US Olympic Combined Nordic Team Trials

Chieko and I went to the US Olympic Combined Nordic team trials in Park City today. I had no idea what Combined Nordic was, but I heard it involved ski jumping and cross-country skiing, which made no sense, but it sounded fun. It is one of the oldest Olympic winter sports, and like the biathlon, it combines two unrelated sports. First the competitors ski jump on very large Nordic skis. Then they race cross-country for 10 kilometers. How these two sports tie together is that the person who jumps the farthest starts the cross-country race first. Each following competitor starts the race after waiting a certain time that is calculated based on how far they jumped. So the person who placed second in the jump may start the race a minute and a half behind the leader.

Attending was free, but we had purchased tickets for access to the VIP tent. This meant that during the two hours between the jumping and cross-country skiing, we hung out in the tent and enjoyed breakfast, which was burritos, hot chocolate and fruit, followed by lunch, which was salad, chicken and corn taco soup and cookies. We also arrived pretty early and got what I think were the best seats in the bleachers for both the morning and afternoon events.

I have to say, this was a lot of fun, especially the race. Because everyone started based on their ski jump distance they were pretty spread out. The race course was 2km, so they made five loops to make 10km. This meant there was always a lot of action in front of us. Plus there were TV cameras along the trail and large monitors for the spectators.

In case you don't know, the Utah Olympic Park is near Kimball Junction, a few miles outside Park City. 

Today the Park was groomed for ski jumping and cross-country skiing. 

By 9 a.m. a pretty good-size crowd had gathered. We arrived about 30 or 45 minutes early and had out pick of spots in the bleachers. 

The Nordic jump is the shorter hill on the left.

NBC Sports broadcast this event, so TV cameras and professional photographers were plentiful. 

Prior to the competition, which included one practice jump and one jump that counted, several young "sport" jumpers came down the hill, as well as several athletes who will be competing tomorrow in jumping only (the combined event was just today). 

Today was only men, but tomorrow will include women, who did some practice jumps today. 

A skier leaves the pole and heads down the hill.  

Preparing to jump. 

The launch. 

Gaining altitude. 

The winds were a little tricky today. They were pretty strong at times, and near the knoll there was a tailwind, whereas down the hill farther it turned into a headwind. Headwinds are best because they provide lift for the jumpers and carry them farther down the hill. 

Midflight. 

Preparing to land. 

The landing. This one is not one of the longest, probably in the 60-meter range.

The top red line is 90 meters, and the bottom red line is 100 meters. Only a couple of competitors made it past 90 meters, and none reached 100. I think about 92 was the longest. 

After the landing. 

At the bottom, near the crowd. 

And the finish. Only one jumper fell during the day, and he was one of the sport jumpers, not a competitor. 

It's now two hours later, and the skiers are ready to start the cross-country skiing. This is skate-style skiing. Skate style is pretty much what it sounds like. When I ski, I do classic style, which is when the skis move in parallel. 

The start. These three jumped nearly the same distance and thus started the race very close to each other. Competitors often join up into groups and work together to beat the others in the race. They take turns drafting off each other much as they do in bicycle races, and then they race each other at the end. 

A taste of the action. 

Bryan Fletcher is Number 5, which means after the ski jump he was fifth out of the nine, so he didn't jump far. He also started out fifth in the race. But here he has passed Number 2, Adam Loomis. Of the nine, there were two Fletcher brothers and two Loomis brothers. Bryan Fletcher, at 31, is the older of the two Fletchers. The younger Fletcher, Taylor, was favored to win today, but he didn't jump well and was only able to move up to fourth place in the skiing competition.

Bryan Fletcher was working with the Loomis brother, but on the fourth loop he took off out ahead on his own. Ben Loomis was Number 1 after the jump and led strongly over the first two loops of the Nordic race. 

Bryan Fletcher is coming in for the finish on the fifth loop. 

At the finish line. 

Anyone who doesn't collapse at the end hasn't given enough. Even the last guy, who trailed the others by quite a bit, barely made it over the finish line when he tumbled over.

There seemed to be a lot of camaraderie among the competitors. 

The winners: First-Bryan Fletcher, Second-Adam Loomis, Third-Ben Loomis.

Lose Weight and Avoid Diabetes the Smart Way

Several people have asked me how I lost about 40 pounds last year. The secret was a not-really-secret program called Omada, that Intermountain Healthcare sponsored. My wife's doctor had recommended the program to her to prevent diabetes, but this is primarily a weight-loss program, and she didn't qualify because she isn't overweight. When she told me that, I said, "Hey, I know someone who may qualify: Me." So I applied via IHC online and was accepted. Within a few days I had cellular-network bathroom scales, a health coach, and a team of other weight-losers, all connected online.

The reason this program worked for me was because it helped me make lifetime lifestyle changes in the way I eat and exercise. I don't believe most diet programs would work for me, especially the ones that require purchasing specially prepared foods or prescribe all-liquid or other weird diets. These are not things I could sustain after the weight-loss period. The Omada program included eating smarter (primarily sensible portions with less carbs) and exercising regularly. These are things I can commit to long term. Even though I'm no longer in the core part of the Omada program, I still weigh myself daily on the scales, track my progress on my phone, and follow the bloglike interactions of others on the program.

Last June The Wall Street Journal ran an article called "How Apps Can Help Manage Chronic Diseases." It featured a section that explains the Omada program very well and includes a short interview the WSJ did with me. Here's the Omada section of the article:

Diabetes: Keeping the Condition at Bay

Prediabetes—higher-than-normal blood sugar—increases the risk of stroke and heart attack. According to the Centers for Disease Control and Prevention, prediabetes affects 86 million adults, or more than one in three, and as many as 30% of them will develop diabetes within five years unless they lose weight through a healthy diet and exercise.

While many health plans and insurers offer diabetes-prevention plans, the lifestyle changes to ward off diabetes can require daily hand-holding, so more are looking for ways to deliver such programs digitally. In collaboration with the American Medical Association, Salt Lake City-based Intermountain Healthcare, with 22 hospitals and 185 clinics, is pilot-testing an online program provided by San Francisco-based Omada Health for patients at risk for diabetes. The yearlong program starts with a core 16-week online course on better lifestyle habits, and assigns patients to a personal health coach and private online support forum with moderated discussions.

Participants receive a pedometer and a cellular scale that transmits their weight readings to their Omada profile, and are visible to the coach. They log their daily activity and food either online or with a mobile app; if they have a connected device such as an Apple Watch, they can link it with the program to transmit activity automatically. Their results are displayed on a personal dashboard. After the initial sessions, Omada provides a 36-week sustaining curriculum focusing on weight maintenance. “You can’t just send someone a scale and a step tracker and pray for results,” says Omada Chief Executive Sean Duffy. “You have to combine these instruments with high-touch intervention” that includes social support and personalization.

Coaches usually reach out once or twice a week to check on whether participants have completed their lesson, answer questions and congratulate the patient on tracking activity or meals. Patients can also communicate as often as they like with coaches, who are required to respond within a day of any outreach. Omada sends Intermountain aggregate patient reports to show how an overall population is doing, but can also send individual patient reports for follow-up. Coaches can also encourage patients struggling in the program to reach out to their Intermountain doctors.

Research has shown that Omada participants are able to maintain weight loss and lower average blood-sugar levels two years after starting. In one study of 501 Humana Medicare Advantage beneficiaries, published in the Journal of Aging and Health, participants lost 7.5% of their initial weight after 12 months, improved blood-sugar levels, and lowered cholesterol. In addition to reducing their risk of diabetes, participants also reported improvements in self-care, diet and exercise, and lower feelings of depression and isolation.

“The new reality is that patients want to seek care in their own environment and on their own schedule online, as opposed to going to the office and waiting for a provider,” says Mark Greenwood, an Intermountain physician and one of the initiative’s program leads. “The future of primary care is to be both physician and navigator, hooking up patients with technology to help them manage their conditions.”

Omada estimates health plans and insurers it contracts with recoup their investment in the program within two years, with a predicted net savings of more than $2,000 per participant over five years. Dr. Greenwood says payment for the program will be based on outcomes. But he also says savings will come from preventing progression to full-blown diabetes, which can cost $8,000 a year to manage per patient.

One Intermountain participant, Michael Astle, 64, enrolled after he learned his blood sugar was in the high range. “I knew that my health was at risk, and I wanted to lose weight,” he says, but he kept putting off doing anything about it. He liked using the cellular scale to track his weight and the app on his phone to record activity and diet, and though he never met the other online participants, he says the forum helped “form a bond if someone was struggling or feeling bad and needed encouragement.”

Within 16 weeks he was down to 190 pounds from 227, and continues to lose weight toward his goal of 180. Mr. Astle says it is motivating to know that every time he steps off the scale, it sends his weight to his coach, “and I can’t let it go back up.”