Alcohol intake increases LDL cholesterol, in some people

Occasionally I get emails from people experiencing odd fluctuations in health markers, and trying to figure out what is causing those fluctuations. Spikes in LDL cholesterol without any change in diet seem to be a common occurrence, especially in men.

LDL cholesterol is a reflection of many things. It is one of the least useful measures in standard lipid profiles, as a predictor of future health problems. Nevertheless, if one’s diet is not changing, whether it is high or low in fat, significant fluctuations in LDL cholesterol may signal a change in inflammatory status. Generally speaking, the more systemic inflammation, the higher is the measured LDL cholesterol.

Corella and colleagues (2001) looked into alcohol consumption and its effect on LDL cholesterol, as part of the Framingham Offspring Study. They split the data into three genotypes, which are allele combinations. Alleles are genes variations; that is, they are variations in the sections of DNA that have been identified as coding for observable traits. The table below summarizes what they have found. Take a look at the last two columns on the right.

As you can see, for men with the E2 genotype, alcohol consumption significantly decreases LDL cholesterol. For men with the E4 genotype, alcohol consumption significantly increases LDL cholesterol. No significant effects were observed in women. The figure below illustrates the magnitude of the effects observed in men.

On average, alcohol consumption was moderate, around 15 g per day, and did not vary significantly based on genotype. This is important. Otherwise one could argue that a particular genotype predisposed individuals to drink more, which would be a major confounder in this study. Other confounders were also ruled out through multivariate controls - e.g., fat and calorie intake, and smoking.

Alcohol consumption in moderation seems, on average, to be beneficial. But for some individuals, particularly men with a certain genotype, it may be advisable to completely abstain from alcohol consumption. Who are those folks? They are the ones for whom LDL cholesterol goes up significantly following moderate alcohol consumption.

800m: Caster Semenya & Robby Andrews

800 m musings - Caster Semenya, Robby Andrews and contrasting pacing strategies

Thanks all for the huge response to the previous post on barefoot running.  I can think of only one other topic that has produced the kind of discussion we've seen in the last few days, and those were our posts on Caster Semenya, who I discuss a little more below.

Some of the comments and discussion on the barefoot running issue were extremely enlightening and if you're eager to learn even more, then going through that discussion is as enlightening as any article, so thanks again and do take time to browse the discussion if you haven't already - we'll outsource it as a post all by itself!

800m - Caster Semenya's performances under the spotlight

Today though, I wanted to discuss the 800m event, specifically to highlight two really great talking points in the last week or so, beginning with Caster Semenya.

Semenya was always going to be one of the most scrutinized athletes in the world, her return to competition after a gender controversy bringing human interest, athletic interest, and scientific interest angles.

Ours is all three, but primarily the scientific and athletic, and so we've been watching closely to see how she performs now that she's had a full off-season to prepare and build to competitive shape.  Her comeback was actually in 2010, and she even won a few races in Europe, but that season was hampered by sporadic training caused by injury and the doubts over whether she would be able to compete.  The same can't be said now - she's known since this time last year that she would be eligible to run.

So her 2011 performances were always going to be the subject of discussion.  This situation became inevitable when Semenya, her lawyers and the IAAF decided that no public announcement of what happened in the aftermath of Berlin would be made.  The result was that the whole world knew there was a question mark, but it was followed by speculation and assumption, rather than an answer, even a basic one.

Speculation no matter what the result - the catch-22 for Semenya

As a result, every race for Semenya would be followed by one of two responses.  Either she would win convincingly, and the world's athletics followers would say "She has an unfair advantage, they obviously didn't change anything, and now thanks to her lawyers, no other women can even compete".  Or, if she didn't win her races, the world would say "This proves that she must have had surgery or treatment".   A catch-22 for Semenya.

But now a third response has appeared - she doesn't win, and everyone says she is losing on purpose.  And that's been the case after her first two races - the came second in Eugene a week ago, and third in Oslo on Thursday, and the talk on athletics websites is that she is deliberately losing races so as to avoid attention and further discrimination. 

No matter how you look at it, it's an impossible situation to be in.  And from the observer point of view, it's similarly difficult.  It would be great to just leave it alone and let her run, but the way things unfolded, that is basically impossible, because people want to know that they are watching a fair race, a competitive event.

So the current speculation was inevitable and this was exactly the reason we argued many times that she (through her lawyers) needed to make some kind of statement to at least assure people that something had changed.  Not the full medical details, those are hers and should be confidential.  But something along the lines of "I have worked with the IAAF and a team of medical professionals over the last six months, and all parties are satisfied with the resolution and progress, and that I can now compete fairly as a female.  I look forward to running and and competing again".

The IAAF could have made a similar statement, supporting that their experts were confident that she no longer had an unfair advantage, and perhaps some of the speculation would have been dealt with.  It would not have removed doubt or controversy, but at least there wouldn't be a shadow hanging over every performance, doubt that she's cheating by running too SLOWLY when she could dominate the event.  And if you think this is an isolated opinion, it's not, I suspect many people are wondering "why is that athlete wearing red trying NOT to win?"

I don't know the answer to this - I would find it difficult to believe that any athlete would deliberately finish second when they could win by a small margin (in a relatively slow time of 1:58.xx too - it's not as though she'd be running 1:54 to win every race).  And to finish third when they could finish second?  I find it difficult to believe, so I'd almost want to give her the benefit of the doubt.  Also, I'm not sure she or her team is that calculating, but perhaps I'm naive.  She is currently 4 seconds off her best, around 3.5%, which is a big distance off your best.  But that could mean one of three things - training hasn't gone well, she's running slowly on purpose, or she had treatment and the 1:54 from 2009 is now never going to be possible.

Also, I've seen her race BEFORE the controversy, and she looked pretty much the same as she does now, even when losing.  For example, in her World Junior Championships in Poland in 2008, she finished 7th in her heat, and looked much the same as she does now.  It may be that she just looks like that, that she never seems to be straining - short, chopped stride, no major upper body rotation - it would easily look like someone wasn't working hard enough.

But, then I see her race in Eugene and Oslo, and I can appreciate what people are saying - she led for 700m in Oslo and then in the final straight, just seemed to coast through to a third place finish.

But, you can see for yourselves if you haven't already.

First, here is the race in Oslo:




And here is the race in Poland, 2008.  As an aside, note the difference in her physical development from 2008 to when she won the World Title in 2009 in Berlin.  Truth is, if it hadn't been for controversies about gender, there'd have been a lot of people speculation about doping, such is the cynical age of elite sport we live in.



Your thoughts?  No matter what one believe, it's a difficult situation - the more I've written about this, and spoken about it, the more I've realized the problem of intersex conditions in sport is basically insoluble - there's no solution to satisfy everyone.  Of course, Semenya's case was handled so poorly and unfairly for her, and her response to it has been admirable.  But for the sport, the questions have to be asked.

Robby Andrews - great finish, interesting contrast in pacing

On a more racing-specific note, here is a fantastic men's 800m from the NCAA championships over the weekend.  It's fast, and competitive, one of the better finishes you'll see in an 800m race.  Watch the clip before reading on, spoilers to follow!



So the interesting thing for me is the pacing strategy - I'm biased, but I read quite a bit into it!  And the guy who ends up second, Charles Jock, runs a first 400m in 49.85s.  Super quick, and followed by a second lap in 54.90s.

Now that's a huge positive split - 5 seconds, which I don't believe is optimal.  Robby Andrews, who catches him, runs the first lap in a low 51s, which means his second lap is around 53.5 seconds.  That's a far more reasonable balance to the race, much more in line with how the best 800m performances have been recorded.

But the point I'd make is that Robby Andrews' super quick finish (which is amazing, don't get me wrong) only appears that fast because the rest of the field was far too fast early on.  To give you more numbers, Jock was recorded at 1:17.1 at 600m.  That means after a first lap of 49.85s, his next 200m took 27.3s. And his final 200m took 29.65s - he was getting progressively slower.

So was Andrews, to be honest, and it's a safe bet that Andrews was a little quicker than 27s to the 600m mark.  But then Andrews finishes with a final 200m of about 26.5 seconds (assuming he's ± 1 second down on Jock at 600m), compared to Jock's final 200m of around 27.65 seconds.

In other words, Andrews just slowed down the least, and that one second gap which looked so enormous at 200m to go, was overcome as a result of a better overall pacing strategy, combined with a huge slow down for the rest of the field.

Pacing strategy is not a precise science, at least with the knowledge we currently have.  But a + 5 second differential in an 800m suggests to me too fast a first lap, whereas the + 2 for Andrews is a much more controlled, and probably closer to optimal, performance.

But a great race, nevertheless.  Can Andrews go faster?  Probably.  Can Charles Jock?  Definitely, because he should have a big improvement there if he gets the pace right!

But more on pacing in the series coming up when I'll share the video of my presentation on the subject from the recent ACSM!

Enjoy the Diamond League!
Ross

Barefoot running, shoes, and born to run

The barefoot running debate: Born to run, shoes & injury: the latest thinking

One of the more interesting, and certainly topical presentations at the recent meeting of the American College of Sports Medicine in Denver was a symposium on barefoot running.  It was led by Irene Davis and Daniel Lieberman, both advocates for barefoot running and top scientists in this field.  Lieberman in particular is something of a 'legend' in the field, and two years ago, he gave the prestigious keynote address at the ACSM meeting.

Since then, the area has moved on, thankfully.  Most recently, Lieberman's group did some fascinating work on the barefoot running concept in runners accustomed to shoes or running barefoot, and that's the focus of this post, along with some thoughts on the concepts underlying barefoot running.  A lot of the time, I'll play devil's advocate, because I believe in Lieberman's findings, and the theory behind barefoot running is sound.  But there are some "loopholes", and I'll end with those.

Not just a fad, and certainly not only for the niche

There are more than a few people who have dismissed barefoot running as a fad.  And many will have labeled it a niche concept, practiced by a very small percentage of runners.  That's only partly true.  If you think that barefoot running has nothing to do with you, think again.  You may not have discarded your shoes, but the truth is the the shoes you are running in have already been influenced by the concepts that drive the barefoot running movement.

That is, the last decade, which has seen more and more evidence come out AGAINST shoes, has also seen a shift in the shoe industry.  Gone are the heavy, bulky motion-control shoes, replaced by shoes that are now marketed to simulate barefoot running.  Nike were apparently the first to do this, though I remember Adidas bringing out "feet you wear" in the 1990s.  But it was the Nike Free that was the first "barefoot shoe", and Irene Davis, in her ACSM presentation, told the story that a famous college coach in the USA was responsible for this because he told a Nike rep who had come to watch his team train that his runners were more comfortable being barefoot. 

The rep rushed back to HQ, reported on the athlete's preference, and it heralded the shift.  Now, almost all the companies are focusing on the 'minimalist concept' of shoes.  There are even new companies (Vibram, Newton).  Of course, there are a few stubborn survivors, but the whole market has shifted, there is no doubt about it.  Why?  Because of the current thinking around running, and the role of footstrike, and our feet, in injury risk during running.  So we're all affected, even if we run in shoes, and here's the theory.

The Born to Run theory - our survival was dependent on being endurance running champs

Barefoot running is fascinating because it has made such a big impact in the mainstream.  And a big part of that is the book "Born to Run", by Christopher MacDougall.  It traces the story of the Tarahumara Indians, and contains chapters dealing with the work on barefoot running - Irene Davis and Lieberman have starring roles.

The fundamental premise behind barefoot running is the theory that we are designed for distance.  Lieberman's first big impact on sports science was his research called "Endurance running and the evolution of homo", where he presented the anatomical evidence that humans are the world's best distance runners.  Let's face it, as sprinters, we're pretty lousy.  Even the super fast Usain Bolt runs half the speed of most big mammals for about a quarter of the duration!  Therefore, if our survival as hunter-gatherers depended on our ability to chase and catch prey, we were pretty much doomed by our lack of speed.  That comes about as a result of many factors (I have a colleague doing research into the muscle and metabolic differences between humans and other animals), but that's for another day.

Compounding this is that we didn't have projectile weapons until fairly recently, so we had to catch our prey up close.   But fortunately, our survival didn't depend on our sprinting ability.  What it did require was endurance ability, and that's where we are the champions.

Thermoregulation, endurance success and persistence hunting

Some of the most important reasons we are so good at endurance relate to thermoregulation.  We are bipedal (which makes us slow), but the linearity is good in terms of helping us lose heat and absorb less from solar radiation.  We are small, we have less hair, and most importantly, we can sweat.  This allows us to exercise at fairly high workrates without reaching what is now known to be a critical body temperature that would force fatigue on us.  This is true, incidentally, of animals, who also stop exercise at a very narrow range of temperature.  And animals can't really lose heat WHILE running - they have to pant, which is not possible during exercise.  So running at the same speed, we have a big thermal advantage.

All of this combined leads to the theory of persistence hunting, where humans are able to hunt by outrunning the intended prey over hours, rather than seconds.  There are a few good videos showing this - the hunter selects to hunt at the hottest part of the day, and then identifies the biggest animal and runs after it.  Over seconds, it's a no contest, but the hunter just continues to run, driving the animal out of the shade and into the sun.  This continues for hours, but eventually, physiology wins the day and the animal reaches that critical temperature.  If you have ever seen what happens at this point, you'll know the scene - the animal staggers as if drunk, losing motor control and eventually, it just stops completely, lying down for the hunter to make the kill.

What's the relevance of all of this, you may be wondering?  Well, this leads to the theory of barefoot running, because Lieberman and others argue that humans are designed for distance - it was essential and the "normal" state.  By extension, wearing shoes is "abnormal", and so we must return to what we were intended for - long distance running WITHOUT shoes.  And that's where the evidence comes in!

Shoes and injury

One of the main lines of evidence is actually a lack of evidence.  That is, there is not a single study that has shown that shoes reduce the risk of injury.  In fact, there is now evidence that the risk of injury is unchanged, maybe even higher in the expensive shoes.  Injury rates haven't come down even a little bit since the 1970s, the period which has seen the explosion in the running shoe industry - back in the 70s, the shoes resemble today's minimalist shoes, but about 70% of runners were getting injured, the same rate as today.

There are studies showing that runners who run in the more expensive shoes are more likely to get injured, even when you correct for distance and previous injury history.  There is also evidence that prescribing shoes according to the shape of the foot (high arch gets a neutral shoe, flat foot gets a motion-control shoe) does nothing to the risk of injury in a sample of 2,000 in the military.

So all in all, it doesn't look great for shoes.  There are a couple of confounders in this line of thinking, which I'll address at the end, but the lack of evidence for shoes doesn't hurt the idea that maybe the foot is best, and we should be discarding the shoes and trusting our feet.

The evidence for barefoot running

But what the theory needs is evidence.  And some of that has come from Lieberman, and was published in Nature last year.  He looked at barefoot and shod running with the important realization that familiarity (which may determine "skill") would have an important effect on how their mechanics (and hence impact forces) might be altered. He therefore tested two groups, one which was habitually shod, and another that was accustomed to running barefoot.

Below are some graphs showing the key concepts, and this is really the best evidence for what Lieberman and Davis are saying, so it’s worth explaining carefully (these graphs came up in all three presentations, it is really the only research so far, but it's very compelling).

So the first graph (above) shows the force measured during a single ground contact period in a person who is barefoot and heel-striking. I’ve highlighted the key point on the graph – the impact transient, a spike in the force up to around 2.5 times body weight within the first 50ms of ground contact. That impact transient represents a sudden increase of force, and the rate at which it is applied (which is basically the slope of the line from contact to that peak) as well as the size of that force are associated with injury, in particular stress injuries of the tibia (Irene Davis spoke of this at length in her presentation).

Shoes - spreading the load

The concept of shoes is that they spread that impact out, absorbing some of the force and reducing both the size of the impact transient and also the rate of loading. That’s what the graph below shows. The top panel is the barefoot situation where you land on the heel, as shown above, and the bottom panel shows what shoes do.   I’ll show more data shortly.

 Forefoot running - the body's cushion, removing the transient

The barefoot condition in someone who is forefoot striking is shown next.  Here, the impact transient has disappeared – the forefoot landing allows the impact peak to be absorbed by the calf, ankle and Achilles tendon and the result is a smoother profile, and significantly reduced loading rates and forces.

 The problem - not all barefoot running is equal, and the consequences are extreme

So that’s great news, right? It says that barefoot running is the way to go? In theory. The problem is that making that transition from wearing shoes to running barefoot involves significant risk, and Lieberman's research shows why.  And if you’re not careful, then you actually end up INCREASING the loading rate and the impact force, because you run “badly” without the protective elastic shoe dissipating that force as was shown in that middle graph above.

So below are the two key graphs. First, a graph of impact force in three conditions. Start in the middle – the yellow bar is the impact force running in shoes, while heel-striking, which is what most people do.  In fact, Lieberman found that 100% of people who were accustomed to shoes would land on the heel when they had to run in shoes.  

Now move right – that green bar is the force for people who run barefoot, but who are “good at it”, and have become accustomed to it.  Lieberman found that in this group, the regular barefoot runners, about 90% land either on the forefoot or midfoot.  As explained, their impact forces are significantly lower. 

But those who are not accustomed to running barefoot are the key group, shown in blue.  83% of runners who usually run in shoes would land on their heel even when running barefoot, at least at first.  And shown by the blue bar, their impact force is very slightly higher.

But that’s not the major difference. That comes when you look at the impact transient and the initial rate of loading, shown below.

Now you see that if you run barefoot and are NOT ACCUSTOMED to it, you land on the heel, as shown by the blue bar (again, 83% of his normally shod runners did this).  And the result is an impact loading rate that is SEVEN times greater than running in shoes with the same landing.  If the theory is that this impact transient, and the rate of loading, is related to injury risk, then what this is showing is that people who are accustomed to shoes who then run barefoot (perhaps following unqualified advice in a magazine) are exposing themselves to higher risk of injury as a result of massively increased loading rates.

So that’s the first problem – the purported reduction in injury risk (which is probably real) is dependent on the technique.  If you get it, and land on the forefoot, the impact transient and loading rate are lower (see the green bar above).  But if you get that wrong, the consequences may be severe (further research is required on this).

Learning - skill will improve and mechanics will be adjusted.  But not without risk...

Now, we’re pretty amazing machines, and I can assure you that most people will be able to learn how to run barefoot effectively. That is, with a little practice, they’ll begin to make the adjustments that move them from that high risk group who heel-strike to a more cushioned forefoot strike.

You can experience this for yourself if you take off your shoes and run – within 50m, you’re already starting to make those adjustments, because running barefoot on your heels, well, it hurts.  So we "feel" the ground, more than we want to at first, and over time, we adjust our mechanics and shift to a forefoot landing.  That's why a comfortable majority - 90% - of people who are accustomed to running barefoot will land on the forefoot.

But that brings us to injury risk number two – the adjustments you make to help cushion the landing have consequences. They transfer the impact forces and loading to the posterior muscles, those muscles at the back of the leg. You land with your toes more pointed away from you, and so your calves are contracted, and catching body weight every landing.  You may reduce the impact forces, but those forces that are left are being applied to very specific muscles.  Muscles that may have never been asked to do that kind of work.

The eccentric load on the Achilles tendon and calf muscles is enormous. Your feet and ankles are working much harder, doing what is probably their job, what they are designed for, but they haven’t done it for many years, perhaps a lifetime! The end result is that the strain on the muscle and tendon systems is just enormous, and people break down very quickly.

This is the same outcome as you get from introducing things like Pose and Chi running either too quickly or incorrectly.  Your mindset is "land on the forefoot" and that's a pretty tough skill, and it's a pretty challenging demand to cope with for muscles that have for years not been asked to do it!  My own personal experience reflects this - I was regularly running upwards of an hour in shoes, no pain.  I went running in Vibrams, and did 30 minutes consisting of 1 min jog, 4 minutes walk.  And for three days, I could barely walk, my calves, hamstrings and glutes were so tight - it was typical DOMS from eccentric loading that muscle was unaccustomed to.

I know a few who have experienced the same thing.  And if they overcome the initial stiffness, there is a big risk waiting a week or two down the line, because the constant load on unfamiliar muscles is a huge factor that sees a lot of people get calf or Achilles injuries when trying to run barefoot.

It shows that a) running in shoes requires next to zero eccentric work in those muscles (relative to shoes), and b) when you start barefoot running, you may have to go way back to basics, beyond beginner level, in order to undo what 20 to 50 years of shoes may have caused. 

Making the switch - the practical problem

And herein lies the key - the shift to barefoot running is theoretically sound.  Lieberman and Davis have a compelling case.  But practically, it may be too big an adjustment for some to make.  People have different abilities when it comes to learning a skill, and skill is what it will take to shift out of the shoes.  It also takes different mechanics, possibly muscle strength, and so out of 100 people, it is quite conceivable to me that you'll get a range of responses.

Some will respond brilliantly, and will be able to run big distance barefoot and have no problem.  Some will really battle, and may have to return to beginner level, but they'll learn it.  Eventually.  Whether they have the mindset or willpower and discipline to do it is another question.  Irene Davis presented her recommendation, which started with taking someone up to 30 minutes of barefoot walking, followed by progressive introduction of jogging.  She started at 1 min jog, 9 min walk for 30 minutes.  That eventually worked its way to 9 min jog, 1 min walk.  Which is all good and well, but if you're running 40 to 80 miles per week, the idea of going that far back...not likely.

Then out of our 100 people, I do think there are some who just will not succeed barefoot.  Perhaps they have a structural problem somewhere, perhaps 20 to 40 years of shoes have caused changes that simply cannot be reversed.  Perhaps they have muscle weaknesses elsewhere, and barefoot running is not sufficient to overcome those.  One of the problems I have in this debate is that those who are advocating barefoot running are basically treating it as medicine (if you have a condition, take a drug.  If you have an injury, take barefoot running...).  The problem is that this is not done with any idea of dosage, "contra-indications" or exclusion criteria, and some might just not be able to do it, which makes 'one-size fits all' advice unhelpful.

The point is that there should never to a single approach to an injury problem.  I think there's no doubt that someone who is chronically injured may have their best chance in trying barefoot running.  But this cannot come at the expense of a holistic view (and I must emphasize, Davis is not guilty of this), and so I'd put barefoot running forward as part of a solution, something to try, and if you are one who succeeds, then go with it.  But if not, then look elsewhere, and don't worry, it's not as simple as some are suggesting.

High performing runners - barefoot may just not be practical

The other group that I have to mention is high-performing runners.  Not necessarily only the elite, but even those who train for a fast marathon, or Ironman, or even high mileage 10km runners.  They are doing 120 to 200 km per week, and a lot of it is fast running.  Much faster than persistence hunting would have required - obviously, there is no data, but it's unlikely that humans have ever tried to cover 200km in a week, a lot of it at 7 min/mile or faster, even getting down under 5 minutes/mile for long periods.

If you are doing this kind of distance, then there is a real question over barefoot running.  Some will argue that the reduction in loading rates and impact transients makes it more likely that you can succeed barefoot, especially at high mileage.  But there's a confounder here too - muscle fatigue.  The third presentation in the symposium showed some really interesting evidence that the loading on the joints and bones was HIGHER as muscles fatigued.  This stands to reason, of course - muscle absorbs much of the impact force, and so tired muscle loses that ability, exposing the joints.

So those who are training for performance may struggle because of a muscle fatigue issue - the muscle is working differently, and harder in certain muscles, when barefoot, and that may be limiting.

The bottom line - individualized approach, but sound theory

On the whole, barefoot running, or at least minimalist shoes, is a sound concept. Lieberman’s theories regarding our ability to run are solid, and I do believe that the days of bulky, motion-control shoes are numbered. I think that barefoot running will be very difficult to implement, if not impossible, for some people and probably doesn’t work in the extremist view that some people are offering for it.

I believe that it may be PART of the solution for SOME of the cases of injury. For SOME, it may be ALL of the solution, the solve-all. For others, it will be completely ineffective, and for other still, it will be the cause of their problems.

Recommendations

So if I had to give some recommendations, speaking now both as a scientist and a coach:

• If you are are injured, or struggle with chronic injury problems, then give barefoot running a try.  It may be especially helpful if you have knee problems, or any anterior injuries (anterior shin pain, for example), because going barefoot will switch the load. 
  
  The benefit (in a backward kind of way) of starting injured is that you're pretty much compelled to go back to beginner level and build up, so your chances of staying beneath that "injury risk line" are better!
  
  
• If you are not injured, but fancy trying it, then by all means, go for it, but be very careful.  I would suggest the best way to approach it is to think of barefoot running as a training modality.  Just like you'd go to Pilates to improve core strength, or spend time in the gym on upper body or leg, think of barefoot running as a session. 
  
  There is some evidence for this, incidentally.  Pieter Bruggemann (of Oscar Pistorius testing fame) actually did a study on the Nike Frees, and found that just using them in the warm-up improved lower leg strength, balance and agility within five months.  So this points out one way to do it - do warm-ups either barefoot or in minimalist shoes.  Or do five minutes at a time, building very, very slowly, so that you don't affect your other training but gradually develop the strength.  If you find that you enjoy it and don't seem likely to be injured, then push on.
  
  
• If you are a high-mileage runner, then think carefully about tinkering with barefoot running, or about changing your technique to land on the forefoot.  For one thing, if you are a competitive runner, or even aspiring runner (going for PBs, that is), then you're the person most likely to overdo it!  It's part of what makes you competitive!  So again, I'd advise that you consider incorporating barefoot running into the programme as a training aid, because it will help your feet, calves and ankles.  But as with any training aid, phase it in very slowly.
  
  
• If you are constantly battling calf, hamstring, foot or ankle problems, then consider barefoot as treatment, but take the most conservative guideline you can think of and halve it - do 50% less than what that says.  The rationale is that someone with a hamstring injury can't just avoid strengthening the muscle - it's part of the rehab.  So for chronic calf and ankle/achilles problems, running barefoot may be exactly what you need.  But you are the kind of runner who has to start with five minutes of walking, not running, and hold back massively.  If you can succeed, then hopefully this will help your return to running in shoes, and maybe, eventually, minimalist shoes.

Then, no matter which category you fall into, golden rule - try not to control your landing.  You shouldn't be thinking about how your foot hits the ground.  Just "listen" and "feel" the contact, and your body will gradually adapt it for you.  The mistake that is made is to think "forefoot" and this leads to excessive loading, as explained above.  You will occasionally land on the heel, but the natural response is to cushion the landing.  The danger is trying to catch the landing, so just relax and focus on not reaching, not pointing, not catching.

Conclusion

And I’d end my opinion on barefoot shoes by just cautioning its advocates to avoid making the same mistake you are accusing the shoe industry of having made for many years. The shoe industry, it is said (with good reason) advocated for many years that shoes were the “answer” – one size fits all (pardon the pun), and that simply putting someone in the right shoe would prevent or cure injury. Now, the barefoot movement is in danger of making the same error – learn from the past and recognize that individuals need individual solutions. So don’t put everyone in a barefoot box.

Ross

P.S.  A footnote...(pardon the pun)

The devil's advocate view

Just to end, I want to point out three counter-arguments to three arguments made by Dan Lieberman in his talk.  Mostly, this is to give you some ammunition when you get overwhelmed by a barefoot advocate who is arguing it as the sole solution, the be-all, end-all of running.  It's likely far more complex, and here are some responses...

1.  Shoes are abnormal, barefoot running is normal

Lieberman said this often often in his talk.  He says that when we see a guy running barefoot, maybe we should think of him as normal and ourselves as abnormal.  And it may well be true.  But the problem is that "normal" doesn't imply good, and "abnormal" is not necessarily bad.  Think back 100 years, life expectancy was about 50.  Go back another 50 years, and you expected to live to your 40s!  People died young all the time, particularly mothers during childbirth.  Today, it's up near 80 in a lot of countries.  You might say that in 1911, you were abnormal if you lived to 80.  Today you'd be normal.  Is "normal" wrong, or just different?  It tells nothing of what is good or bad.  Sometimes "normal" changes as part of progress.

The key is that in this case, normal is meant to convey that our feet should be doing what they're designed for.  And that may be true, but it's still short on evidence.  We can't discard things that are "abnormal" just because they're unnatural...

2.  Our ancestors were great runners, and being barefoot is the reason

This is key to the debate, because it is being suggested that hunter-gatherers, minus the state of the art shoes, were great runners.  And therefore, the lack of shoes is the reason.

So two things.  First, I'm not necessarily convinced that all of them were great runners.  Let's take a group of 100 people today.  There may be 50 who can run at a reasonable level - the finish marathons, half marathons, in the top half of the field.  They get injured maybe once every two years, but if they're good about training (strength work especially), they keep going.  30 of our runners might really struggle.  The do 5 hour marathons, get injured often, but can get through on isolated occasions.  10 might be absolutely incapable of running - they get injured in the warm-up and just cannot finish 5km, let alone marathons.  And 10 are the best runners.  One of them is Ryan Hall, an elite.  Nine are good, competitive runners.  They push the limits and get injured, but recover well, and they are the "runners".

Now apply this to the Kalahari, or the Tarahumara.  Is it not possible that in a village of 100, there are 10 "runners" who are the best, 50 others who are good enough, and that they provide the running for the community.  Maybe there are 40 of those 100 who just suck at running!  They become artisans, doing the building or hut construction, maybe they become fishermen!  But they can't run.  I simply do not know the answer to this one - I don't know, for example, whether 70% of Kalahari hunters get injured every year.  Maybe 2 in 3 Tarahumara get injured, take a few weeks off, and then return to running.  Not knowing this means I'm less convinced by the argument that being barefoot is better.

Then the next point - why is it that we've identified being barefoot as the key difference between us and our ancestors?  We look at them, and we say they were great runners who rarely got injured (a point I'd question, as explained above).  Then we make the next deduction, and we say "they didn't wear shoes, that must be why".

Well, I can think of plenty of reasons why they may have been injured.  For one, they didn't sit at a desk 9 hours a day.  They didn't have Playstation and TV and computers.  I mean, I've been sitting down for 90 minutes typing this - my posture and core muscles have been asleep.  But that wasn't true for Kalahari - they climbed trees, slept on uneven surfaces, walked, were physically active.  All of this may lead to improved strength, especially in the stabilizers - the core and glutes.

That may well be as much a reason for their apparent ability without injury, and barefoot running may only be part of it.

3.  Injury rates haven't changed, so the shoes clearly don't work.

The argument here is that injury rates were 70% in the 70s and 70% in the 2000s.  So, despite shoe technology, which is hugely different, we still get injured just as much.  And sure, this is true, and when viewed together with the other evidence about shoes, I think it's a good case.

But just remember that the people who are running in the 2000s are not necessarily the same as those running in the 70s.  When I think of running in the 70s, I think of Amby Burfoot - small, wiry, probably ultra-economical (sorry Amby!  Thanks for reading!).

When I think of running in 2011, I think of Oprah Winfrey... sorry Oprah.  Simply, the people who run marathons today are not the same kind of runner.  They are heavier, slower, and probably do less training but then still run the marathon distance.  When viewed this way, it's perhaps not surprising that 70% are getting injured.  If anything, it suggests that shoes may be helping, because many of the runners of 2011 are walking/jogging/running injury risks!

So if you're going to attack the shoes, then I'd rather do it on the basis of the evidence that they don't change mechanics/pronation, that they don't alter risk in controlled studies, not because of this historical comparison!

That's all folks.  I know it's a lengthy piece, thanks for reading.  It really is just an overview (this is the summary!).  For more on this, check out the featured series on running technique and shoes here!  I discuss a bit more of that evidence on shoes, which I just touched on in this post.

Ross

PPS:  Thank you for all the comments in the discussion below.  I will do my best to respond, but bear with me if it takes some time!

What is a good low carbohydrate diet? It is a low calorie one

My interview with Jimmy Moore should be up on the day that this post becomes available. (I usually write my posts on weekends and schedule them for release at the beginning of the following weeks.) So the time is opportune for me to try to aswer this question: What is a good low carbohydrate diet?

For me, and many people I know, the answer is: a low calorie one. What this means, in simple terms, is that a good low carbohydrate diet is one with plenty of seafood and organ meats in it, and also plenty of veggies. These are low carbohydrate foods that are also naturally low in calories. Conversely, a low carbohydrate diet of mostly beef and eggs would be a high calorie one.

Seafood and organ meats provide essential fatty acids and are typically packed with nutrients. Because of that, they tend to be satiating. In fact, certain organ meats, such as beef liver, are so packed with nutrients that it is a good idea to limit their consumption. I suggest eating beef liver once or twice a week only. As for seafood, it seems like a good idea to me to get half of one’s protein from them.

Does this mean that the calories-in-calories-out idea is correct? No, and there is no need to resort to complicated and somewhat questionable feedback-loop arguments to prove that calories-in-calories-out is wrong. Just consider this hypothetical scenario; a thought experiment. Take two men, one 25 years of age and the other 65, both with the same weight. Put them on the same exact diet, on the same exact weight training regime, and keep everything else the same.

What will happen? Typically the 65-year-old will put on more body fat than the 25-year-old, and the latter will put on more lean body mass. This will happen in spite of the same exact calories-in-calories-out profile. Why? Because their hormonal mixes are different. The 65-year-old will typically have lower levels of circulating growth hormone and testosterone, both of which significantly affect body composition.

As you can see, it is not all about insulin, as has been argued many times before. In fact, average and/or fasting insulin may be the same for the 65- and 25-year-old men. And, still, the 65-year-old will have trouble keeping his body fat low and gaining muscle. There are other hormones involved, such as leptin and adiponectin, and probably several that we don’t know about yet.

A low carbohydrate diet appears to be ideal for many people, whether that is due to a particular health condition (e.g., diabetes) or simply due to a genetic makeup that favors this type of diet. By adopting a low carbohydrate diet with plenty of seafood, organ meats, and veggies, you will make it a low calorie diet. If that leads to a calorie deficit that is too large, you can always add a bit more of fat to it. For example, by cooking fish with butter and adding bacon to beef liver.

One scenario where I don’t see the above working well is if you are a competitive athlete who depletes a significant amount of muscle glycogen on a daily basis – e.g., 250 g or more. In this case, it will be very difficult to replenish glycogen only with protein, so the person will need more carbohydrates. He or she would need a protein intake in excess of 500 g per day for replenishing 250 g of glycogen only with protein.

ACSM overview: Wrapping up the high (and low) lights

Wrap-up of ACSM: The highlights (and a frustration)

Thanks to all for weighing in on the last post on the stagnant nature of sports science. Or rather, some aspects of sports science.  I know that the last week may have felt a little like an "insider conversation", but moving forward, I'm going to widen the scope and tackle some intriguing topics, inspired mostly by the week in Denver.

Attending ACSM has helped me understand more than ever that like any field, sports science suffers from the constant resistance of the “old guard” pushing back against new ideas. Not that I didn’t know it before…

This is a generalization, of course, because there are some outstanding scientists who, in the fourth or fifth decades of their careers, still challenge their own thinking and innovate and drive knowledge forward. But there are many who do not, and I think that in science, as soon as you begin to believe your own dogma, the drive to innovate is gone. And if you aren't challenging beliefs, then honestly, what are you doing in the sciences?

The solution I'd propose to this problem of "legacy science", is to open the symposia up to younger scientists, or at least those who have been prolific in that field within the last two years. Rather come up with the topics independent of the people you want to present, and then review the published literature and invite researchers who have published regularly and recently in that field. And every speaker really should end each presentation with some discussion of future areas and unanswered questions - meetings should catalyze future research, not congratulate itself for past accomplishments.

Days 2 and 3 - some highlights and great presentations

In any event, the rest of the conference went well, it improved a great deal and I was pleased to attend some very good talks and over the next few weeks I’ll try to roll some of those out here on the site.

Pacing strategy: A window into the experience of fatigue

My own presentation on pacing strategy was part of a symposium that I think was successful. It was very well attended and that’s a good sign for the field, because it suggests increased interest in pacing, which is still an unexplored area. The more minds involved, the better. So I'll use this forum to say thank you to Carl Foster and to Jos de Koning (who I know will read this!) for their support in the field, and to Carl for the invitation. A great privilege and I’d love to do it again.

I would be lying if I said I was happy with my own talk (I’d call it 6 out of 10, if I’m feeling generous), mostly because of time pressure and the impossible task of trying to present a model and all the research underlying it in a short time. It's always frustrating to feel that you've left a key concept or two unexplained, failed to emphasize and highlight the right things - it gives potential detractors too much leeway to undermine the theories.

Dismissals, misunderstandings, tap-dancing around the minefields and being ignored

One of the big challenges I experienced in preparing the presentation is that I’m constantly aware of a prevailing disdain and dismissal of anything related to pacing and the brain that comes from anyone associated with Prof Tim Noakes in Cape Town.  I think it’s fair to say that there’s a history of animosity against Noakes because of historical arguments about central governor vs. oxygen limitation models, and the dehydration/hyponatremia debate.  These issues date back 15 to 20 years, but the legacy still exists, as do the characters, and now seems to have been handed on a generation.

And so any time I am thinking about explaining the theory of how anticipatory regulation (summarized in the slide from my talk below) occurs, I feel the need to tap-dance around the potential minefields represented by those who have been offended in the past (rightly or wrongly).

The problem is that these historical divisions and personal arguments have led to a misunderstanding about what the model of performance regulation is actually saying. There are people who hear "central governor" and sneer and swear and pass crass jokes about it (respected scientists, yes).  And yes, there is growing support, because I think it's so logical and obvious, and I sometimes wonder if I’m paranoid about people’s perceptions of anything that comes out of Cape Town (because it seems that to some, anything and everything from Cape Town must be the same).  But then I am reminded of the attitudes by people at conferences like this one.

For example, one of the world authorities on the brain and exercise told me on Thursday evening that he thought the central governor was “BS, this little man in the brain telling you to slow down”.   I’ve never seen the paper where anyone has described a little man in the brain, but it shows that people don’t really know what they’re dismissing.  The funny thing is that even those who support the concept (and the whole central governor thing, to be clear, is a concept, a process, not a structure) use it as a noun - "the central governor slows you down".   I feel this is an oversimplification of the concept that leads to a fundamental barrier to its acceptance - to me (and perhaps I stand alone on this one), the "central governor" is not a structure or a single area, but a collection of many different processes, pathways, brain areas, that have a single purpose - anticipatory regulation of exercise performance through conscious effort perception.  It's for that reason that I didn't use the term "central governor" in my presentation or in the literature review where the model was proposed.

So in trying to present the theory, I feel the pressure of having to move forward to explain the model, while backpedaling to re-explain the theory that people dismissed the first time around because they didn't listen properly to it.  And this requires a really in-depth presentation of the theories. You can’t present a model for anticipatory regulation without putting the foundation in place properly, because one missed step or explanation and you hit one of the afore-mentioned minefields. And that squeezed out valuable time for the actual theory, forcing me to fly over certain areas.

At the very least, though, I hope that people recognize that there’s a substantial body of literature now available on the regulation of pacing. And what I’d really like is for those who are doing some great work (here, I emphasize my fellow presenters in the session) to actually consider what is being said, recognize that everyone actually agrees more than they realize, and then acknowledge the contribution that each is making, instead of inheriting some stupid, arrogant defiance of a theory that neither side is actually listening to or reading properly.

I plan to make a video of my presentation for you and put it on the site, in due course, so I’ll discuss this much more then.

The highlights

Best talk of the conference for me? Markus Amann’s presentation on afferent feedback and its effects on pacing strategy was excellent. He has incredible data, and I really believe it fits perfectly into the theory of regulation of exercise to avoid peripheral failure.  As does Romain Meeusen's - also brilliant data on how neurotransmitters in the brain may place a role in performance.  What both are missing is the insight into pacing strategy and anticipation/management of fatigue.  And, what the pacing strategy theory is missing is the insight into mechanisms, which Amann and Meeusen provide.  In other words, the combination of their work into the 'anticipatory model' is a perfect fit, from which both models would benefit.

Some of the other really good talks? There was a session on children and specialization that was interesting, in particular the second speaker who presented the case study of Michael Phelps and compared it to other swimmers, charting their paths to Olympic success. It will also provide good content in the not-too-distant future when I turn to the talent vs training debate, are champions born or made?

A session on mind-body and the limits to performance was very good. It introduced the concept of “benign masochism” to explain that elite athletes may be predisposed to enjoying pain (in training) that is not actually harmful, that elite athletes prefer to be just below the threshold of what is intolerable.

There was an interesting session on the East African runners, where Yannis Pitsilades presented his quest to find the genes that may or may not explain performance in that group. Every single world record in track is held by an athlete of African origin (West African for sprints, East African for distance and el-Guerrouj), and so there is a quest to discover the genes. Or, as the present culture seems to be leaning, to prove that the genes don't exist and that it's all down to hard work - see Outliers, Bounce and Talent Code for more.

So far, the gene search has turned up nothing, which has led many, including Matthew Syed of “Bounce” to speculated that there is no gene, that the success of these athletes is purely down to their training and hard work, combined with the opportunities they get.

This is a topic I’m going to tackle at some point – training vs talent, but what I will point out is this: Height is inherited, we know this. Yet genetic studies have failed to identify a single gene, or a combination of genes that predict it. The best studies are able to explain about 40% of height, and that took 200,000 different genetic polymorphisms! If that is the case for height, then how much more complex is something like athletic performance, which involves muscle, heart, lungs, brain, enzymes…? All I’ll say is good luck with that search! We won’t find those gene associations in this lifetime or the next, because there aren't enough Kenyans and Ethiopians to test to do it.

But this does not mean those genes do not exist - I am convinced that the advantage is partly genetic.  Not that training is not important, and of course the champions in any sport will work hard.  But without the right genes, hard work takes you to a ceiling.  Personally, I'd say it would be better to look for the differences in phenotype to explain their performances.

The barefoot running debate

And then finally, as a lead on to the next post, the other good symposium I attended was one on barefoot running - the debate rolls around again! This was a symposium where two big advocates for barefoot running spoke - Dan Lieberman and Irene Davis, and they have some compelling arguments.

But that is for another day! I'll do it in a bit more detail, early next week! Right now, it's time for a short break from academia! Now that ACSM is out the way, I'll start broadening the range of topics again, and get onto some great series - it may have felt like an "insider conversation" this past week! But starting with barefoot running, we'll tackle some topics next!

Ross

ACSM Day 1: Is sports science stagnant?

ACSM Day 1: Is sports science stagnant, or just some of its people?

Day 1 of the meeting of the American College of Sports Medicine has come and gone, and I have to say that I have been fairly disappointed in the standard of the science, the quality of the presentations and the overall quality of the meeting so far.

I hate to come across as negative (and I must point out that Day 2 has already been much better - a great talk on Specialization in sport in children, but more on that later), and perhaps I’ve just been unlucky with my choices, but on the first day, I did not leave a talk feeling that I’d heard anything new.  Overall, my impression is many areas of sports science are treading water.

Or maybe my expectations are simply too high. To give you an idea of how that expectation is set, ACSM is the largest gathering of sports science and sports medicine in the world. Such is the demand to present, that parts of the meeting are planned two years in advance – I’m here in Denver because back in 2009, I agreed to present in a highlighted symposium on pacing and fatigue.

Those highlighted symposia, together with special lectures, are the “focal points” of the meeting. These are the gatherings where world-leaders prepare a series of talks on a specific topic. I guess you could call them “state of the art” (in fact, this is literally what some of them are called).

And so my expectation is to hear the very latest research on a given topic. One of the most published researchers in the world is going to present data, theories and evidence for the latest thinking on a topic. So if a symposium is on overtraining and its effects on performance, muscle, immune function and hormone responses, then it should present the research since the last meeting. Sure, it may require a historical overview, explaining how our understanding of overtraining has evolved.  It may even involve presentation of theories from the 80s, the 90s. But then the focus should be on latest thinking, recent research.

Looking back to the 1990s, but never moving forward

That seems not to happen. The number of times I heard theories put forward that date back to 1990-something was astonishing. In my opinion, the only time you should present a theory or a model from the 90s is to a) prove or disprove it with your very next slide which is on the very latest research, or b) make the strong point that nobody has done any research on the topic since the 90s.

No model or theory from a decade or more ago should be presented and left there. I was studying for my Honours degree in 2002, and if a “state of the art” lecture in 2011 presents the same information I did in my honours degree, it is because the science has failed to move forward.  

No theory should stand there for a decade unchallenged. A quick flashback to 1996, for example, reveals that:

• I was 15 years old;
• Belayneh Dinsamo held the marathon world record in 2:06:50, and;
• Prof Tim Noakes gave the keynote address at ACSM and presented a theory based on AV Hill's work that the heart was protected by a “governor” (Hill’s word) during exercise.

Times have changed – I’m no longer 15. That time of 2:06:50 makes Dinsamo 112th on the all-time list (incredible, I know...), and the theory that the heart is protected has been modified numerous times through about ten different review articles, with hundreds of research studies on performance and the brain, and now includes peripheral regulation of muscle contractility along with theories from around the world that refute and support the concept of central regulation of exercise.  The current theory may not be 100% accurate, but it's different.  It has evolved, which is how things should happen.

Same conclusions, a decade on

But what I saw a great deal of yesterday is pretty much identical to what I saw the last time I was at ACSM in 2005. Or the last time I was at the European equivalent meeting in 2004, or at the South African equivalent meetings.  In fact, what was presented yesterday looked remarkably like the material I was lectured on during my under-graduate and Honours courses in Cape Town over a decade ago.

I remember a guest lecturer at the University of Cape Town in 2004 presenting her theory on overtraining, and that dated back 3 years at the time. Yesterday, that same theory was presented, now dating back 10 years, but it was equally unresearched, unproven, unchallenged.

Children in the marathon - going in circles, back where it began

The result of this is that the conclusion of every single talk that I went to today is identical to the conclusion of the same talk perhaps ten to fifteen years ago. One presentation did a perfect circle. It was called “Too young to run?” and was supposed to tackle the issue about children running marathons. 

It began by showing the recommendations on children in marathons from a 1991 review.  Then it presented some very basic data from all of two studies (the only other data in the presentation was when one of the speakers mentioned that his grand-daughter was six months old).  One hour later, it concluded with the same advice as the 1991 paper.

The only “addition” is that marathons need to rethink allowing children to run because there is a risk they’ll get lost or trampled and the administration may be liable - so clearly, litigation has moved on, but not the science.  At least according to the presenters.  So therefore, advice to disallow children from running marathons should be made for administrative reasons, and not medical reasons.

One hour, almost no data, and that was the result.  Absolutely disappointing.  No discussion of the evidence of children and their responses to endurance exercise. No discussion about children and resistance training, no mention of the work showing that early specialization reduces chances of later success in sport. Just bald assertions, opinions and a conclusion that frankly could have been read in a Runnersworld magazine from 1994.

It turns out that numerous sporting bodies do have guidelines for maximum running distance in children - the IAAF and IMMDA, for example - but neither of these was even mentioned.  This came up in a discussion that started on our Facebook page, and the irony, having joked about Runners World above, is that the latest version of the magazine in the UK has a piece called "Are the kids alright?", dealing with this very question!

And let's be honest, it's a tough question - there's no obvious, direct evidence to answer the question of how far children should run.  However, there is plenty of indirect evidence of how children respond to different types of training, and there will be a physiological basis that at least allows one to form an evidence-based opinion.  It may not have proof, but there is evidence.  Sadly, that evidence was conspicuously absent in the symposium, which didn't even mention that some organizations have made recommendations.  It was very poor - you are better off reading the latest Runners World than listening to "world leaders" in the world's biggest conference.

The physiology of overtraining - inching forward

Exceptions are few and far between.  The other sympsoium I went to today had some very interesting data, and some very good presenters.  And, it must be said, some interesting advances from some of the presenters.  It seems that there are some new discoveries on overtraining in resistance training and also the search for markers of overtraining.  One of the primary advances seems to be the discovery that overtraining in the military leads to a desensitization of the hormonal system, where luteinizing hormone levels rise but testosterone levels fall because the testes are not responsive to the signal from LH.

The only problem is that this is not actually new - evidence from the talk was pretty clear that as far back as the early 90s, it was already known.  The only difference is that technology has allowed continuous measurements of LH, and so it's now possible to see that its levels are raised, where before, there was some misleading data.  But the concept of desensitization or "endocrine system fatigue" is not an advance. 

The end result is that many areas of sports science resemble a TV soap opera – one of those shows that you can neglect to watch for months and then tune in and understand the plot and all the characters, because the increments by which knowledge grows are so marginal.

Sports science is evolving, it's just some people within it are not

Having been relatively negative so far, I will say that so far Day 2 has been much better, and there are still talks on barefoot running to come, and I have hopes of some innovative thinking.  More to come on those in the next post.

So there's no doubt that many areas of sports science are "stuck" in old thinking.  The classic one is fluid balance and thermoregulation, and again, there is this huge dogma about heat and dehydration that should really have been disposed of many years ago.  That's just human nature, refusing to move with the evidence.

But there is without doubt much growth in knowledge, and in very specialized areas, sports science is not stuck on a treadmill.  I still think it's way behind other sciences and it's astonishing how little we know about training and performance, about children in exercise, about weight loss and metabolism.  But within these very specialized areas, there is growth, and at the leading edge, things certainly look different to what they did say 10 to 15 years ago. 

That this does not come across is an indictment on the speakers at ACSM.  Perhaps it is time to realize that the "expert" is not always the best person to take the science forward, and that people stagnate, not science.

Ross

P.S.  If you are here in Denver, feel free to say hi if you see me wandering around!  Oh, and follow us on Facebook to get the quick thoughts and opinions from the meeting, in case I don't have time to share more detailed thoughts!

Edinburgh: The final 3 minutes

The final 3 minutes from Edinburgh

It's here to stay, people, so enjoy it.  We have embedded this from Universal Sports, whose coverage of rugby is actually very good---so readers in the USA take note, they will be covering the Rugby World Cup later this year, too.  This is the best advertisement ever for the sport of Sevens.

These are those final three minutes:

Again, this is embedded directly from Universal Sports, so we should not have any problems with them blocking it from Youtube, which is where the other video was hosted.  At the risk of sounding like we are promoting it, you can even watch the reply of the entire SA vs. AUS match for $3.99, which is a pretty fair price.  Note to international readers, though---this content might only be available to those in the USA.  It kind of defeats the purpose, if you ask us, but perhaps there is a copyright or ownership issue they have to deal with!

Enjoy!