Interview with Dr. Arnie Baker
7.26.07 conducted by Dan Empfield
[FROM THE PUBLISHER: Our next submission takes the form of an interview with Dr. Arnie Baker, a Doctor of Medicine, Master of Surgery. He is a renowned cycling coach, with athletes of his having won 4 Olympic Competitions, 120 National Championships, including 40 who hold U.S. national records. His own race history includes holding Cat-1 road race status, 6-Time National Champion, 8-Time U.S. national record holder, world master's sprint champion, and best all-around U.S. Masters racer. He is a prolific author on the medical aspects of cycling, and is most recently notable for having authored "What's Fair is Clear," the central scientific argument of Floyd Landis' Wiki Defense. We've solicited his input because of his medical training, his comprehensive knowledge of cycling medicine, and his extensive work with masters endurance athletes].
SLOWTWITCH: Dr. Baker, it seems a bedrock question to be asked early on during this discussion is, "What sort of training and racing is accretive to longevity, and long-term quality of life?" One of those submitting for our series placed into play the provocative view that endurance athletics is not universally healthy. Indeed, according to this view the sort of training and racing that goes on at the pointy end of cycling, running, triathlon, is actually lifespan shortening, and not accretive to longevity. In this view, once you're endurance training more than 8 or 10 or 12 hours a week you're on the backside of the curve, and while more training means faster times in the short run, it's at the expense of more long-term health damage, or at least the risk of it. Where do you come down on this?
ARNIE BAKER: I think that's probably right. I think that aerobic exercise, along with strength training and flexibility, are the three activities that lead to good health. If you’re doing more than 8 or 10 hours a week, you are doing more than you need just for physical health -- you’ve got another agenda. It's not necessarily bad, there are a lot of reasons to do it, but it's just not a question of health anymore. I'm not saying this is necessarily bad for health, but you’re not improving health.
ST: There are supplement-related ramifications that follow from holding this view, based what might seem the counterintuitive goals of sports organizations. One need only look at the parcours grand tour riders are expected to negotiate. If 600 miles per week in training, and racing 19 out of 21 days, 125 miles per day, with 10,000 feet of altitude gain, against the best in the world, may be bad for you, then I'm wondering if these race organizers and federations are talking out of both sides of their mouths when they're saying anabolic agents are also bad for you, as well as being unfair.
AB: If you're talking about what's going in the Tour de France, it's not a question of health. If you want to be a great climber, you've got to have extremely low body fat. That’s good for climbing, bad for health. Less than five percent body fat for many climbers would improve their performances, but not their health. If you look at the riders who break bones, or have to withdraw for other medical reasons, we're not looking at general health. It's not about health. Sport can be about health, if we're talking about recreational health, but that brings us back to the 8 or 12 hours per week we were talking about earlier.
ST: As a prominent coach, and doctor, and advisor to age-graded and pro cyclists alike over the years, you're probably as close to ground zero as anyone in a discussion of age-graded anti-doping versus anti-aging and pro-health. Based on your experience, do you think a lot of age-graded cyclists would be found positive if they were tested according to a WADA protocol?
AB: I'll give you a ballpark figure, a guesstimate. If you take my bicycle club's cyclists, about 200 riders, generally the demographic of the rider's I coach, 40-60 year old men, if you say there are 200 men in that group, my guess is that there would be at least 20 who are taking testosterone. Keep in mind, the club I belong to is a recreational club. Most of those supplementing with testosterone are not active racers. None of them are taking it for performance enhancing effects, per se. The demographic of my club is older, all vets. And, all of them are taking it for general health, per the prescribing habits of physicians in California.
ST: Let's talk about TUEs. In your experience, and if you want to take a pass on this, that’s okay, but how responsive do you feel USADA would be to TUE requests presented by the typical among these 20 riders, and do you have a view as to how many of these 20 would be granted?
AB: I've written a fair number of TUE requests or reports. For example, for asthma inhalers, I fill out the form and submit it, there's never a problem. Occasionally, for high level international competition, there has been a requirement for more sophistication in the request. As regards testosterone, I've only been involved in one TUE for testosterone. I told my athlete [an older masters racer], “I don't know that TUEs for testosterone are ever granted.” I'd heard they were, but I didn't know the criteria. My athlete has won national championships, yet has a bona-fide legitimate health reason for testosterone. As to how many of these 20 athletes would be granted a TUE, I can’t say, since I’ve waited more than 6 months for an answer from USADA on the TUE submitted for the one athlete. No response yet.
ST: Whom do you think ought to be the arbiters of what's legal, what's ethical, what's practical, in age-group racing: national federations, world federations, USADA, WADA? Who's responsibility is it?
AB: It is difficult, and there is no right or wrong answer per se. The question is, what is the rule? You're asking, who makes the rule? Is it okay to make a right turn at a red light? In California, yes, in other states no. I have a skinsuit, it’s aerodynamic, it’s illegal for me to use it in USCF racing, because they make the rule for their own races. At master’s games, I can wear it. In triathlon, I can wear it. As for doping, at the moment, it's USADA making the rules in cycling. If you’re saying they don’t care about the age-grouper, that’s frankly been my view over the years.
ST: Aside from whose responsibility these issues are, whom do you think will be the agent for change, and for eventual consensus sportwide on how age-group supplementation -- that is, its anti-doping protocols or any decision to have no protocol -- is handled?
AB: I don't know. My scope is, in a sense, relatively narrow in that I concentrate on cyclists. In cycling, masters rely on the USCF, and masters are by far the majority of the members. Perhaps there will be a masters organization. I would say the principles for masters ought to be the same for all athletes. If there's a medical need, and medication is indicated, the rule ought to be what's good for the athlete. I suppose testosterone in aging men is an issue because it's common enough, whether it's anemia, osteoporosis or depression.
AB: Overall, depression is one of the most common problems people have. The extent to which hormones play a role is uncertain. Perhaps it's better appreciated in women than in men. There are a lot of quasi-legitimate, anti-aging specialists. Apart from that, there is a significant movement for hormonal replacement as one's hormone levels drop off. The [ethical] problem emerges when we look at testosterone’s ergogenic use. Let’s say a master’s athlete has an acceptable testosterone range of 200-800, and he has 63. Do you correct to 200 or to 800?
ST: Yes, that’s the dilemma you eventually face. But I wonder to what extent it’s the tail wagging the dog. Whether it’s the pro racer facing a three-week grand tour, or the masters rider training 20 hours a week, how is it he gets to a testosterone count of 63? Is it because he’s got a sport-unrelated medical problem, or has his over-the-top training lowered his testosterone, with cortisol levels through the roof?
AB: Do they [hard core racers] really need it [testosterone supplementation], or do they choose to need it? There are those who recover better than others. That’s what makes them winners. For the rest, there's always journalism school.