Cycling Over Sixty
The Cycling Over Sixty Podcast is meant to provide information and inspiration for anyone wanting to get and stay fit later in life. Host Tom Butler uses his own journey toward fitness as an example of what is possible by committing to healthy lifestyle practices. After decades of inactivity and poor health choices, Tom took on a major cycling challenge at age 60. After successfully completing that challenge and seeing the impact on his health, he determined to never go back to his old way of living. Each week, Tom shares a brief update on the triumphs and challenges of his journey to live a healthy life.
Episodes feature guests who share on a variety of fitness related topics. Topics are sometimes chosen because they relate to Tom's journey and other times come from comments by the growing Cycling Over Sixty community. Because cycling is at the heart of Tom's fitness journey, he is frequently joined by guests talking about a wide variety of cycling related subjects.
Now in the third season, the podcast is focusing a three areas. First is the area of longevity. Guests this season will be asked to give their expert opinion on what it takes to have a long and healthy life. A second area of focus is how to expand the Cycling Over Sixty community so that members have more success and able to connect with other people who want to cycle later in life. And the final focus is on how Tom can expand his cycling horizons and have even bigger adventures that entice him to continue his journey.
If you're seeking motivation, expert insights, and a heartwarming story of perseverance, Cycling Over Sixty is for you. Listen in to this fitness expedition as we pedal towards better health and a stronger, fitter future!
Cycling Over Sixty
Data Science and Your Health
In this episode of Cycling Over Sixty, host Tom Butler is already looking ahead to next year's cycling season while sharing his latest racing adventure. With the Tour de Cure Pacific Northwest still six months away in May, Tom explains why he's already planning for this spring event that he hopes will become an annual launch into the summer cycling season for Cycling Over Sixty.
Tom also recounts his first cyclocross race experience – a competition that took unexpected turns but left him eager for more racing adventures. His participation may have been different from what he envisioned, but he came away from the event looking forward to tackling more cyclocross events.
This week's guest is Rob MacLeod, PhD, an accomplished cyclist and cycling advocate from Utah. Dr. MacLeod, a professor at the University of Utah, brings a unique perspective to the show. While his work in improving local bike infrastructure could fill an entire episode, Tom dives into Dr. MacLeod's expertise in data science and health analytics. The conversation explores how modern technology allows us to gather and analyze valuable health data, providing deeper insights into fitness and performance. With a lifetime of experience at the forefront of technological advancement, Dr. MacLeod shares his perspective on how data science is revolutionizing the way people can understand their health status.
Whether you're interested in planning your next season, trying cyclocross racing, or leveraging technology to enhance your cycling experience, this episode offers inspiration and insights for cyclists looking to make the most of their time on two wheels.
LINKS
Cycling Over Sixty Tour de Cure: tour.diabetes.org/teams/CO60
Road Scholar Age Well: roadscholar.org/collections/agewell/
Rob MacLeod's Cycling Page: sci.utah.edu/~macleod/bike/
Thanks for Joining Me!
Consider becoming a member of the Cycling Over Sixty Strava Club! www.strava.com/clubs/CyclingOverSixty
Cycling Over Sixty is also on Zwift. Look for our Zwift club!
Please send comments, questions and especially content suggestions to me at info@cyclingoversixty.com
Follow and comment on Cycling Over Sixty on Instagram: https://www.instagram.com/cyclingoversixty/
Show music is "Come On Out" by Dan Lebowitz. Find him here : lebomusic.com
This is the Cycling Over Sixty Podcast season three, episode 39, Data Science in Your Health. And I'm your host. I'm not gonna do an extensive update for this episode because my interview this week was such a great conversation and it went on a little longer than normal. Here are a few things that I want to share. First, I want to continue to invite people to join the Cycling Over 60 Tour to Cure team. I love the idea of using the tour to cure as a launch party for the summer cycling season. The ride in the Seattle area takes place on May 2nd, and there are several tour to cure events across the nation. I know it seems like a long way off, but I'm looking to do some fun things that will take time to develop. So I'm trying to get people signed up really early. The American Diabetes Association organization that I'm working with is in the Pacific Northwest, and the ride is in the Seattle area. I would love it if some of you from out of the area would come visit here and ride with us. One of the reasons that I'm promoting it so early is to give people time to plan a trip here. The route is around Lake Washington, and I believe it's worth a trip here to do that ride. You can find a link to the team in the show notes or go to tour.diabetes.org forge slash teams forge slash CO60. Or you can just go to the tour to cure Pacific Northwest and search for Cycling Over 60. If you'd like to know more about our plans, email us at info.cyclingover60.org. I took the opportunity to participate in a fun event a couple of weeks ago. If you pay attention to the Cycling Over 60 Instagram, you saw a picture of me doing my first cyclocross race. I've talked about doing cyclocross in the past, but my participation in this event happened in a very different way than I thought it would. I originally planned to start training for a race this fall. I didn't know if I would actually do a race, I was going to see how the training went. But only a couple days before the race, Gehrin called me and encouraged me to try it out. The race was put on by an organization called Lemon Peel, and this was in Stillicum, Washington. And a big factor for me writing it was that the course was designed to be very friendly for new riders. We did a few practice laps before the race, and that made me feel pretty confident that I could finish. I really had no idea when I started the race if I would do well or not. Within seconds of the start signal, I knew that I wasn't going to be keeping up with others. My limiting factor is my heart rate. I believe I need to keep from going above 160 beats per minute very often. For the race, my average heart rate was 162 beats per minute. So I was staying right at my max. But I just couldn't generate enough power to keep up with everyone. In fact, I was leapt by the entire group. Interestingly, as I was loading up my bike, some people I knew came by and told me that the race organizers were looking for me. I checked in with the organizers and found out that I had won. It turned out that I was the only category four rider in the over 60 subcategory. So I ended up with a very fun lemon peel winner medal. I guess you could call it a medal. It was actually made out of wood. But if you go over to the Cycling Over 60 Instagram, you can find a picture of it. I enjoyed myself too much. I really want to have a cycling over 60 cyclocross team next fall. The truth of the matter is, I am pretty sure I'm going to be one of the last finishers in any race that I do. But I still found it to be a really fun event in a specific way. There is something about being in a race that I really enjoy. Now here's the problem. If I'm going to ride cyclocross, I do need to have a cyclocross bike. The bike I used for this event was my Trek FX3, and it really wasn't the best thing. I certainly will keep everyone posted on my search for a new bike. The final thing that I want to mention is a new free program being offered by Rode Scholar. Starting Thursday, October 23rd, there is a five lecture series that, in their words, offers open, honest conversations about aging. Canon, uplifting, and grounded in wisdom rather than worry. These online galleries are designed for those navigating life's fourth age. A stage not defined by limitation, but by perspective and resilience. I truly like Road Scholar and the events that they do, even though I've never participated. But I will be checking out these lectures. I'm expecting great things from these five lectures. And again, they're free and I believe really worth checking out. A while ago, I got a message from Rob McLeod. Rob is an avid cyclist who has been heavily involved in the cycling community in Salt Lake City. If you search for Professor Rob's bike page, Utah, you will find some of his writings on cycling. I'll post a link in the show notes. There is a lot of interesting stuff there. But I really wanted to have Rob talk about his professional work. He has been on the leading edge of technology and health for a long time. I was really excited to get his perspective. And here is our conversation. I am really pleased to welcome Dr. Rob McLeod to the podcast today. Thank you, Dr. McLeod, for joining me. Yeah, it's a pleasure to be here. I'm a big follower of your podcast, and it's it's a real honor to be part of it. I'm thrilled because you bring a real combination. Your your academic work, you know, your cycling, everything. There's a real combination of perspectives that you bring, and I'm thrilled to be having this conversation. And I'm gonna let you talk about your background, your professional background, and everything in a bit. But I want to start out by asking you to share your earliest memory of the bicycle.
Rob MacLeod Ph.D.:Yeah, this is this is interesting. I um I thought back a little bit about this, and I and it was sort of a twofold experience which has influenced me in in in both ways. So I remember as probably a six or seven-year-old, you know, getting my first bike and learning how to ride it, and you know, all the usual experiences of crashing and getting better and getting and gaining the independence that a bicycle brings. And that's a wonderful, continues to be a wonderful part of my life for sure. The other aspect that I that also left an indelible impression and I guess shaped a lot of my relationship with the bike was that this is one of the first times that my father and I, or that I can remember, my father and I working on something mechanical together. And so I remember him at some point, you know, taking the axle out of the bike, or I don't think it would think it was a little more than changing a flat tire. It was it was actually doing some servicing on the bike. And for me to get some idea of what the internals of a of a bicycle looked like. And and and that's set a seed that you know continues to this day. And I I don't think I've ever had a time in my adult life when I didn't have some form of a bicycle service space in wherever I was living. Even as a student, I had a closet in my living room and I had all the bike tools in there, and I'd roll out a plastic sheet in my living room floor, and I'd, you know, set up a stand and pull the tools out and and and work on my bicycle even then. And ever since then, it's this mechanical aspect has always fascinated me. I guess as an engineer, I live in a house that I had the good fortune to design. And so the bike shop was built into the house right from the start. And it has, you know, more or less the it's never big enough. You always underestimate how much space you need ultimately. But I have this designated space and and and it is one of my you know truly happy spaces to inhabit. And and the neighborhood kids sometimes bring their bikes over when they need a little service. And so there's there's there's you know that part of it. And and I, as I say, both both the the sense of a cyclist and the sense of flight and the mechanical aspects of a bicycle really went back to those those earliest days of my memory of first exposure to a bike. And and I also, not too long after that, was a few years after I started riding, I had another indelible experience, which I think most of us have had at some point, and that is of having your bicycle stolen. So I, you know, made the beginner mistake. I leaned it up against a window of some kind of store I was going into. I ran into the store when I came out, the bike was gone. And so that is also probably was the beginning of thinking about bicycle advocacy and trying to figure out a comprehensive way to think about how bicycles um should fit into our lives and and the diverse aspects of of support that that are needed to make cycling a viable, safe, functional means of both transportation and recreation and even performance support. Did you keep up with cycling throughout your life? Yeah, it's there was there was sort of, you know, there was a gap after the first bike got stolen, and um it took a little while to to get another one. And then I kind of went through early teenage years not riding so much, then had the enormous good fortune. It was another life-changing aspect of my life. My father was a professor as well, and Dee had a sabbatical, and which is a wonderful element of university life that I'm not very good at taking advantage of in my own professional career. But the idea is fantastic that you get to go to another lab, another setting, another environment, and learn new techniques and broaden your network of scientific connections. And it's an incredibly healthy part of academia. So he had one of these sabbaticals, and by then we were four children. I'm the oldest of four siblings, and he decided that it was time for us all to go to another country, learn another language, and be exposed to a whole different culture. And he was able to merge that goal with his academic goals, and so we ended up ended up in southern Germany in a beautiful city called Freiburg. And so, of course, their bicycle culture is everywhere. And all of my friends at school, I was, you know, more or less thrown into a German school and told to figure it out. And so while I was learning the language as quickly as I could and making friends, I realized if I'm gonna hang out with these guys, I at least need a bike, if if not eventually a moped or something motorized, but at least I need a bicycle to get to and from school. So that was my you know, first purchase of uh what back this is the early 70s, you know, what we call generically the 10-speed, right? So the first kind of racing style of bicycle. And I remember finding one of these somewhere used and bringing it home, and my father again helping me with it and getting it set up to take to school. And this is also where I again learned an important mechanical lesson because my my father had never seen a derailer before. He was, you know, he was good with his hands, and you know, he was more a carpenter than a mechanic, but was, you know, willing to figure this out. So we put the bike together, we got it going, everything was fine. And I was riding it to school very proudly for the first day. And it was a little hill I had to get up to get to the school. And I went to put the bike in the smallest gear. And I don't know if you ever experienced this, but the derailler immediately went into the spokes, ended up wrapped around the axle, and was was snapped in half, literally. It was one of these old plastic irrit was the name of the company that used to make these plastic body derailers for a thing at the time. And it just snapped the derailler in half. So so rather than riding proudly onto the into the school that day, I was, you know, walking, dragging my bike onto the school feeling very despondent, discouraged. So so again, that led to a whole new set of lessons both in bike mechanics and and also of the relationships that one can forge through this common interest in bicycle. It came about because one of my classmates, you know, he heard my story, saw my bike, and spontaneously said, Oh, yeah, I can move to my place. We can figure this out. And so, through some combination of time with him and then, you know, getting a new derailler, he actually taught me, you know, how to set up a derailleur property and how to get it on the bike so that it shifted but didn't run off the rails. And so, again, deepening the mechanical, you know, uh aspects of bicycling and also the this relationships and the notion of the importance of relationships that are formed through common interests. He and I were very different in terms of our background and upbringing. He was he was German, that was a small difference in the end, but but you know, came from a you know wonderfully modest background and you know, lived in an apartment, and you know, like most German sort of middle class people do. And so it was an amazing opportunity to also learn about German culture, what it's like in a typical German family. And we ended up spending a lot of time together, and then and then we started doing a few adventures where we would go off on rides into the foothills and into the higher mountains sometimes of the Black Forest. That was my first exposure going up Nova Scotia. It's not a terribly mountainous place, but it was it was the first exposure, you know, to mountains, to you know, serious cycling culture, and and from from then on, I was pretty much addicted. So I cycled a lot during that year. It was a bit of a hiatus when I came back. Uh, I cycled some, but again, it wasn't as as conducive, you know, in this part of Canada where I was living at the time. But then the big move came when I, you know, was in my undergraduate years. I was spending them mostly in Germany, the summers at least. And then after my undergraduate degree, I I moved, uh, ended up moving to Austria. I lived there for about seven years, and that was where you know things really took off. Don't tell anybody, but I used my student loan to to buy a nice bicycle. And uh and because I was going to university there as well. And so so I was going to university and working and riding my bike and and and and of course, you know, living in a place like Austria is incredibly conducive to bicycling as commuting, but also bicycle as adventure opportunities, bicycle touring and riding in the mountains. And I and I've certainly never let up.
Tom Butler:You talk about these experiences and including uh the bicycle being taken, being stolen, and then kind of you know, looking at the whole, you know, how do we make the environment how uh more conducive to a bicycle? And then being exposed to a different culture, uh do you feel like you're atypical as far as your view of transportation? Because we're so car-centric in uh the US, and uh it seems like you had some experiences that kind of opened you up to to not being so car-centric. Is that a fair assessment?
Rob MacLeod Ph.D.:Yeah, absolutely, absolutely. And and and it's it's you know, we just recently met some new neighbors who grew up in New York and spent the last 25 years in New York City, and they sort of described their urban life and they did some bicycling, but I learned, you know, over time that it doesn't have to be short commutes and dense cities that are conducive to a non-motorized form of transportation. Even in Austria, I lived outside of the city, so I had a fairly long commute by bike. And when I first got there, I thought, oh well, this is way too far. I'll never be able to do this on my bicycle. And so uh for a little while I had a motorcycle. This is you know what you do when you're in your 20s. I had my motorcycle, managed not to have an accident with it. But then found myself when the weather was okay, and I felt like I had the time. And I thought, well, why don't I ride my bike? Let's just see how this goes. And so I, you know, I tried it. And then little by little, the motorcycle was gathering dust and the bicycle was getting more use. And so I thought, okay, this is let's sell the motorcycle before, you know, there's nothing worse or more dangerous, I think, than a motorcyclist who doesn't ride regularly. It it's it's a skilled skill you have to develop, cultivate, and maintain. So I thought, okay, I'm I'm you know, I'm not using it, let's get rid of it. And then by then I was I was getting into riding, you know, many days a week, not every day, you know, weather permitting. And this at that time was probably, I don't know, maybe a 10 kilometer one-way commute with some climbing. I lived in a village above the city, so I was climbing every day. And that really set the tone for you know what it's possible to do, and started me down the path that I'm very much on now. I have a daily commute that's about 15 kilometers each way. I climb 300 meters or a thousand feet to get back to my home every day, and I ride throughout the year, even here in Utah, where we have some, you know, some sometimes some pretty serious winter weather. So it's so it, you know, it sort of expanded what's possible. But at that time, just as a practical possibility, I don't think I really analyzed it as much as I have in in later years. And now it's become such an important part of my physical health and mental well-being. And it it's just a part of my routine that I deeply miss when I actually have to take the car for some practical reason, the weather really does prohibit it. So I think that, you know, it's that's been a process that took time to develop. And I just along with the mindset that, you know, we all hear about, but sometimes it's hard to put into practice that there's no such thing as bad weather. There's just bad clothing. And and so it it took a while for for me to turn that into a practice, and you know, and develop the techniques and clothing and whatever other bits and pieces accumulated that make riding all year round a real possible.
Tom Butler:I love the fact that you have this mindset that I think is is definitely a bicycling mindset, and that comes in a lot of different forms. Today, I want to talk about your view of technology when it comes to healthcare. You have been involved in so many interesting things. I'm not gonna try to encapsulate it, but how do you talk about your professional background? How do you explain who you are as a professional to people?
Rob MacLeod Ph.D.:Sure, that is an interesting question. I I give a a number of presentations to students here at the University of Utah, some of them about career and the pathway to a career. And I emphasize that many interesting careers are are what I would call nonlinear or certainly not predictable. And mine was like that. So going to Austria for all that time was certainly not part of a typical uh academic career. I I went there for a couple of years to do a master's degree, and seven years later I came back with my master's degree. I I did manage to get that, but a whole lot of life experience and professional scientific experience that certainly shaped the future. But along the way, and the master's degree I got ended up not being in what I do now, but actually an audio and sound engineer. So Austria is a wonderful place to experience music, especially classical music, of course, deep traditions of very famous classical composers who dominate and a longstanding support from the public for preservation and public access to both classical and contemporary music. Wonderful setting to appreciate that. But along with that, there's also quite a deep tradition of the technical aspects of audio engineering and sound recording. There's great Austrian acoustic companies that are, you know, still important today. So it was a wonderful place to do both those things. So on the one hand, I was off doing sound engineering and taking music courses and learning how to do composition and what the different instruments sound like. But in my day job, I was learning about the heart and how the heart works. And that institute that I was in was focused very much on the small scale, cell scale. And so that became the foundation for what's you know now become my career. So I continued to study the heart. I came back to Canada. I decided to do a PhD in physiology and get some serious training in the biomedical and mechanistic aspects of how the heart works. Then that was a fairly short time back in Canada. And then in 1990, I moved here to Utah to initially be a postdoc and then eventually a faculty member. And so the heart is is, of course, a naturally a fascinating organ, but it's relevant, I think, because it does tie into our health and our fitness and and so many aspects of our daily lives. Nobody is truly unaware of their own heart. And all of us have had illnesses in our family that have affected people's hearts. So it's a great entry point into lots of interesting conversations. From a scientific perspective, of course, it's as all specialists will tell you, whatever they're studying is the most important organ and the most fascinating thing to know about. But and I certainly suffer from that illness. But it's also, yeah, one of these central organs to what we do. And because it's tied so much to our physical health, um, it became sort of a natural complement as I thought more about the heart and generally the cardiovascular system, all its pieces, and then broadly about the musculoskeletal, you know, all the pieces that are sort of tied together through the cardiovascular system, they overlap so much with all kinds of questions about fitness, fitness from the casual person recovering, maybe even from a heart attack, who needs to get themselves in some kind of shape all the way to the elite athlete. And living in a place like Utah, it's easy to get exposure to that complete rain. So so I've I've literally, you know, countered people just trying to get a lifestyle back after serious illness from cardiovascular disease all the way up to to Olympic and Tour de France caliber athlete. This is the beauty of living in a place like Utah, that we really do have the spectrum. And and so bringing that experience with the people around me, you know, back to my research and thinking about what these relationships might mean and how we identify maladies, how we track people, how we follow our own health, this just became a natural fascination. So I had a polar heart rate monitor, you know, very soon after they came out, and I continue to play with whatever gadgets I have just to monitor what's going on in my bike. And and then I try and bring all that into my classrooms. So I'll I'll use data I've recorded on myself while riding my bike as an exercise for my students to analyze and interpret so that they can understand all the various things that come into power generation, mechanical power generation on a bicycle. I've I've managed to tie all the pieces, I think, together in a way that makes me feel not completely scattered, but with a lot of different aspects to explore, depending on whatever current opportunities uh I'm fortunate enough to have.
Tom Butler:When you moved to Canada to study, uh was there always this element of the connection between technology and the human heart, or did that connection evolve over time?
Rob MacLeod Ph.D.:Yeah, that's an interesting question. So that probably started already when I was in Austria. Uh, you know, I I was in a what's called medical physics department, which can mean lots of different things, but there were people around me, a close friend to this day, who was very involved in elite athletes. He himself was an outstanding athlete, and he became a sports scientist, studying, you know, both biomechanics and physiology. And it was just always intriguing to talk to him and learn from him. He was working, he's worked with a number of different actually ski teams in Austria. And of course, Austria ski teams are the most elite athletes in the country, generally, probably even more so than the soccer player. And so he was working, he was doing you know fitness training with the Alpine ski team. And so it was fascinating to share his observations about, you know, that the training they were doing, you know, uh at this extreme level, and then tying that back to the research that he was doing in the lab. We were both in, you know, in the same lab setting. You know, it was always sort of part of the mix to think about how this material, these concepts we're studying in textbooks or trying to understand a scientific perspective, how do they translate, you know, into the practice, in this case, of extreme elite sports. What we know, one of the observations that came strongly and got reinforced even more when he switched to actually ski jumping. He became actually a very well-known figure in the world of the science of ski jumping. He's designed ski jumps. There's Innsbruck ski jump, which is uh used in international competition regularly, is his design. And so he figured out a lot of the mechanics of ski jumping. And one of the interesting perspectives he had when he started into this field is he he he he knew enough about computing, he had a physics background, he knew about the compute, computational modeling aspects enough to know that there was potential. That's where he and I overlapped a lot. I've I've always been involved in computing and using computers to both understand and simulate physiology of disease and health. And so he started thinking about how he might create a model of ski jumping in order to predict certain behaviors. It turns out this was during an era when it was a change in the style of ski jumping and and some of the elite jumpers were suddenly crashing more than they had before, in part because of this new style of jumping. He was already working with the team, so they came to him and said, you know, you're the physicist, you figure this out. Like, why are we crashing? I mean, these are fabulous jumpers, world-class jumpers. All of a sudden, out of the blue, they're they're crashing. So that got him into a deeper analysis of the whole thing. But the key point here is that he went to all his simulation friends like me and said, Okay, how accurately can we do these models? We would say things like, oh, 10%, maybe 5%. You know, that's enough. We can design cars or lots of things with that level of error. You know, that's an acceptable level level of error. He said, you know, 5% is the difference between a world champion and someone who has no chance of making the when it comes to that level of sports. And he said, you have to be able to get me down to one or two percent to even be vaguely relevant because it really comes down to one or two percent. This kind of made me appreciate just the the impact of this uncertainty, this approximate knowledge that we have and how this plays out at the high end of sports. And that helped that has helped to this day frame you know how I think about physiology and the diseases that we study as well, that that small changes in underlying conditions that we barely can measure and oftentimes can't even include in our thinking, and have profound influences on somebody's health or at the other extreme in their athletic performance. And I just recently heard just randomly an interview between Peter Atia and and Lance Armstrong. And Lance Armstrong, of course, you know, we in the bicycle world have probably mixed feelings about we've all heard of them. And so the question was, what you know, what do you think all those drugs did for your performance? And he said 10%. And and when you and I think about many aspects of our lives, what's 10%? I mean, you know, a 10% increase in salary, sure, we noticed that, but it's not life-changing. But 10% longer on our commute time, you know, what these are not big numbers you know, in in our daily lives. But 10% at that point, that end of the spectrum literally meant the difference between surviving as a professional athlete and not even being being on the team, which of course led to all kinds of problems with drug use in in cycling, um, which legacy we're not we're still living with, or not, of course, proud of. But the point is, from my perspective, that the relatively small changes in our function, our physiology can make really, really big differences in how we perform. And I would argue in how we feel, and so so it it allowed me to focus on on maybe some of the little things that have helped shape my perspective both on you know in physiology and arguably psychology and life in general.
Tom Butler:Well, it really is an interesting illustration, you know, of human potential, you know, that in some aspects, two percent, three percent can make a difference, and to try to improve the systems to give it that kind of accuracy, that's very interesting. You are deputy director of the scientific computing and imaging institute, and you're also an associate professor of internal medicine. And I'm thinking that throughout your career, uh from the time you start forming, you know, your pursuit of of computing and health. And heart function. I mean, I'm think there's just been a dramatic change. There's just been advancements in computing and imaging, and I mean, uh, you know, just the aspect of those early computers that you were modeling, you know, the computing power on those we probably have on our phones, I imagine. You know, so you've seen some incredible advances in medical imaging.
Rob MacLeod Ph.D.:Yeah, the the the the advantages, the advances in computing broadly and imaging and everything that derives from the power that we have in computing. Certainly it's been a central part of my when I was in high school, I was one of those nerds who would you know sneak into a room that we had in our high school that had a paper teletype terminal, and you could sort of type a few commands and it would go off to some computer somewhere and give you some feedback. And when I first my first job as a as an undergrad student in research was, you know, we had cards, literally those old computer cards that you've probably seen in movies and things. And that really was how we program computers. So so yes, I you know, I've followed this along. I mean, I you know, I was born the same year as Bill Gates and Steve Jobs, and of course, not nearly as famous, but I I sort of share with them, you know, moving through this computer generation and engaging in it in a in a different way, I mean, completely different way, but still, you know, benefiting from the progress. So that, you know, in the early 80s, I was doing email. And when I came back from Canada or from Austria to Canada in 1985, I mean, most of the faculty in our department had never heard of me. And and, you know, one of my little side jobs was teaching all the faculty and eventually the other students how to do email because it was totally new. Internet was just getting started, and and so we're we're just sort of you know seeing these things emerge. A little historical side note is that University of Utah was the fourth node on the internet. So we're quite proud of this. And and and so so it's it's very much part of the culture here locally. But even before I came here, I just kept seeing these improvements of storage, of speed, of visualization, graphic capabilities of computers, and as you say, even our even our phones have have just made astounding improvements. And so throughout my career, I've been at, you know, at times at a point where I say I have an idea for what I would like to use the computer to do, but the computers can't do it yet. And this continues on. And uh I I would say it's led up in the sense that we have amazing capacity, which is improving dramatically and has improved dramatically in the last 10 or 15 years. But when we started the scientific computing and imaging institute, which was around, which was in the early 90s, so this was together with a colleague, Chris Johnson, and there's a there's a bicycle connection here, I'll come back to, but but when he and I started this thing, we were both working in, you know, trying to do computer models of some aspect of the heart and the physiology and behavior of the heart. And we just kept running into obstacles. We would go, I remember, you know, going to the official computer center on our campus and saying, you know, can we use your computer? And they looked at us strangely and said, you know, who are you? Sort of explained. And they said, You want to use our computer for what is it you want to use it for? And what makes you think that you can do that? You know, you should have access to this very expensive computer back here that we're busy using to keep track of, I don't know, student records or you know, the finances of the university, whatever they were doing with it. And they basically showed us the door. And and so we regrouped a little bit and said, okay, this isn't working. Fortunately, we were just at a period where still quite expensive, but relatively portable computers were emerging. So from some of the major vendors again, early 90s. So we managed to convince a few companies to give us some computers to play with and a little bit of technical help. And we just started exploring what these computers could do and doing things that I guess others hadn't done with them in our area. And and it just kind of went from there. And we I would say we recognized reasonably early on that we were not that special in the sense that that there were probably other people out there who, if they could get access to computing, could do amazing things, and that the problem was the access. The computers had reached a point where they were powerful enough. Even the computer science that you need to run the computers, solve problems. That was at a mature enough stage. But that there was this huge gap between where the computer scientists were and where the scientific practitioners were, in our case, the medical practice. And we thought we we need to be able to make both sides aware of this opportunity and build bridges between the computer science and the applicant. And that became the basis of the scientific computing and imaging, or we call it ski because we're at Utah. The Ski Institute, you know, took off, you know, because of the relationships that we were able to build. We were able to exchange because again, we were trained enough medically and biomedically that we could discuss problems like this with our biomedical counterparts and say, you know, you could use a computer to do this analysis, whatever. So that's what got it started. And then, you know, along came kind of imaging, mature imaging, especially magnetic resonance imaging, which provided us with a window into the structure of the heart in my case and the brain and other research cases that we just didn't have before the ability to reconstruct in three dimensions, soft tissue and all the structure. That became a whole nother doorway and an opportunity for us that we quickly tried to make use of and continue to make use of. So at every step of the way, and I think we're still doing this today, kind of trying to gauge what's possible with computers today and how can we turn that technology into something that ultimately helps people. I'm a biomedical engineer. I'm that's professorship is in biomedical engineering, and that's very much at this interface in the technology, biology, and then applications to medicine. And I ask my students why in the world would you take on this challenging field of study? They almost all say, because I want to help people. I I don't necessarily want to be a doctor, although some of them do, but I really want to help people, and I'm kind of a geek, right? I mean, you know, I grew up fiddling with things, being an engineer. And but I I I want to see my engineering directly as possible go toward helping people, and that's what our our field is. So so it's a very resonant base for kind of thinking. And then I guess briefly to close the loop. So the bicycle connection here is that when I first came here, I, you know, loved the the cycling here is really quite amazing. The weather is perfect for it. And so Johnson and I would every odd day of the month, there's a canyon here that goes from the city up into the mountains called City Creek Canyon. And every odd day of the month, it's open to cyclists. And so every odd day of the month, we would finish our day, the end of our working day, we would get on our bikes and we would ride up the canyon together. We would talk and scheme, plan, figure out what are we going to do next, what's the next move, what's the next grant opportunity, who's the next collaborator we could find, how are we going to go forward? And so the whole basis of you know the institute, which is now a couple hundred people and has its own building and all this wonderful stuff, way beyond what we ever thought would be possible. Those were its origins. And I and I contend that that mixture of kind of physical exertion, being outdoors. So once you get into the canyon road, there's no traffic, bikes and pedestrians, and you're going uphill, so it's quite calm. You know, you're exerting yourself, but you you know, we would do it at a pace we could still talk. And it was just that setting and those conditions, both in our bodies and around us, is just the perfect place to let your mind run, explore ideas, speculate on what we might do. It really did form the basis, not only for a great friendship, but but also for the ideas that that we were able to convert into practice.
Tom Butler:That's such a great story, you know. I go out, you know, for two-hour rides uh frequently, and never listen to anything, you know. And there's several elements to it. One is just uh I it gives me the space. I don't have to do anything else. It's not easy for me to respond to text messages or anything while I'm writing, and so there's just the space to just think, and then I do believe there's blood moving, there's oxygen moving. I I think there's probably an element of brain function, and then there's an element of rhythm. And I've talked before on the podcast, it seems to me like there's almost this uh physiological meditation body movement kind of element to being in a rhythm on a bike when you get on a long flat and you're just keeping the 90 uh revolutions per minute or whatever. I it just seems like it's a it creates a unique space to really contemplate things.
Rob MacLeod Ph.D.:Yeah, you're absolutely right. And the really fun part, again, this is me geeking out as a scientist, but you know, we have those perceptions which we share and they're very real, but now we know the neuroscience behind a great deal of because there's compelling evidence of the benefits of physical exercise for our mental health, you know, for our psychological well-being, and exactly these sort of zones we get in, the sort of meditative almost aspects that that allows us to think freely, that allows ideas to percolate up. These are now, you know, the study, the topic of studies of, you know, and this again is where imaging comes in. There are their imaging modalities that can give us at least indirect insights into which part of our brains are active during certain exercises or certain activities generally. And they suggest that indeed important parts of our brain are activated during exercise like this. Exercise that is not something we need to focus on. So, you know, this is the beauty, as you say, the rhythm of it. You get into rhythm, you get into a groove, don't have to pay too much attention, assuming you know, there's not too much traffic. Same is true with running and swimming, these sort of aerobic sports where there's a natural rhythm involved that are very different from playing tennis or alpine skiing, really have to focus, or mountain biking. That's a very different type of brain activity that's going on in those two different scenarios. And there's something intrinsically beneficial on top of that, which is also being documented, just being outdoor. There's many studies on trying to understand what is it about being outdoors that just makes most people feel better. Like just going for a walk, just being outdoors. There's something that happens in our brain in that sort of space. Now, again, there's lots of studies to show or try and explore whether it's just the visual or is it the sound, is it the smells of the outdoor? Like, what is it that stimulates our brain in this way, which is you know fascinating. But practically speaking, all we really the takeaway is just go do it because you'll feel better. And cycling, you know, fits so well into that paradigm. I think it combines all of those aspects of, as you say, the blood flow, the circulation, the the disconnection with the daily, you know, requirements, which we have to get to at some point in our lives. But but we decouple from all those external stressors, and then we build a physiology, a physiological base and a neurophysiological that really allows us to recover, to have thoughts that build our happiness. That, you know, I don't know if you can see here. This is my sort of famous my t-shirt. So, you know, life is an integral of happiness over time. And so, so, you know, the more we can improve and do things to improve our happiness, and there's that's a whole field of study by itself, the more we can do that, you know, the I think the just more content and happy and productive and all those things that we feel with our lives and and and cycling and and sports like it are just you know perfect for that.
Tom Butler:This season of the podcast, I've really moved into a realm where I'm talking about the bike as a medical device, you know, and some people feel uncomfortable with that because it's like, well, a medical device, isn't there some kind of approval for a medical device? And and I I think that's a fair thing to question, but if you think of exercise as medicine, you know, if we're gonna embrace that concept, then I think the bicycle is as good of a medical device as anything you can find. And I I'm thinking from what you're saying is that imaging and analysis is really verifying that exercise is medicine.
Rob MacLeod Ph.D.:Exactly. Exactly. I mean, I think especially these functional MRI studies have have really given us important clues because we we know in sometimes remarkably detailed terms what different parts of the brain are, you know, more or less responsible. I mean, there I was gonna say there, there, there's there's a lot of generic knowledge, but it turns out that there's some difference between individuals, of course. But there's enough generic knowledge that certain parts of our brain are responsible for certain actions. And if we can identify which parts of the brain are active under which behaviors, then we can start to tie those behaviors and those responses to different types of brain activity. And that's generically provided us with this insight into why it is that these things have have, why they feel good, why we, you know, we as sort of amateurs just experience a feeling of calm, feeling of inspiration, or or we have insights, we have ideas. I mean, some of my best, but I I would argue some of my worst ideas have probably come to me when I'm out riding my bike. And it just you're in that space where ideas percolate. There's more and more evidence that, again, imaging, especially, has uh allowed us to connect to neurological functions and neurophysiological mechanisms. And then when you tie that into what we know about the brain and the brain has evolved and the various aspects of the brain, you know, primitive limbic brain, the more cognitive brain, and the various perceptive aspects of the brain. Where do we where do we think about words? Where do we put logical ideas together? Where our language centers. And you know, there's we're tying all this together in wonderful ways that continue to point to exercise as probably one of the most fundamental steps to general health, not just physical health, but literally to mental health, happiness, results of improvement in symptoms of depression and anxiety and all the these horrible disorders that are really affecting, especially our young people, and this is where it comes together for me. Positive benefits of exercise there are just getting more and more compelling all the time. It is the best medication. Very many comparisons made. If you know you sort of list all the benefits of exercise, and then you compare that with the benefits of any medication you can think of, even the the other ones that we agree are more or less benign that really help us deal with pain or whatever. If you had a drug that did 10% of what exercise would be, you'd have you'd have a blockbuster drug. And so it's so it's very clear that the benefits are enormous. The trick now, and I'm, you know, while that exploration goes on, it's incredibly important. The trick now, of course, is how do we how do we get people to bring exercise into their lives? Because lots of us know what we should be doing and have a very hard time executing. And so now we're into this place where how do we attract people to, you know, whatever sport it is, in our case, our shared love of cycling, how do we get people into cycling? How do we how do we make it easy for them to get into the sport in a comfortable way where they feel supported, where they don't feel revealed, where they don't feel they have to get competitive, where where they just have mechanical support, where they, you know, they're they're they're not abandoned somewhere by the side of the road with a flat tire and no knowledge of how to fix it. There are so many things we as cyclists, I think are doing and should be doing to enhance at least, you know, some part of the population to spend some of their time doing, you know, what is arguably one of the best life sports that I can imagine. I mean, you know, running tends to be one of those sports that has a limited lifespan. Most people, when they get to a certain age, joint problems, whatever, it makes it very difficult to run. Hiking works pretty well for lots of people, but you know, hiking in nice areas can be a little hard to get to. I mean, you know, we're spoiled here in a place like Utah, but it, you know, it can be a hard one. Cycling fits everywhere. You know, you can cycle in New York City. It is one of those great sports that can provide a life of physical activity. And I think our job, maybe mine as a scientist, is to continue to explore the benefits, but I think our collective as a community, as a bicycle community, I think our role should be, and for an amazing job in that area, our job should be to make cycling attractive, feasible, doable by explaining it, by you know, encouraging people the right way, guiding them gently. You know, maybe it's time to get a pair of bike shorts, you know, maybe it's time to think about a little improvement in your bicycle. It's gentle things like that, but at the same time, just basically saying, welcome to an amazing sport, and we want you to be part of our supportive, wonderful community.
Tom Butler:Have this kind of intersection. I have a master's of public health and health promotion and education, have a master's in marriage and family therapy, and so which is kind of you know, really a systems degree. So it's this kind of combination about you know, kind of healthy behavior systems, you know, and it had all this knowledge, and and yet year after year after year, I kept saying, Man, I gotta do something here. This is the year that got him to do something. It took pictures, you know, literal pictures, but a picture of my function, my metabolic function, that I'm like, okay, if I don't do something about this now, you know, I I'm gonna lose the opportunity to really impact this. And and I'm glad I did. For me, being able to look at a heart as much as we can, you know, through imaging or functional capacity measurements, you know, whatever, and say, look, here's the difference between a healthy heart, someone who stayed active, or someone who got active, and the heart of someone who's 75 who never got active. Uh, that's incredibly valuable at the same time. I think what you're talking about is there is a societal element, and I'm really interested in how we can build a community that has some things that are built into it that are counter-cultural, because the cultural element just frankly is a sedentary element, and so you know, combining like some cultural elements with some real good data about you know what a difference it can make, I I think in there there has to be both those components to actually make real change.
Rob MacLeod Ph.D.:Yeah, no, I no, I totally agree. And and you know, what you would know as a public health expert, that there's lots of things that we know would be good for society and good for our population, yet are incredibly difficult to get into common regular implementation. This is this is one of the aspects of studying the heart that's so compelling that while we work on different details of the heart and how it works and how to fix it, how to understand the illnesses, it turns out that to make a massive improvement in cardiovascular health, we don't need to do any more research. We we we know enough now uh to to change, you know, for enormous percentages of the population. You know, while that might undermine my future career, I I don't care because I, you know, this is this is really I I'd love to see society do better. And so, so I think we're forced now to think about things just as you're describing of how do we combine the information, which is important. People want to know why they're doing something. And and and just telling them, do it, it's good for you, trust me, it is no longer enough, at least you know, among any discerning person who thinks about anything at all. So there has to be some information to compel or to motivate them to think about. Unfortunately, that's not enough to change lifestyle and behavior. So we need to combine that with opportunities that sort of tap into what individual sensations are about what's enjoyable. We have to find a way to make exercise an enjoyable thing and a and a beneficial thing. And so that's where we have to explore like, you know, what role does exercise play for each individual? And how can we sort of just encourage them to explore it? And and that's so varied. And and you know, you've seen with your group rides and the and the sort of bike club activities, that that companionship, that being in a group can be amazingly supportive, really can bring people out on the weekend, even when it's raining, because you know, I got to go because the group's waiting for me, and I've told people I'm gonna be there for the ride, and you know, they've they've gone to all this trouble to organize the food stations. So I, you know, I have to participate. I I learned about this, you know, I I've organized sentry rides, you know, for for a number of years, my early years here. So I I've seen how that plays out and how how incredibly motivating that can be. And that's one view of it. And then another view, which which I have to say is the one I live more now, and so I can convince people maybe more authentically about, is to say, yeah, but just just go out on your own, just like you're explaining, just go out on your own and ride your bike for, you know, and just not not you don't have to go far, you don't have to go fast, just find a nice place, just just go out and do it for a little bit and then see how you feel, you know, like reflect a little bit afterwards and say, how was that? You know, and you might say, Yeah, my knees are sore or or you know, my back's a little sore, but you know, I feel good. And and I, you know, I this plays out, you know, in our home. My my wife is sometimes a little hard to get motivated some mornings to go for a ride, but you know, I I you know, I sort of I convince her and I've done everything I can to make cycling work for her. And she grumbles a little bit and she moans about having to go, but then every time we do it, we come back and she's like, Thank you so much for you know motivating me to go out and do this. And I think that through this range of approaches and and some sensitivity to individual needs and pleasures, we can find ways to get people to ultimately be in that place where they're doing the right thing and feel good about what they're doing, and of you know, and enjoy the health benefits and and all the other psychological benefits that that come with it. It's gonna need this sort of empathetic, appropriate, gentle, coaxing, guiding, supporting combination uh to make it work. And it's it's what I do with my students. I mean, the last thing I say every especially on Friday classes is you know, whatever you do, get outside for some exercise this week. Like, you know, I don't care if you know if you're late for your homework, let me know. But you know, I want I want to know that as many of you as possible are are out there doing stuff. And they know, you know, they can't help but know that I ride my bike, that I'm active. They they I'm very open and vulnerable with them about it. And don't try never to say it out of any feelings of pride or of ego, but just simply to say, please, you know, give it a try. Because and if I see them, I you know, this is the lovely part. I encounter them on my rides. I I bump into my students, and it's a great moment. See them out there. Love to acknowledge them, talk to them, find out how their day's going, where that's what their cycling story is. And I hope in that small way to be, you know, you know, living, yes, what I what I think really is beneficial, being authentic and consistent in a way that that maybe you know could motivate a few of them to give it a try.
Tom Butler:Well, that's fantastic. And you're you're bringing up all kinds of stuff that I could just run with. Yeah, we could talk about this for an hour, you know. But I want to get back to to some of this. I can you um talk about the Delphi Data Science Initiative. What is the aim of that initiative?
Rob MacLeod Ph.D.:Sure, sure. That it's a it's a natural consequence of what I described before of this ongoing effort that I've been lucky enough to be involved in of exploring where computing is from a technical perspective, and then trying to see where we could connect it to other areas of science. And so Delphi is a medical initiative. It includes membership from across our school of medicine and health sciences generally here at the University of Utah. And it really reflects a goal to employ the contemporary, what we call data science technique. So, so data science is uh not a new form of science. You know, performing a statistical analysis of some measurements is arguably a data science method. But as time has evolved and and we've gotten more sophisticated in how we can explore these data sets, and we've gotten bigger data sets that, of course, reveal more information. The computing tools have have allowed us to analyze data in completely new ways. And it's a fundamental different, a fundamentally different approach to science than we've had in the past, which has often been driven by this idea that we have an underlying notion of how A influences B. We, you know, we we enter a warm room and our perspiration rate goes up because our body is trying to cool very direct. And we and we we even represent that as a mathematical set of equations sometimes, write down you know, straight, sometimes very straightforward math and and explain the behavior. Data science does not take that approach, it just says there's patterns in those data sets that we yet, even with our sophisticated brains, really can't see the patterns in without some help. And the data science techniques are are the ways that give us insight into these patterns or connections that we see. And sometimes those connections just lead to sort of what I would say relate phenomena. You know, they they you know, when you look statistically and you look at somebody's age and their weight, you might see a connection, start to assume there's there's some mechanistic relationship age and weight. But as you get deeper into the data science and get richer and richer data sets, then you can get into the more subtle questions and oftentimes the more meaningful questions of, you know, it's not just age, you know, it's age combined with their medical state, combined with their lifestyle, combined with their eating habits, you know, all the there's a whole bunch of factors that drive that output of, let's say, weight or longevity or whatever our output number is. And so Delphi was created to try and leverage those computer techniques in the data science space in a broad range of applications. And so for me, it was another fabulous opportunity to listen to clinical colleagues say, I have this data set. I've been collecting these data. I just thought, I don't know, it's like this is the stuff I can get from my patients easily, and we can anonymize it and protect their privacy and do all those sorts of things. But uh now I need somebody to help me analyze it. And so then I have a number of connections with more technical computer scientists, mathematicians, physicists who may not understand much about medicine, but they have some really fun techniques that they're dying to try out on a good data set. And so the the general approach here is can we bring those, can we build a bridge between those those groups on particular projects? That very much fits into the ethos of what we've always been about at the Ski Institute. And I would argue that ethos is, you know, percolated out across the campus. This is a very intellectually open community, and there are very few boundaries between institutes, departments, whatever on the campus. It's never been a problem for a physician to wander down to the math department and say, I need some help, you know, explaining something that might be mathematically interesting. So Delphi is is really seeking to do that. So it has a very broad range of applications and has has you know led to some really interesting projects, metrics that we in science worry about, like papers published and support we can get to continue that research. So Delphi has been, yeah, I say it just it's been a felt like a natural progression for me to go from some of the physics based or the mathematically based approaches I've pursued in the early parts of my career, now into these data science approaches. Now, of course, data science in the modern vernacular is kind of code for artificial intelligence. A lot of these techniques we're talking about are, you know, come out of that long-standing effort to improve our understanding of data through methods like machine learning. And there's a lot of underlying technologies that sit underneath AI. And what we see as AI and what gets the headlines as AI is really just one small part of it that it's an important part for sure, but there's a lot more technology underneath the hood that we can apply in a range of settings and really make novel breakthroughs that we couldn't otherwise do. Where the where the complexity of the data available is so large that there's no simple equation that's going to link all these things together. We need to take a different view. And the data-driven view is a really fascinating one and it is the contemporary approach that we're trying to chase.
Tom Butler:It's so interesting because there's so many components to it. And then there's the like you're talking about the scientists who are developing ways of using the computer to analyze things, and you know, the analytic expertise that it takes to do that. And then there's the hardware and having the chipsets that are able to uh to move at a speed, and you know, in addition to be cooled and all the things that have to happen in order to have that massive computational power. So it what a unique time to live in to seeing some of those things being stretched to the limits, uh, which is sounds similar to when you were saying, Boy, we could, you know, way back when you're saying, hey, can we use your computer at the university? Because this is this is starting to get more complex, and now you're at an you know a totally different place, but that same thing of seeing the boundaries being stretched from what we have available.
Rob MacLeod Ph.D.:Yeah, yeah. And and uh, you know, the the good news is that here on the on the university campus, things have also evolved in a good direction where where that that you know now in the world of computing, we have administrative computing and we have academic computing and you know, the administrative computing, it's important, track of emails and all that good stuff. Then we have a scientific computing, and things have evolved now on that front. That scientist the the hardware, the people who maintain the systems, work in parallel with us. So they're also under the same director as as they're kind of a parallel organization with us at the Ski Institute. So uh, you know, so now we we bring those two worlds even closer together so that we understand where the new developments are and the limitations are in hardware, try and figure out how to make software that leverages strength.
Tom Butler:Kind of looking at a specific example, and and this might not work. I'm hoping this works, but um, you know, you a long time ago ago got introduced to the carvonin formula. Are you familiar with the carvonin formula? Okay, so no, I don't know. It is you've probably heard of it, you just don't even hear it, but it's it's the 220 minus age. Oh, yes, yeah. And so that was someone looking at data and analyzing data and saying, okay, I think this is a way for us to estimate max heart rate. That formula just I believe has no relevance for me at all. You know, my you know, if I take 220 minus a, I wouldn't be able to, you know, basically bike down the street if I was going to stay below that heart rate. And so and I don't know, you know, I I I don't have a good way right now of knowing what my max heart rate is. I don't want to go to failure, you know, and say, okay, now I know because my heart failed. It's that really rough uh formula from you know decades ago that now things have changed so much as far as how could look at an individual person and say, this is a good training heart rate for you. I don't does that does that bring up thoughts for you?
Rob MacLeod Ph.D.:Yeah, absolutely. I mean, at one point in my career, I was very involved in the bike racing community here as well. I was the president of a local bike racing club, and we would go out on training rides, and we'd be you know a mix of generally fairly fit people. Um, there was certainly the racing team, they were the elite, and then there was the rest of us, and and you know, most of the people in the group would do a little bit of racing, various forms, either time trials or criteria. And I remember going on a ride up a canyon near here. I mean, this what makes riding so great here is we have city is it's on a high plateau, it's relatively high, it's four and a half thousand feet, but it's you know, it's more or less flat. And then the mountains just start right behind the city. So we ride up the canyon. This is some of the most pleasurable rides and the coolest in the hot days of summer. So we were doing one of our regular rides up the canyon. So Rob, the physiologist, was riding up to different people as we were riding up the canyon, saying, What's your heart rate? What's your heart rate? What like because we're all kind of you know going at the same pace, we're all as a group together. There's a reasonable variability in age. Uh, you know, I was probably around 40 or so in my 40s by that stage. And we had certainly people in their 20s, and I don't think we had many people older than that. But so it, so you know, but we were all generating the same power rough. And the range of numbers, people would just look down at their heart rates or look at their watches and say, Oh, yeah, I'm at 130, and this person would be 110, and this person would be cooking along 160. And and the and I realized then, okay, the real this is the reality of physiology. This is this is the the differences naturally, you know, variability, natural variability that exists in us as humans. And it really opened my eyes to you know what we're talking about. Because, like you, I never found that formula was very informative. Really interesting part about our lives today is we have better measurement technology. So we can track our heart rate as long as we're active, and but that also we can use various other input data points like the power we generate, right? You know, I have a set of pedals on my bike that measures the power and that provides some input. And this is where the overlap with the data science happens. So there are better and better models that tap into more variables across a wider range of populations, which paradoxically allow us to more individualize the analysis of our personal. So we can feed our data into one of these models. And this is what's happening in the world of mostly performance sports, you know, it will trickle down to us. And we see a little bit when you input your data into Strava or some other application like it, it's going into a model. And it's, you know, if you do if I ride and don't necessarily have my power meter or my power pedals, it will still come up with an estimate of the power I'm generating. And those models are gonna and are getting more and more sophisticated. And they're using these AI tools, so not large language models, but uh the other aspect of AI, which is machine learning and you know, allowing models to predict individual behavior based on a deep well of data. And so we're gonna see better and better predictions of our performance and analyze this, especially if we follow this over time and see how things are evolving. You know, at our age, you always often wonder how much longer can I keep this up? You know, what can I expect of the inevitability of age affecting my performance? And you know, what are the real boundaries and what are the boundaries that are in our heads? Because society has told us, oh, you're over 60, you know, you're gonna go downhill at some prescribed rate, and you almost feel obliged to follow that decline. And and we're, you know, we're learning that that a lot of that is just not correct. So I think, you know, in ways that we may not even notice, because again, the software is gonna percolate up into these applications that some of us use to track our data. We're gonna see more and more accurate predictions. So so now as another example. So when I finish a straw a ride on Strava and I upload the data, I get a little summary that tells me what kind of workout I have. You've probably seen the same thing. And it notices, oh, you spent some, you know, you did some good three-minute power intervals there. That you that's you know, it's better than last week. So this is where the data revolution is going to one of many ways, it's gonna play out in so much of we do, and and and definitely is gonna affect uh the or give us data that we can use to make our some of our health decisions, some of our training decisions, and you know, some of our nutrition decisions. Or, you know, started playing with an application just to, I was just a little curious, you know, what's my protein output like? The big topic, of course, now. Right. How much protein do we need, and especially as we age and as we exercise? So I, you know, I'm playing with one of these apps and just you know, to see what it will what it will tell me. And and I'm sure it will have insights, some AI type methods that I I hope will give me some some insights, uh you know, how my uh you know, what my overall nutritional status is.
Tom Butler:Do you have a sense of how general practitioners are thinking? Do you are do you think that they are well aware of kind of all the tools that are available? Um, you know, the data analysis. Um is that working its way into the curriculum, or do you think there's a long way to go with that?
Rob MacLeod Ph.D.:Yeah, it it's definitely coming into the curriculum. In fact, generically, the use of computers I've seen come into the curriculum at our university over the course of the last 20 years. It was a time when a medical library was just full of journals, textbooks. And now our medical library has a whole floor dedicated to computers and simulation and you know, various things that uh expose the medical professionals, not just medical students, but PAs and nurses and whoever's getting trained to the use of computers in their practice. So we're definitely seeing more and more of that over the last couple of decades. Of course, the current revolution almost is coming with the advent of machine learning and AI techniques. And this is where um there's some huge, I would say, very optimistic signs that there are new methods, data science-driven methods that really can help with the management of patients, but that they are largely living in the research world. That we had a wonderful presentation by a very, very well known uh, he's actually a cardiologist by training, but much better known as kind of a doctor, very broadly imaginative and wonderfully grounded doctor in this space. His name is Eric Topel. He's had a long career. He's you know, he's also about my age and came to visit last fall. We he had a wonderful presentation he did, and we had some great chats, and and he has written a book on AI and medicine some some some time ago, which was actually turns out to be quite prescient. He gave a wonderful presentation and showed example after example of where AI could change medical practice. In each case, backed up a scientific publications, studies that illustrated the benefits, improvements over unassisted guidance or unassisted decision making, and quite quite convincing. And at the end of the presentation, he said, Yeah, but none of these have actually been tried, none of them are incorporated yet into practice. And that's the stage we're at. We have all these tools that show fabulous potential, but now we're we've got to get into this hard work of trying them in clinical practices, initially in academic medical centers, probably, because that's the way it often goes. And then we're going to see how they percolate out into the community. And you get, you know, very famous advanced clinics like the Mayo Clinic, you know, they have a this is a system I know a little bit about that, they have a dashboard for analyzing ECGs using some very sophisticated machine learning approaches to try and improve diagnostics of their patients. ECG is a wonderful target because it's a very cheap, painless, non-invasive measurement to make. So it's very tempting to try and extract all that we possibly can from it. It has shown, indeed, that there's lots of information that we never thought would be embedded in this in this signal. Cardiologists would have said, yeah, the we figured that out, you know, 100 years ago. We had the ECG, we figured it out 40 years ago, maybe. We have our algorithms, they tell us certain things, but there's just hard limits to what the ECG can do for us. Those limits are now changing and and and very surprising features. Like it's with very good accuracy, it's possible to tell the sex of a subject from their ECG, something that nobody thought would be real. No, nobody ever even guessed that that information was somehow embedded in an ECG signal, but it appears to be. There's lots of other, arguably more medically relevant details that are in an ECG. The Mayo Clinic has, you know, put together a system. They claim it's part of their daily practice. And and and that will only, I think, only be a matter of time before that does make its way out. And then they're, of course, studying carefully the impact of the system. How does it improve patient care? How does it improve outcomes, all those important things? So we're in that stage where proof of concepts are there across almost all of medicine. And now we're at this stage of sort of this hard work of adapting it to practical utility. And I'll close by saying, you know, the the one piece of technology that does seem to have penetrated very quickly into medical practice, it's it's very simple in concept. It's a little device that records the audio of the patient doctor interview and extracts the relevant information from that interview and stores that in the patient's electronic record. So the doctor, instead of sitting at a computer taking notes and obviously being distracted, I mean, you cannot possibly operate a computer and pay attention to, I would argue, anything, and certainly not a patient, you know, at the same time. I mean, multitasking is highly overrated in many people's minds. Lots of evidence to support that too. So the the idea that you could just let this device keep track of things and really focus on the patient and really use the highly evolved medical intuition that good diagnosticians and practitioners develop over time is an incredible opportunity, I think, to improve medical care. If we could have we could have this sense when we're talking to our primary care physicians at least, that they're actually listening to us, they're watching our faces, they're getting our body language, they're picking up on the subtleties because they don't have to worry about taking notes. And because, of course, you know, there has to be a record of makes sense, there has to be a record of this appointment, and they're under all kinds of time pressure, blah, blah, blah. So the challenge that that Topel posed in this talk, and I've heard other people describe, is what will the medical profession and the healthcare industry and the insurance companies drive a lot of it? What will they do with that extra time that a physician in principle will have because they don't have to take notes? And he, of course, as a dedicated clinician, says we should protect that time. We should protect and use that extra time to really engage with our patients and to add value to what we as physicians have developed as a skill set that no machine has so far in the world. And and and we all have our areas of expertise where I would argue we have an intuition of a situation that isn't something you can write down, it doesn't fit into a textbook, it's just a certain sense of for this situation, this is the way to respond. This is the solution, this is the approach we're gonna use to fix this problem. And if physicians can get the opportunity to focus on that skill set, they will be more effective as physicians. And maybe just as importantly, they will feel more satisfied in their profession. They will feel like I'm not being replaced by a machine anytime soon. There's not going to be an AI that takes over my medical practice. I can actually focus on what I've trained for and what I've developed great intuition for, and be ultimately more effective looking after. So this little bit of technology, this ability to transcribe a conversation, is it it has the potential to be transformed. If you know the medical industry complex, whatever you want to see it as, if they're allowed, you know, to operate in a way that that places the patients first, not bottom line and profit.
Tom Butler:Uh it is an elevated view of the opportunity of having more time. And that sounds wonderful. I I hope that that elevated view can win out.
Rob MacLeod Ph.D.:So yeah, I have I have I have clinical colleagues who are completely skeptical who say, no, no, no, that you know, we're gonna have to see twice as many patients. That's what's gonna happen. Right. So I but I I I I think it's a little bit emblematic of what it is that we will see these tools accomplish or at least enable if we handle it right. So in my world as a professor, I can use AI tools in ways that can save time in preparing my classes, doing some of the main mundane tasks, some of the routine things. And if that saves time for me to actually spend more time with my students and listen to them more carefully and work with them more closely, I see that as beneficial and incredibly gratifying. I did not become a professor to spend all of my time on paperwork or on all the background tasks. And it'll be up to every profession to evaluate where these things can help them and and what to do with with the you know space it creates.
Tom Butler:Well, let's end up this way. Do you have any cycling adventures coming up?
Rob MacLeod Ph.D.:Yeah, you know, we were we were just talking about this on the weekend. So not not a lot directly in sight, but just to give you a sense of of what often happens. I travel a great deal. This is part of the life of many academics to go to research meetings and collaborate with other people and often in other countries. And so around 1995, I purchased my first folding bicycle from a company called Green Gear, it was called then, now Bike Friday. So it fits in a suitcase and I travel with it whenever I'm going anywhere for any amount of time. Sometimes a harmless, let's say, you know, quasi-harmless conference can turn into a bicycle adventure quite spontaneously. So that inevitably happens. And I've had some fabulous opportunities to, I mean, I've ridden over there's a pass in the Pyrenees that was actually the very first mountain pass ever used in the Tour de France called the Tour Malais. And I was traveling between Spain and France, you know, for two related, very professional activities, but I got to carve out a couple of days in between and could unpack my little folding bike and ride up the tourmalie. And so we have a lot of ventures that sort of happen that way. What we also have taken to doing is traveling to a place where there is a lot of good cycling, finding a home base, and and rather than bike touring from A to B with or without support, we will settle in ideally a small village somewhere remote. This year we were in the in part of the Provence or the northern part of the Provence, and and we, you know, rented a little Airbnb. And I had my folding bike, and my wife rented an e-bike from a village nearby, which is, of course, easier and easier to do these days. And so every day we would wake up and you know get rolling at some point mid-morning, and then we'd ride for a few hours and end up at some beautiful little medieval village on some other part of the valley, and get there just in time, just randomly in time for a nice lunch. And then we would enjoy a nice lunch, explore the village, and then make our way home again. So a lot of the adventures end up, you know, being those kind of trips. And then every once in a while, like I say, this year, the the other big adventure of something I've always wanted to at least see and explore, is is the the again famous at the Tour de France climb up the Alp d'Oise. And so I we I did a little bit of research and just you know I knew about this little village at the base, and so we rented a place there. And I I did indeed get to ride my bike up the Alp Dues this year. So that's sort of the flavor that our our adventures often take. Just finding a nice spot and not feeling compelled on any given day to do any particular ride. And we love that unstructured approach. It it it's we're so dialed in now that it just runs, you know, sort of by itself. We know what we have to take, we know what we have to do, you know, we we we know how to do the research to find the rental bikes, and so that's become our our ongoing flavor. And I think, you know, there'll be lots of that in the future. We just haven't decided yet which which opportunities to attach to my professional life that we're gonna take advantage of.
Tom Butler:I love it. That just sounds delightful for sure. Well, Dr. McLeod, thank you so much. I'm glad you reached out and introduced yourself, and we got to have a bit of an email exchange. And I'm just really appreciative of you coming on and giving a view of something that you know I just don't see. I don't think a lot of people really see kind of what's behind the scene as far as these things that are are happening to improve the way that we can measure what's going on physiologically with us that enable us to, like you talked about, a paradox, but enable us to to look more individually by being able to gather more data across many realms. So thanks for for coming on and and bringing your expertise to the podcast.
Rob MacLeod Ph.D.:Thank you. It's been a great pleasure. I really applaud um what you're doing with the podcast. I think you're playing an incredibly motivating role for those of us on the latter side of 60, encouraging us to stay active and and I wish good luck going forward.
Tom Butler:Well, thank you. And uh maybe we'll talk again sometime.
Rob MacLeod Ph.D.:Sounds great. All right, bye now. Bye-bye.
Tom Butler:We hear all the time that AI is going to transform every industry. I don't think that's hyperbolic. In my opinion, we need to embrace what AI can provide in the area of the pursuit of longevity. Obviously, AI is far from perfect, but my experience is that there are some interesting outputs that can come from AI with its ability to analyze data. We certainly live in an interesting time. Not only are we seeing the rise of AI, but also we have access to more and more technology that is providing individual data. Rob mentioned power pedals. I really appreciate being given a set of power pedals a few months back. As I look at being able to compete in cyclocross, I have two sets of data that are extremely helpful. My goal is to be able to generate over 200 watts for 45 minutes while keeping my heart rate under 160 beats per minute. If I can do this, I think I'll be happy with my performance during a cyclocross race. And that also gives me a base to try to grow from. On August 17th, 2023, I did an episode that was an interaction with AI. I think I'll do something similar and have a conversation with AI about a training program for doing better with cyclocross next year. Stay tuned for more information on that. I hope that as the weather gets worse here in North America, that you are finding some great fall riding. I also hope that you have what you need to enjoy getting out in less than ideal weather. And remember, age is just a gear change.
