits, vegetables, meats and nuts, as Paleo suggests, there is no reason you should expect to have decreased levels of energy simply because bagels no longer have a place in your meal plan.

Paleo doesn't deprive you of certain nutritional groups but, rather, puts an organic and original spin on the way we look at nutritional intake. Eat the sandwich without the bun (did that this morning at BK), order the wrap without the tortilla and get the salad without croutons. I certainly wouldn't recommend any of this if there was no nutritional value in it.

Expect to feel clean and become lean. Try Paleo for 21 days. And say, "Hello!" to your abs for me they re-appear again!

New Balance MT00 – SNEAK LEAK!

Aww damn, Patti is going to kill me when she sees I leaked her video on my site. The New Balance MT00 is legitimately TOP SECRET right now. You can’t find a pre-order anywhere on the web, and even ShopNewBalance.com doesn’t have any information regarding it.

To my CrossFit family, STAY AWAY from the Minimus-20s! The Minimus-10s are the BEST option. If you know me, catch me in person and I’ll give you the “lowdown” on the 20s vs 10s. But if you can, you should absolutely wait til Mid-March 2012—the BEST Minimalist shoe to ever hit the market is going to explode on the scene with the force of 10 atomic bombs!

The NB Minimus-00 is coming...

March 2012.

DLips & The Magic Hormone

Guest Blogger: Dave Lipson (pictured below) is on the CrossFit HQ Seminar Staff, he’s a CrossFit Level 1 Trainer, Again Faster Athlete, and quite possibly the strongest man in California, or Boston, or wherever the heck he resides right now ... Canada? Cami? What?!

Come on, admit it! The real reason you train is so you can get babes, lift heavy shit and one-up your counterparts. It’s in our DNA people, whether you like it or not. And if you have lost those desires, I'm willing to put it out there that your testosterone levels are kinda low. So put down the soy, take those Crocs off, and hear my call!

Testosterone elicits decreased body fat, increased muscle mass, a higher libido, better athletic performance and vigor for life—what broseph wouldn’t jump at that? Testosterone is the fountain of youth, the magic hormone we produce naturally that is the fuel for our muscle growth.

If we are training for a positive physiological adaptations, we need to be thinking about testosterone. So how can we maximize this? What types of activities and lifestyle habits both in and out of the gym can contribute to our NATURAL production of testosterone? I have compiled a list of the top tips to get the most out of your most important hormone:

LIFT HEAVY SHIZ
If your eyeballs are popping out, if your veins are trying to explode, if you feel as though you are going to either pass out or poop yourself after a lift, you are probably eliciting the magic hormone. Deadlifting and heavy squatting should be your staple when it come to training for testosterone production. These movements recruit a tremendous amount of musculature, both upper and lower body. When it comes down to creating that stimulus to elicit that neuroendocrine hormonal response from our training, you are not going to do better than these two movements. 1-20 reps, mix it up! Mess with the different energy pathways and time domains, as long as you feel like you're going to pop on that last rep. Keep the rest short and get back on the bar!

GET YO SLEEP!
I LOVE SLEEP! I wish I could sleep 14 hours a day—but then I would be back in college. Sleep is fun and exciting, it reminds me of Christmas...I can’t wait to see what tomorrow will bring: PR’s, new toys? Who knows! I like to make sleep a ritual. I get into my jammies, brush my teeth and write down all the things I want to do in the next day. But sleep is also very important for your performance. Your testosterone levels can be decreased by up to 40% by a poor night's sleep. Tips to improve your quality of sleep include:

-Keeping the room cool. A good sleeping environment should be neither too hot or cold. Go for optimum temperature for the best night's sleep.

-Avoid caffeine, alcohol, nicotine, and other chemicals that interfere with sleep patterns.

-Don’t stare at the clock. The more you think you need to get to sleep, the harder it will be.

-Take supplements that induce sleep — such as ZMA and Melatonin.

EAT YOUR FAT!
I lika da bacon. I thinka da bacon tasta gooood! Fats are not only tasty, but very anabolic. They give you a sense of satisfaction. Essential Fats are extremely important in testosterone production. Good sources for essential fats are nuts such as almonds, brazil nuts and nut butter as well as fish/cod liver oil. Fats are the most important micro nutrient in increasing testosterone levels, and good levels of fats are essential in promotion of testosterone levels.

Then there are the not so essential fats that I really love ending in -acon, -utter, and -ausage. While these are not the most favorable, I find them the most tasty!

HAVE LOTS OF SEX
Bow chicka wow wow! I don’t for sure know the meaning of life but I’m pretty sure sex is a major part of it. Sex plays an important role in testosterone, after all, testosterone is the primary sex hormone in males. It’s important to have intercourse at least once a week to keep a healthy level of testosterone and to keep your testosterone levels functioning properly.

It’s believed that a lot of sex can increase testosterone a ton—so boxers do it before a big fight. The effectiveness of that is yet to be proven—it’s more of a mental state of mind rather than playing any actually key function.

Do it early...do it often...keep the Ms. happy!

[I’m not sure about this last section, Dave. There could be a lack of moral instability on my part if I agreed with it completely. But thanks for your hormonal insight... Bow-chicka-WOW-wow!]