Sunday, September 16, 2018

This couple’s ‘first kiss’ was when she performed CPR on him. They’ve been in love since.

© Washington Post, September 10, 2018

Andi Traynor and Max Montgomery met each other on Facebook through mutual friends. They had gotten together casually and nonromantically a few times, then decided to go surfing early one morning on California’s Capitola Beach last October.

When they finished with the waves and were walking off the beach, Montgomery, 56, fell to the ground.

Traynor, a doctor, was confused for a moment. Then she checked and realized he did not have a pulse. He was having a heart attack.

“I saw him fall, and initially I thought he tripped,” said Traynor, 45, a medical professor at Stanford University and an anesthesiologist who works with high-risk pregnancies. “I turned him over, and I immediately realized something was very wrong.”

She yelled for someone to call 911 and then started CPR. She did a rescue breath and then chest compressions for seven minutes to keep his blood circulating before paramedics arrived. They used a defibrillator on him three times to no avail and then carried him to an ambulance.
She was distraught. She didn’t know at the time that videographer Alexander Baker had set up a time lapse video to record nature on the beach and that the entire frightening episode was being recorded.

Actual time lapse footage of the arrest and CPR

“You can see me breaking down at that point,” Traynor said of the video. “I thought, ‘He’s dead, people don’t live through that.’ I can’t believe this just happened. How did this just happen? I just felt sadness.”

In the ambulance, paramedics used the defibrillator three more times and finally revived Montgomery.

Traynor said she was sure he had died and searched his Facebook to try to find his relatives to let them know. She contacted his sister and was flabbergasted to find out he was alive.

“His sister said, ‘He’s out of the procedure, do you want to talk to him?’ ” Traynor said. “I burst into tears.”

Montgomery, an outdoorsman and avid runner, got on the phone and apologized to her for collapsing. The next day he had triple bypass surgery.

Max Montgomery at the hospital with two of the EMTs who helped him. (Help-A-Heart foundation)

Traynor showed up at the hospital and waited long hours with Montgomery’s family and friends. She had already developed a crush on him before the heart attack, and he had told her that he had a crush on her, as well. But their interaction had never been romantic, and they decided they’d take things very slowly. But seeing so many of Montgomery’s family and close, long-term friends together made her realize what a kindhearted good man her new friend was.

She was divorced with two kids and cautious to start a new relationship. He was divorced, as well.

“I saw so many amazing, lovely, kind people who loved him so much,” she said. “I’d spent some time studying what makes a healthy relationship, and one factor is somebody who has a good relationship with family and long-term friendships.”

After the surgery, which was a success, she went to visit his hospital room. He recalled telling her: “Who wants to be with a guy who had heart attack. I won’t blame you if you run for the hills.”

“I’m not going anywhere,” she told him.

For Montgomery, that was a turning point.

“When she said ‘I’m not going anywhere,’ I felt like my heart started to heal from the inside,” he said. “I had a great and fast recovery. I believe it was because I was madly in love.”

Andi Traynor and Max Montgomery during their first paddle after his heart attack. (Help-A-Heart foundation)

Six days later, after Montgomery was discharged from the hospital, they went back to Capitola Beach where they went surfing — stand up paddle surfing, actually — and had their actual first kiss.

“We do consider the CPR our first kiss,” Traynor said. “But the day he got out of the hospital, we had our first real kiss.”

She told him there was footage of him falling to the ground and that the videographer had given it to him for his personal use. They decided together they wanted to use it to help people.

“We didn’t want to put it up on Facebook and say, ‘The craziest thing happened last weekend,’ ” Traynor said. “We wanted to be intentional about it.”

As their relationship grew stronger, they decided to educate people about the benefits of CPR and try to dispel some of the myths and fears. One of the biggest, Montgomery said, is people fear they will do more harm than good, and so they are hesitant to perform CPR, especially on a stranger.

To that, he points out that when someone doesn’t have a pulse, things can’t get worse for them, so it’s always worthwhile to give it a try.

They’ve started the Help-A-Heart foundation, which offers CPR instruction and outreach. It’s part of another nonprofit Montgomery founded, Paddle-4-Good, which offers adventure activities such as stand up paddling for underserved populations and people with physical and developmental needs.

Both Traynor and Montgomery are now certified CPR instructors and recite statistics from the American Heart Association: Every 90 seconds, someone dies somewhere in the United States from sudden cardiac arrest. Bystander CPR can triple the chances of survival. Most heart attacks outside the hospital happen at home, so if you learn CPR, you are most likely to use it on a family member and save the life of someone you love.

Since they started telling their story publicly, they have been on the receiving end of lots of bad jokes: “You have to get someone’s consent before you kiss them,” or “Some people will do anything to get a woman’s attention.”

They roll their eyes and chuckle politely. They don’t mind. Mostly, Montgomery said, he’s happy to be alive.

“It’s a crazy thing. It’s the craziest story of my life thus far,” he said. “I’m glad to be on the lucky side of it.”

Proclamation for Firefighter Combat Challenge Kiev, 15 September 2018

While I am unable to be in Kiev today in person, I am here with you in spirit. I salute all the firefighters who have taken up the Challenge. Not only have you made a decision to help your fellow man, but you have also made a commitment to be the best that you can be by training to do your job better, faster and safer. 

There may just a few winners of the medals, but every one of you is a winner, just by stepping out here on this course and showing the public that you serve that you are ready to go in harm’s way, with the knowledge that you have the capabilities to perform the essential functions of a firefighter. 

With the completion of the course today, you will become a member of one of the most elite global firefighter fraternities. Welcome to the Firefighter Combat Challenge.

Monday, September 10, 2018

Trying to trick yourself into exercising more? Good luck.

A “nudge” is a policy intervention that “alters people’s behavior in a predictable way without forbidding any options or significantly changing their economic incentives,” according to Richard Thaler, the University of Chicago economist who last year won a Nobel Prize in part for his work on the subject.

Nudges are typically used to get people to do things that are good for them or society as a whole, but which they may be otherwise disinclined to do. Famous nudges include painted flies on urinals, reducing “spillage” by giving men something to aim at; automatic 401(k) enrollment; and getting people to use less electricity by showing them how much their neighbors are using.

One type of nudge that's shown a great deal of promise is known as a planning prompt, which asks people to lay out the concrete steps they will take to achieve a certain goal. Research has shown these prompts are effective at getting people to do things such as vote, get their flu shots and go to the dentist.

What about going to the gym?

That's what the team of researchers behind a new working paper set out to discover when they ran a randomized field experiment among 877 members of a private gym in the Midwest. In the realm of exercise, in particular, there's a notoriously large “gap between intentions and actions,” as the researchers describe it. Most Americans know they should be exercising more, but less than a quarter of them are getting federally recommended amounts of physical activity each week. A 2015 experiment conducted among workers at a Fortune 500 company found that “workers’ targeted levels of exercise are 43 percent higher than their actual levels of exercise,” according to the authors of the new working paper.

The researchers recruited subjects from among the gym's active members and divided them into two groups. The treatment group was asked to fill out a schedule indicating the days and times they planned to attend the gym in the following two weeks. A control group filled out no exercise plan, instead simply listing the number of times they had exercised in the previous two weeks. The central question: Would the people who filled out an exercise schedule go to the gym more than the people who didn't?

To keep respondents honest, the researchers used the gym's records of member check-ins to track actual exercise frequency. What they found was slightly dismaying, at least for anyone hoping to nudge themselves into exercising more: “The treatment group made an average of 2.3 visits over the two-week period, compared to an average of 2.6 for the control group,” the authors write. Statistically speaking, the difference between the two groups was zero.

The authors tried to suss out why this was. The subjects certainly believed that planning out their visits could help them exercise more: Before the study period, 60 percent of all subjects agreed with the statement “I don't go to the gym as much as I would like because I don’t set aside time for it in my schedule; then my schedule fills up and I no longer have time to go to the gym.”

The treatment subjects also appeared to try to stick to their plans — “subjects are more than twice as likely to attend the gym on planned days than on unplanned days,” the study found.

But the researchers found that not all plans were fulfilled. There remained a considerable gap between a stated intent to exercise on a given day and actually showing up to the gym that day. In fact, one of the biggest predictors of overall gym attendance during the study period was not whether people made plans to visit the gym but rather how often they visited the gym before the study period.

In other words, people already inclined to go to the gym continued to go to the gym, regardless of whether they made concrete plans to do so or not. This creates a discouraging circularity for anyone hoping to change their exercise routine: If you want to start going to the gym, it's best to already be going to the gym.

Why does the nudge fail in this case? The researchers suspect that planning nudges may be more useful for one-time events, like doctor's appointments. Activities that are repeated, such as going to the gym, are easier to put off. “Repeated behaviors like exercise . . . are very unlikely to produce a feeling of urgency, since many individuals likely have the mindset that they can always exercise 'later,'" the authors explain.

Unfortunately for many of the would-be exercisers among us, that “later” never comes.

Monday, September 3, 2018

Time to Spare? Take WOW Air!

I saw a humorous meme a short while ago. It’s posted here. Basically, it goes something like this: a couple is being served dinner on a flight. They’re so impressed and wonder how luxurious planes in 50 years will be.

This past week, with little pre-planning, I needed to get to Berlin for the 12th Annual Firefighter Combat Challenge, and my options were limited. A never heard of airline, called WOW Air came up on Kayak.

It had the shortest elapsed time to Berlin via Iceland. All the cheap seats were gone, and I hate to pay retail. But, I needed a booking. The International departures are on D concourse, the far end of the airport, where I have not yet traveled. The departure was scheduled for 7PM (1900hrs EDT). The day before, I wanted to check in and the website reported that there was no such reservation. That really bolstered my confidence. I called the airline and after a significant hold time, the agent confirmed my reservation under my last name: DAVISIII. I am the 3rd. But this was a new one. The recommendation was to be at the gate 3 (three) hours before departure. Given the lapse of the confirmation on the website, I thought that I better be present since I could not miss this window.

I arrived at the appropriate three-hours before departure, checked the one bag to avoid the $60 fee and had my carryon inspected to ensure that it would fit under the seat.

In photo two below, you can see about 200 passengers milling about, past 7, with no plane in sight.
Waiting at Gate 12, BWI Airport for WOW Air departing for Iceland, 29 August

The plane from Iceland landed about 15 minutes late and took about a half hour for everyone to unload. With virtually every seat filled, off we went. I took a shot from the aft end of the plane during the flight. Seemed like it was 100m long. 

The plane landed in Iceland around 0500hrs. There was a mad scramble to make the connection to the Berlin flight since we had one hour to get through immigration. Actually, that worked out reasonably well as all the agents were on auto-stamp. 

My seat on this leg was one row from the back of the bus. I was in a middle seat, but the gate agent had told me that while she could not change my seat, the aisle seat was empty. Great news! I hoped. So, I was counting down the minutes before they closed the hatch and here comes some guy who probably tipped the scale at 4-bills. Oh no! 

Fortunately, he had the very last two seats on the back row. Whew. Close call. 

Now, off to Germany. It’s about a 2.5-hour ride. There are absolutely no amenities. Including water. You can rent an iPad if you want to watch whatever they put on it. 

The planes are new and clean Airbuses. All the flight attendants must have to meet a height requirement of 6’2”. I guess this allows them to handle the overhead bins or play on the company basketball team.

The return trip had its interesting moments. So, the flights leave Shoenfield (STX) Terminal D. Basically, it’s a hanger. They had two people checking in 200 passengers. Not one to like standing in line, there were no options but standing in line for an interminable period of time. I would add a caption, but Blogger doesn’t like leaving things where you put them. 

The layover in Iceland was a modest 1.5 hours, with huge lines for the fast food purveyors. What was interesting was the 25 people, dutifully standing in line at the water fountain to fill their bottles. And, you had to go downstairs to find the fountain. 

Back on the plane, heading West. 

The only event of significance was an altercation between two passengers. The flight attendant separated the two family members. 

Back in Baltimore, waiting for baggage, I struck up a conversation with the five flight attendants. We concurred that based upon the speed at which random bags appeared, there must have been one guy on the tarmac. I suggest that they hire more people since they proport to actually be in the black. I’m not so sure. This might be a good stock to short. 

Now, for some real fun, you’ve got to read this poor sap’s experience and why he’ll never fly WOW again.

Why I will never fly WOW Air and neither should you

As for me, well, maybe. And, maybe not. 

Monday, August 27, 2018

Want to live a longer life? Research says you should do these five things.

By Jae Berman

August 21

There seems to always be a mad dash toward the next new thing when it comes to nutrition and fitness — whether it's the latest exercise craze, superfood or diet regimen. But leaping from fad to fad isn't exactly a well-reasoned strategy for improving our health. Nor is it a way to create changes that stick — which are the only ones that will have an impact.

If we're going to generate enough motivation to create sustainable change, we need to have clear objectives and understand how and why our habits fulfill those objectives. That way, when relapses or difficult moments arise — and they always do — our deeper motivation and plan keep us anchored.

If your objective is to live a longer, healthier life, a new study conducted by Harvard's T.H. Chan School of Public Health lays out five practices, none of which needs to involve a fad.

Menopause can be unsettling. These habits can help smooth the transition.

The study, which appeared in the American Heart Association's journal, Circulation, analyzed data on more than 100,000 people, who were followed for up to 34 years. Researchers looked at life expectancy among those who engaged in five "low-risk lifestyle factors," such as not smoking. The researchers concluded that, if practiced together, the five low-risk lifestyle factors could increase life span quite significantly, an average of 14 years for women and 12 years for men.

The five low-risk factors are the following:

1. Avoid smoking. Low risk is defined as never smoking.

2. Maintain a healthy weight. Low risk is defined as a Body Mass Index in the range of 18.5 to 24.9. BMI is a ratio of weight to height that, though imperfect, offers a quick and easy assessment of weight status.

3. Exercise regularly. Low risk is defined as moderate- or vigorous-intensity exercise for 30 or more minutes a day.

4. Consume moderate amounts of alcohol. Low risk is defined as one-half to one drink per day for women and one-half to two drinks per day for men.

5. Maintain an overall healthy diet. Low risk is defined as a diet with high intakes of vegetables, fruit, nuts, whole grains, polyunsaturated fatty acids and long-chain omega-3 fatty acids, and low intakes of red and processed meats, sugar-sweetened beverages, trans fat, and sodium. 

Not only is the research topic compelling because of the large participant sample size and lengthy follow-up — documenting 42,167 deaths over 34 years — but also because it's specifically focused on the outcome of lifespan. People make lifestyle choices for many reasons, but focusing on these five components can support someone who wants to increase their life expectancy.

"This study underscores the importance of following healthy lifestyle habits for improving longevity in the U.S. population," said Frank Hu, chair of the Department of Nutrition at the Harvard T.H. Chan School and senior author, in a news release that accompanied the study.

"However, adherence to healthy lifestyle habits is very low. Therefore, public policies should put more emphasis on creating healthy food . . . and social environments to support and promote a healthy diet and lifestyles."

While public policy may change in the future, there are steps you can take now to implement change.

Begin by taking an honest look and assess how you score among these five parameters. For example, you don't smoke, you exercise regularly, but you drink more than two drinks a day, your BMI is elevated and your diet isn't always healthy. Or you're low-risk for everything, but you only exercise two days a week. Be super specific. Note where you're doing well and where you're really struggling.

Once you get an idea of where you stand, choose just one area you want to focus on and one change you want to make in it. It's common for us to jump in and try to fix everything at once, but success usually occurs through setting small, clearly defined goals and achieving them one by one. For example, if you know you're drinking more than is recommended, but you don't want to decrease intake right now, choose a different first step. Here are some first-step suggestions:

• If decreasing alcohol consumption is your focus, consider cutting out drinking at home. Or if social drinking is your main issue, set a goal for drinks per week to keep you accountable.

• If quitting smoking is your goal, perhaps the first step is to research smoking-cessation programs.

• If improving your diet interests you, start with adding one more vegetable and fruit to your daily diet.

• If exercise is your priority, add one 30-minute workout to your regimen to get you toward a daily routine.• If losing weight is your focus, consider decreasing caloric intake by 250 to 500 calories per day.

Check in weekly to stay accountable. As that habit is incorporated into your regular routine, add more to your weekly agenda, so that slowly, but surely, you're incorporating the five habits.

When bumps in the road occur, remind yourself why you're doing what you're doing. You're taking steps to create habits that could lead to a longer, healthier life. That focus is an important part of achieving the goal. 

Berman is a registered dietitian, a personal trainer and owner of Jae Berman Nutrition.

Friday, August 24, 2018

A New Study Says Any Amount of Drinking Is Bad for You. Here's What Experts Say

A new study concludes there’s no amount of alcohol consumption that’s safe for overall health — a finding that’s likely to surprise moderate drinkers, and that has left some experts unconvinced.

For years, public health officials have said that, while no one should pick up drinking in search of better health, moderate drinking (defined as up to a drink per day for women and up to two per day for men) probably won’t hurt anyone who already imbibes, and may even confer some benefits. This standard is written into the Dietary Guidelines for Americans and is supported by organizations including the American Heart Association and the American Cancer Society.

But the new paper, published Thursday in The Lancet, calls that long-held conclusion into question.

“The evidence is adding up that no amount of drinking is safe,” says study co-author Emmanuela Gakidou, a professor of global health and health metrics sciences at the University of Washington. “I don’t think we’re going out on a limb to say anything that the data do not support.”

The new research was based on a review of nearly 700 existing studies on global drinking prevalence and nearly 600 studies on alcohol and health and found that alcohol was the seventh leading risk factor for premature death in 2016, contributing to 2.8 million deaths worldwide. That number is equivalent to 2.2% of all female deaths and 6.8% of all male deaths that year, according to the study.

The health risks likely only increase the more you drink, the study found. Compared to non-drinkers, people who had one alcoholic beverage per day had a 0.5% higher risk of developing one of 23 alcohol-related health problems, including cancer, road injuries, and tuberculosis, in a given year, the study says. At that level, the absolute increase is small, equaling only four additional deaths per 100,000 people per year, according to the study. But those who had two drinks per day had a risk 7% higher than non-drinkers. At five drinks per day, the risk was 37% higher, the study says.

Gakidou’s paper did show some modest cardiovascular benefits associated with moderate drinking, particularly among women, but she says that effect is overshadowed by the numerous ways alcohol can threaten health. When you consider risks like breast cancer and road traffic injuries, she says, “the protective effect goes away, even at low doses.”

Other experts have recently come to similar conclusions. In May, for example, the World Cancer Research Fund released a report saying that, at least in terms of cancer prevention, “it’s best not to drink alcohol.” The U.K. government made a similar recommendation in 2016.

Meanwhile, some studies have questioned the long-standing idea that moderate drinking is good for heart health. That’s in part because some older studies didn’t account for the fact that many people who don’t drink abstain either because they had addiction issues in the past, or have other health problems that force them to stay away from alcohol. Including these individuals in the general non-drinking population may have skewed research results to make teetotalers as a whole group look unhealthier than they actually are, some studies have suggested.

Walter Willett, a professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health, questions the conclusion that the cons of drinking always outweigh the pros. While there’s “no question” that heavy drinking is harmful, he says that plenty of data supports links between moderate drinking and lower total mortality and a decreased risk of heart disease — which, he says, are far more relevant concerns for most Americans than something like tuberculosis, which the Lancet paper identifies as a leading alcohol-related disease worldwide. Tuberculosis is very rare in the U.S.

“Our decisions about drinking in the United States shouldn’t be influenced by what alcohol does to tuberculosis,” Willett says. “When you throw together everything in one big pot and draw conclusions for the whole world, it’s just misleading.”

Willett does acknowledge that even moderate drinking comes with tradeoffs. A drink a day may decrease a woman’s risk of heart disease but increase her risk of breast cancer. For a young, healthy woman who is unlikely to die of heart disease, those risks might outweigh the benefits. But that’s a decision that woman would have to make with her doctor, Willett says — and it’s unlikely the entire population would or should come to the same conclusion.

“I think they went too far in this paper,” Willett says. “There are risks and benefits, and I think it’s important to have the best information about all of those and come to some personal decisions and engage one’s health care provider in that process as well.”

Gakidou, on the other hand, says her paper’s recommendation is valid precisely because individual health decisions are so variable.

“We don’t have the information for specific individuals…we’re making overall recommendations at the population level,” she says. “If you’re running a health system in a country, it’s better overall for the population of your country to not drink at all than to drink a little bit.”

Dariush Mozaffarian, dean of the Friedman School of Nutrition Science and Policy at Tufts University, agrees with that assessment. It’s clear, he says, that drinking comes with health risks, and far less clear that it comes with any benefits. So while some moderate drinkers might never experience health problems from drinking, “if you look at all the risks and all the benefits of alcohol, it’s probably net harmful, on average, for the whole population,” he says.

While that conclusion may seem stark to people who have come to feel virtuous about their nightly glass of wine, Mozaffarian says it’s actually not so different from current medical advice.

Tuesday, July 31, 2018

This Is the Effect Working Out Has on Your Bones

From Vice
How active you are as a kid affects your bones forever.

Nick Veasey/Getty Images
Bone is a living tissue that reacts to the stresses we place on it. Every year, about 10 percent of our oldest bone matter is expelled from the body and replaced by fresh bone, and exercise and sports can make that incoming fresh bone denser and stronger than it'd be if we just sat on the couch, says Michael Econs, a physician and member of the American Society for Bone and Mineral Research and a professor at the Indiana University School of Medicine.

Many articles will tell you this effect is all about "building bone," but calling it “building bone” makes it sound like building muscle, and the effect isn't quite that straightforward. A person retains the ability to build muscle throughout life. When we ask too much of a muscle during exercise—like a grueling weight training session or running a marathon—the damaged muscle responds by repairing itself to be even stronger.

Bone, too, grows stronger through adolescence and young adulthood by responding to heavy impacts and loads, such as running and lifting weights, by regrowing bigger and stronger. But unlike muscle, there's an age cutoff by which bones can't grow larger. Peak bone mass is the point at which a person's skeleton has grown as big as it'll ever be, and although the right kind of exercise can maintain that size by replenishing it with strong, dense bone, from that point forward you can only maintain or slow down gradual age-related bone loss. Research by the National Institutes of Health and the Centers for Disease Control says we reach peak bone mass between 25 and 30 years old.

Bone is constantly turning over through a process in which cells called osteoclasts dig tunnels through bone, and then cells called osteoblasts re-pave those tunnels with new bone. Econs acknowledges that it sounds like an inefficient system, but it has to work this way because you obviously need to be able to use your bones while those repairs are taking place.

"If you think about it in terms of building a bridge that you can't touch for 80 or 90 years, you want to build in a self-repair mechanism,' he says, 'so if you have a micro-crack, (those cells) can come in and dig out the bad or old bone and lay down new, fresh bone."

Nobody has to work as hard to regain bone mass as astronauts returning from orbit. After a mission of four to six months in space, astronauts lose two to nine percent of bone mass throughout their whole bodies, according to NASA, which they spend many months trying to regain after returning to Earth. “There was a long-standing knowledge gap about the ability of the astronauts to gain back the bone mass that was lost in space,” says Jean Sibonga, lead scientist of NASA's Bone and Mineral Laboratory at Johnson Space Center.

It's possible, Sibonga says, for an adult to gain net bone mass by training with weights two to three times one's bodyweight. The problem is how you measure bone mass. To measure the progress of bone regeneration in the months after astronauts return to Earth, the Laboratory uses areal bone mineral density (BMD), a common technique in which two X-ray beams of different energy are fired into a bone. Areal BMD is limited to two-dimensional measurements and unable to detect three-dimensional changes in size and shape, Sibonga says, “so, while we report that areal BMD can be recovered, the overall structure and 'strength' of the bone itself may be different.”

Read: Working Out a Lot Doesn’t Always Increase Your Appetite

If, through genetics or good exercise and nutrition during adolescence, you achieved a high peak bone mass, you'll fare better as you age, Sibonga says. Age-related bone loss percentage will be lower, and it'll have a lower effect on the bone's strength overall. “We have seen net gain in bone mineral density when assessing on an individual basis,” Sibonga says, pointing out that blog-site headlines talking about "building bone" are trying to make observations of trends on a population-wide scale.

In other words, your ship most likely sailed a long time ago, back when you were a student who cared more about pizza and skipping class than worrying about the size of your future self's skeleton. “For the most part, standard exercise interventions after 30 will not increase bone mass,” Econs says. “[But] the next-worse thing you can do for bone—besides spaceflight—is to sit on the couch and not get any weight-bearing exercise.”

To encourage bone to regrowth as strong as existing bone and not waste away, you have to perform activities with hard impacts or heavy loading of the skeletal system, such as weight lifting and running, Econs says. Cycling and swimming don't induce stronger bones because they don't load the skeletal system enough. Even walking, Econs says, is enough to preserve the skeleton.

Few studies and few words are said about bone regeneration in young and middle-aged adults. Nearly all studies and talk focus on elderly men and postmenopausal women, so when an organization such as the US Department of Health and Human Services says regular exercise increases bone density, the advice tends to be interpreted as “the sky's the limit” and extrapolated to all ages and populations, giving false hope to people who want to turn their scraggly toothpick arm bones into those like the Croods'.

Dig a little further into that 2008 Committee Report, and you see that talk of bone gains is not about net gains—ending up with bones larger than when you started—but about stemming the loss of bone, or breaking even. “Although a benefit of one to two percent (of increased BMD) per year may seem small,” it reads, “this is roughly equivalent to preventing the decrease in BMD that would typically occur over one to four years in postmenopausal women and elderly men.”

You work out to maintain what bone you have by adulthood, not to keep growing it bigger like a muscle. Aside from those few individual cases Sibonga alludes to, you've got all the bone you're going to get. The trick now is to work hard to keep from losing it.