fitness · health · Weekends with Womack

Language matters: how words in health contexts can hurt

CW: talk of fat-shaming and weight connected to health (for purposes of describing my presentation). The past two weeks have been conference-intensive. I was in Guelph, Ontario a couple of weeks ago, listening to talks about Feminism and food and also hanging out with our blog founders and friends Sam and Tracy. I mini-blogged about some of the talks here.

This past week, I was giving a talk at the American Public Health Association Meetings in Philadelphia. It was about health-concern trolling of fat people in the doctor’s office and other healthcare contexts. Spoiler alert: I’m against it.

What do I mean by health-concern trolling? Think of it as fat-shaming speech justified by health concerns on the part of the speaker. Here are some common examples:

  • I’m just concerned about your health.
  • You’d find that life was a lot easier if you weighed less.
  • (insert any disease or condition here) would be less severe/go away/never have appeared if you lost weight.
  • Before treating (insert any disease or condition here), you need to lose weight.

But of course images speak volumes. You’ve seen it before, but it’s a classic:

Comic of a woman impaled on a stake, and a doctor telling her she’d do better if she lost weight.

Apart from the big problem the woman in the comic has, how does health concern-trolling harm us? I think (as do others working in feminist bioethics– there’s strength in numbers…) that it’s a form of microagression, which wears us down with the repeated message that we don’t matter as patients, as persons who deserve respect and care.

What do I mean by microagression? This: A microaggression is a relatively minor insulting event made disproportionately harmful by taking part in an oppressive pattern of similar insults. The pattern of insults tends to be linked to stable traits such as gender, ethnicity, disability status, or (in this case) weight. Philosopher Regina Rini explained the harms of microaggressions well here:

What makes microaggression distinctively harmful is victims’ awareness that each instance is not an isolated accident. It will happen again and again and again. Further, these minor insults are linked to vast social harms…”

There’s a lot written about microagressions, and I’m just getting started thinking and writing about them. Next year I’m applying for funding to do some focus groups of fatter people to ask about their experiences with health-concern trolling in healthcare contexts. The goal is to find out what they think good health care looks like from their perspective. Stay tuned for more updates on the health concern trolling front.

Readers, what does good health care look like to you? What would you want to change in your encounters with health workers? I’d love to hear from you.

burlesque · fitness

Burlesque: bawdy body positivity

I’m in NYC this weekend, visiting my friends Martin and Andrew. I love love love it here– the stimulation of street life, plus the collective enjoyment of food, drink, things, people, and sensations all knock me out. In a good way.

Friday night, we went to a burlesque show at the McKittrick Hotel, called Bartschland Follies. The creator and host of the show is Susanne Bartsch, icon of New York nightlife. She’s been everywhere: hosting parties at the Copacabana in the 80s, raising money for AIDS research with her Love Ball, and being the subject of a recent Netflix documentary.

Our Friday night outing was to see her, along with a varied cast of characters, doing a wide variety of entertaining acts. Of course there was pole dancing– one of the dancers, Opera Gaga, also sang an aria mid-dance.

Opera Gaga, singing while pole dancing.
Opera Gaga, singing while pole dancing.

There were strip teases, a drag king emcee, drag queen emcees, and novelty acts aplenty.

One of the other emcees, Shequida, was funny and talented (she’s a trained opera singer) and, it turns out, very nice. Here’s us– her graciousness extended to not minding fan photos in the bathroom after the show.

Me (on left) and Shequida, hanging in the ladies' room.
Me (on left) and Shequida, hanging in the ladies’ room.

I’m still processing some of the messages from Friday night’s experience. For now, here are a few thoughts:

I’ve been to mostly-male strip clubs where the performers were all women with thin bodies that conform to a very narrow notion of attractiveness and sexiness. I’ve also been to strip shows (think Chippendale’s from way back when, although apparently it still exists) with all male performers of a certain body type and age. This experience was very different from those. How?

I felt happy and comfortable and safe and secure and attracted and included in the sexy funny outrageousness.

There were so many different bodies doing so many funny and sexy things, it was hard to keep track amidst the wash of feelings. But was no need. It was all good all the time. I didn’t feel like some of the show was designated for me, and some of the show was targeted for other groups of people who weren’t like me (whatever that means). All the performers were there to appeal to anyone. Here’s a grainy photo of me with a fun dancer.

Me (on left) with a nice dancer.
Me (on left) with a nice dancer.

By deliberately including me in the audience, the performances were (in Martin’s words) shared, not transactional. They felt (and made me feel) open, seen and appreciated. I also took this in to mean that my body, too, was seen and appreciated. And that it can continue to be seen and appreciated.

For me, body positivity is not a state I manage to embrace very often. Maybe I don’t need to. Tracy has blogged about body neutrality as another option– see some of her posts here and here.

For most purposes, I tend to agree with Tracy. But for one late night in NYC, I enjoyed a heaping helping of full-on bawdy body positivity. Thank you, Bartschland Follies!

Readers, have you had experiences with burlesque and body positive or other messaging? If you’d like to share them, I’d love to hear from you.

fitness · food

Am I a compost pile? Is sourdough sexist? Conferencing on feminism and food

This weekend I’m at a conference called Feminism and Food, courtesy of CSWIP— the Canadian Society of Women in Philosophy. It’s happening at the University of Guelph, where Samantha works, and she’s one of the organizers. Thanks, Sam (and all the others), for such a great conference!

The talks have been so fun and thought-provoking (in very good ways), that I wanted to share a few of the tidbits with y’all. Here we go:

Maybe you’ve been thinking for a while now, “I wonder– is sourdough actually sexist?” Or not. But Vanessa Lehan-Streisel has thought a lot about it. She looked at the resurgence of sourdough bread and the rise of celebrity male bread bakers. What’s the upshot of all this: she says that they’ve injected technical terms (like algorithm) and use of super-fancy and super-expensive appliances that ignore the long ( I mean really long) tradition of women bakers, baking sourdough and all sorts of other bread without shouting about it or going on social media, etc. She’s got a point here.

Am I a compost pile? Well, no, but… Shannon Boss showed us that food is not only about health, but also about dissolution. We may not come from compost, but to compost we shall go. This may not seem like a happy message, but it was refreshing to be reminded that we are natural organisms, subject to the forces of nature.

There’s more to say, but the conference is still going on, and I don’t want to miss a crumb.

A bird, waiting to eat bread crumbs.
Lots of crumbs still to check out.
fitness · running

Inspired by running race signs, a modest proposal…

As much as I love writing for this blog, I also love reading blog posts here at Fit is a Feminist Issue. Tuesday’s post was by Nicole, our newest blogger– welcome Nicole! She wrote about her half-marathon, in which she was aware of previous injuries and pains. She experienced new sensations– some painful– during the race. I’m not going to spoil the ending– you can check it out here.

One thing she wrote really struck me: some of the runners were wearing signs that they were kind of injured, but doing the race anyway. I had never heard of such a thing. It’s…

Pure Genius, stenciled on pavement. By Lance Grandahl for Unsplash.
Pure Genius, stenciled on pavement. By Lance Grandahl for Unsplash.

This idea may not appeal to everyone. Some folks may want to be more private about their injuries. I have one friend who is super-private about her health and injury status, which made it really awkward when I accidentally blurted out to, oh 9 or 10 people that she’d had orthopedic surgery. Oops! Sorry (again).

Sometimes our injuries are noticeable to the outside world, so we don’t have control over that information. Other times they aren’t. On the plus side, it means we can try to be just one of the crowd, trotting along (albeit possibly slower or in a different way). But there are several minuses to having non-visible injuries: we might not get the support we need or want. We might get further injured by trying to move along at a pace or in a way we’re not up to. And, we might not finish, or reach the goals we had set for ourselves at the start line.

By the way, I’m using the word “injury” in a broad sense, mainly for its metaphoric power. I’m not trying to distinguish among injuries, disabilities, and other body changes or states here. I’m just going with the metaphor for now, and hoping you’ll go with me.

There’s a lot written on this blog about mobility, (dis)ability, and movement. Sam has written about her knee brace (lots of times, but check out here here here to start), and also about her new Brompton foldable bike as a mobility aid.

We’ve also written a lot about invisible injuries– from stress, anxiety, depression, trauma, life events, etc. There are too many to link to, but you’ve probably read some of them.

So, to my inspired proposal: wouldn’t it be nice if we could get the support in life for our visible and invisible mind-body states the way you do in a race? Here’s what I have in mind.

  1. Pace bunnies at the ready for long work days, labor-intensive times, finishing that thing you just cannot seem to get done.

I think pace bunnies are the best thing ever. In case this is new to you, they are runners who go at a specified pace; it could be for the whole race, or paced her km/mile. Here are some:

2. Bystanders not actively involved in what we’re doing, but there watching, offering us support, humor, affection, solidarity, the occasional warning, and a reality check that what we’re doing is hard but awesome.

3. Help, when we need it, from friends or family or colleagues or random strangers to make it across whatever line is ahead of us.

4. Permission from ourselves and others to DNF (did/do not finish) when we need to. Finishing isn’t always the right thing to do, and it’s not always possible. We can use some help with that, too.

I don’t have pictures for this one, as it’s hard to illustrate what it’s like to stop doing something. Also, there are lots of fitspo quotes telling you not to DNF. But here’s an article in praise of the DNF. It gives good advice for when to stop racing, which I will add to here:

  • when you can no longer stomach fuel or fluids (or can’t sleep, eat, function)
  • when an injury forces you to stop (we get hurt a lot and try to ignore it; maybe don’t)
  • when you catch a bug (or are ill, under the weather– don’t gut it out)
  • when– even after resting– your condition has not improved (I love this one! If we go back to it, and rest hasn’t helped, maybe this task or direction is not for us)

I’m not a runner (at all). But I wish I had race fans and fellow runners and helpers and lists of tips to help me sprint/slog/trudge/opt out of days that are hard.

Oh, wait a minute– I do! You! Thank you readers and bloggers (in addition to the people in my regular life)!

You = awesome!
You = awesome!

So, readers– any thoughts about getting support around DNFs, injuries, bonking, slogging through, in races or not? We’d love to hear from you.

dogs · fitness

Can fit be a canine issue, too? Dogs and human health

This week, a couple of “having a dog is good for your health” studies came out. One of them , a systematic review of medical studies on associations of dog ownership with health, found a 24% reduced mortality risk across various groups in studies done in several countries. The other one other one found a 21% reduced mortality risk (risk of death from any cause) for people with heart disease. Here’s a bit more detail about this study from the journal commentary:

The effect was remarkably consistent across various demographic subgroups but was modified by the number of individuals in the household: single-person households with dogs were associated with a markedly greater reduction in all-cause mortality than multi-person households. Interestingly, the effect appeared to be somewhat larger for owners of more active breeds like pointers and hunting dogs, possibly due to their need for greater physical activity.

This stands to reason. If you live alone and have a dog, you have to take care of it– feed, walk, play with, throw chew toys around with, etc. And if you have a more active dog, that dog will want and need more stimulation and activity. So you get the same as you take care of your dog. And this is good for you.

Of course, you may be asking the question: does finding an association mean that have a dog causes better health? No. The journal editor made this clear:

… Pet owners tend to be younger, wealthier, better educated, and more likely to be married, all of which improve cardiovascular outcomes… individuals who own a dog may have higher disposable incomes than those who do not. High incomes are in turn associated with a lower prevalence of tobacco use, diabetes, and obesity in the population, so the observed relationship between pet ownership and outcomes may be partially due to socioeconomic factors… Finally, the association between dog ownership and good health may even be reverse causal because adults with excellent physical health are more likely to adopt a dog than those who are too ill or frail to care for a pet…

But, the editor continues, it’s consistent with what we know about human biology that dog ownership has all sorts of positive physical effects on people. And,

…the most salient benefits of dog ownership on cardiovascular outcomes are likely mediated through large and sustained improvements in mental health, including lower rates of depression, decreased loneliness, and increased self-esteem. This may explain why the effect appears to be larger for individuals living alone than those in multi-person households.

The upshot, for me, is this: I should get a dog.

I’ve wanted to get a dog for years. I’ve hemmed and hawed and dragged my feet and trotted out excuses– I’m too busy! I travel too much! My life is already full! I’m not a morning person!

All of these things are true. But I keep coming back to this imperative: Catherine, you need a dog in your life. I do think that, once we (my future dog and me) get settled into a routine, I’ll wonder why I didn’t do this 30 years earlier. (I did grow up with dogs, so I know what I’d be getting into).

Dogs are not fitness accessories like gym memberships or shiny new bikes. They’re creatures with wants and needs who are utterly dependent on us. The seriousness of taking on the care of another creature is what’s given me pause all these years. But I keep coming back to the question: should I get a dog now? How about now?

My inner conversation hasn’t gone anywhere yet, except to endless online perusing of rescue dog sites and breed information gathering. But I am putting this out there as a step forward in the process.

Question to you, dear readers: what are some ways having a dog has affected your health or fitness? Have there been changes? I’d love to hear from you.

fitness · running

Two new marathon records, two different sets of staffing requirements

This weekend, marathon fans were treated to not one but two new world records. One is official– Brigid Kosgei of Kenya broke the existing women’s marathon world record, clocking 2:14:04 in the Chicago Marathon. Paula Radcliffe of the UK held the previous world record of 2:15:25 since 2003.

Brigid Kosgei, new world record holder for women's marathon.
Brigid Kosgei, new world record holder for women’s marathon.

Just the day before, Eliud Kipchoge of Kenya also broke a record: he ran a marathon distance in less than two hours: 1:59:40. The sub-two-hour marathon has been the elusive white whale of running sports, and breaking that barrier is momentous news.

Eliud Kipchoge of Kenya, crossing the line in Austria in 1:59:40.
Eliud Kipchoge of Kenya, crossing the line in Austria in 1:59:40.

Important thing to know: Brigid Kosgei’s Chicago marathon time counts as a new world record, but Eliud Kipchoge’s marathon run doesn’t. Why not? Because Kosgei ran in race conditions (well, in an actual race), and Kipchoge’s run was not in race conditions. What do I mean by that?

Glad you asked.

Kipchoge’s run was set up to optimize on race course, weather, running conditions and nutrition so to maximize the chances of breaking the 2-hour marathon mark. Here are some of the features of the setup, as detailed by an article in the Atlantic:

The organizers scouted out a six-mile circuit along the Danube River that was flat, straight, and close to sea level. Parts of the road were marked with the fastest possible route, and a car guided the runners by projecting its own disco-like laser in front of them to show the correct pace. The pacesetters, a murderers’ row of Olympians and other distance stars, ran seven-at-a-time in a wind-blocking formation devised by an expert of aerodynamics.

Here are pictures of Kipchoge and his ominipresent rotating phalanx of world-class runners, all there with him to optimize his run time.

Kipchoge himself came equipped with an updated, still-unreleased version of Nike’s controversial Vaporfly shoes, which, research appears to confirm, lower marathoners’ times. He had unfettered access to his favorite carbohydrate-rich drink, courtesy of a cyclist who rode alongside the group. And the event’s start time was scheduled within an eight-day window to ensure the best possible weather. 

Brigid Kosgei also had pace runners with her for at least the first half of the marathon. Here’s more about how that works from the Chicago Tribune:

Because Kosgei runs so fast — and because she planned to go out for a women’s world record if conditions cooperated — those pacers were hard to find, according to a marathon spokesperson. Race commentators questioned whether they had gone out too fast and abandoned pre-race strategy.

There are two pacers who work for the elite women’s pack and four for the men’s pack — all accomplished runners themselves. They stay with runners up to the 35 kilometer mark.

Kenyans Geoffrey Pyego, who mainly works as a marathon pacer, and Daniel Limo, who has competed in marathons since 2006, led the way for Kosgei. Limo holds personal bests of 1:01:30 in a half-marathon and 2:08:39 in a marathon, winning the 2015 Los Angeles Marathon in 2:10:36.

They planned with Kosgei on Saturday night to get through the half-marathon mark at 1:08. She passed 13.1 miles at 1:06:59, which was also on pace to break the course record pace of 2:17:18.

Here’s Brigid Kosgei, on the course with a pace runner, and winning the Chicago marathon on her own.

I love watching marathons– I live in Boston and always try to watch the Boston Marathon either in person or on TV. It seems an impossible task to run that far that fast, and I am always in awe of the world class runners (while also admiring the thousands of non-professional athletes who do this as well).

I think it is super-tremendously awe-inspiring that Eliud Kipchoge ran a sub-2-hour marathon course. But, this two-day/two-records-sort-of brings two questions to mind for me.

Question one: I wonder how much faster Brigid Kosgei could run a marathon course if she had 1) her own rotating phalanx of world-class runners; 2) a pace car equipped with lasers to point out the best route on the course; and 3) a personal bike-riding specialized nutrition delivery person?

Question two: how much faster or stronger or better at their sports would women be if their training was at the level of men’s training? What would girls be like as athletes if we trained them and funded them and equipped them and surrounded them with a rotating phalanx of praise and support and encouragement?

Answer to question one: Not sure, but definitely faster. Right?

Answer to question two: Definitely faster. stronger. better at sport. happier. More fulfilled. Right?

Okay, final question to you, dear readers: Which would you prefer, if you could pick one:

  • a rotating phalanx of experts around you all the time?
  • A pace car with lasers to point you in the best direction in life?
  • A personalized-for-you special nutrition delivery person (bike optional)?

I’d like to hear from you…

fitness · walking

Walk faster to outrun the grim reaper? No.

On Friday a new study came out that found associations between how fast we walk in midlife (gait speed) and our overall brain and body health. In case you were wondering, here’s the title, from JAMA: Association of Neurocognitive and Physical Functioning with Gait Speed in Midlife.

Popular news outlets sprinted to the scene, putting out headlines urging us to go faster. See this one from Runner’s World:

Caption reads: Slow walkers might age faster than people who pick up the pace. Smaller print: the quicker you stroll, the more likely you are to keep accelerated brain-and-body aging at bay, a new study suggests.
Caption reads: Slow walkers might age faster than people who pick up the pace. Smaller print: the quicker you stroll, the more likely you are to keep accelerated brain-and-body aging at bay, a new study suggests.

This article sounds less sensational but the idea is the same:

Faster walkers at 45 have younger brains, bodies: study
Faster walkers at 45 have younger brains, bodies: study

You may want to know now: is it true? Do we really need to run for our lives?

No. Photo by Jon Tyson on Unsplash.
No. Photo by Jon Tyson on Unsplash.

Our bloggers have written about claims connecting walking speed to health and mortality risk for a while now. Martha blogged about an earlier study linking walking speed to good health: Walk your way to long life. And Sam recently blogged about being a slow walker in the midst of this scientific flurry of praise of fast walking: Now Sam’s a slow walker will she die earlier than the rest of you?

Okay. But what did this study actually show? In short, it showed that, in a cohort of 904 people who were followed regularly from age 3 through and past age 45, that the adults in the lowest quintile (20%) of gait speed also had poorer physical health (as assessed by 19 different markers like blood pressure, BMI, cholesterol level, etc.), cognitive function, and accelerated rates of aging, compared with adults with normal gait speed (according to some chart somewhere). Because the study also had early childhood medical information (from age 3), they found that the lowest quintile group also was more likely to have manifested early signs of poorer cognitive health.

Do the researchers (or anyone who doesn’t write for a popular news outlet) think that one’s gait speed contributes to poorer physical and brain health and accelerated aging ? NO

Do the researchers think that walking faster will reduce cognitive decline, accelerated aging and poorer biomarkers of physical health? NO.

All health care providers recommend physical activity for health, but walking fast is not the moral of this story. Or any story, for that matter.

There is one good takeaway for clinicians here: including checks of people’s gaits intermittently through life may provide information to help detect conditions, or prevent advancement of conditions, or to treat them. This is still pretty speculative, as the nature of the association and the causal picture are still very unclear.

In an invited commentary on this article, Dr. Stephanie Sudinsky offers a really clear and important message for public health experts and also those of us who care about health through the lifespan:

The human brain is dynamic; it is constantly reorganizing itself according to exposures and experience. It is affected as an end organ by many other organ systems. Perhaps in this sense, brain health, reflected in brain structure, cognition, and gait speed, is not necessarily a first cause, but rather may be a consequence or mediator of lifelong opportunities and insults.

What this means to me is that it’s important to focus on ways to address early childhood cognitive functioning problems right away, through a variety of means. These means include better nutrition, safer physical environments for play and exercise, stimulation through early education and interventions, etc.

For adults, it means that we should consider expanding our notion of health risks to include those “lifelong mediators of opportunities and insults” like access to food, health care, safe living spaces, accessible opportunities for movement, safer workplaces, etc.

None of us can outrun our own mortality. Walking faster won’t whisk us away from our own aging. Walking more slowly won’t send us into cognitive decline or poorer health.

We know roughly what to do for our own health. If you’re looking for tips, I suggest dancing. At your own speed. That’s what these people in Mozambique did to celebrate World Disability Day in 2017.

Dancers at a fair in Namialo, Mozambique.
Dancers at a fair in Namialo, Mozambique.