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New Questions on Treating Cholesterol
NY Times ^ | January 17, 2008 | ALEX BERENSON

Posted on 01/19/2008 8:20:27 PM PST by neverdem

Correction Appended

For decades, the theory that lowering cholesterol is always beneficial has been a core principle of cardiology. It has been accepted by doctors and used by drug makers to win quick approval for new medicines to reduce cholesterol.

But now some prominent cardiologists say the results of two recent clinical trials have raised serious questions about that theory — and the value of two widely used cholesterol-lowering medicines, Zetia and its sister drug, Vytorin. Other new cholesterol-fighting drugs, including one that Merck hopes to begin selling this year, may also require closer scrutiny, they say.

“The idea that you’re just going to lower LDL and people are going to get better, that’s too simplistic, much too simplistic,” said Dr. Eric J. Topol, a cardiologist and director of the Scripps Translational Science Institute in La Jolla, Calif. LDL, or low-density lipoprotein, is the so-called bad cholesterol, in contrast to high-density lipoprotein, or HDL.

For patients and drug companies, the stakes are enormous. Led by best sellers like Lipitor from Pfizer, cholesterol-lowering medicines, taken by tens of millions of patients daily, are the largest drug category worldwide, with annual sales of $40 billion.

Despite widespread use of the drugs, though, heart disease remains the biggest killer in the United States and other industrialized nations, and many people still have cholesterol levels far higher than doctors recommend.

As a result, drug companies are investing billions of dollars in experimental new cholesterol-lowering medicines that may eventually be used alongside the existing drugs. If the new questions result in slower approvals, it would be yet another handicap for the drug industry.

Because the link between excessive LDL cholesterol and cardiovascular disease has been so widely accepted, the Food and Drug Administration generally has not required drug companies to prove that cholesterol medicines actually...

(Excerpt) Read more at nytimes.com ...


TOPICS: Business/Economy; Culture/Society; Government
KEYWORDS: cholesterol; drugs; ezetimibe; fda; health; medicine; zetia
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1 posted on 01/19/2008 8:20:35 PM PST by neverdem
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To: neverdem
There have been dissenters from the cholesterol theory for decades, but you wouldn't know it from the mainstream media and orthodox doctors.

No statins for me!

2 posted on 01/19/2008 8:23:10 PM PST by pbmaltzman
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To: neverdem

My doctor says I’m not getting enough deep-fried cheese sticks.


3 posted on 01/19/2008 8:27:50 PM PST by ElkGroveDan (I'm sick and tired of being sick and tired of all the politics in politics.)
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To: pbmaltzman
No statins for me!

They make my legs and lower back cramp up something fierce.

4 posted on 01/19/2008 8:30:01 PM PST by digger48 (http://prorev.com/legacy.htm)
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To: ElkGroveDan
My doctor says I’m not getting enough deep-fried cheese sticks.

My belt says I am getting a few too many.
5 posted on 01/19/2008 8:33:00 PM PST by goldfinch
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To: neverdem
Next: Cigarettes Prolong Life, Researchers Say
6 posted on 01/19/2008 8:36:27 PM PST by clintonh8r
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To: pbmaltzman
No statins for me!

It is not statins, per se, that's being called into question. Statins also have an anti-inflammatory effect. It's the "lower LDL can only be a good thing," and using LDL as a biomarker that is being called into question.

Data About Zetia Risks Was Not Fully Revealed

7 posted on 01/19/2008 8:39:00 PM PST by neverdem (Call talk radio. We need a Constitutional Amendment for Congressional term limits. Let's Roll!)
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To: neverdem

http://vitamincfoundation.org/statinalert/


8 posted on 01/19/2008 8:41:54 PM PST by Salamander (And don't forget my Dog; fixed and consequent.......)
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To: neverdem

I had a major heart attack at the age of 51. I had had my annual physical exam three weeks before the attack. My cholesterol was normal and so was my blood pressure. I had never had a problem with either and was never on medication. I was not a smoker or much of a drinker. There was no history of heart disease in my family. I was maybe 10 pounds overweight at the most. Five years later, I am still on maintenance drugs but my cholesterol is normal. My doctor has me take 10mg Lipitor tablet and split in half each day. They say a small dose could be preventitive of another attack but I am not taking the statin for a cholesterol problem.


9 posted on 01/19/2008 8:44:07 PM PST by Biblebelter
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To: pbmaltzman

Everyone would benefit from researching their medications thoroughly before taking them. Side effects can be worse than what the drug is treating. For example, some blood pressure medications can cause diabetes or elevated blood glucose levels. Buyer or patient beware!


10 posted on 01/19/2008 8:44:47 PM PST by ExTexasRedhead
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To: neverdem

We all are individuals, and we all will have individual (different) results from a given drug.


11 posted on 01/19/2008 8:50:30 PM PST by Doctor Don
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To: You see my lipid panel


12 posted on 01/19/2008 8:53:41 PM PST by I see my hands (_8(|)
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To: neverdem

My husbands doctor put him on statins years ago. It seemed every time a new one would come out his doctor would change to the new one and up his dosage. My husband got to where his legs are so weak that he can hardly get up. I told him a long time ago I thought the statins were the problem but he believed in his doctor. Now he is finally beginning to believe that may be the case. I don’t know if taking him off would reverse the effect some or not. I think it is to late.


13 posted on 01/19/2008 8:54:34 PM PST by Spunky ("You have Freedom of Choice, but not the Consequences.")
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To: neverdem; editor-surveyor

My doctor told me that the best thing for lowering LDL was exercise, the aerobic kind like swimming.

I was also warned that many of the cholesterol lowering drugs that are meant for lowering LDL also lower HDL. They don’t work on just the bad.


14 posted on 01/19/2008 8:56:58 PM PST by metmom (Welfare was never meant to be a career choice.)
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To: Doctor Don; neverdem; LadyDoc; Jim Noble
We all are individuals, and we all will have individual (different) results from a given drug.

I once saw that high school dropout, Peter Jennings ask why drug companies were allowed to patent and sell drugs that are used to treat conditions similar to other drugs already on the market.

15 posted on 01/19/2008 9:03:19 PM PST by Paleo Conservative
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To: Spunky

Sart giving him high doses of CoEnzyme Q-10, immediately.

Hubby takes the 200-300mg capsules every day and most of the leg [and memory] problems induced by this virtual rat poison have subsided.

I hope it helps your husband as well but it might take a while to see the difference.

Our doctor yanked hubby’s statins as soon as we became his patients and put him on high doeses of Niacin, instead.

Hubby hasn’t taken a statin in -years- and his cholesterol levels are very good.

Hang in there!


16 posted on 01/19/2008 9:03:51 PM PST by Salamander (And don't forget my Dog; fixed and consequent.......)
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To: Spunky

It’s worth a try. If it’s just a side-effect, there’s a good chance it could go away when he’s off the medicine. At least by getting off, it won’t get any worse and he could build his strength back up with an exercise regime, which will help his cholesterol anyway. If he stays on, it likely will since it’s gotten progressively worse already.

Is it worth taking the risk that this will progress to the point where he can’t walk?

If he goes off, it’s probably good to do it slowly, wean off it. With a number of medicines, it’s not good to stop cold turkey.

Google *statins side effects* for something to show your husband for a real eye opener. I just did and now will NOT let my doctor put me on them.


17 posted on 01/19/2008 9:07:02 PM PST by metmom (Welfare was never meant to be a career choice.)
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To: Salamander

CoEnzyme Q-10 is good for many heart, lung and cancer issues. (Just ask Dr. Oz) It thins your blood too, so be careful. CoQ10 is fat soluble, so take it with food. Don’t take it within 4 hours of bedtime, or you won’t be able to sleep!
The statin drugs tend to increase liver damage. Always have your liver enzymes checked.


18 posted on 01/19/2008 9:12:15 PM PST by toothfairy86
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To: metmom
My doctor told me that the best thing for lowering LDL was exercise, the aerobic kind like swimming.

Swimming is anaerobic!!! It depends on strength more than aerobic capacity.

Running & biking are aerobic. Swimming isn't.

-Yossarian, the former (& and future?) triathlete

19 posted on 01/19/2008 9:14:43 PM PST by Yossarian (Everyday, somewhere on the globe, somebody is pushing the frontier of stupidity...)
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To: metmom
Yup.

Three years ago, my doctor prescribed statins for me.

I went home, read up on them (google is my friend), threw out the first bottle unopened, changed my diet radically, fired my doctor, and now feel ten years younger. I've lost thirty pounds, greatly increased my energy and mental alertness, and rid myself of numerous minor ailments.

The side affect that worried me most was the reduced mental alertness associated with statins.

<sarcasm> Thanks heavens for that statin wakeup call. </sarcasm>

20 posted on 01/19/2008 9:20:29 PM PST by ThePythonicCow (The Greens and Reds steal in fear of freedom and capitalism; Fear arising from a lack of Faith.)
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To: Spunky
My husbands doctor put him on statins years ago. It seemed every time a new one would come out his doctor would change to the new one and up his dosage. My husband got to where his legs are so weak that he can hardly get up. I told him a long time ago I thought the statins were the problem but he believed in his doctor.

How do you know if you have rhabdomyolysis from statin use? What are the symptoms?

Click on the link. Unexplained muscle weakness or pain when taking a statin is not good news.

21 posted on 01/19/2008 9:20:59 PM PST by neverdem (Call talk radio. We need a Constitutional Amendment for Congressional term limits. Let's Roll!)
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To: toothfairy86
Don’t take it within 4 hours of bedtime, or you won’t be able to sleep!

Never heard that one. I take it five minutes before lights out, and it's lights out!

22 posted on 01/19/2008 9:23:43 PM PST by steve86 (Acerbic by nature, not nurtureô)
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To: Spunky
My husbands doctor put him on statins years ago. It seemed every time a new one would come out his doctor would change to the new one and up his dosage. My husband got to where his legs are so weak that he can hardly get up. I told him a long time ago I thought the statins were the problem but he believed in his doctor. Now he is finally beginning to believe that may be the case. I don’t know if taking him off would reverse the effect some or not. I think it is to late

Statins interfere with our synthesis of COQ10 or ubiquinol. coq10 is a key element in energy production in the mitochondria. You might have your husband try supplementing with COQ10. Try www.lef.org. They have the medical abstracts there about the statin/coq10 link and they also sell very high quality supplements (including coq10).

23 posted on 01/19/2008 9:23:47 PM PST by ModelBreaker
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To: neverdem
Unexplained muscle weakness or pain when taking a statin is not good news.

But as I'm sure you know, Rhabdomyolysis is quite rare. The great majority of muscle-related pains connected to taking statins are non-serious myalgias. Treatment by Co-Q10 and analgesics.

24 posted on 01/19/2008 9:27:26 PM PST by steve86 (Acerbic by nature, not nurtureô)
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To: toothfairy86

Funny you should mention that.

Many years ago, they found out I had a fairly nasty mitral valve prolapse.

I read somewhere that CoQ10 was helpful for that and took it religiously for about a year.

Several years ago I went in for another routine ultrasound and asked the tech how my MVP was doing.

She asked me “*What* MVP?”.

It was gone.

Completely.

She said she’d never heard of that happening before.

I still take it just because it makes me feel better than if I don’t.

I would never take statins....not even at gunpoint....:)


25 posted on 01/19/2008 9:28:28 PM PST by Salamander (And don't forget my Dog; fixed and consequent.......)
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To: Yossarian

“Running & biking are aerobic. Swimming isn’t.”

Well, it definitely isn’t if you forget to breathe.....;-D


26 posted on 01/19/2008 9:31:21 PM PST by Salamander (And don't forget my Dog; fixed and consequent.......)
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To: neverdem

A ring of kielbasa before bedtime works wonders on the cholesterol.


27 posted on 01/19/2008 9:36:05 PM PST by Lancey Howard
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To: Yossarian

I thought they were all endurance, so all aerobic.

I can’t swim to save my life. My kids are lifeguards.

Swimming has built muscles and lung capacity on them to be envied.


28 posted on 01/19/2008 9:39:04 PM PST by metmom (Welfare was never meant to be a career choice.)
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To: Yossarian

I love your tagline.


29 posted on 01/19/2008 9:39:34 PM PST by metmom (Welfare was never meant to be a career choice.)
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To: Salamander; Yossarian

Forget to breathe? The coaches won’t let you.

Twenty-five yards with no breath is what they want, and my kids can do it.

My daughter is running track now and thinks it’s great cause you can exercise and breathe at the same time, and the coach isn’t yelling at her because she’s breathing too much.


30 posted on 01/19/2008 9:44:50 PM PST by metmom (Welfare was never meant to be a career choice.)
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To: metmom

Just....wow....8-O


31 posted on 01/19/2008 9:58:19 PM PST by Salamander (And don't forget my Dog; fixed and consequent.......)
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To: Biblebelter

“Five years later, I am still on maintenance drugs but my cholesterol is normal. My doctor has me take 10mg Lipitor tablet and split in half each day. They say a small dose could be preventitive of another attack but I am not taking the statin for a cholesterol problem.”

I am not a doctor, but I do take a very active interest in my health. Toward that end, I have been a member of the Life Extension Foundation http://www/lef.org for about the last 10 years. They publish Life Extension Magazine, and there have been numerous articles (including one in the Feb. ‘08 issue) regarding the importance of CoEnzyme Q10. CoQ10 is in every cell of our bodies-it helps protect the mitocondria, the energy powerhouses of the cell. It depletes naturally with age, and the depletion accelerates greatly with the use of statins (because cholesterol and CoQ10 have some common chemical attributes).

Anyhow, you have the phenomenon of people with normal cholesterol (due to taking statins) that end up dying of congestive heart failure. This happens because their CoQ10 is severely depleted, robbing the heart of energy (heart cells have the highest concentration of mitocondria, and the highest need for CoQ10). What used to happen only to the very old, or someone who had damaged their heart somehow (smoking, etc.), is now happening to a lot of people. This is in addition to the possible side effects of muscle pains, liver problems, etc. The latter may not show up in everyone, but the depletion of CoQ10 is a FACT, and it is dangerous. The drug industry is proudly touting the fact that people who take statins have less heart attacks - but they are notably silent about the fact that these same people have about the same death rates as those who DON’T take statins. IOW, you get one benefit, but it comes with a cost - and you end up spending a not so small fortune on drugs for peace of mind - and really get almost nothing.

BTW, it would be untruthful to say that no one benefits from statins. Of course they do - but you just don’t hear much about those who don’t, let alone those who are harmed by them. You, like any consumer, need to educate yourself - especially considering what’s at stake.

Get yourself a copy of the 2/08 issue (most newstands don’t have it, but a Barnes & Noble might), or wait a couple of weeks and the website above will have it posted by then. If your doctor isn’t also advising you to take large doses of CoQ10, then he’s probably doing you a disservice. BTW, it ain’t necessarily his fault - the medical profession is **generally** fairly dismissive of the medical benefits of nutritional supplements, and the drug industry is positively opposed to it (because it’d cost them a fortune if everyone did a few simple things, like take a baby aspirin, 1000 IU of Vitamin D, 1000 mg of fish oil, a couple of cups of green tea, 5 grams or so of soluble fiber, and a good multivitamin everyday). Read up on CoQ10 elsewhere, and then ask your doc about it. If he doesn’t know anything, or very little, about it, seek a second opinion with someone who DOES. Your life may literally depend on it.


32 posted on 01/19/2008 10:03:48 PM PST by Ancesthntr (Iíve joined the Frederation.)
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To: Salamander; Spunky

Both of you should read my post #32, and then read up on cholesterol, heart disease, statins and CoQ10 on http://www/lef.org

BTW, Life Extension Foundation has a new form of CoQ10 that is FAR more absorbable than what you see on the store shelves (and thus is far more effective in raising blood levels of CoQ10). Everything you see is in a form know as ubiquinol, which is fat soluble and harder to absorb than the new form developed by a Japanese company, known as ubiquinone.


33 posted on 01/19/2008 10:08:20 PM PST by Ancesthntr (Iíve joined the Frederation.)
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To: Salamander

I was told I had MVP once, too, around 1988.....then in about 1999 I had another test, and asked them how the MVP was doing, and they said the same thing....WHAT MVP? But, I had not taken any CoQ10. I do however, have a little valve blip....


34 posted on 01/19/2008 10:11:34 PM PST by goodnesswins (Being Challenged Builds Character! Being Coddled Destroys Character!)
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To: neverdem

BTTT


35 posted on 01/19/2008 10:11:52 PM PST by Cold Heart
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To: Ancesthntr

hmmmm....can’t get your link to work.


36 posted on 01/19/2008 10:15:34 PM PST by goodnesswins (Being Challenged Builds Character! Being Coddled Destroys Character!)
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To: pbmaltzman

Agreed. No Statins for me either. Doc is not happy, but I still refuse.


37 posted on 01/19/2008 10:28:59 PM PST by WVNan
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To: neverdem
It's also the whole bloody, hysterical "cholesterol is bad" theory that's been called into question, and about time, too.

I'm already prone to leg cramps. Sorry, but I will never, ever take statins. Not even at gunpoint. There are also side effects in terms of memory loss.

38 posted on 01/19/2008 10:33:20 PM PST by pbmaltzman
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To: goodnesswins

Try this instead:

http://www.lef.org/


39 posted on 01/19/2008 10:46:15 PM PST by Ancesthntr (Iíve joined the Frederation.)
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To: Biblebelter

Low tissue chromium stores is a risk for heart attacks. The chromium amplifies the insulin modulated uptake of glucose into muscle cells. When chromium is not present, the insulin modulated process loses 90% of its effectiveness. Chromium chelated with amino acids or nicotinic acid will increase your insulin effectiveness after a year in the storage pipeline.


40 posted on 01/19/2008 10:46:42 PM PST by kruss3 (Kruss3@gmail.com)
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To: neverdem

Cholestorol drugs are no good? What next? Gatorade causes cancer? Alar will kill your first born? Coffee causes heart attacks? Eggs will kill you but will prolong your life?

I lose track.


41 posted on 01/19/2008 10:51:32 PM PST by VeniVidiVici (10mm. When 9 just ain't enough.)
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To: Ancesthntr
Thanks for the relevant post. I would only add to using olive oil in cooking and enjoy a glass of red wine with dinner!
42 posted on 01/19/2008 10:57:34 PM PST by endthematrix (He was shouting 'Allah!' but I didn't hear that. It just sounded like a lot of crap to me.)
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To: pbmaltzman; digger48; neverdem

“No statins for me!”

When I am asked if I worry about my cholesterol, my answer is “only if it goes too low”

High cholesterol does not cause heart disease or heart attacks. Arterial blockage is generally caused by inflamation and calcium deposits. Stop the inflamation, replace calcium with magnesium in the diet or in supplement form, eliminate polyunsaturated fats (Omega 6’s) and use coconut oil for all your cooking needs (coconut oil is mostly lauric acid, a medium chain saturated fat).

Statin drugs stop production of cholesterol in the liver. the liver produces cholesterol because the body needs it, especially for the nervous system and the brain. Cholesterol is not a disease, nor is it related to any disease - this is doctor/drug company propaganda designed to promote the biggest single money maker the drug companies have - statin drugs.

This all happened when they discovered that “cholesterol screening” was a down and dirty test easily done with quick results. Data is available that shows persons with higher cholesterol live longer than those with lower cholesterol. Data does not prove that lowering cholesterol with statins prevents heart attack or stroke.


43 posted on 01/19/2008 11:02:47 PM PST by GGpaX4DumpedTea
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To: digger48

Cramping up of legs not the only problem. A friend almost collapsed on the east coast after legs gave out on him while climbing up three stairs into hotel!


44 posted on 01/20/2008 1:18:27 AM PST by zerosix (native sunflower)
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To: Spunky

Have you considered taking co enzyme Q10? Statins lower co-enzyme Q10 in addition to reducing cholesterol.


45 posted on 01/20/2008 8:50:56 AM PST by TheCPA
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To: Yossarian; metmom

Whether swimming is aerobic or not, it’s not weight bearing exercise, so it doesn’t help build strong bones and muscles. One way to do both is to do water aerobics. From the outside looking in, it looks as though folks are just kind of jumping around in the water; looks pretty easy. From the pool, it’s quite a different story! I never knew you could sweat while being chest deep in water! It is a real workout!


46 posted on 01/20/2008 10:57:35 AM PST by SuziQ
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To: metmom

Heh, when I swim, it’s a four stroke process. First stroke, second stroke, third stroke with face in the water, fourth stroke, face up to the right and breathe, then repeat one, two, three, breathe. Don’t know when I learned that, I’ve just always done it.


47 posted on 01/20/2008 11:02:47 AM PST by SuziQ
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To: Yossarian
Swimming is anaerobic!!! It depends on strength more than aerobic capacity.

It is both depending on training regiment. You can swim slower distance reps for aerobic development and sprint sets for anaerobic. Now if you are a swimmer with poor stroke efficiency as most triathletes are, than it will be more of an aerobic workout. If you have high stroke efficiency than you will be able to do an aerobic workout. Please check out Total Immersion Swimming.
48 posted on 01/20/2008 11:23:13 AM PST by PA Engineer (Liberate America from the occupation media.)
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To: PA Engineer
It is both depending on training regiment. You can swim slower distance reps for aerobic development and sprint sets for anaerobic.

True. I generalized.

Now if you are a swimmer with poor stroke efficiency as most triathletes are, than it will be more of an aerobic workout.

Ahem. Most triathletes, at least the ones I hung out with, are maniacal about stroke efficiency - even more so than the swimmers I know. It is the same way on the bike - we are way more paranoid about aerodynamics than just straight bikers. We know that we have to maintain muscle energy and fuel for the long run - so we'd rather be efficient but maybe a bit slower, rather than flail around with better speed.

It's why we kick slower in our swim style, too. This may be why I had drilled into me that swimming is anaerobic - because for a good triathlete, that's the case.

Please check out Total Immersion Swimming.

Yes, that is a very popular system with many triathletes I know.

49 posted on 01/20/2008 11:36:37 AM PST by Yossarian (Everyday, somewhere on the globe, somebody is pushing the frontier of stupidity...)
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To: Yossarian
Ahem. Most triathletes, at least the ones I hung out with, are maniacal about stroke efficiency - even more so than the swimmers I know.

I stand by what I said. The three triathletes I worked with last summer were excellent on the biking and running, but horrid in stroke efficiency.

It's why we kick slower in our swim style, too.

Ahem. Kicking is the weakest portion of the front crawl and is used more for body stabilization during high stroke efficiency. Unlike breaststroke and to some degree butterfly, kicking is a minor component of freestyle (front crawl in this case).

Yes, that is a very popular system with many triathletes I know.

After reviewing you knowledge of swimming you should check it out.
50 posted on 01/20/2008 12:00:34 PM PST by PA Engineer (Liberate America from the occupation media.)
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