Health Myths, Then and Now 

Two new books have your health in their hands.

Around the start of the 20th century, doctors began warning that people who exercised too heavily risked sudden death from the killer known as "athlete's heart." It was an earlier era, and attitudes about exercise were appallingly uninformed. Later, when the bodybuilder and Berkeley High School alumnus Jack LaLanne opened a gym in Oakland in 1936, athletes had to sneak into the place to avoid the censure of coaches who were convinced that weight training would render them slow and musclebound. Even as recently as the late 1960s, marathon runners were discouraged from drinking water during their 26.2-mile contests.

Public understanding of the costs and benefits of exercise has come a long way since the fitness boom of the 1970s helped the 97-year-old Bay to Breakers race grow from 25 runners in 1963 to 110,000 two decades later. But how many of today's fitness "truths" will still be standing 97 years hence? New York Times science writer Gina Kolata set out to answer that question in Ultimate Fitness, a breezy pop history of the American fitness movement and its enduring myths. It's a fun summer read for people who are personally enamored of exercise, as Kolata is. But it ends up raising larger questions than its author is apparently interested in answering.

Moving from the era when medical students were told that people over forty shouldn't exercise to a time in which seniors use personal heart monitors to keep their pulmonary exertion within an alleged "fat-burning zone," Ultimate Fitness takes the pulse of this and other questionable maxims. Does exercising at a moderate pace yield greater weight loss than exercising more briskly? (No, Kolata concludes.) Is there truly such a thing as "runners' high," and does it really come from morphine-like endorphins released by the brain? (Probably, but no one knows.)

To the extent that Kolata explains where these spurious doctrines came from, she lays the bulk of the blame in three places. Promoters such as weightlifter Bob Hoffman built commercial empires that spread half-truths as they peddled their fitness programs. Upbeat magazines such as Men's Fitness feature page after page of advertising devoted to dubious weight-loss regimens, food supplements, and muscle-definition fads. And academia and government agencies largely ceded the field to these hucksters, creating an opening for doctors such as the California physician who promised free steroidal injections to all bodybuilders who referred new clients to him.

In short, Kolata blames most of our fitness misconceptions on charlatans and boosters, as opposed to the scientific establishment she covers in the Times. In so doing, she glosses over an important source of medical misunderstandings, and reveals a major failing of contemporary science writing. Modern scientific inquiry is inductive. Broad theories are based upon the accretion of narrow, incremental hypotheses. By showering so much attention on the latest research findings, science writers inevitably help propagate theories that ultimately wither under the weight of additional data. Kolata herself has fallen victim to this in her past reporting.

Modern medicine's incremental path toward knowledge may be fairly inconsequential when it comes to evaluating different ways to train for a marathon, but applied to weightier matters, such misconceptions can ruin lives. That's the lesson that comes from reading another newly published critique of the accepted wisdom in medicine, Dr. William Glasser's sweeping indictment of the psychiatric industry, Warning: Psychiatry Can Be Hazardous to Your Mental Health.

Glasser believes that the modern mental-health establishment is as backward and ignorant as early-20th-century physicians were about bodily health. Echoing and incorporating the criticisms of colleagues who join him in opposing psychiatry's ever-growing reliance upon pharmaceutical solutions to emotional problems, Glasser believes his profession has gone completely astray when it comes to coping with depression. If he's right, the consequences are grave for millions of Americans.

Too many in his field have embraced the still-speculative theory that chemical imbalances in the brain are responsible for the bulk of emotional maladies, Glasser believes. In so doing, he charges, his peers expose tens of millions of patients to the very real risk that the latest crop of psychiatric drugs will prove no more effective than any of their predecessors: alcohol, opium, cocaine, barbiturates, amphetamines, and benzodiazepines such as Valium. Given psychiatry's shameful history of embracing new drugs only to reverse course in the face of widespread addiction, Glasser and a handful of self-styled renegades believe modern psychiatry is perpetrating an unconscionable fraud on the American public.

Glasser believes depression stems not from chemical imbalances we are powerless to control but from the conscious or unconscious individual decisions we make to choose unhappiness. The bulk of this disjointed but compelling book consists of his latest attempt to advance a theory of treatment in which patients are encouraged to take responsibility for their own mental health.

In fact, he proposes that we start thinking similarly about physical and mental health. Just as tens of millions of out-of-shape Americans possess the ability to change through diet and exercise, Glasser believes the vast numbers of unhappy Americans are similarly able to improve their lot by making different choices. He proposes and explains a fascinating self-help approach to mental health that resembles Alcoholics Anonymous for its lack of reliance on either psychiatrists or pharmaceuticals. Successful relationships, he argues, are the fundamental basis of good mental health.

The last word on both books could well spring from an observation that Kolata makes in Ultimate Fitness. During two recent studies of depressed people, comparisons of antidepressants and exercise showed that exercise improved patients' moods much faster than drugs -- and the effects lasted longer. So whether or not you exercise for your body, the latest studies suggest that you should exercise for your mind.

It sure beats waiting around in the drugstore for prescriptions to be filled.


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