Friday, April 17, 2015

Choose Your Fitness Role Models Carefully

The field of personal training started when gym patrons were asking the most fit and muscular gym goers for advice. While I'm grateful for those actions leading to the career that I've been apart of since 2001, taking the advice of such people is a real gamble. Fit people may know what works best for most people...or they can just be individual success stories with advice that isn't safe or effective for the majority.

I really understood this lesson several years ago when I had a unique opportunity: I worked as a personal trainer in a gym with a few active International Federation of Bodybuilding and Fitness (IFBB) and National Physique Committee (NPC) competitors. Out of respect, I will not mention names.

Over the 14 months that I trained clients at this location, I had many opportunities to watch these individuals with their clients. One of the figure competitors - let's call her "Patricia" - was wonderful to her clients. Patricia was very detailed when introducing clients to new exercises - the result of this was obvious with the excellent lifting techniques her clients had. Also, she worked around pre-existing client injuries and developed individualized dietary strategies with her clients who wanted nutritional help. Patricia was certainly not the only trainer I would hire out of the group but she was the best example.

Some gambles produce wins...and some don't. Another trainer was an IFBB professional and among the top 15 in several tournaments in the US and internationally. Let's call him "Ron." Ron struggled with several fundamentals of personal training. His clients generally had terrible form. Ron struggled with how to help clients with basic injuries and pain. Also, it was well-known around the gym that he took steroids, which, in my opinion, makes his training methods difficult to validate. New members were unaware of these things - I think they were consumed by his impressive physique. The same could be said for an NPC champion figure competitor at the gym: she was a poor trainer in several aspects but was able to attract clients due to her impressive physique and competition success.

To be clear, I'm not discouraging you from asking the muscular guys or the extraordinarily fit women in your gym for their thoughts. You don't need me to tell you it's wise to seek the advice of someone who's achieved what you want to achieve, whether it's bodybuilding, weight loss, or another training goal.

Examine your source with detail.
  • Does the person have experience coaching others or just oneself? (If yes, talk to some of those trainees)
  • Does the person have any formal training (certifications)?
  • Does the person have any formal education in the field?

By getting more information on your source, you develop a better understanding of your source's credibility. You also decrease the chances of taking advice that could lead to injury or wasted time spent with ineffective training habits.

We can never completely eliminate risk. However, a little research at the start will help you make decisions pay you back with profits.

Tuesday, July 1, 2014

Lean with Sardines: How Eating Omega-3 Fatty Acids Helps Weight Loss

It's no secret: I love eating sardines.

Sardines pack a nutritional punch with vitamins D, B6, B12, niacin, selenium, magnesium, phosphorous, zinc, copper, manganese, and protein. I enjoy the taste as well (that has to count for something, right?).

However, one of the greatest benefits they have provided me is helping me lose 30 lbs. and sustain that loss. Yes, there's a nutrient in sardines that makes weight loss efforts more successful...and don't worry, that nutrient is NOT only found in sardines.

Omega-3 fatty acids. The nutrient many people take in fish oil pills - to decrease inflammation - actually increases beta-oxidation (the breakdown of fat to produce energy). Several studies have shown that adding omega-3 fatty acids to a diet increases the amount of weight loss, especially midsection fat.

Researchers from Iceland, Spain, and Ireland noticed this in 2007 with middle-aged, overweight to slightly obese adults [1]. The researchers used several diets that were evenly matched for calories and macronutrients (fats, carbohydrates, and protein). Here's what was different:
  • Group one: no seafood or supplements
  • Group two: ate salmon three times per week (an average of 1.3 grams of omega-3 fatty acids per day)
  • Group three: took fish oil capsules every day (1.5 grams of omega-3s per day). 

After eight weeks, the men in the salmon and fish oil groups lost an additional two pounds of fat and several centimeters from their waists when compared to group one.

A study with diabetic women had even stronger results [2]. The experimental group took 1.8 grams per day of omega-3 fatty acids in a supplement, while the other women took a placebo.

After eight weeks, the experimental group lost 3.5 lbs. of fat compared to nothing for the women who took the placebo. What's especially intriguing is that, like the men in the previous study, the women lost mostly midsection fat.

As mentioned, thee reason why omega-3 fatty acids boost weight loss is that they increase beta-oxidation. Researchers in France noticed fat breakdown increased 22% when adding 1.8 grams of omega-3 fatty acids per day to subjects' diets [3].

If you've followed this blog for a while, you know that I struggled with my weight several years ago. I peaked at 201 lbs. To get to 174 lbs. (what I weighed this morning), I made a series of changes. One of those changes was increasing my omega-3 intake by replacing chicken, conventionally-raised beef, and eggs with salmon, sardines, and grass-fed red meat. Till this day, I continue to eat at least one of those foods every day, and I continue to stay within a five-pound weight range.

Take-Home Messages

When it comes to using omega-3 fatty acids for weight loss, there are two points you should be aware of:
  1. Adding them should not be your entire weight loss plan - if you're interested, make them a part of the plan
  2. You may not think the weight loss numbers in the studies are that large, but I also think the amounts of omega-3s taken weren't that significant. If you took an omega-3 supplement AND ate a fatty piece of fish during most days of the week, you're likely going to consume more than the 1.3 to 1.8 grams per day that the studies used, and you'll likely lose more weight.

This website is a great source for learning the amounts of omega-3 fatty acids in various fish. Fish aren't the only natural sources of omega-3s, but they are typically the most abundant sources.

Of course, you could skip the website and just start eating sardines. I wouldn't stop you.

Sunday, March 16, 2014

Before, After, and Way After: The Story of My Sustained 30-Pound Weight Loss

August of 2010 (left), March of 2012 (center), and March of 2014 (right)

About two years ago on this blog, I wrote about all of the changes I made to get from 201 to 171 lbs. In summary, I hit a lifetime peak of 201 lbs. in August of 2010. For the rest of 2010, I made obvious changes, such as eliminating junk foods. In the spring of 2011, I made major changes, increasing my intake of fruits, vegetables, and omega-3 fatty acids (sardines, salmon, anchovies, cod, etc.) while eliminating processed foods from my regular diet. In the beginning of 2012, I regularly weighed in the low 170s, as you can see in the middle picture.

On March 13, 2014, I took the picture on the right. About two years after reaching 171 lbs. for the first time since high school, I still weigh about the same. How have I sustained the loss? I used the same strategy that several of my clients have used to maintain losses ranging from 10-70 lbs.: I made lifestyle changes.

August 4, 2010 (left) and March 13, 2014 (right)

For today's post, I don't need to reference any studies to make my point. I could analyze my changes from a physiological standpoint, but I won't. The point is not scientific. It's logical. The lifestyle changes I made with my eating habits several years ago are habits I still maintain today.

Here's a one-day diet sample of my diet in January, 2012 (from a post I wrote in 2012):

5:30 AM: Can of sardines with a sliced tomato in balsamic vinegar, and a banana
10 AM: Three over-easy eggs with an apple
1 PM: Three hard-boiled eggs and sliced fruit (pineapple, apples, and grapes)
6 PM: A large bowl of romaine lettuce, sliced tomatoes, an avocado, bacon, and chicken with red wine vinegar and olive oil

Here's what I ate last Thursday (March 13, 2014):

5:40 AM: Can of sardines with an apple
10 AM: Eight ounces of turkey and a banana
1 PM: Salad with romaine lettuce, sliced bell peppers, sliced apple, cherry tomatoes, grilled chicken, and a house vinaigrette dressing
5 PM: Eight ounces of grass-fed beef with a broccoli slaw salad (sliced broccoli and carrots, extra virgin olive oil, and a touch of Dijon mustard)

The foods aren't exactly the same, but the principles are similar: my daily eating regimen still features 3-4 meals, 8-10 servings of fruits and vegetables, a natural protein source at every meal, and extra virgin olive oil and salt as some of the few condiments I eat. I also continue to strength train 3-4 days per week.

All people who want to lose weight and maintain it don't have to eat like I eat. I realize eating sardines for breakfast isn't exactly a popular idea. Doing what I do is certainly not the point I want you to take away from this. The real point is, if you want to make a sustainable weight loss, you must make sustainable changes to your habits.

Diets where you are eating less than 1,000 calories per day, eating only one food for several days, or where you are reliant on supplements are not sustainable. Eventually you will have to transition from those initial weight loss-inducing behaviors into another phase that you can live on. 

If you are looking to lose weight, ask yourself this when considering any diet or program: can I see myself doing this in five years? If the answer is no, then the program probably isn't what you are looking are. Lifestyle changes are sustainable. Most commercially-popular diets are short-term weight loss kick-starters. I look the same way I did two years ago because I'm doing similar things. It's not science. It's logic.

Don't get on the weight loss roller coaster. Make changes you can sustain and your new weight will stick around as well.

Wednesday, February 12, 2014

Better Health While at Work: Move Two Minutes at a Time

Let's be honest: even though you are reading this article from a health-based site, you may not be exercising regularly. This is understandable. Exercise may not be a current priority for you, or maybe it is but some short-term situations have arisen that put other demands on your time.

Regardless of the reason, you don't need time for the gym to improve your health. In fact, walking around your office periodically after lunch can help fight off diabetes and heart disease.

As I discussed in The Heart Healthy Lifestyle and an article from 2011, there are several health downfalls that come with sitting. In summary, people who regularly sit many hours per day, without getting up often, are more likely to have larger waistlines and higher post-meal blood sugar spikes. Higher post-meal blood sugar spikes are concerning because they are strongly associated the risk of developing diabetes, inflammation, and artery wall thickening [1]. Overall, the more a person sits, the higher the risk of getting heart disease and insulin resistance (a precursor for type 2 diabetes) [2].

However, if your work and hobbies revolve around you sitting, you're in luck: I'm here to help. A 2012 study showed that a two-minute walk every 20 minutes after a meal led to significant reductions in blood sugar and blood insulin [1]. Specifically, the periodic two-minute walks decreased blood sugar by 24% and insulin by 25-29% for the five hours after the meal. That change in blood sugar is enough for many to drop from a diabetic or prediabetic level to a healthy range.

Reducing insulin is also important because overproducing insulin over time can lead to the death of key pancreas cells that make insulin. Insulin is responsible for helping sugar get out of the blood. When those cells die, less insulin is produced and more sugar remains in the blood, eventually resulting in diabetes.

The study had people sit for two hours before the meal (a 763-calorie drink), then sit for five hours continuously or for five hours with the two-minute walks every 20 minutes. The study was a crossover trial, meaning the same people were used for each experiment. The researchers tested two different walking speeds (2.0 mph and 3.6-4.0 mph) for the two-minute walks, but the results were very similar for both speeds.

How Does This Apply to You?
The setup of this study is similar to the second half of the work day for many people: the participants ate a lunch-sized meal, then spent about five hours sitting. The people in this study were middle-aged, overweight or obese non-exercisers but also did not have major health problems, similar to a large chunk of the US population.

This study shows that you can lower your risk of heart disease or diabetes by taking a periodic two-minute walk after lunch. Depending on your work space, you could accomplish a two-minute walk by taking a lap around your entire office or by using a bathroom on a separate floor. 

You don't need a gym or an hour to improve your health through movement. Rearranging your sitting habits is a small but significant way to improve key health measures.

Friday, December 6, 2013

Obese and Healthy

The debate in the health world this week comes from the reporting of a Toronto-based research review where three doctors concluded that good health cannot be attained while obese. The main supporting factor is the finding of obese individuals being 24% more likely to have a heart problem or die over a 10-year period than those in the "healthy" weight group, with weight categories defined by body mass index (BMI).

I disagree and will state my reasons below. I think this is a very critical point and not at all a scientific discussion that has no significance in the "real world."

Opposing Arguments and My Thoughts

First of all, the weight groups were described as being "metabolically" healthy or unhealthy. This is typically defined by several factors, including blood pressure, blood sugar, cholesterol, and triglycerides. BMI is calculated by using weight and height. Classifications are shown in the chart below.

Here are the two primary arguments for obesity not being healthy (one from the researchers and one I heard from most people I discussed this with over the past few days):
  1. The new study shows a higher risk of heart disease or death with healthy obese individuals.
  2. Obesity wears on joints, leading to knee, lower back, and other pain.
Here are my counterpoints.

 1. Decades of research show that obesity does not consistently demonstrate an increased risk of early death. The National Health and Nutrition Examination Survey (NHANES) is a study that was conducted for several four-to-six-year periods over four decades in the US. After combining all of the data, the researchers found that obese people under 60 years old were 23% less likely to die during the study period when compared to the "healthy" weight group.

2. Obesity assesses total fat, and not all fat is created equal. Inner abdominal fat leads to several negative health consequences, whereas subcutaneous fat (thighs, hips, etc.) produces many benign or healthful actions. This is illustrated by a few points.

First, waist-to-hip ratio, which is essentially a measure of where your fat is stored, is a much more effective way to determine your risk of heart disease when compared to weight. High amounts of abdominal fat often indicate that a person has or will develop diabetes, whereas thigh fat does not indicate anything about diabetes risk. Overall, people who are obese primarily due to excess hip and thigh fat are unlikely to suffer from heart disease or diabetes.

3. Lifestyle is more important than body fat for determining health. Some people are obese but maintain healthy exercise and eating habits. As I pointed out on this blog and in Chapter 3 of my book, lifestyle improvements build health whereas fat removal with no diet/exercise changes (liposuction) does not. When people lose weight while changing their eating/exercise habits, their health improves primarily due to the lifestyle changes, not the fat loss. 

This point is critical to make because many people are genetically obese. In some cases, obese people have abnormally high quantities of fat cells. While you can shrink your fat cells through exercise and diet, you cannot decrease the amount of fat cells that you have. Therefore, some obese people have a limit to how lean they can get, and that limit could be in an obese state.

4. Joint pain is largely a matter of strength. I'm not going to tell you that being obese doesn't put extra stress on joints. It does. It's basic physics: when there's more mass, there's more force on the joints. However, I can tell you from experience in my personal training practice, gaining strength decreases or eliminates knee and lower back pain, regardless of weight change. This is supported by research.

Seniors with osteoarthritis in their knees felt huge reductions in pain after a few months of leg strengthening and no weight loss [1]. The same pain reduction was demonstrated in several studies where people performed only one exercise per week to strengthen their lower back. If obese individuals strength train, their knees and lower backs will likely provide little to no pain.

Final Thoughts

In summary, do I think that obesity is a threat to health? Yes...when body fat is largely located in the midsection. Otherwise, I do not think obesity is a threat to health. Universally, a poor lifestyle is a threat to health. If people - no matter what their weight categories are - regularly practice healthy lifestyle habits, then I think they will maximize longevity while avoiding joint pain, heart disease, and diabetes.

Wednesday, October 30, 2013

Weight and Risk of Death

Weight is not the best predictor of death risk, especially when your weight does not fall into an extreme.

That was a key point during a recent talk I gave (featured in last week's post) on the value of weight and waist-to-hip ratio to serve as health and longevity assessments.

This is supported by the work of Dr. Katherine Flegal, who looked at a series of studies known as The National Health and Nutrition Examination Surveys (NHANES) [1]. Each study featured four-to-six-year samples of the United States, with each sample being representative of the whole US population in terms of sex and race percentages.

Dr. Flegal combined the data from all three study periods to find out the risk of death according to age and weight. The results are shown in the table below, with the percentages showing the likelihood of death when compared to the "healthy" group.

Weight Group
25-59 Years
Very Lean

Very Obese
*Weight groups feature people who have never smoked and weights are assessed by 
body mass index, or BMI.

As you see, the very lean and very obese groups have higher death rates during all age ranges. Specifically, sexagenarians who are very lean or very obese face a much greater death risk.

On the other hand, overweight individuals have lower death rates in all age groups, and the risk associated with obese individuals differs between age groups and is only 13% greater for those who are at least 70 years of age (keep in mind that BMI does not account for the differences in fat mass versus lean mass, so a portion of those in the overweight group likely fall into this group due to an above average amount of muscle and bone tissue).

What does all of this mean? When not falling into an extreme, weight is a poor way to predict how long you will live. In general, weight is a poor way to assess health. As I have discussed before, not all body fat is bad, and habits are much more important to health than size/weight

At almost any weight, if you develop healthy habits, you will achieve health.

Friday, October 25, 2013

Weight vs. Waist: My Talk on a Simple but Valuable Health Assessment

Below is a talk I recently gave in Phoenix about the ability of weight and waist-to-hip ratio (WHR) to indicate your current health status. During the talk, I discuss how weight may or may not indicate how long a person will live, how effective weight and WHR are for predicting a future heart attack or diabetes, and how to measure WHR.

Here are a few points I didn't cover or misspoke about during the talk:
  • During the heart attack slide, I said the researchers split the participants up into different groups based on their weight and WHR. What I meant to say was the researchers split up the data a few times, once into fifths based on weight (heaviest 20%, second heaviest 20%, etc.), and then another time into fifths based on WHR. The rates of heart disease feature the comparison of the top group versus the bottom group.
  • On the same slide, I placed the asterisk on the 44% difference between the heaviest and lightest weight groups because the difference basically disappeared when the researchers controlled for WHR as an interfering factor (confounding variable). In other words, a larger WHR is a major reason why the research showed heavier people had a greater risk of a heart attack.
  • You can measure your WHR in centimeters or inches, as long as you use the same unit of measure for both spots. I prefer centimeters because they are smaller units and are the standard measure in just about every country outside the US.


Wednesday, October 16, 2013

Can Strength Training Help You Sleep?

About one-third of Americans sleep less than six hours per night [1]. Just a few days of sleep loss increases blood sugar, and long-term deprivation greatly increases the risk of diabetes. Due to a variety of causes, many struggle with consistently attaining at least seven hours of sleep per night. Thankfully, strength training helps...but only for some.

Research shows that strength training improves sleep quality and quantity in less than three months. My personal experiences with clients suggest that people can start sleeping better in less than two weeks. However, this doesn't happen for everyone. Some people are unaffected, and some are partially affected.

As far as why it may work for some, strength training improves growth hormone levels, and growth hormone is linked to the quantity of REM sleep. Strength training also may benefit sleep-preventing respiratory issues.

Strength Training and Sleep

Thanks to inactivity, increased sensitivity to light, elevated autonomic nervous system activity, changes in Circadian rhythm, medication side effects, hormonal changes, and illnesses, sleeping becomes increasingly more difficult with age [2]. It only makes sense that strength training is considered as a sleep aid: it does not require a lot of time, it's an intense activity that could increase fatigue at night, and inactivity is a contributor to sleep loss.

Fortunately, strength training does help, but the effects are not universal. A 1997 study lead by a Harvard researcher found that strength training was able to improve sleep quality in 40% of the group [2]. The other 60% did not digress, but also did not improve.

The study placed older adults with sleeping issues into one of two programs for 10 weeks: strength training or a health education group. The strength training group lifted highly challenging weights, involving all of the major muscle groups, for three workouts per week. The other group served as a control, focusing on health education and socializing during twice-weekly visits. The strength training program was about two-to-three-times more effective for improving sleep, which was assessed through detailed questionnaires. 

A more recent study from Texas Tech University also supported strength training's benefit for sleeping, showing a 38% improvement in self-rated sleep quality after three months of training [3]. This study was performed with people who were "good sleepers" to begin with. This demonstrates that strength training can also help those who already have good sleep habits. 

Both studies showed that there were no differences between genders - strength training should aid sleep quality with men and women equally.

Experiences in My Practice and Underlying Reasons

As mentioned, the 1997 study showed that a strength training program either improves sleep or has no effect. This is consistent with what I have found in my training practice. I typically find one of three scenarios occur:
  1. Strength training improves ability to fall and stay asleep, and this happens within two or three weeks. 
  2. The trainee sleeps better on workout nights, but no differently otherwise.
  3. No effect whatsoever.
The researchers offered no explanation for why weight training is beneficial for some, but the reason could be hormonal. Growth hormone levels are connected to REM sleep [4], and strength training increases growth hormone. In addition, many struggle to sleep due to respiratory issues and strength training may improve sleep apnea. A friend of mine is a physician with the Mayo Clinic in Scottsdale, AZ, and she has noticed her patients with sleep apnea begin to sleep better after starting intense strength training programs. Many of these patients do not lose weight, so the improvement can't be attributed to obesity changes. She now refers her sleep apnea patients to facilities with such programs.

As detailed in the 1997 study, strength training poses no detriment to sleep quality. I highly recommend those who struggle getting quality rest to start strength training. If it doesn't work, the consolation prize will be better physical appearance, more strength, and thicker bones.

*Thank you to Dr. Ben Bocchicchio, who contributed to the information presented in this post.

Wednesday, October 2, 2013

My Talk on the Impact of Diabetes and Lifestyle Changes

I recently gave a talk in central Phoenix on why diabetes should be taken seriously and the potential for diabetes prevention through lifestyle changes. The talk is a brief summary of some key points in chapters two and three of my book, The Heart Healthy Lifestyle: The Prevention and Treatment of Type 2 Diabetes.

The video is below. The slide show was left out of the video, so I posted the nine slides under the video.