Human Limits

Exploring performance and health with Michael J. Joyner, M.D.

Photo of Michael J. Joyner, M.D.

Archive for December, 2014

New Year’s 2015: Drinking Charts to Ponder

Who can think about New Year’s without thinking about drinking. The chart below is about 15 years old but still considered accurate and shows the relationship between drinking and the risk of cardiovascular disease. It shows that moderate alcohol consumption (essentially 1-2 standard drinks per day) is generally protective.






While moderate drinking is generally good for you, it is important to remember that binge drinking (4 drinks for women 5 for men) is bad news, and it is common.




The highlights of the bad news according to the CDC include:


  1. Motor vehicle crashes. Every day, 32 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver.


  1. Intimate partner violence. About 2 of 3 incidents of intimate partner violence are associated with alcohol.


  1. Risky sexual behaviors. Excessive drinking increases risky sexual behaviors, including unprotected sex and sex with multiple partners, which can result in HIV infection, other sexually transmitted diseases, and unplanned pregnancy.


  1. Fetal alcohol spectrum disorders. Any alcohol use by a pregnant woman can cause harm to a developing fetus, resulting in physical, behavioral, and learning problems later in life.


  1. Chronic conditions. Over time, excessive drinking can lead to alcohol dependence, liver disease, high blood pressure, heart attack, stroke, and certain kinds of cancer.



The data above and resources in the links speak for themselves. Enjoy New Year’s and every other social occasion that includes alcohol but remember that alcohol is perhaps the most dangerous drug and needs to be used judiciously.





Aging: The Political Elite & Airline Pilots

The reemergence of former Vice President Dick Cheney in the CIA torture debate raises or re-raises all sorts of questions. One question that is not getting much attention is the health and age of key decision makers like Supreme Court Justices and high ranking elected officials.   I bring this up because Cheney has a long standing history of cardiac disease including at least four major open heart surgeries (two bypasses, an artificial heart and finally a heart transplant).   I also bring it up in the context of commercial airline pilots who are forced to retire at age 65 and prior to that are limited from working if they have significant medical problems. Additionally, depending on their age, they have to pass yearly or twice yearly physical exams to continue flying.


The Supremes

Currently, five of nine members of the Supreme Court are over 65 and would be ineligible for a commercial airline pilots licence based on age alone.   Justice Samuel Alito is knocking on the door and will be 65 on April 1st, 2015.


The Senate and House

The US Senate is an “old” organization with 40 of 100 members over 65. Harry Reid is 75 and Mitch McConnel is 72. I have no idea about the health status of Mitch McConnel, but Reid suffered strokes in 2013 and 2005. John Boehner is 65 and Nancy Pelosi is 74.



If Hillary Clinton were to be elected president in 2016 she will be 69, and she has a history of a venous blood clot in her brain. Vice President Joe Biden just turned 72 and has had brain surgery and also atrial fibrillation. Mitt Romney is 67, and at least as of 2011 was very rigorous about his diet and exercise regimen, but again as fit as he appears to be — he can run for president but can’t fly a commercial airline.


Does it Matter?

In the case of Dick Cheney there has been speculation dating from the middle 2000s that his medical condition(s) might have led to cognitive issues and clouded his judgement. There are also long standing concerns about the health of Franklin Roosevelt in the waning years of World War 2. He had a history of severe hypertension and other problems that almost certainly limited his ability to function late in the war.   Woodrow Wilson had a debilitating stroke in office that was largely covered up. Then there is the case of William Howard Taft who weighed over 300 pounds, was likely diabetic and clearly hypertensive with systolic blood pressures over 200. Taft also had sleep apnea.   After his presidency he served as Chief Justice of the Supreme Court and more or less acknowledged that he was having cognitive issues before he resigned and then died shortly thereafter at age 72. While we are at it, let’s not forget JFK, who was much younger but a medical train wreck.


Age Limits?

I am an advocate of healthy aging and believe that there should be no hard age limits for most jobs. However, I do believe that the health, especially the cognitive health of older decision makers needs to be evaluated and that those who show evidence of impairment should not be eligible for service. The other issue here is ongoing testing and evaluation of those already in office. Ronald Reagan was confused and rambling in one of his debates with Walter Mondale in 1984. Was it an early sign of his cognitive decline? A key elected leader or judge can make decisions that affect thousands of people in major ways with far more lives at risk than a full airplane. The president can embark on most military interventions with limited oversight. And don’t forget, there is a co-pilot on the plane.



A Holiday Gift For Your Athlete

I get a lot of questions about exercise equipment. What is the best exercise? How to workout on the road? What “should my kid be doing to improve” etc.   There is one simple answer to this question and it is also an ideal gift for almost anyone with fitness or athletic goals regardless of age who does not have too many orthopedic limitations. So what is the answer?


Get a Jump Rope and use it!

Jumping rope (or skipping rope) is outstanding for general conditioning. It can be used to generate an aerobic workout and you can things like minute on minute off intervals skipping rope. Skipping rope also develops footwork and balance. For younger athletes these are skills that carry over to almost all sports. For middle aged and older people these skills are critical to ward off things like frailty and falls.   Jump ropes are also cheap, portable, and don’t require a lot of space. The video clip below shows some classic footage of boxers jumping rope. Note especially the foot work and wild routine of the great Sugar Ray Robinson.   Later in the video you can see Bernard Hopkins who keeps fighting at age 50.



click for video

What kind of rope?

I have a 40 year old Everlast leather jump rope with ball bearings that my mother got me sometime in the early 1970s. This is the type of rope the boxers use and it has stood the test of time. It is also a beautiful piece of functional industrial design. But almost any rope will do.





No barriers

The specifics of skipping rope aside it is important to remember that you don’t need much if any equipment or space to develop an outstanding and effective whole body exercise routine. Skipping rope along with some simple calisthenics is free, can be done almost anywhere, and requires minimal equipment. The key requirements are simply self-discipline and motivation.