The Healing Power of Touch



I’m a fan of systems, or at least systems thinking. Organizing ideas into a cohesive structure makes the application of the ideas more targeted and appropriate, especially when exercise and health are the goal. Having said that, I think that we’re a long way off from a total understanding of the nuances of anatomy, physiology, neuromuscular physiology, etc. to be able to determine the “best” system (though evidence points us in the right direction).

I often demonstrate this notion by stating that the only undefeated team in the history of the NFL used the Nautilus system of training, ergo Nautilus is the best training system for football teams that want to win. This isn’t true necessarily but it demonstrates how much such declarative statements are at least inaccurate.

An extension of any training program is the regenerative components of the program. At EE Westlake, I use a sufficient volume of soft tissue work, the Med-X Super Stretch, and the Back Revolution to help clients feel their best. I’ve found good success with this but I’m not convinced it is because of any “magic” in my system; rather I think it’s just the fact that I am paying attention to these at all.

Example: Dr. Craig Bueller, founding of Advanced Muscle Integration Techniques, claims that during his tenure at the Utah Jazz, his teams had “lowest ‘Player Missed Games due to Injury Rate’ of any team in the NBA for 25 years.” Juxtapose that with Gray Cook, PT who is one of the developers of the Functional Movement Screen. The Atlanta Falcons claim that their reduced injury rate has been a direct result of using the Functional Movement Screen to assess the body before an injury can occur.

So if one system is better than the other, why do both produce a result of reduced injuries? It could be the luck of the draw: some seasons have less injuries no matter the system. However, I think it is the fact that there is someone paying attention to trying to heal you as a human.

A great article out of Wired magazine discusses this phenomena. Titled “Dr. Feelgood” in the mag but “Forget the Placebo Effect: It’s the ‘Care Effect’ That Matters” on the internet, Nathanael Johnson discusses a sham acupuncture treatment creating results:

We’ve known for decades that when sick people are given a treatment, even if it’s just a sugar pill, their condition often improves. But that can’t be the whole story, if only because the size of the effect varies wildly from one study to the next. One clue to a better answer is found in research led by Ted Kaptchuk at Harvard Medical School: Patients with irritable bowel syndrome were told they’d be participating in a study of the benefits of acupuncture — and one group, which received the treatment from a warm, friendly researcher who asked detailed questions about their lives, did report a marked reduction in symptoms, equivalent to what might result from any drug on the market. Unbeknownst to them, the researchers used trick needles that didn’t pierce the skin.

Now here’s the interesting part: The same sham treatment was given to another group of subjects — but performed brusquely, without conversation. The benefits largely disappeared. It was the empathetic exchange between practitioner and patient, Kaptchuk concluded, that made the difference.

What Kaptchuk demonstrated is what some medical thinkers have begun to call the “care effect” — the idea that the opportunity for patients to feel heard and cared for can improve their health.

Clients who don’t have a doctor ask me if I know any good ones. I know of one or two but none locally who are primary care. I tell them, “Find a DO; at least they’re good at touching and figuring out what is wrong.” This healing touch of the physician, the laying of the hands, is a lost art. There are far more sophisticated tests, but the touch was only part of the diagnosis; it was a reminder that someone was there for you, caring for you.  Dr. Abraham Verghese of Stanford University agrees, which is why he’s trying to bring back the lost art of the physical:

He came to know many of his patients and their families. He visited their homes, attended their deaths and their funerals. One patient, near death, awoke when Dr. Verghese arrived, and opened his shirt to be examined one last time.

“It was like an offering,” Dr. Verghese said, with tears in his eyes. “To preside over the bed of a dying man in his last few hours. I listen, I thump, I don’t even know what I’m listening for. But doing it says: ‘I will never leave you. I will not let you die in pain or alone.’ There’s not a test you can offer that does that.

So my point is this: care is part of treatment, not only in medicine, but in exercise, health, and longevity. Some call it the placebo effect, but we’re fantastically adaptable creatures…maybe the fact that someone is caring (and not doing something that can hurt you in the process) is enough to help supercharge healing and recovery. Readers, it would behoove you to take advantage of this whenever you’re in need.


251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.

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Fun With Numbers: Fat Intake and Life Expectancy

Now, as much as I love the idea of The Economist (the magazine, not Ben Bernanke), I’ve never actually read a full issue. An informal survey of my (relatively affluent, highly intellectual, very good looking) client base confirms that nobody on planet Earth has read a whole issue of The Economist. I believe there is a job that pays just to read the whole issue every week.

That said, every year The Economist does us a solid and releases the “Pocket World in Figures” which has all sorts of crazy stats, like who had the highest rate of inflation (Belarus, 59.2%) or who produces the most cocoa (Côte d’Ivoire, 1,486,000 tons). However the figures that I’m interested in are fat consumption and longevity per country.

There is a list of countries by fat consumption, noting who has the highest average  percent in the world. It looks like this:

  1. Australia 41
  2. France 41
  3. Spain 41
  4. Belgium 40
  5. Bermuda 40
  6. Cyprus 40
  7. Iceland 40
  8. Italy 40

Now if we compare their fat intake to their life expectancy in years (and rank) it looks like this:

7. Australia 82.1 yrs

8. Iceland 82.0 yrs

Italy 82.0 yrs

11. Spain 81.8 yrs

12. France 81.7 yrs

21. Bermuda 80.8 yrs

33. Belgium 80.0 yrs

36. Cyprus 79.9 yrs

Now unfortunately they do not list the fat intake for all countries, but this begs the question: how can similar fat intake result in such different life expectancies? The short version: there’s a whole lot more to life expectancy than just fat intake.

This is where the model breaks down: when a country (typically France) eats a lot of fat and lives a long time, they call it a “paradox.” It’s only a “paradox” because it doesn’t fit the model, which is that “high fat intake leads to heart disease leads to death.” So instead of changing the model, the label a country “paradoxical” and move on trying to prop up a faulty model.

A great example of this is the clip below, where Dr. Malcolm Kendrick looks at the data compiled from the WHO MONICA study, which is the largest heart disease study ever undertaken. Have a watch:

So what’s the take away? There is a LOT that can happen between when you eat food and what your body does with it. It is very difficult to pin health and longevity on one single data point. It’s interesting in creating better questions for investigation, but there is too much noise between that first point and an outcome of lifespan changes.

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.


Exercise Doesn’t Burn Fat By Itself, Like, At All

treadmill guy

Maybe the title is a slight exaggeration, but not by much.

Exercise doesn’t burn a lot of calories under the best of circumstances ( think 100 kcal/mile during a marathon ), hence why exercise is a bad idea if it is going to be your only means of trying to reduce fat mass.

When I tell my clients this, it blows their minds. When I tell a new trainee this, it REALLY blows their minds.

In a recent study titled “Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults” showed that cardiorespiratory exercise was “superior” to resistance training with regards to reducing fat in obese men. This made the rounds on message boards and even had a science daily feature with a nebulous title.

You can’t trust an editorial at science direct, as you don’t get the whole story. As a result you have to look at the whole study, which  on the balance is well done. However let’s look at the changes that show “proof” of how bad lifting weights is for fat loss. The before and after fat mass and lean mass changes between resistance training (RT) and aerobic training (AT) before and the change after the length of the trial:

RT = Fat mass 34.3kg −0.26
AT = Fat mass 34.7kg −1.66

RT = Lean mass 54.4kg 1.09
AT = Lean mass 53.3kg −0.10

RT = Fat % 38.8 −0.65
AT = Fat % 39.4 −1.01

Now a couple of things to note here based on those results:

1. This was an 8 month trial and all they can manage was a 3.52lb (1.66kg) loss with cardiorespiratory training alone? Yes that’s “8 times” the fat loss but I could do that with an obese person in 2 weeks with a dietary intervention. To repeat: Exercise isn’t good at fat loss in the absence of dietary intervention.

2. When you account for the recomposition effect of the RT increasing muscle mass (where the AT group lost muscle), their body fat percentage loss was nearly identical.

This study doesn’t tell us anything new regarding exercise and fat loss. Dietary intervention is still king with regard to fat loss and AT only has statistical superiority in this particular study, as nobody who lives in the real world is getting excited about 3.52lbs of fat lost over 8 months in clinically obese individuals. It makes for a great headline but so what?

So what is exercise good for? A whole bunch of other things that diet cannot improve in healthy human beings. Getting mad at exercise for not causing fat loss is like getting mad at Red Lobster for not serving Chicago deep dish pizza; your expectations do not match what it is actually capable of providing.

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.

Pulmonary Ventilation and Altitude

This is a post about your lungs. I’m going to allow you a minute to get in the right mindset because they’re probably not something you think too much about.

Good? Good. Specifically, I’m going to talk about why it feels like an elephant is standing on your chest when you’re trying to be athletic at altitude when you spend most of the year at (or near) something approximating sea level. First, a bit of anatomy.


So what you’re looking at is the pulmonary anatomy, where gas exchange occurs in the lungs. There is an interface of capillaries and alveolus that allows for red blood cells to collect oxygen from the air drawn into the lungs. While the lungs are very elastic, they don’t control the pressure that allows filling to occur. For that, you have a swath of muscle tissue, shown here:


On the left you see muscles that are used to create negative thoracic pressure. Specifically, the diaphragm pulls down while the intercostals flare the ribs out, reducing compression on the thoracic cavity, thereby allowing air to be driven in my atmospheric pressure. So you’re not “sucking” air as much as you’re “creating space for the environment to move air into your lungs.” This tends to blow peoples minds. But once the air is there, how does this happen? As mentioned above, at the capillary-alveolus interface. Take a look:

Red Blood Cells

So you have these super tiny spaces, the alveolus, where oxygen gets into the nooks and crannies. Individual red blood cells get into the capillaries that interface with these spaces, where the red blood cells offload CO2 and pick up O2. Awesome.


So where does this all go wrong at altitude? Well it’s really about what we call the partial pressure. At sea level there is a uniform atmospheric pressure that is acting on the gases in the air, which are nitrogen, oxygen, and carbon dioxide. These gases each have their own partial pressure, which is the pressure of that gas if it alone occupied the volume of the mixture at the same temperature (and altitude). Add those up and you get the atmospheric pressure at sea level, like this:

Pressure & Gas

So what happens at altitude is that, while there is exactly the same percentage of oxygen in the air, the atmospheric pressure drops very fast. As a result, the saturation of hemoglobin (the oxygen binding pigment in red blood cells) cannot “grab” as much oxygen per unit of time. So it feels like an elephant is on your chest because you’re experiencing oxygen deprivation.

However, it’s important to note that this effect doesn’t happen until ~4900 feet above sea level. Once you’re above that, your body deals with it in interesting ways, like breathing faster, increasing heart rate, and adjusting its blood chemistry (mostly by increasing red blood cell count). The last part is why blood doping and the use of drugs like EPO are illegal in sport: they increase the red blood cell count, which increases blood oxygen, improving performance.  It takes roughly 11 days per kilometer of altitude to manifest these changes.

Finally, the best way to “leverage” this, if you happen to be an endurance athlete, is not to train at altitude but to live at altitude and train below 4900 feet. This way you gain the advantages of altitude without compromising the intensity required in your training. It should come as no surprise that there is an Olympic training facility in Salt Lake City (Elevation: 4,226 ft) but athletes live in Park City (Elevation 7,000 ft).

If you’ve ever wondered why this happens, I hope this answered it for you!

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.

Central vs. Peripheral Cardiovascular Adaptations

There’s some science ahead, folks, but I’ll try to keep it interesting.

One of the things that we get asked frequently at EE is why we focus on resistance training. The short version is that, by focusing on high quality movements with resistance, we can positively affect the totality of the physiology including components that improve heart health. People have a hard time understanding this, so this post is largely about that.

The role of the heart

So why do we “need” to do cardiorespiratory training? People largely give me a tautological answer like “…Because we need to do cardiorespiratory training.” The “need” to do this has become so engrained in the zeitgeist of fitness that people accept the supposed requirement like they accept the need for oxygen in order to keep living. If you’re “fit,” you include cardiorespiratory training.

That still doesn’t answer “why.” If pressed, people then cite their heart health as the reason. Better answer. As amazing as the heart is, it’s simply a four chambered pump. Its action is modulated by the nervous system to meet the demands of any activity you’d participate in, from relaxing to high level athletics. The heart’s main role is to pump oxygenated blood to the working tissues of the body and to seamlessly meet this demand in a changing energetic environment. Put another way: your heart is there to serve your muscle tissue. Period. So we focus on improving muscle tissue at EE to make the heart healthier.

Central Adaptations

Now telling people this usually blows their minds. The assumption is that all of the changes that result in a healthier heart come from changes to the actual heart muscle. There are changes to the health muscle in high level endurance athletics to be sure; take a look at this graph:

Heart Volume

In this case, LVID stands for “left ventricular internal dimension,” MWT stands for “Mean Wall Thickness,” and LVM stands for “Left Ventricular Mass.” It’s important to note that chronic endurance athletics (though not as much with ultraendurance athletics, paradoxically) does change the size of heart components, which generally return to normal after the athletics career has ceased. These adaptations are generally considered positive in the context of athletics.

Peripheral Adaptations

Where the rubber meets the road is in the periphery. In this case, we’re not referring to the heart muscle but the muscle tissue and vascular structure that the heart is actually delivering oxygenated blood to and through. There is a significant amount of changes to tissue as a result of training including:

  • Capillary Number & Recruitment
  • Myoglobin
  • Mitrochondria density
  • Enzymatic activity

The last one is what I’ll focus on. First, take a look at this chart:


So when you look at that chart, you’ll see that cardiorespiratory (“aerobic”) training is associated with larger increases in enzymes that deal with the large amounts of pyruvate that such training results in. As expected, you see that anaerobic training results in substantial increases in the enzymes responsible for mobilizing ATP and increasing the accessibility of glycogen, anaerobic substrates.

Here’s the thing: if you train in a manner similar to how we do at EE, you get the best of both worlds. Studies have shown that when high intensity interval training is used, both anaerobic and aerobic enzymes increase substantially. (1, 2, 3). More muscle tissue means more of the changes discussed above and less stress on the heart at any workload. Will it make you an endurance athlete without specific training? No, but in one of the studies such training doubled endurance capacity (time to fatigue), which would come in handy during such events.

That’s a long way of saying: we use weights in an interval fashion because it builds muscle and makes your heart healthier with no time wasted. Simple, really.

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.

Integrating What We Do With Other Activities

This past weekend at the PaleoFX conference, I had a number of conversations with people who were curious as to how we incorporate what

we do at Efficient Exercise with other activities. They were having a hard time rectifying how such a small amount of exercise could benefit their activity.


There first thing I explained was simply that we at EE don’t want them to be “good” at working out. Not that we don’t want them to get better but that we want them to do only well enough to benefit the activity that they’d rather be doing. For endurance athletes, this means that they really only need one workout per week with us. The trick is that they need to replace one of their training days with our workout: you can’t just add the strength training on top of a loaded endurance schedule. Studies showthat the combination of strength and endurance only works if some of the endurance activity is replaced with strength work. It’s also been shown from the same studies that this strength work reduces injury potential and improves oxygen consumption.

So how might that look in practice? My friend Patrick Diver has combined an approach similar to ours with his cycling. In this interview, he explained the schedule he used when competing at the highest levels (Florida Pro I/II criterium championship):

  • Monday:   Off
  • Tuesday:  Intervals on bike + short HIT session
  • Wednesday:  Training Race
  • Thursday: Off
  • Friday: Off
  • Saturday:  Race
  • Sunday:  2.5 hour fast group ride

Total weekly hours: 5-7

Welcome to the gun show.


So if you know any cyclists who compete, they’ll scoff at this amount of training but it was an intelligent application of leveraging the highest quality hours that produce the best result.

What about other activities? It’s pretty in vogue to focus on moving naturally, attempting to apply how humans may have moved and build a workout around it. This sort of activity is a lot of fun and that’s part of my point: you should be doing things you like doing more often with less injures. That’s what resistance training like what we do at EE can provide. Back to my point, how do we mesh the two? Again, Patrick’s answer is more succinct than I could provide:

My take on it goes like this:  do a (high quality strength) session once a week to cover your bases, and then go jump, roll, fight, climb, cycle or whatever else that seems like fun to you.

Remember, unless you have a specific performance goal that pertains to the gym, you don’t have to spend much time there to get the benefits to health and vitality. This is also true if you’re attempting to improve the performance of other activities. The gym only improves the baseline strength of the muscles involved; you’ve got to use them in the activity to maximally transfer that raw strength.

It’s really that simple.

Strength is a Skill

The subtitle of the post should be “…that doesn’t always lead to mass.”

The trainers at Efficient Exercise like to wax poetic about studies as they come out. I came across a study on exercise volume and hypertrophy & strength changes. The study is titled “Strength and neuromuscular adaptation following one, four, and eight sets of high intensity resistance exercise in trained males” and is found in the Journal of Applied Physiology. Click above for a preview.

The study used 32 resistance trained males in a 10 week study of the squat at 1, 4, and 8 sets per workout performed twice a week. The authors concluded ” The results of this study support resistance exercise prescription in excess of 4-sets (i.e. 8-sets) for faster and greater strength gains as compared to 1-set training.” Yup, that’s true. No beef there. But let’s look at the numbers.

Strength Stats

So the numbers are cut and dry: the 8 set group saw an average increase in 37kg in their 1 rep max squat over the course of the 10 week study, compared to a 17kg increase from the 1 set group. Here’s the thing: when you compare the lean tissue changes, the result is much, much smaller. The 1 set group gained 2.03kg lbm over the 10 weeks, while the 8 set group gained 2.69kg lbm. So for the 8x increase in time spent training, and a 1 rep max 20kg higher over the same period, the trainees gained…only 0.66kg more? Really?

Strength is a skill and all of that time spent under the bar is practice. It just also happens to contribute to hypertrophy but not in a linear fashion. The fact is that if you want to get strong as fast as possible, more practice will get you with the movement pattern will allow a larger exertion to be controlled when performing that movement pattern. This is wrapped up in some of the mechanisms I discussed in the “Aging: What’s The Metric?” post: our muscles and nervous system get more efficient within the very narrow movement parameter that you’re practicing, meaning you can exert harder without leaving the groove.

The problem with these studies is that they cannot, due to funding, account for the long view of time. I’ve shown this crude sketch before but it’s relevant here.

Rate Of Gain vs. Injury Potential

While reaching one’s “absolute” potential is something very few are in danger of achieving, the fact is our progress slows down as we get closer to that absolute max. Understanding that each one of us has a limit, it must be asked that does doing more sets merely get us to that limit faster, only to coast longer? Given a time frame of say 5 years, would the 1 set group and the 8 set group be moving very nearly the same weight, all things being equal? I’d suggest that they’d be very close, with the reduced set group having spent less time in the gym and reduced occurrence of injury. There’s only so much recovery to go around and the tolerance for error becomes smaller under heavier loads.

Studies like this (there are many) should beg the question: what’s your goal? If you want to powerlift, more time under the bar is better (though 8x the sets only got a bit more than 2x the strength gain…4 sets is a nice compromise in that regard). If your goal is lean tissue gain, strength improvements are important, though a side effect of quality contractions under sustained load with sufficient metabolic distress and enough rest and calories…and picking the right parents! Finally, if your goal is robust health, improved function, and a better looking naked body, 1 set with a sound set of eating habits centered around real food is hard to beat. The time investment is paltry and the return is profound. That’s the reason why we at Efficient Exercise keep the number of sets of exercise  low: you have the greatest return on time invested for the goals our clients are after.

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.

Lifestyle Habits: “The Blue Zones”

Back in my Alameda 7 post, I made reference to “The Blue Zones,” which is a demographic study of areas of the world where people live measurably longer periods of time.The Blue Zones idea and suggested conclusions (more on that in a moment) were vaulted into the consciousness of health-minded folks largely due to Dr. Oz and an entire episode on Oprah outlining the 4 Blue Zones that had been discovered at that time (there are now 5).

I’ll give a brief rundown of the gist, outline these zones, list the found similarities in how these groups live, and offer some criticism as to the conclusions drawn.



The main thrust of the Blue Zones starts with a study, known as the Danish Twin Study. This study followed 2872 Danish Twins born between 1870 and 1900. After all of these pairs had died, statistical analysis was performed and determined that ~25% of the variance in longevity can be attributed to genetic factors. Later studies give a slightly larger range, from a high of one-third to a low of 15%. So if we’re pessimistic, only one-third of our longevity is related to genetic factors, thus the remaining 70% is due to lifestyle. This was the thrust of the Alameda 7 study: follow some simple habits and you’ll gain quality years of life.

The book is based on the work of Michel Poulain, who identified a mountainous region of Sardinia where men lived longer than women, but both live longer than the rest of Sardinia. Fun fact: it’s a “Blue Zone” because that’s the color they used to identify the region. Really, take a look:

After the statistical analysis was found to be accurate, that there was in fact a positive longevity outcome, the search for more of these places around the world began. Many Don Quixote-types claim that their area of the world has a positive outcome on longevity. My wife even spent a year in one of these places: Vilcabamba, Ecuador.  In her own words, “The guy who probably convinced the gringos that you lived forever there was my host father. He was a fantastic story teller.” I mean it’s a gorgeous place, but no longevity advantage has been found:

The Five Blue Zones

So after digging and intense statistic analysis, these 5 zones have been confirmed:


From these 5 spots, the authors attempted to “tease out” a de facto longevity formula, which is this:

Now I won’t spend time unpacking those, but I would suggest that they’re directionally accurate and very similar to what was found in the Alameda 7 study. If you were able to follow the above list regularly, then you’d likely be in a good place to maximize your longevity free of chronic diseases.


I have some problems with the conclusions derived from the Blue Zones. Not enough to throw it out (it’s really a great piece of work) but to bring attention to things that I feel are worth reducing the importance of when compared to the authors of the book:

  1. The book goes on about all of the exercise of a decent intensity that these people are doing, but then concludes that if you “move naturally” you don’t need to exercise. They’re not talking Movnat-style exercise, but maintaining a high level of physical activity through gardening, walking, or “inconveniencing yourself.” This is great stuff, mind you, but the audience of the books needs to be considered. I learned in graduate school how if a researcher is not on top of a person, they’d count walking to the mailbox as “10 minutes of moderate intensity physical activity.” For Americans, I feel there needs to be some sort of intervention of activity to demonstrate meaning of “moderate physical activity” while also addressing the musculoskeletal imbalances these people have. It’s not like I’m talking out of my ass here: I’ve made a career of this because it’s so common. Eventually, when you’re in better shape, you want to move more, like you can’t sit still. This isn’t accounted for: the conclusion ignores the cause of why these people move so much, which is that they’re already healthy and fit. It’s the same reason all the fat people on the “Biggest Loser” are forced to move a ton. Correlation and causation are flipped.
  2. It’s also noted that all of these groups are isolated, which means that there is a significant “Founder Effect” to consider. That is when a population splinters off from a larger population, thus reducing genetic variation. While the Blue Zones demonstrate a founder effect that selects for a genetic maximization of these good habits (e.g. phenotypic expression), other founder effects lead to things like the incredibly high rate of deafness on Martha’s Vineyard, leading to things Martha’s Vineyard Sign Language. Remember that while genes play a relatively small part of longevity, these populations may have the most important reduced genetic variation to maximize the longevity effects of their lifestyles.
  3. It’s hard to prove a negative. In the New York Times article about the Ikarian blue zone, Gary Taubes asks this question: “Are they doing something positive, or is it the absence of something negative?” So while they are eating more vegetables than your average American, they’re also eating very little white flour and sugar compared to your average American. If it’s not there, you can’t see its effect. What is being contributed to veggies might actually be the lack of sugar and flour. It’s especially hard to compare the lifestyle effect; again these are isolated populations. Would the lifestyle-credited longevity benefits remain if sugar and flour were added?

I like this book. I have a dog-eared copy that I’m sure I’ll have to replace at some point because I read it so much. I’m on board with the lifestyle habits that maximize longevity but I like to remind people that, due to a variety of factors, these habits may simply be what maximizes longevity in these populations due to their genetic makeup. Take these habits on and you’ll significantly improve the quality of your life, just don’t expect to live to 110 because some of those in the Blue Zones have.

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.



Grand Unified Theory 2.0

Since posting a couple weeks ago, I’ve received some good feedback and had a few “duh” moments myself regarding how this should look. As much, I’ve already updated and improved the design, which now looks like this:

GUT 3.0So one of the things I’ve done is expanded the “general” section because there is more leeway in avoiding creating dysfunction or injury when your movements are biomechanically congruent. Second I expanded the purple dysfunction areas to be larger when specializing or rehabilitating, as the more specialized you become the greater your risk of injury. It seems funny to “specialize” in general movements or movement patterns, but you can. This is seen a lot in the HIT crowd where the range of motion that is best loaded (from a force output perspective) is the “only” range of motion that these people venture. Stretching and mobility are dirty words; however if you can’t get into that range of motion voluntarily, and you have to venture there for some reason in real life, you’ll end up injured. Again, this is what I referred to in the first post as improving your boundary conditions and if you’re a HIT practitioner it would be wise to spend a little time here each week.

Next, this doesn’t account for modalities within each spectrum, which was a comment I received: “This doesn’t account for X’s work.” This was not a comprehensive spectrum of technique modalities because A) the distinctions can be arbitrary and B) modalities that may be the cornerstone of a bodybuilder might only see minor, but valuable, use by those in rehab or movement specialization (if they’re paying attention to what I wrote in the first paragraph). Modalities are a bit more fluid because their use is specific to the individual you’re training; remember, this is a global view of how training endeavors fit together, not the techniques you’d use in those endeavors.

Further if you’re healthy, the directionality would be from left to right or center toward the edges. Only if injured (or are on the verge of injury because you’ve ignored boundary conditions), should you regress back to the left as you primary focus. What happens as you move from left to right is that you transcend and include the previous level. Think about it: if you’re healthy, you’re likely using physical therapy exercises as “prehab” for your joints and muscles. Or if you’re venturing into a specific sport or movement activity, you’re likely using basic strength drills to “activate” muscles for your complex movement patterns, especially when they’re new to you. This does not mean that everyone needs to ever reach the movement or sport performance stage as some sort of “zenith” to your ability. Rather, it’s important to understand that though I’ve delineated these overarching themes, the reality is that the lower levels are part of the upper levels, though serving a different purpose in the scope of training goals.

Finally, I’ve added some examples to the spaces so that people understand what might “fit” each section. Clearly not an exhaustive list, merely a jumping off point for categorization and recognition.

GUT Examples

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.


Physical Strength Through Aging: What’s the Metric?

Early in training at Efficient Exercise, a client might come to the conclusion that they’re going to keep getting stronger at the rate they have been, soon being so strong that they’ll plan on giving Atlas a smoke break. Alas, this isn’t how this stuff works: the body has limits and, over time, we start to decay. With that in mind, is there a “best” way to judge our muscular strength through aging? The numbers on the machine or the bar? Something else?

This exchange was between two trainers, one in his 60’s (Ed) and the other in his 50’s. It gets to the heart of the matter:

“Another Point: Folks, don’t fool yourself into thinking you’re “stronger” after 5 Years of aging – one might perform exercises better or score well on machines, but age Kicks Your A**”

Not sure I agree. I firmly believe that I’m as close to defying the aging process as could happen. Between 61 and 63 my measurable strength levels went up about 60-70% (despite “working out” with weights for 20 years prior…I had a good start). Going on 69 and they have not dropped one bit. So that said, in the last 5 years I’ve seen no decline in what I accomplished the first 2 years. Which says to me, I’m just as strong now as I was 5 years ago (not to mention I feel fantastic!)

The other trainer basically waves off Ed’s statement by saying he’s “keeping score on machines” and implies that a barbell bench press would be the “real” scorekeeper of his strength levels. Let’s talk about this.

What the heck is strength, actually?

Or specifically, what are the ways in which our body manifests strength? People with a little experience in this field understand that it’s not *just* muscle mass being added. There’s a whole host of compensatory mechanisms being used to make one “stronger” without a corresponding increase in size.

In Neuromechanics of Human Movement, Roger Enoka lists eight potential neurological areas for non-hypertrophy related strength gains:

  • Enhanced output from supraspinal centers (which they show from simply imagining muscle contractions)
  • Changes in descending drive that reduce the bilateral deficit (the inability to fully recruit all of the motor units during dual limb compound movements)
  • Increased motor unit synchronization
  • Greater muscle activation (EMG)
  • Heightened excitability and altered connections into motor neurons
  • Reduced coactivation of antagonist muscles
  • Greater activation of agonist and synergist muscles
  • Enhanced cross-education

I’d like to add a couple of psychological things that might not be so obvious not listed above including:

  • Motivation
  • Pain tolerance
  • Perception of difficulty
  • Confidence
  • Experience

Big list, but the important component is that basic coordination between the muscles is the single greatest contributor to non-hypertrophy related strength gains. Along with neurological adaptations, adaptations involving increased stiffness in the tissues that connect from bone to bone (tendons, extracellular matrix, etc.) can lead to increased force transmission from muscle to bone, which play a significant role in increased strength gains. The more “spring-like” the tissue can become, the more the force produced ends up moving through the barbell or apparatus attempting to be moved.

So in that sense, the trainer talking about keeping “score” with machines (or any exercise) is correct: they can lie to you, especially if you lift like powerlifter on every rep. However, it’s important to note that these mechanisms cannot compensate forever. Imagine if they could: you’d be the 98lb weakling dead lifting 800lbs. Rather, these compensations occur in parallel with hypertrophy and within parameters. Eventually the compensatory ability reaches its ceiling for a given amount of muscle mass and you either add tissue or, if you’re near your genetic limit, don’t get any stronger or bigger. Such is life. But the take away is that if you’re getting stronger and your weight is stable, you’re probably not losing muscle. Strength, as measured by weight on the machine or on the bar, is directionally accurate.

So how else can you keep score?

Body composition

Let me remind you that Ed is nearly 69. He’s on the downward slope of muscle mass and strength gains, where his peers are withering. Ed is making progress due to their rapid loss of tissue due to inactivity and sudden fat increase, a term called “sarcopenic obesity.” A great review of this can be found here.

From a visual perspective, this curve can be displayed. Here’s how it looks based on the literature:

Muscle curve age

The original curve is from “Bending the Aging Curve” by Joseph Signorile. I added the “Paddon-Jones” curve, as one of Dr. Doug Paddon-Jones former students was a muscle physiologist at Texas State University.  She explained that the original curve doesn’t account for the fact that people get injured, lose a lot of mass, and never recover to a “normal” projected loss. So the “gap” between a good functioning person training and their sedentary peers is even larger.

It looks great on a graph, but something more substantial is required. How about images?


The 40 year old and 74 year old triathlete look nearly identical as far as muscle mass are concerned. Remember it is the total volume of tissue we’re looking at here; it’s difficult to sometimes see how a person actually is doing when they’re aging because of the breaking down of the collagen matrix in their skin making them look less “hard” than when they were younger. The muscle is there, but the skin lies a bit. The big takeaway is that the tissue volume is still similar assuming constant activity.

Ed notes substantial strength and tissue gains in his early 60′s. We see these improvements in sedentary 90+ year olds. It looks like this:

90 muscle

For those who have trouble reading the text, the 92 year old increased the cross sectional area of his thigh by 44% in 12 weeks of resistance training. Based on the above, it is reasonable to assume that one could “jump” a line of muscle decay if training is sufficient in intensity and progression. Perhaps this explains Ed’s jump in strength and maintenance thereof.

Another point: muscle is an endocrine organ. High quality work with muscle stimulates a more youthful expression in all of the organ systems in the body. It is literally the gatekeeper to youth.

So that’s the long version of saying: strength is an outcome of a complex system of events. If you’re maintaining your strength or even getting just a little stronger, you’re going to age physically as well as a human being can. Keep working hard!


  1. Strength is a directionally accurate indicator of lean tissue maintenance and/or gain during aging.
  2. Decay is inevitable but the rate of decay is largely within your control.
  3. The surest way to “keep score” of your physical function throughout aging is a yearly DXA scan to assess muscle and bone, a basic mobility screen, and strength as assessed by your training regimen. All of this with feeling really damn good covers both objective and subjective measures of physical function.

251505_10151024760092405_1633409149_nSkyler Tanner is an Efficient Exercise Master Trainer and holds his MS in Exercise Science.  He enjoys teaching others about the power of proper exercise and how it positively affects functional mobility and the biomarkers of aging.


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