Researchers have thrown tons of time and money into studying whether exercise has an effect on depression, but far less research has gone into how exercise might affect antidepressants. If serious athletes are upping their training, it could change how the drugs are metabolized in the body, and how much medication they should take at a given time, an interaction scientists are only now beginning to investigate.
For now, the research is thin. Though drug companies are required to submit data about the effects of drugs on pregnancy and other factors, they're not required to provide any data about physical exertion. "We know nothing about the majority of the drugs and their interaction with exercise," says Dr. Ira Jacobs, a professor and dean of the faculty of Kinesiology and Physical Education at the University of Toronto. With one in ten Americans taking antidepressants, and a constant effort to encourage patients to be more active, it's an important area of study—though only a handful of people are actively researching how they interact.
Jacobs spent 25 years of his career working for the Canadian Department of Defence researching topics like the effects of performance-enhancing drugs on special operations units. Anecdotally, he found that after troops deployed, they reported side effects from various medications that they had never experienced pre-deployment. It made him wonder how acute bouts of exercise might affect medication generally.
"People who are exerting themselves acutely all of a sudden are diverting blood flow to their muscles," he says. "Where it's coming from, among other organs, is the liver, one of primary organs where we metabolize drugs."
It's possible that as we exercise and move blood away from the liver, we metabolize our medication more slowly, meaning we may need less of it.
Last year, Ethan Ruderman, a then a graduate student under Jacobs' supervision, conducted a pilot study looking at the effects of one acute bout of cycling on sertraline, also known as Zoloft. He found that the drug was removed from the body slightly more slowly during exercise.
The study is very preliminary, and Ruderman cautions against making any conclusions based on the data—particularly for people who have a constant amount of daily exercise, as opposed to a single, intense bout—but it "does help to lay the groundwork for future studies in this area."
Though doctors still don't know a lot about how exercise affects antidepressants, Ruderman and Jacobs agree it's still worth discussing with your doctor. "If an athlete is getting an improper dose of anxiety/depression medication, this may impact their mood, ability and effort to train and practice, which will certainly impact their performance on game day," Ruderman says.
For years, scientists and climatologists have expected to see climate change impact malaria's deadly reach, since the parasites that cause it (Plasmodium), and the mosquitoes (Anopheles) that spread it, grow and survive best in warm climates. Now a new study out of the University of Michigan confirms that the disease, and the bugs that bear it, are expanding into higher altitudes and previously unexposed communities.
The study, published in the journal Science, analyzed malaria records from highland regions of Ethiopia and Colombia, and then normalized them for influences such as malaria control programs or unusually high rainfall (control programs are reducing malaria rates, overall, and high rainfall boosts cases).
"We saw an upward expansion of malaria cases to higher altitudes in warmer years, which is a clear signal of a response by highland malaria to changes in climate," said the study's author, theoretical ecologist Mercedes Pascual.
The researchers examined malaria case records from the Antioquia region of western Colombia from 1990 to 2005, and from the Debre Zeit area of central Ethiopia from 1993 to 2005.
The report is especially troubling because the tropical highlands of Africa and South America contain very dense populations. The Debre Zeit region sits between roughly 5,000 and 8,000 feet above sea level and is home to 37 million people, or nearly half of Ethiopia's population. Many of these people live in rural areas where the insects could thrive.
"Because these populations lack protective immunity, they will be particularly vulnerable to severe morbidity and mortality," said co-author Menno Bouma, honorary senior clinical lecturer at the London School of Hygiene & Tropical Medicine, which contributed to the study.
In an earlier study, the same researchers estimated that without new control programs, just one degree (Celsius) increase in temperature could lead to an additional 3 million malaria cases annually in Ethiopian children.
"Historically, the highlands regions of those countries were considered havens from malaria, places where people could go to get away from the disease," says University of Michigan spokesman Jim Erickson.
For travelers, this trend should not immediately impact malaria rates for those who follow the Centers for Disease Control recommendations to take antimalarial drugs when visiting areas up to 8,200 ft in Ethiopia and up to 5,577 ft in Colombia (the Antioquia region sits just under 5,000 ft).
Still, it's important to consider that warming temperatures are already changing the footprint of at least one serious (yet preventable) disease. Plus, while the CDC rates the risk of contracting malaria in Ethiopia as "moderate," it notes that the Plasmodium parasite there is resistant to the common anti-malarial drug chloroquine.
Want proof that the world is flat? Consider this: how much you pay for your next jacket or sleeping bag could depend on whether 1.4 billion Chinese order Peking duck. China produces roughly 70 percent of the world's down, a by-product of the estimated three million tons of ducks and geese its population consumes each year. But China is rapidly urbanizing, and the burgeoning middle class is eating more beef and less fowl. Combine that with panic over recent bird-flu outbreaks and growing demand in the West for jackets, sleeping bags, and comforters, and the result is a massive spike in down prices. In 2009, a pound sold for $10; today it goes for $50.
In the U.S., higher materials costs are driving up prices on store shelves, where down jackets and sleeping bags now sell for about 30 percent more than they did five years ago. That has some manufacturers ramping up R&D to devise man-made fibers that can match down's exceptional warmth-to-weight ratio. Indeed, synthetics are undergoing a massive technological upgrade. "On a scale of one to ten, we're at five in terms of potential," says Joe Vernachio, vice president of global apparel and equipment at the North Face. "We'll be having sixes and sevens soon," he says. And a nine or ten? "It's out there," Vernachio says, "but we haven't seen it yet." Here's a rundown of the current crop of next-gen insulation.
What It Is: Clusters of tiny balls of synthetic fiber designed to mimic the loft and compressibility of feathers.
Who Has It:ThermoBall is currently exclusive to the North Face, but expect other brands to bring out products with it in 2015.
Warmth: One of the most insulating synthetic fibers we've ever tested.
What It Is: A fusion of natural and synthetic insulation.
Who Has It: This fall, Columbia will introduce TurboDown, which combines natural down with a proprietary insulation and the company's popular reflective technology, a metallic lining that bounces heat back to the body. Insulation maker PrimaLoft and major supplier Allied Feather and Down have plans to unveil down-poly blends within the year.
Warmth: Should be comparable to straight down, but it remains to be seen.
Archibeque, a "ruminant nutritionist," is part of a small cadre of researchers and business people working to make pork and beef healthier by pumping them full of the same omega-3 fatty acids that are found in most fish.
Their interest is fueled by research suggesting these fats cut the risk of heart problems and are critical to brain development. The hype around omega-3's has food companies adding them to everything from eggs to milk to Wonder Bread. So why not the meat counter? Packages of grass-fed beef already declare they have omega-3's, but it's just a fraction of the amount recommended by the American Heart Association.
That's attracted the attention of a few entrepreneurs, including Don Smith. The former energy executive is working with Archibeque and several other Colorado State scientists on ways to feed algae rich in omega-3's to cattle. The goal is to get omega-3 levels in the meat much closer to salmon, without triggering the fishy flavor that can come with these oils. A serving of grass-fed beef, for example, contains up to 50 milligrams of omega-3s; Smith says a serving of his beef will come closer to 140 milligrams of o-3s. That could help people get the healthy fats they need, even if they aren't seafood fans. "Not everybody likes fish. That's really what it comes down to," said Archibeque.
But don't fire up the grill yet. Right now, omega-3 infused meat is about as rare as salmon at a Texas barbecue. Smith has had so much trouble finding investors that he's resorting to crowdfunding to raise $800,000 to finance the research needed to get the beef into stores. Another company that feeds omega-3-rich flax seeds to its cattle just started distributing it's GreatO ground beef through a grocery chain in the Lone Star State. Some processed meats with omega-3 mixed in, like sausages, are sold in Europe and Japan.
Perhaps the most successful outfit in North America so far is a small hog farm near Toronto, Canada. Paul Hill, whose family owns the Willowgrove Hill farm, feeds fish oil to his pigs to produce omega-3 enriched pork. A quarter pound pork chop from Willowgrove has roughly 450 milligrams of omega-3's—about one-fifth of what you'd find in an equivalent portion of king salmon. The heart association recommends getting at least two servings of fish per week.
Hill swears his pigs taste the way pork is supposed to. Apparently his customers think so, too. His pork is sold at several fancy Canadian restaurants, and his bacon and sausage was served to world leaders at the 2010 G8 summit in Canada attended by President Barack Obama. Hill plans to expand to the Chicago area later this year.
Even though this industry barely exists, there's already feuding over whose meat is best. Most of the studies about the benefits of omega-3 focus on DHA and EPA, the kind of fatty acids found in ocean-going organisms like fish. There's less research on the omega-3 from plants like flax, called ALA, though it's thought to have benefits, said Penny Kris-Etherton, a Penn State nutritionist and vice-chair of the heart association's nutrition committee. That has the meat producers using algae and fish oil declaring their products superior. But they can't escape these facts: enriched burgers won't ever deliver the amount of omega-3s found in a salmon fillet, and the meat still has relatively high levels of saturated fat. In other words, if you take your beef with a side of fries and a beer, your health gains may wind up a wash.
Run four miles. Follow with a mile-long ocean swim. Then tread frigid water for an hour. Warm back up by cranking out crazy high reps of pushups, burpees and jumping jacks. This is all in a day’s workout for Stew Smith, former Navy SEAL Lieutenant and author of The Special Ops Workouts.
With the steamrolling popularity of Crossfit, Tough Mudders, and ultramarathons, workouts like these are no longer reserved for our country’s reserves. “We are always pushing the envelope to be bigger, faster, stronger,” says Smith. “Humans just want that next level.”
Russian sports scientist Dr. Yuri Verkhoshansky set out in the ‘50’s to explore how much an athlete’s body could handle. His studies exploited everyday people to explore the physical limits of Olympic athletes. He required them to jump from 20-foot ladders barefoot or attempt 800-pound bench presses. By testing how far he could push average Joes, Verkhoshansky found the breaking point for elite Soviet athletes. One of his athletes, Boris Zubov, became a European record holding sprinter. It was all a matter of pushing the limits.
But that doesn't mean you should break them. "Overreaching can easily become overtraining," says Bryan Mann, assistant director of strength and conditioning at the University of Missouri. Injury and burnout are only a few steps away. So how do you maximize your potential without finding yourself at doctor’s office?
Recognize the difference between working out and training. “Working out is acute. It feels like work,” says Kelly Baggett, a performance consultant who has worked with athletic programs at Texas A&M and the University of Arkansas. “Training is synergistic: you find your threshold. There is a goal, plan and end result.”
Break past your limits during training—yes. Break past your limits during every workout—no. Workouts should progress throughout the year. Training should frame a specific goal, race or event. There is a fine line between mental toughness and stupidity.