Belgian Chocolate

Belgian chocolate is almost as famous as Belgian beer. Over the years that I lived in California I have seen Belgian chocolate ease out Swiss chocolate as the world's number one -at least in the minds of Americans. Although Americans claim to love Swiss and now Belgian chocolate, they keep on buying the much cheaper and exceptionally poor tasting Herschey's. Even today it is not uncommon to see self-proclaimed chocolate aficionados munch Herschey's kisses in a dark alley.

Pralines in Brussel

Herschey's existence and persistence proves one point: humans like other animals imprint the tastes and smells of home and these stay with us for the rest of our lives. No matter how unappealing, foul or tasteless these markers of home are, they will always occupy a special place in our minds for as long as we live. But back to business.

Much like the beer revolt that targeted Budweiser -now a Belgian brand- and Coors, a chocolate revolt appeared and some American micro-chocolate makers have acquired a reputation for perfection and a dedicated following. One such brand is the local Scharffen Berger, a brand that calls itself America's Finest Dark Chocolate.

Ghirardelli square, too sweet for me

Scharffen Berger is much better than the overly sweet older local, San Francisco's Ghirardelli. That brand is housed in the famous Ghirardelli square, a San Francisco landmark that is worth visiting. The chocolate however is no longer taken very seriously by the local cognoscenti, although Ghirardelli has tried to reinvent itself and catch on to the dark wave.

The dark wave has transformed chocolate  from an unhealthy candy snack for the masses to a sophisticated delicacy for the up and coming. Dark has risen to prominence and in the minds of some at least become a health food or even a supplement. Now here is one supplement I can wholeheartedly endorse.

That is not to say that Belgians were or are dark chocolate lovers. Far from it. The most popular chocolate in Belgium is milk and the most popular brands such as Cote d'Or and Jacques- Callebaut sell a lot of milk chocolate bars. Belgians also eat a lot of Swiss milk chocolate and Milka is a favorite. The brand is actually owned by Kraft foods.

Milk-hazelnut, the Belgian staple

One thing I can say about the lowly Belgian bar is that, unlike American bars, it tastes like chocolate and is not overly sweet. I also think the addition of hazelnuts, a weird idea in the American mind, where the peanut dominates, adds to the flavor in unexpected ways.

Godiva??

What surprises many Belgians (and Americans for that matter) is that for the longest time, Belgium's premium praline maker Godiva was owned by Campbell Soup, a brand most Belgians only know about through the work of Andy Warhol.

Belgian chocolate comes in two main varieties: the chocolate bar, usually milk with hazelnuts, that is a children's favorite, and the praline or chocolate confectionary that helped launch Belgium into the chocolate stratosphere. There is a third -largely unknown variety- that has a much to do with recognition as the other two, and that is the raw or bulk chocolate used by cooks, dessert makers, and confectioners. These people buy the raw material they use in the their creations and their selection determines who wins the crown. And it is in the third category that Belgium has acquired a reputation for exceptional excellence.

Here Callebaut and others compete with world leader, Valrhona from France. The latter also makes a mean chocolate bar and is -by the way- one of my all time favorites for chocolate bars. How is that for an endorsement?

You've probably already guessed that I prefer dark chocolate. My favorite Belgian brand is Cachet made by Kim's chocolates in the city of Tienen (once known as the sugar capital of Belgium). Cachet makes a variety of bars that are all of excellent quality.

When it comes to pralines, I bypass the big 3, Godiva, Neuhaus (better) and Daskalides that dominate the Brussels airport, in favor of The Chocolate Line, surely some of the most innovative creations ever seen. The chocolates are made in West Vlaanderen, and sold in stores in Brugge and Antwerpen. The Chocolate Line is -to quote the famous Michelin guide- worth the detour.

I will also recommend any local bakery or chocolate shop that makes their own chocolate creations. These are often on par or better than the big 3.

Happy New Year everyone!

Post crash recovery

It's been almost three weeks since my crash on Pinehurst road. There I suffered a some road rash, a bruised hip, a grade I/II AC (acromio-clavicular) separation and a cracked rib. Now things are finally getting better and I am able to exercise at moderate intensity without too much pain.

AC separation. In Grade 3 the AC ligament that supports your arm is torn.

Although I had trouble walking the night of the crash, my hip problems went away in less than one week. The shoulder still hurts but I regained nearly all movement -albeit with some pain- about a week later. I can move but I cannot sleep on it although now it is quite manageable. Much, much better than the grade III separation I suffered on the right shoulder in 2008.

The ribs are another matter. They hurt very little now, except when I cough or sneeze, but then the pain is pretty bad and it takes time to go away.

At first all I could do in terms of exercise was pedal easily on my rollers. Now I can run or ride relatively well as long as I don't push it too hard or for too long. But even then there will be a dull pain in my chest afterwards and that pain will last for several hours. Although the rib injury is much less painful than a grade III AC separation, what it lacks in intensity, it makes up for in being always there. With a shoulder injury one can find a spot where the pain is hardly noticeable. Not so with ribs. They always move and they are always painful.

More good news: the podium in Bredene today looked like a who's who in cross: Stybar, Nys and Albert. It also appears the snow is gone.

Also, the abbey at Rochefort got damaged by fire, but the beer and the beer brewers (the monks) are OK! That is excellent news for those who love a good Trappist Ale.

Event horizon

We all know that it takes just seven days to make us a man. Unfortunately, it takes almost 10,000 hours to turn that man into a world class performer. 10,000 hours is about 10 years. Nobody in their right mind wants to wait that long, nor -we are constantly reminded- should they have to do so. These days we can get what we want, when we want it. It is called instant gratification and like greed it is one of the pillars upon which our consumer society was built.

In just seven days, I will make you a man

No doubt this is why we all look for shortcuts. Maybe we need a power meter so we can train smarter? Or perhaps we need to change our nutrition and add more micronutrients? Or analyze our sweat to see what electrolytes we are missing? Or strengthen our core so we can be more efficient?

It is also why we are so eager to correct any perceived defects. Better get to it before it gets to us is the mantra. Better drink before you are thirsty, or eat before you are hungry. Or start pedaling circles before you know how to pedal. Or correct your gait before you have developed a proper stride?

We study and analyze and we take great pride in our deep understanding of physiology. Unfortunately though, every time we test that understanding in the real world, we are -most likely- in for a big surprise. All those things that seemed so rational and logical, all those things that just had to work, turn out to be for naught. Whenever we apply our fabulous insights or clever tricks we risk doing more harm than good. The road is littered with great ideas and fool proof remedies that achieved little or nothing beneficial.

Meanwhile our friend Iljo Keisse is still on for the Zesdaagse in Rotterdam, Alberto Contador is booked for the Tour of Murcia -all these conditional on any last minute UCI or WADA interventions, and Zdenek Stybar is back in cyclocross. There, Sven Nys suffers one mechanical failure after another, while Lance Armstrong bailed out of the New Zealand Ironman race and possibly Kona?


In other news, I have discovered a great Kriek (cherry beer) for you. Earlier I introduced you to Cantillon, no doubt a very worthy brew, but one that I am sure many will find too dry and too sour. Turns out Oud Beersel, makers of authentic Gueuze Lambic, make a fantastic Oude Kriek that is full of flavor, just a tad sour, and lacks the cloying taste of most popular Krieks. Like Cantillon it is deep red. A superb beer to top off a great workout.

Authentic super kriek

New Year's resolutions

2010 is coming to a close and this is as good a time to start thinking about your future as any. January 1 is when people want to start anew with a clean sheet. Many make firm resolutions to better the remainder of their existence. Most of these resolutions will not survive January and so the more experienced among us may not bother, but if you do, let me help you along by showing you how to save some time.

New Year

Whether you are aiming to lose some weight and get back into shape, or whether you are aspiring to become a top racer, here are some things you should know about. I want to warn you beforehand that these are not what you expect nor what you will see or read about elsewhere, especially not in trade journals. I would dare to say that these time-savers might be seen by some as crazy, inflammatory, irresponsible or just plain wrong.

So let me state the following in a way of disclaimer: these are my personal opinions only and in presenting these to you I speak as an individual from personal experience.

My favorite list of things that do not matter and that you should not worry about.

1. Nutrition. As our friend Bjarne Riis said, you can eat pasta and ketchup and train seven hours a day. In short, despite all the hoopla and talk, nutrition is one thing you need not worry about. As long as you don't get an upset stomach during the race -nearly always due to eating too much or eating stuff other than carbs- and as long as you don't gain too much weight, you will be fine. For more details check here.

During the race, eat candy bars, i.e. carbs (sugars), any sugar, it does not matter, but if the race is longer try eating normal food. Forget everything else, it will make things so much easier. For more on eating while racing, check this out.

Food

2. Drinks. Yes you read that right, drinks. You can drink anything you like during the race as long as you don't drink too much. You should also mind the calories. It is easy to get an extra 5-600 calories from drinking. Don't worry about complex or less complex sugars, or glycemic indices, or even electrolytes. If your race is longer than 3 hours try to ingest some salt as well.

3. Vitamins, minerals, supplements. These items are a waste of money for everyone, period. If anything they can be dangerous to your health and taking these is riskier than not taking any. If you live in the Western world and eat a normal diet and go outside for a few hours each day you will be OK. For my take on micronutrients and other scams, check here.

4. Anything performance-enhancing. The only performance enhancing drug that is legal is caffeine. Why that is so has to do with culture and social norms, not science or reason. Everything else either does not work or is on the prohibited list -which does not necessarily mean it works. Caffeine works well as long as you don't overdo it. Like most drugs it shows tolerance.

5. Weight loss pills. These either don't work or are illegal to use (see section 4).

6. Stretching. It is fun and may be entertaining to put your feet behind your head, but it won't make you a better racer. As a matter of fact, being stiff is beneficial for runners and bikers, but not swimmers, who need flexible ankles. Leave the stretching to ballerinas.

7. Massage. Also great fun -unless you are standing in line after the ironman, getting cold. Better in not-safe-for-work settings, massage is a feel-good form of entertainment that has no proven performance or recovery benefits. It does release endorphins and other signaling molecules, but that should not surprise you unless you believe in ghosts. You can only feel good if your brain is swamped in feel-good molecules.

8. Core exercises. Great fun to roll around on a ball but if you want to become a better runner or cyclist you should run or cycle instead.

9. Yoga. Another great way to spend the off-days and impress your friends. Yoga may be a great stress reducer and have tons of other (largely unproven) benefits, but it won't make you faster on the bike, regardless of what superstar so and so says.

10. Any mechanical fix, gadget, widget, wedge, or "technique." It does not matter how you pedal, how fast you pedal, whether you pedal in circles or in squares (like all the pros), or what crank length you use. It does not matter -for runners- whether you are a toe striker or a heel striker or whether your shoes are motion control, padded, or have wedges in them. You can run barefoot if you like but shoes protect you from sharp objects.

Chain ring shapes are irrelevant and so are pieces of padding under the ball of your foot. I would add bike fits to the list but that is sure to infuriate some of my friends who stand to gain financially from this activity. I can certainly add any mechanical fix to "correct" a perceived problem or any method, video or otherwise to diagnose such "problems."

Unless you have a real problem don't fix it.

BioPace anyone?

In conclusion:

What does help and what you need to focus on is training hard with adequate recovery. The only skill you need to learn is to listen to your body. That is easier if you don't have beeping heart rate monitors or distracting GPS voices, or erratic power meter displays to worry about. In this case, as in many others, less is more.

Pasta and mayonnaise

In a recent interview with Ekstra Bladet, former Tour de France winner and manager extra-ordinaire, Bjarne Riis contends that many young riders "are spoiled so rotten that they must be spoiled before they will be required to do something" (sic). Since my Danish is not that great I too was forced to read these comments in Cycling News. Clearly something got lost in the translation.

For example, Bjarne who ate spaghetti and ketchup in Luxembourg recommends that young riders should "get the right diet," and "settle themselves in a place where there is someone who can ride the motorcycle to pace [them]." I assume he means Luxembourg. No self-respecting Belgian would eat ketchup with anything. Mayonnaise perhaps, but not ketchup.

It is customary for the older generation to lament the good fortunes of youth and the downfall of values. Obviously Bjarne knows what he is talking about. After having spent some quality time on Fuerteventura (in the Canary islands) engaged in team building exercises, the manager of Saxo Bank claims young people "would rather have an expensive vacation."

Things to do after spaghetti and ketchup

Or a nice car perhaps, preferably with their name and logo on it?

I don't think the problem is that young people are "spoiled rotten." Undoubtedly they are, especially in the US where it is customary to find 13 year olds riding $5,000 carbon fiber frames with $3,000 Zipp wheels, a $3,000 SRM set, and a ton of GPS gadgets, heart rate monitors and the like.

Instead of sleeping in tiny apartments in Luxembourg, these California kids have their own bedroom and bathroom in a 5,000+ square foot McMansion. There they relax in their oxygen tents while playing the latest version of Call of Duty Black Ops on their XBox. And instead of eating pasta with ketchup they swallow vitamins, minerals, micronutrients and munch on the latest builder bar from Clif.

There is no lack of motorcycles to pace them. Or physiological tests to guide them. There are sweat tests, wind tunnels and gadgets galore.

The kids are spoiled and it probably would be better if they weren't. But how are we to change the fact that their parents have tons of disposable income? Or to turn back the clock and get rid of the iPhones, XBoxes, flat screen TVs and BluRay players?

The problem is not that they are spoiled. The problem is a loss of perspective. Everyone wants to go to Harvard at 5, climb Everest at 10, and win the Tour de France at 15. And it isn't just the kids. It is their overachieving parents and win-obsessed coaches.

Unlike what Bjarne wishes for, clubs and teams are not places where people "learn something," There is no time to learn. Everybody is too busy living. Teams turn into sweatshops where kids are driven to win to add kill stickers to the team van and please the sponsors.

Look how many wins I have.

The American mantra is, you can have your cake and eat it too. Furthermore, you don't have to wait, you can have it right now with some ice cream on top;  and then you can have it over and over again. No money? No problem, we got you covered. Just sign on the dotted line. We will take care of the rest.

You see the economy is already on the mend. People spent more money this Christmas than they have since 2007. Never mind that half of the country has zero net worth or that the foreclosure crisis has yet to get rolling.

Optimism is one thing, but delusional optimism is another. Just ask Sarah!

Bringing home the bear

Last minute gift ideas

Here are some last minute ideas for your Christmas shopping list. Don't worry you are not alone in needing to find that last minute present.

Retailers all over the country are bracing for a second black Friday onslaught. What better way to spend your Christmas Eve than to do your patriotic duty and go shopping to rescue the economy?

Here is my list:

For the athlete who has it all (including a power meter) there is sweat analysis, courtesy of Carmichael systems. Move over lactate, VO2 max and threshold power, in come the bodily fluids. I am sure they will throw in a free urine analysis to check for doping if you ask politely enough.

For the athletes who like to impress their prospective girl/boyfriends or the neighbors with their awesome power output, there are a number of power meters, including these beauties.

For those having trouble finding their way out of a paper bag there is an endless list of GPS toys. And for the bikeless runners who might get lost and fall prey to mountain lions, rattlesnakes and killer bees, there are these. Highly recommended for your baby boomer athlete!

Here is a cure for those in the hood suffering from wheelset envy.  If the set exceeds your disposable income, you can always go back to your childhood days and attach playing cards to your spokes.

Other neighborhoods like to show off their lights instead. Here are some great ideas that won't require a second mortgage but are sure to dazzle Wusteria lane.

For those unfortunate enough to be snowed in, there is the revolution trainer from good old Greg. This one will get you ready for the Tourmalet once the white stuff turns to slush.

If your bikes tend to get stolen you can always use these. They are guaranteed to work better than a Kryptonite lock. Not to mention the visual deterrent factor. Take that bike thief-wanna bees!

If you really run out of ideas there is always a box of protein bars or some magic powder at the grocery store. This stuff will surely propel your would-be athlete to the top of the podium.

For those down to earth, nothing works better than a pair of warm socks, or mittens.

As for me, I will be indulging in a Belgian Christmas brew while waiting for my New Year's gifts.

Happy Holidays.

Belgian New Year's present

It is never to soon to start thinking about New Year's presents and one Belgian brewery has just what it takes. Bon Voeux or Best Wishes is a top fermented strong blond ale from Brasserie Dupont, makers of Saison. Befitting the season, Bon Voeux is a strong beer topping out at 9.5% alcohol by volume. According to the website, the brewery has been making this jewel since 1970, albeit only in small batches at first. This is one New Year's present that you may want to keep for yourself.

Best Wishes for the New Year

For the traditionalists and lovers of Lambic, I recommend Cantillon Kriek. This intense red (and sour) brew is made the old fashioned way using sour cherries for flavor and color. It is not a beer for everyone and I am sure the much better known (syrupy sweet) Lindemans Kriek will appeal to many more palates.

Cantillon calls itself "Brewers of Belgium's Most Authentic Lambic" and this Lambic is about as authentic as you will find anywhere. Although fruit flavored beers are more of a summer drink, this Lambic will do well with just about any festive end-of-year meal you can think of.

100% Lambic brewed with Cherries

Solstice lunar eclipse

Last night I witnessed something that the world had not witnessed for the past 400 odd years: a full lunar eclipse on the winter solstice. Not that it looked different from other lunar eclipses I have seen, but to think that something like this hadn't happened since way before bicycles were invented and before triathlon became the sport that it is today, made it extra special.

The bringer of good tidings???

Meanwhile I am still out recovering from my separated shoulder and cracked rib. I still haven't been able to get a refill for my prescription despite five calls and a useless visit to the pharmacy where nonplussed personnel told me they did not have any refills for me. Given all that I was extra pleased to see the attorney general from the Commonwealth of Virginia talk about his court victory against the recently passed, but not yet fully enacted health care reform bill. It is good to know that so many people care about keeping the US healthcare system in the poor state it is currently in.

Cycling on the other hand could not be doing better. The drug scandals keep on coming and WADA is deeply concerned "about the Iljo Keisse case and the message it sends." One message that WADA no doubt does not approve off is the recent Sporza vote that picked Keisse's win in the Zesdaagse van Gent as one of the major cycling events of 2010. WADA would have preferred a message that is more in line with the "purity of the sport," whatever that may mean? Like Woody Allen would say, all good things in life are messy.

Meanwhile another rider, the Dutch National mountain bike champion tested positive for clenbuterol. He too blamed tainted meat, this time consumed in Mexico. So far, no reaction from the Mexican butcher's union. If someone thinks the bad news will ever stop they must be dreaming or maybe they are smoking the same stuff WADA is smoking.

An ongoing battle

The Wall Street Journal weighed in on the doping matter with a story about the people behind the scenes. Here we read about the men (and women presumably) whose money carried Lance and his postal buddies to victory and who are now in danger of being dragged into a rather nasty court case. One famous backer was quoted as saying, "most fans couldn't care less."  I said as much in an earlier post.

But then I uncovered that some fans think we should let bygones be bygones because the whole matter is getting better. That -it appears- is also the official position of cycling's national governing bodies and ASO, the most famous race organizer in the world. They seem to think increased scrutiny is working and the sport is getting to be "cleaner." Victory is just around the corner!

I have no data to say otherwise of course, but I strongly doubt that that is the case. Why would it be? Do people really think increased scrutiny works? Has it ever worked before? Fortunately, now is as good a time to believe in magic as any. Christmas is the time when we all pay lip service to "Peace on Earth," which must be the greatest wishful thinking of all. But perhaps now that the heavens sent us a signal they haven't sent in over 450 years, things will change?

Running with a cracked rib

This weekend I found out that running with a cracked rib is a non-starter. It has been almost two weeks since my accident and my ribs felt a lot better so I was eager to go on a short run. Although I can still feel pain when I inhale deeply or when I cough, all in all the pain was moderate (before the run). Not so after my aborted run attempt.

Starting off was painful but I remember from my previous AC separation days that once the adrenalin kicks in things get better and then stay that way for about an hour. So I tried to ignore the pain and kept running hoping the pain would go away. But it did not go away it got worse; nor could I find a position -hard to do with ribs- where the pain was tolerable. It hurt no matter what. I had to abandon my endeavor.

All taped up and ready to roll...

Before the run I had taped up my shoulder because I found that that helps a little bit. But my shoulder was not the problem this time around. The AC separation is only a grade I or II, not the grade III that I suffered on the other side a few years ago. In any case, the rib pain quickly overshadowed everything and put an end to my attempt. After the "run" I taped my ribs and found that that helps a little too. Maybe it is just drawing my attention away from the injury--one does sense the tape on the skin- but it does appear to help a bit.

I guess I will have to take it easy for a while longer.

Meanwhile I had some more experiences with the famed US healthcare system -this time under the guise of a large HMO. Try to get a simple prescription refill. My package of dangerous vicodin says no refills but my doctor had assured me that this was just standard for this type of medication and that I could just call in and have it filled if I needed it.

It is not as easy as that. So far I have called three times and made no headway. It seems nothing can be achieved here without spending hours on the phone, listening to muzak and stupid messages, and being put on hold time after time. It really should not be that hard to get basic healthcare. In Europe I would have just walked into a pharmacy and bought the extra pills.

No sweat (analysis)

The new new thing in training is sweat analysis. You read that right, and before you start laughing so hard that you fall off your chair, remember that this is offered by Lance Armstrong's coach and confidant and was developed in conjunction with Stanford University, home of Dr. Condoleezza Rice. If that does not give it street cred and WMD legitimacy I don't know what will. So off you go, start sweating for science and the goal of self-improvement beyond your wildest dreams.

getting ready for sweat analysis

One of the key lessons people learn in medical school is how limited our understanding of human physiology is, especially when it comes to practical applications. Another lesson they learn is that when we try to intervene, even when it seems smart and logical to do so, it either won't make a difference or it will make matters worse**

(**rarely and only very rarely do we find something that truly helps. And in all those cases, we found it by accident or serendipity and fitted the physiological reasoning post hoc.)

The medical school scenario works as follows: first, you spend a whole year learning about human physiology, a favorite subject among medical students. Physiology, unlike the dreaded human anatomy is not a test of learning by rote, but rather a sensible, meaningful insight into the workings of the human body. It is a confidence booster that has many students look forward to the clinic. As soon as they enter that clinic however, they start noticing that everything they learned in physiology is either wrong or needs heavy editing.

gross anatomy

Although as a young intern they will try hard to hang onto that shred of science, and although their favorite teachers will do what they can to support them there by asking post hoc questions to purportedly explain what was happening to patients, they'd have to be oblivious to reality -or true believers- not to notice that the practical value of what they learned in science class is extremely limited if not absent altogether.

A friend of mine put it this way: "First you spend a year to learn physiology and then you spend another one unlearning it all."

It is orders of magnitude easier to harm than to help

Apart from saying that medicine is largely heuristic and empirical, this also teaches us one other valuable lesson: that the human body is a very complex machine. A machine that has devised many ways around its own limitations and the limitations imposed by the data it can gather from the environment.

A very large part of our physiology evolved because it significantly reduced our susceptibility to the vagaries of the moment. For most parameters we adapt over very large ranges -usually orders of magnitude- with virtually no loss in performance. With sufficient training nearly all differences in initial conditions tend to zero.

We see true colors regardless of the spectral composition of the light. We can adjust to food choices from nearly 100% vegan to nearly 100% carnivorous. We can run barefoot or with crazy shoes. We can deliver the same power regardless of crank length. We can pedal squares on round chainrings. We can fit on bikes within a large size range and even get used to different fits at the same time.

It appears there is but one rule here and that is to practice, practice, practice,  and to make all changes incremental over time.

Happy training.

Heavy holidays

As we are heading into the Christmas-New Year's binge period it is good to remember rule number one for endurance athletes: keep your weight down. Excessive weight is the enemy of all endurance athletes, but none more so than runners and cyclists. Cycling is a bit more forgiving than running and heavier people can still do well in the sport, provided they either have the genetic make-up of a sprinter -sprinting ability is largely genetic according to those who studied it extensively -, or they focus on short-duration, level events such as track racing.

Swimming is the most forgiving of all endurance sports and probably the only category where (slightly) overweight competitors have brought home the dough.

Gold medalist taking a break

For many athletes fighting weight is never ending battle and in their desperation, many seek help in the medicine cabinet. Others, like Dutch champion mountain biker Rudy van Houts and Alberto Contador stick to eating a lot of meat instead. Both approaches are wrought with danger and it is always wise to check your meat provider, especially in Spanish speaking countries.

From Amazon.com

Weight loss, like training is surrounded by a lot of mythology and magic. There are special diets such as Atkins, Mediterranean, South Beach and others. Some of these are backed by scientific rationales but most are not. There are magic (read scam) potions such as Zylotrim and CentriLean, backed by pseudoscientific hoopla and there is even an FDA approved pill (alli) that will prevent fat uptake in your gut and result in gastric upset, bloating and diarrhea. If the latter does not stop you from overeating, I honestly don't know what will.

There is also a long list of failed products, some of which are somewhat effective but dangerous (Acomplia, Phen-Fen, amphetamines), but most of which are not. Recently a new entry, Contrave, got the thumbs up from an FDA panel, the first drug to do so in a decade. We will have to wait until next year to see if FDA will act on the panel's recommendation. Like most entries, Contrave shows marginal effectiveness and some potentially troubling side-effects. But the nation is desperately overweight and something needs to be done.

Temptation

The bottom line in weight loss is quite simple. You will lose weight if and only if you eat less calories. For the sake of completeness I can add that you can also try to burn more, but that is pretty much a losing battle as your ability to burn excess calories is extremely limited. Burning more is an insignificant factor in weight loss programs.

So it all comes down to eating less.

How you achieve your goal of eating less is immaterial, especially for adults. It does not matter what foods you eat, when or how you eat these foods, whether or not you perform rituals such as drinking water beforehand or after. It does not matter how often you eat, what time of day or night you eat, as long as you eat less than you did before. Granted eating less is easier with certain food choices -fats make you feel full easier than carbs- but ultimately it all boils down to the calories you ingest.

Also, and again for completeness sake, some programs may show a small initial advantage, but in the long run (say four weeks or more) it all evens out. And remember, even programs that do show some advantage initially do so through consuming less. Ultimately it all comes down to calories ingested.

Exercise and sleep are important but probably more so because these activities prevent you from eating for extended periods of time, or limit your uptake, or both.

Although some weight gain in the off-season is normal and may even be beneficial, it is probably better to limit your gains. The more your weight oscillates back and forth, the harder it becomes to lose the excess when you want to.

The best advice for the holiday is, indulge but keep it under control.

P.S. Although less weight will benefit any endurance athlete, there comes a point where further weight loss will no longer be of value. If you are lean and have been competing well for a many seasons chances are you have found that optimal weight and you know what it is. Trying to reduce your weight even further will most likely result in worse outcomes.

Belgium: wardrobe malfunctions galore

A friend of mine sent me a link to a Dutch cycling site yesterday and it reminded me of something I haven't discussed when it comes to riding and racing in Belgium.  The article in question describes Mark Cavendish's newest ride. Here is the link and I want to warn the reader beforehand that this is definitely UNSAFE FOR WORK, as they say in the US. You go there at your own risk.

The article is full of wardrobe malfunction. As an American, you might at first be tempted to think that this type of magazine or site caters to a specific audience and that no European cyclist or cycling fan would go there, but you would be mistaken.

As a matter of fact, wardrobe malfunction is very common in the Belgian cycling world. The mechanic's area of bike stores, which is also the place where team members, including youth members convene on a regular basis, often displays cycling themed wall calendars with lots of wardrobe malfunctions. Every year the popular sports new site Sporza displays pictures of  German cycling calendars containing plenty of wardrobe malfunction. Sporza even holds contests where you can win such calendars.

Belgian pharmacies: where wardrobe malfunction is prevalent

But lest you think Belgian cyclists and-or mechanics are perverts, let me warn you that many regular stores in Belgium display posters with wardrobe malfunction. One place where you are almost guaranteed to see examples of wardrobe malfunction -and where you perhaps least expect it- is the pharmacy. Pharmacies in Belgium are stores where children walk in and out all the time.

You don't even need to go the pharmacy. Topless women are all over billboards and signs and nobody thinks twice of it. Although Belgium has only one official nude beach in Bredene, topless sunbathing is quite common in Belgium (and the rest of Western Europe).

A political ad 

Although Belgians are in general fairly relaxed when it comes to nudity, that is not a general rule and in rural areas in particular, people are often quite modest. But even here you may find images of topless women, albeit in distinctly non-sexual settings such as medical or health-related ads.

Another fact that often surprises foreigners is to find out that prostitution is legal in Belgium. Not only is it legal it is quite visible in certain areas. And these areas include rural locales outside big cities. The highway from Gent to Deinze for example is dotted with bordellos that cater to truck drivers. These establishments often have window displays akin to the more famous red light district in Amsterdam. Just be careful when you drive there the first time around: keep your eyes on the road, it is safer.

A great bike and a great beer

The past weekend was decidedly mixed. My injuries are slowly healing up but late Sunday evening I was struck with a mild flu like illness that added more misery and is only now starting to clear. Before that happened however, I did have some great weekend moments.

First we picked up a new bike for Alistair, courtesy of Above Category. They built him a Moots Vamoots, which looks and feels totally spectacular. I am not one to go overboard on bike esthetics -a bike is after all just a machine that allows us to do certain things more efficiently- but the MOOTS is a beauty to behold. It has that coveted super cool brushed titanium look. What I find the most appealing about the bike though, is its simple esthetics. No oversized anything here, no beefy bottom brackets, specially reinforced this or that, or grossly misshapen tubing.

The new MOOTS

It is strange how people's perceptions change over time. I remember the days when Cannondale first came out with their oversized aluminum tubing, eliciting aversive reactions from most everyone I knew.  Even those in favor had to admit the bike looked different.

Now look around you. These days nearly every bicycle has oversized or oddly shaped tubing. Some have gone as far as making it appear as if the down tube was just bent back at a 150 degree angle to produce a top tube thereby totally obliterating the shape of the head tube. To say nothing of the "beefy bottom brackets," a source of endless ridicule for the infamous bikesnobnyc.

These days, bicycles have tubing that is larger in diameter than most cyclist's arms. But for one reason or another we have all gotten used to it. Just like we have gotten used to overweight people and think of them as normal. Only those who are grossly obese now strike us as being overweight. Supersize me is every bit as relevant today as it was six years ago.


On Sunday I went Christmas shopping with my daughter -well mostly window-shopping that is- and later topped it off with some seafood from Whole Foods, and a Westmalle Triple.  The Triple tasted so good -or maybe the alcohol got to me so quickly- that I almost finished the bottle before thinking about taking a picture.

Westmalle Triple

The Westmalle is an authentic abbey beer, as evidenced by the hexagonal seal on the neck of the bottle. Many consider Westmalle to be the trendsetter among Trappist ales. Purists in Flanders will never forget to remind you that Westvleteren is the real stuff -but maybe that will change once Westvleteren is for sale at Colruyt, who knows?- but in my opinion, Westmalle Triple can stand its ground. Especially when it comes to blondes.

The triple is a golden blond ale, i.e. a darker shade of blond but still blond in my opinion, with a refreshing citrus taste and a seriously heady alcohol level. A good beer for the holidays, and one to enjoy after a good ride. I wish my injuries would heal quickly so I can go on a long ride and top it off with another Westmalle soon.

The Keisse saga continues

Iljo Keisse won the six days of Gent and put in a good showing in Zuerich. But when he went to Manchester to compete, he was sent home, apparently by UCI. That happened even though the Belgian courts had imposed a EUR100,000 fine to anyone who would step in Iljo's way.

Clearly someone does not mind paying 100,000 euros to get Keisse. Someone is out to get Iljo come hell or high water. Someone does not just want him out of the sport they want to wreck his career, maybe even burn him at the stake to save his soul?

If this does not smell like cruel and unusual punishment or vengeful behavior to you then I don't know what will. It is clear that this is no longer about sport or fair competition. This is punishing people for transgressing holy laws. Stoning for adultery? Does that sound excessive to you? Maybe you should think again.

This is taboo in the Old Hawaiian sense, but this time with no place of refuge.

Anyone who thinks this is acceptable behavior should ask themselves a simple question. Is there any other form of cheating that would result in this type of prosecution? And then bear in mind that Iljo did not show any evidence of forbidden fruits. Only masking agents were found in his sample. But hey, it's the thought that counts right?

Thank Kreitler for rollers!

What do you do when you have a separated shoulder and a cracked rib? You can't swim or run because you can't lift your arm above the vertical or endure the rocking of your shoulder when you run. This type of pain is not very amenable to conventional pain killers, and who wants to run while being on codeine anyways? I am surprised opiates are on WADA's list but that just goes to show you that, either they are bureaucrats who never exercise, or, their real intent is not unfair competition but just to be an extension of the war on drugs. 

Identical to my setup, except for the bike

Riding is possible but only if you ride easy -no heavy breathing here, no coughing, sneezing or laughing.  Also, no sudden stops or grabbing the brake. What is left is ride to on rollers and that works well as long as I ride easy. The forkstand helps but it  is not absolutely necessary. For now, the bike is on the stand and I don't want to take the trouble (and endure the pain) to undo it.

I found that a Lidoderm lidocaine patch on the rib helps to dull the initial pain. I put it on 10-15 minutes beforehand and then I hop on. Once I get going things are Ok as long as I control my breathing and don't stop. I can't ride very fast because breathing deeply is pretty painful, but at least I can get some exercise in. My hip -apart from the skin- is completely back to normal and spinning actually feels good. So I spent 50 minutes on my rollers today, pumping out an easy 190W average. I still managed to burn a good 500 calories.

Health Care in the US

My crash on Tuesday once again brought me in contact with the US Health Care System, a system that is often lauded as the "best in the world," but in reality leaves much to be desired.  A lot of that resides in what computer experts call "the user experience."

Let me first illustrate what would have happened in Belgium (and likely other parts of Europe) after my crash. Given that it happened around noon I probably would have stopped by the local doctor's office on my way home to receive acute care. If the doctor were out, I would have asked whomever was there to have the doctor come over and see me at home. Or I would have gone home and called the office to arrange a house call that same afternoon. If the doctor were very busy I could call another doctor.

The doctor likely would have taken care of my skin wounds, given me a prescription for a strong pain killer (codein is available without prescription) and he or she would have made arrangements for an X ray at a local hospital or sent me to an orthopedic surgeon.

In the US things work a bit differently. Much depends on one's health plan and health care provider of course, but in the span of twenty five years I have been fortunate enough -if one can call that fortunate- to experience nearly every flavor of health care that is available to US residents. Not one of these compares favorably to the European system and all are a whole lot more expensive. My current plan is an HMO.

The first thing that matters in the US is where the accident occurred with respect to one's "area of coverage." Areas of coverage are often remarkably small and it is not unusual for people in the San Francisco Bay Area not to have coverage in Tahoe-where many go skiing in winter- for example. I.e. if you are into sports, it is quite likely that you get injured out of area.

In Belgium or France that is totally irrelevant and one would use the same mechanisms, have access to the same care, pay a similar amount, and receive the same reimbursement regardless of where the crash and treatment happened. Here it does matter. "Out of network coverage" is much more limited, more expensive, and often difficult to get reimbursed for. One has to receive approval beforehand for out of network care. For a borderline injury like mine -where the seriousness may not immediately be apparent- that can be very problematic.

If you go see a doctor and claim an emergency, they may refuse to reimburse you later saying this was not serious enough and you should have received approval before going there. Since you often do not know beforehand how serious something is, that may leave you in a quandary. The insurance bureaucrats have no such issues. They have the benefit of hindsight. If it turned out to be minor, they will promptly refuse to pay you back. But even within the network things are far more difficult and cumbersome than they should be.

My current US procedure starts with a call to my HMO. I automatically get put on hold and have to listen to advice such as "If this is a real emergency call 911" followed by a lengthy explanation of what constitutes a real emergency; next comes a friendly referral to "our website" and all the issues I can solve there; and then a very long-winded message about seasonal flu shots and where to get those. It takes almost 3 minutes before I am connected and before I can start entering relevant information. And by far the most relevant information in the US is your insurance number, because without insurance you are out of luck. Not only will it cost you an arm and leg, but most places won't even want to treat you.

In Belgium, trained medical personnel have to provide care to anyone in need. In the US there is no such provision and it is not uncommon for emergency rooms to refuse patients (arriving in an ambulance with real emergencies!!) and send them on to another hospital. People have died being shuttled from one hospital to the next and nobody thinks twice about that.

After many more messages, muzak, holds, transfers, etc. I finally get to talk to a nurse, who asks a few questions and then tells me I have to come into the emergency room. "Can they prescribe a pain killer because I am really in pain?" Of course not, not until the doctor sees you. And when will that happen? Well that depends on how busy the emergency room is at this time. 

There is also no other option available. Making an appointment would take 2 or 3 weeks. I don't even bother making appointments for other issues because most are over with by the time I get to see someone.

Acute care of any sort means emergency room care. In Belgium nobody would dare to show up in the emergency room with flu symptoms, but in the US that is how things are done. If you have flu symptoms and want help at night of after hours, you go to the emergency room. Going to the emergency room with a relatively minor injury (read, not a gunshot wound) means waiting for hours before someone will see you. Once again, people have died sitting in the waiting area of emergency rooms.

Going to the emergency room also means paying a hefty price, because emergency care is expensive and nobody cares that no other options are available. A few non-emergency, acute care facilities do exist in select hospitals but by and large, all acute care is done in emergency rooms.

Getting a few Vicodin tablets, something every Belgian household has lying around in their medicine cabinet (Codis is an equivalent product available in Belgium) cost me several hours of waiting. I had to drag myself to a local hospital and pay $100 for the privilege. I also received many sheets of paperwork warning me of the dangers of this rather pedestrian medication.

In Belgium I could have just gone to the pharmacy and bought some.

After I spent a night in pain with a cracked rib and an AC joint separation, I called in again and waited for another 10 minutes on hold to ask for another option. I was told I would have to come in again and would then get a higher dose formulation -but essentially the same drug.

It appeared everyone was more worried about me becoming an addict than actually treating me. The orthopedist said, "Well there is nothing we can do for that [the rib] but kill the pain. " But apparently giving a pain killer was not part of that equation.

A very rough night

I had a very rough night last night. The rib pain is now my major problem. The shoulder hurts too but I can easily find positions where it hurts very little. As long as I avoid certain movements (especially raising my arm or putting my elbow forward) there is no issue. I can type just fine for example, with very little pain. My hip is no longer very painful either. Just a bit where the skin got an imprint from the roadway. But the rib pain is not getting any easier.

A road rash tattoo on my hip

Although you can take shallow breaths, which I am definitely doing, you can't totally avoid movement in your chest ever. Since every movement hurts that is not good. The background pain from my chest is always there and it is pretty bad, even with the pain killers. But that is not all. You can't very well go without coughing or sneezing and that REALLY hurts. It is totally surprising to me how often I cough (I was warned by the orthopedist that humans cough more often than they think) even though I have no colds or other respiratory issues such as allergies. I also suspect the shallow breathing makes it necessary for me to clear out airways more frequently.

I was shown how to cough with a pillow on the ribs to minimize the pain, but that only goes so far. And sneezing is far less predictable.

Despite the vicodin and a healthy dose of ibuprofen, I did not sleep well. I woke up at 4 AM and was quite sweaty. I had a hard time getting up and doing so only increased the pain further. I also got cold and felt even more miserable then. With my arm out of commission I cannot move my covers as easily and that surely had a lot to do with me getting too hot and sweaty.

I found out that one holds one's breath when getting up from the couch or bed. At least that is what I think is happening. You probably stabilize your chest so the long back muscles -the ones that get up you upright have a firm contact point. Or maybe I can just feel them contracting against a damaged rib cage? The latter sounds less convincing since they do not insert that far laterally on the rib. I have the distinct feeling I hold my breath to get up. It is something I never noticed before. One thing about getting hurt is that you suddenly realize all the unconscious movements you make to achieve something simple.

No more training for now. Deep breathing is no longer an option. Plus the shoulder makes riding dangerous and running next to impossible.

Another picture of my damaged helmet. You can see the missing chunk and a big scratch higher up.

Crash

Yesterday I crashed on my bike. The weather was nice even though it had been raining the past week, and I decided to go a 30 mile ride before the next storm hit. I had ridden the day before and avoided Pinehurst road, which is always shady, wet and full of debris this time of year. But yesterday I thought I might give it a try. Although it looked wet at the top it had been two days since the last rain and I felt it should be no problem going down the steep descent.

As I was coasting along, taking it easy and daydreaming, I suddenly lost control in a turn and went down. I clearly remember the whole sequence and I remember thinking, "wow this will be a lot of road rash." But I did not slide very far and quickly came to rest near the side of the road. I banged my shoulder and hip and had some difficulty getting up, but eventually I managed to get off the roadway. I also remember my face being very close to the roadway and what a strange perspective that was.

When I got up I walked a few steps and was able to get on my bike and ride some more. My bike was undamaged. Although the crash was similar to the one Alistair had that broke his frame, mine was unscathed. I was able to continue riding for eight more miles with very little problems but then decided to get home as my shoulder felt awkward and I could not put any weight on it or use the front brake effectively.

Very little damage to the jersey. It isn't even torn

I was able to undress and take a shower although I got very cold in the process. My clothes were black but Ok and I did not suffer much road rash (just the elbow), although I did get an imprint (tatoo-like) of the rough asphalt on my hip. After dressing my wounds I went to bed and lay there for a while. The pain in my shoulder, hip and chest became more intense and so I took some painkillers.

At night the pain got worse and I decided to call the doctor who sent me to the emergency room. I got X-rayed, got a brace and was sent home with a prescription for vicodin. They asked me about a head injury repeatedly but I could not remember hitting my head, nor did I feel any pain or show any other symptoms of a concussion. I was able to read and concentrate well in the afternoon and so I was not worried.

When we came home, my wife wanted to see my helmet and when she touched it she yelled out because  two large pieces came off that were loose. The helmet is an older helmet I have had for years, and one I wear in winter because it does not have large vents and is warmer than the newer versions. As far as I know it was without issues before the ride.

Some rather serious damage

My old Bell helmet with missing pieces

I had a rough night, despite the pain killers.

This morning when I woke up I felt better. My hip was a lot better and I was able to walk well. But my rib cage felt a lot worse. I had an appointment and went to see the orthopedist at Kaiser. There I was told I had a cracked rib and a grade I/II AC joint separation in my shoulder. Nothing much can be done about either of these and I was sent home with pain medication, instructions on how to cough with a pillow bracing (and keep coughing to clear my lungs) and an appointment for early January.