Monday, May 22, 2017

Strength Training and Pregnancy: The Real Risk

We don't live in a world where there are usually only two options...even if it seems that way. High school graduates don't have to choose from the only two local colleges. Saying "no" to vanilla doesn't mean we're eating chocolate.


With any activity during pregnancy, a common thought is to "take it easy." The insinuation is the opposite (high-effort activity) is dangerous. This may explain why more than 60% of expectant mothers remain sedentary throughout pregnancy (1). It is possible that higher-intensity exercise could be dangerous for the mom and fetus. However, there is a third option: challenging exercise that is thoughtfully planned, beneficial, and safe.

Not only should pregnant women perform challenging exercise, but exercising is the safest way to go...for the mom and the fetus. Specifically, strength training during pregnancy is extremely valuable to both parties involved. In fact, I feel strength training should become the default for expecting mothers.

Value for the Mom

Pregnancy is a risky period for the mother. If the mother is inactive, she could gain an excess of weight and lose a large amount of muscle (1). These changes are often never corrected (1). The expecting mother also could develop gestational diabetes, which increases the risk for eventual type 2 diabetes (1,3).

So...why should expecting moms strength train?

Women who strength train during pregnancy gain less weight (1). Strength training improves or maintains posture and strengthens key muscles involved with labor (2). It's no surprise that labor strain is less for these women (2). Strength training may accelerate recovery from giving birth and is connected with a lower rate of operational births (2). Lower back pain is also much less common for expecting mothers who strength train (1).


Exercise in general reduces the risk of preeclampsia by 24% (1). However, high-intensity exercise, which is what strength training is, reduces the risk by 54% (1)! In other words, high-intensity exercise prevents one out of every two women from suffering preeclampsia. 

For women who develop gestational diabetes, strength training reduces or eliminates the need for insulin (1,3). This is especially noteworthy since insulin treatments increase the risk for the newborn being undersized for at least the first few years of life (3). Weight training improves post-meal and fasting blood glucose, too (3).

Value for the New Life

Strength training during pregnancy enhances the mom's status as a benefactor for the baby (you know, in addition to the fact that she's doing the baby a solid by hosting him or her for nine months).  

Babies from strength-trained moms are generally longer and have more lean mass (1). A study of five-year-olds from groups of moms who did or did not strength train also provided other possible insights (1). Offspring from trained moms were more attentive, disciplined, and showed better overall neurological development (memory, emotional development, etc.).

Safety

None of these benefits matter if strength training isn't safe for the expecting mom and fetus. Fortunately, it is. Common exercise concerns during pregnancy are trauma to the fetus, hyperthermia (elevated body temperature), and disruptions of regular blood flow to the uterus (2). Strength training does not cause any of the three to occur (1,2). Strength training, or any general high-intensity exercise, does not increase the risk of a miscarriage or any negative labor side effects (1).

My Experiences and Recommendations

I strongly feel exercise, especially strength training, should be the default for expecting moms unless informed otherwise by the personal OB/GYN. It's the safest way to go for women during pregnancy.

Based on the research and my personal experience with training pregnant women, here are a few practical recommendations:
  1. This article, especially these recommendations, assumes the pregnancy isn't high-risk. Seek the opinion and clearance of the personal OB/GYN before proceeding with anything relating to exercise. The recommendation of the OB/GYN trumps anything shared here.
  2. After the first trimester, avoid prone and supine positions (lying facing down or up).
  3. After the first trimester, avoid overhead lifts. These lifts might add stress to the lower back (1) and also significantly increase blood pressure.
  4. Breathing continuously throughout an exercise is especially critical during pregnancy. Holding one's breath increases blood pressure, and that could harm the fetus (2).
  5. Move continuously between sets to avoid blood pooling in the veins.
  6. Due to an increase in the hormone elastin, ligaments become more flexible during pregnancy. If the mother stretches, avoid pushing the stretch the whole way. Doing so could lead to long-term tissue damage with the more lax, damage-susceptible ligaments.
  7. With the previous point in mind, go to a comfortable but not full range of motion on hip adduction and abduction machines in the second and third trimesters.
  8. Due to the greater risk of potential fetus trauma and bone/ligament/tendon injury, researchers recommend avoiding lunges, back squats, and stiff-legged deadlifts (2). (I personally trained most pregnant clients on machines and cables.)
  9. For mothers with healthy, low-risk pregnancies, I've trained them close to complete muscle fatigue with challenging weights and controlled movements on each set...into the start of the third trimester...with no ill effects. Effort is not dangerous for women in healthy pregnancies. Poor exercise choices and breath-holding are dangerous.

References

  1. Schoenfeld, B. (2011). Resistance training during pregnancy: safe and effective program design. Strength & Conditioning Journal, 33(5), 67-75.
  2. Pujol, T. J., Barnes, J. T., Elder, C. L., & LaFontaine, T. (2007). Resistance training during pregnancy. Strength & Conditioning Journal, 29(2), 44-46.
  3. Brankston, G.N., Mitchell, B.F., Ryan, E.A., & Okun, N.B. (2003). Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus. Elsevier, 190, 188-193.

Thursday, May 11, 2017

Why the Negative Leads to Positive Training Results

Don't skip the opportunity to make $50 an hour to earn $20 an hour. Imagine you ran a business where you offered two services: option A, a flashy service that offers some value and helps you earn $20 an hour; and option B, a less sexy but more valuable service which you earn $50 an hour for.

The downward phase of the dip is more valuable than the upward phase.

Which service would you spend the majority of your time on? I would focus on option B...and I hope you would, too.

However, many strength training enthusiasts focus on option A. Option A is the positive, or lifting portion, of a repetition. The lifting phase of the repetition is sometimes sexy (have you seen an Instagram video of a person lifting a weight, then dropping it?). Option B is the negative, or the lowering phase of the repetition. While it is less sexy, the negative provides the majority of strength and muscle gains.

Unfortunately, many trainees avoid the negative (dropping the weight) or race through the negative. This is the exact opposite of what people should do.

Advantages of the Negative

There are a few ways to test which part of the repetition is more valuable. One way is to compare people who performed the positive AND negative to people who performed twice as many positives but NO negatives. This was tested in two studies (1,2). In both studies, the people who lifted and lowered the weight gained more muscle and strength. In one study, the group performing the full rep gained 25% more muscle than the group who only performed the positives (1). In the other study, the positive and negative group gained 73% more strength than the positive-only group (2).

To maximize your benefits on the leg press, bring the weight down slowly.

Another way to get an answer is to compare negative-only training to positive-only training. A meta-analysis (research combining the results of other studies) of 20 studies comparing the two training types determined that negative-only training leads to more strength and muscle development (3).

While both are valuable, the negative is more important than the positive for building strength and muscle.

Negative-Accentuated Repetitions

The negative offers one additional benefit: people can lower more weight than they can lift. Knowing that, you can perform "negative-accentuated repetitions," which is when extra weight is added on the negative. This can be practiced by adding more weight to the negative on each rep, just before starting to lower the weight. Another method is to use a weight 20-40% heavier than your usual training weight, but have someone help on the lifting phase. The weight would be lowered entirely by yourself.

Negative-accentuated reps, with 40% more weight on the negative, leads to more endurance and muscle growth than traditional training (4,5). Researchers also found accentuated reps increased the production of testosterone, cortisol, and growth hormone (4). Those hormone changes are generally associated with enhanced strength and muscle growth during training (4).

My Recommendations

The negative is more important. With that in mind, we should emphasize it. Here's how:

  1. The negative should be as slow, if not slower, than the positive. If you generally lift the weight in two seconds, you should lower the weight in at least two seconds. 
  2. Ideally, I recommend you shoot for at least four seconds on the lowering phase. Slow negatives will lead you to perform less overall repetitions, but the goal is to gain strength and muscle, not perform reps. Keep that in mind.
  3. If you have a training partner, consider negative accentuated reps. Make sure to perform at least two warm-up sets before doing this! Consider starting with a weight 20% above your usual training weight. Ask your partner to help you lift. Hold at the end of the positive, remove the assistance, and lower as slow as you can.

Don't let the Instagram videos fool you. The lowering phase is where your "gains" are coming from.

References

  1. Hather, B.M., Tesch, P.A., Buchanon, P., & Dudley, G.A. (1991). Influence of eccentric actions on skeletal muscle adaptations to resistance training. Acta Physiologica, 143(2), 177-185.
  2. Dudley, G.A., Tesch, P.A., Miller, B.J., & Buchanon, P. (1991). Importance of eccentric actions in performance adaptations to resistance training. Aviation, Space, and Environmental Medicine, 62(6), 543-550.
  3. Roig, M., O’Brien, K., Kirk, G., Murray, R., McKinnon, P., Shadgan, B., & Reid, W.D. (2008). The effects of eccentric versus concentric resistance training on muscle strength and mass in healthy adults: a systematic review with meta-analysis. British Journal of Sports Medicine, 43, 556-568.
  4. Walker, S., Hakkinen, K., Haff, G.G., Blazevich, A.J., & Newton, R.U. (2017). Acute elevations in serum hormones are attenuated after chronic training with traditional isoinertial but not accentuated eccentric loads in strength-trained men. Physiological Reports, 5, e13241, DOI: 10.14814/phy2.13241.
  5. Walker, S., Blazevich, A.J., Haff, G.G., Tufano, J.J., Newton, R.U., & Hakkinen, K. (2016). Greater strength gains after training with accentuated eccentric than traditional isoinertial loads in already strength-trained men. Frontiers in Physiology, 7, 149.

Wednesday, May 3, 2017

Ab Exercises and "Ab Exercises"

There are some fields where professionals aren't needed to get involved. While we need a pilot to fly a plane, we don't need a financial adviser to invest money or a doctor to buy (many) medications. While the freedom allows us to learn with first-hand experience, it can also lead to issues, such as poor returns on investments or not curing acute illnesses quickly.

Those abs likely weren't developed with leg lifts.

Exercise is another field where a professional isn't needed. While training oneself has advantages (autonomy, saving money), it also has disadvantages. Not using an exercise physiologist or personal trainer adds to the risk of using fitness practices that are ineffective or even dangerous. One of the most common examples is how people train their abs.

Most "ab exercises" provide little to no benefit for the abs. They actually train other muscles which have no connection to how we look. Also, the perceived "ab exercises" are extremely strenuous for the lower back.

What Movement Trains Ab Muscles

The main role of the rectus abdominis, or "abs," is to curl the back into a 'C' shape (lumbar flexion). The most common example of this is a crunch. The pseudo ab exercises do not cause the back to curl at all. These movements actually focus on moving at the hip (hip flexion). The muscles that perform hip flexion are referred to in general as the "hip flexors" (iliopsoas and illiacus).

The photos below show you views from the front of the body. In the first image, blue indicates the abs while the red indicates the hip flexors. Notice that the abs are on the top surface while the hip flexor muscles are deeper, being close to the spine and under layers of muscle. In other words, if you train your hip flexors, you won't change the way your midsection looks.



Crunches train the abs and can improve the appearance of the midsection. If your spine curls into a 'C' shape during an exercise, it's likely an ab exercise. Below are examples of ab exercises. Note the green line, which is intended to mimic the shape of the spine in each position.

The "C" shape of the spine indicates the abs are the main working muscles.

Notice that the upper back leaves the surface but the lower back doesn't.

The Dangers of "Ab Exercises"

Pseudo ab exercises that actually focus on the hip flexors are leg lifts, knee lifts, and sit-ups. Also, ab machines are mostly used incorrectly, with people leaning forward, which emphasizes the hip flexors. During all of these movements, the spine is mostly or completely straight. Notice the straightness of the green line in the pictures below.

This is an ab machine but used incorrectly.

Leg lifts typically involve almost no "curling" of the spine.

Sit-ups mainly work the hips flexors. Notice how straight the spine is.

What makes this common exercise error a large concern is the stress hip flexion exercises put on the lower back. Research from the lab of Dr. Stuart McGill, largely considered the leading researcher in spine biomechanics, indicates the lower part of the lumbar spine (L4/L5) experiences a large amount of force during sit-ups and leg lifts (1). Injuries, in general, occur when bones, muscles, and other tissues are given more force than they can support.

The graph below shows the results of a study looking at how much force (measured in Newtons) each exercise places on the lower lumbar spine when the exercise reaches the peak of the movement. The higher the bar goes, the greater the force placed on the spine.

Source: Axler & McGill, 1997. (1)

The pseudo ab exercises, along with twisting crunches, place large loads of force on the lower lumbar spine.

My Recommendations

The truth is all non-isometric ab exercises place at least a moderate amount of stress on the lower back (1). The smartest move for your lower back is to only perform isometric movements, such as the plank and side plank. However, isometric exercises do NOT lead to muscle growth. I care about how my abs look and I imagine you do, too. Therefore, here are my thoughts on how to minimize your risk of a back injury while maximizing what you can do to help improve how your abs look:
  1. Unless you're an athlete who needs strong hip flexors, stop performing hip flexion exercises. Drop the sit-ups and leg lifts.
  2. Avoid ab machines...unless you are positive you are using them correctly. Your lower back should ALWAYS remain in contact with the lower back pad on the machine. Also, you should not feel any lower back ache or weakness when properly using this machine.
  3. Avoid twisting crunches. The lower back stress isn't worth the benefit.
  4. Perform crunches. Use a very challenging resistance (dumbbell on your upper chest?) and increase the resistance at least every two weeks. Perform only 1-2 sets, with each set continuing until complete exhaustion. The small number of sets should minimize your risk of injury.

Reference

  1. Axler, C.T. & McGill, S.M. (1997). Low back loads over a variety of abdominal exercises: searching for the safest abdominal challenge. Medicine and Science in Sports and Exercise, 29(6), 804-810.

Thursday, April 27, 2017

My Fitness Program, Results, and Rationale: Part II

This is part two of a two-part series detailing what results I'm currently seeing along with my habits and lifestyle. In part one, I shared my results: my joint health, metabolic and cardiovascular numbers, and body composition data. In this part, I share what I do and why.

A crock pot dish of tomatoes, carrots, spinach, chicken, and beef broth.

This post is for anyone who follows this blog and is curious about my personal habits/routines. Before continuing, keep in mind:
  1. My habits and routines are not perfect - it's just what works for me at the present time.
  2. I'm frequently adjusting and experimenting, so what I do now isn't necessarily what I did six months ago or what I'll be doing in six months from now.
  3. As mentioned in part one, my goals are health, longevity, being satisfied with how I look, and having an above average amount of strength and muscle.

My Habits and Routines


Exercise

Using my last 30 days of logging in MyFitnessPal, I average 40.7 minutes per day of activity. Focusing on my high-intensity exercise only (no walks or hikes), I average 24.7 minutes of exercise per day. 

Here's a look at my last 30 days of activity and exercise in terms of total minutes each day, and a table featuring a more comprehensive breakdown of my routine.

W = walks.

Type of Exercise
Frequency
Other Details
Strength training
5x/week
Workouts last 20-28 minutes.
Walking
1-2x/week
Walks are slow and last 30-90 minutes.
High-intensity intervals on a stationary cycle
1-2x/week
Total workout is 10-15 minutes.
Warm-up/cool-down: 5 minutes total.
Workout is three 30-second intervals of 90-100% effort with light pedaling in between.
Hiking
1x/month
Average hike is 3-5 hours.

I don't really consider walking to be exercise. Walking is effective for reducing blood pressure and improving insulin sensitivity (diabetes prevention), but doesn't produce physique or skeletal changes. I walk for mental clarity and sun exposure

My current strength training routine features three days of training, followed by two days of rest. In each day of training, I perform three pairs of exercises. My workouts feature 14-18 total sets. I work until exhaustion on each set and pick weights that lead to exhaustion in 4-7 reps. My reps last around eight seconds each. I increase the weight when I'm able to perform seven reps in the first set.

Day 1 (Upper)
Day 2 (Lower/Midsection)
Day 3 (Accessory)
Lat Pulldown
Incline bench press
3 sets for each
Leg Curl
Hack Squat*
3 sets for each
Seated Barbell Military Press
Seated Calf Raise Machine
3 sets for each
Cable Row
Barbell Bench Press
3 sets for each
Deadlift with Cable Machine
Leg Press Machine
3 sets for each
Standing Barbell Curls
Cable Pushdown
3 sets for each
Neutral Grip Pull-ups
Dumbbell Bench Press
3 sets for each
Floor Crunch (dumbbell on my chest)
Back Extensions
1 set for each
Dumbbell Hammer Curls
Overhead Dumbbell Triceps Extension
2 sets for each

I am removing the hack squat to eliminate unnecessary stress on my lower back. In regards to the structure of my workout program, here are some reasons why I do what I do:
  • Short workouts: performing long workouts almost every day leads to immune system weakness, a drop in metabolism, a lack of recovery, and added joint breakdown (1). Exercise should improve health and fitness, not damage it. Also, long "cardio" workouts can limit the strength and muscle growth benefits from strength training. However, short, high-intensity interval training could enhance strength training results, plus provide health benefits (2).
  • Compound exercises: in my upper and lower body training days, I focus on compound movements, which are exercises which require multiple joints to move (bench press, pull-ups, row, deadlift, leg press, etc.). These exercises train more muscles at one time. Also, compound exercises have larger effects on metabolism and stimulate a greater production of growth hormone and testosterone, which could improve muscle growth (3).
  • Short rest between sets: resting just one minute between sets leads to fewer reps performed in the following sets (3). However, it leads to a greater increase in blood flow (3), and leads to larger improvements in blood pressure, cholesterol, and artery functioning (4). 
  • One set each for abs and lower back: crunches and back extensions put a fair amount of stress on the lumbar spine (lower back). Therefore, I use a very small amount of exercise with each. Also, one set of back extensions are all that's needed to improve back strength and reduce pain (5).

Eating Habits

Here's a rundown of what I eat:

Basics
Averages (my last 20 days on MyFitnessPal)
Total Calorie Intake
1,716 calories/day
Intermittent Fasting
I eat only between the hours of 12 PM and 8 PM, then fast the rest of the day. I do this 5-6 days per week.
Fat
30-40% of total calories (50-115 grams per day)
Carbohydrates
30-40% of total calories (120-200 grams per day)
Protein
25-35% of total calories (120-180 grams per day)

In each meal, I eat a protein source (usually sardines, salmon, tuna, turkey, or chicken) with fruit (orange, banana, grapes, kiwi, mango, berries, etc.) or vegetables (salad, carrots, tomatoes, sweet potatoes, etc.). Most of my meals are pan-fried, from the crock pot, or involve no cooking at all.

Besides proteins, fruits, and vegetables, I eat beans and yogurt each about twice per week. I eat a sandwich or wrap once a week. My diet includes 1-2 large meals (>1,000 calories) per week and days where I consume 2,400+ calories, which are balanced by eating less than my average amount on most days.

My drinks are almost always water and carbonated water. I drink four energy drinks per week (an area I want to improve in), and 1-2 cocktails over the weekend.

  • Calories. Obviously I don't eat a lot. Between this and my protein intake being less than optimal, I am not optimizing the amount of muscle I can have. I eat so few calories partly due to the fast (eating for only eight hours per day). Mainly, I eat few calories because people who eat less tend to age better and live longer (6,7). 
  • Fasting. Fasting helps control my weight, plus it is known to improve health, especially in areas related to diabetes and heart disease (8).  
  • Protein. People who strength train should eat, on a daily basis, at least their weight in pounds multiplied by 0.82 (9). For example: 181.4 lbs. x 0.82 = 149 grams per day. When eating very few calories, that requirement increases (10). This is an area I plan to work on more soon.

Other Health-Related Habits


Donating platelets in 2014.

Here are a few other things I do to obtain or reach my goals:
  1. Sleep. Since February, I average about 7.5-8 hours of sleep. Sleep deprivation increases blood sugar, total calorie intake, and junk food cravings (I'll blog about this in the near future).
  2. Self-monitoring of activity and eating: I use MyFitnessPal most days of the week to track my protein intake, overall calorie consumption, and activity (as you saw before). Monitoring increases self-awareness and leads to better control of habits (11).
  3. Self-monitoring of weight: I weight myself every morning. While this may sound like a nightmare to you, daily weighing is shown to help reach weight goals effectively for the same reason: increasing self-awareness (11). I don't stress about small fluctuations. I hope to weigh in a specific range (178-183 lbs.). If I fall out of that range, then I pay more attention to my habits so I can work back into the range.
  4. Platelet donations: I donate platelets through United Blood Services twice per month. Blood donations are shown to help control iron in the blood (prevent an excess of iron). I don't know if donating platelets provides health benefits, but it could.

Final Thoughts

While I do switch my workouts every few months, my total workout time doesn't change significantly - I'm not interested in spending an hour at the gym, five days per week. If I were to change anything with exercise, I would actually decrease my strength training workload. Speaking of changes, I'm planning to add a little more protein and decrease my energy drink consumption in the next two months.

Thanks for reading through this post and part one. I hope this two-part series gave you a better idea of who I am, where I'm at, and provided at least one idea for something you can add to your own health habits.


References

  1. Preuss, S.R. (2017). When exercise is toxic. The Heart Healthy Lifestyle, retrieved from http://www.thhlblog.com/2017/03/when-exercise-is-toxic.html
  2. Preuss, S.R. (2017). Does cardio "kill your gains?" The Heart Healthy Lifestyle, retrieved from http://www.thhlblog.com/2017/04/does-cardio-kill-your-gains.html.
  3. Kraemer, W.J. & Ratamess, N.A. (2004). Fundamentals of resistance training: Progression and exercise prescription. Physical Fitness and Performance, 36(4), 674-688.
  4. Tan, B. (1999). Manipulating resistance training program variables to optimize maximum strength in men: A review. Journal of Strength and Conditioning Research, 13(3), 298-304.
  5. Preuss, S.R. (2013). The direct approach: treating lower back pain with strength. The Heart Healthy Lifestyle, retrieved from http://www.thhlblog.com/2013/02/the-direct-approach-treating-lower-back.html.
  6. CR Society. (N.d.). Calorie restriction research moves forward! CR Society International, retrieved from http://www.crsociety.org/science/research 
  7. Buettner, D. (2010). The blue zones: Lessons for living longer from the people who've lived the longest. Washington, D.C.: National Geographic.
  8. Preuss, S.R. (2013). The fast diet and the effectiveness of intermittent fasting. The Heart Healthy Lifestyle, retrieved from http://www.thhlblog.com/2013/03/the-fast-diet-and-effectiveness-of.html
  9. Lemon, P. W. (2000). Beyond the zone: protein needs of active individuals. Journal of the American College of Nutrition, 19(5), 513S-521S.
  10. Helms, E.R., Zinn, C., Rowlands, D.S., & Brown, S.R. (2014). A systematic review of dietary protein during caloric restriction in resistance trained lean athletes: a case for higher intakes. International Journal of Sport Nutrition and Exercise Metabolism, 24, 127-138.
  11. Robinson, D. (2015). Could you triple your weight loss? Beyond Diets, retrieved from http://www.beyonddiets.com/beyonddiets-blog/2015/4/8/could-you-triple-your-weight-loss.html.

Tuesday, April 25, 2017

My Fitness Program, Results, and Rationale: Part I

For all of you who regularly follow this blog, I wrote this post and the next post to give you a transparent view of where I'm at (health-wise and fitness-wise), what I do, and why I do what I do. I would be a complete hypocrite and lack credibility to write about health and fitness but be in poor standing myself. 


Summer of 2010 versus April, 2017

In this post, I'll share my current health status and results. In part two of this series, I'll discuss my current training routine, diet, and other lifestyle habits. If you have no interest...I don't blame you...and come back next week when I get back to general exercise and nutrition topics.

Before diving into my current health and fitness, you should know what I'm aiming to do. While I'd like to be very muscular and build my athletic skills, I don't care enough to focus on those at the expense of my primary goals. Just as it's difficult to date the woman in California while living in New York, it's difficult to train for health and longevity, maintain leanness, and maximize muscle mass. We can't have everything we want, so we have to prioritize what's most important and focus on that.

Here are my primary fitness-related goals (in order):
  1. Health (short- and long-term) and longevity
  2. Being satisfied with how I look naked (how's that for honesty?)
  3. Having an above average amount of strength and muscle

My Results and Status

Here's an overview of my body composition and health with a little context on how I've fluctuated over the past few years.

Body Composition

Measurement Type
Current Measurements (taken 4/25/17)
Weight
181.4 lbs 
Waist Circumference
81.8 cm (32.3 inches)
Hip Circumference
101.4 cm (40 inches)
Waist-to-Hip Ratio
80.7

4/25/2017 (no oil, no filter...just me)

For most of my adult life, I've weighed around 187-190 lbs. At my heaviest (left side of the photo at the top of this article), I weighed 201 lbs. I've maintained my current weight range (179-183 lbs.) mostly since mid-2011. (This post details how I lost the weight.)

Since I've started tracking waist and hip measurements (2014), my waist and hip have increased by one and 1.5 centimeters.

As mentioned, I care most about health and being satisfied with how I look, so I track my body composition using photos and waist-to-hip ratio (WHR). WHR is more effective than weight or body fat percentage in determining a person's risk of developing heart disease or diabetes. With a WHR of 80.7, I fall into the "excellent" or "low risk" range for men, which is below 85. My BMI is 24.6 (I'm 6' tall), which is classified in the "normal" or "healthy" weight range.

Cardiovascular and Metabolic Health

Here are snippets of my most recent measurements. I'm 33 years old (birth date: 7/19/1983).

On 4/21/2017, my total cholesterol was 134 mg/dl and my blood pressure was 107/59 mmHg.

On 3/23/16, my HDLs were 70, LDLs were 86, and my triglycerides were 41 mg/dl.

This is my last fasting blood glucose test, measured at 83 mg/dl.

I fall into healthy ranges for all measures. Healthy ranges for each are the following:

  • Blood pressure (me: 107/59): 80-120 (systolic)/60-80 (diastolic) mmHg
  • Total cholesterol (134): under 200 mg/dl
  • HDLs (70): the desirable level is greater than 60 mg/dl 
  • LDLs (86): less than 100 mg/dl
  • Triglycerides (41): less than 150 mg/dl
  • Fasting blood glucose (83): 70-99 mg/dl

Joint Health

As you will see in part two of this series, I exercise regularly but not as much as many fitness professionals. One reason for this is out of concern for joint health. One four-year study showed people who exercise very frequently experience just as much joint deterioration as people who don't exercise at all (1).

I have no regular joint pain. However, I experience back stiffness and ache about two or three times per year. Also, I recently experienced left knee pain on a 12-mile hike (a one-time event). While my lower back is generally pain-free (thanks to back extensions) despite an injury in 2008, the ache usually follows exercise "experiments." Examples are trying new exercises with more loading on the spine (hack squats, deadlifts, etc.) or adding volume with exercises that put force on the spine.

Final Thoughts for Part I

One thing I want to improve on is being a little smarter in my exercise experiments; while I love experiencing what others are doing, some pursuits aren't wise for joint health. As I mentioned at the start, I want to be around for a long time and to be functional during all of those years. Some risks aren't worth the minor benefits they might provide.

In part two, I'll share what I'm currently doing with my exercise program, diet, and in other areas.

Reference

  1. Lin, W., Alizai, H., Joseph, G. B., Srikhum, W., Nevitt, M. C., Lynch, J. A., ... & Link, T. M. (2013). Physical activity in relation to knee cartilage T2 progression measured with 3 T MRI over a period of 4 years: data from the Osteoarthritis Initiative. Osteoarthritis and Cartilage21(10), 1558-1566.

Thursday, April 20, 2017

Eating More Meals for Metabolism and Muscle

In life, there are times when the actual evidence doesn't match the narrative we believe to be true. We believe a friend is a generally moral person, but he steals money from his employer, doesn't spend time with his kids, and frequently treats people disrespectfully. Some say older adults should "take it easy," but inactive people die sooner while those who exercise intensely live longer and higher quality lives.


If the evidence doesn't match the narrative, it's probably time to reconsider the narrative.

One of the most popular narratives in nutrition is eating smaller, more frequent meals "revs up" metabolism, and the increase in metabolism leads to weight loss. However, large-population studies in the US have found that increases in eating frequency are the biggest dietary change from the late 1970s to the mid 2000s (1)...a period of time when obesity was increasing in the US.

Is it time to change this recommendation in favor of traditional eating (three meals per day)? Maybe.

Meals and Metabolism 

A few well-controlled studies measured metabolism with diets featuring the same amount of daily calories, but in different amounts of meals. A month-long study of women who were obese or overweight compared eating two meals per day versus eating 3-5 (2). Sleeping metabolism and total daily calories "burned" were the same in both groups. Other studies comparing two versus seven meals, three versus six meals, and two versus three meals also found no difference in metabolic rate following the different eating frequencies (3,4,5).

After seeing all of those results, you likely won't be surprised to read that a review of meal frequency studies concluded "increasing meal frequency does not appear to significantly enhance diet-induced thermogenesis, total energy expenditure, or resting metabolic rate (6)."

For the research measuring weight loss, one study showed different meal frequencies had no effect on weight or fat loss (2). Other research showed men and women lost more weight and fat when eating one meal per day compared to when they ate three meals per day, despite eating the same amount of calories with both approaches (7).

Eating more often does not increase metabolism or enhance weight loss.

Meals and Muscle Retention 



For maintaining or building muscle, some believe eating more frequently is necessary. In the research review, three out of four studies showed no difference in a measure of muscle maintenance/growth when comparing different amounts of daily meals (6). One study advised that it's more important to concern yourself with how much protein you eat, not how often you eat it (6).

Meals and Hunger

Metabolism isn't impacted by how often you eat, but hunger is. A few studies asked the participants to rate their hunger at various times during each day. People were less hungry when eating three meals per day (when compared to one, two, or six meals per day), or when eating five meals (when compared to one meal per day) (7,5,3,6).

To minimize hunger, a middle ground of about 3-5 meals seems best.

Conclusion

There's one additional important point to note that the research doesn't cover: self-control. Many people (including yours truly at times) don't consistently control portions. While eating small, frequent meals may sound easy, they may actually become frequent, moderate-to-large meals. Therefore, I think eating less often (3-4 times per day) is smarter as it limits the opportunities for a person to overeat.

The narrative of eating small, frequent meals to boost metabolism and lose weight is simply a narrative...a fictional story. It's not true. Eating small meals throughout the day does NOT increase metabolism. In fact, it may increase your hunger.

If you want to lose weight, focus on the quality of your foods, eating enough protein to maintain your muscle mass, and eating around 3-4 meals per day to satisfy your hunger while minimizing opportunities to overeat. 

Also, stop people when you hear them recommending small, frequent meals to "rev-up" a person's metabolism. The evidence doesn't fit the narrative.

References

  1. Duffey, K.J. & Popkin, B.M. (2011). Energy density, portion size, and eating occasions: contributions to increased energy intake in the United States, 1977-2006. PLoS Med, 8(6): e1001050.
  2. Verboeket-Van de Venne, W.P. & Westerterp, K.R. (1993). Frequency of feeding, weight reduction and energy metabolism. International Journal of Obesity and Related Metabolic Disorders, 17(1), 31-36.
  3. Verboeket-van de Venne, W.P. & Westerterp, K.R. (1991). Influence of the feeding frequency on nutrient utilization in man: consequences for energy metabolism. European Journal of Clinical Nutrition, 45(3), 161-169.
  4. Ohkawara, K., Cornier, M.A., Kohrt, W.M., & Melanson, E.L. (2013). Effects of increased meal frequency on fat oxidation and perceived hunger. Obesity, 21(2), 336-343.
  5. Smeets, A. J., & Westerterp-Plantenga, M. S. (2008). Acute effects on metabolism and appetite profile of one meal difference in the lower range of meal frequency. British journal of nutrition, 99(06), 1316-1321.
  6. La Bounty, P. M., Campbell, B. I., Wilson, J., Galvan, E., Berardi, J., Kleiner, S. M., ... & Smith, A. (2011). International Society of Sports Nutrition position stand: meal frequency. Journal of the International Society of Sports Nutrition, 8(1), 4.
  7. Stote, K. S., Baer, D. J., Spears, K., Paul, D. R., Harris, G. K., Rumpler, W. V., ... & Longo, D. L. (2007). A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults. The American journal of clinical nutrition, 85(4), 981-988.

Friday, April 14, 2017

Is Static Stretching Necessary?

"We use only 10% of our brains." It was the start of a funny and cheesy pick-up line in Wedding Crashers. It was also widely-accepted as true for decades. Is it true? No, 90% of our brain is not freeloading. Despite lacking any scientific support, many believed this was a fact.


Stretching, specifically static stretching (holding a stretch for 30 or more seconds), has been considered an essential part of exercise for a long time.. This is largely because it reduces soreness and injury risk with exercise and sports...but does it really provide those benefits? Is this an actual fact? Research largely says "no."

Soreness

Delayed Onset Muscle Soreness (DOMS) is the discomfort people feel about 24-72 hours a workout or sport, especially when starting a new activity. Stretching just before or after is commonly said to prevent or reduce DOMS. This is not true, at least based on current research. A review, published in 2006, assessed five studies measuring soreness (1).  People who stretched felt no reduction in soreness at 24, 48, or 72 hours after exercise. Stretching was performed for 5-10 minutes, including holds ranging from 20 seconds to two minutes. Some people stretched before the workout; some stretched afterwards. Regardless, stretching had no effect on post-activity soreness.

Injury Risk

The evidence supporting stretching to reduce injury risk is not encouraging as well (if you're a fan of stretching). A review from 2005 looked at studies focusing on lower body stretching and various lower body injuries (strains, sprains, shin splints, etc.). The result? Stretching did not reduce injury risk.

A study of about 3,000 runners had a similar result when assigning runners to stretching or non-stretching groups for three months (3). In both groups, 16% of people suffered an injury.

A more recent research review did cite a few studies where the static stretching group suffered from fewer injuries...but there was a huge influencing factor: they all performed a warm-up activity of some kind (4). Static stretching by itself does not reduce the risk of injury.

Performance



In regards to soreness or injury risk, stretching is ineffective but not harmful. Stretching could be harmful to your workout or athletic performance. When performed beforehand, static stretching leads to an average reduction of 3-4% in a maximal vertical jump and 1-2% in sprinting speed (4). Obviously these are not huge decreases but could be significant if competing against a person with similar abilities.

When performed before strength training, static stretching reduces the amount of reps a person can lift a weight for (4, 5). Specifically, people perform an average of 8% fewer reps following static stretches (4). One study found rep totals decreased by 9-24%, with the effect increasing with heavier weights (5). This likely happens because stretching reduces the amount of muscle fibers that contract during an exercise.

Is Stretching Useful?

Before answering the question that leads this section, I have one point you should know: I have no "dog in the race." I have no personal vendetta against stretching. I am simply looking for the truth.

Is stretching necessary? Is it useful? In the previous post, I started by saying life is mostly gray, not black and white; a universal rule or answer generally doesn't work. Therefore, my answer to these questions is conditional.

Stretching is useful for increasing joint range of motion, and people in sports requiring large movements (e.g. gymnastics, track and field) should perform static stretching (4). Also, if stretching temporarily reduces pain that you feel, then I think you should stretch. For injury prevention, soreness prevention, or when you are going to strength train, I recommend avoiding static stretching.

References

  1. Herbert, R.D. & Gabriel, M. (2006). Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. BMJ, 325(7362), 468.
  2. Hart, L. (2005). Effect of stretching on sport injury risk: a review. Clinical Journal of Sport Medicine, 15(2), 113.
  3. Oddi, V. (2010). USATF Announces Results of Pre-run Stretch Study. USATF. Retrieved from http://www.usatf.org/news/view.aspx?DUID=USATF_2010_08_20_12_13_14
  4. McHugh, M.P. & Cosgrave, C.H. (2009). To stretch or not to stretch: the role of stretching in injury prevention and performance. Scandinavian Journal of Medicine & Science in Sports, 20, 169-181.
  5. Nelson, A.G., Kokkonen, J., & Arnall, D.A. (2005). Acute muscle stretching inhibits muscle strength endurance performance. Journal of Strength and Conditioning Research, 19, 338-343.