Saturday, December 27, 2008

A Pleasant 20km

Today was the first time I ran the Hartamas route in about a month. It was a slow and easy run, completed 20km together with my brother. Rather quiet day, there was only one other person running 20km. Since it was a slow and easy run, I did not bother to carry a running belt and only rehydrated myself at 10th km.

My left hip flexor hasn't felt the same since a week before the marathon. At certain positions it feels tight. Also, I have to ban myself from wearing heels..my left big toe and bunion were hurting from wearing heels a few days ago.

ON the way back, when we were running past the tennis courts, there was a motorcyclist there who was watching people play tennis. Just as we hit the pavement, the idiotic motorcyclist decided to ride on th pavement, AND against traffic. He honked expecting us to give way but in any case he was happily watching the tennis game until we started running on the pavement. Secondly, the pavement is not intended to be a bike lane and thirdly he was against traffic anyway. We ran as fast as we could because there was no telling if this man could be psychotic enough to run us down.

Anyway we finished the run quite easily, and it was a very pleasant run.

Sunday, December 21, 2008

Malakoff 12km

Went for the Malakoff 12km at Tmn Rimba Kiara this morning...Quite a huge turn up, with the new route, I had expected a jam similar to the ones in SIngapore Marathon. In the last minute the organisers decided that it was too dangerous to run on the SPRINT highway, so the race was limited to running 2 laps of the road from the Tmn Rimba up to Sime Darby Convention centre and back.

Flag off was delayed, we started about 7.15am I think (my watch is forever fast so I wasn't really sure of the actual time). It was quite a fast race (well at least for me it was, as I am more of an endurance than speed person). It was quite a gruelling circuit, with a total of 6 major slopes. By the time I finished 1 lap, I was really regretting doing heavy pec workouts on Friday...I was still quite sore and by the time I hit 6km, my shoulders were super duper tired, they almost felt numb! BUt of course with the crowd and adrenaline i just pressed on.

There was an anorexic looking lady who tried to outrun me at several points in the race,but here's where having fat reserves help - at the last hill when she tried to outdo me, alas I completely lost her going uphill... I had the extra fats (ie fuel) to propel myself uphill.

Finshed the race in 76 mins.

Thursday, December 18, 2008

Barrier Broken!

Finally!! I have broken the barrier! I am finally back to my original weight 2 years ago. Last year was a rather sluggish year physically, and towards middle of this year I gained a hefty 5kg. (Yes it was THAT much.) Even after I started my marathon training, weight loss was progressive and very very slow. Towards the few weeks before the race, my weight had remained stagnant for a long time and it was difficult to break that barrier.

When I returned from Singapore, I realised I had lost another 2kg!! I've lost a total of 5kg alltogether.I believe it had something to do with the 1 week break, when I started exercising again my body responded better to the exercise. During the week before the marathon and the week after, I ate more carbohydrates than usual, and I believe it's because of that that I've had a speedier recovery.

I've managed to reduce my BMI to 23.07. Hurrah! Overjoyed!

Tuesday, December 16, 2008

Dangers of Herbal Weight Loss Products

Individuals with eating disorders no longer have to obtain a prescription or use over-the-counter drugs to lose weight or suppress their appetite. Instead, the whole arena of "dietary supplements" is now open for them to explore. They may come upon herbal preparations that appear to help in weight loss or appetite suppression, or that promise to raise mood or decrease anxiety. Unfortunately, they may also encounter agents that cause significant side effects and/or drug interactions. Use of such products can also delay appropriate treatment. Often these agents are thought to be safe because they are "natural." Extrapolation to over-the-counter and prescription medications may lead consumers to expect that these products must have demonstrated effectiveness because, after all, they are on the market.

Background
In 1994, Congress passed the Dietary Supplement and Education Act (DSHEA),(1) which relegated herbal agents to the category of "dietary supplements." In effect, this removed these products from the purview of the Food and Drug Administration (FDA). Currently there are no standard requirements that herbal products be either safe or effective. In addition, no government agency inspects the manufacture or degree of purity or accuracy of contents of these products. Thus, there is no way to know how much of the ingredients listed are really present in any sample. As a result, herbal products are a completely unregulated source of potentially dangerous products readily available to anyone who wants to lose weight. A recent review demonstrated how widespread use of these agents is in the general population.2 Between 1990 and 1997, use of herbal therapies increased by 380%, and in 1997 alone consumers spent $5.5 billion on herbal therapies. Advertising for these agents is also ubiquitous. Magazines, newspapers, TV, and health food stores, grocery stores, and pharmacy outlets are prominent sources that extol the advantages of these preparations. In addition, direct consumer mailings, many targeting teenage girls, encourage patients with eating disorders to read fantastic claims for these agents and how to acquire them. The Internet has exploded with an abundance of claims for various herbal preparations. The question may not be "if" your patient is taking one of these agents, but "when" and "how many" of the preparations are being consumed. Remember that 60% of patients do not tell their physicians that they are using herbal products.(2)
60% of patients do not disclose the use of herbal medicines to their physician.

Types of Agents
We recently published an overview of alternative medications used by eating disorder patients, including a review of locally available preparations.(3) A partial list of active ingredients found in the various types of preparations is shown in Table 1.

Weight loss agents. This category includes a number of different types of products. The only type of treatment that has actually produced short-term weight loss is the combination of ephedrine and caffeine.(4-7) This type of product may be marketed as a drug combination or as the herbal sources, which include ma huang (ephedrine) and a caffeine source such as guarana seed or Kola (cola) nut. However, extrapolating results from clinical trials that employ pharmaceutical-grade ephedrine and caffeine or research studies using standardized herbal preparations to the use of botanical sources available to a patient is not without difficulties. The botanical sources chosen by the patient may not have the same amounts of either ingredient in the preparation despite the labeling (there could be more or less). Attempts to identify empirical data concerning the effectiveness of other putative weight loss products or ingredients have proven unsuccessful. Unfortunately, the available studies are few and often methodologically flawed. (8, 9)

Laxatives. Laxative preparations are often combinations of multiple ingredients, many of which have little to do with producing the laxative effect. Such products may contain either herbal or pharmacological sources of stimulant cathartics, such as bisacodyl, cascara sagrada, or senna. Other potent cathartics, such as magnesium hydroxide or citrate, may be included. Methylcellulose or other bulk laxatives may also be added. At first, these products are quite effective at producing diarrhea. However, over time stimulant cathartics tend to lose their efficacy and can result in a hypoactive bowel.

Diuretics. Diuretic agents are mostly represented by sources of caffeine (guarana seed, cola nut) or the mild diuretic pamabrom. Mild diuresis can be obtained with these products but they are not as effective as prescription agents such as furosemide (Lasix™) or hydrochlorothiazide (HydroDIURIL™).

Adverse Effects
The magnitude of the risk of side effects associated with herbal therapies is well illustrated by a recent case. An herb, Aristolochia fangchi, was inadvertently substituted for another, Stephania tetrandra, in a weight-loss preparation compounded in Belgium. Seventy individuals who took the herb developed complete renal failure, and 50 more had kidney damage. Cancerous or precancerous lesions were found in 37 of 39 who had a kidney removed.(10) This unfortunate incident is a dramatic illustration that "natural" agents can have very undesirable effects.

Caffeine and ephedrine. Caffeine, found in many beverages, can cause mild agitation, insomnia, tremor, and diuresis. However, ephedrine, which is often combined with caffeine in products, generates a larger concern. Sudden death (myocardial infarction), hemorrhagic and ischemic stroke, acute hepatitis, nephrolithiasis, dizziness, tachycardia, headache, tremor, nervousness, and insomnia have all been reported with this combination. (4, 11-17) The most common adverse events identified in a recent report included: hypertension (17 reports), palpitations, tachycardia or both (13), stroke (10), and seizures (7). Ten events resulted in death and 13 events produced permanent disability. Fifty-nine percent of the users were taking the supplements in order to lose weight.(11)

Yohimbine. Occasionally appetite suppressants will contain yohimbine, an indirect adrenergic agonist. Anxiety, elevated blood pressure, queasiness, sleeplessness, tachycardia, tremor, and vomiting are potential side effects related to this agent.(18)

St. John's Wort. St. John's Wort has been included in many preparations. Photosensitivity, gastrointestinal irritation, allergic reactions, tiredness, and restlessness have been reported, along with drug interactions. Recently St John's Wort has been reported to stimulate the CYP450 3A4 enzyme, which is involved in the metabolism of many important medications. Stimulation of this enzyme's activity may lead to a reduction of the blood levels of certain concomitant medications, including cyclosporine, indinavir or possibly oral contraceptives. (19-21)

Chromium picolinate. This product has been reported to be associated with cases of hypoglycemia, nephrotoxicity (at high doses), dissolution of muscle tissue, acute generalized pustules, as well as cognitive and personality disturbances.(22-29)

Laxatives. As mentioned earlier, laxative products often contain a form of a stimulant cathartic (bisacodyl, cascara sagrada or senna). Problems associated with these agents3 include: Bisacodyl-GI irritation, fluid and electrolyte loss, cramping, development of tolerance.(30) Cascara sagrada-severe vomiting with fresh bark, electrolyte imbalance with misuse, hypokalemia potentiates the toxicity of cardiac glycosides and thiazide diuretics.(31) Senna-hepatitis, abdominal cramping, nausea, electrolyte disturbance (e.g., hypokalemia, hypocalcemia, metabolic alkalosis or acidosis). Increased mucus secretion, reduced spontaneous bowel function, and melanotic pigmentation of the colonic mucosa (melanosis coli) may confirm laxative abuse. (32, 33) Another ingredient in laxatives, bladder wrack kelp, is a source of iodine, which may potentiate hyperthyroidism, worsen preexisting acne, or lead to new acneiform eruptions.(34, 35)

Other herbs. Skullcap has been associated with hepatic toxicity. (41, 42) The berries of wahoo bark are toxic. Reactions may include GI symptoms (colic, bloody diarrhea), elevation of body temperature, circulatory disorders, elevated cerebrospinal fluid pressure, stupor progressing to unconsciousness, or tonic clonic spasms.(43) Wild yam root has produced a picrotoxin-like effect (tonic clonic spasms headache, dizziness, nausea) on overdose.(44) The mild diuretic uva ursi has been reported to cause nausea and vomiting. (45) Other agents include gingko biloba, which has been associated with headache, GI upset, allergic skin reactions, and several cases of cerebral hemorrhage, possibly related to its interaction with platelet aggregation and thrombolytic therapy.(42-46)

Conclusion
Herbal therapies may include ingredients that are very potent and pharmacologically active. Along these lines it should not be surprising that adverse reactions and drug interactions may follow. Uncertainty about these issues stems from the lack of data regarding effects of various herbs, concerns as to what the active ingredients may be, the lack of the practice and enforcement of good manufacturing standards and a lack of a mechanism for adverse reaction reporting. Recently Congress created the National Center for Complimentary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH), which may help in addressing some of these issues. The mission of this organization is "to explore complementary and alternative healing practices in the context of rigorous science; to educate and training CAM researchers; and to disseminate authoritative information to the public and professionals."(46) The Center has set out to investigate certain herbs for efficacy, currently St. John's Wort, gingko biloba, saw palmetto, and glucosamine/chondroitin, which has shown some evidence of efficacy. This process is long overdue but may not produce clinically applicable data soon. Thus, clinicians treating patients with eating disorders should attempt to identify any alternative medicine treatments the patient is currently using or has used. Then, consulting the literature and/or individuals knowledgeable about herbs will help in determining if the individual has adverse reactions or drug interactions associated with these therapies.

Active Ingredients in some Alternative Drugs

WEIGHT LOSS AGENTS:
  • Caffeine
  • (guarana seed, kola nut)
  • Ephedrine (Ma huang)
  • Chromium picolinate
  • Gingko biloba
  • Stimulant laxatives (Cascara sagrada, Senna)
  • St. John's Wort
  • Yohimbine


LAXATIVES:
  • Bisacodyl
  • Bladder wrack kelp (iodine)
  • Cascara sagrada
  • Gingko biloba
  • Magnesium hydroxide or citrate
  • Rhubarb
  • Senna
  • Skullcap
  • Wahoo bark
  • Wild yam root


DIURETICS:
  • Guarana seed (caffeine)
  • Kola nut (caffeine)
  • Uva ursi extract (bearberry)

Source: www.bulimia.com

I'll Keep my Big A**, Thank You

This morning my running buddies and I ran about 6km. Felt great and strong, after a whole week of rest, and I still felt strong running uphill. Except that my glutes and hamstrings were quite sore from yesterday's workout!

Anyway the topic of our conversation over breakfast this morning was on fad diets.We've some friends who've been on Nutrilite or Herbalife diets, and they've lost a tremendous amount of weight, compared to me, who's been running and running and running and yet still have big hips and a**. It's amazing how much of weight one can lose going on these diets, especially on the hip area, where stubborn fats easily accumulate.

As much as I suffer from body dysmorphic disorder , I would still rather lose weight through exercise instead of consuming anything unnatural to lose weight. Many of these diet and weight loss products claim to have natural substances, but my question is, how long can you continue to consume that product, and are you sure there are no side effects from consuming it in the long term?

Also, we have to be aware that a number of these weight loss products (eg. Xenical)were designed for obese people, who truly need to lose weight for health reasons, and for not the average person. So is it healthy for a normal person to consume these products?

Some of the potential dangers of consuming weight loss products are:
1. potential for dependence
2. disrupts your metabolism
3. depression
4. raised blood pressure
5. heart damage
6. liver damage
7. malnutrition due to deprivation of certain food groups
8. Fatigue
9. Irritabtility
10. Subsequent AND quicker weight gain

Although I do complain about being fat etc etc (that's the paranoid side of me), nevertheless I am glad I am not as obsessed as some people who are already like stick insects AND still think they are fat and want to lose 10-20kg etc etc. I do admit that I'm still not entirely happy about my body shape, but it's learning to accept who are you, which I am slowly learning over time. Also you'll find that you can't really fight age, eventually your body breaks down and your metabolism slows down anyway.

So, instead of spending money on weight loss programs,I'd rather be the fit marathoner that I am, and despite I am a bit chunky, I'd rather keep my big a** and keep running, thank you.

Shopping in Singapore




I was very pleased I managed to buy some running gear in Singapore.First of all, I managed to get my pink shirt!!I had wanted a pink shirt for the race, but could not manage to find the right one. I usually prefer the vest type and not the tank top type (too tight and the material is usually thicker). I was quite pleased that there was a 10% discount on it too. Sportsgear in SG is so much cheaper if you earn in SGD.

My friend also brought me to Cineleisure, where I went crazy and bought 2 hydration belts! I've always thought the Nathan hydration belts are too chunky....so I managed to find a Nike one, which was on 40% discount (cost me about SGD32 after discount) and an Adidas one which was on 30% discount (about SGD22 after discount). They are probably old models, but heck, it's hard to find them in Malaysia and they were on discount anyway. I prefer the Nike to the Adidas one, as the Adidas one uses elastic material and they become loose after a while. The Nike one also comes in different sizes whereas the Adidas one is a standard size. The size I bought was one size smaller as they didn't have my size, but I guess it's ok if I'm just using them for training.

PS I'm being interrupted by my niece as I type this, so I haven't time to check my grammar etc!

Monday, December 15, 2008

Back to the gym

It's been a week since my marathon! Have rested the entire week, taking it easy and not watching my diet...much to my surprise I did not gain weight, but lost 1kg - I am sure it's water loss and not fat loss considering the amounts I ate over the week.

Well, it's back to unclogging arteries today - oatmeal diet and exercise. Ran about 3km on the treadmill, slow and easy. Feels kind of nice. My left hip flexor doesn't exactly feel normal, so i took it easy.

Back to weight training too. Missed it for a while week. Did legs today..nothing too strenuous.

I've signed up for the Malakoff 12km run, but I haven't received any confirmation email from PACM, so I'm not entirely sure I'll be running that race.

Saturday, December 13, 2008

Analysis of Marathon Run

This is the analysis of my run, and my position in the entire race. There were 12393 full marathon participants altogether, where 15% were female and 85% male.

Result in Entire Field - 4317th place
8076 finishers behind. About 35% of finishers ahead.

Result in Gender (Female) - 557th place
1296 finishers behind. About 30% of finishers ahead.

Result in Division (F3539) - 122nd place
132 finishers behind. About 48% of finishers ahead.

Average split time:7 min 42 sec per km

Average speed:7.8kph

For the record, I was ahead of about 64% of male finishers. GIRL POWER!!!

I was at around 16thkm when Luke Kibet won the race.(2:12:01)

SECTION KPH
Start -10k
10k -Half
Half -30k
30k -Fin

Singapore Marathon 2008



I made it! My 3rd full marathon! Coming from someone who hated running in school and used to cheat on laps around the field, it’s a huge achievement. I still remember doing those 100m and 20m dashes, I never used to qualify for them.

Anyway, this time I completed it in 5:24:37. Which is worse than my previous one (5:20) but better than my first (5:29). I’m pretty consistent I guess….consistently slow! But I am not complaining because I NEARLY did not run the race at all. The 2 weeks running up to race day had been very hectic – I had been having long days and stressful days at work, not to mention the lack of exercise (with the view of tapering) made me even more tired. On top of that I seemed to have pulled my left hip flexor and it was still acting up until the race itself. And finally, on the night before the race, we did the traditional carbo loading at Pasta de Waraku at Marina Square…that was when I started to feel nauseous. Before dinner I was having a bit of a headache – I thought it might have been from dehydration as I drank very little water on the bus – so I took a Panadol. After dinner, while stretching myself, suddenly I felt the whole world sinking. I felt a bit nauseous and light headed. My friend said I looked pale..I could not even walk back to the hotel which was 15 mins away – I had to take a taxi back.

When I got back I just immediately jumped into bed. I could not sleep immediately as my niece and nephew were around and they were talking very loudly. Nevertheless I managed to knockoff, after listening to my mp3.

Got up at about 3.45am on race day..felt much better but wasn’t sure if I could pull through a 42km. Spent the entire hour sitting on the throne (with no success) and eating a Power Bar (ya I know, disgusting….trying to fill one end and empty the other!) I had my bib and chip all fixed the afternoon before, so all I had to do was just put on my running gear.Slapped on loads of petroleum jelly everywhere – that was the greatest because I had absolutely NO CHAFING at the end of the race!

Left hotel room about 4.50am and headed to the starting point. As I approached the starting point I began to feel quite nauseous as there were far too many people – total of over 43000 participants – plus the smell of Deep Heat ointment really put me off. Was very tempted to just quit, but I thought, heck, I’d been training for almost 4 months,and I’d come all the way….why don’t we just try it?

By the time the gun went off, I still hadn’t reached the starting point – far too many people!!! Took me about 4 minutes to get to the starting line. It was so crowded that by the time we came to the 3rd km after the U turn, I had to walk for a bit..there was no room to run! After I had started running, I felt much better but not completely great either. But you know what? I didn’t even feel like I needed much mental strength until about 30km….with the crowd pushing you on , you just keep running and running and running. Almost autopilot.

I was feeling alright until about 15th km..I felt a bit of a stitch coming on – I think I was feeling a little dehydrated perhaps. I stopped for water at 4th, 8th and 12thkm. (Water only, no 100 Plus. Usually only begin taking 100 Plus between 15th to 20th km) I stopped to consume my 1st power gel. After that I began to pick up pace. I missed the banana at 12th km – I didn’t see it but I saw other runners around me carrying a banana. At about 22nd km they were giving out some Gu Gel so I grabbed 2. Continued running until about 25th km before I took my second gel…was still feeling strong and on autopilot! In the past, the crowd starts to disperse after 21st km..people start to walk etc but this time round, the crowd didn’t clear until about 30th km! That shows you how crowded it was.

At about the 28th km I spotted Tey, the resident PACM photographer, then I waved at him and said I was from PACM too, and that was when he took my glorious, glamourous photo in action. This is the best running photo I’ve ever had! (Well I guess it’s because I knew he was taking my picture :P)

Stopped at 32nd km for banana and 100 Plus. Think I was beginning to feel tired but could still push on after the banana. I actually ran continuously until about the 37th km before my hip flexors started feeling sore and tight..that was when I had to do intervals of walk – run. My pace slowed down incredibly in the last 5km and I knew I could not beat my previous timing but I kept reminding myself that my aim was to complete it. I began to feel very hot and sometimes I would stop at the waterstops not to drink but to pour water on my head.

Between 40th to 42nd km felt like the longest, especially near the F1 pitstop…it was very hot. Finally as I approached the finishing line, I picked myself up again, though my thighs were very very tired, I spirinted to the finish line.

What an achievement!

I have to say though that this time I had absolutely no sore knees at all after the run. Hurrah! My thighs were sore for about 2-3 days only but that was it, no injuries. I think what also helped was that after the run I took my niece to the swimming pool, and I did some running on the spot in the pool, which relaxed my hip flexors a lot. (And also very good for the joints)

I’m ready to run again.

PS. Forgot to mention that I ran until there was a hole in my new New Balance RM49 socks! Bah!

Friday, December 05, 2008

Adios!

This will be my last post before the run. Strangely I have been feeling fatigued this whole week...Even when I was ill previously I recovered quite fast. Could it be pre-race jitters? Also, I've got a muscle pull around my left hip flexor. SIgh, all throughout the training when I was running long distance I had no problem at all. I felt this pull last week when I was doing my 10km, and when i coughed a bit, i felt a slight muscle pull. Seems to have lasted the whole week.

Went for a steambath this morning and it felt a little better but it's still there.

Cant expect much or run as fast as I would want to, with that niggling feeling there.

Just hope for the best I guess, and only hope to finish the race.

I'm leaving tomorrow.

Monday, December 01, 2008

Thinking Positive

I’m feeling super right now! I just hope this energy can sustain until end of the week. From Friday right up to Sunday I was feeling quite groggy and low on energy, as I was on medication. I’ve been popping lots of Berocca as well, and my only hope is that I will be energetic enough for the run on Sunday. I woke up this morning feeling not that great but still mustered enough energy to go to the gym (late although). I usually run on Mondays to kickstart my week, but today I went slow with some interval walk-runs. Also did my last set of weight training for the week (for 2 weeks actually since I will not be exercising much next week). Only did upper body as I avoid weight training on legs on the week before the race.

I’ve really got to psyche myself up now.

Think POSITIVE.

POSITIVE
POSITIVE
POSITIVE

I’ll be ok.

I've to kill the butterflies in my stomach.