Interview with Ken Snyder about Biometric Data

Kenneth Snyder is the founder of the London-based start-up LifeGadget which is a platform for aggregating and analyzing one’s social, activity, health and wellness data through a contextual interface. Ken has almost two decades of experience in Information Technology through a diverse range of experience spanning from leadership positions at established players such as Sapient to founding roles at various start-ups. When Ken is not working on his next project he shares his entrepreneurial passion through various strategy workshops in the United Kingdom.

Here are my 5 questions with Ken and his answers:

1) Only a few years back there was a budding hope that simply empowering someone with their own health data, with nothing else needed, would be enough to see measurable improvement based on the attribute being measured (see Data is the Next Blockbuster Drug). The current general belief is that some sort of guidance is a necessary component for human improvement and that data, for the simple sake of data, is an ineffective intervention. What is your point of view on the importance of data and its role given this context?

The word empowerment means different things to different people. I believe data is very valuable and is allowing us to see correlations and patterns that we simply did not have access to before. For me there are four powerful aspects to tracking data:

  1. The ability to reflect on historic data to identify patterns, patterns which are pretty much imperceptible experientially.
  2. The ability to share historic artifacts about yourself with others – be it your doctor, a wellness advocate, and/or social supporter such as a family member. For many people memory is a poor substitute for the truth.
  3. The ability to make predictions and correlations based on multiple data sources. For instance, weight by itself can be interesting, but put that into an ecosystem with other data and it gets a lot more interesting. One can begin to derive secondary effects and make better choices.
  4. The ability to make data sharing frictionless and explicit. In other words, data sets are becoming rich and the integrity of the data is getting better as we move away from pen and paper.

That said there are still some universal truths that are important. For instance, sustainability is one. The four aspects I just mentioned don’t mean anything if the means to which one tracks their data is difficult. If the process/method is difficult then utility is compromised. Another truth is that people’s goals change and interest in anything tends to trend in an angulating fashion. This needs to be incorporated into the ease of use of collecting data since it’s a norm, and developers should build products around expecting data to come in ebbs and flows.

2) LifeGadget is being developed in part so that people will better understand their behavior and choices holistically. How profound do you speculate facilitating better access to biometric and behavioral data will move the needle towards allowing users to find unique correlations in aspects of changeable behavior that aren’t available today?

There is a balance between the value data provides and the effort needed to get data. We are getting better at lowering the effort threshold by reducing the friction between users and their data. We are also making data more enjoyable through various methodologies such as gamification. Regarding your question, single variables are important but it is exploring the complex relationship between those variables that ultimately will really move the needle.

For someone to really understand what is going on, they need access to a more complicated picture of their environment. As individuals we are usually not well-suited (without good tools) to explore our raw data and extrapolate meaning from that environment. Secondarily, even those that might be great at Excel modeling and have the aptitude to generate meaningful complex algorithms won’t have the time to do it just for themselves. Great tools let people bring forth observations quickly and easily by finding meaningful relationships in the data effortlessly.

3) One of major themes of this year’s Quantified Self Conference was the fact that hardware and software manufacturers have done little to standardize biometric data types. With the exception of the FIT Protocol and Open mHealth Architecture data standards for biometric data practically do not exist. What do you perceive as the implications of this, both as an advocate of the space and a product developer?

We are still in what I call a “Wild West” environment, meaning rapid change is taking place. At a personal level I naturally gravitate to these types of environments. This type of great change is very exciting. Since it is still a land grab you have players like Nike that do not want standards because it gives them a competitive advantage. Also it is important to note that not having standards creates a lower cost for start-ups and pioneers because they’re not limited by boundaries. However, from an infrastructure standpoint standards are starting to develop and that is unlikely to slow down… things like OAuth 2.0 and RESTful APIs are making data integration easier and cheaper to orchestrate.

I believe when a standard(s) do begin to take root you will see a very rapid move towards standardization. I suspect this will happen – the drawbridge will get lowered if you will – when businesses see value in collaboration. This will naturally happen as the ecosystem evolves. The industries that service this data will push for it and data producers will either fall in line or face exclusion.

4) Aside from the issue discussed in question three, what is one thing you would do today to improve the biometric tracking industry at large if you had unlimited resources?

I think one potential roadblock is the inherent cautiousness of the healthcare industry. If I had unlimited resources I would use them to influence the constructive disruption of the healthcare industry. I’m not suggesting we throw out caution, but I am suggesting we don’t let it get in the way of innovation. A great example is the stethoscope. The stethoscope was invented and it took another 30 years for it to get adopted by the healthcare industry. These types of delays as it pertains to biometric data innovation would be catastrophic. People need better access to genetic data and data generated by remote monitoring now. There is so much potential but progress is being hindered by legal and risk-based boundaries. For example the Federal Trade Commission is blocking the ability to see real-time glucose monitoring… why? Seriously, what is the harm in that? This is where I would like to see the industry improve.

5) The space is evolving rapidly, in part driven by the need for innovation to help improve healthcare. A recent article from CNN (Tracking Your Body with Technology) suggests that mind-blowing devices are on the horizon. From what you have seen and heard, what excites you the most about the future of self-tracking, biometric hardware, and/or mHealth?

I am excited about the rapid growth of this sector and the acknowledgment that it is beneficial to people (and these benefits are only getting better). I am excited to be involved in this not only professionally, but also personally. I started going to Quantified Self meet-ups because I have been tracking my own data for years. I’m excited that devices are improving with each iteration. For example, sleep tracking devices right now, in my opinion, are good but not great. I’m excited to see devices such as the Zeo get better because sleep quality is such an important piece of the puzzle… so we need better data regarding sleep. Another thing that excites me is seeing the way we track food intake improve. No one has gotten that down yet but someone will. This goes back to my answer to question two… right now the effort to track food is too high to maintain sustainability, but someone will solve this and that excites me. Lastly, it excites me to think that blood and biometric markers will likely be available to consumers without having to puncture the skin. Things like cholesterol, reactive protein counts, and other standard measures will be easily obtained without a blood draw. Once this happens we are going to be able to do some really great correlative analysis and really empower people with a clear, unique picture of their data and what their data means.

Interview with Brian Russell about Wearable Sensors

Brian Russell is the Founder and Chief Executive Officer of Zephyr Technologies, a biotechnological company that specializes in remote monitoring and mobile health (mHealth) products. Zephyr Technologies is an industry leader in health monitoring solutions and has been supplying advanced monitoring technology to groups such as the National Football League, US Special Forces, National Guard Civil Support Teams, and the NASA Ames Research Center (to name a few) for nearly a decade. Zephyr also has a proven track record of helping athletes measure, track and subsequently enhance their performance and endurance.

Here are my 5 questions with Brian and his answers:

1) Science has come a long way regarding the ability to tailor performance enhancing regimes against one’s biological markers. Where is science now with regards to tailoring performance enhancing regimes as it pertains to immediate biological feedback (allowing users to make adjustments in real-time)?

So previously accuracy was the problem, which has been solved for the most part now. Now companies like our own are looking at specific problems and doing a complete integration of the solution. Smart phones have really moved us forward in that regard, and biometric devices are also getting a lot more wearable. The overall experience can now be a very natural, entertaining experience that is also helping you improve performance. Furthermore, the devices are more user-friendly today so the education load needed to get going on a device has almost gone to zero, plus the experience is becoming more social.

The fact that we can now accurately measure somebody in either a shirt, patch or strap, and give them information in real time on devices they are familiar with is incredible. Plus, you have devices like Motorola’s MOTOACTV that can alter your environment based on your performance. In the case of MOTOACTV it is the music you hear, but that is just the tip of the iceberg.

Devices are now letting people close the loop on their goals too. Up until recently one could argue biometric devices were really just arming people with data, which is great. However, now a user can say, “what’s my goal?” and can use these devices to make better choices. It used to be that the primary success metric for most was race day. That is nonsensical and not appropriate for the masses. With something like our new product ZephyrLIFE you can assess your stress level and/or fitness level and manipulate your activity against real-time feedback. So again, we can now close the loop for the user. We start the goal at the top, then we add a stimulus and track the performance of that stimulus (which is what the industry has been doing for years), but now we also are adding the element of immediate feedback whether it is suggested tweaks to behavior or a change in the users environment such as the example with MOTOACTV.

Also, the software is getting better. VO2 Max use to be the big thing but a big part of that marker is genetic. Your anaerobic threshold can now be determined with a high degree of accuracy through consumer biometric devices. Using good software we can create custom workout regimens tailored to the user based on training zones, which is nothing new, but it doesn’t end there… these protocols use to only be prescriptive, now the software is adaptable so you can challenge your program’s recommendations and change up the workout to see if you get better results. If you do, the software starts to learn this and continues to optimize a workout for you that gets you results as quickly as possible. The days of using normative data to calibrate these initiatives will soon be a thing of the past and that’s terrific and is leading to a super cool user experience.

2) With the advances in sport biometric devices, do you think that there might be some interesting synergies with the expanding consumer biofeedback market?

That’s a great question actually. If you look at the latest research regarding all the 10,000 step programs, they are failing in a lot of areas because we are learning through study that exercise intensity is an important part of the equation for reducing stress. So for the sake of improving our nation’s health, I am hoping people will move on from just these counting step type programs. Accelerometers are neat, they are very cheap and simple, but they don’t address using muscle or heart rate activity. You lose visibility regarding heart rate and stress and therefore nothing about the user’s mental state is captured.

If you are healthy and you introduce some sort of stress, great. However, if you are unhealthy then maybe adding a high level of stress into your life is not a good idea. This is where advances, such as the ones we are driving, are really adding value for consumers. We are enabling people to make healthy choices about their activity, so we are a perfect example of something that started with sport and now is really improving the lives of a broader audience. For instance, hypertension is one of the top three killers in the country at the moment so we can also use devices in conjunction with behavioral psychology and motivate people to take action using their own data. And here is the magic: we know exercise metabolizes stress hormones so sport, exercise, fitness, whatever you want to call it is not just for athletes. It is proven to improve overall well-being. And it goes both ways, products that are being designed for consumers regarding sleep and stress will help athletes perform better too.

Also, most people now agree exercise is medicine. The medical bill for this country is almost up to 25 percent of GDP, which is significantly higher than any of the other G6 countries. We know that exercise reduces diabetes when introduced to an at risk population. And it is not like these people need to become Ironmen, simple changes at the right intensity have huge results and so with regards to your question there is a significant benefit in the two sides influencing each other. If we agree exercise is medicine then these devices give us visibility and tools across the health continuum. They help focus people on staying well instead of the alternative, which is medical intervention. As a society we are only accustomed to worrying about health when we are sick. The departure for this flawed system is exciting!

3) For someone just starting to track athletic performance through data, what do you believe should be focused on first (regarding this new information) to make the biggest personal impact?

Let’s start with someone who used to be active but because of various life events adopted a sedentary lifestyle and now is motivated to get back in shape. For the sake of this example let’s say the person in question has chosen to run as the way to get fit. First off, for the majority of the population one shouldn’t jump into a standard training regimen (ex. some 5 day a week program). So I would suggest to this person, for a couple of weeks choose to run one or two times during the week, for no more than 20 minutes. In these training sessions focus not on the effort but running “well”, good form, steady biometrics, etc. In layman terms, run in a way your body really likes… feel your feet, feel your heels, feel your knees, make sure your muscles, your glutes, your thighs, are doing what they should do. So that is the first thing I suggest.

Number two is looking at your sleep. Sleep hygiene is so underrated when it comes to performance. So track your sleep and do what it takes to improve in this area. Figure out what works best for you, whether that is lowering your caffeine consumption or not watching television in your bedroom, do whatever it takes to get restful sleep and start doing it every night.

Three is about creating a closed loop system with your device of choice based on personalized goals. So whether someone is motivated by performance, or reducing stress, we calibrate the routine to optimizing against that goal which keeps the person engaged and then this positive cycle feeds itself.

And the last pieces are the workout and proper recovery, so I personally believe that workouts should be spaced out at least 48 hours apart from each other. If you workout smart and give yourself enough time to recover from your workouts most people will see measurable improvement in their wellness within four weeks.

Once we’ve accomplished getting you fit then we can talk about more advance tactics like gamification, social sharing, and competition to see if any of these initiatives are in line with your personality… helping you move the needle even more.

4) I asked Gear Fisher this same question, and I would be interested to hear your answer: where do you think the balance between a platform’s utility and ability to be user friendly lie? Dealing with the unfortunate reality that in the world of fitness that positive outcomes are for the most part reliant on user compliance, is it sometimes necessary to compromise sophistication for usability?

We have some fundamental beliefs here at Zephyr. If you can present people’s data to them in an easy to understand way… they will get it, they’ll see the picture. Once they get it, the experience will be entertaining which assists one in making positive changes easier. The story I love to tell is the time I had a bioharness on my young daughter and I caught her playing with her breath so that she could see how it affected her ECG on our family’s computer monitor. I didn’t provoke her or encourage her… good devices when designed right foster this type of self discovery.

We use a ZephyrLife Score to give users an easy biometric gauge if that is something that works for them, other products have similar functionality. With a well designed product if you want to go deeper you have the ability to do that easily as well, it is about usability. Something like the ZephyrLife Score also lets people compare themselves against other groups whether that is other members of the same sex in their age group, their friends, or their cohorts at work is up to the way the campaign is set up. Regardless, of the specific set up it is all about letting people self educate in a way that is meaningful and specific to their goals and style of achieving goals. Technology should never smack someone in the forehead; usability is paramount.

5) Looking out at the landscape of mHealth and wearable devices with regards to biometric tracking, what do you think is going to be the next industry game changer?

I think it is three things, two are current and one is up and coming. The first, which is now, is that the option for insertion of biometric sensors in wearable items is plentiful. You can put them is a compression shirt, you can put them in a watch, people now have choices about what to wear and how to wear them, so that is happening now. There are even disposable devices entering the market for certain applications, so choice – moving beyond just a chest strap – that is exciting!

Second, accuracy is now a requirement. We are getting medical grade data now, so with the right algorithms you can get home from a workout and an alert is waiting for you that says, “This is not a diagnosis but your heart rate data suggests you might benefit from seeing a cardiologist,” and as such you are able to save lives with simply your own data. How cool is that?

The third thing is the way we will soon be handling the data. Frictionless sharing – using things like cellular transmitters – getting the biometric data to the Cloud will involve no effort on the user’s part… this is also very exciting. The data is there when the user is ready for it but it is always being collected. We are removing all of the hassle factors for the user, which will lead to better adoption and ultimately help this country get back on its feet again regarding their health.

Interview with Nadeem Kassam about Biometric Devices

Nadeem Kassam is a serial entrepreneur and investor who has been focusing on innovation in the health and wellness arena for over a decade. He is a Director at Zynik Capital and founder and Chief Alliance Officer for BASIS, a revolutionary new biometric device. Nadeem’s passion is to make wellness more socially appealing through technology and is a recognized thought leader in this space. If you are interested in learning more from Nadeem Kassam you can visit his blog at

Here are the 5 questions with Nadeem and his answers:

1) Biometric devices like heart rate monitors and accelerometers have been around since you began your journey into exploring health and wellness technology over a decade ago; what has changed in the last 12 months that has made biometric devices much more interesting than they have been in the last 12 years?

Technology is accelerating at an exponential rate, and so everything from batteries, to Bluetooth, to the smartphone ecosystem have become cheaper, faster, and smaller. Also, the space is heating up, from cool start-ups and new entrants like Jawbone, Nike+ and others, increased awareness and technical talent, and – very important – increased venture capital dollars are being allocated to our sector. We used to talk about “when” the mobile space would hit and now we are talking about how fast it is going to explode and then mature…

2) Biometric devices have not yet “crossed the chasm” but they seem to be getting close. In your opinion, what are the signs to look for that will indicate we are reaching the tipping point of mass adoption?

I really like that you’ve asked me “when” will mass adoption occur and not “if”. People like you know it is just assumed, I love that. The signs will come from the press, evident on the wrists of Middle America like the white earphones of the iPod, and when mass amounts of “consumer” health data actually begin to influence healthcare in this country.

3) Do you believe this market will ever consolidate in a similar fashion to digital audio devices and smart phones? Or is the assortment of data available from our bodies large enough that there will always be a need for a large number of biometric device manufacturer types to focus and specialize in specific areas of interest (e.g. weight, movement, blood glucose, blood pressure, heart rate, etc.).

It has been my vision for almost a decade that, “in the end there can only be one.” I don’t mean just one company standing, as I believe there is a lot of space in this huge industry for strong competitors. I mean, that at the end of the day, humans are only going to want one biometric device strapped to their body. I believe the wrist is the natural place for that device. This device will fit within an ecosystem of the smartphone, and the PC/TV, as these devices continue to learn how to interact with our bodies to give true meaning while entertaining us on the way to personal and social well-being.

4) Aside from your involvement with the BASIS device which is extremely exciting, what in the biometric space is on the horizon that excites you the most? In addition, where do you think the industry can do better?

The stuff that excites me the most, unfortunately, I really can’t talk about yet. But let’s just say that medical technology is advancing so fast, that invasive techniques are becoming more passive. But to give you an answer, I find it exciting that the day in which we have consumer devices that are truly medical grade, but possess a user experience that rivals Apple, is not that far away. I’m also very excited about the merger between mind and body and how new technologies will bring what has traditionally been known as ‘biofeedback’ into the mainstream.

It’s not so much what our industry could do better … We are still in the early stages and we are just figuring out collaborations between great companies. Awesome organizations have emerged like Rock Health to foster entrepreneurship in this space and Steve Krein’s StartUp Health program that has been set up to not only foster friendships and synergistic relationships in this industry, but also to help grow the industry as a whole. As a product of our industry’s lifecycle, we are working on what we can do better, and it’s exciting!

5) Borrowing from David Hansson, how do you plan to ‘put a dent in the universe’? When you are done leaving your footprint, how do you want to be remembered?

If there is one thing that I have learned from my father it is that you are never done, it only becomes grander, more enjoyable and relaxed as you get older. I want to be remembered as a great father, leader, and philanthropist to those that knew me, and as a radical spark of change for those who did not. I want to help make a powerful impact on health and wellness in the world and will use fun and entertainment to do just that.

Interview with Alex Gourley about Technology and Exercise

Alex Gourley is one of the co-founders of Active Theory, the company behind BitGym a mobile application that has been getting a lot of recent buzz including recent features in TechCrunch and VentureBeat. Alex studied computer science at the University of California, Davis and before founding Active Theory, held engineering positions at Loopt and Krugle. Alex is an enthusiast of both fitness and gaming so Active Theory provides an entrepreneurial outlet to create market solutions in both these areas of interest.

Here are my 5 questions with Alex and my summary of his answers:

1) One of the core value propositions behind your BitGym product line is to provide an exercise option to those that aren’t necessarily interested in traditional fitness. When was that “ah ha” moment that you were on to something (i.e. you had the solution to a problem)?

The initial idea to combine proper video games with exercise was first conceived during a conversation with a friend. Wanting to test it out as soon as possible and see what people thought, I had several of my nerdy and non-athletic friends over to my house. I had set up an exercise bike with a bunch of wires hanging off it leading to an Xbox 360 controller which itself was wirelessly connected to a racing game running on the screen in front of them. I told them their speed of their pedaling would accelerate the car and to steer they would simply use the controller like normal.

They all had a blast and were sweating in an uncharacteristic way. That’s when I first knew I was on to something. Of course, my bike sensor didn’t actually work yet. Unbeknownst to my friends I had run some wires to a hand-held knob which was controlling the acceleration. As they sped up I would simply turn the nob a bit to match their effort. Active Theory has been a lean start-up from the very beginning!

2) It can be argued that some of the success of your technology relies on the content and engagement of the games you provide. Game play and game environments tend to uniquely match up to certain player attributes such as: gender, personality, and other psychographic characteristics. This is a problem that is outside the realm of designing for the general fitness user. What is your strategy to work with content owners and game developers to maximize your reach in the fitness market?

Our approach is to learn by observing the video game industry. One thing we know by watching Nintendo is that there are certain aesthetics and game play concepts that have wide appeal. For example the Zelda series has universal appeal among gamers and the Wii Sports series has universal appeal to, well, humans. The games we produce in-house will follow this tradition of non-offensive aesthetics and a focus on accessible game play.

We also observe that if you have a user base willing to pay money there are always game developers willing to create experiences for them. We see it as our job to get people excited about the idea of exercise video games while establishing that they will cost more than regular iPhone/iPad games. If we can accomplish those two things we can foster an ecosystem of developers working to build exercise game experiences for all types of people.

3) The United States Surgeon General and the Office of the National Coordinator for Health Information Technology have challenged technology developers to build apps that “empower users to engage in and enjoy healthy behavior” (United States Surgeon General’s Healthy Apps Challenge). You have uniquely positioned your company to influence non-fitness enthusiasts into a healthier lifestyle through mobile devices. Through the point of view of Active Theory’s market vantage point, what role do you think mobile devices will play in helping people get healthier?

First of all I view these app challenges with skepticism. Building the app and winning the contest based on app quality and adherence to the contest rules is only step one. Actually getting it into people’s hands and getting people to use it – that’s the real challenge. However with that said, mobile devices (mobile phones and the coming wave of smart wearable technology) are clearly poised to bring about significant change in people’s health.

But specifically in diet and fitness, we’re not quite there yet. I would argue that right now what we have is only iteratively better than the analog tools we’ve had in the past. How many apps are simply replacements for a workout notebook, workout tapes, or a meal diary? These only help the people those analog tools would have helped… those with enough willpower to deploy the tools.

Unwilling or occasionally unwilling participants (most people) still find no help from diet/fitness apps and devices. But that will change soon. The next generation of mobile technology will be full of trickery – exploiting our impulses instead of trying to suppress them. And it will be very powerful.

4) Conceding that it requires critical mass first, how far do you think you’re away from the ability to offer a MMOG (massively multiplayer online game) version of one of your fitness games? For instance, is it in the realm of possibility to offer a virtual 10K race, or maybe even a virtual marathon, in the future?

Taking the analog concept of a marathon and making it digital is something we’ve kicked around a lot at BitGym. But before copying a thing you have to know the true essence of a thing. The essence of a marathon isn’t thousands of people running in the same place at the same time – the essence of a marathon is a hard schedule of self imposed training followed by a dated and well-understood certification of accomplishment.

So then let’s paint a picture of what a virtual marathon should have. It should have a concept of persistent identity. It should have schedule of challenging fitness tasks to accomplish. It should have a set end date (perhaps one every three months) so that people can experience it in sync with participating friends. It should have a standardized certification of achievement. All of this will be possible in BitGym mid to late 2012.

5) In building a platform to inspire people to workout, what is one thing you have learned about fitness in the process that you did not know before you started (that you wish you had)?

I wish that when I started I had a deeper appreciation for the difference between a fun cardiovascular experience and a sticky cardiovascular experience. From the day of my first Xbox prototype we knew how to make an exercise machine fun. But fun isn’t enough, and I know now we still have a lot of work on the behavior modification part of our product before we’ll really convert non-exercisers into exercisers.

Interview with Dr. Liz Applegate about Nutrition

Dr. Liz Applegate is an author, consultant, and respected expert in the area of nutrition and fitness. She has authored six books in the field including Nutrition Basics for Better Health & Performance, Eat Smart Play Hard, Bounce Your Body Beautiful and Encyclopedia of Sports and Fitness Nutrition. She is a column writer for Runner’s World magazine and is also on the faculty at the University of California, Davis, where she teaches courses in nutrition. Dr. Applegate has worked with a wide range of competitors from professional sports teams to USA Olympic athletes. She is a Fellow of the American College of Sports Medicine and her prestige in the field has made her a sought out keynote speaker at nutrition and fitness conferences, forums, and seminars.

Here are the 5 questions with Dr. Applegate and my summary of her answers:

1) What are some good glycogen boosters for endurance athletes? And is it true with respect to glycogen boosters that effectiveness, regarding both type and dosage, is going to vary amongst different people?

People underestimate the power of training and what that does in terms of muscle adaptation. So rather than discussing a particular supplement or food, let’s look at the body’s adaptation to exercise. Adaptation to exercise is dramatic adaptation – changes in different proteins occur, we increase our ability to store glycogen – all as a result of endurance training.

Also, there isn’t a consensus on the right way to influence glycogen efficiency. There are carbohydrate recovery products made for the purpose of promoting glycogen resynthesis and recovery. There is also another camp of researchers with fairly substantial evidence regarding the notion of “training low”. This means maintaining a low carbohydrate diet and training twice in a day, so that during training sessions you are exercising in a carbohydrate deficit. There is evidence that shows that one’s muscles respond and adapt with increased mitochondria and aerobic capacity in this state even better than those that maintain a carbohydrate rich diet during training. Talk to someone like Dr. Ed Howley, and he’ll tell you not to worry about carbohydrates and to, “train low, and compete high.”

My approach is to look at the athlete’s history and ask questions like, “How many hours are they training? What’s their mileage? What is the time spent doing aerobic exercise?” I then examine what their typical training diet consists of, how they are responding to their diet, and then make a judgment on what I see fit for them to change. I am not a proponent of a one-size-fits-all plan. With many of the athletes I see, the discipline is usually there with regards to strict regimen adherence and control, but they come to me a mess because the particular system that they prescribed themselves to does not work for them. This has a negative psychological and physiological impact, and as such their training sessions are not as productive. By the time they get to their event they are so beat up that they end up not doing very well.

So I start by looking at the hours one spends training, and come up with a formula to baseline carbohydrate intake and go from there. I am not a supplement person. In my opinion, the best legal ergogenic aid is caffeine. That aside, one has to eat real foods. I’m dealing with 20 year olds that want to take a supplement approach to their diet. So given this case I will probably, in reality, weed supplements out and replace them with real foods. So to truly answer your question when looking for “glycogen boosters” I will look at what carbohydrate foods a person likes, what foods they are missing in terms of micronutrients and phytonutrients that may be beneficial for muscle recovery and anti-inflammatory response, and I will try to implement those foods into their diet until I am satisfied with the carbohydrate availability based on the feedback and response to these changes.

2) Is the latest research on DNA dieting more hype than science (

In general terms, these findings are very intriguing. I don’t know when it is going to happen, but in broad futurist terms I do think there is some appropriateness to the idea, and we are already seeing it in the most basic of recommendations. The United States Dietary Guidelines basically speak to a range of intakes that are meant to help prevent chronic diseases such as diabetes and heart disease. Again, there isn’t a one-size-fits-all diet and it is good we are recognizing that.

Should I sit down with a 28 year old who is now done with their cross-country career, their focus isn’t joining a national team, but they are still an avid elite runner… would I recommend this person go get their cheek swabbed? No, probably not, there just isn’t enough evidence yet. I think they, at least from what we know now and the current costs of these tests, are better off sticking with the diet that has gotten them this far and tweaking it where appropriate.

But I’m holding the hope that we’re going to be there soon. I was just at the Olympic Training Center earlier this week, and while they are not doing genetic testing on these athletes they certainly are doing very specific diet counseling based on that athlete’s sport. Periodization is being looked at not only in regards to training but with one’s diet now as well. In other words, where is the athlete in their training schedule? For example, if they are in the pre-competition stage or in the competition stage of a 52 week cycle, I would ask, “how many weeks do they have away from their sport? How many weeks will they have in competition? How many for preparation and training?” And then you periodize their diet based on those demands… again, for any given athlete there isn’t a one-size-fits-all plan. So our field is already highly customizing athlete’s diets, just not based on a DNA test yet… because we just don’t have the research to back up that method.

However, there is a lot here. And to answer your question, I don’t think it is more hype than science. I mean we’re always looking for the next great thing. There’s very intriguing science to back up the method… but as it relates to both sport performance and chronic diseases we simply have more to learn… and there’s more to come.

3) Does creatine supplementation provide any benefit to endurance athletes? And what is the deal about avoiding caffeine when supplementing with creatine, is there a valid concern?

To answer the first question, does creatine supplementation provide any benefit to endurance athletes, my answer to that is no. A majority of the research shows that it doesn’t support endurance performance and can be detrimental, even for athletes that might be anaerobic competitors (ex. swimmers) but train in an endurance format. For an endurance athlete you have to consider the weight gain and muscle hypertrophy that creatine promotes, and that’s not optimal for a lot of endurance athletes. I can tell you of the athletes I have seen, that have come in and come out of creatine supplementation, usually in the end they don’t really want to have anything to do with creatine.

Now, for some athletes, such as shorter distance track athletes at the 400 to 800 meter range, there are certainly some potential benefits there. However, you have to deal with the modification in body weight and what the implication is for a runner at that level.

In my experience, people that really track improvements see better results by asking questions like… how well do I sleep, how good is my training program, how consistent am I with my eating, and what diet works best for me… rather than looking to creatine or glutamine or any of these other type of things. So what I see is that the people who get into a supplement get right back out and realize it’s more the day to day consistency that fosters results.

Regarding your question about caffeine and creatine, actually when you look at the research, caffeine supplementation combined with creatine actually enhances anaerobic performance. I appreciate your question, and the fact that people try their best to fine-tune their effort but if an athlete came to me, that was a strength training athlete, and she or he was taking creatine would I suggest avoiding caffeine? No, I would not.

4) Can l-glutamine be effective at raising one’s growth hormone levels (

In the mid-90s there was more of a push with glutamine in that regard, if you look at the research now it is really relating glutamine to possibly being an immune boosting amino acid. So to your question… do I view it as an effective growth hormone stimulant… my answer is no. That is not how athletes are using it these days. I remember going through that research a number of years ago but today glutamine just is not talked about in terms of performance boosting, but rather its effect on immune health.

Weight bearing exercise is a better option than supplementation. Take a look at the author Dr. Keith Baar. He is from UC Davis as well. He is a molecular biologist that looks at protein synthesis within the muscle and the factors that stimulate it in terms of nutrient timing, particularly with amino acids. If anything, the amino acid that people should be focusing on is glycine as far as enhancing and remasking. It has been shown repeatedly that one can get greater lean mass gains if, after exercise, they ingest a dose of protein which includes glycine – because glycine enhances the availability of protein in the body.

So I look at the glutamine story as more of an issue of immune health and the glycine story as directly impacting protein synthesis within the muscle fiber. So those readers interested in your question might want to look at the possible benefits of glycine instead.

5) Beer drinkers like me rejoiced after hearing that beer might be better than water after a race (,2933,307518,00.html). In 2007, however after learning a little bit since then I’m under the impression your best bet is always to try and get a carboprotein drink in right after a race. If alcohol retards glycogen uptake, should someone looking to recover from an endurance event wait awhile before grabbing a celebratory beer?

In June, I actually spoke to the researchers of a more recent publication on the subject (than the one you cited), their article is titled Non-Alcoholic Beer Reduces Inflammation and Incidence of Respiratory Tract Illness. Their participants drank a fair quantity, about a liter and a half every day, which you know… if you ask a person to do that, that’s a commitment! Of course it was non-alcoholic beer in the study and the concept was to look if the phenols and other compounds in beer are potentially beneficial in one’s immune response. What these researchers chose to look at was the immune response following the Munich Marathon. Lots of runners get sick following a big effort like a marathon, and in this study fewer of the runners got sick on the beer protocol than the control group. So the story is, okay who’s going to drink a liter and a half of non-alcoholic beer? Certainly not me. So I don’t know if today we can translate the findings to regular beer. Especially considering that while alcohol is metabolized in the liver it can impair glycogen resynthesis, particularly after an overnight fast. So when you look at when beer is typically consumed, later in the day, this could be problematic for somebody who might be working out in the morning who really does want to have a good workout. One might say, “Oh I’ll drink beer and go glycogen depleted during my 10 mile run”. Well, there is a possibility you may be OK, but there is a chance you may feel so lousy during that 10 mile run that you train at a slower pace and the whole training benefit is impaired… it becomes a Catch 22.

To answer your question direct, if your goal is to optimize recovery so that you can workout the next day my answer would be a carbohydrate protein drink over beer. But if your goal is a set lifestyle – i.e. I’m doing these runs to be social as well as to be healthy – I would say pick the beer because we can’t be so concerned with every detail a hundred percent of the time. If you’ve trained hard then it’s fine to celebrate, but if you’re going to train the next day you want the product that’s going to offer you the nutrients that you need for recovery… plain and simple.

Interview with Ellen Burton about Exercise is Medicine

Ellen Burton graduated from Boston University with a master’s degree in public health and is a Certified Health Education Specialist. She has a lengthy history in health and wellness with prior engagements that include serving as the Director of the Money Follows the Person Program with the Indiana State Division of Aging, as well as the Director of the Maryland Association of County Health Officers with the Johns Hopkins Bloomberg School of Public Health. She is currently the Program Officer for Exercise is Medicine®, a multi-organizational initiative coordinated by the American College of Sports Medicine.

Here are my 5 questions with Ellen and my summary of her answers:

1) The current chair of Exercise is Medicine® Dr. Robert Sallis stated, “Regular physical activity, at the correct intensity, is so powerful in maintaining and improving health that it should be prescribed, just as a medicine or drug would be.” It is quite clear that empirical evidence backs this up. The government has recently come out with ChooseMyPlate to help influence dietary choices and Let’s Move! to help influence children to increase their physical activity. These are primarily passive programs. Why is it important that your doctor or primary medical provider take an active role in your fitness regimen?

There is a significant amount of research indicating that people who discuss exercise with their health care provider as an important part of their overall health and wellness are more likely to start routine physical activity. Exercise is Medicine rolls this into an actual prescription because getting and filling a doctor’s prescription is a familiar process for people. There are numerous studies indicating that people tend to engage and adhere to prescriptive exercise compared to self-started programs (Decision Making Versus Decision Implementation: An Action Control Approach to Exercise Adoption and Adherence), so empowering doctors to use the prescription referral process to assign exercise makes sense.

As you highlighted in the quote from Dr. Sallis, there is significant scientific data that shows one of the best ways to prevent and treat disease is to get at least 150 minutes of moderate-intensity physical activity each week. Our aim at Exercise is Medicine is to make this powerful concept a part of every discussion about health and well-being. With that in mind, it becomes essential that your doctor or primary medical provider plays an active role.

2) One of the many important areas that Exercise is Medicine is focusing on is benefit reimbursements and legislation initiatives related to health improvements through exercise. There are inflation-adjusted per capita health savings estimates as high as $544 per year (Costs and Benefits of Bicycling Investments in Portland, Oregon) for individuals that exercise regularly. Are there any ideas being executed that use this economic incentive to help with patient adherence?

It’s widely known that disease treatment is also an economic concern. As you’ve said, there are numerous studies that point to the economic benefit of disease prevention. We like to couple the discussion of physical activity with the discussion of fiscal responsibility. We are fortunate to live in a time where one’s life expectancy continues to increase. However, per capita health expenses continue to increase as well, and medical entitlements are a consistent part of the debate over national budget reform. We are working to influence national policy based on the evidence that exercise can reduce the cost of disease. We are also working with insurance companies and other health care associations to encourage referral reimbursements. This effort involves including exercise as part of one’s documented medical history, and we are seeing it documented more in people’s electronic medical records (EMRs). There are no pass-throughs yet (that reach the patient) in terms of economic gain, with the notable exception that the data shows they are likely to spend less on medical care in their lifetime if they adhere to the established federally mandated exercise guidelines.

3) With regard to the established federally mandated exercise guidelines, within the current Exercise is Medicine fact sheet it is stated that four out of every ten U.S. primary care doctors, and more than one third of U.S. medical students are failing to meet the minimum requirements. Further, physically inactive doctors are less likely to provide exercise counseling to patients and provide less credible role models for the adoption of healthy behaviors. What strategies are being used to help doctors understand that physical activity (at the right intensity) is a valuable prescription, for themselves and their patients?

We are employing several different strategies to improve these statistics. Our website features the Exercise is Medicine Health Care Providers’ Action Guide and also provide supplemental materials to tell physicians and health care providers about the evidence supporting exercise prescription. We also have developed strategic partnerships with health advocacy groups, such as The Institute of Lifestyle Medicine, who create training courses for health care providers and physicians.

We are also working to ensure that exercise education becomes part of the standardized curriculum at medical schools. Reaching doctors before they begin practicing is one of the most effective approaches to improving these statistics. It is critically important that doctors understand that they are role models and their behavior is proven to have an impact on patient outcomes. Therefore, it is important that doctors understand the role exercise plays in preventative medicine.

4) Exercise is Medicine’s approach seems to be focusing their effort on establishing a connection between medical practitioners and their patients. In an era where some people are choosing to have more personal influence over their own health care, are there strategies in place to help provide influential advice through information channels that cater to this segment of the population (ex. WebMD, Healthline, Wikipedia, etc.)?

We understand you do not need to talk with your doctor to know walking is good for you. Our focus at Exercise is Medicine is incorporating the idea that exercise is a medicinal tool, which needs to be properly addressed with health care providers and their patients. It is something that should start with the doctor, potentially get passed along to the engaged health-and-fitness professional, and ultimately adhered to by the patients themselves. We are quite aware that, for instance in pharmaceutical sales, direct-to-consumer marketing can influence patient behavior. To the extent that we can pass along information to consumers about the benefits of exercise, we will do that. Our overarching goal for all audiences is to make physical activity an integral part of every discussion about the prevention and treatment of disease.

5) With innovations such as FitBit, BodyBugg, and BodyMedia there are ways of tracking physical activity and progress through technology, in turn providing positive feedback loops that can assist with patient adherence. To what extent do you see the importance of technology playing a role in achieving Exercise is Medicine’s mission?

We are always exploring ways to use technology effectively. We have partnered with Interactive Health Partners of PCE Fitness to create technology that improves the way patients connect with doctors and health care providers. The software lets doctors risk-stratify patients by determining their activity levels, and it assists them in providing personalized exercise prescriptions that are medically precise. It will also help doctors in the next step of the referral process by giving them access to a database of qualified health-and-fitness professionals. If the prescription can be self-monitored by the patient, the software will enable patients to log exercise results and track outcomes and other valuable metrics.

We are also currently redesigning our own website, which includes several micro-sites. There will be behavioral tools, ways to track physical activity online, and other applications to help users create positive feedback loops.

It is important to note however, that as great as technology is, not everyone has access to it or the inclination to use it. For many families, the gym, Internet service, and unfortunately even medical care, might be cost-prohibitive. We are cognizant that if we rely on technology too heavily, we could potentially exclude a segment of the population. In that regard, we are careful to make sure that we include initiatives that can cast the widest net and help everyone.

Interview with Margaret Moore about Wellness Coaching

Margaret Moore (also known as Coach Meg) has established herself in the world of prevention, health and well-being by founding Wellcoaches Corporation. Wellcoaches is widely known for setting the gold standard for training and credentialing of professional wellness and health coaches, and trains more than 1000 coaches per year. Margaret is also the co-director of the Institute of Coaching at McLean Hospital/Harvard Medical School and its annual coaching conference. Furthermore, she is a founding adviser for the Institute of Lifestyle Medicine at Harvard Medical School which was the result of her collaboration with Edward Phillips, MD, to build a Harvard CME course that teaches basic coaching skills to physicians.

Here are my 5 questions with Margaret and her answers:

1) There still seems to be some confusion about what a “coach” actually is, and is not. There are different types of coaches, and within these segments varying levels of expertise. With that in mind, when someone decides they desire a wellness coach what are the right questions to ask in the hope of optimizing the chance of a successful engagement?
There are really four things you want to ask when looking to engage a coach:

1) What expertise and knowledge does a coach have relative to your particular interest?

2) What coach training and credentialing does s/he have? What have they learned, and what is their philosophical view of coaching? In other words, do you like the story they tell about what they do and how they’ve helped other clients? Does it resonate with you? Does it sound like it’s something that would work for you? Coaches vary widely in their personalities, their training and education, expertise, and their ability to engage and help people go beyond what they think is possible. So you have to get a sense of what your coach does and where they are coming from. In short, ask yourself, “Does their approach sound like something that would work for me?”

3) Ask them about their life experience. What else have they done in their education and career? Coaches have interesting and diverse backgrounds, and their stories may inspire you as well. You want someone that’s going to be energizing, and a role model. Someone full of ideas, full of positivity, zest, and things that will energize you. When you get through all of the above, at this point it really goes to your gut feel, leading to…

4) Does this seem like the right match for me? You really should feel a little excitement when you are introduced. You mind should be saying, “My gosh, this person can help me, this is cool!” Coaches, generally, in initial conversations move immediately into a coaching mode. They ask interesting questions; they try to understand what you are looking for; they try to get into a dialogue that feels more like it’s a coaching interaction – they shouldn’t be trying to sell you. If there’s a hard sell then it’s not coaching. If you find your energy going up in the initial conversation and you are getting excited about the proposition of working with this coach there is promise that it will a good fit. When you make contact with a coach and the chemistry does not feel right, keep looking.

Last, ask for references and talk to them. Coaching is like most helping professional services, the best coaches attract referrals.

2) Is there any pre-work or preparation you can do to get ready to be coached and enrich the experience for both yourself and the coach?

That’s an interesting question. Before you find a coach, no, not necessarily. If a coach has a website s/he may have things available to read. Do a little playing around on the Web to find out what coaches do. Most coaches have a body of homework and assignments to augment their coaching, and if you want more than is being offered it is just a matter of asking. We’ve all got plenty of tools for people to think about themselves and help them along. It is not always immediately offered, because the truth is some people will do homework and others won’t. And so we have plenty of homework that could be done if you’re really interested… again, it is usually just a matter of asking. I personally have a set of pre-coaching questions you can ask your spouse, your friends, and/or colleagues, which help you bring yourself into the experience and help you think about where you are going.

As for reading materials, if you have the appetite to read books, ask for recommendations for books that might be appropriate given your situation. You like reading articles and blogs better? The Web is rich with information. I share my blogs with potential clients at and I often give my clients a book or a DVD, something that is relevant for them. Clients that want to develop mental processes and are ready to really expand their knowledge are great to work with. The journey is much more fulfilling (for them and the coach) if they are learning and exploring, in addition to pursuing their goals, in between coaching sessions.

3) What are some important success measures a client should have to gauge their progress? And what is an appropriate tracking mechanism and frequency to evaluate progress?

That’s something that you really want to build into the coaching process and a good coach will help you imagine what your better future looks like: visualize it, put it into words, and figure out how to measure success. A great coaching question is: how will you know when you get there? Is it you want more life balance, you want more energy, you want more vitality or zest… what is it that you want more of? Furthermore, what will success look like and how will you know when you get there? Some things you can measure with numbers. You can measure your blood pressure, you can measure your waist size and body fat percentage…. However, a lot of things that people desire are subjective. Therefore we need to create scales to quantify things that are not easy to quantify. Asking questions like, “What is your energy level today out of 10, if 10 is the peak? …that being the case, where are you right now?”

I remember working with a client with fibromyalgia. When we started a coaching program she rated her energy level as a 3. Three months later she rated it as a 7. We parsed it out a bit because it turned out that her mental energy and her physical energy were different numbers. We were able to get her mental energy up to a 7 and her physical energy got up to a 5. We recorded our sessions and that allowed both of us to follow the change of energy in her voice. That was very meaningful for her because the transformation was objective. Sometimes it is easy to forget the 3 when you’re at the 7. In fact, you actually do forget that you’re in a new place. It is rather easy to lose track of how far you’ve come. So using a ruler or scale like that is a nice way to capture something that is hard to quantify. It gives you a sense of “gosh, I’ve really changed here for the better, this is different than what it was!”

4) How is the current innovation happening in positive psychology influencing wellness coaching?

Positive psychology is central to wellness. The latest research in Positive Psychology concludes that 80% of us aren’t flourishing. This means only 20% of adults are flourishing and now we know the main ingredients. We actually know what drives flourishing and can measure it via the Positivity Ratio. In fact, the wonderful thing about the Positivity Ratio is that it’s a number that can be measured over time as one works on increasing positivity. Not that it’s easy to develop positive emotion habits, but if you work at it, like any new habit your brain will change and you can shift to a more positive frame of mind more often. You can savor more; you can connect to your purpose more; you can be more mindful and appreciative in your relationships; you can empower yourself to get more out of your connections every day. You can stop and enjoy your coffee in the morning instead of spilling it on the carpet because you’re rushing around. You can relish the things that make you thrive.

I’ve always viewed wellness coaches as the army of agents to really deliver on the scientific mechanisms of flourishing in the world. Also, I’ve envisioned wellness coaches as unique in tackling both physical and mental issues together. Let’s move mental flourishing out into the open, from behind the therapy door, to help lots of people create a more positive future including resilience, confidence, purpose and all those type of things. Let’s make flourishing a focus of coaching to change the world.

Optimizing physical and mental health together, wouldn’t it be amazing how our paradigm would change? I think that cognitive psychology has provided a scientific framework for coaching. It provides the basis for understanding where people can take their minds. When it comes to emotional flourishing, –everybody’s got their own recipe for purpose, strengths, flow, relationships, flourishing, and positivity. Once you understand in yourself what makes you thrive, what are the main wellsprings that make you feel good every day, what are the main toxic things that drag you down… once you really have a command of these things, you can make some real progress because now you have clarity about where you want to go.

5) You are currently heavily involved in translating science and research into coaching practice at Wellcoaches and the Institute of Coaching at McLean Hospital/Harvard Medical School. Why is this important?

Like a subject out of Malcolm Gladwell’s Outliers, I am a person who was at the right place, at the right time, with the right talent, who put in the 10,000 hours, and in that journey helped to build a robust scientific foundation for coaching in health and wellness. My legacy will probably be, at least one piece anyway, the polishing and translating of theory, theoretical concepts and evidence – bridging the science and the practice of coaching. My colleagues and I are innovators as well as translators of important theoretical, evidence based concepts into practice.

I started Wellcoaches 10 years ago and this year we’ll hit 5,000 coaches trained in ~33 countries. My hope is that we find a way to produce a master’s degree in coaching in the not so distant future and then maybe before I’m done there will even be a PhD. Wellcoaches is where I started, and from there I was looking enthusiastically for an academic home for coaching (because it is an important step in order to further credibility). So what came out of teamwork to create a new theory for coaching, which we call relational flow, was collaboration with Carol Kauffman at McLean Hospital. Dr. Kauffman is a professor at Harvard Medical School, a psychologist at McLean for ~30 years, and she and I started what is now the Institute of Coaching with a $2M dollar philanthropic donation by The Harnisch Foundation to give out coaching research grants. And we’re just about to launch the Institute of Coaching Professional Association, which has an amazing rich set of resources for leadership, health and wellness, and positive psychology coaches… where we are really translating science into practice for the masses. We are fostering coaching research and fostering re-education around the science of coaching.

Most recently I helped to start a national team to build a national certification and training and education standards a for health and wellness coaches. This effort is now 80 organizations strong. We hope to have a national certification board in the not so distant future. We are on the move to create a scientific foundation, robust training and education programs that produce masterful coaches. Then the research, curriculum, and standards will become global accepted. That is probably 10 years for now, which will be 20 years in the coaching game for me by then. Before I am done we’ll have established the professional health and wellness coach as an accepted part of the healthcare and consumer wellness landscape.

Interview with Thom Gilligan about Destination Marathons

Thom Gilligan is the president and founder of Marathon Tours and is a premier player in the endurance and adventure travel industry. He has been distinguished as the top specialist in running-related travel by Condé Nast Traveler magazine for many years. He has also been featured in The Wall Street Journal, Runner’s World, and made the cover of Travel Agent magazine. He is the former president of the Greater Boston Track Club and has personally run over 60 marathons.

Here are my 5 questions with Thom and his answers:

1) Even though you are considered a top player in endurance travel, you have decided to primarily focus on destination marathons. Why marathons?

I began endurance travel in the late 1970s and a lot has changed since then. The marathon used to be an endurance competition but it has evolved into a lifestyle activity… if not a phenomenon. This evolution/revolution means that, as a lifestyle choice, people now organize their leisure time around marathon training. It has also become a social activity and a very popular way to stay healthy. We tried organizing travel for triathletes in the 80s but ultimately the dynamics weren’t right.

What Marathon Tours does exceptionally well is blend the thrill of destination travel with the fulfillment of marathon racing. In a unique sort of way it inspires people to travel to places they might not otherwise. Intrigued by the face shaped statues and rich mysterious history of Easter Island one might have a yearning to visit, but couple that with a compelling race – The Easter Island Marathon – and now you tie in reason (the event) along with that desire. Or maybe someone has always wanted to go on a safari but needed an event to act as a tipping point to commit – in that instance a race like Safaricom is an excellent choice. Adding a great event to an exotic destination is a powerful motivator. We do our best to ensure that our travelers maximize their experience regarding both the destination and the event, which has helped us with our continued success in this space.

2) Many people come to you with various hopes and dreams. For instance, in 2005 I personally witnessed William Tan try to become the first wheelchair participant to complete the Antarctica Marathon and unfortunately he was unable to finish his goal due to circumstances outside of anyone’s control. In your business acts of nature and other unforeseen circumstances are going to happen, how do you help people cope when circumstances end up foiling long, hard-fought goals?

Most people seek out adventure because risk is part of the attraction. Runners are Type A people for the most part. In the case of Dr. Tan, we knew it would be a tough challenge but he asked us to let him try, and after consideration we let him try. Actually we let him try twice and ultimately the environment in Antarctica is just too prohibitive for wheelchairs (even well-equipped wheelchairs).

The downside is there are no guarantees. That is the risk. Especially with destination races, you never know what conditions you are going to get, what might happen between leaving Point A and getting to Point B, and how your body will react to the new environment. Ironically, that is the appeal as well. Runners like to tell stories and contingencies, acts of nature and other unforeseen circumstances help create the dynamics of their personal story regarding a particular event.

3) Reminiscing on all the fitness adventures you have had and/or orchestrated and made possible, what is your favorite war story?

I’m not sure if it is my favorite story, but certainly the most infamous story is when we had to facilitate the Antarctica Marathon on the deck of a ship. Organizing a race in Antarctica (as you can imagine) brings with it a whole set of unique challenges, which consequently makes it the coolest race on earth. In 2001, we set forth for Antarctica on the Lyubov Orlova, which is important because it is the first time up to that point that we had a ship that had a deck that one could completely jog around. Weather conditions that year made it impossible for us to get Zodiacs over to race on land. We had to get resourceful due to these unforeseen circumstances, so we measured out how many laps it would take to complete a marathon on the ship (it ended up being 422 laps) and over a hundred runners were able to complete the challenge. As a result, they became part of history as the first runners to ever run a marathon on a ship. That year this became part of their particular story.

4) Since you organize and facilitate the marathon experience for so many people you must observe the positive and negative consequences of runner preparation. What is something that you see people do right that helps ensure a positive experience? What is something you see people do (or maybe not do) that is likely to contribute to a negative experience?

When I began running marathons the common goal of most runners was to qualify for Boston. Now the common goal shared by a majority of runners is to finish. Running went through an evolution, but now we are seeing more of a revolution. There is a new class of runner that is not worried about their finish time at all. This is okay. However, I believe the marathon experience can be enhanced by setting a personal time goal. This can be specifically unique to the individual, so I am not suggesting that everyone needs to try and qualify for Boston. The goal should be realistic, and since we have been talking about destination races, it is important to mention that they should be specific to the race itself as well. They should also be realistic given the individual’s skill and conditioning. With all that said, I believe that a realistic time goal adds to the experience of a race.

Again regarding destination races, I see people not honor the fact that travel is a fatigue inducing activity. They will fly to a foreign country less than 24 hours before a race assuming that they do not need to acclimate to a new environment. It takes time to recover from jet lag and it takes time to adjust to new time zones. When people don’t give themselves enough time to settle into new conditions it negatively affects performance, which ultimately will influence the level of satisfaction they experience from a particular event.

5) What are three pieces of good advice you can give to a new marathoner with regards to their first destination marathon?

1) Always carry your race day gear (including your shoes) in your carry-on luggage.
2) Traveling by airplane is dehydrating, so always drink extra water during and after long flights.
3) There are a lot of unknowns when running in a new destination: road conditions, weather and climate, course amenities, etc. Accordingly, temper how you measure your race day satisfaction. In other words, don’t go to the Antarctica Marathon in the hopes of setting a new personal marathon best. Set reasonable expectations, relish the challenges as a part of the process, and give the event your best effort.

Lastly, as a standard rule of thumb regarding any marathon, don’t try and/or test something new on race day. For example, if you want to experiment with local cuisine, perhaps it is best to wait until a day after the race to roll the dice. Race smart and you increase the probability of ensuring yourself an enjoyable experience.

Interview with Brodie Burris about Acupuncture and Sport Injury

Brodie Burris is the President of the Michigan Association of Oriental Medicine, the Founder of The Lotus Center of Ann Arbor, and a standing member of the American Association of Acupuncture & Oriental Medicine. He is a seasoned acupuncturist, herbalist, and is renowned for his work in the field of Eastern Medicine.

Here are my 5 questions with Brodie and his answers:

1a)In your point of view, what is acupuncture’s place in the sphere of sport medicine?
I believe acupuncture has a significant role in sport medicine, yet unfortunately it is currently being under utilized as a therapy. More often than not, athletes respond especially well to acupunctural treatments. Athletes tend to be full of vigor and in tune with their body, which helps with the response to treatment and makes acupuncture a very effective way to treat sports injuries. Regarding acute sport injury, acupuncturists have specific techniques and methods to decrease recovery time and reduce pain.

1b) What are the benefits of acupuncture beyond the treatment of sport injury?

There are quite a few actually:

  • Increases blood flow
  • Relaxes muscle tissue
  • Reduces cramping due to fatigue
  • Alleviates distorted energy and increases Qi
  • Accelerates the removal of metabolic waste and improves metabolism
  • Increases stamina
  • Helps with stress management
  • Lowers the body’s pain response
  • Increases one’s ability to concentrate, which can also assist dexterity

…and this is a short list of potential benefits. Through acupuncture we can stimulate the muscles, accelerate healing by assisting the body to remove noxious elements, and increase stamina and recovery by increasing one’s natural ability to provide nutrients to tissue. These benefits of acupuncture make it ideal for athletes in a number of different situations and applications.

2) What is the most common misconception you hear about acupuncture treatment that you would like to dispel?

One misconception is that acupuncturists use tons of needles per treatment. Photographers who want to capture interesting photographs of acupuncture in practice will tend to publish photos that are interesting to look at. However, these photos usually do not represent an accurate picture of a normal treatment. Rather, the average person can expect to have somewhere between 10 to 20 needles placed throughout their body in any given treatment.

Acupuncture is not without sensation, but for the most part it should be enjoyable, relaxing, and comfortable. It is known with Traditional Chinese Medicine that your Qi cycles about every 20 minutes. Therapies therefore will generally last between 20 to 60 minutes to give enough time for full cycles of Qi to take place.

3) If seeing an acupuncturist makes sense, what questions should one ask to help ensure they are choosing the right acupuncturist?

  • Confirm they have a degree from a reputable school
  • Confirm they have passed their National Boards
  • Ask how many years of practical experience they’ve had, and then ask yourself if you are comfortable with their level of experience

Acupuncture is a very interactive therapy, and outcomes can be tied to the working relationship you have with your acupuncturist. If you don’t feel that your situation has improved after 4 to 6 sessions seek out another acupuncturist. Results benefit from a good working relationship. If this relationship isn’t established, it behooves one to try another acupuncturist to try to improve upon the results.

4) Discuss an example of success where you believe Eastern Medicine served an athlete better than Western Medicine would have.

As a practitioner this is a fairly easy question to answer because by and large, in Western Society, people do not come to an acupuncturist first. A good portion of clients will come in when Western Medicine has already failed them, so I have numerous examples. Left to its own devices, our bodies will eventually heal from most ailments on their own. The object of medicinal intervention then is to assist this process and speed it along. The first responder to an athletic injury more times than not will be a trainer or physical therapist who will run down the checklist of what they believe to be appropriate treatments: rest, ice, compression, elevate, etc.

These are very useful treatments, but are not augmenting the body’s natural processes. I usually get patients after all these interventions have failed to produce an acceptable result. In 50 to 70 percent of the cases I see I can significantly improve the patient’s current condition. However, because acupuncture is still a bit misunderstood in Western society these successes can occasionally lead to complications for me and the patient as well. For example, I had a young female softball player come in with a rotary cuff injury so severe she could barely move her shoulder. Her range of motion was extremely limited when she came in and after three treatments she was practically mobile again (it should be noted that this was not necessarily a common result). It is important to remember however that like most Western treatments for sport injury, acupuncture simply assists the body to heal… albeit sometimes in miraculous ways. When extremely positive results are achieved quickly with acupuncture patients sometimes forget that acupuncture, like many other treatments, is a process and not an overnight miracle cure. In the case of the softball player, against my advisement, she went out and immediately played on her injured shoulder because of this positive result and to no one’s surprise reinjured herself.

5) If an athlete comes to an acupuncturist for treatment of an ailment, what can they expect?

I can only talk about my practice specifically. When you come in to see me for the first time you can expect a careful evaluation and assessment of your condition and if it is specific to an injury I will palpate the area to ensure I know exactly where things are disrupted.

If the ailment is acute you can expect to see me at least three times a week. If it is a semi-acute injury maybe two times will be enough, and pre-existing injuries perhaps as little as once a week. Another often overlooked aspect of acupuncture is that each treatment should be considered a dose. Treating with the correct dosage is important for creating successful treatments. There seldom will be the time that just one or two treatments of acupuncture are going to facilitate complete recovery.

As I previously mentioned, each treatment session will last between 20 minutes to an hour and usually consist of 10 to 20 strategically placed needles around the body.

Again, healing is a natural process. Acupuncture is a very useful tool in actively accelerating this natural process and because of this it is an ideal medium for treating sport related injuries.

Interview with Gear Fisher about Performance Metrics

Gear Fisher is the Chief Operating Officer of Peaksware, a company that has been evolving since the late 1990s to provide coaches and athletes innovative tools to monitor, plan and analyze athletic performance. Gear is responsible for managing all business processes and product development at Peaksware. He is also an recreational cyclist, who in is prime landed top ten honors in various cycling events while competing at the category II level.

Here are my 5 questions with Gear and his answers:

1) You have been building exercise technology for more than a decade now. In that time what do you think the biggest game changer has been regarding technology and fitness – an innovation that when observed for the first time made you realize the environment has now permanently changed?

The acceptance and understanding of downloadable training devices like heart-rate monitors, GPS, and power meters has changed how people train and their expectation of what to expect when buying these sorts of devices. From a high level, we’re seeing the formation of a “consumer health data warehouse” that previously only doctors, hospitals and maybe professional athletes might have had access to. We are seeing the landscape for an interconnected health management system affordable by the masses beginning to take shape. This will truly be the major game changer in the next 10 years as the world struggles with the changing health care system.

I first wrote a web-based .csv file reader for the PowerTap in 2001. At the time, it was pretty cutting edge, maybe too cutting edge. At one point, I was on the phone with Saris showing them what I had done and how you could view the data files on the web, they basically said, “nice, but nobody downloads, so, we’re not sure why you spent time doing it.” At the time, they had just been acquired and were rebuilding their newly acquired PowerTap technology from its original creator, so I think they might have underestimated the importance of post exercise data analysis and athletic performance metrics.

There were a few other companies with downloadable devices at the time (Polar, CompuTrainer, SRM, to name a few) but there are now so many excellent companies bringing downloadable training devices to market, consumers have come to expect the feature on any new device over $200. We’ve moved beyond a “geeky” feature into an expected and sought-after feature. Thanks to Garmin, Timex, Suunto, Saris, Polar, and SRM many others are preparing more downloadable devices. To bring this topic fully up to date, I have to mention the work that Dynastream has done to standardize the ANT+ protocol for enabling wireless sensors and devices in the “personal area network” space too. This has made the sensors easy to install and manage, as well as allowed consumers to easily get the data from their device to the cloud or to their personal computer.

2) A big movement in health and fitness innovation has been the ability to amass and store user metrics quickly and easily. For example, regarding health, the consumer start-up company ZEO was able to accumulate the largest known sleep study database in less than a year. This has given ZEO the ability to identify key factors that affect people’s sleep, which up until this point had been unavailable (even to the academic community). In theory, the ability to amass and identify trends from performance metrics should be beneficial in fitness applications in a similar way. Do you see this evolution in the ease and ability to store performance data enabling fitness professions to expand the breadth of their ability to foster athletic improvement? And, if yes, then how?

Without a doubt, yes. As I mentioned above, we’re seeing a changing health care system, one that is moving from a 3rd party managed system, to a self-managed, self-informed system. We look at what we’re doing at Peaksware as the top of the health care pyramid. Our customers have taken control of their health, are self motivated and looking for fitness and performance. This will trickle down to the masses as health insurance, doctors and hospitals begin to adopt a more wide-ranging care system beyond the walls of the doctor’s office and hospital. Let the people manage the data collection, provide easy access to it by professionals, then make decisions based on data and consultation with experts. Right now, we are performing this feedback loop in the performance realm, but it makes sense to translate this to general health as well. We often refer to it as the “monitor, analyze, and plan” cycle.

The data we’re collecting is going to inform the decisions and algorithms of tomorrow’s innovation. Power meters are a great example. Before power meters, the training “dose” was pretty much limited to duration and distance. Now, we have new metrics like the Training Stress Score that provide concise feedback and performance prediction, born out of data collected by people using power meters. Of course, we believe in giving the tools and technology to the people, and our software lets you “visualize your fitness and performance” and enables our customers to monitor their own data. This gives every individual the user interface for their own physiology so they can investigate and discover their own correlations and metrics by analyzing their data through TrainingPeaks.

Who knows, someday we may find a correlation to threshold power/heart rate and heart disease. I’m certain there are amazing discoveries just waiting to be found in the data.

3) Biofeedback capturing is a key element in the ability to provide practical output to users regarding exercise. Are there any innovations you see on the horizon that will accelerate this ability, or alternatively, you have a desire to see? For example, GPS units are getting smaller, heart rate monitors better, bike computers more savvy, and we can tell body fat through electrical impedance… what’s next?

I think there is a long way yet to go with data collection. The easier and faster we can get data to the cloud, the better, faster, more intelligent we can become with regard to making decisions on our training or on our general health. Lots of people recognize this and we’re seeing some great innovation in this area. I would love to see more integration with Wi-Fi and cell networks to enable easier data transfer from device to the cloud. The Withings Wifi Body Scale is the first Wi-Fi device I’ve seen that really works. You stand on the scale, it sends your weight and body composition data directly to the cloud instantly. Nothing to write down, no “work” to save and store, it just gets saved right in your TrainingPeaks account. I want to finish a bike ride, roll into my garage, have the bike computer recognize my wi-fi network and beam the ride’s data to my TrainingPeaks account. Garmin and Dynastream have done some great work in this area too.

There are several iPhone and Android phone apps that do this sort of data collection, even in real-time, but it has got a ways to go for enabling more data sensors like heart-rate and power. I’ve seen several ANT+ dongles like Digifit that plug into an iPhone and enable ANT+ sensors to beam their data to your phone during a workout. You then can send the data to your personal TrainingPeaks account, but it’s just now coming to market. The phone essentially brings a super-computer along with you on your ride, run, hike or walk. It’s a great point for doing data capture and transmission. There are some problems and challenges with it, but we will see incredible innovation in this space soon.

I’m particularly excited to see these technologies move indoors as well. As odd as it sounds, we’ve captured more data out on the trails and roads than we have in health clubs and spinning rooms. There is so much potential for data collection within the walls of the health club, and the opportunity to further push the technology that has already been invented and adopted by athletes down to general consumers just trying to lose weight and maintain some healthy habits while in the gym.

I’ve also seen new athletic performance metrics being collected. Respiratory rate, body position, skin temperature, real-time VO2, water consumption… So many new sensors and things we can manage. My partner, and CEO, Donavon Guyot half-seriously joked 7 years ago about under-skin sensors that collect data. This year, Allan Lim had Lance Armstrong swallowing “pills” that measure core temperature during exercise. We simply don’t know how some of these data points affect performance, because we haven’t been able to collect the data in real-time during exercise outside of a lab. We’re getting there now. And that’s a critical component, outside the lab, under pressure of a race, in the heat and cold, while raining and at altitude. So many environmental factors go into performance, training and fitness.

4) How do you foresee fitness software progressing? Will it become more dynamic and adaptive? Currently, most online products sell static programs that promote authorship (and commerce) from fitness experts (i.e. training zones are established but then set for the duration of the program). However, this approach somewhat limits the potential of software to tailor itself to an individual’s specific adaptations over time. Do you think endurance software will advance to the point that programs literally optimize daily workouts based on biofeedback from the prior day/week?

Without a doubt, software will be able to do this, it’s already started. Remember that weather forecasting model I mentioned earlier? We need a physiology model to make optimized workouts and changes based on biofeedback. Several companies have, or have tried to build these tools, but I have yet to see a comprehensive system. It’s an enormous task to make it affordable and most of all, to make it actually work. As soon as a computer-generated system gets it wrong, you lose trust in it. It comes back to the data collection and analysis. We need a LOT more data to make this sort of model truly work. But, we’re getting there. The VirtualCoach within is based on Joe Friel’s “TrainingBible” methodology and was an early version of this sort of system. It’s a tool that embodies much of Joe’s periodization ideas into a down-to-earth, go workout today and do “xyz” system. However, even today, after many updates and tweaks, it continues to only serve a certain population, and it’s not comprehensive, but it’s very effective for that narrow band of user.

5) Lastly, where do you think the balance between a platform’s utility and ability to be user friendly lie? Dealing with the unfortunate reality that in the world of fitness that positive outcomes are for the most part reliant on user compliance, is it sometimes necessary to compromise sophistication for usability?

This is a fascinating topic for me. I live this balance every day and make decisions constantly that go one way or the other. Ultimately, and I’ve said this for years, it comes down to ‘reason for use’. It’s a term I’ve thrown around for a decade, and I believe it’s the ultimate driver of a user’s decision to buy or use a product. If the product provides enough reason for use, whether it be because a friend suggested it, a doctor told them to do it, or it provides a key feature or has a function that is not found elsewhere, it’s the ultimate decision maker. On top of reason for use though, comes ease of use. On top of ease of use, comes the age old cliche “form follows function”. So, if it does something cool, is intuitive and looks good, you’ve got the magic three ingredients… except there’s one more issue: everyone has a different opinion on what’s easy, pretty and useful. That’s both the frustration and the fun. We build stuff that we use, based on feedback from others and incorporate some very forward thinking into the recipe. The end result is our vision of an app. To be clear, I will say that again: we don’t think of ourselves as having a weblisite, we have an appcation.

Every software system that’s developed follows the same path: build it, start adding to it, eventually re-build it, add more stuff to it and repeat. We just went through this cycle ourselves. We chose to scrap 7 years of code and rebuilt our entire web application from the ground up much to the disdain of many users that were infuriated we’d do such a thing. Many people exclaimed that we’d “wake up” when our horrible decision hit us in the pocketbook. The end result: sales have doubled and we’re reaching new markets that would have never considered us before, largely because of the elegance and simplicity of the new interface. Some old customers wanted to strangle us, but over time, they’ve come to understand the new systems and how to get things done, and it’s been a big hit. New users have no “baggage” and we’re seeing that they get up to speed much faster with the revised tools.

As far as usability, if you can get the most critical things communicated to your user quickly, you’ve done a good job. From there, they can dig in to the deeper, more complicated features. The people that dig in are ultimately your best customers, and they quickly move past ease of use and just want features. Speed is the #1 feature, from there, it depends on what you identify as important for your audience. Carefully managed and supported features are the foundation to our approach.

Ultimately, deciding form over function depends largely on what you’re trying to accomplish, it depends more on your business model, target audience, corporate goals and direction. For instance, Nike+ is a huge hit, but they focus on a single sport: running. It’s a drastic simplification that they can afford to do. They also pour millions of dollars into it in order to engage customers with their brand, instead of charging a fee to buy it. That’s a fine business model if you like making people pay for shoes but not software. Selling software is tough, and constantly evolving, it’s hard to get people to pull out their wallets and actually make them pay for what you’ve produced. A couple years ago, we were told by many that we couldn’t charge for software and that we’d need to pay for it through advertising. No thanks, not the business we’re interested in. Same thing in 2000 when we started, it was only about eyeballs. Instead, we charged for our product from day 1. We focus on providing value to our customers, and we’re not afraid to make people pay for it. If we do a good job, we believe we’ll be rewarded by paying customers, and so far, that’s worked out very well for us.