Adirondack Sports November 2023

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16 Adirondack Sports Discover the Difference. From nursing to administrative roles, there’s a position for you! Enjoy a family-first, worklife balance culture, flexible work schedule and comprehensive benefits package. Full-time, part-time and per diem positions available at 21 locations. Apply today! HHHN.org/careers ▲ Elliptical bikes have a gentle long-stride motion that feels like running on air. Take Your Fitness to the Next Level! 8C – 8-speed. The 8C is the world’s most popular elliptical bike. You’ll feel like you’re “running on air” with eight gears capable of tackling tough climbs, it suits athletes and recreational riders. Whether your goal is to lose weight, crosstrain or just get moving, it delivers the best bang for your buck. 11R – 11-speed. If you seek the ultimate elliptical experience, the 11R is the only one that offers the patented running-like pedaling motion, vibration-dampening carbon-fiber drive arms, and a folding-steering column for easy transport – and has the widest gear range of any bike. Over 250 high schools, colleges & universities use the ElliptiGO as a training tool for their cross-country running teams. Low impact training allows recovery of injured hips, knees, ankles. So smooth it feels like running on air, very gentle on your joints. ElliptiGO delivers a low-impact, full-body workout that burns 33% more calories than a traditional bike. Stand-up riding reduces stress on your neck/back and eliminates seat pain. It is a great workout since it engages your core and upper body in addition to your legs. The higher riding position makes it easier to see and be seen. Electric conversion kits available for all models. ▲ Fluid 365 trainer – Make your ElliptiGO work for indoors, it fits all models, plus add-on Wahoo sensors. Hitch Rack for All ElliptiGO Models -1.5 & 2” Receiver. ▲ See, touch, test, rent, buy, parts & service: AdirondackElliptiGO@gmail.com • All models and colors in stock. 403 West Bay Plaza, Plattsburgh • 518-310-7030 GET PHOTOS, PRICES AND MORE: ELLIPTIGO.COM Stand-up bikes have a circular pedaling motion and offer a more comfortable and superior workout compared to a traditional bike. ▲ RSUB – 8-speed. The premier road bike in the SUB lineup may be the fastest standup on the road today with full-size 700c tires and disc brakes to cruise or compete. MSUB – 10-speed. Ready for an exhilarating off-road adventure? The mountain standup takes cyclists from dirt trails to urban landscapes with knobby 27.5” tires, smooth, front suspension and disc brakes. Facebook.com/ AdirondackElliptiGO
NOVEMBER 2023 17 NON-MEDICATED LIFE Potential Benefits of Advanced Cholesterol Testing, PART ONE By Paul E. Lemanski, MD, MS, FACP Medicines are a mainstay of American life and the healthcare system not only because they are perceived to work by the individuals taking them, but also because their benefit may be shown by the objective assessment of scientific study. Clinical research trials have shown that some of the medicines of Western science may reduce the risk of Type 2 diabetes, heart attacks, strokes, cardiovascular death and even some cancers. In the first 111 installments of the Non-Medicated Life, a healthy diet and lifestyle has been shown to accomplish naturally for the majority of individuals most of the benefits of medications in the prevention of the chronic medical conditions mentioned above. In order to maximize the benefit of lifestyle changes it is best to first establish a baseline of laboratory tests of so called “surrogate markers” of risk. Markers such as fasting blood sugar, Hgb a1c, total cholesterol, HDL (the good cholesterol) and LDL (the bad cholesterol) and Triglycerides (blood fats) are routinely followed serially to determining increasing or decreasing risk. After a discussion with your primary care physician or cardiologist additional testing may be helpful. “Advanced” cholesterol testing such as High Sensitivity C-Reactive Protein (HS-CRP), Apolipoprotein B (Apo B), Trimethylamine-N Oxide (TMAO), and Nuclear Magnetic Resonance LipoProfile (NMR LipoProfile) may offer additional identification of risk and when measured serially may help direct and refine lifestyle choices. In this two-part article, Part One will address the first two advanced tests, Part Two the remaining advanced tests. HS-CRP (cardiac CRP) is a mark- Editor’s Note: This is the 112th in a series on optimal diet and lifestyle to help prevent and treat disease. Any planned change in diet, exercise or treatment should be discussed with and approved by your personal physician before implementation. The help of a registered dietitian in the implementation of dietary changes is strongly recommended. er of inflammation. Atherosclerosis (literally, athero equals artery, sclerosis equals stiffening), the hallmark of arterial disease-and the cause of heart attacks and strokes-occurs as a consequence of inflammation. LDL (the bad) cholesterol normally exists as spherical particles in the blood and, generally, when the concentration is low atherosclerosis risk is low. However, when excess LDL cholesterol is produced, it penetrates the arterial wall, where it forms a structure called a plaque. A decreased consumption of the natural antioxidants in vegetables and fruit results in the LDL in the plaque becoming oxidized (Ox-LDL). Ox-LDL is recognized by the immune system as nonself and is attacked by specialized white blood cells called macrophages. Literally, it is the infiltration of macrophages into the plaque that causes the plaque to become inflamed setting up the conditions for a heart attack or a stroke. In most non-acutely ill individuals HS-CRP measures the inflammation caused by the process of atherosclerosis. Unfortunately, if someone were to be acutely ill with a cold or flu this could cause the HS-CRP to be elevated as well. It is, therefore, best to measure when you are not acutely ill and if elevated it is best to remeasure a second time, the lowest value generally being the most accurate measure of risk. Individuals with other inflammatory conditions such as rheumatoid arthritis and inflammatory bowel disease may not use the test to indicate cardiac risk. Physicians may use HS-CRP to determine whether medication is needed in individuals at an intermediate level of cardiovascular risk as determined by the American Heart Association and American College of Cardiology risk calculator (tools.acc.org/ldl/ascvd_risk_estimator). Elevated HS-CRP values greater than 3.0mg/dl generally indicate higher risk, 1-3mg/dl moderate risk, and less than 1.0mg/dl lower risk. How does an individual lower HS-CRP with lifestyle changes? Daily aerobic exercise, increasing the consumption of vegetables and fruit, and the consumption of whole grains as with a Mediterranean diet, increasing consumption of omega-3 and omega-9 oils (olive), and decreasing consumption of omega-6 oils, avoiding an excess of simple sugars, losing weight when overweight, and stopping smoking, all will help lower HS-CRP. The benefit of the test is that it provides you a quantitative measure of the benefit of such lifestyle changes. Apo B is another advanced marker of cardiovascular risk and in clinical trials proves a better predictor of risk that the more widely used LDL (bad) cholesterol. In part, this is because while a major contributor to risk for most individuals, LDL is only one of several plaque forming particles including more rare species called intermediate density lipoprotein (IDL) and chylomicron remnants (CR). In part, it is because LDL particles come in different sizes that carry different levels of risk. LDL exists as particles of varied sizes, some particles being smaller, some medium sized, and some larger. The relative number of particles of different sizes approximate a bell curse in normal individuals, with medium size particles at the central portion of the bell curve predominating. Individuals at higher risk have proportionately more numerous smaller particles and fewer medium size and large particles- at the same total level of LDL. Moreover, the smaller LDL particles are more likely to form a plaque because they more easily penetrate between the cells that line the artery walls to get deeper layers where plaque accumulates. Thus, an LDL equal to 100 mg/dl may be achieved by more numerous smaller particles or fewer larger particles and routine testing does not differentiate between the two. Because a single apo B molecule is found in each atherogenic particle regardless of size, a measure of apo B gives an accurate measure of all atherogenic particles, including LDL as well as IDL and CR. Unfortunately, apo B is a significantly more expensive test than LDL, and may not be covered by insurance. However, a close approximation of apo B derived risk may be gleaned from a normal, inexpensive lipid profile by calculating the non-HDL cholesterol. Indeed, the National Cholesterol Education Program (NCEP) guideline recommends using the non-HDL cholesterol as a secondary target of treatment after LDL. In short, the non-HDL cholesterol equals the total cholesterol – the HDL (good) cholesterol. Thus, the total minus the good yields what’s bad and this would include all bad species of particles including LDL, IDL and CR. NCEP recommends a non-HDL cholesterol 30mg/dl higher than LDL target. Thus, for example, if you had a heart attack, the LDL target would be 50-70mg/dl and the non-HDL target would be 80-100mg/dl. How do you lower apo B or the non-HDL cholesterol using lifestyle? The two most powerful ways would be weight loss, if overweight, and daily aerobic exercise. The benefit of this test is that it provides you a quantitative measure of the benefit of such lifestyle changes. In summary, in most individuals the standard lipid profile provides important information in calculating an individual’s global cardiovascular risk. More recently, “advanced” cholesterol testing has become available to further refine the calculation of risk. HS-CRP and apo B are two markers of cardiovascular risk that may help in this regard. Beginning with a baseline, serial measures may allow a quantitative measure of the benefit of lifestyle changes, and serve as both useful feedback and an aid in sustaining such changes. Look to Part Two (January 2024) for a discussion of two additional “advanced” tests, TMAO and NMR LipoProfile. Paul E. Lemanski, MD, MS, FACP (plemanski3@gmail.com) is a boardcertified internist practicing internal medicine and lifestyle medicine in Albany. Paul has a master’s degree in human nutrition, he’s an assistant clinical professor of medicine at Albany Medical College, and a fellow of the American College of Physicians.
Page 1 and 2: COVERING UPSTATE NY SINCE 2000 FREE
Page 3 and 4: CONTENTS 5 NEWS BRIEFS 7 WINTER SPO
Page 5 and 6: News Briefs Double H Ranch Named an
Page 7 and 8: & Northeast Ski EXPO The Adirondack
Page 9 and 10: NOVEMBER 2023 9 Mountain Adventure
Page 11 and 12: NOVEMBER 2023 11 RUNNING & WALKING
Page 13 and 14: ◀ 2022 ELLIS CARDIAC CLASSIC. NOV
Page 15: NOVEMBER 2023 15 ALPINE SKIING & SN
Page 19 and 20: COMMUNITY Buck 50 An Epic Trail Rac
Page 21 and 22: NOVEMBER 2023 21 ■ GETTING BODY M
Page 23 and 24: CALENDAR OF EVENTS NOVEMBER 2023 TO
Page 25 and 26: NOVEMBER 2023 25 14 Inaugural ADK T
Page 27 and 28: NOVEMBER 2023 27 15-19 North Americ
Page 29 and 30: NOVEMBER 2023 29 10 HMRRC Doug Bowd
Page 31 and 32: RACE RESULTS 9TH ANNUAL THE ADIROND
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Page 37 and 38: RACE RESULTS RUN THE RUNWAY 5K Octo
Page 39 and 40: RACE RESULTS NOVEMBER 2023 39 41ST

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