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In our high-tech world, it is easy to neglect the physical body. However, the body requires exercise to function at its best and to maintain health. BEAST is an acronym for a five-point lifestyle that focuses on the ideals of this book. The name reminds us that no matter how sophisticated we consider ourselves, we still need to sweat to achieve our fitness goals. The BEAST system is made up of the following parts: • B icycling (or other aerobic exercise)

BEAST training applies our scientific concepts to improve fitness for all types of athletes: recreational athletes, competitive athletes, younger athletes, older athletes, and elite athletes. The specific goals of endurance, power, weight control, seasonal training, and event peaking will be addressed. Common features include intensity to build fitness, frequency to prevent atrophy, base mileage for endurance and fat burning, strength training to build muscle mass, avoidance of injury and overtraining, and the motivation to stay in the sport for years (or a lifetime).

We will detail the fuels and macronutrients that your cells require to maximize physical performance. Sports nutrition and hydration will be explained scientifically at the cellular and subcellular levels. Specifically, we will explain why a balanced diet of carbohydrates, protein, and good fat is required to supply and support your biologic machine. In this section, we offer evidence-based advice on what you should eat and drink, and when. We will emphasize the importance of nutrients that stoke energy production rather than empty calories that contribute to weight gain. This advice applies to both athletic performance and overall health.

The advantages and limitations of various forms of athletic monitoring will be discussed including: speed, mileage, heart rate, respiratory rate, cadence, cardiac output, VO2 max, climbing altitude, and pulse oximetry, with an emphasis on the importance of measuring watts (power). For those averse to electronic devices, there are accurate ways to self-perceive physical effort such as breathing, foot pressure, and muscle soreness. For example, VO2 max is a reliable measure of an athlete’s fitness, as it reflects cardiac output, oxygen consumption, and mitochondrial mass. At his peak, Greg LeMond had one of the highest VO2 maxes ever recorded. However, the bulky VO2 max apparatus makes it impractical outside of the laboratory.

When you are young and vibrant, it is all too easy to take your body and health for granted. But as you get older, you may begin to wonder: how long can you sustain activity and health, what can be expected in terms of physical performance as you age, and what if anything can be done to slow the aging process? The mitochondrial theory of aging is the latest and most complete explanation of how we age at the cellular level. Mitochondria generate but also neutralize many of the harmful free radicals that cause cumulative intracellular damage. Beneficial antioxidant foods work at the mitochondrial level. A healthy diet and lifelong exercise are proving to be the best way to curtail the ravages of aging. Recent studies have shown that exercising your muscles helps your entire body ward off preventable diseases and slows the onset of degenerative diseases in the brain. Although mitochondria are not a mystical fountain of youth, they are the fountain of your energy. Aging cannot be reversed, but understanding mitochondria gives you the opportunity to slow the aging process.

Strengthening the body strengthens the brain. This connection between physical activity and intellectualism was recognized by different cultures in antiquity. Scientists now understand the biologic basis of the body–brain connection. Exercise boosts the brain in many ways: increasing connections between brain cells, increasing blood flow and oxygen to the brain, stimulating many areas of the brain (not just those sections involved in motor function), and increasing neurotransmitters (the vital chemicals used in nerve cell communication). There is also evidence that exercise can delay the onset and progression of neurodegenerative disorders in the brain. With our aging population, exercise has never been more important to maintain cognitive function and independence.

Mitochondria can be negatively affected by inactivity, toxins, and genetic diseases. Many diseases of inactivity (metabolic syndrome, obesity, and type 2 diabetes) can be prevented by strengthening our mitochondria with exercise. Many inherited mitochondrial disorders have been identified. Mitochondria are suspected of having a role in degenerative diseases of the brain. Mitochondria are important in understanding cancer because they are at the center of apoptosis (programmed cell death) and tumor cells have altered metabolism, skewed toward growth rather than energy production. Mitochondria are complicated biological entities and are very sensitive to a multitude of chemical toxins. Mitochondrial toxins can be divided into environmental/dietary toxins and medication-related toxins and are detailed here so the athlete can best avoid them. Mitochondrial toxicity cut short Greg LeMond’s racing career.

Mitochondria are the tiny descendants of bacteria that inhabit each of your cells. We need mitochondria (they provide us with energy) and mitochondria need us (we provide them with oxygen and nutrients). Mitochondria generate your cells’ energy. In an orchestrated series of chain reactions, mitochondria generate ATP, the chemical driving force behind cell function, muscular power, and cardiac output. The vast majority of human energy comes from ATP generated within mitochondria, which are therefore the key in understanding athletic performance. This chapter explores mitochondria from a number of perspectives: structure, origins, biochemistry, and genetics. The final step in the production of ATP involves the most intricate enzyme known in biology. Driven by the proton battery inside each mitochondrion, ATP synthase churns out ATP using a high-revving nanomotor mechanism. Whereas most other enzymes are made of a single protein, ATP synthase is a complex of 31 proteins, with several parts analogous to the machinery in a high-performance automotive engine. Variations of this enzyme give vitality to virtually every form of life on Earth. It is also the athlete’s engine.

Empowered with the knowledge of how your body works, how your cells function, and how mitochondria make your energy, you will be able to optimize athletic power and improve overall health. This book charts the way to a complete, science-based training system, one that will lead to a fuller and more energetic life. The goal of this book was to make physical training more scientific and less dogmatic by explaining why exercise works. Because mitochondria are so pervasive in our bodies and cells and because the supply our energy, understanding them can help keep us get or stay physically fit and avoid preventable diseases.

In this section, we will review (with a skeptical eye) the scientific evidence regarding supplements that are claimed to support mitochondria and energy metabolism. Although the following supplements are natural and generally considered safe in recommended amounts, they should only be taken with the approval of your physician, especially if you are taking other medications or have allergies. These supplements are not intended to replace exercise. Nor should they be taken primarily for weight loss. There is no substitute for physical exercise and there is no such thing as exercise in a bottle. The supplements we will review include vitamins, coenzyme Q10, acetyl-l-carnitine, R-lipoic acid, magnesium, resveratrol, fish oil, olive oil, multivitamins with iron, and dietary fiber.

Whereas most fitness books focus only on muscles, this book explains how all of the human organ systems are involved in athletic performance. Each organ system has a different role in your energy metabolism. Understanding how your body works is the first step toward optimizing your fitness potential. This chapter walks you through the functions of the following organ systems: digestion, blood sugar regulation, hormones, liver, heart, lungs, body fat, fluid balance, muscles, and the brain.

Thoracic duct injury and chylothorax are rare consequences of blunt thoracic trauma. A contained mediastinal lymph collection (ie, lymphocele) is rarer still. The article describes a case of posttraumatic mediastinal widening resulting from a high-speed motor vehicle accident. During the patient's radiologic assessment aortic rupture, paraspinal hematoma, esophageal injury, mediastinal tumor, and pseudomeningocele were sought and subsequently excluded. At this point a traumatic lymphocele was suggested, and the diagnosis was confirmed by computed tomography-guided percutaneous needle aspiration. The anatomy and physiology of the thoracic duct are reviewed.