Thursday, June 27, 2013

Book Review: Body by Science, by Doug McGuff, MD, and John Little

Five Stars out of Five. Highest recommendation.

STOP. Read this book before you do one more exercise routine.

McGuff is an Emergency physician with an avocation for fitness and John Little is a professional fitness trainer. Body by Science is subtitled “A research-based program for strength training, body-building and complete fitness in 12 minutes a week.” The authors cite empirical studies relating workout regimens and formulate a specific routine to most efficiently build muscle while burning fat.

Many of the principles outlined here are in contradistinction to modern convention about exercise. For example, the authors show that prolonged aerobic activity--such as long distance running-- does little to contribute to overall fitness and almost all runners have chronic injuries that limit their long term well-being. Most individuals can achieve their fitness goals more safely in very little time per week; likewise, most faddish regimens-- Tai Bo, Crossfit, P90X-- do little more than waste your time and can lead to serious injury.

While I am usually skeptical of anybody who purports to know a quick and easy way to achieve a difficult goal, I have to say that this book has extremely useful information about metabolism, biochemistry and muscle kinetics. The authors explain the evolutionary rationale for the exercise routine they advocate and also discuss diet, limiting grains and emphasizing whole foods.

On the savannah, prehistoric man evolved to exert himself in short bursts of highly intense activity: avoiding predatory lions or chasing game.  Successful individuals were also able to endure famine and dehydration and certain body habitus were selected. Today, endomorphs who store body fat are often looked upon as less fit than, say, Arnold Schwarzenegger or Sylvester Stallone, who are ectomorphic with more lean mass. Counterintuitively, however, individuals who have adequate fat stores are able to survive seasonal food shortages better than ectomorphs.

In fact, Stallone and Schwarzenegger are genetic mutants who likely would not do well on the prehistoric savannah. Large muscle mass inefficiently burns calories even at rest and these individuals, while looking fit in modern civilization must consume an inordinate amount of resources to maintain their basal metabolic rate.

The purpose of any exercise routine is not to look like Stallone. First of all, it would be impossible for most of us. McGuff and Little explain the genetics of muscle development and review the specific mutations discovered over the last decade, including myosin light chain kinase and myostatin genes among others.

The kernel of the book is the Big Five workout, encompassing slow movements using the largest muscle groups in the body. The authors liken exercise to a medical prescription, looking for the dose that will give the greatest benefit with minimal side effects. The BIg Five includes latissimus pull-downs, chest press, seated row, seated military press and leg press. The safest, most efficient method is to use Nautilus or other progressive cam machines.

Loss of muscle mass-- sarcopenia--  has deleterious implications as we age, limiting our activity and increasing our risk of injury. Building muscle is all-important to overall fitness, and the authors cite studies that show this regimen not only build muscle but also increase aerobic capacity and flexibility. Complex routines, such as Crossfit, on the other hand, are more likely to lead to injury and other practices like stretching actually can lead to muscle weakness.

The key to the Body by Science workout is to continue each exercise in a slow sustained movement until muscle failure. Done properly, you should feel quite uncomfortable at the end of each exercise. Think Neanderthal running from a Lion. The upside is that nothing builds mass and aerobic capacity as quickly as high intensity exercise ending in muscle failure.

The authors recommend 5-7 days rest between workouts. Youtube videos are available to view by googling “Doug McGuff doing the Big Five” or “Body by Science.” The videos make the routine look deceivingly easy, but with heavy weights and slow sustained muscle contraction your heart rate and respiratory rate elevates.

The review of diet is also important. I have always worked out and would consider myself fit-- able to run 5K’s and lift weights--  but chronically overweight. McGuff and Little are quick to implicate the workout industry in giving false expectations that exercise alone can lead to weight loss. Nope. The fact is that I eat too damn much and no amount of exercise will make up for that.

Personally, I found this book an invaluable and readable review of metabolism, genetics and muscle function. It has changed the way I exercise, reducing my risk of injury and increasing the efficiency of each workout. I still do other things, namely an hour-long highly intense full body aerobic regimen with a trainer, but the Body by Science workout has become a weekly added ritual.  I have noticed a significant increase in lean muscle mass, as measured by my trainer, and a generally improved sense of well-being.

Book Review: Lolita, by Vladimir Nabokov

Four stars out of Five.

Set in post-War United States, this story recounts the obsession of a European immigrant with adolescent girls, and Lolita in particular. Nabokov writes in the first person as the protagonist Humbert Humbert is awaiting trial for pederasty and murder. The account is a memoir of Humbert as he pursues the affection of Lolita the daughter of his landlady, taking the girl on a cross-country trip, engaging in illicit behavior and eventually the murder of her paramour.

I read this book because it’s on nearly every list of the best books of the 20th century and I had no idea what to expect.  In order to make a fair judgement since the topic is beyond controversial I purposely read no formal reviews of the book prior to starting. The book is almost beyond description.

On the one hand, the primary theme-- pedophilia-- is a contemptibly bad notion to incorporate as the primary topic of an entire novel, but Nabokov seems to have purposely chosen such a theme for the challenge of constructing a readable full-length novel on a tough subject. He succeeds in spades.

Nabokov exhibits his mastery of language, playing with words and phrases to entertain the reader, which is quite impressive given that Lolita is his first novel written in English, a language he learned as an adult.  Nabokov expounds on the difference between European continental lifestyle versus the United States middle-class style. Darkly comical, Humbert relates his opinion of the fatuity and lack of couth in America, all while engaging in the most vile acts imaginable.

Nabokov uses this novel as a vehicle to mock psychiatry and psychoanalysis. Humbert misleads psychiatrists and, just for fun, consciously confirms their biases toward unproven hypotheses about psychopathology. Another theme is the ease with which Humbert, a good-looking man of means, can easily skirt laws and conventions of behavior by virtue of his appearance.

Much of the book traces the travels of Humbert and Lolita across the United States by car, making this a road story of sorts. He describes the people and places from Connecticut through the Midwest and mountains and out to California.

Lolita, the novel, defies description. Nabokov seems to be attempting to make Humbert a sympathetic character but in the end Humbert becomes self-loathing, recognizing his flaws and the damage he has done to Lolita.

For the writing style and language this is among the best books written.   Recommended.

Wednesday, June 12, 2013

Book Review: Destiny of the Republic, by Candice Millard

Three Stars out of Five. Recommended.

James A. Garfield was an unlikely selection for president in 1880, having won the Republican nomination only after he was drafted at the convention due to an electoral impasse.  Within months of the general election he was shot in a Washington, DC train station and subsequently died.

Millard presents a favorable view of Garfield, the man, Union Civil War General, husband and father, and President. Her glowing depiction recounts his unification of party factions and calm demeanor under duress. Unfortunately, the reluctant Garfield only served as president a few months before being killed by Charles Guitaeu, a mentally disturbed office seeker.

One subplot in the story is the poor surgical care that Garfield received following the shooting. Conjecture is that his wounds were not life-threatening and that he died of fulminant sepsis due to the unsanitary practices of Dr. W. Willard Bliss, his attending physician.  Bliss, the same physician who attended Abraham Lincoln following his shooting 16 years prior, did not ascribe to the latest medical advances about hand washing and sterilization of instruments that was advocated at that time by British physician Sir Joseph Lister.

Millard also describes the frantic efforts made by Alexander Graham Bell, the young teacher and inventor, who tried to devise a method for finding the errant bullet sitting in Garfield’s abdomen. Before xrays (invented 20 years hence by Marie Curie) doctors had no way to image the patient looking for foreign bodies such as shrapnel and ammunition rounds. Bell contrived a prototype metal detector using electric current and capacitors for doctors to identify metal fragments in soft tissue.

Dr. Bliss, while inclined to help Garfield, was reluctant to allow a non-physician like Bell to attend to his patient. The device was implemented incorrectly and therefore failed to detect the bullet. Bliss, the other physicians, Garfield’s family, the nation, and Bell all watched as the President deteriorated and finally died of overwhelming infection two months after the shooting.

Millard’s book is easily read and provides a concise account of the the seminal events of the period. My only misgiving is trivial, i.e., that her characters are simplistic, either paragons of virtue or despicable villains. Oddly, the killer Guiteau is perhaps the most complex persona presented, shown to be conflicted, ambitious and mentally disturbed. Alternatively, Garfield and Bell apparently have no faults and Bliss is seen only with contempt.

Regardless, this is an educational book regarding events in US history about which I was unfamiliar. Her style is similar to Erik Larsen or David McCullough. Recommended.