Year in Review: 6 vital health stories from 2014

Working to improve the understanding, diagnosis, treatment and prevention of illness

Michael Kennedy

In 2014 the University of Toronto continued its legacy of life-changing discovery and solidified its reputation as a global medical-research powerhouse. 

It was a year that saw U of T medical researchers tackle everything from treatments for childhood brain cancer to the debunking of fad diets and explaining unconventional methods of teeth whitening

And researchers at the Faculty of Medicine, the Dalla Lana School of Public Health, the Lawrence S. Bloomberg Faculty of Nursing, the Faculty of Dentistry, the Faculty of Kinesiology & Physical Education and the Leslie Dan Faculty of Pharmacy weren’t the only ones working to improve health and wellness. Engineering researchers also shared knowledge that contributed to innovative health practices used to tackle disease locally and around the world

Writer Michael Kennedy reports on health and wellness stories for U of T News. Below, Michael shares some of his favourite stories from 2014.

Reducing risk and complications in the operating room

Researchers create “black box” for use in operating rooms to improve patient care

Associate Professor Teodor Grantcharov and his team of researchers have developed a “black box” for using in operating rooms, similar to that used in the airline industry. It's been tested here in Toronto, at St. Michael's Hospital, and in hospitals in Copenhagen, Denmark. The goal: to improve patient safety by identifying where and when errors occur in an OR and teaching surgeons to prevent them.

Publishing the largest genomic study to date on any psychiatric disorder

U of T researchers shed new light on biology underlying schizophrenia

As part of a multinational, collaborative effort, researchers from the University of Toronto and the Centre for Addiction and Mental Health (CAMH) helped identify more than 100 locations in the human genome associated with the risk of developing schizophrenia. It's hoped this work will lead to new treatments for the disorder, which has seen little innovation in drug development in the past 60 years.

“Large collaborative efforts such as this one are needed to identify genes that influence complex disorders,” said Jo Knight, professor of psychiatry at U of T’s Faculty of Medicine, CAMH senior scientist and the Joanne Murphy Professor in Behavioural Science. “The result is a major advance in understanding the genetic basis of brain functioning in schizophrenia.”

Diagnosing Autism at a younger age so treatment can start sooner

Unlocking Autism’s code

Dr. Stephen Scherer leads the Toronto research team that has identified the formula for diagnosing autism spectrum disorder (ASD) at an earlier age. This will let patients receive therapies at an earlier age, while helping to create  more advanced genetic diagnostic tests.  

Explaining how sitting is killing you and what you should do about it
Everyone says sitting is the new smoking

Study after study has highlighted the dangers of a sedentary lifestyle that includes extended periods of sitting, and the catchphrase “sitting is the new smoking” has gained traction in the media and in popular consciousness.

Writer Jenny Hall turned to Assistant Professor Greg Wells of the Faculty of Kinesiology and Physical Education at U of T and an associate scientist in physiology and experimental medicine at the Hospital for Sick Children. His advice? 

“For every 20 minutes of sitting, stand up and stretch for 20 seconds. Beyond that, within every two-hour block, try to find 15 minutes to do some activity, be it walking or stairs. Even just standing for a while is better than sitting down. I tell people to stand up in meetings. If everyone else is sitting, find a spot to stand up in the back. If you’re doing a phone call, get up and do it with headphones while you’re standing.” 

Discovering a new class of stem cell

Stem cell pioneers’ major, multinational discovery may speed research 

It was an effort so huge, they dubbed it Project Grandiose. U of T’s Professor Andras Nagy led a team of almost 50 scientists on four continents and the results, published simultaneously in five separate scientific articles in Nature and Nature Communications, grabbed headlines around the world. (Read the TIME magazine article. Read the South China Morning Post coverage.)

Committing to reduce hospitalization for heart failure by 50 per cent over the next decade

Historic $130 million gift to establish Ted Rogers Centre for Heart Research

With a $130 million from the Rogers family – the largest monetary gift ever made to a Canadian health-care initiative – The Hospital for Sick Children, the University Health Network and U of T announced the creation of the Ted Rogers Centre for Heart Research. 

“The Toronto region is home to one of the world’s largest biomedical science and health education clusters,” said President Meric Gertler. “This exceptionally powerful network of researchers and educators is translating exciting ideas, innovations and therapies in stem cell research and regenerative medicine into clinical settings where they will address the most challenging problems across the spectrum of heart disease. With its pioneering spirit and innovative approach, the Ted Rogers Centre for Heart Research will be a world-class collaboration and a most fitting tribute to its namesake.”

Posted Friday, December 19, 2014

Posted on January 8, 2015 and filed under Live Better, Move Better.

Outside Magazine: Not all Goals are Created Equal

Not All Fitness Goals Are Created Equal. Choose the Right Ones.

Ill-chosen goals put you at risk of injury and burnout. Here's how to avoid that fate in seven easy steps.

By: Jennifer Van Allen

When Nick Symmonds won silver at the 2013 World Outdoor Track and Field Championships, he immediately started eyeing his next conquest: the World Indoor Championships. "As soon as I crossed that finish line, I wanted more," says Symmonds, an 800-meter specialist. "I was coming off a season where I was ranked second in the world. I hadn't been injured for five years. I had this huge burst of confidence. And I had this idea that I was invincible."

He kept hammering through workouts, despite aches, pains, and urgings from his coach to take a break. Then he broke. A small chunk of bone attached to a tendon started pulling away from the bone in his left knee; Symmonds was sidelined for three months with an avulsion fracture. "I was so set on accomplishing my goal," says Symmonds, who's based in Seattle and Los Angeles, "that I basically broke my body."

The track star learned a painful truth in a painful way: sometimes the more-better-faster model can get you hurt. "We're always thinking about the next thing to shoot for," says Steve Magness, a Houston-based coach and exercise physiologist and author of The Science of Running. "But for the sake of your long-term success and enjoyment, you've got to find a balance of other goals."

There's no doubt that goals are good. They breed elites like Symmonds, and they make us Boston qualifiers and Ironmen instead of just half-hearted gym rats. Goals make us extract the best from ourselves, pull us out of bed at 4 a.m. for speedwork, and push us out the door to slog 20 miles in weather that most people won't drive in. But gunning for new PRs season after season can backfire in a big way.

"If you keep pushing and grinding, it's eventually going to catch up," says Magness. "There's a diminishing return. How many times do you run a personal best? Or a new race distance?"

Think if you were graded at work on a daily basis. "You wouldn't reach your maximum potential every single day," says Magness. "It's just the nature of performance."

We love the thrill of striving to be our best. But if we don't choose our goals wisely, we could face burnout that leaves us unmotivated to work out and eat right—or even worse, injured like Symmonds. In other words, inappropriate goals can take us out of the game. Here's how to ensure your athletic drive endures.

Get SMART

Effective goals must be specific, measurable, achievable, relevant, and timely—a concept sports psychologists convey in a tidy concept called "SMART." A few examples: finishing your first 50K, breaking 20 minutes in a 5K, or qualifying for Boston. Setting a blasé goal of getting in shape, losing weight, or even just getting faster won't give you the framework you need to shape your workouts. "Those sound like goals, but they're really not," says Adam St. Pierre, a Boulder-based coach and exercise physiologist. "And they're just not enough to keep you motivated." As a result you could end up at the starting line undertrained, overweight, and totally burnt out. "You end up in a funk," he says.

Embrace the Process

"It's easy to get engrossed with always grading and judging yourself based on numbers," says Magness. "But often if you take care of the process [like nailing your pacing, fueling, and hydration strategies], the outcome goals [like a desired race time] take care of themselves. And you learn to enjoy the process." Symmonds does this by focusing on immediate, intermediate, and long-term goals that feed on one another, like hitting daily workout paces or completing high-mileage weeks. "Breaking it down into more manageable chunks makes it seem less overwhelming," Symmonds says.

Listen to Your Body

As runners we're used to pushing through discomfort. We welcome aches as reminders of workouts where we pushed farther and faster. But it's critical to know which pains to work through, and which pains demand surrender. If a pain persists or worsens during the run, or causes you to alter your gait, stop and rest. It may also be wise to see a doctor.

"Compensating can cause other injuries," says Magness. And watch for other signs that you might be breaking down. If the breezy 8:30-mile pace on your normal route suddenly drops to 9:00 and feels just as hard, it may be a sign that you're heading toward overtraining.

Don't Compare Yourself to Others

"Being a world-class athlete means being the very best that you can possibly be given where you are right now," says Greg Wells, an assistant professor of kinesiology at the University of Toronto. "The reality is, we're all trying to do the very best we possibly can given our current life situation."

Avoid comparing yourself with others who may have different set of responsibilities—no kids or more flexible work hours, for instance. "A lot of runners will get demoralized, hearing about some guy who's putting down 200-mile weeks, and figure 'I can't compete with that, why should I try?'" says St. Pierre. All you can do is give it all the time and energy you have, and be proud of whatever that amounts to. "But it can be tough to accept your limitations," he says.

Don't Compare Yourself to…Yourself

Resist holding yourself to standards that your younger self may have achieved. Each of us has our own unique orthopedic threshold—how much volume and intensity our bodies can take before they start to break down. Those thresholds are highly individual, and determined by factors like genetics, biomechanics, and history of injury. And they can change with age. Even Symmonds knows that. "The things I could push through at 22 I can't push through at 30," he said. "That's really frustrating. Every day I have to relearn the whole sport again."

Think Beyond Medals

Not all goals have to be tied to races. And the ones that aren't might actually bring you a deeper sense of accomplishment. Case in point: After a disappointing Vermont 50-miler, St. Pierre scrapped the plan he had for a 100-miler, and challenged himself to run the 3.1 mile, 1,300-foot route of Mt. Sanitas as many times as he could in a 24-hour period. The feeling he got from dreaming up the challenge and making it happen ended his season on a high note. "It was a huge confidence booster," he says. "It was as hard as most 100-milers and super fun, and it was a good indicator that I was in shape."

Remember: You're Doing This for Fun

"Some people put so much pressure on themselves and it's almost like their self worth and life's meaning is tied to running a certain time," says Magness. Often this comes when you latch on to whatever socially-accepted definition of success is in vogue—say, a sub-four first marathon—regardless of whether it fits your current level of fitness. Even if you do achieve your goal without destroying yourself, it doesn't always justify the anguish and sacrifice involved in getting there. "It creates this warped sense of reality," says Magness. "You need to step back and decide where you're at as an individual."

Posted on December 23, 2014 and filed under Move Better, Work Better.

Iroman training blog day -278: #Unplug & Be Happy

Today I'm traveling for work. One of the best ways to see a new city is to go for a run. Which is what I did this morning.

The run set was simple - 9 km negative split. I held 6:00 min / km on the way out, 5:30's on the way home.

But 2 cool things happened on the run that I think can help all of us train better and live better.

The first thing was that happened was that as I was running I came up to a busy street. I stopped, waiting to cross the road. I was not at an intersection as I was following a path I'd found so I was just going to wait until there was a break in traffic to cross. Something strange happened. The cars in both directions stopped to let me cross.

Now I'm from Toronto, and under normal circumstances in Toronto when people stop their cars for runners or cyclists it is generally to either get out and start yelling or to get better positioning to try to run them over. So I was a bit taken aback by everyone stopping to let me cross the road.

I nervously jogged across the road and the drivers waved to me. I waved back. Everyone smiled. We were all happier. In case you're wondering where I am - I'm in Charlottetown PEI on the east coast of Canada.

Lesson learned - slow down and be nice. Simple stuff - huge impact.

Second cool thing that happened was that as I hit the 4.5 km turnaround point on the run I walked for a few moments to check where I was on the gps on my phone. I noticed that I had some email notifications and twitter notifications, which I scanned and checked as I walked for a minute.

When I looked up I saw a silver fox on the path in front of me.

Pretty cool stuff that I almost missed because I was absorbed in the electronic device in front of my face. It was a great reminder to put that stuff away and enjoy yourself. Focus on where you are. Give your brain a break. #Unplug.

That's it for now - off to go to the University here for a presentation.

Posted on November 26, 2014 .

Globe and Mail: Meditate on this to jumpstart your immune system

If you’re at all like me, you dread getting sick. I’m just not very good at lying around for days feeling as if I’ve been run over by a truck. So I’m all about trying not to get sick in the first place.

As a researcher at SickKids Hospital in Toronto, I have to get a flu shot. But since the flu shot is not 100-per-cent effective, I am working on other ways to avoid getting sick or, if I do, to get better as fast as I can.

In my hunt through the research on influenza, I came across a very interesting finding. In a paper published in the Annals of Family Medicine, Dr. Bruce Barrett and colleagues from the University of Wisconsin-Madison looked into the benefits of meditation and exercise for prevention of the flu.

Before the annual flu season began, they divided their research volunteers into three groups: one that would practise meditation, another that would exercise regularly and a third control group that just carried on with normal daily life. They then tracked how many people in each group got sick and how severe and long-lasting their symptoms were.

The results were surprising.

As an exercise physiologist, I would have bet that exercise would be more powerful than meditation for preventing the flu. I was wrong.

Both meditation and exercise reduced the number of people who got sick by about 25 per cent.

The severity of the symptoms was lowest in the meditation group, followed by the exercise group and most severe in the group that did neither.

The duration of the illness was reduced equally by meditation and exercise.

Perhaps the most interesting finding was the total number of missed days of work in each group. The meditation group only missed 16 days, compared with 32 in the exercise group and 67 in the observation-only group.

The researchers conclude that exercise and meditation are both effective in reducing the burden of respiratory-tract infections. Moderate exercise is known to be very beneficial for your immune system – the body’s system that fights off infection, illness and disease. This is partly because exercise improves the flow of fluids in your lymphatic system, which means that viruses, bacteria and toxins are filtered from your blood and lymph more effectively. Consistent exercise also increases the number and potency of macrophages, which are white blood cells that travel around your body and attack and destroy invaders. We know that exercise works and how it works.

Although meditation, yoga and relaxation have all been used effectively to help people reduce stress, hypertension, anxiety, insomnia and illness, how meditation works to accomplish this is less clear.

But some new research studies have shed some light on this area.

A group at Massachusetts General Hospital found that when people practised meditation – either experienced practitioners for a single session or novices consistently for eight weeks – there were improvements in the function of mitochondria (the energy factories inside all the cells of the body), better insulin metabolism (which helps your cells absorb blood sugar which they then use for energy) and less inflammation (high inflammation is related to many illnesses and diseases).

In addition, a research study published in the Journal of Alternative and Complementary Medicine found that students who practised meditation increased their levels of immunoglobulin A (which is a substance that identifies invaders such as viruses and bacteria so that they can be destroyed by your immune system) and that the levels kept increasing over the course of the four-week study.

At this time of year, some people are going to get sick. If you don’t want to be one of them, be sure to work out and take time to relax each day. Even better, try meditation. You’ll be doing your body, your mind and your immune system a lot of good.

Health Advisor contributors share their knowledge in fields ranging from fitness to psychology, pediatrics to aging.

Dr. Greg Wells is an assistant professor in kinesiology at the University of Toronto and an associate scientist in physiology and experimental medicine at the Hospital for Sick Children. He is a health and high-performance expert who inspires better living through better nutrition and better fitness. You can follow him on Twitter at @drgregwells or visit his website at drgregwells.com.

Posted on November 23, 2014 .

Greg's Ironman Training Blog Day -284. Testing the training: Critical Velocity.

Over the years I am proud to say that I have imposed a significant amount of pain and suffering on many many athletes of all levels. I was known as doc blood at one point of my career. One of my favourite tests of physiology which I have imposed on my athletes was some form of the critical velocity set.

This set came to me in the mid-90's from my coaching mentor Mark Temple and Bob Treffene who was a brilliant sport scientist in Australia. I've adjusted and adapted the set over the years to different sports but it usually entails 5-7 repeats of a distance that you can complete in 3-5 minutes with 2-3 minutes rest between intervals. Each interval has to get faster until you fail. You know what's coming and you can't escape it.

As you go from slow to fast you track your physiology (heart rate, lactate, breathing, technique etc..) and you can see where you break point is technically and physiologically. It's also good for evaluating psychology as well.

So today I decided to impose that pain and suffering on myself. On the treadmill. Looking at a white wall. I figured I deserved it. Its like Karma for physiologists. Here's todays set:

2 km run @ 6 mph warm up.

Stretch and foam roll etc...

1000m @ 3.5 miles per hour: Heart rate was 117, 3 min EZ at 3.5 mph walking

1000m @ 5.0 miles per hour: Heart rate was 132, 3 min EZ at 3.5 mph walking

1000m @ 5.5 miles per hour: Heart rate was 138, 3 min EZ at 3.5 mph walking

1000m @ 6.0 miles per hour: Heart rate was 144, 3 min EZ at 3.5 mph walking

1000m @ 6.5 miles per hour: Heart rate was 152, 3 min EZ at 3.5 mph walking

1000m @ 7.0 miles per hour: Heart rate was 158, 3 min EZ at 3.5 mph walking

My max HR right now is about 167 which is down about 20 beats since my heart infection 2 years ago.

You can graph the results in Excel pretty easily:

This is a simple test that anyone can do anywhere that's as accurate as a VO2max test for tracking physiology over time. I've used this with dozens of Olympians in many sports. If you extrapolate the line up to max HR you get a value we call Critical Velocity (not critical speed for you physiology geeks out there.

Critical velocity is a magical training speed that causes rapid adaptations in the aerobic system. It was the foundation of the hyper successful Australian distance swimming program (think Ian Thorpe and others). It was also used by the infamous Michaele Ferrari to train Lance Armstrong (with loads of drugs which makes the point less powerful but regardless its a useful indicator of training and performance).

Here's a more involved graph:

The 2 curves are basically before and after training. Critical speed (should read velocity) increases after training. The green text shows what direction the curve moves when you get sick or stressed. If you really want to geek out on this check out this blog post.

So try it out. Test your training and you can track your improvement. Let me know if you have any comments or questions!

Anything is possible!

--Greg

Posted on November 20, 2014 .

Greg's Ironman Training Blog Day -285. Swimming and The GOOD day plan.

I had a good day today. Its usually tough to balance work and training but today worked out quite well. If I can replicate this we'll be all good. Here's a recap of the day with some notes on the successes of the day. Note that these contrast completely with yesterday which was a total shitshow and I didn't train.

6 AM wake up. Stood up and did set my intentions for the day. I just did a simple affirmation - like "This is going to be a great day". It sounds totally hokey but its great and works awesome for me. Especially when life is crazy like mine is most of the time.

6-6:45. Get organized shower etc...

6:45-7:30. Get my daughter out of bed, fed and dressed for school. Drink protein / almond milk / almond butter / cocoa smoothie.

7:30 - 8:15. Head to work. I'm really into podcasts while I commute. Today I listened to the Tim Ferris podcast. I find his interviews with ultra-high achievers to be really fantastic. Check it out at www.thefourhourworkweek.com/podcast/.

8:15. Set up at my desk to write. Pound double espresso (just being honest) - this will not be an ongoing habit but I was a bit tired so I needed a kickstart.

8:15 - noon with a good walking break around 10. Write my new book. Amazingly having been busy and dealing with family etc... for the last week I think my subconscious mind must have figured out how to structure the chapters because today went great. At 10 AM I had a living fuel shake, and at 11:45 I had a cobb salad.

12 - 1. Workout. Swimming today. First time in the water in at least 2 months. I love swimming. I'm a swimmer. When I'm in the water my body does very well. When I'm out of the water I get tight and sore. BUT the first time back in the water after a break usually means that I feel like a bunch of lead sticks strapped together by chains. That is how I felt for the first 2000 m today. Last 500 I loosened up and felt awesome. The set was a simple get back in the water routine:

600 swim

25 / 25 kick fast / swim; 50 / 50; 75 / 75; 100 / 100. (400 m of kick / swim)

400 Pull

Main set

200 Free last 25 fast

150 Free last 25 fast

100 Free last 25 fast

75 Free last 25 fast

50 Free last 25 fast

25 Free fast.

200 EZ

Post swim I had a veggie wrap with side salad.

1:30 - 5 pm I re-read what I wrote this am and was pretty happy with it. Then I hammered through a ton of admin emails and other tasks that don't require as much concentration as writing does.

Overall this is a good example of how you can construct high-performance days where you can get in a decent workout and also do awesome work should you not be a pro-triathlete.

I'm heading home now and will pick up some protein and a load of veggies for dinner. I skipped the afternoon snack which can sometimes lead me to eat badly when I get home so I'm just going to bring some good stuff home with me so I don't make any bad decisions when I get there.

So that's it for today. I'd love to hear from anyone that has good daily routines that help you get training done while you do great work and also manage your family life. Any and all tips and thoughts are appreciated!

Until next time! - Greg

Posted on November 19, 2014 .

Greg's Ironman Training Blog Day -287: Back to Business

Well its been an interesting few weeks. We have a new addition to the family and mom and baby are doing great. So that has gone awesome. Training has taken a back seat so its time to get back in the game. We're very lucky that so far the new little one is sleeping like a champ.

This morning was back to running. We had some snow overnight so the workout was 2 km warm up then 6 x 250 m hills. Pretty hard even though I was running steady.

I learned a few things:

I hate not being good at athletic things. And I suck at running hills.

I need to lose a lot of weight if I'm going to be able to do Muskoka well next summer - its all hills all the time.

I am going to train like a madman this winter.

That's it for now - more to come as this training thing gets revved back up.

--Greg

Posted on November 17, 2014 .

Explaining McDavid's Recovery

Will Connor McDavid be ready in time to represent Canada at the World Junior Hockey Championship? In this interview with Gino Reda on TSN's That's Hockey I explain the steps that McDavid will go through as he rehabs his broken hand. Check it out!

Posted on November 13, 2014 .