2012 Year in Review Sports Quiz

The Science of Sport Year in Review Quiz

2012 is almost at an end, and it's been a year of gold medal triumphs, and more than a few major controversies.  Armstrong, Wiggins, Farah, Bolt, Ennis, London, Messi, Spain, Tygart, Kimmage and Walsh were some of the newsmakers of the year, not often for the right reasons, in a year that brought many firsts.  

Rather than do my usual year in review series, I thought I'd try to sum up the year with a quiz on some of the major stories of the year.  I'm biased heavily in favor of what was covered here on The Science of Sport during the year, so that means a lot of athletics, cycling and of course, the Olympic Games feature heavily in the fifty questions below.  You'll have to forgive me for not covering the US-sports and no, there's no Formula One or horse-racing here either!

And I took the opportunity, in providing answers, of editorializing somewhat, and embellishing those answers with some facts and trivia, to sum up what has been a memorable and enthralling year in sport.  I know the last month has seen the posting frequency dwindle - let's call it a loss of creative energy, but the plan is to do more posting next year, including more translation of sports science research during slower news times.  I'm mindful that there are outstanding journalists who do a better job of reporting the news (e.g: Armstrong and cycling's dramas this year), and so we'll try to return to a more niche-based offering in 2013.

It's difficult to see how 2013 can provide any more drama - there are no Olympic Games, and I can't think of a bigger controversy than Armstrong in 2012!  But whatever happens, science or sport, we'll do our very best to cover it, here, and on Twitter and Facebook, so join the community and bring on the New Year!

I take full responsibility for any errors, but I whipped the quiz up quickly, so go easy on the odd omission!  The points don't matter anyway - they're like doping controls in the 1990s.  There are fifty questions, but most have multiple answers.

The answers are at the end of the quiz.  Enjoy! Ross.  

Track and field at the London Olympic Games

1. Name the top five countries on the overall London Olympic Games medal table
2. What was the winning time in the men’s 100m final at the London Olympic Games?
3. How many men broke 10 seconds in the 100m final?
4. Of the fifteen medals available in the men’s ‘sprint’ distance events (100m, 200m, 400m, 400m hurdles, 110m hurdles), how many were won by the USA?  How many were won by Jamaica?
5. So far, only one track and field athlete has been stripped of a gold medal at the 2012 London Olympic Games.  Name the athlete and the event where the gold medal changed hands weeks after the medal ceremony
6. How many track and field defending champions were able to repeat as Gold medalists in London 2012?
7. Usain Bolt was one of eight multiple individual medalists in track and field in London 2012.  Name the other seven athletes who won more than one medal, excluding medals won in relay events.
8. Trinidad & Tobago won only its second ever Olympic gold medal in London, from an unlikely source.  Who was it and in which event?
9. Controversy in London 2012 surrounded an eventual gold medalist who was first disqualified from running a final because he had not given a maximum effort in a heat of a different event.  Who was it, and which event did he go on to win?
10.  There was one track and field event where more than three medals were handed out because of a dead heat/tie for places.  Which event was it?
    
    Cycling
11. Name the three men who won the Grand Tours in 2012
12. Frank Schleck was suspended during the Tour de France after testing positive for which substance?
13. Name two of the three men who won stages in two out of three of the Grand Tours this year
14. Name the dominant Dutch cyclist who won the world cyclo-cross championships, the Giro Donne (including five stage wins), the Olympic Games Road Race and the UCI World Championships.
15. Which big name team sponsor reacted to cycling's latest doping controversy (precipitated by the Armstrong USADA report) by announcing that they would end a 17-year long association with the sport on December 31 this year?
    
    Track & field 
16. Five world records were set in track and field athletics this year.  Name the athletes and the events in which they were set
17. Name the men’s and women’s winners at the Marathon Major events in 2012
18. Who were named the IAAF’s male and female athletes of the year in 2012?
19. Name the Brazilian double amputee who surprisingly beat favorite Oscar Pistorius in the London Paralympic 200m, before ironically being accused of Pistorius of gaining an unfair advantage through the use of technology by increasing the length of his carbon fiber prosthetic blades?
20. Two American sprinters made news in October when they switched the tartan tracks for ice runways to qualify for the USA bobsled team.  One of them was Lolo Jones, the 100m hurdler.  Who is the other?
    
    Team sports
21. Who was named the IRB Rugby Player of the Year for 2012?  Who was the IRB Sevens Player of the Year?
22. Who were the Six Nations Champions of 2012?
23.  Lionel Messi will end the calendar year with 91 goals for club and country, a record setting year for the three-time world player of the year.  Whose record did he beat?
24.  In a thrilling end to the English Premier League, the title swung from the blue to the red half of Manchester before finally coming to rest with Manchester City, thanks to two stoppage-time goals in a come-from-behind victory.  Who did City beat on the final day, and who were the two players who scored the goals that pulled them passed Manchester United, who had all but begun celebrating their late surge to the title?
25. Spain completed a historic treble by winning their third consecutive global football title in Kiev in July.  They won the Euro2012 title to go with their Euro2008 title, and the 2010 Football World Cup.  Who did they beat in each of those three finals, and who were the four goal scorers in the latest triumph? (I know, we're going further back in the memory banks than just 2012 here!)
26. Which nation won the ICC World Twenty20 title in Sri Lanka in October, and who did they beat in the final?
27. Name the highest run-scorers in Test, one-Day and Twenty20 cricket , and the highest wicket-taking bowlers in each of the three formats of the game during the past calendar year (as of 27 December this year)
28. One USA-sport question, easy for our US-readers, but not as simple for those outside.  Who are the current NFL, NBA and MLB champions?
29. The Ryder Cup produced one of the year's most dramatic comebacks in Chicago in September, as the European team came from a 6-10 deficit to retain the Cup.  Name the player who sank a clutch five-foot putt on the 18th hole of the 11th singles match to give Europe an unassaible 14-13 lead?  Who did he beat?
30. Name the number-1 ranked MEN'S teams in the following three sports:  Handball, field hockey, volleyball
    
    The business of sport
31. The most recent TV rights deal to broadcast the English Premier League is worth £3.2 billion over three years, in effect from 2013.  This is a jump of 71%, and will return the EPL to the status of being the most lucrative broadcast deal.  Which league currently tops the list?
32. Which three sports brands were named by Forbes as being the most valuable in 2012?
33. According to a similar Forbes’ list, which three sportsteams top the list of “most valuable teams” in 2012?  And yes, I know how fraught with difficulty it is to value these teams and brands, so I’m going by those lists, which are disputable (and even disagree with one another, if you read the closely)
34.  Last Forbes’ based question – name the top five highest earning athletes in 2012.  The earnings consist of salaries/winnings plus endorsements 
35. Which tennis player caused controversy in 2012 when he said the following: "men's tennis is ahead of women's tennis" and "men spend twice as long on court as women do at Grand Slams" to re-ignite the debate about equal pay for men and women?
    
    
    Other Olympic sports
36. Michael Phelps retired after London 2012 as the most decorated Olympian in history.  How many gold medals, and how many total medals has he won?
37. Name the men's and women's allround gymnastics gold-medalists from London
38. The women's triathlon event in London featured one of the closest finishes of the Games, as a photo-finish after nearly two hours of racing was required to separate gold from silver.  Who were the two athletes involved?
39. One of the powerhouse nations of swimming, Australia endured a disappointing Games.  How many gold medals did Australia win in the London pool?
40. Seven nations won their first ever Olympic medals in London.  Can you name three of them?
41. Prior to London 2012, Sir Steven Redgrave was the most decorated British Olympic athlete with one bronze and five gold medals between 1984 and 2000.  Once the flame went out in London, he was third on the British list for total medals, and second for golds.  Which two athletes jumped ahead of Redgrave thanks to their London hauls?
42. There was controversy in the women's football tournament in London, when one of the teams refused to take the field after the wrong flag had been shown on the jumbo screen.  Which team was involved and what was the specific error?
43. Two fifteen year old swimmers won gold medals in the pool in London.  Name them
44. Who were the flag bearers for the hosts at the opening and closing ceremonies of this year's London Olympics?
45. How many medals were awarded at the London Olympic Games (to the nearest ten will do!), and how does this compare to medals at the Paralympic Games?
    
    Tennis
46. Men’s tennis’ big four continued to dominate the Grand Slams in 2012, sharing the four Grand slams.  Djokovic won the Australian Open, Nadal the French, Federer Wimbledon and Murray the US Open.  They also occupied 12 of the potential 16 semi-final places between them, leaving only four slots for other players to reach Grand Slam semi-finals.  Name the three players (one of them did it twice)
47.  Which player won the most singles titles on the men's ATP Tour in 2012?
48. Which player won the most singles titles on the women's WTA Tour?
49. Who set a record for the fastest-ever recorded serve in an official ATP event this year?
50. The women's world number one ranking changed hands three times in 2012.  Name the three women, who at some stage during the year, occupied the number one spot

And here are the answers

Track and field at the Olympics

1. USA, China, GB, Russia, South Korea
2.  9.63s, by Bolt, a new Olympic Record
3. Seven.  Asafa Powell was the only man to fail to go under 10, and that was arguably only because of an injury that forced him to pull up about 40m from the line.  He finished in 11.99s.  Three men broke 9.80s, incidentally – Bolt, Blake and Gatlin
4. Four – Justin Gatlin in the 100m, Merrit and Richardson in the 110m hurdles, and Michael Tinsley in the 400m hurdles.  Jamaica won six, largely thanks to Bolt and Blake going gold and silver twice, with Warren Weir completing a podium sweep in the 200m,  and Hansle Parchment winning bronze in the 110m hurdles.  The other medals (five) were won by athletes from other Caribbean nations – Puerto Rico, Grenada, Dominican Republic, Trinidad & Tobago.
   In the 400m, no American even qualified for the final, while Caribbean islands claimed all three medals, signaling the next phase in the shift in power in the sprint events.  This had begun in Beijing, where Jamaica’s women won the 100m, 200m, 400m hurdles, and 4 x 100m relay, while their men (that is, Usain Bolt), won the 100m, 200m, and the 4 x 100m relay.  The USA women got some consolation winning the 4 x 100m relay in London, in a new World Record, to dethrone the Jamaican women.
5. Nadzeya Ostapchuk of Belarus was stripped of her shotput gold medal after failing a test for the steroid metenolone.  The gold medal was awarded to Valerie Adams of New Zealand
6. Men:  Usain Bolt repeated twice - the 100m and 200m.  The Jamaican men’s 4 x 100m relay team.  Tomas Majewski of Poland in the Shotput
   Women: Shelly Ann Fraser in the 100m, Tirunesh Dibaba in the women’s 10,000m.  The USA women in the 4 x 400m relay.  Valerie Adams in the shotput via the disqualification of Ostapchuk.  Barbora Spotakova in the javelin
7. Mo Farah won double gold in the 5,000m and 10,000m.   Yohan Blake won two silvers.  Will Claye (USA) won silver in the triple jump and bronze in long jump.
   For the women: Tirunesh Dibaba won gold at 10,000m and bronze in the 5,000m. Shelly-Ann Fraser-Pryce won gold in the 100m and silver in the 200m.  Carmelita Jeter won silver and bronze in the same two events.  Vivian Cheruiyot won silver in the 5,000m and bronze in the 10,000m
8. It was Keshorn Walcott, who won gold in the men’s javelin
9. Taoufik Makhloufi of Algeria had already qualified for the 1500m final when he ran an 800m heat, effectively jogging 200m before stepping off the track.  He was disqualified, but later reinstated after providing a medical certificate of injury.  That “injury” didn’t hamper him in the 1500m final, which he won in dominant fashion
10. Men’s high jump saw a three way tie for bronze – Barshim, Drouin and Grabarz all cleared 2.29m and could not be separated on count-back, and so five medals were awarded.  Gold went to Ivan Ukhov of Russia, who cleared 2.38m
    
    Cycling
11. Giro d’Italia:  Ryder Hesjedal
    Tour de France:  Bradley WigginsVuelta Espana:  Alberto Contador
12. Xipamide, a diuretic.  Schleck initially claimed to have been poisoned.  His case was heard in December, with a decision expected at the end of January
13. Mark Cavendish – Giro and Tour; Joaquim Rodriguez – Giro and Vuelta;  Alejandro Valverde - Tour and Vuelta
14. Marianne Vos
15. Rabobank, who in a statement expressed a lack of confidence that the status of cycling could change "for the better in the foreseeable future"
    
    Track and field
16. David Rudisha broke his own 800m WR to win the Olympic gold in London.  Aries Merritt broke the 110m hurdles record post-London.  Ashton Eaton broke the decathlon world record in the USA Olympic Trials.  Jamaica’s men broke the relay record in London.
    
    The USA women’s 4 x 100m relay team won gold in a WR time in London
17. Boston: Wesley Korir and Sharon Cherop (both Kenya)
    London: Wilson Kipsang and Mary Keitany, both Kenya
    Olympic Games: Stephen Kiprotich of Uganda and Tiki Gelana of Ethiopia
    Berlin: Geoffrey Mutai (Kenya) and Aberu Kebede of EthiopiaChicago: Tsegaye Kebede and Atsede Baysa, both of Ethiopia
    New York: No running due to Hurricane Sandy
    
    The scoreboard reads three Kenyan wins to one Ethiopian and one Ugandan on the men’s side, and three Ethiopian wins to two Kenyan wins on the women’s side.  On the other hand, looking at the top 10 times of the year, Ethiopia had seven, Kenya three on the men’s side, whereas it was five apiece on the women’s side.  So we’ll call 2013 an even year in the East African battle, and acknowledge that it was Uganda who claimed perhaps the biggest single victory with Kiprotich’s Olympic gold!
18. Usain Bolt and Allyson Felix.  For Bolt, it was the fourth time in five years that he had received the honour (David Rudisha was the exception in 2011).  It was Felix’s first such award
19. Alan Fonteles Cardoso Oliveira, aged 20.  His blades were later confirmed to be within the allowable limits according to the formula used by the sports governing body, but the incident highlighted the complexity of technological devices that affect running performance without known or agreed upon standards, and hint at what is to come when other athletes emerge with similar technology in the future
20. Tianna Madison, a 100m sprinter who ran the first leg of the USA's world record breaking relay team in London 2012.
    
    Team sports
21. Dan Carter of New Zealand, his second such award (2005).  The Sevens player of the year was New Zealand's Tomasi Cama, who won the award for the first time
22. Wales, who were unbeaten throughout the tournament
23. Gerd Muller, who in 1972 scored 85 goals for West Germany and Bayern Munich.  To give perspective and context to Messi’s year, the stats show that he scored his goals in 69 matches – 79 in 60 for Barcelona and 12 in 9 for Argentina.  That’s 1.3 goals per match, lower than Muller who scored 85 in 60 (1.4 per game).  For more statistics, including a video of all 91 (in just over 10 minutes), check out this link
24. City beat QPR at the Etihad Stadium, thanks to a 92^nd minute goal from Edin Dzeko and a 94^th minute goal from Sergio Aguero.  The title had by that stage looked to have slipped from their grasp, as United had beaten Sunderland, and were virtually celebrating before news of the City comeback reached the Stadium of Light
25. Euro 2008 - Germany; World Cup 2010 - Netherlands; Euro 2012 - Italy, who were beaten 4-0 courtesy goals by David Silva, Jordi Alba, Fernando Torres and Juan Mata
26. West Indies, who beat the hosts Sri Lanka by 36 runs
27. Run-scorers:  Test – Michael Clarke of Australia, One-day – Kumar Sangakarra of Sri Lanka; Twenty20 – Martin Guptill of New Zealand
    Wicket-takers:  Test – Herath of Sri Lanka; One-day – Lasith Malingo of Sri Lanka; Saeed Ajmal of Pakistan
28. NFL - New York Giants; NBA - Miami Heat; MLB - San Francisco Giants
29. Germany's Martin Kaymer, who beat Steve Stricker 1 up.  It was Kaymer's first point of the Ryder Cup, having played in only one of the previous four matchups
30. Handball - Germany; Field hockey - Germany; Volleyball - Brazil
    
    The business of sport
31. Italian Serie A
32. Nike, worth $15.9 billion; ESPN at $11.5 billion; Adidas at $6.8 billion.  The complete list can be found here
33. Manchester United, valued at $2.23 billion, followed by Real Madrid at $1.88 billion and then the New York Yankees at $1.85 billion.  For the complete list see this link
34. Floyd Mayweather, Manny Pacquiao, Tiger Woods, LeBron James and Roger Federer.  Mayweather tops the list purely on winnings/direct earnings with $85 million.  Pacquiao is largely winnings-based, with small endorsements, whereas Woods, James and Federer rely on endorsements (all significantly made up of Nike deals).  Woods remains the holder of the most lucrative endorsement “suite” ($55 million), whereas Haloti Ngata of the Baltimore Ravens, down in twelfth place, is the highest earner of any team-sport athlete without endorsements.  Full list and breakdown can be found here
35. Gilles Simon, speaking at Wimbledon.  Not surprisingly, there was a backlash, though Simon claimed that many of the male players on the Tour agreed with him, but would not speak out because of the charged nature of the debate
    
    Other Olympic sports
36. 22 in total, 18 of which are gold.  The next highest in history is Larisya Latynina, who won 18 in total, nine of which were gold.  Phelps’ medal haul, incidentally, puts him level with Argentina and Austria on the all-time medal list for countries.  He is one gold medal ahead of Jamaica, who should pass him in 2016!
37. Men - Kohei Uchimura of Japan; Women - Gabby Douglas of the USA
38. Nicola Spirig, the eventual winner from Switzerland, and Sweden's Lisa Norden, who got silver
39. Only one.  They actually won ten medals in total, which was joint third highest on the swimming medal table.  However, their gold medal count placed them only seventh in the official rankings, which are done by gold medals. That solitary gold came from the women's 4 x 100m freestyle relay team.  For context, in 2000, 2004 and 2008, Australia won 5, 7 and 6 medals, respectively.  It didn't help that a good number of swimmers who won gold medals representing other countries were prepared in or coached by Australians
40. Any three from:  Gabon, Grenada, Botswana, Montenegro, Bahrain, Cyprus and Guatemala
41. Sir Chris Hoy and Bradley Wiggins.  Hoy won two golds in London, taking his tally to seven, consisting of six golds and one silver.  Wiggins won cycling's time-trial gold medal to join Hoy on seven total medals, made up of four golds, one silver and two bronzes
42. The North Korean team refused to play the South Korean flag was displayed on the jumbo screen as the team was being introduced during warm-up.  The match was delayed by an hour, the mistake corrected and an official apology made by organizers
43. Ruta Meilutyte won the 100m breaststroke title and Katie Ledecky won the 800m title in an Olympic record.  The other famous teenager is Ye Shiwen, who won the 200m and 400m Individual Medley, but she is 16 years old.  
44. Chris Hoy at the Opening, Ben Ainslie at the closing
45. 962 medals in total (302 were gold), compared to 1522 medals, and 503 golds, in the Paralympic Games
    
    Tennis
46. David Ferrer at the French Open and US Open; Jo-Wilfried Tsonga at Wimbledon; and Thomas Berdych at the US Open.  All the other semi-final places were taken by Djokovic, Federer, Nadal or Murray
47. David Ferrer of Spain, who won seven titles.  Djokovic and Federer were next with six.  One half of the Bryan brothers, Mike, won seven doubles titles and one mixed doubles title.
48. Serena Williams, who won sevens singles titles, two of which were Grand Slams, as well as the Olympic Gold, and the season ending WTA championships. Sara Errani of Italy was the most successful player on either Tour, winning a total of twelve titles, eight of which were doubles titles
49. Samuel Groth of Australia, playing in the Busan Open Challenger Tournament in May, was clocked at 263 km/hour, beating the previous record held by Croatia’s Ivo Karlovic (251 km/hour).  This remains the fastest in an ATP  World Tour or Davis Cup level match.  Groth had two other serves faster than Karlovic’s previous record, but lost the match
50. Caroline Wozniacki, Victoria Azarenka and Maria Sharapova.  Wozniacki started the year as #1, but lasted only a month before Azarenka assumed it after the Australian Open.  She held it for just over four months before Sharapova became #1 in June.  That lasted one month, before it went back to Azarenka, who has held it since, despite Serena's late season dominance.  Wozniacki ended the year ranked tenth.

The 2012 Atherosclerosis egg study: More smoking is associated with more plaque, unless you eat more eggs

I blogged before about the study by David Spence and colleagues, published online in July 2012 in the journal Atherosclerosis (). This study attracted a lot of media attention (e.g., ). The article is titled: “Egg yolk consumption and carotid plaque”. The study argues that “regular consumption of egg yolk should be avoided by persons at risk of cardiovascular disease”. It hints at egg yolks being unhealthy in general, possibly even more so than cigarettes.

I used the numbers in Table 2 of the article (only 5 rows of data, one per quintile; i.e., N=5) to conduct a type of analysis that is rarely if ever conducted in health studies – a moderating effects analysis. A previous blog post summarizes the results of one such analysis using WarpPLS (). It looked into the effect of the number of eggs consumed per week on the association between blood LDL cholesterol and plaque (carotid plaque). The conclusion, which is admittedly tentative due to the small sample (N=5), was that plaque decreased as LDL cholesterol increased with consumption of 2.3 eggs per week or more ().

Recently I ran an analysis on the moderating effect of number of eggs consumed per week on the association between cumulative smoking (measured in “pack years”) and plaque. As it turns out, if you fit a 3D surface to the five data points that you get for these three variables from Table 2 of the article, you end up with a relatively smooth surface. Below is a 3D plot of the 5 data points, followed by a best-fitting 3D surface (developed using an experimental algorithm).

Based on this best-fitting surface you could then generate a contour graph, shown below. The “lines” are called “isolines”. Each isoline refers to plaque values that are constant for a set of eggs per week and cumulative smoking combinations. Next to the isolines are the corresponding plaque values. The first impression is indeed that both egg consumption and smoking are causing plaque buildup, as plaque clearly increases as one moves toward the top-right corner of the graph.

But focus your attention on each individual isoline, one at a time. It is clear that plaque remains constant for increases in cumulative smoking, as long as egg consumption increases. Take for example the isoline that refers to 120 mm2 of plaque area. An increase in cumulative smoking from about 14.5 to 16 pack years leads to no increase in plaque if egg consumption goes up from about 2 to 2.3 eggs per week.

These within-isoline trends, which are fairly stable across isolines (they are all slanted to the right), clearly contradict the idea that eggs cause plaque buildup. So, why does plaque buildup seem to clearly increase with egg consumption? Here is a good reason: egg consumption is very strongly correlated with age, and plaque increases with age. The correlation is a whopping 0.916. And I am not talking about cumulative egg consumption, which the authors also measure, through a variable called “egg-yolk years”. No, I am talking about eggs per week. In this dataset, older folks were eating more eggs, period.

The correlation between plaque and age is even higher: 0.977. Given this, it makes sense to look at individual isolines. This would be analogous to what biostatisticians often call “adjusting for age”, or analyzing the effect of egg consumption on plaque buildup “keeping age constant”. A different technique is to “control for age”; this technique would be preferable had the correlations been lower (say, lower than 0.7), as collinearity levels might have been below acceptable thresholds.

The underlying logic of the “keeping age constant” technique is fairly sound in the face of such a high correlation, which would make “controlling for age” very difficult due to collinearity. When we “keep age constant”, the results point at egg consumption being protective among smokers.

But diehard fans of the idea that eggs are unhealthy could explain the results differently. Maybe egg consumption causes plaque to go up, but smoking has a protective effect. Again taking the isoline that refers to 120 mm2 of plaque area, these diehard fans could say that an increase in egg consumption from 2 to 2.3 eggs per week leads to no increase in plaque if cumulative smoking goes up from about 14.5 to 16 pack years.

Not too long ago I also blogged about a medical case study of a man who ate approximately 25 eggs (20 to 30) per day for over 15 years (probably well over), was almost 90 years old (88) when the case was published in the prestigious The New England Journal of Medicine, and was in surprisingly good health (). This man was not a smoker.

Perhaps if this man smoked 25 cigarettes per day, and ate no eggs, he would be in even better health eh!?

Does tallness cause heart disease? No, but sex does

Popular beliefs about medical issues are sometimes motivated by a statistical phenomenon known as “spurious relationship”, among other names. Two variables X and Y are influenced by a third variable C, which leads to X and Y being correlated and thus the impression that X and Y are causally associated.

Take a look at the table below, which I blogged about in a previous post (). This table shows that there is a strong unadjusted correlation between height and arterial stiffness, a marker of heart disease. The likelihood that the correlation is due to chance is lower than one tenth of a percentage point (P<.001).

Interestingly, the authors of the study even use height as a control variable to narrow down the “true” causes of arterial stiffness (column with adjusted results), assuming that height did indeed influence arterial stiffness and what they found to be a key predictor of arterial stiffness, 2-hour postprandial glucose.

But there is no convincing evidence that height causes heart disease, with exception of pathological extremes – e.g., acromegaly. Extremes tend to influence statistical results somewhat, leading to conflicting conclusions that end up being disseminated by the popular media (). This is one of the sources of popular beliefs about medical issues.

Another, more important, source are real confounders. And this takes us back to the issue of height being associated with heart disease. In fact, height will typically be significantly associated with heart disease in almost any study that includes men and women and does not control for biological sex.

One of the reasons is that women overall tend to have a significantly lower incident of heart disease than men. The other is that height is significantly lower among women than men, on average, even though there are several women who are taller than the average man.

The table above was from a study including both sexes. Therefore, the strong association between height and arterial stiffness is a “reflection” of the strong association between being male and increased arterial stiffness. If one were to add a variable coded as 0 for male and 1 for female, and use it in a multivariate analysis of predictor of arterial stiffness, together with height, the effect of height would probably “disappear”.

Biological sex is the control variable, the “confounder”, that the authors should have used to narrow down the “true” causes of arterial stiffness (second column in the table). In the absence of biological sex, controlling for height accomplished something similar, but in a “wobbly” way, leaving many readers scratching their heads in confusion.

No fat gain while eating well during the Holiday Season: Palatability isolines, the 14-percent advantage, and nature’s special spice

Like most animals, our Paleolithic ancestors had to regularly undergo short periods of low calorie intake. If they were successful at procuring food, those ancestors alternated between periods of mild famine and feast. As a result, nature allowed them to survive and leave offspring. The periods of feast likely involved higher-than-average consumption of animal foods, with the opposite probably being true in periods of mild famine.

Almost anyone who adopted a low carbohydrate diet for a while will tell you that they find foods previously perceived as bland, such as carrots or walnuts, to taste very sweet – meaning, to taste very good. This is a special case of a more general phenomenon. If a nutrient is important for your body, and your body is deficient in it, those foods that contain the nutrient will taste very good.

This rule of thumb applies primarily to foods that contributed to selection pressures in our evolutionary past. Mostly these were foods available in our Paleolithic evolutionary past, although some populations may have developed divergent partial adaptations to more modern foods due to recent yet acute selection pressure. Because of the complexity of the dietary nutrient absorption process, involving many genes, I suspect that the vast majority of adaptations to modern foods are partial adaptations.

Modern engineered foods are designed to bypass reward mechanisms that match nutrient content with deficiency levels. That is not the case with more natural foods, which tend to taste good only to the extent that the nutrients that they carry are needed by our bodies.

Consequently palatability is not fixed for a particular natural food; it does not depend only on the nutrient content of the food. It also depends on the body’s deficiency with respect to the nutrient that the food contains. Below is what you would get if you were to plot a surface that best fit a set of data points relating palatability of a specific food item, nutrient content of that food, and the level of nutrient deficiency, for a group of people. I generated the data through a simple simulation, with added error to make the simulation more realistic.

Based on this best-fitting surface you could then generate a contour graph, shown below. The curves are “contour lines”, a.k.a. isolines. Each isoline refers to palatability values that are constant for a set of nutrient content and nutrient deficiency combinations. Next to the isolines are the corresponding palatability values, which vary from about 10 to 100. As you can see, palatability generally goes up as one moves toward to right-top corner of the graph, which is the area where nutrient content and nutrient deficiency are both high.

What happens when the body is in short-term nutrient deficiency with respect to a nutrient? One thing that happens is an increase in enzymatic activity, often referred to by the more technical term “phosphorylation”. Enzymes are typically proteins that cause an acute and targeted increase in specific metabolic processes. Many diseases are associated with dysfunctional enzyme activity. Short-term nutrient deficiency causes enzymatic activity associated with absorption and retention of the nutrient to go up significantly. In other words, your body holds on to its reserves of the nutrient, and becomes much more responsive to dietary intake of the nutrient.

The result is predictable, but many people seem to be unaware of it; most are actually surprised by it. If the nutrient in question is a macro-nutrient, it will be allocated in such a way that less of it will go into our calorie stores – namely adipocytes (body fat). This applies even to dietary fat itself, as fat is needed throughout the body for functions other than energy storage. I have heard from many people who, by alternating between short-term fasting and feasting, lost body fat while maintaining the same calorie intake as in a previous period when they were steadily gaining body fat without any fasting. Invariably they were very surprised by what happened.

In a diet of mostly natural foods, with minimal intake of industrialized foods, short-term calorie deficiency is usually associated with short-term deficiency of various nutrients. Short-term calorie deficiency, when followed by significant calorie surplus (i.e., eating little and then a lot), is associated with a phenomenon I blogged about before here – the “14-percent advantage” of eating little and then a lot (, ). Underfeeding and then overfeeding leads to a reduction in the caloric value of the meals during overfeeding; a reduction of about 14 percent of the overfed amount.

So, how can you go through the Holiday Season giving others the impression that you eat as much as you want, and do not gain any body fat (maybe even lose some)? Eat very little, or fast, in those days where there will be a feast (Thanksgiving dinner); and then eat to satisfaction during the feast, staying away from industrialized foods as much as possible. Everything will taste extremely delicious, as nature’s “special spice” is hunger. And you may even lose body fat in the process!

But there is a problem. Our bodies are not designed to associate eating very little, or not at all, with pleasure. Yet another thing that we can blame squarely on evolution! Success takes practice and determination, aided by the expectation of delayed gratification.

The bipolar disorder pendulum: Depression as a compensatory adaptation

As far as explaining natural phenomena, Darwin was one of the best theoretical researchers of all time. Yet, there were a few phenomena that puzzled him for many years. One was the evolution of survival-impairing traits such as the peacock’s train, the large and brightly colored tail appendage observed in males.

Tha male peacock’s train is detrimental to the animal’s survival, and yet it is clearly an evolved trait ().

This type of trait is known as a “costly” trait – a trait that enhances biological fitness (or reproductive success, not to be confused with “gym fitness”), and yet is detrimental to the survival of the individuals who possess it (). Many costly traits have evolved in animals because of sexual selection. That is, they have evolved because they are sexy.

Costly traits seem like a contradiction in terms, but the mechanisms by which they can evolve become clear when evolution is modeled mathematically (, ). There is evidence that mental disorders may have evolved as costs of attractive mental traits (); one in particular, bipolar disorder (a.k.a. manic-depression), fits this hypothesis quite well.

Ironically, a key contributor to the mathematics used to understand costly traits, George R. Price (), might have suffered from severe bipolar disorder. Most of Price’s work in evolutionary biology was done in the 1970s; toward the end of his life, which was untimely ended by Price himself. For many years he was known mostly by evolutionary biologists, but this has changed recently with the publication of Oren Harman’s superb biographical book titled “The Price of Altruism: George Price and the Search for the Origins of Kindness” ().

Bipolar disorder is a condition characterized by disruptive mood swings. These swings are between manic and depressed states, and are analogous to the movement of a pendulum in that they alternate, seemingly gravitating around the "normal" state. See the figurative pendulum representation below, adapted from a drawing on Thinkquest.org.

Bipolar disorder is generally associated with creative intelligence, which is a very attractive trait (). Moreover, the manic state of the disorder is associated with hypersexuality and exaggerated generosity (). So one can clearly see how having bipolar disorder may lead to greater reproductive success, even as it creates long-term survival problems.

On one hand, a person may become very energetic and creative while in the manic state. This could be one of the reasons why many who suffer from bipolar disorder have fairly successful careers in fields that require creative intelligence (), which are many and not restricted to fields related to the fine and performing arts. Creative intelligence is highly valued in most knowledge-intensive professions ().

On the other hand, sustained acute mania or depression are frequently associated with serious health problems (). This is why the clinical treatment of bipolar disorder often starts with an attempt to keep the pendulum from moving too far in one direction or another. This may require medication, such as clinical doses of the elemental salt lithium, prior to cognitive behavioral therapy. The focus of cognitive behavioral therapy is on changing the way one sees and thinks about the world, particularly one’s “social world”.

Prolonged acute mania, usually accompanied by severely impaired sleep, may lead to psychosis. This, psychosis, is an extreme state characterized by hallucinations and/or delusions, leading to hospitalization in most cases. It has been theorized that depression is an involuntary compensatory adaptation () aimed at moving the pendulum in the other direction, out of the manic state, before more damage ensues ().

Elaborate approaches have been devised to treat and manage bipolar disorder treatment that involve the identification of mania and depression “prodromes” (), which are signs that a full-blown manic or depressive episode is about to start. Once prodromes are identified, cognitive behavioral therapy techniques are employed to prevent the pendulum from moving further in one direction or the other. The main goal of these techniques is to change one’s way of thinking about various issues (e.g., fears, pessimism). These techniques take years of practice to be used effectively.

Identification of prodromes and subsequent use of cognitive behavioral therapy seems to be particularly effective when dutifully applied with respect to manic episodes (). The reason for this may be related to one interesting fact related to bipolar disorder: manic episodes are not normally dreaded as much as depression episodes.

In fact, many sufferers avoid taking medication because they do not want to give up the creative and energetic bursts that come with manic episodes, even though they absolutely do not want the pendulum to go in the other direction. The problem is that, if depression is indeed a compensatory adaptation to mania, it seems reasonable to assume that extreme manic episodes are likely to be followed by extreme episodes of depression. Perhaps the key to avoid prolonged acute depression is to avoid prolonged acute mania.

As someone with bipolar disorder becomes more and more excited with novel and racing thoughts (a prodrome of mania), it would probably make sense to identify and carry out calming activities – to avoid a fall into despairing depression afterwards.

A fictional portrayal of running injuries

So this time of the year is historically a bit slow on the site, although this weekend the New York City Marathon will be run in spite of the recent carnage brought to the region by Hurricane Sandy. Interestingly the decision to go ahead with the race has sparked a bit of debate, with maybe the starkest quote against the decision coming from the Staten Island borough president: " “My God. What we have here is terrible, a disaster. If they want to race, let them race with themselves. This is no time for a parade.”  

That could be considered a bit harsh, but on the ground the perception is likely different, so it is probably understandable why he thinks the use of city resources for the race is frivolous.  But nevertheless the race is set to go off as planned, and the part that is getting less coverage is that the race activities have been pared back.  For example they canceled the opening ceremony on Friday and the 5km race on Saturday, and they also revised their cancellation policy to accommodate those whose travel plans were fouled by the weather.

As normal, we will analyse the race in real time providing we can access a live feed and/or the splits, so watch the site for updates followed by our standard race report.

But the real reason for this post is comic relief, and to share a link our friends at LetsRun.com posted the other day.  We posted it on our Facebook page, and it has received lots of views over there so we figured we would share it for site readers, too.  In the words of one reader on our Facebook page, "72 hours of YouTube video is uploaded every minute and that is a real 3.5 minute gem. . ."!

Those of you in academia who have experience with the peer review process might have come across the video spoof of that process.  It first appeared several years ago, and since then a few different versions have been posted, as well as spoofs of other topics using the same video clip---"Hitler finds out Osama bin Laden is dead,"  "Hitler finds out Obama won," 
and also, "Hitler finds out Chuck Norris is coming," just to name a few.

The clip is from the German film "Downfall," and depicts a scene in which Hitler is forced to realize his defeat.  German speakers will have to try to ignore the audio and focus on the spoof sub-titles, but here is one of the original spoofs of the peer-review process.  Once you have picked yourself up off the floor and have stopped laughing, try going back and reading the two most popular comments on YouTube, they are almost equally as funny!

Interestingly, the original clip from the movie with real subtitles is also on YouTube, and the uploader of that clip actually mentions it was all the parodies that made him watch the real film!

And the most recent spoof added on October 26 pokes fun at previously injured runners everywhere.  So if you have ever been injured, especially in the run up to a big event or goal, this will resonate particularly well.

Language alert:  there is foul language in the subtitles (not the original German), so if you don't like seeing the f-bomb on your screen then this is not for you.

Enjoy, and good luck to any readers who will be running on Sunday!

The man who ate 25 eggs per day: What does this case really tell us?

Many readers of this blog have probably heard about the case of the man who ate approximately 25 eggs (20 to 30) per day for over 15 years (probably well over), was almost 90 years old (88) when the case was published in the prestigious The New England Journal of Medicine, and was in surprisingly good health ().

The case was authored by the late Dr. Fred Kern, Jr., a widely published lipid researcher after whom the Kern Lipid Conference is named (). One of Kern’s research interests was bile, a bitter-tasting fluid produced by the liver (and stored in the gallbladder) that helps with the digestion of lipids in the small intestine. He frames the man’s case in terms of a compensatory adaptation tied to bile secretion, arguing that this man was rather unique in his ability to deal with a lethal daily dose of dietary cholesterol.

Kern seemed to believe that dietary cholesterol was harmful, but that this man was somehow “immune” to it. This is ironic, because often this case is presented as evidence against the hypothesis that dietary cholesterol can be harmful. The table below shows the general nutrient content of the man’s daily diet of eggs. The numbers in this and other tables are based on data from Nutritiondata.com (), in some cases triangulated with other data. The 5.3 g of cholesterol in the table (i.e., 5,300 mg) is 1,775 percent the daily value recommended by the Institute of Medicine of the U.S. National Academy of Sciences ().

As you can see, the man was on a very low carbohydrate diet with a high daily intake of fat and protein. The man is described as an: “… 88-year-old man who lived in a retirement community [and] complained only of loneliness since his wife's death. He was an articulate, well-educated elderly man, healthy except for an extremely poor memory without other specific neurologic deficits … His general health had been excellent, without notable symptoms. He had mild constipation.”

The description does not suggest inherited high longevity: “His weight had been constant at 82 to 86 kg (height, 1.87 m). He had no history (according to the patient and his personal physician of 15 years) of heart disease, stroke, or kidney disease … The patient had never smoked and never drank excessively. His father died of unknown causes at the age of 40, and his mother died at 76 … He kept a careful record, egg by egg, of the number ingested each day …”

The table below shows the fat content of the man’s daily diet of eggs. With over 14 g of omega-6 fat intake every day, this man was probably close to or in “industrial seed oils territory” (), as far as daily omega-6 fat intake is concerned. And the intake of omega-3 fats, at less than 1 g, was not nearly enough to balance it. However, here is a relevant fact – this man was not consuming any industrial seed oils. He liked his eggs soft-boiled, which is why the numbers in this post refer to boiled eggs.

This man weighed between 82 to 86 kg, which is about 180 to 190 lbs. His height was 1.87 m, or about 6 ft 1 in. Therefore his body mass index varied between approximately 23 and 25, which is in the normal range. In other words, this person was not even close to obese during the many years he consumed 25 eggs or so per day. In the comments section of a previous post, on the sharp increase in obesity since the 1980s (), several readers argued that the sharp increase in obesity was very likely caused by an increase in omega-6 fat consumption.

I am open to the idea that industrialized omega-6 fats played a role in the sharp increase in obesity observed since the 1980s. When it comes to omega-6 fat consumption in general, including that in “more natural” foods (e.g., poultry and eggs), I am more skeptical. Still, it is quite possible that a diet high in omega-6 fats in general is unhealthy primarily if it is devoid of other nutrients. This man’s overall diet might have been protective not because of what he was not eating, but because of what he was eating.

The current debates pitting one diet against another often revolve around the ability of one diet or another to eliminate or reduce the intake of a “bad thing” (e.g., cholesterol, saturated fat, carbohydrates). Perhaps the discussion should be more focused on, or at least not completely ignore, what one diet or another include as protective factors. This would help better explain “odd findings”, such as the lowest-mortality body mass index of 26 in urban populations (). It would also help better explain “surprising cases”; such as this 25-eggs-a-day man’s, vegetarian-vegan “ageless woman” Annette Larkins’s (), and the decidedly carnivore De Vany couple’s ().

The table below shows the vitamin content of the man’s daily diet of eggs. The vitamin K2 content provided by Nutritiondata.com was incorrect; I had to get what seems to be the right number by triangulating values taken from various publications. And here we see something interesting. This man was consuming approximately the equivalent in vitamin K2 that one would get by eating 4 ounces of foie gras () every day. Foie gras, the fatty liver of overfed geese, is the richest known animal source of vitamin K2. This man’s diet was also high in vitamin A, which is believed to act synergistically with vitamin K2 – see Chris Masterjohn’s article on Weston Price’s “activator X” ().

Kern argued that the very high intake of dietary cholesterol led to a sharp increase in bile secretion, as the body tried to “get rid” of cholesterol (which is used in the synthesis of bile). However, the increased bile secretion might have been also been due to the high fat content of this man’s diet, since one of the main functions of bile is digestion of fats. Whatever the case may be, increased bile secretion leads to increased absorption of fat-soluble vitamins, and vitamins K2 and A are fat-soluble vitamins that seem to be protective against cardiovascular disease, cancer and other degenerative diseases.

Finally, the table below shows the mineral content of the man’s daily diet of eggs. As you can see, this man consumed 550 percent the officially recommended daily intake of selenium. This intake was slightly lower than the 400 micrograms per day purported to cause selenosis in adults (). Similarly to vitamins K2 and A, selenium seems to be protective against cardiovascular disease, cancer and other degenerative diseases. This man’s diet was also rich in phosphorus, needed for healthy teeth and bones.

Not too many people live to be 88 years of age; many fewer reach that age in fairly good health. The country with the highest average life expectancy in the world at the time of this writing is Japan, with a life expectancy of about 82 years (79 for men, and 86 for women). Those who think that they need a high HDL cholesterol and a low LDL cholesterol to be in good health, and thus live long lives, may be surprised at this man’s lipid profile: “The patient's plasma lipid levels were normal: total cholesterol, 5.18 mmol per liter (200 mg per deciliter); LDL, 3.68 mmol per liter (142 mg per deciliter); and HDL, 1.17 mmol per liter (45 mg per deciliter). The ratio of LDL to HDL cholesterol was 3.15.”

If we assume that this man is at least somewhat representative of the human species, and not a major exception as Kern argued, this case tells us that a diet of 25 eggs per day followed by over 15 years may actually be healthy for humans. Such diet has the following features:

- It is very high in dietary cholesterol.

- It involves a high intake of omega-6 fats from animal sources, with none coming from industrial seed oils.

- It involves a high overall intake of fats, including saturated fats.

- It is fairly high in protein, all of which from animal sources.

- It is a very low carbohydrate diet, with no sugar in it.

- It is a nutritious diet, rich in vitamins K2 and A, as well as in selenium and phosphorus.

This man ate 25 eggs per day apparently due to an obsession tied to mental problems. Repeated attempts at changing his behavior were unsuccessful. He said: “Eating these eggs ruins my life, but I can't help it.”

UCI uphold USADA findings - surprised?

Could have gone either way. . .

On Monday, as scheduled, the UCI held a press conference to announce it would recognize the reasoned decision submitted by USADA and not appeal to the CAS.  Honestly, based on the UCI's history, it was 50/50.  I don't think any one who follows the sport would have been surprised had they chosen to appeal the decision up to CAS.  Yes, many big sponsors had already "endorsed" the decision by sacking Armstrong, but again given the UCI's past behavior it was plausible they could appeal.  Perhaps they realised they had no choice but to uphold the decision, perhaps there was pressure from somewhere else like IOC (unlikely, but we don't know), but whatever the reason, they chose wisely in our opinion.  It does not redeem them by any stretch, and they should still be removed and replaced by new leadership, but that is the topic of another post!

We have been sharing links and comments on our Facebook page, so if you have not visited, check there for some discussion and links.  Our page is a great way to keep the info and discussion rolling when we don't have exhaustive hours to spend digesting the data ourselves and synthesizing a post, which is most of the time these days.

Exploring the USADA case

So I had some time Monday night during an exam to pore over some of the documents from the USADA case.  If you visit the USADA website, you might see why it took them over month to produce the evidence to the UCI---it must have taken them that long just to upload all the files.  Kidding aside, though, it is an absolute mountain of detailed information and evidence.  

Especially relevant to this week's news, though, is the correspondence between UCI President Pat McQuaid and the USADA.  Recall that McQaid first stated at the outset that the UCI would stay out and let the USADA proceed with their investigation. . .only to change his tune later and challenge the organisation's jurisdiction. . .only to take another about face and now validate the findings and decision by USADA.  It's farcical that the president of a global sporting organisation behaves like this, and that as late September 17, still was challenging the jurisdiction USADA had over Armstrong.

It's a rule violation, not an illegal activity

A common argument that keeps coming up from supporters is that there is no "evidence" to support the sanction, or cries that the information provided by USADA hardly passed for evidence.  This is amusing since witness testimony contributes to the body of evidence in legal cases, so I don't think that argument really works.

But more importantly, we have to be clear that USADA did not evaluate whether or not Armstrong broke a law.  Instead, they evaluated whether or not he broke a rule, specifically as outlined in the rule books for cycling and triathlon during the years in question.  Whether or not Armstrong is charged with a crime in the United States remains to be seen.  Currently people are murmuring about the possibility of a perjury charge, since on at least one occasion during the SCA hearings he testified under oath.  Can a prosecutor prove he lied?  We don't know---that is not our area here, you have to visit our sister site The Law of Sport to read about that.

No human rights, constitutional rights, or any other rights have been violated.  USADA operated within its responsibilities as an anti-doping organisation.  And for anyone whose doping paradigm is still stuck in last century, sanctioning athletes in the absence of an "analytical finding" is entirely acceptable, and in this case Armstrong is just another athlete on the growing list of those who have in fact been sanctioned without ever testing positive (officially).  

So don't bemoan the process.  If you want to support him as a cancer survivor, please do.  By some accounts it's a near miracle he survived such an advanced case of cancer that had spread throughout his body.  But it has now become patently obvious that at least since 1998, all of his cycling success was achieved by breaking the rules.  Was the era fraught with doping?  Absolutely, and the UCI more than anyone else is to blame for t hat.  But that does not make it ok that anyone broke the rules.  And worse, he and his foundation benefited immensely as a direct result of his sporting success, which was fraudulent.  His net worth is estimated upwards of $125 million, and does anyone reading think it would be that high had he not won seven tours?

Be informed:  read the USADA documents

The information there is sometimes old, most of the time revealing, and always interesting.  If you are a cycling fan or want to have all the facts to form your own informed opinion, we suggest you wade through them.  Due to the volume there is likely to be more analysis of them in time as people can consume and digest all the info there.

For now, visit our Facebook page to follow the comments and links we post there (and please "Like" us if you have not already, that's social currency for us!).

Jonathan

Sponsors overboard & a guest post on legalized doping, the Armstrong dilemma

It's not about the evidence: Sponsors retreat, and a guest post on legalizing doping, amnesty and more

It began with the swoosh, as Nike issued a statement yesterday saying that in the face of "seemingly (emphasis mine) insurmountable evidence that Lance Armstrong participated in doping and misled Nike for more than a decade", they were making the "sad" decision to end their association with him.  Then followed a host of his long-time supporters - RadioShack, Anheuser-Busch, Giro, and most recently, Trek bicycles.  Armstrong also stepped down as chairman of his LiveStrong foundation, though he remains on its board, and both Nike and Trek have pledged their continued support for the foundation, if not for its founder.  

Here's where the lines get blurred.  Drawing a clear distinction between Armstrong and Livestrong requires setting aside the foundations on which Livestrong was built.  Livestrong may deserve continued support, of course, and one would not want to undermine the work it has done for awareness and to support those with cancer (but not research, I have to point out), but the corporate backing of Livestrong independent of Armstrong is the sponsorship equivalent of a front.  Armstrong's continued presence on the board and the 'shared DNA' between him and Livestrong means that any corporate backer will never fully separate itself from the athlete, whose success has now been shown to everyone to be built on cheating, lying and intimidation.

There's also the reality that Nike and co had little alternative than to make a move to distance themselves from Armstrong.  It was the only move left on the chessboard for them.  Sadly, it wasn't the details and 1000 pages of evidence in the USADA report that prompted yesterday's procession of abandonments, but the growing resentment and backlash from the public towards, in particular, Nike and Oakley.  Telling as it may be, it is unsurprising that companies are more concerned with the opinions held by their consumer markets than with the "trivial" matter of breaking the rules of sport to sell more product, and yesterday was a good illustration of this.  It would be oversimplifying it to say that for the likes of Nike, it is a simple question of "Will we sell more product with or without Lance Armstrong?"  Brands consider more than just profit and loss, and brand equity has an unquantifiable component to it.   However, on both the P&L basis, and the brand equity, some time in the last week, the balance has tilted in favor of the "without", hence their action.  Continuing the association with Armstrong produced a net downside, and so we should not be too quick to commend the sponsors' actions yesterday.

Then there are the very clear and direct allegations that the sponsors were not merely ignorant, but complicit in what USADA called the "most sophisticated, professionalized and successful doping program that sport has ever seen".  Nike were alleged to contribute to pay-offs to the UCI to bury doping offences (as per Kathy Lemond's affadavit) and other sponsors are alleged to have spoken openly about doping or harshly condemned those who opposed the Armstrong myth (Trek's statement included no apology to Lemond).  Whether yesterday's retreat spares them the scrutiny to confirm these allegations (made for example by David Walsh, and we've seen that he is worth paying attention to) remains to be seen.

Stepping back to be mindful of the big picture once again, it is interesting to consider how this impacts on the UCI.  Once Nike acted, other sponsors were compelled to follow suit - you could hardly be the minnow sponsor remaining steadfast in support while the big ones are jumping ship.  Does the UCI decision change in any way as a result?  It's difficult to see that yesterday directly impacts on them, but it does emphasize once again how deep the issue was, and just how dramatically inadequate UCI leadership was during this period.

And on an even larger scale is the question about why Armstrong is so squarely the center of attention when it is becoming clearer and clearer that the entire sport had this problem?  That is a question which is addressed in the guest article below.  Written by Dr John McGowan, who is the Academic Director of the Department of Applied Psychology at Canterbury Christ Church University in Kent, it tackles the following three questions:

1. Should we offer amnesty to convicted dopers?
2. Should doping be legalized?
3. Why does Lance Armstrong provoke such particular ire?

Dr McGowan emailed me a few weeks ago to request this piece, and given my own time constraints, and my desire to hear views from outside, this seemed an excellent opportunity to host our first "guest post" on the site.  It's something I hope to do much more often in the future, provided articles contribute value and fall within the scope of the site.  As some of you may know, I spent two years working in sports sponsorship and business, and the big-picture, strategic thinking where commercial interests intersect with sports performance and science is a particular interest.  So the last week has been enthralling, if only to see how reactions have swung, and why.

Dr McGowan's piece, unedited, touches on some of the themes, including the legalization of doping argument, and how to police sport better in the future.

Ross

Lance Armstrong: It's not about the doping (Dr John McGowan)

As the time approaches for cycling chiefs to decide if they accept the recent rulings of the US Anti-Doping Agency, I’ve been wondering what to think about Lance Armstrong. Clearly many feel the evidence of rule-breaking, cover-up and intimidation is so overwhelming it’s high time he got his comeuppance. Despite everything though, he still has his partisans. Interestingly however, even some of them don’t care if he was doper. As commentator Gary Imlach commented,“an argument about Lance Armstrong is almost a faith-based matter”.

Amid the storm of claim and counter-claim one piece in particular caught my attention. On a site called Practical Ethics, Julian Savulescu and Bennett Foddy (both of Oxford University) argue that the prevalence of performance-enhancing drugs is such that there need to be important changes in cycling (and perhaps other sports too). However, unlike USADA and the majority of journalistic opinion, their prescription is that, instead of punishing rule-violators andtightening testing, we should be offering amnesty to drug-takers and relaxingthe rules on doping.

The Practical Ethics article raises issues of justice, liberty and expectations of public figures: evidence that cycling can be about a lot more than skinny guys pedalling up hills (though I’m personally quite fond of that bit). Specifically their piece poses three interesting questions: should we offer amnesties to those caught doping, and should we have more liberal rules? And why, when so many others are implicated, does Lance Armstrong provoke such particular ire?

Is a doping amnesty a good idea?

This isn’t something only advocated by those sympathetic to doping. The rationale was outlined in a Scientific American article a few years ago (text-only version here) by Michael Shermer. To lower drug use in cycling he suggested a first step would be to,

“Grant immunity for all athletes pre-2008... Immunity will enable retired athletes to work with governing bodies and anti-doping agencies for improving the... system.”

The benefits of dopers confessing, and telling the authorities how they did it, are envisaged as bolstering a post-amnesty regime of more stringent testing and harsher punishments. While there is evidence that the last two elements are effective, the question of amnesties is more difficult. The motives to conceal doping (financial or retaining your reputation) still likely to be very strong. Unless you were already being investigated, hanging on to your palmarès might not necessarily provide an incentive to fess up. 

A second problem is the seriousness with which people take the message, “I know we said we meant it last time but this time we reallymean it.” Behavioural psychology would suggest that such intermittent reinforcement of rule breaking (by getting off) might make giving the finger to authority more rather than less tempting. It’s also worth considering where an amnesty would leave those who did try and play within the rules. While it’s probably unrealistic to think that they might be awarded titles stripped from others, it does seem somewhat unfair on them that some people would get the slate wiped clean.

For all these reasons many of us might struggle with an amnesty. It’s worth noting that the governing body of cycling have recently come to the same conclusion, though perhaps for different reasons. There is evidence though that sometimes humans let an aversiontounfairness get in the way of bigger gains. It could be a reluctance that’s worth getting over though. It might be in all our interests us all to bail out people in negative equity though it may feel like rewarding those who borrowed irresponsibly. We use amnesties and lenient sentences in criminal trials all the time to produce (hopefully) wider benefits. It may stick in the throat but it’s often worth trying to swallow.

Of course the discussion so far has been about amnesty as a tool to stop doping. If you would be happy with more liberal rules, amnesties may be less problematic. Why wouldn’t you have an amnesty if you decided doping was OK?

Should doping rules be relaxed?

It’s worth bearing in mind that simply prohibiting something society is concerned about is not always the best way to control its use. For example, the effects of  laws prohibiting recreational drugs have often had mixed results, especially when it comes to regulating safe supplies. There is also the issue of personal liberty. In cycling, arguments for the rights of athletes to take what they want in order to perform go back at least to the great Italian champion FaustoCoppi.

Savulescu and Foddy (also see this more detailed paper) use these arguments to call into question several principles underlying the World Anti-Doping Agency Code. In particular they challenge: 

• the idea that anti-doping measures will ever have a significant impact, 
• the view that competition enhanced by pharmacology is not desirable, and 
• the principle that curbing doping means fairer and safer sport.

These areas have been discussed extensively in other postings. In particular, regular readers will have some knowledge of advances in anti-doping paradigms and might conclude that Savulescu and Foddy are overly pessimistic about tackling the issue. So let’s say we can have an impact on doping. Maybe not eliminate it but certainly achieve reductions. Should we try?

On Savulescu and Foddy’s second challenge (to the illegitimacy of doped competition) it’s often pointed out that drugs may affect competitors differently. This might distort contests that many feel should be based primarily on biological potential and training. This issue is perhaps a matter of taste. A vision of the human body as a kind of laboratory-cum-Formula 1 car competing with the aid of the most cutting-edge science (including pharmaceuticals) might appeal to some but repel others. If it does seem a bit WWE for your taste it may be worth thinking why.

If you can accept such a vision of sport, what about fairness and safety? Inequalities related to wealth, diet and demographic factors are legion and it’s naive indeed to suggest that eliminating doping automatically equals fair sport. However, introducing more liberal rules, especially related to a potentially expensive commodity, would seem very likely to skew the playing field even more in favour of the wealthy. Still, there was a time when having a coach was seen as an unfair advantage so I guess it’s possible that I’m just being like the old duffers who were snooty to Harold Abrahams in Chariots of Fire.

As with fairness, it may be rather simplistic to insist that doping-free sport eliminates risks. Elite sport in particular can reward all sorts of risk-taking, but opening the door to more drug use again seems to potentially worsen the problem. For this author at least it’s this issue of safety that finally leads to a parting of ways with Savulescu and Foddy. I’m not sure I can get comfortable with a sport where a legitimate route to winning is for young athletes to push the limits of pharmaceutical assistance. Should I be comfortable with sport that encourage pushing the limits in other ways? Perhaps not. But that doesn’t mean I want to open another avenue of risk. There is the possibility of improving safety with medical supervision, but a glance at the motley collection of doping medics who populate recent sport memoirs leaves me a little low on confidence that this would help.

The involvement of those dubious doctors, though, highlights a counter-argument and brings us back to the issue of illegality itself compromising safety. As with recreational drugs, if a substance is permitted there may be a greater incentive to improve its safety (rather than at present where the emphasis is on undetectability), and for people of greater integrity to become involved in its supervision. In the end the issue pivots on whether you can argue convincingly enough that, as in the case of something like heroin, prohibition actively contributes to the risks via dodgy suppliers, unsafe drugs or badly controlled administration. If someone could make this case might it change things?

Why Lance Armstrong?

“Wear yellow for Armstrong? Fucked if I will. Wear it for Fignon? In a heartbeat.”

@festinagirl

Though they didn’t broach this subject explicitly, Savulescu and Foddy’s arguments did get me thinking about why many seem to have such particularly negative feelings about the man formerly known as winner of seven Tours de France. The New Yorker’s Michael Specter, author of a famous profile in 2002, recently pronounced that now Armstrong “is nothing”. Really? Nothing? While there's a case for doping being outside the rules, there are clearly far greater wrongs in the world. Though it’s tempting to see dopers as simply cheats who take unfair advantage, the experiences of athletes suggest a far more complicated picture than baddies who did and goodies who resisted. But, as the quote from the estimable Festina Girl suggests, we seem disinclined to cut Armstrong slack even compared to other admitted dopers. 

Here are three possible explanations for why we are so down on Lance. One thing they have in common is that none of them suggest the main problem is simply taking performance-enhancing drugs. To coin a phrase: it’s not about the doping.

1. Unlike many others, Armstrong hasn’t admitted fault and asked for forgiveness: a well trodden path for celebrity transgressors. Instead he has doubled down on a career of denials and cast himself as a victim of unfair accusations. This may satisfy the loyalists but seems guaranteed to infuriate everyone else. Of course the potential consequences for him go far beyond annoyance. Potential litigationover sponsorship deals and prize money are looming large. Doping is one thing but clearly lying is quite another. (My addition: as is the possibility of perjury charges considering that some of these lies have happened under oath)

2. Armstrong has behaved very badly towards anyone who has threatened him: a major element of the USADA case . Of course there is no rule that sporting champions have to be nice. Many famously seem not to be. Few however have been as publically contemptuous of their doubters as Armstrong after the 2005 Tour de France (“I’m sorry that you can’t dream big”).  Whatever you think of revelations from disgruntled ex-friends, statements like this are asking for schadenfreude.

3. I suspect the main reason for the strength of reaction is to do with what Armstrong has received from cycling: wealth, fame and status far greater than any other cyclist. This makes him vulnerable to the “Tiger Woods Effect”. During Wood’s sex-scandal a few years back the question arose of whether his behaviour would compromise his standing and, crucially, his endorsement contracts. Surely we were beyond holding a man’s private indiscretions against him? The business journalist James Surowieki  suggested that actually Woods was in line for some big losses. The reason was the way he was perceived in the public mind: as mentally tough and possessing almost superhuman discipline. It turned out that, when confronted with a line of blonde cuties throwing themselves at his feet, he was actually just like most other guys. Tiger had effectively undermined his own brand.

(My addition: in sponsorship, a fundamental concept is that of 'transferred attributes', in that the attributes of the sponsored athlete are meant to be transferred, in the mind of the consumer, to the product.  Endorsement relies in part on the (false) perception that it's the Wilson tennis racket, or Adidas boots, that make Federer or Messi so talented.  Puma must be fast because Bolt is.  Drinking Red Bull must be cool because Felix Baumgartner skydives from outer space, and so on.  When Nike invested in "hope" and "courage" and "hard work" of the Armstrong story, the most damaging thing imaginable would be to introduce "deceit", "immorality" and "short cuts".  For this reason, their endorsement fails anyway.  Remember when Paula Radcliffe failed to finish the 2004 Olympic Marathon?  It damaged sponsors because their association with her was on going the distance, and not quitting.  Clearly, some transgressions are worse than others, notwithstanding that some are just downright illegal)

So what is (or was) Lance’s public image? Cancer survivor, ferocious competitor and charity campaigner are all well established. I’d go further and suggest the essence of brand Armstrong is actually hero. How does being a hero square up not only with doping, but also with deceit? Throw in the actions of a bully, and the strain between the emerging picture and the brand reaches breaking point. Something has to give and his hero status looks unlikely to withstand such an onslaught. Where this leaves his charitable foundation is something else again.

Another way to look at it though is to consider the possibility that Armstrong is not quite as reprehensible as all that. It could be that we are seeing (as Tyler Hamilton and others have suggested) someone trapped inside a lie that’s too big for easy escape and driven by fear. Fear of failing, of discovery, of loss of the esteem which some still have. How would most people deal with that? How would you? Armstrong’s public stance of studied (or pretend) indifference is quite agonising to watch. It may be that that he is simply an ordinary person, albeit in extraordinary circumstances, with weaknesses and flaws like the rest of us. And this is the heart of his problem: if you’re Lance Armstrong, the journey to just being an ordinary guy is a long, long way down.

Dr John McGowan

Year/Academic Director,

Department of Applied Psychology

Canterbury Christ Church University

Kent

TN3 0TG