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Inquiring Minds Want to Know: Older Bolder Links, Reads, Podcasts, Recipes, and More 24 June 2020

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Quote of the Week on Saturated Fats from the J. Of the American College of Cardiology

…Whole-fat dairy, unprocessed meat, eggs and dark chocolate are SFA-rich foods with a complex matrix that are not associated with increased risk of CVD. The totality of available evidence does not support further limiting the intake of such foods…

Read the entire piece here.

More Research and News You Can Use This Week

Dropping body fat appears to improve cancer outcomes.

Caffeine drinkers have more red blood cell glutathione (powerful antioxidant).

More good news on Vitamin D and COVID-19.

Speaking of COVID-19, a UK hospital study found lots of viral RNA on surfaces, but very low viral loads.

The younger your blood donor, the shorter your hospital stay?

Ways loneliness changes brain and body.

Can strenuous exercise actually shorten life span? The study the article is based on.

Podcast of the Week

Robert Mack on the tie between happiness and success.

Food, Glorious Food

Zucchini Jalapeño Salad

Older Bolder Coronavirus Update 2 March

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There’s been a fair amount of water under the bridge since I first posted a few thoughts about the COVID-19 story unfolding with ever increasing speed and vigor around the world two weeks ago.

While not intended in any way to be a comprehensive primer on the COVID-19 outbreak, here’s a quick rundown of key points I’ve been sharing with friends, family, and clients this past week in response to questions that keep rolling in.

There’s Still a Lot We Don’t Know (and for a Variety of Reasons)

One of the hallmark features of this COVID-19 story has been the lack of hard data available for public perusal, beginning from the earliest days in January when eyes and ears around the world began to pay attention to what was happening in Wuhan Province.

The authorities in China have a long and checkered history of not disclosing information which shines a revealing light on life there, and there of course has been and continues to be extensive criticism of early management of the COVID-19 outbreak and the lack of critical and accurate information provided the rest of the world as the virus has advanced beyond China’s borders.

To be sure, there’s much, much more information available today than two weeks ago, for example, the genome has been well mapped and tracked as the virus mutates (typical viral behavior) as it migrates through new hosts.

Vital information detailing the actual disease process induced by the viral infestation, how truly infectious the particle is, the impact of various co-morbidities on the natural history of the resultant illness, and even testing protocols have yet to be fully developed and dispersed.

Digging into the clinical details takes time; hard data is coming, but it’s simply not available at the granular level we’ve all come to expect in North America.

Hello, I’m Here from the Government, and I’m Here to Confuse You About COVID-19

Sadly, and impressively, the Chinese authorities haven’t been the only agency withholding information. The debacle unfolding in Washington State is a stunning example of such – it’s becoming clear that at least one of the early infections among the nursing home patients and staff was identified as early as six weeks ago, and not explored and addressed with purposeful intent and care in its earliest stages. (References: 1 2 3 4 )

Impressively, the mis-handling of the nursing home nexus in Washington has exposed thousands in the community unnecessarily; heads should roll once the relative crisis there has been averted.

Several states are withholding numbers and locations of patients under monitored or isolation protocols, and the frank – and let’s be damned honest about it – overt politicization of the issue by many at the national level is absurd, inflammatory, distracting, and harmful. RUN from anyone attempting to make this a political game – it is most certainly not – and you can be damned sure that any politician, regardless of stripes or tenure, doesn’t have your or the nation’s best interests in mind if they’re playing the COVID-19 politics card. RUN, and don’t look back.

Who Should Genuinely Be Concerned About COVID-19 Today?

As to who should be genuinely concerned about the COVID-19 outbreak today, those with preexistent lung and / or cardiopulmonary disease, especially if symptomatic, remain at the very top of the “should I really worry list”. By the relatively limited available data, most fatalities related to COVID-19 have occurred in this group, and those older than 80.

I’m hearing some chatter among physician friends that those with T1DM appear to be at higher risk, and of course anyone with impaired immune function for what ever reason needs to exercise due caution.

Another issue you won’t hear discussed in main stream media venues is a probable fecal-oral vector; this is very likely part of the nursing home catastrophe in WA, and would raise the potential for critical issues in locales such as San Francisco, where you need an app to navigate city streets to avoid current defecation sites. Cities with large homeless populations – LA, SF, Portland, Seattle, Austin, etc. – will need be watched carefully, and if they’ve not yet disclosed outbreaks by now, count me among those betting it won’t be long.

So What’s a Prudent Family to Do This Week to Deal with COVID-19?

So what’s a prudent family to do this week?

You’ve no doubt heard much of this same stack of advice from many other sources, and you’ll hear it / read it again and again this week as well. There are of course easy points to add to a list like this – don’t travel to high risk countries, cruise ships aren’t a great choice right now (at least in the Orient), and it’s worth keeping an eye on outbreaks as they develop around the country – at least as they’re reported – using your local health department or the John Hopkins mapping tool here.

Standard, time-tested and proven protocols for managing flu season risk are good to brush up on. Even better – simple hand washing and avoiding touching your face (especially around the eyes) – lower flu season risk dramatically and are available to everyone.

Might you have to sequester yourself in your home for a short time? Perhaps, if you live in the epicenter of a community eruption such as the one very likely coming in Kirkland, WA (the nursing home story we’ve been talking about) or have someone in the family with very high risk factors.

In many locales it’s probably too late for a full-on “prepper” stock-up, though putting together two weeks of food, water, personal hygiene items, medications, and home care products isn’t a complex game. As I write this late yesterday afternoon, there are reports across media outlets of runs on grocery stores (Costco in particular for some reason) all day yesterday.

I agree with those who suggest the supply chain disruptions caused by this event may be more seriously impactful on daily life than the risk of the actual infection, which for most will most likely be a flu-like event. Supply chain problems are just beginning to develop now, and will worsen down the line; having a store of food and supplies offers a buffer for these issues as well.

Still smoking? The data suggests that smokers are at particular risk for COVID-19 infection and more serious clinical syndromes – it’s past time to stop. Get it done, and now.

Have a potential option to work from home? It might be a good idea to chat about options and work through a few details with your employer before the (potential) sh*t hits the fan at some point down the road.

And finally, if you’re overweight, have the metabolic syndrome, are carb-dependent, and out of shape, any effort you expend starting NOW to overhaul your nutrition plan and begin to rebuild your fitness will pay off in the months to come, regardless of what issues this viral syndrome brings to your own neighborhood.

Pay attention, plan well, get moving.

Health and Fitness Expectations After 40: Can I Live Absolutely Pain Free?

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During my twenty-five plus years in medicine, most of that focused on the conservative (non-surgical) management of musculoskeletal injuries (roughly 70% spine-focused) and trauma, I had the pleasure of interacting with an astoundingly varied assortment of patients presenting with a host of aches, pains, and pathologies. No day was ever quite the same, and there was (and is) always something new to learn every day.

My principle task was of course helping figure out what the heck was the main problem at hand (diagnosis), because frankly it’s impossible to articulate an effective and cogent treatment plan unless you really understand the underlying issue(s). Only then could an effective treatment plan be customized to optimally fit a patient’s needs; that process typically also involved laying out a list of best choices in terms of treatment options and potential outcomes.

I believed then, and still do adamantly today, that a caregiver’s most critical tasks are making an accurate assessment of the issues at hand (there’s that diagnosis issue again) AND educating their patient (or client if you will) about a host of things – the problem itself, options to make things better, consequences of not dealing with the problem, and finally – managing expectations about recovery and the future.

Though it took several years to really appreciate all the moving parts in play here, over the long haul one of the more challenging aspects of that entire process was managing expectations patients brought to our relationship – the most challenging of all was the expectation that there was some magic pill, potion, therapy, surgery, or other treatment that could and would make them “pain free”.

The Pain Free Life After 40: Myth or Reality?

No doubt some will disagree, but after spending the better part of four decades studying human physiology, focused both on response to injury and normal degeneration (let’s call it wear and tear), along with ways to mitigate the problem(s) and improve function using a variety of approaches – I’m convinced it’s nigh on impossible to live an active, healthy lifestyle and NOT experience a host of aches and pains along the way, particularly for those of us who have invested four decades or more living our lives.

My rationale is pretty simple, and of course is colored in part by my own personal experience.

First, no matter if you come from the intelligent design or the evolution camp, there’s no question that the human body we see wandering the earth today experiences wear and tear changes along the way. This is of course common sense, something that we see all around us, and feel ourselves, just about every day, and yet several interesting points apply.

The longevity of the human body is critically impacted by how you care for it along the way. There are a host of great examples, but here’s the easiest one – living for years overweight increases joint loading (think hips, knees, ankles/feet, and spine) and accelerates degenerative changes in vital joint structures.

Or how about that combination ACL/MCL tear on the high school sports field or the ski slope (actually pick your major joint here – the other common example I see over and over again is a shoulder/AC joint/rotator cuff problem that starts at a very young age) that almost always leads to accelerated degenerative joint changes down the road.

Even some of the fitness activities that we all laud and encourage – jogging, running, cycling at a high level, hours spent in the pool swimming, some would even include CrossFit here – stress joints and other parts of the musculoskeletal system mechanically and probably do, at some level, indeed accelerate inevitable wear and tear.

We continue to do those fitness activities because the myriad benefits far outweigh the wear and tear we’re inducing, however there’s still a wear and tear component to the process.

Those changes wear and tear changes accumulate over the months and years, and now and again will inflame and generate what we all perceive as aches and pains. Don’t forget that typical age-related muscle and strength losses happen too, impacting joint support and mechanics; throw in a sedentary lifestyle and even worse overall physical conditioning, and joint changes worsen even more – and so do the inflammatory-driven aches and pains.

So Being Absolutely Pain Free After 40 Is Indeed a Myth?

What I suggested to patients for years and now for coaching clients is simply this – I think it’s virtually impossible to be absolutely free of aches and pains after 40 living an active and functional lifestyle.

Perhaps even more importantly, I’d argue that there are some “aches and pains” that are unquestionable a good thing; probably the best example is DOMS (delayed onset muscle soreness) after a new workout or pushing your game a little.

Wear and tear of the human body (sometimes referred to as the degenerative cascade) just happens; part of your musculoskeletal longevity might be genetically influenced, but the most critical impacts are related to how well you care for yourself over the long haul.

There’s no question whatsoever than you can dramatically influence inflammation levels in your body via diet (we’ll be looking at detail in inflammatory impacts from diet in a several post series shortly). Moving closer to whatever you consider your ideal body weight will have dramatic impacts as well, as will rebuilding (or working hard to maintain) practical levels of functional conditioning – getting into, and staying, in “fighting trim” will itself invoke some soreness and aches along the way.

Your body has amazing recuperative powers.

Is it theoretically possible to live a pain free life? Sure it is, it’s just not very probable.

Instead, embrace the occasional joint tweak, morning stiffness, and sore muscle group – it’s going to happen again and again. And relish those days when everything feels pretty good, modify on the days that it doesn’t, and just keep moving.

Health and Fitness Expectations after 40: Managing the Timeline Game

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Last week I introduced a series to come focusing on managing expectations, in particular expectations that those of us working to maximize our health and fitness after our 40th birthdays create for ourselves.

Given what we know about athletic performance, I’m thinking here of the old rule of thumb that your VO2max (think of VO2max as a measure of your body’s ability to utilize oxygen) declines by about 10% every decade post age 30, we probably should really be talking about expectations we create for ourselves post age thirty. (And this old study shows that the traditional 10% per decade decline doesn’t hold true for fit people actively exercising, even in their 7th decade).

And of course, the absolute crux of the timeline expectation game is damned simple – the time it’s going to take you to get from your starting point to your fitness, or weight, or metabolic health target depends on a host of factors unique to you, and critically where – relative to your targets – you’re starting from.

An Embarrassing Example from my Own Experience

When I first made the decision now just about three years ago to do what ever it might take to reclaim my health and fitness, I was a physical and metabolic disaster. In a full blow metabolic syndrome (I could have been a poster boy), I had just finished a round of treatment for renal cancer, had developed an idiopathic thrombocytopenia (low platelet count), weighed 412 pounds, and had so many aches and pains I could hardly walk through a store without the aid of a cart, and on the worst days, needed help tying my shoes.

A mentor helped me take the first steps in terms of revamping my diet and beginning at the most basic level in terms of rebuilding my fitness, and drilled into me the importance of setting attainable and rational short and intermediate term goals (incentives, and success, are huge helps). He also challenged me to set “reach for the stars”, seemingly at the time almost crazy goals as well; we can talk about structuring goals in detail sometime in detail – the psychology is fascinating – for sake of this story let’s just say I did set some seemingly unreachable long term goals (most of which I’ve now surpassed at the almost two year mark).

My mentor, wise friend that he is, hammered into me week after week that part of the process is indeed expecting life to get better (fitness to improve, weight to drop, etc), but he cautioned every single time that trying to pair my fitness and weight loss goals with a timeline I’d pulled out of thin air was a fool’s errand. He (correctly) harped on the principle that our expectations (especially when it comes to timelines) need to be tempered and tied to our reality unfolding day by day.

For Every Year a Couch Potato a Month in Recovery?

My mentor repetitively hounded me with another rule of thumb that he swears he learned from Dr. Phil Maffetone (I’ve yet to find it expressly stated on his site or any of his books), basically saying that after 40 (arguably 30 or 35 as well), for every year you’ve spent not exercising and overweight, you’ll spend at least a month of consistent fitness and healthy eating to reverse and overcome the damage and deconditioning done on your way back to a healthy baseline.

To be perfectly honest, I despise most rule of thumb discussions in health and fitness in general, as there’s simply too much variability in human physiology and experience to make them conform meaningfully to an individual’s reality.

That said, I’ve used this principle in advising clients and patients for years now – for every year a couch potato you’ll spend a month eating healthy and exercising consistently to restore a healthy baseline – and I’ll be damned if it doesn’t ring ring true more often than not. And note I’m talking about a healthy baseline here – becoming a masters cyclist or runner might take a little longer.

The Bottom Line: Play to Win the Long Game

In particular for those of us over 40, restoring optimal health and fitness after a period of…let’s say any time living with less than optimal nutrition and shunning exercise…is going to be a long game; accepting that reality will make the process immensely more rewarding, enjoyable, and sustainable.

Amazingly I still have people contact me for help in “easily dropping 50 pounds in three months”; most of the time we don’t mesh and work together – unrealistic expectations at the start are a huge hurdle to overcome. (Can somebody drop 50 pounds in three months? While possible, it’s sure as hell not probable, but it depends on where you’re starting from and how you want to get there; I dropped 50 pounds in four months myself at one point in my journey. )

By 40, most of us have accumulated at least a few dings and bruises, we don’t recover as quickly from aggressive workouts or injury, we often have very demanding work and family responsibilities, and we’ve often accumulated some damned harmful and deeply ingrained habits too. These things won’t prevent you from coming back, but they’ll impact your approach, and the timeline.

Have a long way to go to rebuild your health and fitness? It can be done; embrace the longer journey, savor the victories along the way, and build a lifestyle to take you into later years, remaining active, vital, and engaged.

Reclaiming Health and Fitness After 40: Five Quick Thoughts

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A couple of weeks ago I had a chance to reconnect with a friend from residency days back in Salt Lake City in the mid-80s; we were residency mates there in the University of Utah hospital system before he headed back home to San Diego to set up his practice and later found his own company.

My friend had something of an unusual story; he was a gifted mechanical engineer who later went into medicine with a goal of designing adaptive equipment for people with profound neuromuscular disease and injury. He was a delight, one of those rare hyper-intelligent and inquisitive people we all (rarely) have occasion to meet, and was an uber-fit skier, distance runner, and surfer.

Without boring you with details, through a mutual connection in England, he’d heard of my recent health transformation, and ended up calling to chat one afternoon. We covered a lot of ground in an hour, but he was particularly interested in what I’d done to reclaim my health and lessons I’d learned along the way. He shared that he had an adult “child” in her mid 40s who desperately needed a lifestyle and fitness change, and he was at the end of his rope trying to encourage her to start. He shared, among other things, that she felt she was “too far gone” to ever make a meaningful impact.

Thinking about it on the fly as we talked, I offered him five quick thoughts about reclaiming health and fitness after 40 gleaned from my own experience.

It’s Never Too Late to Start

I am profoundly and utterly convinced that it’s never too late to jump in with both feet, start moving physically, and reshape one’s approach to nutrition. At 57 I did just that, and started from a point of metabolic and physical disaster – 412 pounds, unable to tie my own shoes some days, with so many aches, pains, and symptoms I’m embarrassed to list them all. Now, just a bit over three years later, I’ve lost nearly 200 pounds and 20+ inches at my waist, am more fit than ever, and am even training for sprint competition in Senior track and field events upcoming.

Clearly your mileage may vary, but I have clients now in their 80s who’ve made similar changes and reshaped their approach to life. It’s never too late.

Reclaiming Health and Fitness After 40 Is a Long Game

Expectations can be an interesting beast to tame, at least for most of us. We’re an impatient society, and often fall prey to tall tales and crazy promises to shed improbably amounts of excess weight and gain extraordinary levels of fitness over very short time frames (30 days wonders) by following some magic diet, taking a wonder supplement, or copying the routine of a sculpted gym barbie with an Instagram following.

Attaining optimal health, fitness, and wellness at any age is a long game, most often measured in months if not years, but particularly for those of us north of 40. It’s a lot more enjoyable journey if you embrace the long view, and don’t sweat the day to day and week to week stuff.

Reclaiming Health and Fitness After 40 Might Take Baby Steps, But Take ‘Em

Talking with my friend, we agreed that life in today’s world, at least for the majority, is astoundingly sedentary. Many sit all day at work, commute sitting, come home and eat a poorly composed meal, and then sit on the couch for the next four hours before tossing and turning at night and starting it all over again.

Thoughtfully incorporating movement into the day can make a world of difference when starting from fitness ground zero; we’ve all heard the suggestions (park at a distance and walk in, get up and walk 10 minutes every two hours, etc), and these steps are easy to incorporate into one’s day. I’m a HUGE fan of walking outdoors, still do it daily to start my day myself, even on sprint training days, and just about every one on the planet can do it with minimal investment in time and equipment.

Baby steps turn into meaningful fitness routines over time.

Reclaiming Health and Fitness After 40: Embrace the Aches and Modify

One of the things I learned with my 30+ years in medicine is that the human body, despite its astoundingly complex design, function, and capacity to repair itself, is nonetheless designed to wear and tear over time. It’s inevitable, though manifests differently and at unique times for all of us.

The point: we all have our various aches and pains, joints that have been injured or have advanced markers of degeneration (read wear and tear); some days you’re going to be more sore and achy than others. Accept that reality, and modify, modify, modify exercise and fitness to accommodate your function on a given day. Remembering that you’re playing a long game makes this strategy more sensible too.

Personally I’ve been astounded at what a difference rebuilding functional strength has made in my own “aches and pains” related to prior orthopedic injuries, and just general activity and functional tolerance. Of course, that’s in part related to the last point…

Personally Optimizing Nutrition Makes Life So Much Better

Finally, I suggested my friend gently remind his daughter that there is a far, far better way to fuel the human machine than via the SAD (standard American diet). The point I tried to convey was simple from our perspective – the food we eat now is so much tastier, interesting, and flavorful than any we’ve consumed over the years, AND is so much healthier – less inflammatory (there’s that aches and pains concept again), less atherogenic, and more physiologically sensible given the science that has evolved over the past twenty years.

Personally I think for almost everyone walking on the planet, metabolic flexibility is the holy grail of nutrition – not being in ketosis or rigidly adhering to some arbitrary set of dietary rules. There is no one size fits all nutrition plan. Metabolic flexibility is key for anyone at any age, but perhaps even more meaningful for those of over 40, busy with all that life has to offer.

The challenge, of course, is to find the nutrition plan that resonates with your own particular physiology and metabolism, and make the tweaks and adjustments that work for you. It can be done, and again, it’s never too late to start.

Enjoyed the call JS, best of luck with your daughter and I’m happy to help any way I can.

A Thoughtful Reminder About Using Weight As a (Primary) Measure of Health

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Family physician Yoni Freedhoff, MD (Associate Professor, Department of Family Medicine, University of Ottawa; Medical Director, Bariatric Medical Institute, Ottawa, Ontario, Canada) recently penned a worthy read over on MedScape – Scaling Back on Weight as a Measure of Patient Health. (Note – free account required to read the full article).

From the article –

…When I was a medical student in the 1990s, I wasn’t taught how to use a scale, and I’m betting that the same is true for most medical students today. Don’t get me wrong; it’s not that I think scales are complicated pieces of equipment, but after exclusively practicing obesity medicine for the past 15 years, I do think that their proper use is worth discussing.

Scales do measure the gravitational pull of Earth at a given moment in time. Scales don’t measure the presence or absence of health, nor do they measure lifestyle or effort. And for patients, it’s useful to note that scales don’t measure happiness, success, or self-worth, either…

He goes on to remind that while weight is without question a significant risk factor for a plethora of medical conditions, particularly at the extremes of the body weight curve, weight alone is not a guarantee that any or all of these conditions will occur. He also reminds that inferring health status from body weight alone is often a fool’s errand, and that scales don’t measure lifestyle.

My specific intent in mentioning the article is two-fold. One, to remind us all that the principle objective of improving our nutrition and fitness is to optimize our health and ability to function in life, not necessarily attaining some (often arbitrarily derived) number on a scale that conforms to our (real or not) body image.

And two, it’s always interesting to read responses to opinion articles that are targeted toward a physician audience and “peek behind the curtain” if you will at their responses. I for one think it’s a good thing conventional medicine is beginning to talk in earnest (at least part of the time) about lifestyle influences on health…

Question of the Day: How Often Should I Weigh?

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Interesting question from John about how often to check in on the scales…

I’ve just now been converting to a healthy diet (more or less classic paleo) over the past six weeks or so. I’m what most would consider a huge guy – I weigh over 420 pounds – and realize that it’s going to take me months (maybe years) to recover my body. I dropped 15 pounds in the first two week, and now progress is much slower. Weighing every day, and even every week is pretty discouraging given the big challenge facing me, what would you advise?

I’m on the road today, but wanted to share a few quick thoughts with John, given in particular that I personally faced a similar, and at one point, discouraging challenge. (As an aside, I happen to be a data nerd and love tracking all sorts of metrics, but I stopped doing weekly weight checks as I’ll share below.)

That said, several quick thoughts…

Attaboy John, You’ve Made the Right Choice to Get Started

First, an enthusiastic attaboy for making the decision to get started on your journey to recover your health, fitness, and function. Never doubt that it can be done; I weighed over 400 pounds myself a little over three years ago, and am a today few weeks away from having lost half my former body weight.

It’s not a glamorous process, but a very attainable one, and you’ve gotten off to a great start thus far. My first piece of heartfelt advice is this: recognize it’s going to take a months to reach your targets (whatever they might be at this point), focus on working your persistence and patience muscles daily.

Remember that Body Weight is Only One of Many Meaningful Metrics

For those of us facing the daunting challenge of dropping significant excess body weight, using the scale as our only measure of success, especially early on, can be discouraging given the rate of change we see, particularly if weighing daily (which I don’t advise for you), or at this stage in the game, even weekly.

Look for other tangible and valuable measures of success; clothes fit better and then you’ll find the need to drop a size or two. As you move more in daily life, walking becomes easier, your endurance will improve, and exercise for strength and endurance will become something you’ll look forward to. Sleep will improve, heartburn will resolve, and I’ll bet the barn your mood and attitude will begin to reshape too.

Numbers on a scale may not end up being the most valuable indicator of progress at all.

How Often to Weigh? Consider This Option With A Long Way to Go…

When it’s all said and done, how often to weigh eventually boils down to a matter of personal preference, and there’s clearly no right or wrong answer as long as the scale doesn’t become an instrument or focus of an obsession.

Let me share a quick story from my own experience; early on in my own recovery journey, I charted weekly weights, though found three or four months in that dropping anywhere from 1-2 pounds per week seemed discouraging, even with an occasional 3 pound week mixed in. Looking at where I was, and comparing to my end goals (>200 pound loss), on some days prompted that voice of self doubt to creep in, usually something along the lines of “who in the hell do you think you are to imagine you could drop this much weight; you’ll never get there, etc…”.

A friend, actually a former 800m Olympic runner back in the day, encouraged me one day to quit focusing so much on the scale, and focus more on my daily process – eating good food that’s been well-prepared in line with my goal macros and that day’s fitness pursuits (whether fun or a grind it out workout). She challenged me to move to monthly weigh-ins, which I did over two years ago and continue to this day. For those of us with goals of dropping a lot of pounds, I still advise considering a trial of at least a couple of months weighing only monthly.

And to be frank, in my own experience, changing my wardrobe has been a hell of lot more gratifying – and reinforcing – than dropping big numbers on the scale.

I’d certainly encourage you to eschew the daily weight checks, and weigh no more often than weekly. If monthly checks leave you feeling a data void, consider twice a month on the first and fifteenth.

More to come…

Best for Fat Loss: HIIT, SIT, or MOD?

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One the most common questions I hear, as do fitness trainers across the fruited plain, is this:

What exercise will make me lose weight fastest?

First Caveat: That’s Sorta’ve a Trick Question

Before looking at some interesting data recently published in the British Medical Journal, it’s worth stating one more time that in my opinion, for most of us, our body composition is by far and away largely a result of what we eat, not how much we exercise.

You can split hairs as to how much diet and exercise each play a role in determining your body composition, and as always, your specifics depend on a host of factors unique to you and you only. From where I sit these days, it’s reasonable to argue (again for most of us) as does Sisson that roughly 80% of your body composition is related to what you eat, roughly 10% to exercise, and 10% to managing stress and sleeping well. Do those exact numbers apply to everyone? Of course not, but it’s a decent conceptual starting point to launch from…

The trick question issue has to do with the fact that exercise is in no way the biggest determinant in “losing weight”; no matter how hard you try to burn calories, you still can’t outrun your fork, particularly if you’re eating along the lines of a standard American diet. Another way to look at it, and one that’s particularly damning to the traditional medicine and nutrition way of thinking, is that in no way does the simple adage of calories in, calories out ring true.

That said, here’s an interesting spin on the issue from the BMJ, first published in Feb 19.

HIIT, Particularly SIT, Beat MOD for Absolute Fat Loss

From the abstract –

Objectives To compare the effects of interval training and moderate-intensity continuous training (MOD) on body adiposity in humans, and to perform subgroup analyses that consider the type and duration of interval training in different groups.

Design Systematic review and meta-analysis.

Data sources English-language, Spanish-language and Portuguese-language searches of the electronic databases PubMed and Scopus were conducted from inception to 11 December 2017.

Eligibility criteria for selecting studies Studies that met the following criteria were included: (1) original articles, (2) human trials, (3) minimum exercise training duration of 4 weeks, and (4) directly or indirectly compared interval training with MOD as the primary or secondary aim.

The Summarized Results: Interestingly, they found that both MOD and HIIT reduced participants’ body fat percentage, with no statistically meaningful difference noted between the groups.

The kicker was this, when looking at loss of total absolute fat mass (the magical “weight loss”), HIIT groups, particularly those engaging in SIT (sprint interval training) dropped 28.5% more total fat mass than the MOD groups.

The Take Home: Adding sprinting to your routine offers a host of benefits regardless if weight loss is an objective or not, but it is particularly beneficial if you have pounds to drop.

Granted, for some of us, adding HIIT and in particular SIT (Sprint Interval Training) might see like a long shot given current physical condition, joint or other orthopedic issues, or any number of other things. I get that, and it can be a real challenge to incorporate, but it’s doable with imagination, willingness to experiment a little, and some trial and error.

We’ll revisit the sprinting for the non-sprinter, older wannabe fitness jockey, and the rest of us in the next week or so.