Feminist reflections on fitness, sport, and health
Well, it’s happened again– we are falling back (as opposed to springing forward) in North America. For me, falling back is great, as I love the feeling of having another hour to sleep, loll, and in this case, think about what to write for the blog.
Sometimes, however, a picture (or in this case, a video) is worth more than words. If any of you, dear readers, are having trouble with falling back today, I’ve found the perfect assistance, courtesy of Facebook:
Happy seasonal fallback day!
CW: mention of some extreme (but real) health injustices and harm done to people and groups because of it.
This past week was a full-service one for me: after two days of teaching, I flew from Boston to Portland, Oregon for the American Society for Bioethics and Humanities meeting. This is a group of medical professionals, including clinicians, directors of programs, patients’ rights lawyers, clinical ethicists working in hospitals, researchers, and a smattering of philosophers.
I was there to give a talk on GLP-1 (weight-loss) drugs and the complexity of hunger. This is one of two health ethics projects my friend Norah and I are working on these days. More on that in another blog post.
Here are some of the fascinating and important topics people are working on that I Iearned more about:
I met lots of interesting and nice people (including a bunch who live in the Boston area) and also saw some colleagues I hadn’t run into in a long time. It was great to see bioethicist Peggy Battin, who is famous for her work on assisted suicide, among many other things. She gave a powerful TED talk in 2014 on her experiences around her husband Brooke’s death five years after he suffered a broken neck in a bike accident. I regularly show this to my students in my Contemporary Moral Problems class during our module on end-of-life ethical issues.
Because we were in Portland, Norah and I had to sneak away from the conference for a couple of hours to go to the Portland Japanese Garden. We were treated to fall colors as well as the varied shades of green in the moss and leaves.
There was a bridge/walkway over and around a pond with large and beautiful fish, several other water features, and a lovely zen garden, carpeted with white Canadian rocks.
You may be wondering, what about that llama? Yes, there was a llama– Caesar, the no-drama llama, a prominent Portland celebrity, visited the conference on Friday for a meet-and-greet and photo ops. If you want a moment of respite from our harsh world, look at the video of Caesar here.
Norah and I of course got our pictures taken with Caesar. He is sweet and calm and oh so fluffy!
Everyone gets tired occasionally, especially when they’re the object of so much attention. Caesar is capable of extraordinary ranges of emotion, and his yawn is a sight to see.
Despite two cross-country flights, I am feeling refreshed and energized, ready to continue my research work, pursue more fall nature, and keep an eye our for fluffy animal encounters.
Readers, how was your week? Did you get to pet any nice creatures? Stroll through nature? Expand your mental horizons? I’d love to hear from you.
I love gardens all year long. Yes, the spring and summer are the flashiest times to visit, with all the wild colors and shapes and so many shades of green. But I really enjoy the shift to subtler color palettes– the browns and yellows, darker greens, all made different by the softer light and shadows.
I’m a member of the Native Plant Trust, which gives me access not just to this botanical garden, but also to dozens of gardens all over the US. I’m planning a few free fall garden walks with friends for November.
But before that, I’ll be in Portland, Oregon at a conference. I’m headed there on Wednesday. While there, my friend Norah and I are taking a little break from the conference activity to visit Portland’s Japanese Garden. I can’t wait to see this place in its version of fall color. Here are some pics from their Fall Colors Tracker page:
Closer to home, the Mount Auburn Cemetery is putting on its own show of colors. On their “what’s in bloom” page for this week, here’s what they say:
By mid-October Mount Auburn’s landscape is awash in color. As our many deciduous trees and shrubs begin to transform their foliage into jewel-tone shades of red, orange, yellow, and purple, other plants set out their fall fruits and nuts.
Here’s a photo from Instagram from this week of Mount Auburn Cemetery:
Readers, do you have any tips for great garden walks in the fall? Let us know.
One thing I do in my not-so-copious free time is scan medical journal tables of contents each week. This way I get at least a glimpse at what is going on in medical research at the moment, sometimes provoking a deeper dive into a study or sub-discipline of medicine.
Last week in JAMA (Journal of the American Medical Association), the top article caught my eye for its very particular area of inquiry: Respiratory Gas Shifts to Delay Asphyxiation in Critical Avalanche Burial– A Randomized Clinical Trial.
The researchers were testing a gadget that facilitates increased air flow to a person trapped under snow in an avalanche. TLDR: it worked very well. So that’s good.
The study subjects (24 in total) were about equally divided between men and women.
In that week’s editorial, titled “A Breath of Fresh Air”, the editors of JAMA offered historical context for this new research result. They also said that the researchers should be applauded for narrowing the gender gap in this type of research.
Applauded.
Applauded?
Yes, they said “applauded”.
As in:
I’m afraid I don’t agree here.
Increasing representation by gender, race, ethnicity, age, etc. in medical research has been and continues to be a big project, with lots of players contributing to small shifts in research participant selection. And I’m glad to see that this study included women as research participants; after all, women as well as men engage in back-country skiing, so it’s important to test out potentially lifesaving devices on all relevant populations.
Do the researchers deserve our thanks? Yes, for working hard as scientists. But for including women in their study? No. They’re just doing their job. They may be doing it well, but it’s their job to do so.
The movement to make human scientific and medical research truly representative isn’t finished yet. I’m glad to see widely-read medical journals paying attention. But I think they can hold their applause.
October is an extra-busy travel and research month for me. I’m giving four talks and flying to two conferences, one in Hamilton ON and one in Portland OR. I also have to decide what to pack for Portland, as the peaceful and creative citizens of that lovely city have broken out the Halloween costumes early in response to incursions by masked ICE teams and National Guard troops. The main choices seem to be frog or chicken suit:
As you can see, there’s a lot on my plate this month. However, in the brief lull beforehand, I found myself last Friday with room for some self-care. Herewith, my trifecta of attention to reducing stress and increasing yummy feelings of well-being.
Stop one: physical therapy.
I’ve been in PT since August for sciatica, and am recovering, albeit slowly. The last thing to get better is my ability to climb stairs without pain or weakness in my right hip. It’s improving, but not there yet. So, the PT bros at my great physical therapy practice have me working with weights, from farmer’s carry to asymmetrical weights for stepping up and down stairs and such like. Also, I’m doing one-legged leg presses (which are harder than I expected, but good for me) in addition to regular leg presses. And of course core and stability stuff. All good and good for me. I felt thoroughly worked out by the end of the 60-minute session.
Stop two: acupuncture.
I have been getting acupuncture for musculo-skeletal pain for many years now, and I really like it. There’s ample evidence for its effectiveness– look here, for example, for a review of studies. I also find that I’m super-duper relaxed after a session, due to addition of ear points (see here for an interesting case report), dreamy music and a heat lamp on my knees. My only wish is that someone would show up at the end of a session to escort me to the back of their station wagon and drive me home… However, I did manage to get in my car and get back to my place with no problems. Once home, I did some reading and then fell asleep for a 30-minute luscious nap.
Stop three: restorative yin yoga.
After waking up refreshed from movement and chill stillness, I did some light housework (dishes, laundry, and a little cooking) before heading out to my local yoga studio, Artemis in Watertown, MA, for evening restorative yin yoga. Norah had saved a spot for me up front, and I gathered up an armload of blankets, a long round navy-blue bolster, and blocks, depositing them in my little space. There was slow, chill music playing, and I settled in for 75 minutes of stretching and relaxing. Here are some yin poses, including several we did Friday night:
Our yin teacher, Liz G (there are multiple Lizzes teaching at Artemis) apologized for not having a yin bus parked outside to take us all home afterwards. We agreed that this would be a welcome addition, but we happily toddled off to our respective homes after class.
Optional stop four: the Great British Bake-Off
Once I got home, I remembered that there was a new episode of Bake-Off, so I woozily watched the contestants labor over pastries. However, I felt no stress at all, either on their behalf or mine. Not too long after, I shuffled to bed, sleeping like a log, perhaps dreaming of elaborate confections.
So readers, what are your favorite chill modalities when you have some time to shift into the slow lane? I’d love to hear any suggestions.
CW: discussion of body weight, weight gain and body shaming.
This week in the New York Times Ethicist column (written by a famous and very good and very nice philosopher, Kwame Anthony Appiah), the featured question was by a couple who expressed their concern about their adult daughter’s weight.
Okay, I guess there are people on the planet that haven’t yet gotten the memo that talking to people about their weight is virtually always (as a philosopher I admit that maybe there’s some strange exceptional case, but I can’t think of one) the wrong thing to do.
Basically, the daughter used to take dance classes, which the parents really liked. But she doesn’t dance now, and they think she eats too much sugar and fat in her diet. They ask for advice from the Ethicist, wrapping it up this way:
She may be headed for a serious weight problem. How can we raise this with her without making her feel self-conscious or judged, and without pushing her away from us? We love and respect her and want to see her live a healthy life. Please advise!
This would now be the perfect time for the Ethicist to say, kindly:
Be quiet. Do not talk to her about this. Say nothing. Shhh!
But no. He didn’t do that. Instead he said this (an excerpt from his response here from the New York Times):
If the undertone of your concern is nostalgia for the lean dancer she used to be, she will hear it, no matter what words you choose, and you’ll only push her away.
If, however, what you truly want is to support her well-being, then speak to her as an adult, with respect and candor, rather than as a child whose body you wish were different. That means keeping the focus on health and family history. Make sure she knows the concern comes from love, not disappointment — that your concern is for her well-being, not her waistline.
Well, the NYT commenters had other thoughts.
There were 1.1K comments this week, and, while I didn’t read all of them, they were pretty much of one voice about talking to the daughter (or anyone, ever) about their weight. Here’s one of my favorite comments:
Don’t comment on others’ weight. Never. Not when they’re pregnant, not when they’ve lost weight, not when they’ve gained weight, not when they have cancer. It is never helpful.
Some folks in the comments section were genuinely interested in whether there was something you COULD say that would be helpful. Here’s how that went:
“There has to be a way to productively comment on someone’s weight in a way that will help them.”
If that were true, don’t you think we would’ve hit on it by now?
Yep. Totes agree.
I liked this response, too:
To the mother asking “Should I tell my daughter I’m concerned about her weight?” – Trust me: you already have.
Many commenters told stories about having been fat-shamed by family and then distancing themselves in order to maintain their own well-being. Others maintained contact but still feel the hurt. They all agreed:
Just don’t do it. Ever.
Lots of questions about personal interactions are complicated. This one isn’t. The NYT commenters have spoken.
The internet is full of advice for how to get more sleep, better sleep, deeper sleep, delicious sleep– you name it, the internet has a to-do list for anything related to sleep.
Don’t even get me started on pillows. Nap dresses have been well-covered by Sam here.
It turns out (unsurprisingly), that modern medicine has been working on better understanding sleep for a long time. I came across this 1925 article (reprinted in JAMA– The Journal of the American Medical Association) that offers us some useful observations about sleep. Here are some of them:
The state of sleep is NOT like being under anesthesia or in a faint (in case you were wondering).
Pulse rate and blood pressure drop during sleep, but do not cause sleep; rather, it’s the other way around.
To wit: “if the drop in pressure were causative, then reclining, being a position favorable for loss of tone, should lead to a more pronounced pressure drop than that of the semierect position, being more conducive to sleep.”
Sleep is sometimes peaceful, but other times we have active dreams and nightmares.
To wit: “the conception of sleep as a period of quiescence and recuperation has thus to be qualified by the contingency of disturbed sleep with active calls on the nervous system, the heart and the blood vessels.”
And here’s their conclusion, which no one can argue with:
In other words, what is true of many factors in life seems also to apply to sleep: most sleeps are good, but some may be far better than others.
Who needs the internet when researchers were hard at work explaining sleep to us a century ago?
Sleep well, dear readers…
In architecture, form is supposed to follow function– the style of an object or structure should reflect its purpose (says the NY Times, paraphrasing Louis Sullivan). But I’m being reminded (again) in physical therapy (for sciatica) that form in fact precedes it.
I guess we all know this– from tennis strokes to proper stance for weight lifting, getting the form right is key both to success in performance and reduction of injury risk. The “aha” moment of getting the form just right and feeling the movement as fluid or effortless or smooth or faster– it’s one of the great personal pleasures of physical activity.
One of my physical therapists (I alternate between Louis and Julian, both of whom I really like and respect) started me doing some piriformis and hip flexor stretches before doing work on the hip machine (extension, flexion, abduction). There was a noticeable reduction in the difficulty and improvement in the feel of the exercises, especially the abduction ones (moving my leg outward using the weight machine).
I mentioned this to Louis while I was using the machine. He said that this was very good information for us, that the exercises helped improve the structural form of my hips, glutes, etc, so that my muscles worked more efficiently. He said other things which I can’t quite recall, but the point was that the stretches helped my body getting in the right form for weight-bearing effort. And I think it’s helping. Yay!
I’ve still got a ways to go before I’m back to climbing stairs without pain or weakness. But this week felt like it gave me more tools for working my body and reminding it how to do its job for me. Yay again!
CW: discussion of eating, processed food, weight, health outcomes
Five years ago, I wrote on this blog about then-new studies on ultra-processed foods. You can check it out here:
The newest processed food nutrition studies: more to chew on
What was the verdict? Ultra-processed food diets were associated with weight gain (compared with minimally processed food diets) as well as increased mortality risk.
Just FYI: ultra-processed foods are pretty much what you think they are. But here’s a definition from the NOVA classification system for foods:
[Ultra-processed foods are] ready-to-eat industrially formulated products that are “made mostly or entirely from substances derived from foods and additives, with little if any [minimally processed plant or animal] foods.
It’s now time for an update.
In a recent scientific advisory, the American Heart Association clarified the messaging around ultra-processed food (UPF) consumption. On the one hand, they advise us to:
However, they also said this:
… not all UPFs are harmful. Certain whole grain breads, low-sugar yogurts, tomato sauces, and nut or bean-based spreads are of better diet quality, have been associated with improved health outcomes, and are affordable, allowing possible inclusion in diets. These food products should be monitored and reformulated if future data show harm to overall health.
The focus should be on cutting back the most harmful UPFs that are already high in unhealthy fats, added sugars, and salt while allowing a small number of select, affordable UPFs of better diet quality to be consumed as part of a healthy dietary pattern.
So what’s the more nuanced message here, and why does it seem like nutrition scientists are pulling their punches on processed foods? These are complicated questions. But, here’s my attempt as a first pass.
We know that a lot of people consume ultra-processed foods for a majority of their daily diets.
Recent data from the US Centers for Disease Control and Prevention (CDC) show that from 2021 to 2023, people in the US aged 1 year or older consumed an average of 55% of their calories from ultraprocessed foods. For youth aged 1 to 18 years, ultraprocessed foods made up about 62% of their diets.
Just telling people they’re eating a lot of junky food and to stop it forthwith isn’t an effective public health policy. Instead, we can focus on a few more specific strategies.
Not all food additives are created equal, or equally harmful, or equally regulated. Through a combination of closing some regulatory loopholes on “generally regarded as safe” food additives,, adding front-of-package nutrition labeling for foods, and focusing on specific foods and beverages, nutrition experts argue that a more incremental and nuanced approach holds more promise for improving the public’s health. For instance,
“When we’re shifting the 55% to 60% of calories from ultraprocessed foods,” [nutrition professor Maya Vadiveloo] said, “we really need to be reducing sugar-sweetened beverages, processed meat, candies, baked goods.”
Still, she noted the considerable challenges ahead. It’s difficult for people to make wholesale changes to eating behaviors, especially when there are barriers to accessing and affording more healthful foods. Plus, preparing whole foods often takes longer—time that many households may not have.
“We want people to make healthier choices most of the time, and we need to set up the food environment in a way that allows that, which involves changing so many different things, including the marketing of different foods; the cost of raw ingredients used to make different foods; the availability of adequate fruits and vegetables and whole grains and things that people need to consume more of; and the skills that they need to have to prepare them,” she said.
What does this mean?
Focusing on particular ultra-processed foods–paying more attention to them as individual consumers, community members, voters, and policymakers– can pay off in terms of incremental and sustainable changes in diet patterns, and hopefully public health in the long term.
Also, we need to work towards building a food environment with better access to good-for-us and yummy-tasting fruits, vegetables, whole grains and proteins, which includes pricing and easy consumability (I made up that word, but I mean not having to cook for five hours to make it edible).
How do nutrition experts and medical organizations propose to do this?
They don’t know exactly. But they think it’s important, and need our help. So I though I’d put this in bold letters too.
Personally, I love pictures to help illustrate complicated and often technical messaging. So in summary, even though we often eat like this::
We should apply principles of nuance to our eating, which will help, like this:
Sometimes a thousand words are better than pictures, eh?
Is it just me, or is everyone getting blammed with “reset your workouts! reset your nutrition! reset your home decor! reset your nervous system!” messaging this month?
You may now be thinking, “I get the multiple fall resets, along with the deluge of pumpkin spice-filled potables and edibles messaging”. But reset your nervous system? What does that even mean? How am I supposed to do that? Also, is a cold reboot of my brain or body even a good idea?
Well, some folks think so and are enthusiastically offering us tips on restarting our environments, habits and even neural circuitry in time for fall. Here is an example of what I’m seeing/hearing.
Dan Harris, founder of my favorite meditation app Happier (nee 10% Happier), is doing a whole September reset month of podcast episodes on rewiring your nervous system to reduce stress, heal from trauma, and avoid self-sabotage. Here are some of the topics:
I have some thoughts about this.
First, I’m not super handy around the house, so when and if there’s rewiring needed, I outsource it to the professionals. Honestly, this is the kind of thing I don’t ever want to take on as a DIY project:
Similarly, for really big me-problems that require, as it were, major rewiring, I make sure to get some help. And I do, on a regular basis. I’m a long-term fan and participant in therapy, and also an intermittent and enthusiastic physical therapy client.
Second, I agree that it’s important to be the stewards of our own well-being; I mean, if not us, then who? And we all know this. I have my daily and weekly schedules of things-to-do and things-to-do-for-me, which are always in flux, but which I work on and adjust as life unfolds. And one of the things I like about these schedules and routines is that they can be tweaked when unexpected things happen, or when I just need a little change-up. Engaging in a major directional change is not easy– it’s super-disruptive in itself, so I try not to throw out my usual plans unless there’s a really compelling set of reasons.
Of course, sometimes there are compelling reasons. These podcast speakers talk in detail about those life extremes and offer an account of how they navigated through them to calmer times, along with some suggestions for us.
Third– as I said, deciding to embark on a completely new daily life plan is a very big deal. The fact that fall is here is not (for me) a good enough reason to throw myself into resetting my brain to fix all my life-long quirks and vulnerabilities.
September is an important transition time, even for those of you whose lives aren’t governed by the school calendar. I’m all for new beginnings, embracing the change, and welcoming in another season with its new foods, fabrics, and fun times. I’d prefer to meet these shifts without taking on extensive neurophysiology renovations at the same time.
So, dear readers, I encourage us all to take it a bit easier on ourselves from the neck up this month. Except for pumpkin spice– feel free to do you and swan-dive into sights and sounds and smells and tastes as you see fit.
