Unpublished Letter to Triathlete Magazine

The advice in the July issue of Triathlete assumes that all fluid lost needs replacement.  The article ignores the fact that water is a byproduct of glycolysis, as has been pointed out by Tim Noakes, MD.[1]  Effectively two molecules of H2O for every molecule of glucose in glycolysis and an additional two molecules via the citric acid cycle.[2]  In the small samples cited in the magazine article one wouldn’t expect much statistical significance, but they were correct that individuals must determine their own needs.   Polymorphisms of genes such as GH1 have been shown to be associated with different sweat rates.[3]

While dipsogenic genes modulate hydration status including fluid intake, the practical conclusion from prospective and retrospective evidence is to consume fluids and electrolytes ad libitum.[1,4]

1. Noakes MD, Tim.  Lore of Running.  Champaign, IL:  Human Kinetics, 2003.
2.  Nelson, David L. and Cox, Michael M.  Principles of Biochemisty.  Worth Publishers, 2003.
3.  Walpole B, Noakes, TD, Collins M.  Growth Hormone 1 (GH1) gene and performance and post-race rectal temperature during the South African Ironman triathlon.  Br J Sports Med 2006;40:145-150.
4.  Saunders CJ, di Milander L, Hew Butler T, Xenophontos SL, Carioulou MA, Anastassiades LC, et al.  Dipsogenic genes associated with weight changes during Ironman Triathlons.  Human Mol Genet.  2006 Oct 15;15(20):2980-7. Epub 2006 Sep 1.

In hindsight the above could have been more refined; but, the bottom line is chemical equations need to be balanced.  One can expect fluid lost in sweat is partly a byproduct of glycolysis.  Enough with the dangerous medical advice.

Prostate Cancer Awareness Month

We might have to take a step back for some general anatomy and physiology awareness.  You know people will profit from your ignorance.

Over the past couple years molecular analysis has brought about some important discoveries, or otherwise promising diagnostic advances on the horizon.  Clinical laboratory science may move beyond PSA and free PSA to subsets of bound PSA.  Prostate basal cells, with their stem cell like properties, are now thought to be a primary origin of malignancy.  Morphology is finally becoming outdated as it is with blood malignancies.  The American Cancer Society has given due consideration to quality of life, and rightfully so.  With individuals more likely to die with it than from it, caution has been urged in screening with PSA.  To begin with prostate-specific antigen is a misnomer; it's found in other body fluids.  It is the product of one of 15 kallkreins (i.e. serine proteases; enzymes) in a cluster on Chromosome 19.  To me it doesn't seem likely that the gene for a kallikrein would be completely methylated in all other tissue.  Sure it may have some post-translational modification that may have it more or less organ-specific; but, the enzyme is found elsewhere.  Furthermore when is a single enzyme value ever specific for a disease?  One large epidemiology study analyzed the meteorologic correlations with prostate cancer [St-Hilair, Mannel, Mandal, and Derryberry 2010].  The latitude factor appeared to be most directly linked to pesticide use in agriculture combined with snowfall.  The study noted known endocrine disruptors used in agriculture.

Men advocating for their collective interest seems to be almost nil.  I think nothing on a par with the breast cancer marches.  In the 21st Century along comes Athletes for a Cure.  Perhaps this angle will more effectively utilize the competitive nature.  From my subjective observation fundraising and "awareness" campaigns are more prevalent among the long course athletes (e.g. Ironman/70.3).  At 70.3 Cancun in 2008 I noted a couple traveling the world doing 70.3 races with the stated purpose of raising awareness of brain injuries and testicular cancer.  Maybe merely doing extraordinary distances already attracts a fair amount of attention.  Hopefully the active community can keep due attention to quality of life as both proposed prevention and treatment modes threaten health and vigor.

Until their is Athletes for a Reliable Diagnosis, I will leave it in the hands of the PCF.  But, maybe the diagnosis is the problem.
http://athletes.kintera.org/faf/donorReg/donorPledge.asp?ievent=186390&lis=0&kntae186390=758C247C4E2C473E915B4F0DB2FB42BC
At this time "cure" seems to mean absence of malignant cells, even though functional organs are lost.  I expect that genuine elimination of only malignant cells will remain a pipe dream for the foreseeable future.  First getting priorities straight will be the first step towards success.  Prevention will be everything for quality of life. Public health needs reform.  Enough with the politicized "cost/utility" war on diseases and in with the humanity.  With need molecular data more than family history spurious correlations.  There are mutants among us.

Hopefully genuine awareness will prevent profiteering.

Age Group Nationals

Tuscaloosa was a great host city with good places to ride and run.  The park was a good venue, aside from the cold start in the Black Warrior River that it may have necessitated.  I could have used more time to warm up; heart rate can get out of whack with a race start in an overcrowded river.  Water temperature was well into the 80's.  That big gap (1/2 hour) in the waves did a good job giving the 30 and 40-somethings a hot run.

As the pundits say, it's not how hard you train but how hard you recover.  In the end it's the little things.  Forgetting the address and contact information of VeloCity Pro Cycle had me going in circles late on Thursday and having to wait until late morning Friday to get my bike and losing sleep in the process.  Either those antacids were a little too far past expiration or I should have started the cycle earlier.   22nd out of 85 at Nationals...  I can live with that; but, I'm having some regrets that I did not rent race wheels after missing official Team USA qualification by four places.