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	<title>Comments on: Statins and Sprints: News Alert</title>
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	<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/</link>
	<description>Serving up health and fitness insights (daily, of course) with a side of irreverence.</description>
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		<title>By: Trinkwasser</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-280262</link>
		<dc:creator>Trinkwasser</dc:creator>
		<pubDate>Thu, 05 Feb 2009 19:49:20 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-280262</guid>
		<description>My experience, which is not untypical: simvastatin more or less halved my LDL but did nothing to affect my abysmal HDL and trigs, which I now realise were the result of the Heart Healthy diet and got significantly worse when I was told to further reduce my fat consumption and eat more carbs.

Switching to a low carb diet slashed my trigs to 10% of their original number and doubled HDL. My LDL increased slightly but my GP wasn&#039;t fussed, as she appears to have read some of the same stuff the rest of us have read.

She was a bit more fussed when I discovered increasing my sat fats increased HDL and decreased LDL by about the same amount (like me she is of the generation brought up to believe fats are the spawn of the devil) and I&#039;m not going to tell her until after the results that I intend dropping the statin for a month prior to my next bloods to see what my unmedicated lipids come out to.

Just as dietary fats are only dangerous in the presence of toxic levels of carbs I suspect LDL is only dangerous in the presence of toxic levels of trigs and reduced HDL. My body, my science experiment . . .

 . . . it may be I will need to remain on them, some people have crap lipids whatever they eat or do,but in terms of reducing cardiovascular risk diet has beaten statins hands down in my body.</description>
		<content:encoded><![CDATA[<p>My experience, which is not untypical: simvastatin more or less halved my LDL but did nothing to affect my abysmal HDL and trigs, which I now realise were the result of the Heart Healthy diet and got significantly worse when I was told to further reduce my fat consumption and eat more carbs.</p>
<p>Switching to a low carb diet slashed my trigs to 10% of their original number and doubled HDL. My LDL increased slightly but my GP wasn&#8217;t fussed, as she appears to have read some of the same stuff the rest of us have read.</p>
<p>She was a bit more fussed when I discovered increasing my sat fats increased HDL and decreased LDL by about the same amount (like me she is of the generation brought up to believe fats are the spawn of the devil) and I&#8217;m not going to tell her until after the results that I intend dropping the statin for a month prior to my next bloods to see what my unmedicated lipids come out to.</p>
<p>Just as dietary fats are only dangerous in the presence of toxic levels of carbs I suspect LDL is only dangerous in the presence of toxic levels of trigs and reduced HDL. My body, my science experiment . . .</p>
<p> . . . it may be I will need to remain on them, some people have crap lipids whatever they eat or do,but in terms of reducing cardiovascular risk diet has beaten statins hands down in my body.</p>
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		<title>By: Dan Abshear</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-279665</link>
		<dc:creator>Dan Abshear</dc:creator>
		<pubDate>Thu, 05 Feb 2009 05:05:16 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-279665</guid>
		<description>Facts Believed To Be Qualities Of All Statin Medications:

Statins are a class of medications specifically prescribed to lower LDL- one of five lipid parameters of a person’s lipid profile, which is alto the name of the blood test to measure these parameters.  They are known as statins, as all of these types of medications end with the letters, statin.
There are about 6 available statins to choose for lipid management as needed- with three that are combination drugs that have a statin in these combinations, I believe. 
There are other classes of medications for lipid management, such as bile acid sequestrants and nicotinic acid, which is known as niacin.  Yet the side effect profile is more unfavorable of these classes of medications compared with the statin class of drugs.  
One’s cholesterol level is primarily due to how they produce cholesterol in their liver, which is overall genetically determined.  This level is also determined by one’s lifestyle and diet as well.  If a person has too much cholesterol in their blood, it can lead to hardening and narrowing of their arteries as well as the formation of coronary plaques in the coronary arteries.  
If these plaques break off of the arterial wall, this leads to a myocardial infarction, or heart attack.  Statins are believed to stabilize coronary plaques so this does not occur.  
To measure one’s cholesterol, a blood test called a lipid profile is obtained from a person after they have fasted for at least 12 hours.  The test should also be performed only if the person is free of any acute illness, as this may affect true lipid measures. 
 If the results prove to be abnormal, lipid altering medicinal therapy may be initiated- according to the discretion of the person’s health care provider.  This therapy usually involves a statin medication.
Adverse events associated with the statin class of pharmaceuticals are thought to occur more often than they are reported- with high doses of statins prescribed to patients in particular at times that may not be necessary to control their dyslipidemia based on their lipid profile.  Side effects may include muscle pain, or possible damage to the patient’s liver.
However, since this class of statin drugs has existed for use for over 20 years, statins are considered to be  overall safe and effective for enhancing the clearance of LDL noted to be elevated in the lipid profiles of patients.  
Also, they have proven to reduce cardiovascular mortality with one who is treated with a statin that has dyslipidemia.  In addition to lowering LDL by up to about 60 percent- depending on the choice of the statin prescribed for the patient, and how high the LDL cholesterol is in a patient.  
This class of drugs also has the ability to raise their HDL lipid parameter as well as lower to their benefit their triglyceride parameter of their lipid profile.  Both of these additional effects in addition to lowering the LDL parameter from taking a statin drug is ultimately beneficial for the patient on a statin drug for lipid management.
Statin therapy is also recommended for those patients who have a greater than twenty percent risk of developing cardiovascular disease, or those patients that have clinical evidence of this disease.
Additionally, there appears to be no comparable reduction in cardiovascular morbidity or mortality, as well as a difference in the increase of one’s lifespan, if one is on any particular statin medication for their lipid management over another, others have concluded.  So caution should perhaps be considered if one chooses to prescribe a statin for a patient if they are absent of, or have only mild dyslipidemia to a significant degree.  
Furthermore, research should be done by the health care provider if they are under the belief that one statin medication provides a greater cardiovascular benefit over another.  In other words, the health care provider should be assured that any choice of statin therapy for their patients is considered reasonable and necessary if the LDL in their patients need to be reduced, and the statin selection should be determined by the results that have been shown with a particular statin.
There exist abstract etiologies for health care providers at times to choose to prescribe statin drugs on occasion for reasons not indicated with the medicinal treatment of these statin drugs.  Examples include the speculated benefits associated with statins- such as reducing CRP levels, or for Alzheimer’s treatment, or other reasons not directly related to cholesterol management. 
Statin therapy for such patients may not be considered appropriate, reasonable, or necessary prophylaxis at this point for any patient who does not have the indications for which statins are approved for to treat patients with dyslipidemia. All other benefits that appear to have favorable effects in such areas not involved with a patient&#039;s cholesterol are suggested at this point due to minimal research in these other variables aside from lipid management.  
Other reasons for placing a patient on a statin drug at this time require further research for these disease states and dysfunctions that may exist with a patient aside from dyslipidemia.
Statins as a class of drugs seem to in fact decrease the risk of cardiovascular events significantly, it has been proven.  Statins also decrease thrombus formation as well as modulate inflammatory responses (CRP) as additional benefits of the medication.  
For those patients with dyslipidemia who are placed on a statin, the effects of that statin on reducing a patient’s LDL level can be measured after about five weeks of therapy on a particular statin drug.  
Liver Function blood tests are recommended for those patients on continued statin therapy, and most are chronically taking statins for the rest of their lives to manage their lipid profile in regards to maintaining the suitable LDL level for a particular patient presently. Patients should be made aware of potential additional side effects as well, such as myopathy and muscular dysfunctions that occur on occasion when one is on statin therapy.

Yet some have said that about half of all strokes and heart attacks that do occur are not because of increased cholesterol levels of these patients.  So it appears clear that high cholesterol may not be an absolute for cardiovascular events for them to occur.
Others believe that it is oxidized cholesterol that causes vulnerable plaques to form on coronary arterial walls, which is the catalyst for a heart attack, and that there is no medicinal treatment for the formation or stabilization of these plaques to prevent heart attacks or strokes.  
Some who support statin medicinal therapy for their clinically appropriate patients claim that these drugs, do, in fact, stabilize these plaques as an added benefit, and therefore are beneficial.  
As stated previously, in regards to other uses of statins besides just primarily LDL reduction, there is some evidence to suggest that statins have other benefits besides lowering LDL, but not enough evidence yet. 
These other disease states include aside from what has been stated already, such as those patients with neurological disease, as well as statins being beneficial for certain cancer patients.  Some have suggested that statins interfere with cancer treatment with bladder cancer patients as well. Yet again, these other roles for statin therapy have only been minimally explored and researched, comparatively speaking.  
Because of the limited evidence regarding additional benefits of statin medications, the drug should again be prescribed for those with dyslipidemia only at this time involving elevated LDL levels as detected in the patient’s bloodstream.
Yet overall, the existing cholesterol lowering recommendations or guidelines should possibly be re-evaluated.  The cholesterol guidelines that presently exist may be over-exaggerated possibly due to tacit suggestions from the makers of statins to those who create these current lipid lowering guidelines. 
This is notable if one chooses to compare these cholesterol guidelines with the other guidelines that have existed in the past.  The cholesterol guidelines that exist now are considered by many health care providers and experts to be rather unreasonable and unnecessary, as well as possibly have the potential to be detrimental to a patient’s health.
Yet statins are beneficial medications for those many people that exist with elevated LDL levels that can cause cardiovascular events to occur because of this abnormality.  What that ideal LDL level is may have yet to be empirically determined.
Finally, a focus on children and their lifestyles should be amplified so their arteries do not become those of one who is middle-aged, and this may prevent them from being candidates for statin therapy now and in the future, regarding the high cholesterol issue.  Treating children with a statin drug for dyslipidemia is controversial presently.  Dietary management should be the first consideration in regards to correcting lipid dysfunctions that may exist in patients,
Dan Abshear</description>
		<content:encoded><![CDATA[<p>Facts Believed To Be Qualities Of All Statin Medications:</p>
<p>Statins are a class of medications specifically prescribed to lower LDL- one of five lipid parameters of a person’s lipid profile, which is alto the name of the blood test to measure these parameters.  They are known as statins, as all of these types of medications end with the letters, statin.<br />
There are about 6 available statins to choose for lipid management as needed- with three that are combination drugs that have a statin in these combinations, I believe.<br />
There are other classes of medications for lipid management, such as bile acid sequestrants and nicotinic acid, which is known as niacin.  Yet the side effect profile is more unfavorable of these classes of medications compared with the statin class of drugs.<br />
One’s cholesterol level is primarily due to how they produce cholesterol in their liver, which is overall genetically determined.  This level is also determined by one’s lifestyle and diet as well.  If a person has too much cholesterol in their blood, it can lead to hardening and narrowing of their arteries as well as the formation of coronary plaques in the coronary arteries.<br />
If these plaques break off of the arterial wall, this leads to a myocardial infarction, or heart attack.  Statins are believed to stabilize coronary plaques so this does not occur.<br />
To measure one’s cholesterol, a blood test called a lipid profile is obtained from a person after they have fasted for at least 12 hours.  The test should also be performed only if the person is free of any acute illness, as this may affect true lipid measures.<br />
 If the results prove to be abnormal, lipid altering medicinal therapy may be initiated- according to the discretion of the person’s health care provider.  This therapy usually involves a statin medication.<br />
Adverse events associated with the statin class of pharmaceuticals are thought to occur more often than they are reported- with high doses of statins prescribed to patients in particular at times that may not be necessary to control their dyslipidemia based on their lipid profile.  Side effects may include muscle pain, or possible damage to the patient’s liver.<br />
However, since this class of statin drugs has existed for use for over 20 years, statins are considered to be  overall safe and effective for enhancing the clearance of LDL noted to be elevated in the lipid profiles of patients.<br />
Also, they have proven to reduce cardiovascular mortality with one who is treated with a statin that has dyslipidemia.  In addition to lowering LDL by up to about 60 percent- depending on the choice of the statin prescribed for the patient, and how high the LDL cholesterol is in a patient.<br />
This class of drugs also has the ability to raise their HDL lipid parameter as well as lower to their benefit their triglyceride parameter of their lipid profile.  Both of these additional effects in addition to lowering the LDL parameter from taking a statin drug is ultimately beneficial for the patient on a statin drug for lipid management.<br />
Statin therapy is also recommended for those patients who have a greater than twenty percent risk of developing cardiovascular disease, or those patients that have clinical evidence of this disease.<br />
Additionally, there appears to be no comparable reduction in cardiovascular morbidity or mortality, as well as a difference in the increase of one’s lifespan, if one is on any particular statin medication for their lipid management over another, others have concluded.  So caution should perhaps be considered if one chooses to prescribe a statin for a patient if they are absent of, or have only mild dyslipidemia to a significant degree.<br />
Furthermore, research should be done by the health care provider if they are under the belief that one statin medication provides a greater cardiovascular benefit over another.  In other words, the health care provider should be assured that any choice of statin therapy for their patients is considered reasonable and necessary if the LDL in their patients need to be reduced, and the statin selection should be determined by the results that have been shown with a particular statin.<br />
There exist abstract etiologies for health care providers at times to choose to prescribe statin drugs on occasion for reasons not indicated with the medicinal treatment of these statin drugs.  Examples include the speculated benefits associated with statins- such as reducing CRP levels, or for Alzheimer’s treatment, or other reasons not directly related to cholesterol management.<br />
Statin therapy for such patients may not be considered appropriate, reasonable, or necessary prophylaxis at this point for any patient who does not have the indications for which statins are approved for to treat patients with dyslipidemia. All other benefits that appear to have favorable effects in such areas not involved with a patient&#8217;s cholesterol are suggested at this point due to minimal research in these other variables aside from lipid management.<br />
Other reasons for placing a patient on a statin drug at this time require further research for these disease states and dysfunctions that may exist with a patient aside from dyslipidemia.<br />
Statins as a class of drugs seem to in fact decrease the risk of cardiovascular events significantly, it has been proven.  Statins also decrease thrombus formation as well as modulate inflammatory responses (CRP) as additional benefits of the medication.<br />
For those patients with dyslipidemia who are placed on a statin, the effects of that statin on reducing a patient’s LDL level can be measured after about five weeks of therapy on a particular statin drug.<br />
Liver Function blood tests are recommended for those patients on continued statin therapy, and most are chronically taking statins for the rest of their lives to manage their lipid profile in regards to maintaining the suitable LDL level for a particular patient presently. Patients should be made aware of potential additional side effects as well, such as myopathy and muscular dysfunctions that occur on occasion when one is on statin therapy.</p>
<p>Yet some have said that about half of all strokes and heart attacks that do occur are not because of increased cholesterol levels of these patients.  So it appears clear that high cholesterol may not be an absolute for cardiovascular events for them to occur.<br />
Others believe that it is oxidized cholesterol that causes vulnerable plaques to form on coronary arterial walls, which is the catalyst for a heart attack, and that there is no medicinal treatment for the formation or stabilization of these plaques to prevent heart attacks or strokes.<br />
Some who support statin medicinal therapy for their clinically appropriate patients claim that these drugs, do, in fact, stabilize these plaques as an added benefit, and therefore are beneficial.<br />
As stated previously, in regards to other uses of statins besides just primarily LDL reduction, there is some evidence to suggest that statins have other benefits besides lowering LDL, but not enough evidence yet.<br />
These other disease states include aside from what has been stated already, such as those patients with neurological disease, as well as statins being beneficial for certain cancer patients.  Some have suggested that statins interfere with cancer treatment with bladder cancer patients as well. Yet again, these other roles for statin therapy have only been minimally explored and researched, comparatively speaking.<br />
Because of the limited evidence regarding additional benefits of statin medications, the drug should again be prescribed for those with dyslipidemia only at this time involving elevated LDL levels as detected in the patient’s bloodstream.<br />
Yet overall, the existing cholesterol lowering recommendations or guidelines should possibly be re-evaluated.  The cholesterol guidelines that presently exist may be over-exaggerated possibly due to tacit suggestions from the makers of statins to those who create these current lipid lowering guidelines.<br />
This is notable if one chooses to compare these cholesterol guidelines with the other guidelines that have existed in the past.  The cholesterol guidelines that exist now are considered by many health care providers and experts to be rather unreasonable and unnecessary, as well as possibly have the potential to be detrimental to a patient’s health.<br />
Yet statins are beneficial medications for those many people that exist with elevated LDL levels that can cause cardiovascular events to occur because of this abnormality.  What that ideal LDL level is may have yet to be empirically determined.<br />
Finally, a focus on children and their lifestyles should be amplified so their arteries do not become those of one who is middle-aged, and this may prevent them from being candidates for statin therapy now and in the future, regarding the high cholesterol issue.  Treating children with a statin drug for dyslipidemia is controversial presently.  Dietary management should be the first consideration in regards to correcting lipid dysfunctions that may exist in patients,<br />
Dan Abshear</p>
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		<title>By: Sharon</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-279601</link>
		<dc:creator>Sharon</dc:creator>
		<pubDate>Thu, 05 Feb 2009 03:42:52 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-279601</guid>
		<description>Hey Mark....I stopped taking Lipitor on Jan 15th...I feel good like I did a good thing for my body...been on them too long and felt guilty the whole time...geeez....Liked your article...</description>
		<content:encoded><![CDATA[<p>Hey Mark&#8230;.I stopped taking Lipitor on Jan 15th&#8230;I feel good like I did a good thing for my body&#8230;been on them too long and felt guilty the whole time&#8230;geeez&#8230;.Liked your article&#8230;</p>
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		<title>By: Mark Sisson</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-278880</link>
		<dc:creator>Mark Sisson</dc:creator>
		<pubDate>Wed, 04 Feb 2009 16:20:02 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-278880</guid>
		<description>Ryan, sprints of all types will work. Swimming isn&#039;t quite as productive as running, cycling or even elliptical sprints for these short intense bursts, but if swimming was all you had, you&#039;d still benefit.  Once a week is probably enough for running (mostly because if you do it right, it&#039;s not as easy to be fully recovered &quot;injury-preventionwise&quot; as it is from the others). Someone really fit could probabaly do once every 5 days.</description>
		<content:encoded><![CDATA[<p>Ryan, sprints of all types will work. Swimming isn&#8217;t quite as productive as running, cycling or even elliptical sprints for these short intense bursts, but if swimming was all you had, you&#8217;d still benefit.  Once a week is probably enough for running (mostly because if you do it right, it&#8217;s not as easy to be fully recovered &#8220;injury-preventionwise&#8221; as it is from the others). Someone really fit could probabaly do once every 5 days.</p>
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		<title>By: Chris</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-278554</link>
		<dc:creator>Chris</dc:creator>
		<pubDate>Wed, 04 Feb 2009 10:58:39 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-278554</guid>
		<description>One of the researchers turned up on a forum to support his paper.  But, he appears to be a &#039;calories in = calories out&#039; kind of guy:

http://www.ukclimbing.com/forums/t.php?t=339222&amp;v=1#x4997900</description>
		<content:encoded><![CDATA[<p>One of the researchers turned up on a forum to support his paper.  But, he appears to be a &#8216;calories in = calories out&#8217; kind of guy:</p>
<p><a href="http://www.ukclimbing.com/forums/t.php?t=339222&amp;v=1#x4997900" rel="nofollow">http://www.ukclimbing.com/forums/t.php?t=339222&amp;v=1#x4997900</a></p>
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		<title>By: Tom Parker - Free Fitness Tips</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-278409</link>
		<dc:creator>Tom Parker - Free Fitness Tips</dc:creator>
		<pubDate>Wed, 04 Feb 2009 07:32:12 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-278409</guid>
		<description>Hey Mark, Informative post as always.  I didn&#039;t know about the different types of LDL cholesterol until reading this.</description>
		<content:encoded><![CDATA[<p>Hey Mark, Informative post as always.  I didn&#8217;t know about the different types of LDL cholesterol until reading this.</p>
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		<title>By: Mark Sisson</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-278198</link>
		<dc:creator>Mark Sisson</dc:creator>
		<pubDate>Wed, 04 Feb 2009 02:37:47 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-278198</guid>
		<description>Fate, I have supplemented with CoQ10 for 15 years. It&#039;s one of those critical nutrients you tend to deplete with age, stress, activity, etc, but you just don&#039;t get much in food. My Damage Control Master Formula was originally designed to provide high levels of hard-to-get antioxidants and other phytonutrients to hard-training athletes.</description>
		<content:encoded><![CDATA[<p>Fate, I have supplemented with CoQ10 for 15 years. It&#8217;s one of those critical nutrients you tend to deplete with age, stress, activity, etc, but you just don&#8217;t get much in food. My Damage Control Master Formula was originally designed to provide high levels of hard-to-get antioxidants and other phytonutrients to hard-training athletes.</p>
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		<title>By: Ellen</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-278031</link>
		<dc:creator>Ellen</dc:creator>
		<pubDate>Tue, 03 Feb 2009 23:02:30 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-278031</guid>
		<description>Hey David at AKW!

&quot;In the past, I’ve done Hill Sprints in the past, and have always found them to be really effective. (I can’t do them now, though, as it’s winter in Vancouver). This study doesn’t surprise me at all.&quot;


Do the sprints with snowshoes. Awesome awesome workout. With snowshoes, I run fast in the snow for about 50 steps, and then walk for about 30 and repeat. Works just as well as Mark&#039;s beach sprints, I bet.</description>
		<content:encoded><![CDATA[<p>Hey David at AKW!</p>
<p>&#8220;In the past, I’ve done Hill Sprints in the past, and have always found them to be really effective. (I can’t do them now, though, as it’s winter in Vancouver). This study doesn’t surprise me at all.&#8221;</p>
<p>Do the sprints with snowshoes. Awesome awesome workout. With snowshoes, I run fast in the snow for about 50 steps, and then walk for about 30 and repeat. Works just as well as Mark&#8217;s beach sprints, I bet.</p>
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		<title>By: Holly</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-277886</link>
		<dc:creator>Holly</dc:creator>
		<pubDate>Tue, 03 Feb 2009 20:05:45 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-277886</guid>
		<description>Sprinting on the beach is one of my favorite things. I seem to go super slow because of the sand, but geez is it a good workout.</description>
		<content:encoded><![CDATA[<p>Sprinting on the beach is one of my favorite things. I seem to go super slow because of the sand, but geez is it a good workout.</p>
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		<title>By: Fate</title>
		<link>http://www.marksdailyapple.com/statins-and-sprints-news-alert/#comment-277841</link>
		<dc:creator>Fate</dc:creator>
		<pubDate>Tue, 03 Feb 2009 19:09:43 +0000</pubDate>
		<guid isPermaLink="false">http://www.marksdailyapple.com/?p=2843#comment-277841</guid>
		<description>Speaking of CoQ10.  I know there&#039;s a big market for supplementing CoQ10.  Currently the only supplements I take are a daily multi-vitamin, fish oil, vitamin D, and ZMA.  But as a hard-training athlete, is there any benefit to CoQ10, or anything else for that matter?</description>
		<content:encoded><![CDATA[<p>Speaking of CoQ10.  I know there&#8217;s a big market for supplementing CoQ10.  Currently the only supplements I take are a daily multi-vitamin, fish oil, vitamin D, and ZMA.  But as a hard-training athlete, is there any benefit to CoQ10, or anything else for that matter?</p>
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