Kampuchea Crossings

Bump to baby on the beaten expat track

Getting the kids to like ampalaya (bitter gourd)

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I can say I like this horrible thing now, as an adult, but as a kid there was nothing I hated more. I guess after repeated exposure – it’s a staple food item in Asia – our palates can’t help but adjust to it.

Ampalaya (Filipino word for it) is a tropical vine, related to the squash. To blunt that sharp bitter taste, some people like to cut it up (remove the spongy middle and seeds), rub with salt, and leave it in salty water for half an hour before cooking with it. It’s a great source of vitamin C, folate and antioxidants. There’s growing evidence in western literature supporting what indigenous populations around the world use it for. It has cancer-fighting properties, helps lower cholesterol and controls blood sugar.

This vegetable is so ubiquitous in simple Filipino foods, that I try to have it around for the kids so they get used to it too. I’ll saute thin slices of it with onion and scramble eggs into the pot (add a teaspoon of fish sauce for every two eggs). I also add chili flakes or hot sauce here but that’s not a Filipino thing.

The purple vegetable are banana buds (flower buds).
To get rid of the sharp bitter taste, rub with salt and soak in saltwater for half an hour.

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Gender differences in athletic training

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Did you know that performance advice for athletes are mostly based on studies done on young white males, but are generalized to all other populations? How should those of us, from demographics who are not typically studied, approach the mainstream training advice? .

So I’m training for a marathon this year. It’s been a while since I was on a training regimen, and I had coaches back then to push and help me do my best. These days I’m on my own to figure out my workouts, fueling, hydration, etc. There’s a lot of new info!

Below are notes from the various emerging research on gender differences and performance. At the end of this post I reference resource persons and podcasts where I learned these.

Note this is specific to female athletes and how we can leverage the phases of our menstrual cycle to maximize performance potential. There’s also new research for those across the gender spectrum, and other demographics.

Leveraging the Menstrual Cycle for Training Effects

This visual below depicts the typical cycle of 28 days (this length varies by individual). Day 1 indicates the first day of bleeding, and this onset occurs due to the drop in oestrogen and progesterone.

Image source: ZRT Laboratories

In the week before bleeding starts:

  • It’s harder to access carbs to fuel high intensity workouts.
  • Instead of focusing on intensity, focus on skills-based, de-loading, technique and functional movement, to lower our cardio stress, e.g., work on form when doing reps, when running, etc.
  • Keeping our training stress down helps reduce cortisol, the hormone involved in storing body fat.

During the period (Day 1 of the menstrual cycle is the first day of bleeding):

  • Mineral needs go up, e.g., Mg (that’s why there’s chocolate cravings) and Zinc 
  • More carbs are needed to do higher intensity work, because our energy needs grow by ~150cal; the body is building uterine lining. 
  • Kispeptin (co-transport mechanism) is sensitive to low carb situations, so its activity falls if our diet is low on carbs, which puts the body in starvation mode and leads to increased storage of body fat. 
  • Endocrine function is also thrown off if the body doesn’t get enough carbs. It is different for men because they have a different endocrine environment. 

In this first half of the cycle, or low hormone phase (Day 1-14): 

  • This is when women can work to improve strength, the overall top end power, our aerobic or anaerobic capacity.
  • The body uses carbs well – it can access and store carbs, so we can decrease carb intake in this phase.
  • As estrogen and progesterone start to rise – first estrogen during Ovulation – our carb intake needs to increase. Our protein intake needs to increase also, to counter the catabolic effect of progesterone (muscle tissue breakdown).
  • Aim for high intensity workouts during this low hormone phase, e.g., fast repeats, hills, plyometrics, heavy lifting with low reps.

Around Ovulation the ligaments loosen (part of preparation for possible pregnancy) which brings increased risk for ligament years, like ACL tears.

In the high hormone phase the body can’t access and store carbs as well, so carb intake should increase, e.g., foods that are low on the food chain, like greens.

  • Hydration should increase during this high hormone phase; it’s not a good idea to rely on thirst so in long duration activity like long runs, drink on a schedule.
  • Training should be lower intensity with more focus on functional fitness, technique, running skills, in high hormone phase (e.g., the week before period).

This strategy is better for lean mass and muscle development than doing strength training 3-4x/wk strength:

  • Low intensity work (form and function) towards the later half of the cycle, or the high hormone phase
  • High intensity workouts in the first half of the cycle, or the low hormone phase

These quick summaries are for my personal reference; there is so much to learn. Anyone who has a daughter or who coaches or mentors young girls and women can help them stick to their sports, or optimize their athletic potential(!), by just knowing and working with this menstrual cycle. It’s a game changer that helps girls stay active (rather than letting them quit because of a lack of understanding about all the changes happening at puberty and by cycle). I’m grateful for the scientists who are spearheading research studies around this important topic. Only a few of them are listed below, but I’ll add to it as I learn of them.

Researchers Studying Gender Differences and Exercise Science

Researchers who are active online on their blog, on twitter or instagram:

Podcasts I found really helpful are below. For some of them, I had to listen a few times!

Commuting and office work in the time of Covid

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After nearly a year of working from home, 10 days ago I started that commute back to an office environment at the hospital. Rapid-fire emergent findings, compounded by active misinformation and sabotage by the trump administration, and now these variants(!) make it very difficult for the average office worker to make sense of how best to protect ourselves.

So here I talk about what I use and what’s recommended: masks (always outside the home), goggles (for public transport, grocery store runs, or other crowded spaces), fans (to maintain air flow in the office) and, if needed, a portable air cleaner with HEPA filter for the workspace.

My commute is in the NYC subways where that ‘rush hour’ is still fairly crowded. In this age of mutant viruses, I am all about the protection cuz we are SO CLOSE to getting a vaccine(!) so here’s what I do on the commute and at the office:

Walking down the street with the wind blowing (usually), I just wear a mask. The double mask guidance is a stopgap, but effective: the surgical mask does not give a good fit so the cloth mask over it gives a better seal. If you can afford it, get yourself a good mask that satisfies three criteria:

  1. Fit – your breath should not fog your glasses or goggles – your breath should go through the mask and not escape out the top or sides of the mask
  2. Filtration – 3 layer tightly woven fabric is the current consensus for best filtration, until official criteria are released
  3. Breathability

Some great resources for masks guidance are below:

Here’s what Joseph Allen has to say about masks (he’s an epidemiology professor at the Harvard School of Public Health:

For that subway ride, I use GOGGLES. These are my favorites for the fit (small face, low nose bridge):

Below are my go-to MASKS for when I use public transport, for the office and any grocery store runs. I have several of each on hand and bring a spare with me when I go out. For work, I use one mask for the commute and switch to a fresh one for the day.

  • Livinguard 3-layer Safety mask with hygiene technology that uses negatively charge ions to trap and destroy germs. They aren’t cheap at $29.95 but their designation and the studies supporting the claims seem legitimate.
  • Rafi Nova 3-layer Performance mask, which comes with toggles to pull tight either the top of the mask or chin. They are 2 for $22.

In a hospital building, regulations require frequent air change so the ventilation systems are good. In an office environment, especially older buildings, we’re on our own. There aren’t many people in our office (all nurses and healthcare staff), and minimal visitors since the pandemic began (also all clinicians). I feel ok just having a variety of FANS moving air around, including this on my desk:

If you can afford a portable air cleaner with HEPA filter for your desk / cubicle / office, it can help cut down on your exposure. Below is what Dr. Allen has to say. And if you

And the tool referenced below, for determining the size of air cleaner needed, is in this link:

The Defense Production Act combined with the work done by the CDC should soon provide standard criteria and guidance, as well as a stable supply of reliable, certified masks at scale.

Stay safe..!

Until Covid-19 messaging improves, who do you turn to?

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It’s February tomorrow – a snow day here, yey!! – and over a full year into this pandemic. It’s frustrating that to manage every new situation, the general public still has to scour Twitter for a prevailing consensus. We don’t have better guidance on masks (like what type and where to get them) and managing risky situations like public transportation. I fully agree with this piece in the NYTimes: It’s been ten months, and I still don’t know when to replace my masks!

“Quickly synthesizing emerging evidence and providing practical guidance for the public and communicating it well is what the C.D.C. should be doing, and should have been doing. The new administration seems to have hit the ground running, and I hope that this is what it will be doing going forward.”

https://www.nytimes.com/2021/01/29/opinion/coronavirus-masks.html
Began using these when I started a new project; the NYC subway is packed at rush hour!

So, like many, I often field questions from friends and family (or push unsolicited advice to counter clearly misguided or false information). Since national messaging might take a while to cohere (there’s been active sabotage on our national systems and infrastructures, after all), below is a list of regularly updated and easy-to-understand resources that distill the rapidly changing Covid-19 advice for us lay folks. I’ve been referring folks to these same sites and experts for months cuz they’re who I turn to. Hope it helps!

On Masks, now that the variants are a real threat. Your mask criteria are FIT, BREATHABILITY, and FILTRATION. For example, if your glasses are fogging up then your FIT is off. See the below for great advice:

  • Great mask guidance for these precarious next weeks, in anticipation of the variants–> Friendly Neighborhood Epidemiologist (27 Jan 2021).
  • I’ve tried tens of masks on my family over the past year, e.g., masks from Etsy or retailers in the $5-30 range. I’ve put the others on a ‘backup’ bin and highly recommend these below. Note each one’s specific washing instructions to maintain full efficacy.
    • Livinguard mask – Their 3-layer Safety masks have the best fit and breathability for me and my family. The hygiene technology is based on positive and negative charges to trap and inactivate the microbes’ protein structure (destroying the virus) on contact. Read their FAQ for more info.
    • Rafi Nova – Their 3-layer Performance masks come with toggles to pull either the ear or chin seal tighter. We really love these masks and love the family’s philosophy on giving back to and helping the community. Some of their textiles are sourced from the minority communities in Laos.

Podcasts:

  • In the Bubble is a great podcast from Andy Slavitt, an advisor in the Obama administration and now a senior advisor on Biden’s Covid-19 Team. The conversations between the science, health and medical experts are designed for practical consumption by the general public. The January 18 episode is particularly useful, given the variants’ debuts and threats to impact the US (no new guidance, just double down on what we should already be doing). Slavitt’s Twitter stream is also excellent.
  • Unbiased Science talks about current issues in the sciences, and in the past year the topics have been mostly about Covid-19. But they still occasionally cover other items, like dismantling the myths around organics or helping to understand GMOs, etc.

Twitter streams:

  • Zeynep Tufekci – Turkish sociologist and writer, focusing on ‘the social implications of new technologies, such as artificial intelligence and big data, as well as societal challenges such as the pandemic using complex and systems-based thinking.’
  • Andy Slavitt – tirelessly engaging both professionals and the general public in conversation since this pandemic began, to offer all of us some practical guidance. From his profile: ‘White House Sr Advisor for COVID Response – Let’s Work Together to Defeat COVID-19. Past head of Medicare/Medicaid for Obama/Biden. Personal account.’
  • Michael Mina – Covid-19 diagnostics, like gold standards for testing and thoughts on public health approach. From his profile: ‘Epidemiologist, Immunologist, Physician, Harvard Public Health/Medical School. Discuss vaccines, immunity, infectious diseases, public health, and tests‘
  • Angela Rasmussen, PhD – From the latest studies to the newest guidance, her stream is very useful. From her profile: ‘Excessively direct virologist. Affiliate @georgetown_ghss. Soon @VIDOInterVac. Emerging virus host responses. 1X Jeopardy! loser. Rep: @anniescranton. she/her’
  • Peter Hotez, MD PhD – From his profile: ‘Vaccine Scientist-Pediatrician-Author-Combating Antiscience, Prof Dean @BCM_TropMed @TexasChildrens, Univ Prof @Baylor, Hagler Inst @TAMU, Founding Ed @PLOSNTDs‘
  • Eric Feigl-Ding, PhD – From his profile: ‘Epidemiologist & Health Economist. Senior Fellow, FAS. Fmr 16 yrs @Harvard. Health justice advocate. RoomRater 10/10. COVID19 updates since Jan ’20′

Facebook pages – and they are all women scientists from various fields, US states and backgrounds! They have also consulted each other to coordinate their content and messaging:

Filipino snack

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It’s Friday night, before Monday, 14 December when the electors submit their votes. The Supreme Court just tossed out the Texas lawsuit seeking to reverse the election outcome in four states won handily by Biden, saving the constitutional representative republic we know as the United States of America.

Texas Attorney General Ken Paxton (R) was clearly trying to obtain a pardon with this pathetic stunt, yet people and the media continue to give these people credibility.

I know I have another bottle of champagne somewhere around here. Hard to keep them in stock when we keep winning all the time. (Where are trump and his seditious GOP followers? 1-57? They are has-beens and losers to the core and we all need to move on.)

In the meantime, I need a good snack to go with a mindless action movie that I still need to find.

Pronounced bago-ong, it is a shrimp paste that serves as a dip.
Here it is baby eggplants and cherry tomatoes.

Bok l’hong (a photo recipe of papaya salad)

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Khmer spicy green papaya salad. I miss so many things from Southeast Asia, and this is one of them. In Khmer it’s pronounced ɓok lhoŋ: បុកល្ហុង. You can order sôm tām, or ส้มตำ, in a Thai restaurant. In Laos it is tam maak hoong, or ຕໍາ ຫມາກ ຫຸ່ງ. And I didn’t realize they also have it in Vietnam, gỏi đu đủ (pronounced guy dodo). The premise is the same but each has its own distinct flavor.

Thankfully the ingredients are locally available. Here we visit a Khmer friend who just whips everything out of her pantry like it’s the simplest thing, and in 5 minutes she has some on a plate for me.

Besides the ingredients we used, you can add others: yardlong beans (cut in small pieces), grated carrots, crab meat, finely chopped lemongrass, palm sugar. If you add bean sprouts don’t smash it too much – add it at the end.

Garlic cloves, Thai chillies, sliced cherry tomatoes, baby eggplant, grated green papaya , sugar, prahok, fish sauce
You can get a bottle of prahok in any Thai grocery store (Chinese stores likely won’t have it)
She’s adding fish sauce.