Fiction and poetry are doses, medicines. What they heal is the rupture reality makes on the imagination.

(If you’re looking for the manifesto, please scroll down the page and there’ll be more soon)

‘Fiction and poetry are doses, medicines. What they heal is the rupture reality makes on the imagination.’ Jeanette Winterson 

Looking through the newspapers over the last few days, I’ve been overwhelmed by the usual round up of ‘highlights’ of 2011: successes, failures, deaths and revelations. I’m still surprised how little is reported on the on-going crisis resulting from the tsunami in Japan in March.

How is the health and well-being of the displaced people around Fukushima, now that the Japanese government has increased the levels of radiation it is permissible and ‘safe’ for its citizens to be exposed to? Although barely noticeable in the printed media in the UK, counterpunch have provided some compelling detail, exposing the very real and enduring plight of people in Japan. What is particularly poignant, is the focus on women's voices, reminiscent of Greenham Common in the early 80’s, when 30,000 women held hands and formed a human fence around nine miles of the US nuclear missile base, and sung They Shall Not Pass. 

The women of Japan sing a traditional song of remembrance and longing, Furosato:

Someday when I have done what I set out to do,

I will return to where I used to have my home.

Lush and green are the mountains of my homeland.

Pure and clear is the water of my old country home.

This year has also seen societal unrest on a scale unseen in a generation. Whilst focus in the UK media has been on the ‘Arab Spring’ and the unfolding crisis in Syria, the voices of school girls unbalanced the political system across Chile, resulting in a number of government resignations and questioning wider social inequalities. The voices of the young women of Chile cannot be ignored.

Closer to home, and less apparently sensational, the small print in the Guardian on 30th December revealed that antidepressant use in the England has risen by more than a quarter over the last 3 years. Prescriptions for anti-depressants rose from 34m in 2007/08 to 43.4m in 2010/11: an increase of 28%. Furthermore, in the North West we have the highest antidepressant use over 2010/11, with 7.2m prescriptions dispensed.

I have no doubt at all, that antidepressants offer critical respite from serious and debilitating depression, but we mustn't lose sight of some of the factors that impact on our mental health, and the current economic crisis plays a real part in this. Whilst counselling and talking therapies can help turn lives around, it is significant that as the government have increased their support for Cognitive Behavioral Therapy, this apparent treatment of choice is both time-limited and ‘measured’ in part, by the individuals’ ability to find employment/return to work. And we’re told that depression is costing the economy almost £11bn a year. I seem to remember the wonderful Dorothy Rowe telling the Un-Conference here at MMU in October, that guilt, blame and shame are all part of that complex baggage that erodes our well-being and can cause depression. (see Greenberg in recommended books for the big picture)

Doesn’t it seem like we’re in some horrible muddle, measuring our well-being...measuring our ‘happiness’ ad infinitum. The writer Jeanette Winterson sums it up perfectly, ‘...when money becomes the core value, then education drives towards utility...the life of the mind will not be counted as a good unless it produces measurable results.’

In her autobiography, Why Be Happy When You Could Be Normal? Jeanette Winterson paints a picture of her life, originally fictionalised in Oranges Are Not The Only Fruit. It’s an enthralling read and one that I won’t spoil, but one in which we are given some very strong ideas about the potential impact of the arts on our well-being, and how as ‘meaning-seeking creatures’ in an increasingly secular world, we need to find ‘new ways of finding meaning.’ She also succeeds in blowing the myth, that poetry and prose are luxuries for the educated middle classes, suggesting ‘a tough life needs a tough language - and that is what poetry is. That is what literature offers - a language powerful enough to say how it is.’


In his report to HM Treasury, didn’t Derek Wanless suggest that evidence showed that one of the strongest determinants of health impact, wasn’t in fact, the reach of health services, but the female literacy rate?

I wonder how the people of Japan will describe this experience of being; will the actions of the young women of Chile go down in song, and how will we make sense of the here-and-now on our increasingly depressed little island?   C.P

Thanks to Dr Nick Shimmin for sharing counterpunch; Professor Chris Williams of Pace University for his essay; the inspirational young people of Chile and Jeanette Winterson.

Ground meat treats: Zucchini and onion meatloaf

A cousin of the meatball (), the meatloaf is a traditional German dish. The recipe below is for a meal that feeds 4-8 people. The ground beef used has little fat, and thus a relatively low omega-6 content. Most of the fat comes from the 1 lb of ground grass-fed lamb in the recipe, which has a higher omega-3 to omega-6 ratio than the regular (i.e., non-grass-fed) ground beef. The egg acts as a binder. Leave the potato out if you want to decrease the carbohydrate content; it does not add much (nutrient numbers are provided at the end of the post).

- Prepare some dry seasoning powder by mixing salt, parsley flakes, garlic powder, chili powder, and a small amount of cayenne pepper.
- Grate one zucchini squash and one peeled potato. Cut half an onion into small pieces of similar size.
- Mix 2 lb of very lean ground beef (96/4) with 1 lb of ground grass-fed lamb.
- Add the dry seasoning, zucchini, potato, onion and a whole egg to the ground meat mix.
- Vigorously mix by hand until you get a homogeneous look.
- Place the mix into a buttered casserole dish with the shape of a loaf.
- Preheat the oven to 375 degrees Fahrenheit.
- Bake the meatloaf for about 1 hour and a half.

It is a good idea to place the casserole dish within a tray, as in the photo above. The meatloaf will give off some of its juices as it bakes, which may overflow from the casserole dish and make a mess in your oven. Below is a slice of meatloaf served with a side of vegetables. The green spots in the meatloaf are the baked zucchini squash pieces.

A thick slice like the one on the photo above will have about 52 g of protein, 15 g of fat, and 6 g of carbohydrates (mostly from the potato). That'll be about 1/5 of the whole meatloaf; the slice will weigh a little less then 1/2 lb (approximately 200 g). The fat will be primairly saturated and monounsaturated (both healthy), with a good balance of omega-3 and omega-6 fats. The slice of meatloaf will also be a good source of vitamins B12 and B6, niacin, zinc, selenium, and phosphorus.

Days

What are days for?

Days are where we live.

They come, they wake us

Time and time over.

They are to be happy in:

Where can we live but days?

Ah, solving that question

Brings the priest and the doctor

In their long coats

Running over the fields.

Philip Larkin 1964

Best things...manifesto and first networking evening 2012

Just a couple of things for this last posting of 2011…

I want to give a big thanks to everyone who’s been supportive of Arts for Health over the last 12 months and wish you all the very best for whatever 2012 throws at us. On a personal note, it has been incredibly exciting to see people joining our supposedly ‘regional’ network from all areas of the globe! It’s wonderful to have lots of comments about the manifesto (part 1) too, some of which I will include in part 2 in January.
 

Work in progress from 1st session in Manchester...

If you haven’t sent thoughts or responses to me about the manifesto, but were involved in the process, I’d be really keen to hear your thoughts, or collect your comments before its next incarnation. So please send them to artsforhealth@mmu.ac.uk
I have collected some sharp, subtle and inspirational thoughts from people who were involved in the sessions, from those who weren’t but feel passionately, and from the wider world of Culture, Science, Politics and the Arts.

Dementia and Imagination evening
I’m thrilled that the artist Claire Ford will be sharing reflections of her Churchill Fellowship at our first network event of 2012 on Thursday January 26th between 6:00 and 8:00pm (venue to be confirmed at MMU). As usual the event is free to our members, and will be informal. Claire spent 10 weeks in the USA exploring different approaches to dementia and the arts, and will be sharing this experience, her findings and ideas about future developments in the field.

Final details of the venue and confirmation of places will be sent out one week prior to the event, but please drop an expression of interest in attending to artsforhealth@mmu.ac.uk before Thursday 19th January. Please enter Dementia and Imagination in the subject line of the email.

For now, my very best things to you...Clive

2

Protein powders before fasted weight training? Here is a more natural and cheaper alternative

The idea that protein powders should be consumed prior to weight training has been around for a while, and is very popular among bodybuilders. Something like 10 grams or so of branched-chain amino acids (BCAAs) is frequently recommended. More recently, with the increase in popularity of intermittent fasting, it has been strongly recommended prior to “fasted weight training”. The quotation marks here are because, obviously, if you are consuming anything that contains calories prior to weight training, the weight training is NOT being done in a fasted state.

(Source: Ecopaper.com)

Most of the evidence available suggests that intermittent fasting is generally healthy. In fact, being able to fast for 16 hours or more, particularly without craving sweet foods, is actually a sign of a healthy glucose metabolism; which may complicate a cause-and-effect analysis between intermittent fasting and general health. The opposite, craving sweet foods every few hours, is generally a bad sign.

One key aspect of intermittent fasting that needs to be highlighted is that it is also arguably a form of liberation ().

Now, doing weight training in the fasted state may or may not lead to muscle loss. It probably doesn’t, even after a 24-hour fast, for those who fast and replenish their glycogen stores on a regular basis ().

However, weight training in a fasted state frequently induces an exaggerated epinephrine-norepinephrine (i.e., adrenaline-noradrenaline) response, likely due to depletion of liver glycogen beyond a certain threshold (the threshold varies for different people). The same is true for prolonged or particularly intense weight training sessions, even if they are not done in the fasted state. The body wants to crank up consumption of fat and ketones, so that liver glycogen is spared to ensure that it can provide the brain with its glucose needs.

Exaggerated epinephrine-norepinephrine responses tend to cause a few sensations that are not very pleasant. One of the first noticeable ones is orthostatic hypotension; i.e., feeling dizzy when going from a sitting to a standing position. Other related feelings are light-headedness, and a “pins and needles” sensation in the limbs (typically the arms and hands). Many believe that they are having a heart attack whey they have this “pins and needles” sensation, which can progress to a stage that makes it impossible to continue exercising.

Breaking the fast prior to weight training with dietary fat or carbohydrates is problematic, because those nutrients tend to blunt the dramatic rise in growth hormone that is typically experienced in response to weight training (). This is not good because the growth hormone response is probably one of the main reasons why weight training can be so healthy ().

Dietary protein, however, does not seem to significantly blunt the growth hormone response to weight training; even though it doesn't seem to increase it either (). Dietary protein seems to also suppress the exaggerated epinephrine-norepinephrine response to fasted weight training. And, on top of all that, it appears to suppress muscle loss, which may well be due to a moderate increase in circulating insulin ().

So everything points at the possibility that the ingestion of some protein, without carbohydrates or fat, is a good idea prior to fasted weight training. Not too much protein though, because insulin beyond a certain threshold is also likely to suppress the growth hormone response.

Does the protein have to be in the form of a protein powder? No.

Supplements are made from food, and this is true of protein powders as well. If you hard-boil a couple of large eggs, and eat only the whites prior to weight training, you will be getting about 8-10 grams of one of the highest quality protein "supplements" you can possibly get. Included are BCAAs. You will get a few extra nutrients with that too, but virtually no fat or carbohydrates.

Make getting and giving vaccines a holiday tradition

I'm finally joining the#VaxDrive after being inspired by all the tweets and, especially, from Dr. Rubidium's post. Honestly, I was looking for something just like this to write about, because I've found myself completely disenchanted with this year's holiday season. It has become the season of buying junk for people who don't need it and receiving junk from people who have no idea what to buy for you. It's stressful, it's wasteful, it's expensive, and it's turned into a stupid tradition. Why not just skip it? Instead, save some lives, buy measles vaccines by clicking here. It only costs a dollar to vaccinate each child, or you can vaccinate a village for $500. A whole village!

Another thing: first, go get a flu shot yourself and, second, go help an older person (your mom, dad, grandma, or grandpa) get him or herself a high-dose flu shot. Why a high-dose flu shot? Why not just a standard dose?

Here's why: As recently as November, I attended the 2011 American Society of Consultant Pharmacists annual meeting in Phoenix and reported on a few of the "product theaters" at the event. A couple of the articles were published earlier this week in the December issue of Annals of Long-Term Care: Clinical Care and Aging (1). One of the product theaters I reported on was about new Fluzone High-Dose, which I'll discuss briefly about on this blog today. As reported in my article, "older adults make up about 15% of the U.S. population, but account for more than 60% of estimated 226,000 annual hospitalizations and 90 percent of the 3,000 to 49,000 annual deaths attributed to influenza and pneumonia." If an older person has other conditions, risk of death increases dramatically. This is where Fluzone High-Dose comes in, containing four times the standard dose, as the life-saving treatment of the future. Three clinical studies showed it raises antibody levels significantly higher than the standard dose in older adults. More antibody means better immunological response for beating back the flu.

What I left out of the technical article was just how colorful clinical pharmacist Frank Breve was in ridiculing people who believe in the myths suggesting that vaccines may be somehow dangerous. He, of course, brought up the history of the Spanish flu of 1918-1919, which killed off something like 30 to 50 million people worldwide and more than 675,000 people in the U.S. population (2,3). In only a few months, it was the worst epidemic ever in world history, killing more in a year than the Bubonic Plague and more than World War 1. Looking back at that history, it's hard to imagine why folks turn to believing in anti-vaccine literature.

The truth is, Breve said, people are just so far removed now from the threats of Spanish flu, measles, and small pox. It's easy to underestimate what a tiny virus can do. Then, based on myths of dangerous vaccine side effects, they refuse inoculation for themselves or their families. They might even claim that getting the flu naturally builds up their own immunity. Unfortunately, despite these anecdotes, refusing a flu shot can have devastating consequences -- especially if spread to the very young and the very old. The very young are more vulnerable to infection and complications because they may not be equipped with an immune system developed enough to handle infection. The very old are more vulnerable because their immune systems have weakened over time and don't respond to flu shots as well as in younger years. In these cases, the severest of complications could be death from flu or pneumonia.

Anti-vaxxers are quick point out that the concentration of mercury in the high-dose vax may be higher, Breve said. He dismisses these concerns by saying, "A multi-dose vax contains about 25 micrograms of mercury. A tuna fish sandwich contains 28 micrograms. What does that tell you?" He also said people raise concerns about side effects like Guillain-Baré syndrome. He responds by saying "the risk of Guillain-Barré syndrome is one in a million; the risk of dying from flu is one in 8,333. You decide." Lastly, when people tell Breve that they've heard stories about people getting the actual flu from a flu shot, he responds by saying "It's not true. It's impossible."

So don't be fooled; once again, get a flu shot, and make sure older loved ones get their high-dose flu shots. And, if you really want to make a difference by saving lives this season, here's the link again to American Red Cross.

References

1. Despain D. Product Theaters: Preventing Influenza With Fluzone High-Dose in Older Adults. Annals of Long-Term Care: Clinical Care and Aging. 2011;19(12):17-18.
2. Regional History from the National Archives. The Deadly Virus: The Influenza Epidemic of 1918. Available at http://www.archives.gov/exhibits/influenza-epidemic/
3. Billings M. The Influenza Pandemic of 1918. Human Virology at Stanford [website]. June, 1997 modified RDS February, 2005. Available at http://virus.stanford.edu/uda/

M A N I F E S T O and more...

M A N I F E S T O  Part ONE
Our manifesto is just as much about education as it is health; the arts as it is science, communities as it is the individual. Well-being is central to our vision. The arts are central to fulfilling our fundamental human rights.

• this is not a quick fix
• this is not about benign lumps of municipal sculpture
• this is not about reducing the arts to a cost-effective prescription
• this is about well-being
• this is about democracy
• this is about human flourishing
• this is about new ways of understanding impact and value
• this is about solidarity

Click on the image above to access full-colour, black and white and podcast versions. I'll be collating all comments and thoughts over the new-year.

NETWORKING EVENINGS at MMU
Please keep your eye on the blog for updates on three very special networking events over winter/spring 2012:

• Stroke and the Arts
• Dementia and Imagination
• Fourth Culture

Response to the European Review Consultation

For those of you who were interested in the response to the European Review Consultation lead by Sir Michael Marmot for the World Health Organisation, emphasising the importance of creativity, culture and the arts in relationship to social determinants of health and health inequalities, please see the co-ordinated response from Stephen Clift, to whom I extend my thanks.

(Click on image below)

 Experience of Creativity Questionnaire

Elaine McNeill from Liverpool John Moores University is undertaking a study that network members may want to contribute to.
The purpose of the study

This study is part of MSc in Consciousness and transpersonal Psychology and will look toward developing an understanding of personal transformation as an outcome of creative practice.  As a participant you may benefit by gaining a deeper understanding of your creative practice. 

Taking part

It is entirely up to you to decide whether or not to take part. If you do you will be asked to complete a 10-15min questionnaire online. You are still free to withdraw at any time and without giving a reason. A decision to withdraw will not affect your rights. The online questionnaire requires you to consider a time when you were being creative. The questionnaire should take approx 10-15mins. You may be asked to take part in an in-depth interview which will take 20-30mins, please leave a contact email address at the end of the survey. The interview will be exploring the aspects of the creative process discussed in the questionnaire.

The possible benefits include:

A greater understanding of creativity which could inform your studies/practice.

Confidentiality

As a participant you will have access to the final report and you may be quoted verbatim in future publications. However, your participation and contribution to this research will be kept confidential as you will remain anonymous in all information/data. 

Please click on this link to access the questionnaire:  http://www.survey.ljmu.ac.uk/ecq

The Two Wheeled Key to Better Health and a Better World
Thanks again to Cheryl G for another excellent info-graphic. Click on the graphic to go to the full document.

Finding your sweet spot for muscle gain with HCE

In order to achieve muscle gain, one has to repeatedly hit the “supercompensation” window, which is a fleeting period of time occurring at some point in the muscle recovery phase after an intense anaerobic exercise session. The figure below, from Vladimir Zatsiorsky’s and William Kraemer’s outstanding book Science and Practice of Strength Training () provides an illustration of the supercompensation idea. Supercompensation is covered in more detail in a previous post ().

Trying to hit the supercompensation window is a common denominator among HealthCorrelator for Excel (HCE) users who employ the software () to maximize muscle gain. (That is, among those who know and subscribe to the theory of supercompensation.) This post outlines what I believe is a good way of doing that while avoiding some pitfalls. The data used in the example that follows has been created by me, and is based on a real case. I disguised the data, simplified it, added error etc. to make the underlying method relatively easy to understand, and so that the data cannot be traced back to its “real case” user (for privacy).

Let us assume that John Doe is an intermediate weight training practitioner. That is, he has already gone through the beginning stage where most gains come from neural adaptation. For him, new gains in strength are a reflection of gains in muscle mass. The table below summarizes the data John obtained when he decided to vary the following variables in order to see what effects they have on his ability to increase the weight with which he conducted the deadlift () in successive exercise sessions:
    - Number of rest days in between exercise sessions (“Days of rest”).
    - The amount of weight he used in each deadlift session (“Deadlift weight”).
    - The amount of weight he was able to add to the bar each session (“Delta weight”).
    - The number of deadlift sets and reps (“Deadlift sets” and “Deadlift reps”, respectively).
    - The total exercise volume in each session (“Deadlift volume”). This was calculated as follows: “Deadlift weight” x “Deadlift sets” x “Deadlift reps”.

John’s ability to increase the weight with which he conducted the deadlift in each session is measured as “Delta weight”. That was his main variable of interest. This may not look like an ideal choice at first glance, as arguably “Deadlift volume” is a better measure of total effort and thus actual muscle gain. The reality is that this does not matter much in his case, because: John had long rest periods within sets, of around 5 minutes; and he made sure to increase the weight in each successive session as soon as he felt he could, and by as much as he could, thus never doing more than 24 reps. If you think that the number of reps employed by John is too high, take a look at a post in which I talk about Doug Miller and his ideas on weight training ().

Below are three figures, with outputs from HCE: a table showing the coefficients of association between “Delta weight” and the other variables, and two graphs showing the variation of “Delta weight” against “Deadlift volume” and “Days of rest”. As you can see, nothing seems to be influencing “Delta weight” strongly enough to reach the 0.6 level that I recommend as the threshold for a “real effect” to be used in HCE analyses. There are two possibilities here: it is what it looks it is, that is, none of the variables influence “Delta weight”; or there are effects, but they do not show up in the associations table (as associations equal to or greater than 0.6) because of nonlinearity.

The graph of “Delta weight” against “Deadlift volume” is all over the place, suggesting a lack of association. This is true for the other variables as well, except “Days of rest”; the last graph above. That graph, of “Delta weight” against “Days of rest”, suggests the existence of a nonlinear association with the shape of an inverted J curve. This type of association is fairly common. In this case, it seems that “Delta weight” is maximized in the 6-7 range of “Days of rest”. Still, even varying things almost randomly, John achieved a solid gain over the time period. That was a 33 percent gain from the baseline “Deadlift weight”, a gain calculated as: (285-215)/215.

HCE, unlike WarpPLS (), does not take nonlinear relationships into consideration in the estimation of coefficients of association. In order to discover nonlinear associations, users have to inspect the graphs generated by HCE, as John did. Based on his inspection, John decided to changes things a bit, now working out on the right side of the J curve, with 6 or more “Days of rest”. That was difficult for John at first, as he was addicted to exercising at a much higher frequency; but after a while he became a “minimalist”, even trying very long rest periods.

Below are four figures. The first is a table summarizing the data John obtained for his second trial. The other three are outputs from HCE, analogous to those obtained in the first trial: a table showing the coefficients of association between “Delta weight” and the other variables, two graphs (side-by-side) showing “Delta weight” against “Deadlift sets” and “Deadlift reps”, and one graph of “Delta weight” against “Days of rest”. As you can see, “Days of rest” now influences “Delta weight” very strongly. The corresponding association is a very high -0.981! The negative sign means that “Delta weight” decreases as “Days of rest” increase. This does NOT mean that rest is not important; remember, John is now operating on the right side of the J curve, with 6 or more “Days of rest”.

The last graph above suggests that taking 12 or more “Days of rest” shifted things toward the end of the supercompensation window, in fact placing John almost outside of that window at 13 “Days of rest”. Even so, there was no loss of strength, and thus probably no muscle loss. Loss of strength would be suggested by a negative “Delta weight”, which did not occur (the “Delta weight” went down to zero, at 13 “Days of rest”). The two graphs shown side-by-side suggest that 2 “Deadlift sets” seem to work just as well for John as 3 or 4, and that “Deadlift reps” in the 18-24 range also work well for John.

In this second trial, John achieved a better gain over a similar time period than in the first trial. That was a 36 percent gain from the baseline “Deadlift weight”, a gain calculated as: (355-260)/260. John started with a lower baseline than in the end of the first trial period, probably due to detraining, but achieved a final “Deadlift weight” that was likely very close to his maximum potential (at the reps used). Because of this, the 36 percent gain in the period is a lot more impressive than it looks, as it happened toward the end of a saturation curve (e.g., the far right end of a logarithmic curve).

One important thing to keep in mind is that if an HCE user identifies a nonlinear relationship of the J-curve type by inspecting the graphs like John did, in further analyses the focus should be on the right or left side of the curve by either: splitting the dataset into two, and running a separate analysis for each new dataset; or running a new trial, now sticking with a range of variation on the right or left side of the curve, as John did. The reason is that nonlinear relationships tend to distort the linear coefficients calculated by HCE, hiding a real relationship between two variables.

This is a very simplified example. Most serious bodybuilders will measure variations in a number of variables at the same time, for a number of different exercise types and formats, and for longer periods. That is, their “HealthData” sheet in HCE will be a lot more complex. They will also have multiple instances of HCE running on their computer. HCE is a collection of sheets and code that can be copied, and saved with different names. The default is “HCE_1_0.xls” or “HCE_1_0.xlsm”, depending on which version you are using. Each new instance of HCE may contain a different dataset for analysis, stored in the “HealthData” sheet.

It is strongly recommended that you keep your data in a separate set of sheets, as a backup. That is, do not store all your data in the “HealthData” sheets in different HCE instances. Also, when you copy your data into the “HealthData” sheet in HCE, copy only the values and formats, and NOT the formulas. If you copy the formulas, you may end up having some problems, as some of the cells in the “HealthData” sheet will not be storing values. I also recommend storing values for other types variables, particularly perception-based variables.

Examples of perception-based variables are: “Perceived stress”, “Perceived delayed onset muscle soreness (DOMS)”, and “Perceived non-DOMS pain”. These can be answered on Likert-type scales, such as scales going from 1 (very strongly disagree) to 7 (very strongly agree) in response to self-prepared question-statements like “I feel stressed out” (for “Perceived stress”). If you find that a variable like “Perceived non-DOMS pain” is associated with working out at a particular volume range, that may help you avoid serious injury in the future, as non-DOMS pain is not a very good sign (). You also may find that working out in the volume range that is associated with non-DOMS pain adds nothing in terms of muscle gain.

Generally speaking, I think that many people will find out that their sweet spot for muscle gain involves less frequent exercise at lower volumes than they think. Still, each individual is unique; there is no one quite like John. The relationship between “Delta weight” and “Days of rest” varies from person to person based on age; older folks generally require more rest. It also varies based on whether the person is dieting or not; less food intake leads to longer recovery periods. Women will probably see visible lower-body muscle gain, but very little visible upper-body muscle gain (in the absence of steroid use), even as they experience upper-body strength gains. Other variables of interest for both men and women may be body weight, body fat percentage, and perceived muscle tone.

Is a Pizza a vegetable?

Thank you SO MUCH for all the thoughts and comments on the manifesto part 1. Everything is valid and will be thrown in the mix for part 2. Sorry for my slow response if you've emailed me whilst I've been in Australia. I am back in the UK now and will be updating this blog in the manner in which you are accustomed to.

So for now, and to get us in the mood for all that 2012 offers, a question.
IS A PIZZA A VEGETABLE?
It appears that congress thinks so. Read on by clicking on the pizza!
Best things, Clive

Want to make coffee less acidic? Add cream to it

The table below is from a 2008 article by Ehlen and colleagues (), showing the amount of erosion caused by various types of beverages, when teeth were exposed to them for 25 h in vitro. Erosion depth is measured in microns. The third row shows the chance probabilities (i.e., P values) associated with the differences in erosion of enamel and root.

As you can see, even diet drinks may cause tooth erosion. That is not to say that if you drink a diet soda occasionally you will destroy your teeth, but regular drinking may be a problem. I discussed this study in a previous post (). After that post was published here some folks asked me about coffee, so I decided to do some research.

Unfortunately coffee by itself can also cause some erosion, primarily because of its acidity. Generally speaking, you want a liquid substance that you are interested in drinking to have a pH as close to 7 as possible, as this pH is neutral (). Tap and mineral water have a pH that is very close to 7. Black coffee seems to have a pH of about 4.8.

Also problematic are drinks containing fermentable carbohydrates, such as sucrose, fructose, glucose, and lactose. These are fermented by acid-producing bacteria. Interestingly, when fermentable carbohydrates are consumed as part of foods that require chewing, such as fruits, acidity is either neutralized or significantly reduced by large amounts of saliva being secreted as a result of the chewing process.

So what to do about coffee?

One possible solution is to add heavy cream to it. A small amount, such as a teaspoon, appears to bring the pH in a cup of coffee to a little over 6. Another advantage of heavy cream is that it has no fermentable carbohydrates; it has no carbohydrates, period. You will have to get over the habit of drinking sweet beverages, including sweet coffee, if you were unfortunate enough to develop that habit (like so many people living in cities today).

It is not easy to find reliable pH values for various foods. I guess dentistry researchers are more interested in ways of repairing damage already done, and there doesn't seem to be much funding available for preventive dentistry research. Some pH testing results from a University of Cincinnati college biology page were available at the time of this writing; they appeared to be reasonably reliable the last time I checked them ().