Category Archives: Exercise

Burn More Fat With Interval Training Versus Continuous Exercise

From JAMA Network:

Exercisers can burn slightly more body fat with interval training than moderate-intensity continuous training, according to a recent systematic review and meta-analysis in the British Journal of Sports Medicine. Although the differences in fat loss weren’t huge, the interval workouts were shorter, which could make it easier for people to adhere to them.

Source: For Fat Burning, Interval Training Beats Continuous Exercise | Lifestyle Behaviors | JAMA | JAMA Network

Click pic to purchase book at Amazon in the U.S.

How to Strengthen Your Core Without Injuring Your Back

A position you’ll see in the Five Tibetan Rituals for prevention and treatment of back pain

Fanatic Cook posted some (potentially) myth-busting videos featuring Dr Stuart McGill that may challenge your preconceptions about core exercises.

He [Dr McGill] says that a flexible back or a strong back are not protective of back injury. In fact, they are associated with more injury. The muscles of the back are meant to stabilize, to prevent movement. This is true for abdominal muscles and others of the core or torso. However, since back and stomach muscles are in constant use, they need to be maintained to provide endurance.

Now I don’t feel so bad about not being able to touch my toes by bending over at the waist. I regained the ability to do that eight years ago by following the Core Performance program. But that regimen took about five hours a week—more than I wanted to invest long-term

Source: How To Strengthen Abdominals Without Injuring The Back | Fanatic Cook

Exercise Training Adds Heart and Metabolic  Benefits to a Paleolithic Diet in Type 2 Diabetes Mellitus

Caveman selfie

“Abstract

Background

The accumulation of myocardial triglycerides and remodeling of the left ventricle are common features in type 2 diabetes mellitus and represent potential risk factors for the development of diastolic and systolic dysfunction. A few studies have investigated the separate effects of diet and exercise training on cardiac function, but none have investigated myocardial changes in response to a combined diet and exercise intervention. This 12-week randomized study assessed the effects of a Paleolithic diet, with and without additional supervised exercise training, on cardiac fat, structure, and function.

Methods and Results

Twenty-two overweight and obese subjects with type 2 diabetes mellitus were randomized to either a Paleolithic diet and standard-care exercise recommendations ( PD ) or to a Paleolithic diet plus supervised exercise training 3 hours per week ( PD – EX ). This study includes secondary end points related to cardiac structure and function, ie, myocardial triglycerides levels, cardiac morphology, and strain were measured using cardiovascular magnetic resonance, including proton spectroscopy, at baseline and after 12 weeks. Both groups showed major favorable metabolic changes. The PD – EX group showed significant decreases in myocardial triglycerides levels (-45%, P=0.038) and left ventricle mass to end-diastolic volume ratio (-13%, P=0.008) while the left ventricle end-diastolic volume and stroke volume increased significantly (+14%, P=0.004 and +17%, P=0.008, respectively). These variables were unchanged in the PD group.

Conclusions

Exercise training plus a Paleolithic diet reduced myocardial triglycerides levels and improved left ventricle remodeling in overweight/obese subjects with type 2 diabetes mellitus.

Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01513798.”

Source: Exercise Training Adds Cardiometabolic Benefits of a Paleolithic Diet in Type 2 Diabetes Mellitus. – PubMed – NCBI

Carbohydrate Restriction: What’s the Effect on  Resistance-Based Exercise Performance? 

Should she load up on carbs before weight training?

From a recent scientific article:

“Highlights

•The metabolic glycolytic response to resistance exercise is diverse and likely most attributable to volume, duration, and intensity of effort.

•Low muscle glycogen may not impair all resistance exercise performance, but increasing blood glucose before exercise may enhance higher-volume, longer-duration performance.

•Carbohydrate-restricted hypocaloric diets are effective for reducing fat mass during resistance exercise, but carbohydrate-sufficient hypercaloric diets are likely optimal for inducing muscle hypertrophy.

Source: Carbohydrate restriction: Friend or foe of resistance-based exercise performance? – ScienceDirect

Weight Training Rather Than Aerobics Is Better for Heart Health

One…..more…..rep!

“Lifting weights is healthier for the heart than going for a run or a walk, new research has found.Scientists looking at the health records of more than 4,000 people have concluded that, while both forms of exercise reduce the risk of developing heart disease, static activities such as weight lifting or press-ups have a greater effect than an equivalent amount of dynamic exercise such as running, walking or cycling.

The research challenges commonly held assumption that so-called “cardiovascular” pursuits like running are of greatest benefit to the heart.”

Source: Weight lifting better for heart health than running, new study finds

I like these findings, but wonder if they can be replicated.

Sitting is the new smoking? No, it’s worse than that.

exercise for weight loss and management, dumbbells

At least he’s trying…

I’ve long advocated that life-and health-insurance companies base their premiums on results of individual treadmill exercise tests or similar. Here’s why.

From CNN:

We’ve all heard exercise helps you live longer. But a new study goes one step further, finding that a sedentary lifestyle is worse for your health than smoking, diabetes and heart disease.

Dr. Wael Jaber, a cardiologist at the Cleveland Clinic and senior author of the study, called the results “extremely surprising.”

“Being unfit on a treadmill or in an exercise stress test has a worse prognosis, as far as death, than being hypertensive, being diabetic or being a current smoker,” Jaber told CNN. “We’ve never seen something as pronounced as this and as objective as this.”

Source: Not exercising worse for your health than smoking, diabetes and heart disease – CNN

Most folks can improve their fitness by exercising regularly. But what about nonresponders?

Steve Parker, M.D.

PS: All of my weight-loss books recommend and teach you how to improve your level of fitness.

ACFT to Replace APFT

Push-ups are a classic component of the Army Physical Fitness Test

I have long advocated measuring your fitness level periodically and seeing how you stack up against a benchmark. My favorite benchmark is the U.S. Army Physical Fitness Test (APFT).

The new Army standard testing will be too complicated for most non-military folks.

UPI has the story:

The U.S. Army is introducing an extensive overhaul of its physical fitness test that, with minor changes, has mostly been the same since 1980.The new test, announced this week, changes the name from the Army Physical Fitness Test to the Army Combat Fitness Test and is planned to become gender and age neutral. It will include a series of physical events, while the APFT was a series of pushups, situps and a 2-mile run.

The new standards call for deadlift tests, throwing ten-pound balls for distance backwards, and hand-relaese pushups that require hands to be taken off the ground for greater muscle tension. It also includes sled drags to simulate casualties, sprints with 40-pound kettle bells, hanging from a pull-up bar with legs up and the standard 2-mile run.

Source: U.S. Army to introduce new physical fitness test – UPI.com

You may also find the comment section interesting.

Are Pills the Answer to Unhealthy Lifestyles?

paleobetic diet, low-carb diet, diabetic diet

“This is much easier than exercising and losing 30 pounds!”

Fiona Godlee, editor-in-chief of the British Medical Journal, has a heretical short article at BMJ. I recommend you read the whole thing. It starts thusly:

More than half of adults aged over 45 will be labelled as hypertensive if new US guidelines are adopted, concludes a study in The BMJ this week (doi:10.1136/bmj.k2357). This equates to 70 million people in the US and 267 million people in China being eligible for antihypertensive drugs, a marked increase on already high rates of drug treatment for high blood pressure. Furthermore, the study calculates that 7.5 million people in the US and 55 million in China would be advised to start drug treatment, while 14 million in the US and 30 million in China would be advised to receive more intensive treatment. The evidence from trials indicates some benefit from drugs in terms of reduced risk of stroke and heart disease, but is mass medication really what we want?

Hypertension is just one of the many heads of the lifestyle disease hydra. Another is type 2 diabetes. Once thought to be irreversible and progressive, it is now known to be potentially reversible through weight loss. This is the cautious conclusion of the review by Nita Forouhi and colleagues (doi:10.1136/bmj.k2234), part of our series on the science and politics of nutrition (bmj.com/food-for-thought). Whether by calorie or carbohydrate restriction, weight loss has been shown to improve glycaemic control, blood pressure, and lipid profile and is the key to treatment and prevention of type 2 diabetes, they say.

She goes on to talk about fatty liver disease (NASH) and offers an alternative, of sorts, to pills. Good luck with that.

Source: Pills are not the answer to unhealthy lifestyles | The BMJ

Even short bursts of exercise can reduce risk of disease and death

Steve Parker MD

Bouts of 5 minutes may be enough

From ABC News:

The old benchmark of 150 minutes per week of moderate activity (or 75 minutes of vigorous activity) originated in 1995. The “rules”: Each time you exercise, it should be for at least 10 minutes.

“For about 30 years, guidelines have suggested that moderate-to-vigorous activity could provide health benefits, but only if you sustained the activity for 10 minutes or more,” an author of the research, William E. Kraus, M.D., of the Duke University School of Medicine, said in a press release. “That flies in the face of public health recommendations, like taking the stairs instead of the elevator, and parking farther from your destination. Those don’t take 10 minutes, so why were they recommended?

“The new study finds that the length of each bout or episode of exercise is unrelated to the benefit seen in living longer. Five minutes of jogging, researchers said, “counts” toward better health.

Source: Even short bursts of exercise can reduce Americans’ risk of disease and death, study says – ABC News

Book Review: “Fit With Diabetes” by Christel Oerum

Front cover

Ginger Vieira introduced me recently to Christel Oerum via email. I was pleased to hear about Christel’s brand new e-book, “Fit With Diabetes.”

*  *  *

Physical fitness is a major determinant of longevity. It’s truly our only fountain of youth, and it’s available to most everybody. The only way to get and stay physically fit is through regular exercise. Some studies document shorter life spans for PWDs (persons with diabetes). So it’s particularly important for them to maintain a good level of fitness.

I like this e-book and highly recommend it to adults taking insulin for diabetes who need a great physical activity program but don’t know how to go about it. Use of insulin, whether in type 1 or 2 diabetes, significantly complicates exercise due to sometimes mysterious effects on blood sugar. Christel de-mystifies the issue in a clear and science-based manner.

The most dangerous interaction between insulin and exercise is hypoglycemia, although the opposite can be a problem, too. Much of the book is about avoiding dramatic swings in blood sugar, particularly hypoglycemia. Christel teaches the reader how to balance insulin, food, and exercise to keep sugars on an even keel. Aerobic exercise tends to cause hypoglycemia, whereas anaerobic exercise tends to cause high sugar spikes. But your own reaction may be a little different, if not a lot. As you might imagine, monitoring and record-keeping are critical, and Christel shares her own downloadable log.

Trust me, most primary care physicians and many endocrinologists are not going to be much help in the exercise advice department. I only remember one thing my first-ever accountant told me 30 years ago: “No one cares about your money as much as you do.” Likewise, no one cares about your health as much as you do. You’ll have to become your own expert.

The author is like a trusted old friend who’s “been there, done that,” and is sharing freely with you.

Christel has had type 1 diabetes for 21 years and is a diabetes coach. She’s been an avid exerciser since 2010. At that time there were very few resources that addressed vigorous exercise in the setting of T1 diabetes. Learn from her clients’ experience and her own N=1 experimentation so you don’t have to make the same trial-and-error mistakes.

The author works out five days a week. That doesn’t mean you have to. I suspect you can achieve 80–90% of the maximal longevity and other health benefits with just three days a week, maybe two. (Note: I am contradicting several authoritative medical panels!) If you’re sedentary now, two or three days a week should definitely improve your fitness. But you have to exercise right.

Early on, the author talks about how to get motivated for exercise. I like her SMART goal setting-checklist: Goals must be Specific, Measurable, Achievable, Relevant, and Time-bound.

She recommends a combination of aerobic exercise (“cardio”) and weight training. (I wouldn’t be surprised if we find out one day that the right weight-training program alone is good enough.) Christel tells exactly how to get started and maintain both types of exercise. She outlines both home-based and gym-based training programs.

Dietary calories for adults in the U.S. come 16% from protein, 48% from carbohydrates, and 34% from fats. Alternatively, the author recommends dietary calories come 40% from protein, 30% from carbohydrates, and 30% from fats. So 150 carb grams/day if eating 2000 calories, limiting meal carbs to 30 grams. I wonder if most folks will end up closer to 30% protein and 40% fat, especially for those not doing as much exercise as Christel. (Protein is important for muscle building and maintenance.) Many of my patients do well with additional carbohydrate restriction, but most don’t exercise as much as Christel despite my encouragement.

You can easily track your macronutrients and calories at MyFitnessPal.com.

The author shares some recipes and tells you how to get started on the all-important meal-planning and coming up with your own recipes. There’s even a helpful and realistic chapter on loss of excess weight.

As a reviewer, I always feel like I have to pick a few nits, so here it is. Christel says cardio exercise is great for losing weight. That probably true if you’re competing for $250,000 on TV’s Biggest Loser show. But usually exercise contributes at most 10% to a successful weight-loss program. Diet’s is critical. Exercise does help with prevention of weight regain and has many other benefits.

Again, I like this e-book and highly recommend it to adults taking insulin for diabetes who need a great physical activity program but don’t know how to go about it. Get the e-book here.

Of course, get the blessings of your personal healthcare provider before making any changes to your diet, exercise program, or medications.

Steve Parker, M.D.

PS: Disclosure: Christel kindly gave me a copy of the e-book. Otherwise there was not, and will not be, any remuneration for this review.