Saturday, November 17, 2007

Gut Feelings by Flash Gordon m. d.

The following article was copied from the Medical Motorcycling column in the December 2007 issue of Motorcycle Consumer News

Medical Motorcycling
Gut Feelings
A READER E-MAILED ME asking if a big gut helped your back when riding a naked cruiser, since he'd seen so many riders of that description on that kind of bike. At first, I thought he was joking, but, after consideration, realized that he had a good point. Cruiser riders tend to have a more upright position than sport bike riders, so from your back's viewpoint, there are major differences between cruisers and sport bikes.

Sport bike riders lean forward, flexing the low back and putting weight on the wrists. This aggravates certain back problems (and if you have these kind of problems, you'll know it when you either ride a sportbike or just look at a Ducati 748). The weight on your wrists can aggravate conditions like carpal tunnel syndrome, especially if you don't keep your wrists relatively straight.

Sitting upright on a cruiser, on the other hand, lets you see over the top of other vehicles more easily. Your back's not flexed forward, and there's less weight on your wrists.

Before concluding that "upright is good" from a back standpoint, consider evolution. Mammals evolved as four-legged creatures, and the reason we have so many back problems nowadays is that we walk upright. When you ride upright and bottom out your suspension on a pothole, your entire upper body weight slams down on your lumbar discs, which provide padding between vertebrae. I find the best position for my back is leaning slightly forward, letting the wind support much of my weight.

When sitting straight up on a naked bike, there are only three ways to keep the wind from pushing you over backwards. First is a death grip (literally) on the bars. This, though, causes loss of control, and keeps the bike from doing its job.

The second way is to tense your stomach muscles. This works, but when your speed picks up you need quite a six-pack. The third method, I realized, is letting a good-sized gut act as ballast! And upon further thought, I realized that sportbike riders might benefit, too. Having a nice soft gut to lean on can take your weight off your wrists.

To be honest, I'd never considered all these advantages of having a big gut before. My medical experience has led me to be gut-averse because of the health problems big guts cause: high blood pressure, stroke, diabetes, cancer, back problems, knee problems, heart disease, etc. But if I can help you develop an adequate abdominal anchor attachment, I will.

Here are some methods for developing and maintaining a good-sized gut, just to make it easier to ride upright without the danger of developing a six-pack.

First, of course, is avoiding daily exercise. Not exercising keeps your body in fat-conserving mode. Daily exercise, however, will convince your body that it's out hunting or gathering, and that you're not stuck in a cave waiting for springtime.

Your body only knows what you're doing by what you do: in other words, you must avoid walking an hour a day (or burning the same 300 calories by running, swimming, bicycling, or other exercise) to prevent your body from starting to burn that all-important belly fat.
Another way that exercise can endanger your gut is by lowering insulin levels in your bloodstream. Insulin's main job is to open the gates in the muscles that allow the sugar (glucose) to get inside and be used as an energy source. When you're exercising, your body both allows some of your precious stored fat to be released into the bloodstream and burned during the exercise, and also lets your muscles burn some glucose without needing insulin. If your body doesn't need that insulin, it won't make it.

In addition to allowing resting muscles to burn glucose, insulin also causes fat to be deposited (helping maintain that big beautiful belly). Also, insulin helps your arteries deposit cholesterol, which causes coronary artery disease and sudden cardiac death if you don't exercise.

Of course, since the big gut keeps you making insulin, your pancreas is more likely to wear out prematurely, giving you diabetes. And having diabetes is just as risky for your heart as already having had one heart attack. (The risk of blindness and amputation that accompanies diabetes is just "gravy.").

Once you have diabetes, though, keeping the belly is a lot easier. Most of the drugs people take for diabetes cause weight gain, which makes diabetes worse. And though there's a new diabetes medication that typically causes weight loss, known as exanatide (trade name Byetta), it's given twice daily by injection. True, the injection's basically painless, but the psychological barrier is real.

Not to worry, though: even without having a massive, meticulously maintained and managed midriff, you've still got a good chance of sudden cardiac death (SCD). Almost one out of every six deaths in the US is due to SCD, so your odds are about the same as playing Russian roulette (put in one bullet, spin the chamber...).

SCD is the most common way that people find out they've got a heart problem (and heart problems are the No. 1 cause of death in the US). Of course, once you drop dead, your range of options in terms of managing the heart disease are, shall we say, limited.

Sadly,a prodigious paunch isn't a guarantee of a quick checkout. Many cancers, like prostate, kidney, breast, esophagus and colon cancer, are obesity related, too. And checking out from one of those causes can be as slow as a TSA security line at the airport the day before Thanksgiving.

So, what's a rider to do? Sounds like the only way to stay upright on your windscreen-less cruiser is having strong abs, a big gut (for counterbalance) or buying a windshield. And for you sportbike riders who decide to lose your pillow—think what you'd have to spend to save 20 Ibs. by buying carbon fiber!

Flash Gordon, m,d., is a primary care physician practicing in Greenbrae CA. and the author of Blood Sweat And Second Gear.