What’s the Single Best Exercise?

"THE GUARDIAN

Let’s consider the butterfly. One of the most taxing movements in sports, the butterfly requires greater energy than bicycling at 14 miles per hour, running a 10-minute mile, playing competitive basketball or carrying furniture upstairs. It burns more calories, demands larger doses of oxygen and elicits more fatigue than those other activities, meaning that over time it should increase a swimmer’s endurance and contribute to weight control.

So is the butterfly the best singleexercise that there is? Well, no. The butterfly “would probably get my vote for the worst” exercise, said Greg Whyte, a professor of sport and exercise science at Liverpool John Moores University in England and a past Olympian in the modern pentathlon, known for his swimming. The butterfly, he said, is “miserable, isolating, painful.” It requires a coach, a pool and ideally supplemental weight and flexibility training to reduce the high risk of injury.

Ask a dozen physiologists which exercise is best, and you’ll get a dozen wildly divergent replies. “Trying to choose” a single best exercise is “like trying to condense the entire field” of exercise science, said Martin Gibala, the chairman of the department of kinesiology at McMaster University in Hamilton, Ontario.

But when pressed, he suggested one of the foundations of old-fashioned calisthenics: the burpee, in which you drop to the ground, kick your feet out behind you, pull your feet back in and leap up as high as you can. “It builds muscles. It builds endurance.” He paused. “But it’s hard to imagine most people enjoying” an all-burpees program, “or sticking with it for long.”

And sticking with an exercise is key, even if you don’t spend a lot of time working out. The health benefits of activity follow a breathtakingly steep curve. “The majority of the mortality-related benefits” from exercising are due to the first 30 minutes of exercise, said Timothy Church, M.D., who holds the John S. McIlhenny endowed chair in health wisdom at the Pennington Biomedical Research Center in Baton Rouge, La. A recent meta-analysis of studies about exercise and mortality showed that, in general, a sedentary person’s risk of dying prematurely from any cause plummeted by nearly 20 percent if he or she began brisk walking (or the equivalent) for 30 minutes five times a week. If he or she tripled that amount, for instance, to 90 minutes of exercise four or five times a week, his or her risk of premature death dropped by only another 4 percent. So the one indisputable aspect of the single best exercise is that it be sustainable. From there, though, the debate grows heated.

“I personally think that brisk walking is far and away the single best exercise,” said Michael Joyner, M.D., a professor of anesthesiology at the Mayo Clinic in Rochester, Minn., and a leading researcher in the field of endurance exercise.

As proof, he points to the work of Hiroshi Nose, M.D., Ph.D., a professor of sports medical sciences at Shinshu University Graduate School of Medicine in Japan, who has enrolled thousands of older Japanese citizens in an innovative, five-month-long program of brisk, interval-style walking (three minutes of fast walking, followed by three minutes of slower walking, repeated 10 times). The results have been striking. “Physical fitness — maximal aerobic power and thigh muscle strength — increased by about 20 percent,” Dr. Nose wrote in an e-mail, “which is sure to make you feel about 10 years younger than before training.” The walkers’ “symptoms of lifestyle-related diseases (hypertension, hyperglycemia and obesity) decreased by about 20 percent,” he added, while their depression scores dropped by half.

Walking has also been shown by other researchers to aid materially in weight control. A 15-year study found that middle-aged women who walked for at least an hour a day maintained their weight over the decades. Those who didn’t gained weight. In addition, a recent seminal study found that when older people started a regular program of brisk walking, the volume of their hippocampus, a portion of the brain involved in memory, increased significantly.

But let’s face it, walking holds little appeal — or physiological benefit — for anyone who already exercises. “I nominate the squat,” said Stuart Phillips, Ph.D., a professor of kinesiology at McMaster University and an expert on the effects of resistance training on the human body. The squat “activates the body’s biggest muscles, those in the buttocks, back and legs.” It’s simple. “Just fold your arms across your chest,” he said, “bend your knees and lower your trunk until your thighs are about parallel with the floor. Do that 25 times. It’s a very potent exercise.” Use a barbell once the body-weight squats grow easy.

The squat, and weight training in general, are particularly good at combating sarcopenia, he said, or the inevitable and debilitating loss of muscle mass that accompanies advancing age. “Each of us is experiencing sarcopenia right this minute,” he said. “We just don’t realize it.” Endurance exercise, he added, unlike resistance training, does little to slow the condition.

Resistance training is good for weight control, as well. In studies conducted by other researchers, a regimen of simple weight training by sedentary men and women led to a significant decrease in waist circumference and abdominal fat. It also has been found to lower the risk of developing diabetes and cardiovascular disease. Counterintuitively, weight training may even improve cardiovascular fitness, Phillips said, as measured by changes in a person’s VO2max, or the maximum amount of oxygen that the heart and lungs can deliver to the muscles. Most physiologists believe that only endurance-exercise training can raise someone’s VO2max. But in small experiments, he said, weight training, by itself, effectively increased cardiovascular fitness.

“I used to run marathons,” he said. Now he mostly weight-trains, “and I’m in better shape.”

But there’s something undignified and boring about a squats-only routine. And the science supporting weight training as an all-purpose exercise approach, while provocative, remains inconclusive. Is there a single activity that has proved to be, at once, more strenuous than walking while building power like the squat?

“I think, actually, that you can make a strong case for H.I.T.,” Gibala said. High-intensity interval training, or H.I.T. as it’s familiarly known among physiologists, is essentially all-interval exercise. As studied in Gibala’s lab, it involves grunting through a series of short, strenuous intervals on specialized stationary bicycles, known as Wingate ergometers. In his first experiments, riders completed 30 seconds of cycling at the highest intensity the riders could stand. After resting for four minutes, the volunteers repeated the interval several times, for a total of two to three minutes of extremely intense exercise. After two weeks, the H.I.T. riders, with less than 20 minutes of hard effort behind them, had increased their aerobic capacity as much as riders who had pedaled leisurely for more than 10 hours. Other researchers also have found that H.I.T. reduces blood-sugar levels and diabetes risk, and Gibala anticipates that it will aid in weight control, although he hasn’t studied that topic fully yet.

The approach seems promising, since most of us have minimal time to exercise each week. Gibala last month published a new study of H.I.T., requiring only a stationary bicycle and some degree of grit. In this modified version, you sprint for 60 seconds at a pace that feels unpleasant but sustainable, followed by 60 seconds of pedaling easily, then another 60-second sprint and recovery, 10 times in all. “There’s no particular reason why” H.I.T. shouldn’t be adaptable to almost any sport, Gibala said, as long as you adequately push yourself.

Of course, to be effective, H.I.T. must hurt. But a study published last month found that when a group of recreational runners practiced H.I.T. on the track, they enjoyed the workout more than a second group of runners who jogged continuously for 50 minutes. The H.I.T. runners, the study’s authors suspect, were less bored.

The only glaring inadequacy of H.I.T. is that it builds muscular strength less effectively than, say, the squat. But even that can be partially remedied, Gibala said: “Sprinting up stairs is a power workout and interval session simultaneously.”Meaning that running up steps just might be the single best exercise of all. Great news for those of us who could never master the butterfly.

LINK

Making More by Trading Less

TRADINGMARKETS.com

I've lost track of how many times traders have related to me how some system, method or approach doesn't work in real time. They readily admit that the given approach (none specific) works during simulated trading efforts, but once they switch to real money the whole thing falls apart.

Hmm...

Constantly Variable

Scientific study is all about working with constants and variables. The constants are a standard of measure while the variables are that stuff which one tries to make yet another constant. So in the equation of trading, when a traderapplies some method or approach with profitable success in mock or simulated mode, that is a constant. All things being equal, if the hypothetical profit margin is high enough to overcome slippage and costs of execution, it is a winner. Add that one to the category of "constant".

It does not matter to the market if you, me or anybody is attempting paper fills or actual real-dollar fills. This truth may hurt, but the market really doesn't know or care if any of us are even alive. It doesn't. The market exists to facilitate price discovery at highs and lows until all bidders in the auction are positioned accordingly. Whether we operate in paper trade mode, sim trade mode, one contract (100 shares) live, ten contracts (1,000 shares) live or one hundred contracts (10,000 shares) live is only a matter of market liquidity. If the chosen symbol can handle those fills in the normal course of its movement, there is scientifically = mathematically zero different across that spectrum to the market itself.

For example, if the S&P 500 futures (ES) is trading at the 1001.00 level and we decide ahead of time to fill a long trade at 1000.50 level, the very act of ES printing 1000.25 level after that decision means the trade decision was successful. In the normal course of a regular trading session period, that order would fill one contract or ten contracts or fifty contracts without one tick slipped. Most of the time you could fill 100 or 200 ES contracts on the mark or within one tick of slippage. In this example the market is agnostic and unbiased towards anyone and the actions they take. The only bias and prejudice, the only variable in this example is us.

Scared Stiff To Lose

Here's a question that has a no-brainer predictable answer. Of these two hypothetical choices, would most traders rather make +$100 per day, every trading session... or +$4,000 per month for ten months out of twelve, remaining two months breakeven?

Yes, you guessed it: +$100 per session would be the choice of many if not most aspiring traders alive.

A calendar year has roughly 250 trading sessions available. Multiply +$100 per day to that and we get $25,000 per year as a result of the steady, consistent daily production. But wait: the other choice of +$4,000 per month times ten calendar months equals +$40,000 returned in the same year. How can this be a no-brainer choice? Are we dealing with some brain damage involved?

No, not at all. Just a matter of how the human brain is wired from birth and supported through life. Humans are animals and animals are wired to perform tasks for rewards. That's the only way animals can be trained and/or behavior controlled at all. Perform a task, get a reward. Sit, stay = tasty treat. Push the right button each time from a selection of three = tasty treat. Jump on people when they walk through the front door = swatted with a rolled newspaper. Each of those three actions (performed tasks) by any dog were met with three rewards. Two were positive, one was negative but they were all nothing more than biofeedback response. Guess which ones the animal wishes to repeat versus the one to shy away from?

We could expend a few thousand words here rehashing the pleasure - pain operating system that runs the animal brain. I'm assuming everyone here is aware of animal = human psychology, so let's get right to the core with trading at heart.

Trading is a profession, a job, a performance task, a contest, a game, a measuring stick, a source of entertainment all layered into one big roll. Each of us desire different degrees of each factor from trading. Some find it pure entertainment from the gaming aspect. Others find it a big contest to measure self-worth. A relatively few view trading as a job or profession above all, but they are actually a rather small minority of all aspiring traders. That last sentence is important for you: please read it several times over before continuing on.

Let's get back to the hypothetical question at hand. Why would someone, anyone choose earning $25,000 annual versus $40,000 annual? Is there something involved other than the money itself? Yes... the other stuff listed above. In order to make that $4,000 per month, the average weeks (with all days more than or less than +$100 individual) might go 

something like this:

Week 1: +$500
Week 2: +$1,500
Week 3: -$500
Week 4: +$2,500

That is generally how ten out of the twelve total months resulted. The remaining two months were breakeven, no net profit or loss either way. Do you see the major psychological problem there? It is staring us all right in the face.

Humans are taught to measure & compare everything. That's how we make just about every decision in life, nil exceptions. Which apple is reddest and ripest? That's the one to eat. Which loaf of bread appears freshest? That's the one to buy. Which jeans make me look most fit? Those are the ones to wear. Which job pays most? That's the offer to accept. Comparison shopping is how we get through our day. That's how we are all wired to survive. Make the right choices for desired rewards. Pretty much describes the survival process itself. Would you agree?

Back to trade results. Most traders would think they died & arrived at the CME pearly gates if they could average +$100 daily per each ES contract. That x 20 per month would be perfect. Every day the same tasks are performed with expected positive outcome rewarded. Exactly what the animal behavior wiring craves. Task performed for reward realized. Task performed for immediate gratification = feedback. Perfect.

Now we all know by now that trading absolutely does not work that way in real life. Real life involves imperfection. No trader on earth has ever or ever will earn +2pts per ES contract daily, every day. That should go without any need to state, but we'll say it anyway. But if it were possible, such would allow no need for comparison to anyone else, at all. With known input > outcome, task performed for reward realized is ironclad.

But what about the monthly sequence of +$500 > +$1,500 > -$500 > +$2,500 results? What is wrong with that? Simple & easy to explain. The first week of comparison to +2pts daily shows no advantage. The second week shows a great advantage.

The third week shows a seeming disadvantage. "Net loss? Are you freakin' kidding me? We performed our tasks for five full sessions... where is our reward? Darnit, we want our deserved reward! Those other people got theirs... every day. Right there it was, +2pts. See that? They won doing what they did."

The fourth week comes along and trades left to run for distance did exactly that. Knocked the proverbial ball out of the proverbial park. Worst of all, two random months sprinkled in there result in no gain or loss at all. One washes the other, but for eight long weeks the daily grind of tasks performed resulted in no reward realized. All that time spent running around the web from 4:16pm est onward peeking at "results" in every blog, every hindsight call & claim in public message boards, every crack & crevice on the web where two traders gather to compare whose was bigger that given day.

It feels good to measure up every day. Matter of fact, it feels so good to measure up every day that most traders will settle for less in the end just to enjoy the fuzzy feel-good emotional state through it all. Anyone focused on pure $ alone would find this long-term comparison a no-brainer themselves. But we already affirmed that traders with pure $ at the forefront of desire are a relative minority. The vast majority needs to enjoy constant positive feedback as the reward to their efforts = expenditure = risk. There cannot be one week of par results and another week of 3x worse results when compared. The key word here is compare. Traders who are in it for the thrill of game, the self-measure, the contest, the competition, the challenge have a core need to constantly compare.

They must be continually assured that all tasks performed are being met by positive reward. Otherwise, what if the reward stops? What if there is never another positive reward in the end, and all that effort of tasks performed is wasted? THAT my friend is the true fear which makes the choice of trader performance posed in the beginning as a no-brainer. A vast majority of traders would readily settle for less with $25,000 annual versus +$40,000, $250,000 annual versus +$400,000 annual, $2,500,000 versus +$4,000,000 annual earned due solely to the manner in which it came.

Task for reward. Relative comparison. Immediate feedback gratification. Do those core animal behaviors stand between you and what you aspire to achieve in trading? No single session ever makes a trader's career, but any lone session can end one. If you find yourself on the fightin' side of market trends, let yesterday be fair warning of what lies ahead in your career. It won't be pretty unless you learn to do otherwise.

You could say that retail traders survive by learning to play in traffic. We are constantly hitching rides north or south for brief distances in small cars on highways crowded with big rigs. Some of those other cars wreck all around us. Every now & then we see big rigs bearing straight down on us head-on. It's our job to learn where entering the highway, merging with traffic, maintaining our flow amidst vehicles of all sizes & speeds AND most importantly where to safely exit. All along the way, we must properly manage our natural fears.

Trade Your Plan

How is it that so many aspiring traders fail to trade their plan? Where does the fear come from that holds them back? How does fear manifest itself in so many ways, through so many manifestations to wreck the simple mechanical process of paper-trading sim to one contract live, two contracts live, ten contracts live? Fear of loss is the first step on a straight path to overall loss.

Being well-capitalized is one important part for creating success. How many of us have at some point in our career fantasized about having account balances too big to fail? No matter how many mistakes we might make, no matter how bad a day we might have, in the end there would always be plenty of money left for recovery. Well I hate to be the bearer of terrible news, but no such account balance exists in this life. Plenty of traders and ex-traders can tell painful stories of how big accounts became small in a hurry.

Unfortunately, losing is a natural part of winning in our chosen profession here. Try as one might, there is no possible way to eliminate loss. Nor does that even matter... once traders grasp the truth that managing wins is much more, way more important than managing losses. It is the size of our wins which ultimately keeps an account balance black instead of red.

Make More

Cut losses short, let winners run. To me that sounds a lot like keeping losses smaller than wins. Do you interpret that aged adage any other way? Can it be interpreted any other way. No, but aspiring traders try mightily to do so.

You cannot and absolutely will not create lasting, sustained success from a core foundation where average losses in relative $ size exceed average wins. You cannot sustain a win rate of +70%, +80% or +90% of your trades over a long period of time. It is a statistical impossibility that no one has ever accomplished, and no one ever will. Regardless of system, method or approach, evolving market conditions will eventually roll around to the most adverse degree possible for awhile. During that stretch of "awhile" your high win rate will be decimated. Just like the balance in your trading account.

If you try to risk -$2 to make +$1, you are lost in the desert and wandering towards a steep cliff. The bottom is a long ways down, and it's going to hurt badly (at best) if you survive the fall.

Trade Less

Over-trading kills. You already know this. Chances are you've already experienced this yourself. But the fear(greed) of loss = missing out on profits naturally overrides the logic & reason that tapes are moving, therefore opportunity for profit exists. You cannot win if you don't play. Right? That's certainly true... and it is likewise the cornerstone mantra of Vegas and Atlantic City for good reason. Think about it.

The desire to over-trade stems from fear/greed which is essentially the same emotion expressed in various ways. It is masked by excuses such as "scalping" or "high frequency" trading. You'll often hear a new or beginning trader say they want to learn that approach because it fits their personality.

So what exactly does that say about their personality? It says they are seeking the thrill and excitement of pure action. This type of person has not asked which approach is easiest to succeed with, what the most profitable approach is or any other pre-qualifier. They are saying that the idea of pushing lots of buttons & keys in frenetic fashion while numbers roll around is the primary payoff they seek. If you try to learn the frenetic scalper game without first mastering all other aspects of trading, you are wandering lost in the desert. Without water for three days under a hot blazing sun. You will (fiscally) die without question, and you die real soon.

Make Friends

The trend is your friend. Trading is like swimming. You can swim with the current or against it. In a survival situation, you can swim with the current forever. Outside factors such as water temps, need for food and sleep are another matter, but as for pure swimming ability you could swim with a slow or strong current forever.

Not so with swimming against the current. You will eventually tire and drown. That is an absolute certainty. Unless you find intricate ways to reserve kinetic energy and escape the current's ravage for periods of respite, you will die. The same concept is true for trading with market direction versus against it. If I only had $100 for every person I heard say, "I'm a contrarian... I don't follow the herd" through the past ten years, I'd have $10,000s of free money right now. Any idea where all those market contrarians are today? Other professions than trading.

Here's a news-slap of reality for trend fighters: the herd is always right at beginning of trend moves. The "herd" itself is contrarian. The "herd" or masses do not follow a trend... they collectively fight it. That's the fundamental why the primary wave of a directional move following first pullback from breakout of congestion is so powerful. Ever wonder why? It is the collective herd of contrarians tossing in towels from failing their fight against prior direction. Their collective stop-out and re-enter reverse is the jet fuel behind that wave.

So for a little while the herd is right. Until the collective contrarian herd thinks = feels that move has reached its end. Then they begin fighting the trend and subsequent waves of price undulation are created. Downtrends end when there are no more sellers. But those sellers aren't all sell-to-open interest. Most of the selling exhaustion to mark a market bottom comes from stubborn contra-trend longs getting slammed out on sell stops. Once a majority of contrarian buyers in a downtrend finally puke and stand aside (busted, disgusted and not to be trusted) the market is free to reverse and turn upwards.

That is the perverse part of market behavior. Those contrarian longs were correct: price would eventually turn as expected. But the collective herd of trend fighters missed picking a bottom and instead have to pick up the pieces of their remaining depleted accounts. It's perfectly OK to swim cross-current at times. But trying to swim upstream in contra-trend fighting fashion will leave you soaking wet, cold, hungry and exhausted. There is only one outcome to that failed effort, and it always ends the same.

Austin Passamonte is a full-time professional trader who specializes in E-mini stock index futures and commodity markets. Mr. Passamonte's trading approach uses proprietary chart patterns found on an intraday basis. Austin trades privately in the Finger Lakes region of New York.

LINK

Hedge Fund Wizards

"WASHINGTON POST

Scarcely a day goes by without another story of some large hedge fund blowing up due to bad bets. While many of the latest hedge fund casualties are linked to the subprime mortgage crisis, investors should not be lulled into thinking that the problem will be solved once the mortgage mess is mopped up.

Hedge funds are risky for another reason. It is extremely difficult to tell, based on past performance, whether a fund is being run by true financial wizards, by no-talent managers who happen to get lucky or by outright scam artists.

To illustrate how easy it is to set up a hedge fund scam, consider the following example. An enterprising man named Oz sets up a new fund with the stated aim of earning 10 percent in excess of some benchmark rate of return, say 4 percent. The fund will run for five years, and investors can cash out at the end of each year if they wish. The fee is the standard '2 and 20': 2 percent annually for funds under management, and a 20 percent incentive fee for returns that exceed the benchmark.

Although he has no investment track record, Oz has a smooth manner, a doctorate in physics and many rich acquaintances. He raises $100 million and opens shop. He then studies the derivatives market and finds an event on which the market places fairly long odds, say 9:1. In other words, it costs $.10 to buy an option that pays $1 if the event occurs and $0 otherwise. The nature of the event is unimportant: it might be a large fall in the stock market, Florida getting hit by a Category 5 hurricane or Russian President Vladimir Putin dying before the end of the year.

Next Oz writes some covered options on this event and sells 110 million of them in the derivatives market. This obligates him to pay the option holders $110 million if the event does occur and nothing if it does not. He collects $11 million on the options. To cover his obligations in case the 'bad' event occurs, he uses the investors' money plus the proceeds from the options to buy $110 million in one-year Treasury bills yielding 4 percent, which he deposits in escrow. This leaves $1 million in "pocket money," which he uses to lease some computer terminals and hire a few geeks to sit in front of them, just in case his investors drop by.

The probability is ninety percent that the bad event does not occur and Oz owes nothing to the option holders. With a gross return (before expenses) of $15,400,000, the investors are thrilled, and so is Oz. He collects $2 million in management fees (of which he has only spent $1 million), plus a performance bonus equal to 20 percent of the 'excess return', namely, 20 percent of $11,400,000. All in all, Oz nets over $3 million for doing absolutely nothing.

Oz can then repeat the same gambit next year. When the fund terminates after five years, the chances are nearly 60 percent that the unlucky event will never have occurred. Oz looks like a genius and gets paid like a genius.

While most hedge funds probably don't operate in such a nakedly self-serving way, the underlying logic of Oz's strategy is quite common: take a position that yields high returns with high probability and extremely poor returns with low probability, and keep your fingers crossed. Credit default swaps are one example, so are bets on interest rate spreads. Such strategies are risky but not fraudulent; the manager can always argue that his opinion about the odds differed from the market odds (he was simply engaging in arbitrage).

Eliminating such scams through regulation is not going to be easy due to the unusual nature of the product. Yet, some steps toward protecting investors can -- and should -- be taken.

All hedge funds should be required to register as soon as they are established and to report their returns on a regular basis. Such tracking would allow potential investors to study the records. New rules could also require managers to keep investors apprised of the fund's downside exposure. Alternatively managers could guarantee that losses not exceed a certain level, similar to a car manufacturer offering a warranty.

Although individual hedge fund managers may drag their feet, it is actually in the industry's best interest to encourage greater regulation and transparency. Otherwise, a rising tide of failed funds could cause a collapse in investor confidence, putting both the good and the bad wizards out of business."

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How Western Diets Are Making The World Sick

"In an essay published last November in Canada's Maisonneuve journal, physician Kevin Patterson described his experiences working as an internist-intensivist at the Canadian Combat Surgical Hospital in Kandahar, Afghanistan.

One detail he noticed: The Afghan soldiers, police and civilians he treated in Kandahar had radically different bodies from those of the Canadians he took care of back home.

"Typical Afghan civilians and soldiers would have been 140 pounds or so as adults. And when we operated on them, what we were aware of was the absence of any fat or any adipose tissue underneath the skin," Patterson says. "Of course, when we operated on Canadians or Americans or Europeans, what was normal was to have most of the organs encased in fat. It had a visceral potency to it when you could see it directly there."

In a conversation on Fresh Air, Patterson tells Terry Gross that the effects of urbanization are making people everywhere in the world both fatter and sicker.

"Type 2 diabetes historically didn't exist, only 70 or 80 years ago," says Patterson. "And what's driven it, of course, is this rise in obesity, especially the accumulation of abdominal fat. That fat induces changes in our receptors that cells have for insulin. Basically, it makes them numb to the effect of insulin."

For a long time, the human body can compensate — the pancreas secretes even larger amounts of insulin, which regulates blood sugar levels. But over time, the pancreas begins to fail to secrete enough insulin, and that is when diabetes develops.

He explains that the increase in abdominal fat has driven the epidemic of diabetes over the last 40 years in the developed world — and that he's now seeing similar patterns in undeveloped regions that have adapted Western eating patterns.

Patterson explains that in his Canadian practice, where he takes care of indigenous populations near the Arctic Circle, there is a marked increase in the number of diabetic patients he sees.

"The traditional Inuit culture of relentless motion and a traditional diet consisting mainly of caribou, Arctic char, whale and seal has been abandoned over this period of time for Kentucky Fried Chicken and processed food and living a life very similar to ours," he says. "[They're] spending a lot of time in front of a glowing screen."

Part of the problem, says Patterson, is that it's so much cheaper for processed food to be flown into the Arctic Circle than fresh food.

"There's no roads or rail access to any of those communities," he says. "So a 4 liter jug of milk can cost you $10 or $11. But there's a very clear parallel between that and the inner city. In poorer neighborhoods in North American cities, fresh food is either not available or extremely expensive compared to — on a calorie-by-calorie basis — compared to fast food available on every street corner."

And the diabetes epidemic correlates to a strain on health care systems around the globe, says Patterson.

"No country in the world has the resources to continue to treat diabetics the way that they're being treated now, if the prevalence rates increase at the rates that they're increasing for much longer," he says. "I worked in Saipan, which is in the Marianas Island in the Pacific, and there, the dialysis population was increasing at about 18 percent a year, all as a consequence of diabetes and acculturation — exactly the same process as what's going on with the Inuit.

"When you look at the curves, it's clear how unsustainable it is. In 20 or 30 years, everybody on that island will either be a dialysis patient or a dialysis nurse unless something fundamental is done about the rise in diabetes. That's no less true in Canada and in Samoa and Hawaii, and even in Omaha and Toronto. We all have exactly the same problem when we plot out those curves."

Patterson fictionalized his experiences working with the Inuit in Canada in his novel, Consumption, about an Inuit woman who spends her teen years in a sanitarium. His other books include Outside the Wire: The War in Afghanistan in the Words of its Participants and the short story collectionCountry of Cold, which won the Rogers Writers' Trust Fiction Prize in 2003."

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