Archive for October, 2012

Waste not, want not

As my part of the country battens down the hatches as Sandy approaches (all the businesses in my town have boarded or taped their windows and sandbags line the sidewalk), it seems appropriate to write about nature.

The changing of the seasons is always a beautiful sight here in the northeast US.  Early in the year, greens and yellows of spring welcome a new year of growth and productivity.  The banner at the top of this blog is a picture taken in my parents’ garden of aconites, a flower that blooms in February when the rest of the world is still brown and gray.  Now, in the throes of fall, the changing of the seasons is obvious in the reds, yellows, oranges, and browns of the changing leaves.  When you see the cycle of the seasons, with trees budding and leafing out in the spring only to see the leaves turn color and drop 6-months later, it can seem a little wasteful.  So much growth, only for the trees to be bare once more.

But what is waste, in nature?

One of the arguments frequently used against the eating of meat is the toll that animal waste takes on the environment. The run-off of nitrogen-laden (not to mention antibiotic-riddled) water from large-scale feedlots can wreak havoc on waterways and land (though it bears mentioning that run-off of nitrogenous fertilizer from crop land can be equally detrimental).  In a non-industrial setting, however, is “waste” really such a problem?

On the contrary- in a more natural world “waste” is not a toxic hazard, but rather an important part of life.  I snapped this picture at a farm near where I grew up. For as long as I can remember, this land has been “hayed” (in our area, farmers usually make 2, sometimes 3, cuttings of hay per year). In the last couple of years this land has changed hands, and now belongs to a vet with a great interest in grass-fed meats (as well as quality horses). The fields that have been farmed for vegetative crops will now be home to livestock… Just look at what their waste has done!

Animal impact: “waste” = growth

Look inside the fencing. See those dark green areas where the grass is particularly lush (and extra long)? THIS is what nature does with waste: nature turns waste into growth.

This land was productive as crop-land (you can see in front of the fenced land that part of this property is still in hay), but I suspect that with the return of animals to this land the grass will actually grow more, not less.  Hayed land can be (and should be) replenished with potash (for potassium), lime (to maintain an appropriate pH), and nitrogen (in some bioavailable form to help plants grow) to compensate for the nutrients being continually removed by the cutting and bailing of hay. While many farmers slack on replacing the more expensive lime and potash, most put down nitrogen to help the grass “pop” so they get a good yield (biomass). Putting animals on the land reduces (or eliminates- once the soil is replete) the need for added fertilizers, as the grass is not being shipped off the property as hay, but is rather being cycled right there on the property into biomass (beef) and fertilizer.

What our modern, industrial world sees as waste is really part of a natural (not to mention efficient) cycle…

This isn’t just true with animals.  I recently took a lightening visit to go hiking in the mountains of North Carolina. With a surprise 3-day weekend on my hands (my out-patient medicine preceptor was sitting for the boards), I couldn’t say no to a last minute invite.  With views like this- I’m very glad I said yes!

It was almost the perfect time to visit, with leaves seemingly changing colors in front of our eyes. The palette of fall colors was stunning, and led to an enjoyable arts and crafts session of the patio of my friend’s cabin while enjoying a post-hike cider.

Nature- embrace the rainbow

In the woods, these leaves lay where they fell (save the ones I carried back or the few the chipmunks and squirrels use to cushion their nests).  Again, it can seem like a dreadful waste, until you realize that this process, which occurs every year, feeds the insects, grubs, fungi, and molds that turns these leaves into rich topsoil to encourage new growth.

One childhood family activity that I remember was raking leaves. I somewhat fear that the advent of leaf blowers has replaced good old-fashioned rakes (and more importantly, good old-fashioned leaf piles that were great for jumping in!), but whatever the mechanism of collection, leaves are generally not abided in our modern world. While I take no issue with clearing leaves, it pains me to see leaves bagged up and put out to be collected as “trash”. There is definitely an increase in people composting “yard waste”, but the name, again, shows how people see the world and nature- a progression, not a cycle.

A bit of google-mining suggests that the saying “Waste not, want not” can be attributed to Benjamin Franklin (1706-1790), but it is nature that best embodies this philosophy.

(Stay safe out there- all my fellow northeasters in the path of Sandy!)

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Many people get their start in the ancestral health/evolutionary wellness world through food.  Be it “paleo” or “primal” (or perhaps the ever practical advice of Dr. Emily Deans: “Don’t eat like a Jerk”), most people start this journey with food, and then start to apply the evolutionary mindset to other aspects of life. Once the logic of “eating evolutionarily” sets in (and once you realize how good you look and feel while doing it), you might start to apply the evolutionary approach to other aspects of your life.

Once you’ve been at this long enough, you start to think about the evolutionary aspects of everything- food, movement, socialization, sex, sun, stress, and sleep (so many s’s!)- but it seems that the two that most frequently go together are food and feet.  The exact timeframe may vary, but there’s usually not a huge gap between someone adopting a “primal” or “paleo” diet, and someone purchasing their first pair of Vibram Five Fingers– and so your migration to the fringe begins…

The jump from an evolutionary approach to food to barefoot running is an appropriate one.  The evolution of the foot (and our ability to run) is often traced to the human ability to run down prey, and thus the evolutionary argument that meat is an important part of an appropriate human diet. From an evolutionary health perspective, the argument that “these feet were made for moving” (without the help of massive rocker-bottom shoes) just starts to make sense, and might just prevent (or explain) injury.

If you’re not familiar with the arguments for a barefoot approach (or if you are, but haven’t seen this video), I highly recommend the following brief video, made to accompany this paper [1], in the eminent journal Nature*.

It certainly makes sense that a forefoot foot strike pattern inline with our evolutionary “design” might be protective against running-induced injury.  Indeed, a small retrospective study that was published this July showed exactly that.  In cross-country runners, those with a forefoot foot strike had significantly less repetitive stress injuries than their rearfoot-striking counterparts [2].

Embracing the barefoot message does not mean you have to embrace actually going barefoot.  You can see from the VFF link above that there are options for those who want the barefoot experience without the unpleasant effects of doggie-doo.  For those worried about being labeled part of the monkey-foot army, have no fear- there are minimalist options out there that are relatively indistinguishable from *regular* footwear.

In the last few years there’s been an explosion of minimalist or “barefoot” shoes. Those in the market can chose from a number of mainstream or more esoteric brands.  From New Balance Minimus Zeroes and Merrel Gloves to Vivobarefoot and some of the Inov-8 options, there are many options for the barefoot enthusiast to try.

I’ve gone through a number of pairs of VFF at this point, with the rather simple KSOs being my style of choice.  I’ve endured the occasional joshing from friends and entertained many questions from strangers out on trails, and am generally enthusiastic about VFFs, but they’re definitely not a “stealth” minimalist shoe.  On the other hand, the Vivobarefoot sneakers that I wear in the hospital look like totally normal sneakers. [I’ll admit my favorite hospital “outfit” is the 4 S’s- Scrubs, Sneakers, Sweatshirt, and Stethoscope]

I’m not here to write a review of the Vivos I’ve been wearing (though they’ve been great for me). My advice for anyone looking to explore minimalist shoes is to go to a store and try on the different options. I know some people love the Merrel line, but they’re definitely too narrow in the arch area for me (they leave me feeling like I’m in shoes with big arch support).  I want to try the NB Mimimus Zeroes (the newest NB “barefoot” option with no heel drop) before I purchase my next pair of sneakers.

Shopping for a new pair of sneakers is definitely on my mind, as I’ve recently realized that my original pair of Vivos is on the way out. They’re had a good run, but some of the luggs are now totally worn down, and the sole is starting to erode too. I hadn’t noticed in the way they wore, but when I flipped them over I was initially surprised to see where there was wear.

Ever since I was a kid I’ve been “hard” on sneakers. I’ve worn through the soles of many shoes (and stomped down the back of many an unlaced sneaker- much to my parents chagrin). In the past, I’ve always noticed that it was the heels of my sneakers’ soles that went first.  With my Vivobarefoots, the wear is only prominent at the ball of my feet. I dug up an old pair of sneakers (not worn out, as I switched over to minimalist options before these were done) and you can clearly see that the greatest wear is in the heel areas. Yes- there is some wear in the toes, but not much. For contrast, look at my ailing Vivos.

The different wear patterns in my last pair of normal Merrels and my minimalist Vivobarefoots.

For me, this is pretty convincing evidence that minimalist shoes do, in fact, encourage the midfoot strike that is desired by those that go barefoot. That’s not to say that minimalist shoes are a cure-all for heel striking. You can check out this video from the 2011 NYC barefoot run to see the variety of footfall patterns- many of those with minimalist shoes have a different footfall from the truly barefoot, with a couple examples of heel-striking in minimalist shoes… ouch!

Some technical difficulties aside, minimalist shoes are definitely a step in the right direction (pun intended?) for those wishing to get a more “evolutionarily appropriate” footfall, without going truly barefoot (or for those who might like to go barefoot, but are constrained by social norms (or hospital policy!))

Lunch/sun break on a sunny day on my surgery clerkship.

Usual disclaimers apply- minimalist shoes are not for everyone. Getting accustomed to minimalist shoes can take time. Consult a medical professional before starting any exercise regime. Go in search of the Wizard of Oz (NOT DOCTOR OZ!) if you are in need of your own brain.

*For those keen on reading more about evolutionary medicine, Daniel Lieberman published an article on evolutionary medicine and barefoot running in April [3].

1.         Lieberman, D.E., M. Venkadesan, W.A. Werbel, A.I. Daoud, S. D’Andrea, I.S. Davis, R.O. Mang’eni, and Y. Pitsiladis, Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature, 2010. 463(7280): p. 531-5.

2.         Daoud, A.I., G.J. Geissler, F. Wang, J. Saretsky, Y.A. Daoud, and D.E. Lieberman, Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc, 2012. 44(7): p. 1325-34.

3.         Lieberman, D.E., What we can learn about running from barefoot running: an evolutionary medical perspective. Exerc Sport Sci Rev, 2012. 40(2): p. 63-72.

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