Exercise: Is Less More?

OK. I finished my five-mile run early this am. I generally do this five days a week. And it takes me about an hour each day from start to finish. Am I exercising too much for my own good?

Maybe.

I’ve been doing this now for more than 30 years. And like most nonprofessional runners, I started one day long ago by huffing and puffing trying to make my way around the block. Then a year or so later I found myself crossing the finish line at the Columbus Marathon.

The theory was always to push as much as possible. Add miles and time spent on the concrete or treadmill progressively. And I have the log books to prove it.

But an article in the NYT — “Phys Ed: Moderation as the Exercise Sweet Spot” — advances the idea that when it comes to the health benefits you get from exercise, moderation is key. And less might just be more.

For people who exercise but fret that they really should be working out more, new studies may be soothing. The amount of exercise needed to improve health and longevity, this new science shows, is modest, and more is not necessarily better.

That is the message of the newest and perhaps most compelling of the studies, which was presented on Saturday at the annual meeting of the American College of Sports Medicine in San Francisco. For it, researchers at the University of South Carolina Arnold School of Public Health and other institutions combed through the health records of 52,656 American adults who’d undergone physicals between 1971 and 2002 as part of the Aerobics Center Longitudinal Study at the Cooper Institute in Dallas. Each participant completed physical testing and activity questionnaires and returned for at least one follow-up visit.

The researchers found that about 27 percent of the participants reported regularly running, although in wildly varying amounts and paces.

The scientists then checked death reports.

Over the course of the study, 2,984 of the participants died. But the incidence was much lower among the group that ran. Those participants had, on average, a 19 percent lower risk of dying from any cause than non-runners.

Notably, in closely parsing the participants’ self-reported activities, the researchers found that running in moderation provided the most benefits. Those who ran 1 to 20 miles per week at an average pace of about 10 or 11 minutes per mile — in other words, jogging — reduced their risk of dying during the study more effectively than those who didn’t run, those (admittedly few) who ran more than 20 miles a week, and those who typically ran at a pace swifter than seven miles an hour.

“These data certainly support the idea that more running is not needed to produce extra health and mortality benefits,” said Dr. Carl J. Lavie, medical director of cardiac rehabilitation and prevention at the Ochsner Medical Center in New Orleans and an author of the study. “If anything,” he continued, “it appears that less running is associated with the best protection from mortality risk. More is not better, and actually, more could be worse.”

Oh, mama. Something else to fret about.

Regardless, any amount of walking, running, swimming, biking and so on seems to me to go in the plus column.

And if more people exercised even moderately instead of regularly downing a keg of Coke and a trailer full of popcorn at the movies, we might all be better off.

Will Eating Chocolate Make You Thin?

Well, as with most things in life, it looks like I have this exercise and diet thing all wrong. I’m up nearly every day grinding out the miles on the treadmill or concrete. And I’m fairly regimented about what I stuff in my mouth — not withstanding the daily routine of downing Jameson during happy hour.

Better that I should just eat chocolate. And hey. I’d be OK with that. The view from the treadmill hasn’t changed all that much in 30 years, even as my waistline keeps expanding.

Here’s from USA Today, “Chocolate lovers are thinner, study says“:

Sweet news about those chocolate cravings: People who eat moderate amounts regularly are thinner than those who eat chocolate less often.

The new research involved 1,018 healthy men and women, who exercised on average 3.6 times a week and had a balanced, nutritious diet. The body mass index of those who ate chocolate five times a week was 1 point lower than people who did not eat it regularly. Body mass index (BMI) is a measure of body fat based on height and weight.

“I was pretty happy with this news myself,” says lead author Beatrice Golomb, associate professor of medicine at the University of California-San Diego. “Findings show the composition of calories, not just the number of them, matters for determining ultimate weight.”

And from the NYT, “The Chocolate Diet“:

Chocolate may not be as hazardous to your waistline as you think — at least in moderation.

A new study shows that people who eat chocolate frequently have lower body mass indexes than those who eat it less often. The researchers could not explain precisely why something usually loaded with sugar, fat and calories would have a beneficial effect on weight. But they suspect that antioxidants and other compounds in chocolate may deliver a metabolic boost that can offset its caloric downside.

Chocoholics may know that in recent years chocolate has been linked to a growing list of health benefits. Studies have found, for example, that regularly eating chocolate may lower blood pressure and cardiovascular risk, and improve cholesterol and insulin regulation.

Although the new study is among the first to look at chocolate’s effect on weight, the findings “are compatible with other evidence showing favorable metabolic effects that are known to track with body mass index,” said Dr. Beatrice A. Golomb, lead author of the study and an associate professor of medicine at the University of California, San Diego.

Dr. Golomb’s study, published in Archives of Internal Medicine and financed by the National Institutes of Health, involved roughly 1,000 adults. The researchers looked at data on how often they exercised, the amount and type of calories they ate — including a breakdown of the types of dietary fat they consumed — and how their health and weight related to their chocolate intake. On average, the subjects were middle-aged, exercised about three times a week and ate chocolate about twice a week. There was no breakdown of the kinds of chocolate they ate, whether dark, milk or white.

The people who ate chocolate the most frequently, despite eating more calories and exercising no differently from those who ate the least chocolate, tended to have lower B.M.I.’s. There was a difference of roughly five to seven pounds between subjects who ate five servings of chocolate a week and those who ate none, Dr. Golomb said.

Sweet.

I guess it won’t be too long before someone is opining that eating popcorn may be better for you than many fruits and vegetables.

That will give me something to think about while chasing the treadmill belt tomorrow early a.m.

 

 

Holiday Eating: Fighting the Battle of the Bulge

Good grief. Will this long national nightmare currently being played out in Iowa ever be over? I spent 60 minutes chasing the treadmill belt this early a.m. and what I found out from the Talking Heads on CNN and Fox News was that Newt was down, Paul was up, and Santorum is climbing fast. And Romney, who most conservatives don’t like, will most likely win the GOP presidential nomination anyway.

As Michael Barone opines in the WSJ, “As Iowa Goes, So Goes Iowa.”

Anyway, I’ve got bigger fish to fry. As we near the end of the year, my running log shows that I’ve hit the concrete or treadmill belt for about 1,400 miles. Still, I’m gaining weight — which I attribute in part to a mutant thyroid and a fondness for Jameson over ice. And like many others, this time of the year is particularly challenging.

I’m a big believer in exercise. But I’m not so sure exercise along wins the battle of the bulge. Here’s from the NYT, “Curbing Holiday Weight Gain With Exercise“:

The next few months, filled with holiday feasting, represent a dire threat to most people’s waistlines. Even those of us who normally eat a wholesome diet can find ourselves gorging on fatty, high-calorie foods and gaining the annual Christmas inner tube. But several new studies promote a simple and effective response: Run or walk from the buffet. Even if you’ve already overindulged, the studies suggest, exercise can lessen or reverse the unwelcome consequences.

For the studies, Paul T. Williams, a staff scientist in the life sciences division at Lawrence Berkeley National Laboratory, enlisted the help of more than 100,000 runners and, for a second study published last week in the journal Obesity, almost 40,000 walkers. He had each group fill out extensive questionnaires that asked about their running or walking history, including when they’d begun running more than 12 miles a week or walking at least half a mile most days of the week, as well as, for the runners, their current mileage, best race times, numbers of recent marathons, and so on. The questionnaire also asked about current and previous body weight: how much they had weighed when they started exercising, what they weighed now, their waist size and height. Finally, the volunteers were asked about eating habits, and specifically, how much red meat (beef, pork and lamb) they consumed each week and how many servings of fruit they ate each day.

“We used servings of meat and fruit as markers of the overall quality or type of the diet,” Dr. Williams says. People who frequently eat meat and rarely have fruit are more likely, over all, to be eating a fattier, higher-calorie and potentially less healthy diet, he says.

Certainly, in his new research, they weighed more. Among both the runners and walkers he studied, whether male or female and whatever their age, those who ate more meat and fewer servings of fruit tended to have a higher body mass index, an indicator of overall body fat, than those who ate less meat and more fruit. They had also gained significantly more weight over the years.

Unless they exercised diligently. The more someone walked or, even more strikingly, the more they ran, the less likely they were to have gained large amounts of weight, even if they ate what the study politely calls a “high-risk diet.” Runners who ticked off about five miles a day stayed relatively lean over the years, even if they regularly consumed a meaty and presumably high-fat diet. Most still had gained some pounds, according to their running and weight histories, but less than would have been expected, given their eating habits.

“Usually, B.M.I. and waist circumference increase if you eat more meat and less fruit,” Dr. Williams says. But his data indicate that exercise reduces this effect. The more miles run, the less a person is likely to be affected by questionable dietary choices or by what Dr. Williams calls “lapses, like those that happen during the holidays.”

These are hardly the first studies, of course, to suggest that exercise can help to control weight or reduce the depredations of an imperfect diet. A 15-year study of more than 30,000 middle-aged women by Harvard researchers found that while virtually all of the women gained weight over the years, those who walked about an hour a day gained the least, averaging less than five added pounds over the 15 years. The study did not examine eating patterns, though.

An interesting animal study published this year looked directly at the effects of exercise on rats eating a high-fat diet, however. The rats were given free access to fatty foods for 12 weeks, by which time they all had become rotund and developed metabolic syndrome, a constellation of unhealthy conditions that includes insulin resistance, poor cholesterol levels and high blood pressure. Then the researchers divided the animals into several groups, with some remaining on the high-fat diet but running every day, while others were switched to a standard kibble, and still others changed nothing. This new program also lasted 12 weeks.

By the end of that time, the rats that ran had managed to “reverse almost all the atherosclerotic risk factors linked to obesity,” the researchers found, even though they remained on the high-fat diet. They also had stopped gaining weight. The rats that had been switched to a standard diet but didn’t run improved their metabolic profiles, too, but not as much as the running rats. The researchers speculate that exercise activates certain metabolic pathways that undo the damage of a high-fat diet, even if that diet continues.

Dr. Williams suspects that similar mechanisms are at work in human exercisers, and that the effects are commensurately greater the more a person exercises. “It’s well established that endurance training enhances the body’s ability to burn fat” from foods, he says, so serious runners can incinerate the fat marbling a serving of beef before it is stored as flab around the waist. Which means that, if you work out dutifully, you should “get through the holidays without too many regrets,” he says.

Oh, well. I guess it could be worse. I could be chasing after voters in Iowa, munching on corn dogs and fried chicken.

Wonder how Ron Paul stays so thin doing that month after month?

 

 

Running, Exercise and Health Care Reform

Well, today is off to a great start. I managed to get outside and hit the concrete at 5 a.m. for my five-mile running tour of the neighborhood. And that’s the first time for me running outside since late January. I’ll admit it. I miss the quiet, the ability to mull things over in my little brain, and the endorphin rush that builds on heart-pounding activity and fresh air.

Saying that, I recognize that I’ve reached the age where I have to make some changes to a routine that has been pretty compulsive set for 30 years. I worry now about slipping and falling — even in good weather. It’s increasingly difficult to get all the body parts working in frigid conditions. And I have a chronic foot injury that ain’t going away. So the reality is that I’m going to be spending more time indoors, chasing the belt on the treadmill and grinding away on the elliptical.

Does that really matter?

Well, in two words: yes and no.

Gina Kolata addressed this issue in her NYT Personal Best column, “Winter Training: Faster and Safer Indoors?“:

The sad answer, exercise researchers say, is that you really cannot get the same training effect with indoor substitutes. That’s not to say that indoor training is useless, but rather that it has real limitations, with differences that sometimes are subtle, but significant.

“I think most athletes know that,” said Peter R. Cavanagh, an exercise researcher at the University of Washington in Seattle. “That’s why they are out there in all seasons.”

The most obvious difference with indoor exercise is a lack of wind resistance, Dr. Cavanagh said.

So for those training for a marathon, you might find the transition from the flat surface of the treadmill to Heartbreak Hill a little difficult.

Still, there comes a point where even the elite athletes have to consider an alternative to being outdoors in potentially dangerous weather. From Kolata’s article:

Other athletes say that there comes a point when an indoor alternative is better than a workout in cold, icy weather. That’s what drove Brian Sell to buy a treadmill.

Mr. Sell, an elite marathoner who ran in the 2008 Beijing Olympics, trains in Rochester, Mich. He bought a treadmill four years ago, after he had fallen a few times on icy roads, injuring himself so badly he could not train at all while he healed.

“I probably fall at least once a year here in Michigan,” he said. “My injuries ranged from a bruised hip to a pulled groin. That time it took three weeks to get back. I said, ‘If I was doing this on the treadmill, I wouldn’t have missed three weeks of training.’ ”

Mr. Sell continued, “If it’s really icy out or if it’s negative 10 degrees and you are doing an easy six-miler, it probably makes a lot more sense to do it on a treadmill than to risk hurting anything.”

Mr. Sell — all I can say is woot. I’ve been fretting over this for a month and you’ve made me feel like less of a wimp. Oops. I digress.

Anyway, I read that NYT article about indoor training  last week and thought about it this morning as I pushed off on the concrete. For most of us, in the long run, does it really matter how we exercise? Nope. The key is to just keep moving — and as I get older, I’m convinced that is more and more important. Do something. Do it consistently. And hey, so something that you enjoy — for as long as you can.

And as evidence, consider this article in the NYT by Jane Brody, “Even More Reasons to Get a Move on“:

In a commentary on the new studies, published Jan. 25 in The Archives of Internal Medicine, two geriatricians, Dr. Marco Pahor of the University of Florida and Dr. Jeff Williamson of Winston-Salem, N.C., pointed to “the power of higher levels of physical activity to aid in the prevention of late-life disability owing to either cognitive impairment or physical impairment, separately or together.”

“Physical inactivity,” they wrote, “is one of the strongest predictors of unsuccessful aging for older adults and is perhaps the root cause of many unnecessary and premature admissions to long-term care.”

They noted that it had long been “well established that higher quantities of physical activity have beneficial effects on numerous age-related conditions such as osteoarthritis, falls and hip fracture, cardiovascular disease, respiratory diseases, cancer, diabetes mellitus, osteoporosis, low fitness and obesity, and decreased functional capacity.”

Prez O and members of Congress appear to be nearing the finish line on some form of health care reform. And I’ll admit that I would be hard pressed to opine with any certainty on what the latest proposal(s) contain — despite the millions of words that have been written and spoken on the subject.

So I wonder if the reform measures take into account the benefits of exercise — and what effect keeping people out of the health care system could have on costs, access, treatment and so on.

If they don’t, we’re missing an opportunity. Exercise, whether indoor or out, matters to all of us.

Fighting the Winter Blahs

Gee. This new year has been tough. I’ve been chasing the treadmill since the aughts faded away. And I generally don’t mind the cold — although this morning’s minus-16 wind chill in NE Ohio is more of a hurdle than I care to jump over to get outside at 5 a.m. Still, what’s keeping me inside and off the concrete is the snow and ice on the roads. I’m leery of slipping and falling these days.

Hey. Falls, according to the National Safety Council, are the second leading cause of accidental death for people 45 to 75. Give me a break. Sheesh.

Saying all that, I’m a big believer in the power of exercise to beat the winter blahs. C’mon. Admit it. The weeks (months?) immediately following the end-of-the-year holidays are the gloomiest of the year, particularly for those of us living in a part of the country where the sun no longer shines. In fact, Sol is on vacation until April.

And while we view the new year as providing a fresh beginning, most would agree with a former colleague of mine at Goodrich who opined when asked how he was doing: “New day, same shit.” He was a medical doctor. Go figure.

Anyway, exercise beats the blahs. And here’s an interesting article I saw this morning in USA Today while fretting about how cold it was that offers tips for getting up, getting out and getting moving into the New Year: “Winter workouts can boost your mood, but stay safe.”

And the key is just to get started: walking, skiing, running, whatever.

Hey. Just like writing the first blog post of the year.

OK. Off and running in 2010.

Anxious: Why Exercise Helps

I circled my little world on the elliptical trainer this morning. Admittedly, I don’t get much of an endorphin rush from moving my legs up and down and around and around for an hour or so. But hey. It’s exercise. And now I’m cool, calm and relaxed.

At least I should be.

The NYT in a “Well” blog post earlier this week had an interesting perspective about the link between exercise and anxiety, “Phys Ed: Why Exercise Makes You Less Anxious.” Here’s from the post by Gretchen Reynolds:

Other researchers have looked at how exercise alters the activity of dopamine, another neurotransmitter in the brain, while still others have concentrated on the antioxidant powers of moderate exercise. Anxiety in rodents and people has been linked with excessive oxidative stress, which can lead to cell death, including in the brain. Moderate exercise, though, appears to dampen the effects of oxidative stress. In an experiment led by researchers at the University of Houston and reported at the Society for Neuroscience meeting, rats whose oxidative-stress levels had been artificially increased with injections of certain chemicals were extremely anxious when faced with unfamiliar terrain during laboratory testing. But rats that had exercised, even if they had received the oxidizing chemical, were relatively nonchalant under stress. When placed in the unfamiliar space, they didn’t run for dark corners and hide, like the unexercised rats. They insouciantly explored.

Ah, can’t argue with that. Whatever it says. I’m a big believer in the benefits of exercise: mental and physical. And if it makes us less anxious — so much the better.

But unlike laboratory rats, people exercising in health clubs (remember when we used the descriptor gym?) watch the giant TVs plastered on the walls. And doesn’t the news these days lend itself to increasing anxiety — possibly diminishing the benefits of exercise? Wonder if there is any chance I could get a federal jobs creation stimulus research grant to investigate this issue? I digress.

Anyway, I don’t know about you, but these stories that keep rotating on the TV screens this a.m. raised my level of angst.

• The debacle over the new guidelines for breast cancer screening do nothing but cause confusion — and anxiety — for women, their husbands/significant others and their families. This is a serious — in many cases life-or-death — matter. It also puts the spotlight on an issue that concerns many as we continue to debate health-care reform: the rationing of medical services and tests. Ah, death panels, anyone?
• Does the Obama administration really know how many jobs have been “saved or created” with the billions of taxpayer bucks contained in the second stimulus package? Nah. Here’s a WSJ online article “Stimulus-Jobs Tally in Doubt.” OK. We needed to do something to take the economy off life-support — but the results in terms of jobs have been meager at best. Just sayin’. And my level of anxiety starts to increase when I hear there is going to be a White House jobs summit Dec. 3 with possibly talk of a third stimulus package. Sigh.
• And I’m not much for conspiracy theories. But what’s up with this? The House rams through its version of health-care reform late on a Saturday night a few weeks ago. Now the Senate is planning the same approach for this Saturday. Everyone knows that I’ll be asleep and not able to follow in real time who voted on what, or if at all. Should I/we be concerned about this Saturday night voting-in-essentially-secret strategy?

Oh well. We’re heading to the weekend and I’m old enough to remember when the OSU vs. Michigan game mattered. Guess I don’t have to worry about that any more.

 

Who Else Wants to Tax Fat People?

Wow. Talk about being cranky this morning. Here’s the story. I managed to run 10 miles over the weekend. Did five on the concrete Saturday and another five on the towpath trail near where I live Sunday. This morning my foot hurt so bad — chronic nerve inflammation — that I could barely stumble out of the house and make it to the health club for an engaging 50 minutes of gliding on the elliptical trainer. Oh, mama.

Yet I learned something. Prez O and gang appear to be giving up on the so-called public option that once was a centerpiece of the health care reform package. That proposal had and has strong supporters inside the Beltway. But it’s not playing so well out in the real world. And I’m not sure why. We already have a large public option provider. It’s called Medicare (and Medicaid as well). And I’m sure it can be improved. But my sense is that for most seniors (myself included in a little more than three years) it works well.

So there are a couple problems facing the administration and the Dems in Congress in the current debate about health care. First, they have lost control of the message. Here’s what the opponents are saying. One, the plan takes away choice and will lead to government control of health care. Two, it’s expensive — and the winners in all this will be the lobbyists and special-interest groups. Three, do you really want Grandma hauled before a “death panel” that may place some limits on the time left in the golden years? Sheesh.

Those are the points that I hear over and over again. And they are sticking. Factual or not.

On the other hand, any idea what the administration and Congress are actually proposing? That’s the more difficult position — talking about what it is versus what it ain’t. And it’s a lesson for all of us in the communications business. It’s tough to gain understanding and acceptance for complex issues. And in an environment of uncertainty, people will resist change. For those of you with a background in employee communications, think about how hard it is to explain health care plans and coverage. And remember years ago when we first started to talk about deductibles and co-payments?

So here’s my plan for the Prez and his supporters. Change the argument. Get away from telling people that you plan isn’t about sending Grandma before a death panel. And tell them that a big part of the solution — from reducing the need for medical services to costs for health care — relates to preventing illness in the first place.

And as a start: tax fat people.

Crazy? Unfair? Well, I thought so too — until I read this article in The New York Times, “Should Fat People Pay More for Health Care?” The article, in part, focuses on the views of Delos M. Cosgrove, CEO at the Cleveland Clinic. Here’s part of the story:

You can disagree with the doctor — you can even be offended — and still come to see that there is a larger point behind his tough-love approach. The debate over health care reform has so far revolved around how insurers, drug companies, doctors, nurses and government technocrats might be persuaded to change their behavior. And for the sake of the economy and the federal budget, they do need to change their behavior. But there has been far less discussion about how the rest of us might also change our behavior. It’s as if we have little responsibility for our own health. We instead outsource it to something called the health care system.

The promise of that system is undeniably alluring: whatever your ailment, a pill or a procedure will fix it. Yet the promise hasn’t been kept. For all the miracles that modern medicine really does perform, it is not the primary determinant of most people’s health. J. Michael McGinnis, a senior scholar at the Institute of Medicine, has estimated that only 10 percent of early deaths are the result of substandard medical care. About 20 percent stem from social and physical environments, and 30 percent from genetics. The biggest contributor, at 40 percent, is behavior.

Today, the great American public-health problem is indeed obesity. The statistics have become rote, but consider that people in their 50s are about 20 pounds heavier on average than 50-somethings were in the late 1970s. As a convenient point of reference, a typical car tire weighs 20 pounds.

I’m sure that “taxing fat people” is an idea that won’t fly for a host of reasons. But I do believe there should be some serious discussion about health and preventing illness — and about obesity in this country which is a major health and economic issue.

As someone who is both old and overweight, I would much rather go before a “fat board” than a “death panel.”

And the notion of a fat tax has already generated some advertising. According to USA Today, the American Beverage Association has uncorked a $2 million campaign to oppose a tax on sugar-sweetened drinks. That trial balloon has been floated in Congress and elsewhere. But it’s not part of any specific proposed legislation — as yet.

Stay thirsty, my friends.

The Secret of Exercise and Weight Loss

For the thousands hundreds one or two of you who read this blog regularly, you know I am a big believer in the benefits of exercise. And it has been tough going for me since early spring when I first hurt my foot and later my leg — injuries basically bad and lingering enough to take me off the daily running schedule for the first time in 30 years.

So I was interested in a story by John Cloud in Time, “Why Exercise Won’t Make You Thin.” I first saw references to this article yesterday on Twitter. And some of the tweets were predictable: Glad I never considered exercising and so on. (Gross generalization there on my part.)

Actually, the article makes some valid points and packs a considerable amount of information into an important discussion overall about exercise, weight, obesity and health.

If interested, take a few minutes to read the article. Saying that, here’s the quick take: Cloud makes the case, backed by considerable research and peer-reviewed studies, that exercise may actually cause you to eat more and therefore not be of much (any?) value in losing weight. But generally speaking, exercise makes you healthier.

I’ll admit that when I first saw the tweets, I was ready to dismiss the article — particularly given the growing national epidemic relating to obesity among adults and children in this country. But Cloud makes a strong case — and I agree with him based on my own experience over the last three decades of exercising regularly. Here’s why.

When I first started running 30 some years ago, I lost 25 pounds or so in the first few months. Then my body adapted to the exercise and it has been a constant battle of the waistline ever since. Now, I can exercise all I want (and at this moment that isn’t all that much) and still gain weight — unless I am absolutely ruthless in watching what I eat and eliminating virtually all sugar. That’s more difficult than hitting the concrete almost every day at 5 a.m. Trust me. (And I’m still convinced that my ill-treated low thyroid disease contributes to this problem with weight gain. But I am through mentioning that to my doctor for fear that she will send me to explain myself before one of the death panels apparently now being organized. I digress.)

Still, exercise has its benefits. I’m convinced it makes you healthier over the long run. (Sorry about that. Had to say it.) And for me, the daily run has provided as much mental relaxation and stress relief as anything. I miss that now. The chatter at the health club and the ability of the TV talking heads to prattle on and on and so on presents the polar opposite experience of being out on the road or trail by yourself or with a friend or two.

So the secret of exercise and weight loss comes down to this. As Cloud writes, exercise might not make you thin. But you’ll still be a lot better off by adding some form of exercise to your daily life than not.

And talking about exercise — as a follow-up to yesterday’s post, the U.S. soccer team manged to lose again to Mexico in the World Cup qualifier, 2-1. Tough for players not used to the altitude to compete in a venue with an elevation of more than 7,000 feet.