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Sunday, December 9, 2012
For Athletes, Risks From Ibuprofen Use - NYTimes.com:
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Many active people use the painkiller ibuprofen on an almost daily basis. In surveys, up to 70 percent of distance runners and other endurance athletes report that they down the pills before every workout or competition, viewing the drug as a preemptive strike against muscle soreness.
But a valuable new study joins growing evidence that ibuprofen and similar anti-inflammatory painkillers taken before a workout don’t offer any benefit and may be causing disagreeable physical damage instead, particularly to the intestines.
Studies have already shown that strenuous exercise alone commonly results in a small amount of intestinal trauma. A representative experiment published last year found that cyclists who rode hard for an hour immediately developed elevated blood levels of a marker that indicates slight gastrointestinal leakage.
Physiologically, it makes sense that exercise would affect the intestines as it does, since, during prolonged exertion, digestion becomes a luxury, said Dr. Kim van Wijck, currently a surgical resident at Orbis Medical Center in the Netherlands, who led the small study. So the blood that normally would flow to the small intestine is instead diverted to laboring muscles. Starved of blood, some of the cells lining the intestines are traumatized and start to leak.
Thankfully, the damage seems to be short-lived, Dr. van Wijck said. Her research has shown that within an hour after a cyclist finished riding, the stressed intestines returned to normal.
But the most common side-effect of ibuprofen is gastrointestinal damage. And since many athletes take the drug for pain before and after a workout, Dr. van Wijck set out to determine the combined effect of exercise and ibuprofen.
For the new study, published in the December issue of Medicine & Science in Sports & Exercise, researchers at Maastricht University in the Netherlands recruited nine healthy, active men and had them visit the university’s human performance lab four times.
During two of the visits, the men rested languorously for an hour, although before one of the visits, they swallowed 400 milligrams of ibuprofen the night before and also the morning of their trip to the lab. (Four hundred milligrams is the recommended non-prescription dosage for adults using the drug to treat headaches or other minor pain.)
During the remaining visits, the men briskly rode stationary bicycles for that same hour. Before one of those rides, though, they again took 400 milligrams of ibuprofen the night before and the morning of their workout.
At the end of each rest or ride, researchers drew blood to check whether the men’s small intestines were leaking. Dr. van Wijck found that blood levels of a protein indicating intestinal leakage were, in fact, much higher when the men combined bike riding with ibuprofen than during the other experimental conditions when they rode or took ibuprofen alone. Notably, the protein levels remained elevated several hours after exercise and ibuprofen.
The health implications of this finding are not yet clear, although they are worrying, Dr. van Wijck said. It may be that if someone uses ibuprofen before every exercise session for a year or more, she said, “intestinal integrity might be compromised.” In that case, small amounts of bacteria and digestive enzymes could leak regularly into the bloodstream.
More immediately, if less graphically, the absorption of nutrients could be compromised, especially after exercise, Dr. van Wijck said, which could affect the ability of tired muscles to resupply themselves with fuel and regenerate.
The research looks specifically at prophylactic use of ibuprofen and does not address the risks and benefits of ibuprofen after an injury occurs. Short-term use of Ibuprofen for injury is generally considered appropriate.
Meanwhile, the Dutch study is not the first to find damage from combining exercise and ibuprofen. Earlier work has shown that frequent use of the drug before and during workouts also can lead to colonic seepage. In a famous study from a few years ago, researchers found that runners at theWestern States 100-Mile Endurance Run who were regular ibuprofen users had small amounts of colonic bacteria in their bloodstream.
Ironically, this bacterial incursion resulted in “higher levels of systemic inflammation,” said David C. Nieman, a professor of health and exercise science at Appalachian State University who conducted the study and is himself an ultramarathoner. In other words, the ultramarathon racers who frequently used ibuprofen, an anti-inflammatory, wound up with higher overall levels of bodily inflammation. They also reported being just as sore after the race as runners who had not taken ibuprofen.
Animal studies have also shown that ibuprofen hampers the ability of muscles to rebuild themselves after exercise. So why do so many athletes continue enthusiastically to swallow large and frequent doses of ibuprofen and related anti-inflammatory painkillers, including aspirin, before and during exercise?
“The idea is just entrenched in the athletic community that ibuprofen will help you to train better and harder,” Dr. Nieman said. “But that belief is simply not true. There is no scientifically valid reason to use ibuprofen before exercise and many reasons to avoid it.”
Dr. van Wijck agrees. “We do not yet know what the long-term consequences are” of regularly mixing exercise and ibuprofen, she said. But it is clear that “ibuprofen consumption by athletes is not harmless and should be strongly discouraged.”
Saturday, October 20, 2012
Dane’s Wild Tale of Ruse to Find Anwar al-Awlaki - NYTimes.com
A Biker, a Blonde, a Jihadist and Piles of C.I.A. Cash
By SCOTT SHANE
WASHINGTON — The man with the wire-rim glasses and bushy beard, speaking calmly in American-accented English, is familiar from dozens of Web videos urging violent jihad against the United States.
But in one astonishing clip, recorded more than a year before the man, Anwar al-Awlaki, was killed by a C.I.A. drone strike in Yemen, the American-born cleric had a very different mission: to propose marriage to a third wife.
“This message is specifically for Sister Aminah,” Mr. Awlaki says in the video to his future bride, a comely 32-year-old blonde from Croatia who he hoped would join him in his fugitive existence. The woman had expressed fervent admiration for Mr. Awlaki on his Facebook page and later made clear in her own video reply that she shared his radical views, saying, “I am ready for dangerous things.”
Neither Mr. Awlaki nor his prospective wife knew it, but their match was being managed by a Danish double agent as part of an attempt to help the Danish intelligence service and the C.I.A. find the cleric’s hiding place in Yemen. The attempt failed, but the undercover agent, Morten Storm, 36, a former motorcycle gang member who had converted to Islam, continued to communicate with Mr. Awlaki. When Mr. Awlaki was killed in a drone strike on Sept. 30, 2011, Mr. Storm was certain his efforts had been instrumental in it.
But eventually Mr. Storm’s resentment at not getting what he regarded as sufficient credit boiled over. He phoned Jyllands-Posten, the second-largest newspaper in Denmark, and told the bewildered receptionist that he had helped track down one of the world’s most wanted terrorist leaders. The Danish newspaper spent 120 hours interviewing Mr. Storm and verifying his account.
Among the evidence that the burly, red-haired Mr. Storm produced to confirm his wild tale, in addition to the video of Mr. Awlaki and e-mail exchanges with him, were postcards from intelligence agents, an audiotape of a C.I.A agent he knew as Michael and a photograph of $250,000 in $100 bills — money he says the C.I.A. paid him for his role as marriage broker.
As part of that plan, the suitcase carried to Yemen by the bride, identified only as Aminah in her video messages to Mr. Awlaki, was secretly fitted with a tracking device that the C.I.A. hoped would reveal the cleric’s location, Mr. Storm told the Danish reporters. But a wary associate of Mr. Awlaki’s had her discard the suitcase when she arrived in Sana, Yemen’s capital. She traveled on to meet and marry Mr. Awlaki, but the C.I.A. plan was thwarted.
Mr. Storm’s tale shows the lengths to which American intelligence officials went to hunt down Mr. Awlaki, a leader of Al Qaeda’s affiliate in Yemen who some counterterrorism officials believed posed a greater threat to the United States than Osama bin Laden did. Their method was a variation on the traditional so-called honey trap, in which spy services use the lure of sex to ensnare male targets. Mr. Awlaki had been arrested during his years as an imam in the United States for hiring prostitutes; his two Arab wives lived apart from him in 2010, and he had asked Mr. Storm to find him a European woman willing to stay with him in hiding.
His eloquent calls for violence, scattered across the Web, helped radicalize dozens of young, English-speaking Muslims. He was added to the Obama administration’s “kill list” after intelligence officials concluded that he had helped plan the failed bombing of a Detroit-bound airliner on Dec. 25, 2009.
His influence has survived his death. A 21-year-old Bangladeshi man, charged Wednesday with trying to blow up the Federal Reserve Bank of New York in a sting operation by the F.B.I., told an undercover agent that he had formed his jihadist views listening to Mr. Awlaki’s sermons.
The killing of Mr. Awlaki, an American citizen, without a trial and based on secret intelligence, set off a legal and ethical debate in the United States. Now, in Denmark, the articles in Jyllands-Posten have prompted some Danes to ask whether their government was complicit in Mr. Awlaki’s death and, if so, whether that violated Danish law.
Mr. Storm, whose life has been threatened since he went public, is in hiding and could not be reached for comment. The Danish intelligence service said in a statement that it “cannot and will not publicly confirm whether specific individuals have been used as sources.” A spokeswoman for the C.I.A. said the agency had no comment.
In a conversation in October 2011 with Mr. Storm and a Danish intelligence officer, which Mr. Storm recorded on his cellphone and which the Danish newspaper posted online, the purported C.I.A. officer known as Michael praised Mr. Storm’s efforts and even said that President Obama had been briefed on his efforts against Mr. Awlaki.
But he said “other projects” by the agency had located Mr. Awlaki. “We were very, very close,” Michael said on the tape, comparing their position to players in a World Cup soccer championship who might have scored the winning goal but did not. Mr. Storm can be heard on the tape protesting that the C.I.A. officer was playing down his own role and Denmark’s role.
Pierre Collignon, the editor in chief of Jyllands-Posten, said in an interview that the two reporters who met with Mr. Storm over a period of months, Orla Borg and Carsten Ellegaard, corroborated much of what he said about his dealings with Mr. Awlaki, the Danish intelligence service and the C.I.A.
“We were very cautious,” Mr. Collignon said. “We were afraid he might still be a jihadist and might be luring our reporters into a trap, maybe to kidnap them. He was a criminal before becoming a devout Muslim, and it’s difficult to trust him entirely. But we were able to document his story.”
The newspaper has examined paperwork showing regular payments to Mr. Storm from the Danish intelligence service and has confirmed that the snapshot of $250,000 spilling from an attaché case — the purported C.I.A. fee — was taken at his mother’s house. Mr. Collignon said the newspaper was planning to publish more articles based on Mr. Storm’s account of his six years of undercover work if it could confirm the details.
But he said that Jyllands-Posten, which was the target of terrorist threats after it published a dozen cartoons of the Prophet Muhammad in 2005, had decided not to post another video that showed Aminah removing her head covering to prove that she had blond hair, Mr. Collignon said. He said it might be considered provocative and invade the woman’s privacy.
Aminah is hiding with Qaeda militants in Yemen and helping produce Inspire magazine, a slick English-language publication that offers bomb-making advice and taunts against the United States. She last contacted Mr. Storm a month ago, Mr. Collignon said, and told him her dream was to become a suicide bomber.
Saturday, October 13, 2012
Why Netanyahu Retreated on Attacking Iran Soon - NYTimes.com
Why Netanyahu Backed Down
By GRAHAM T. ALLISON Jr. and SHAI FELDMAN
Published: October 12, 2012
FOR three years Israel’s prime minister, Benjamin Netanyahu, and his defense minister, Ehud Barak, seemed to be united in urging an early military attack on Iran’s nuclear facilities. But last week that alliance collapsed, with Mr. Netanyahu accusing Mr. Barak of having conspired with the Obama administration, in talks behind his back.
The clash came as a surprise in Israel, but in hindsight, there was a prelude — the speech Mr. Netanyahu delivered a week earlier to the United Nations General Assembly. In a memorable cartoonish graphic, Mr. Netanyahu depicted a “red line” that he said Israel would not let Iran cross. But he also acknowledged that Iran would not be able to cross it until next spring or summer. In doing so, he essentially reset the urgency of his warnings and ended speculation that Israel might mount a unilateral attack on Iran before the American presidential election.
The public row with Mr. Barak illustrated the magnitude of Mr. Netanyahu’s retreat and his difficulty in explaining it. He was left with implying that he had been undermined, if not betrayed by, his own defense minister. But that was not the full story of why he had blinked.
In fact, Mr. Netanyahu’s about-face resulted from a long-building revolt by Israel’s professional security establishment against the very idea of an early military attack, particularly one without the approval of the United States.
For months, former and even serving chiefs of Israel’s defense and intelligence communities have vigorously and publicly opposed Mr. Netanyahu’s case for attacking Iran sooner, rather than after all other means have been exhausted. Meir Dagan, the much respected former head of Mossad, did so to an American audience in an interview with Lesley Stahl broadcast last March by CBS’ “60 Minutes.” In Israel earlier, he had been quoted as saying that such an attack was “the stupidest idea I have ever heard.”
In addition, Mr. Netanyahu and Mr. Barak had proved unable to win sufficient support for early military action from other members of the government. Despite months of sustained effort, Mr. Netanyahu was not able to muster a majority even in his nine-member informal inner cabinet, much less Israel’s larger security cabinet, whose agreement he would need before attacking.
And in August, Israel’s president, Shimon Peres, took the occasion of his 89th birthday celebration to decisively reject any unilateral Israeli attack. The country’s pre-eminent elder statesman and the father of Israel’s own nuclear project, he broke with the nonpolitical traditions of Israel’s largely ceremonial presidency to argue that the central issue was the harm that going it alone could do to future American-Israeli relations.
Meanwhile, behind the scenes, the Obama administration was conducting a quiet campaign that would strengthen the view, already circulating among Israeli security professionals, that prematurely attacking Iran would not advance Israel’s interests and would damage Israel’s relationship with America. Instead of holding Israel at bay or threatening punitive action, the administration was upgrading American security assistance to Israel — so much so that earlier this year Mr. Barak described the level of support as greater than ever in Israel’s history.
This increase was manifest at every level: intelligence sharing that resulted in a convergence of assessments about Iran’s nuclear efforts; joint cyberoperations to slowIran’s nuclear program; support of Israel’s development of antimissile defenses; and reaching a common declared strategic approach to Iran’s nuclear program. That approach now focuses the two countries’ efforts on preventing Iran from obtaining nuclear weapons, while also ruling out the option of a retreat to containing and deterring a nuclear-armed Iran.
Equally important, increased American assistance has been accompanied by closer institutional links between the two countries’ defense and intelligence communities, as well as more intimate personal ties between both communities’ top echelons. Through numerous meetings in Tel Aviv, Jerusalem and Washington, the Obama administration has used these connections to convey an unambiguous message: Do not attack before all nonmilitary efforts to roll back Iran’s nuclear program have been exhausted.
Ever deeper American-Israeli defense ties have created what might be labeled a “United States lobby” among Israeli security professionals, who now have a strong interest in continuing the close partnership. It is no accident that the security institutions have become among the most vocal opponents of attacking Iran. No one knows better than they what is at stake if they ignore Washington’s concerns.
And their views have resonated with the Israeli general public: a poll conducted jointly last month by the Truman Institute at Hebrew University and the Palestinian Center for Policy and Survey Research found that 77 percent of Israelis now oppose a military attack on Iran that is not approved by Washington, although 71 percent would support an attack with American consent.
The plain fact is that the Obama administration achieved its objective of persuading Israel to refrain from a premature attack largely without explicit or implied threats. Instead, it has built a closer relationship with Israel’s defense community, and has capitalized on it.
And that should be a model for the future.
Especially when allies are as close as Israel and the United States, the relationship between them should not depend on whether the personal chemistry between their leaders is strong or weak. Instead, it should be based on firm mutual respect for the enduring national interests each side has. On that score, the professional security officials on both sides can be counted on to put domestic politics aside and to try to find a mutual approach to thorny problems, so long as they can talk candidly, and often, with each other.
A related conclusion is that an American administration will be most successful when it speaks, publicly and privately, with one voice — with the same message coming from the White House, the Pentagon and the Joint Chiefs. Then, its interests and priorities will be unmistakable to Israeli leaders, all of whom know how important American largess is to their own country.
These are important lessons not only for the future American-Israeli discourse on Iran, but also in the event that the next American administration, re-elected or new, will attempt to resurrect efforts to achieve Arab-Israeli peace. In that case, too, the United States is most likely to gain Israel’s cooperation by coupling a demonstrable commitment to the country’s security with a clear, unambiguous and sustained articulation of American national interests. And a thick, multilayered conversation between the national security elites in Israel and the United States could ensure that the two countries remain in sync, even when their leaders are not.
Graham T. Allison Jr. is director of the Belfer Center for Science and International Affairs at the Harvard Kennedy School. Shai Feldman is director of Brandeis University’s Crown Center for Middle East Studies.