Category: Lifestyle

30 Minute Magic

“I wasted time, and now doth time waste me…” – William Shakespeare

Of the many health and wellness misconceptions that plague the general public, the most insidious is the notion that to be in great shape requires a time investment approaching that of top athletes. And, being the all-or-nothing culture that we are, that misconception easily translates into an excuse to do nothing at all.

So let’s dispel that time requirement myth, once and for all. And remove any remaining excuse you have not to get in great shape.

Now, to be fair, most people I speak with do have a pretty accurate notion for the time investment required to perform at the top level of any sport. For instance, few would be surprised over the details of a day-in-the-life of Michael Phelps, depicted below:

Note: for the full infographic, depicting the example daily schedules of many Olympic athletes, see this. The overall time commitment required of these athletes is mind-boggling.

And yes, reaching and maintaining athletic mastery requires an unworldly devotion and dedication to task.

So where, you might ask, does this leave your average Joe or Jane? Those juggling jobs, kids, family and, well… life? If we were able to manage to eek-out a bit of time during the week for exercise, is that effort all in vain? Would that time be better spent binge-watching old Seinfeld episodes?

Well, the short answer is, absolutely not. And the more expounded answer is that even the smallest time investment can pay huge dividends. The caveat here being that most are just squandering that time. It’s all no doubt well intentioned… though, at best, misguided and misinformed. And it’s painful to witness.

Let’s do this right

The first thing we need to consider when examining the daily schedules of top-end athletes is that a preponderance of their training time is spent in what is known as skills acquisition. That is, the laborious, repeated (and time consuming!) act of practicing those skills pertinent to their particular sport — over and over and over again. Baseball is a fine example: the batting and fielding practice never ends. The tennis player honing her serve and volley. The golfer’s putt after putt after putt.

Now, to the extent that the body is in motion, there is a degree of low-level physical exertion present. And that’s a good thing… for those who choose to devote time toward such ends. But is that activity necessary to be healthy? Or even to look good naked? The good news is that it’s not. In fact, there’s much more effective, low hanging fruit to pursue.

That “low hanging fruit” forms the bedrock of every top-end athlete’s training regimen: his strength and conditioning program. And if we think of that program in total as being a pyramid, the base of that pyramid would be basic strength, ease and range of movement, and work capacity. The very things we prioritize at Efficient Exercise. And when compared to the time investment that skills acquisition requires, that portion of an athlete’s overall program is minimal. Unless, of course, the sport in question is strength and conditioning, (think CrossFit).

So now we’ve reduced this time requirement beast into something much more manageable. But we’re not done yet. By intelligently targeting those aspects of strength, movement and work capacity that offer the biggest bang for the time investment buck, we can fashion a commitment to health, wellness (and looking good naked!) that even the most time-crunched professional or soccer mom can adhere to.

The Great Equalizer: Time

At Efficient Exercise, we recognize that there are many strength and conditioning programs that are highly effective at achieving results in those “base of the pyramid” qualities described above. But from our perspective, the major drawback to those programs is, again, the required time investment.

For example, during my collegiate football days, it was perfectly normal for me to spend up to two hours a day, in the off season, just on the strength and conditioning portion of my training. Was it effective? Extremely. A huge investment, both in time and physical recovery ability? Absolutely. But at that point in my life, the time investment (both in actual training, and in recovery modalities) was a non sequitur. My job was to be a student-athlete.

I laugh at devoting that much time to training now. And although mentally and emotionally I’d love to spend that much time in the gym, with my hectic schedule, it’s simply not possible.

And let me be clear: there was no wasted effort in that two hours a day of training. I was lucky enough to come under the tutelage of one of the finest strength and conditioning minds of that time. The programming was highly efficient, effective and directed. And therein lay another thread of the fitness tapestry that we need to define in order to create effective programs for our Efficient Exercise clientele: the idea of diminishing return on effort.

The Winning Combination: Technology + Expertise

“The journey of a thousand miles begins with a single step.” – Lao Tzu

The greatest advancement in any endeavor comes in the transition from doing nothing, to doing something. With everything after that being a balance between effort and return on effort, vis-a-vis one’s goal. The key is to strike a healthy balance between the two. And at Efficient Exercise we’ve done just that by combining ARX’s 21st century technology with the finest in training protocols and expertise.

So in the case of my former football jock self, I was more than willing to trade an inordinate amount of time and effort investment for the smallest of incremental returns. In fact, I had to, if I wanted to compete with more naturally gifted athletes. My goals at that time were well beyond the purview of health and fitness, and were directed to competition at the highest level. And at that level of competition, incremental differences in strength, speed and mobility are everything.

But now the same “me” can stay in great shape with a fraction of the time investment. And so can you. How is that possible? Because at Efficient Exercise, we put into practice the theory of the 80/20 rule — The Pareto Principle — which posits that 80% of an effect comes from 20% of the causes / effort. The flipside of this is also true: that to reap that extra 20% requires an additional 80% time and effort investment. An investment I was happy to make in my late teens and early 20s. Not an investment, however, that I’d even consider now.

And neither should you. Unless you plan on competing at the highest levels, and where that extra 20% will make a substantial difference. Olympic gold not on your bucket list? Cool. Then our innovative, twice weekly, 30 minute sessions will be more than enough to get you beyond 80% of your fitness and body composition goals.

In later installments we’ll discuss what you should do (if anything) in addition to your Efficient Exercise workouts. Because we’re certainly not opposed to extra physical activity, we just want to make sure you’re assessing that activity — and the motives toward pursuing that activity — correctly.

In Health,
Keith

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Reflections

As I sit down to write the inaugural blog post of our newly launched web site, I reflect on years past. It was February 2001 when I first started Efficient Exercise in a small studio on Far West Boulevard in Austin. As I think back about that time period, the overwhelming feeling of gratitude hits me. We have been operating in Austin for 16 years now and many wonderful relationships have been formed. I want to send out a thank you to all of the early clients that supported us back in those first years on Far West. There were many great memories and a lot of entrepreneurial lessons learned the hard way to say the least.

Our first studio on Far West, circa 2001

As we move into a new season, I am more than pleased when I reflect on where Efficient Exercise is today. Some of the old guard so to say has moved onto new horizons including Skyler Tanner, Keith Norris, and myself. We gladly welcome the new guard as they are the leaders of Efficient Exercise today and represent us well as we grow into a bright future.

As a founder with a vision to provide a personal, more viable option to the traditional gym, I think we have accomplished this mission. As a matter of fact, when I look around Austin, or even more specifically just taking a stroll up north on Burnet Road from where we sit at 45th Street and Burnet Road, I see many alternative options to the big box traditional gym and that pleases me. I think it speaks volumes to the quality of service we provide at EE knowing the fact we have thrived for this long.

The foundational principles of Efficient Exercise are still in place, and key evolutions to our business are also fundamental to the services we provide today and into the future.

We still believe in our original foundational pillars that every workout should be safe, effective, and efficient. Similar to the medical oath, first do no harm, we aim to never hurt our clients with our exercise prescriptions. If the workout is not effective, then clients will not achieve their desired results. And of course, efficiency is the name of our game (and business). We want to keep workouts to 30 minutes because we know that our clients value their time, and working out enables them to live a healthier, more vibrant life. The gym scene is not our vibe, and we serve clients that prefer to live their life outside of the gym, getting the most bang for their exercise buck at EE. The fundamental changes in our service over the years include implementing ARX technology and making mobility and corrective exercises part of our programs.

ARX – adaptive resistance exercise, is a computer-controlled, motorized resistance training technology that advances the human body while tracking progress in the software system. We believe that proper resistance training is the foundation to our exercise prescription and ARX allows us to provide that stimulus in a more effective, safe, and efficient manner than ever before.
Strength is the base of good health and performance. Whether you are an elite athlete or a grandmother that wants to keep up with her grandchildren, we can provide you strength to live a healthier and more vibrant life. However, strength should be aligned with proper biomechanics, moving effectively in your daily life, and ensuring that your body is mobile and injury free whatever your goals may be. We assess your movement and mobility and supplement ARX-based resistance training programs with corrective exercises and mobility movements that will allow for pain-free living.
We sincerely thank everyone that has supported us over these 16 years and we gladly welcome new faces to the Efficient Exercise family. I hope to see you around EE in the many years to come.

Yours in Health,
Mark Alexander
Founder – Efficient Exercise

The “Critical Point of Change”

Success truly is a habit, not a destination or static state.

I note this because we’re coming up on the New Year and people will invariably think that if they just really want something, that not only can they have it but they can keep it once they have it. This presupposes health and fitness are trinkets, items that once collected are kept in perfect order unless acted on by an outside force.

Here’s the thing: doing “nothing” once achieved *is* the outside force. What maintains health and fitness is not really wanting it, but wanting it just enough to regularly check in on it, in this case that means habits conducive to maintaining your earned health and fitness. What it is not, in spite what we might wish, is a “critical point of change,” a threshold that once crossed, changes the state of affairs permanently.

What do I mean? In the book Ubiquity, physicist and science journalist Mark Buchanan introduces the reader to the science of what he calls “historical physics”–the study of systems that are far from equilibrium and, as he puts it poised “on the knife edge of instability”. He describes a much-studied model of such catastrophe-prone systems, a simple sandpile. Build a sandpile by dropping one grain at a time on the now heap of sand grains. It will eventually reach a critical state at which a grain can either make the pile a bit taller or start an avalanche, small or large. Scientists experimenting with real and virtual sandpiles have observed several important regularities:

  1.  The time between avalanches is extremely variable, making it essentially impossible to predict when the next avalanche will occur.
  2.  The size of avalanches is also extremely variable, making it essentially impossible to predict whether the next avalanche will be tiny or huge.
  3.  A big avalanche doesn’t need a big cause; one grain can trigger a sandpile-flattening event.

While biological systems absolutely adhere to the laws of physics, human beings and their behavioral tendencies do not. The idea that, at some point, a switch is flipped and you are on good behavior autopilot is a fallacy. It gets easier, of course, approximating automatic, but if you slack off, backsliding is still very easy. This is why you build an environment that makes that backsliding hard (i.e. no junk food in the pantry) so when our fragile humanity kicks in, we’ve saved ourselves ahead of time.

To put it another way, when asked how long you have to do this, a trainer friend of mine put it succinctly:

Till you die, ma’am.

The Middle Way

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Health and vitality is the birthright of everyone on Earth. It’s not just the United States that is experience an obesity epidemic, and the health implications that come with it, but the rest of the world as well. Locally, this is a function of being the “Great Experiment,” where a melting pot society allows those to live however they choose. This means that one is free to follow, or ignore, cultural norms as they choose.

However, cultural norms have stood the test of time for a reason: they’re a directionally accurate answer to many of the societal problems encountered by a group. When it comes to health and vitality, long standing cultural norms are a constant reminder of the steps needed to keep healthy. I’ve discussed this a number of times in previous posts (here and here).

Most of us learned eating habits from our parents, who came of age in a TV Dinner/Fast Food nation that valued access and volume over quality and health. It’s no wonder we continue to get fatter!

In the absence of culture, you can pay to have someone do all the work for you. A personal chef controls the portions, food stuffs, and shopping, so you don’t have to think about that. Last I checked, none of my clients are in a position to afford such a luxury.

We’ve been trying to solve this dilemma at EE for a while now: how do you help people to learn how to eat better (not what to eat, necessarily) while making the information actionable without breaking the bank?

I had trouble putting it together until my last bit of graduate school, where my Health Education coursework introduced me to theories and frameworks that had already been used to create lifestyle habit change in the real world for things like smoking cessation, AIDS education, as well as alcohol reduction. By comparison, dietary habit changes should be quite doable!

So I’ve been referring to this as a “Middle Way”: all of the cultural and research-based lifestyle components that can get you lean and healthy without an obsession or an overly restrictive life bent to the will of your diet. Sounds good to me!

We’re calling it “Concierge Coaching” and here’s what you get:

  • Daily Content delivered and personalized just for you
  • Full Access to Exclusive Concierge Content
  • Only 10 minutes of reading 6 days per week
  • Actionable items to implement and practice
  • Weekly check-ins with your personal coach
  • A strong and effective community

The goal is the leverage all of the power and proven success of the health education foundation with a program delivered to you, that you can actually stick with. It’s a re-education program, not a diet. When you’re done, you should never have to “diet” again!

Sound interesting? Click here to find out more and inquire about getting on board.

 

It’s still about lifestyle, mostly.

I’ve examined a number of studies on how important lifestyle factors are in health and longevity. With this post I wanted to tie the threads together to get a big picture.

It’s easy to get hung up on tiny variables, on nerding out with the bleeding edge of science. I get it; I’ve been there. It makes it sounds really tough, like you have to time everything by an Atomic Circadian Clock. Really, this stuff isn’t that hard. If you’re on the bleeding edge of the BMI scale, you likely need some very specialized help. If you’re not, you don’t need daily mental masturbation about minutia that probably doesn’t make that much of a difference. Not in practice.

And that’s really it: things that can be done in the controlled lab environment are very rarely externally valid. Controlled meals and metabolic chambers? Nay. Metabolic carts and a perfectly timed bolus of amino acids? Nope. You get none of these, free-living human.

The fact of the matter is that the leanest, longest-lived cultures on Earth aren’t accounting for any of that crap!

A quick rundown, shall we?

The Aladema Study

The Blue Zones studies attempted to tease out a defacto longevity formula from the longest lived cultures on Earth. I’ll talk more about them in a minute, but if you back the longevity train up a bit further, you’ll find a researcher by the name of Lester Breslow. In 1965, Breslow started a study in Alameda country, California that examined the health habits of 6,928 people, with an eye toward 7 health habits he deemed most important (which is why the study is referred to as the “Alameda 7″). Their behavior was examined over intervals of up to 20 years and the data was parsed with quantitative analysis (which at the time didn’t happen with longevity studies). As a result, Breslow found that a 45 year old who followed at least 6 of the 7 habits had a life expectancy 11 years longer than that of a person who followed 3 or fewer. And these were good, strong, functional years free of major disease or complication, because what does it matter that you live longer if you can’t do anything with it?

What were the habits? Here’s his original list of the Alameda 7:

  1. Avoiding Smoking
  2. Exercising regularly
  3. Maintaining a healthy body weight
  4. Sleeping 7 to 8 hours per night
  5. Limiting consumption of alcoholic drinks
  6. Eating Breakfast
  7. Avoiding snacking between meals.

…That’s it. You were expecting some sort of lifestyle calculus? Something only the “chosen few” could accomplish? There’s nothing sexy here and that’s the point: what is done consistently, albeit imperfectly, is what makes changes in the long term. Interventions require rigidity and high effort; lifestyles do not.

Don’t believe that this one study was enough? The good news is that the research has been followed and examined many times over the years. More recently, Dr. Jeff Housman (one of my graduate school professors) and colleague put together a review of the data that came from the study and subsequent reviews. Check this tidbit:

 The linear model supported previous findings, indicating regular exercise, limited alcohol consumption, abstinence from smoking, sleeping 7–8 hours a night, and maintenance of a healthy weight play an important role in promoting longevity and delaying illness and death.

So really the “Alameda 7″ is the “Alameda 5,” meaning that 1-5 on my list above are the big lifestyle “tricks” you need to attempt to do in order to set yourself up for a longer, stronger life.

So what happened to Lester Breslow? He died quietly in his home in 2012…at the age of 97. Maybe there’s something to this stuff after all?

Blue Zones

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.

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

bluezonesmap

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 (5?) 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. 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.
  2. 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?
  3. Much of the book is hooked on the dietary component and emphasizes movement, though not “exercise.” Fine, but  a recent analysis showed that the variable that most correlated with the longevity of the Sardinia blue zone men was *drumroll*… physical activity.  Not training, but “pastoralism,” grade of the terrain, and, distance traveled to a place of work. Not magic legumes, not red wine, not cheese, not a super-secret workout…physical activity!

Adventists & Mormons: It was never about meat

Going back to my whine about isolating small variables and attempting control them, remember that our bodies aren’t these time-dependent output machines. That is, an input will not always give you the same output, in the same amount of time…there’s a constellation of variables all in flux that affect the final outcome.

This is the problem with any self experiment: humans tracking inputs into our biology leaves all sorts to be desired…the margin of error is just too much for any sort of meaningful information to be derived:

nancy-qs

We’re not machines; if we were, we could expect a given input to yield a linear, time-consistent response. X volume of powder A yields Y response in Z minutes. But it doesn’t and we don’t. Not only are we not machines, but some of the greatest advances in phlebotomy and proteomics research have come when we get the human element out of the way, mostly for the “unreliable/distractions/kittens” element mentioned above.  Examples:

So just live all Dionysian and  attempt to not control anything? No, but you must understand that the inputs are signals…they are stimuli. The stimuli is directionally accurate and dose-dependent. Further, the dose will have varying outcomes depending on the state of your physiological milieu at the moment of input. You can be sure ingesting protein will lead to new amino acids being available for protein synthesis, but the standard deviation of the response will vary depending on a variety of factors that you can never hope to control.

Further, the body is directionally set by the stimuli…it doesn’t care nearly as much by the context of delivery as much as by the quality of the content. This is especially true in the “paleo” community, with the idea that “Caveman X was on the savanna, therefore only could lift heavy rocks and get thorns in their ass when they screwed. I must mimic this for maximum health!” Here’s the thing:

The body doesn’t care about concepts; it only cares about stimuli.

The SAID principle (specific adaptation to imposed demand) referred to the type, quantity, and frequency of a stimuli. So while our hunter-gatherer ancestors trained their posterior chain by hauling an animal, we might dead lift or use a good lumbar extension. The stimuli is similar, no hauling required. The mismatch was never “We’re not hauling bison out of a ditch and eating mongongo nuts”; it was “we’re never exerting to a sufficient intensity while eating lots of processed garbage.” You mimic the stimuli while reducing the risks.

Why mention all of that? Well I think the above is largely the root of why people get hung up on a single dietary variable like meat (for instance). Never mind that so many studies lump meat in with, say, “fatty” foods like potato chips and ice cream (really!); the food stuffs are just one variable in a larger picture, going back to the title of this post. If the totality of the lifestyle is in order, the inputs hold less weight because the whole spinning plate is much more balanced.

Example: Seventh Day Adventists are often credited for their longevity, which is always reduced to diet. However, the most thorough studies never claim it’s just the diet: they’re always looking at the total lifestyle to draw their conclusions.

Similarly, studies that look at a similar population (California Mormons & California Adventists) show similar improvements in longevity due to the totality of the lifestyle:

  • Adventists: 7.28 years in men and by 4.42 years in women from age 30
  • Mormons: 9.8 years in men and by 5.6 years in women from age 25

Now it’s important to note that this isn’t a comparison between groups…or rather, it’s between one religion and the average Californian of the same age. And the statistics used in each study may be slightly different (like which inputs & variables they found most valuable, etc. I have no interest in unpacking them). The point is that if a single variable, meat, was a keystone/linchpin/cornerstone in the longevity equation, then the statistics should indicate some change. And since it’s often cited as “the” culprit, the statistic should jump out and punch you in the face, the same way cancer rates in those who smoke isn’t a tiny statistical anomaly.

Here’s the point: all of the nerding out in service of the big picture, the lifestyle, is great. A regular sanding of the details leads to a better overall picture. However, nerding out in order to replace the big picture is a fools errand, a big distraction that keeps one focused on a “big secret” that simply doesn’t exist.

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.

Dynapenia: The Real Problem With Not Resistance Training

women-muscle-mass1-e1355934724840-28641_500x300

At Efficient Exercise, we use the term “Sarcopenia” when discussing why new clients should endeavor into resistance training. This is Latin for “poverty of the flesh,” which really means age and/or inactivity-related losses in muscle mass. This was thought to be a primary driver of things like osteoporosis and obesity, even associating the term “sarcopenic obesity.”

However, this implies a sufficiency issue: just have enough muscle mass and you’re insured against many of the future losses that come with simply having the muscle. However, this did not explain why people of varying levels of muscle mass were experiencing these symptoms with prolonged inactivity. This is a bit like how skinny people can be “obese” as far as visceral fat to lean body mass ratio. There’s  a hormonal milieu that can only be accounted for through the lens of use rather than presence.

At EE, we’ve always focused on maintaining muscle mass through aging, but it’s become increasingly clear that what matters most about muscle is the use rather than the amount. It makes sense that the focus was on sufficient muscle mass, as we were unable to measure any element of the tissue that communicated with the rest of the body…they were merely motors. Now we understand that muscle is in fact our largest endocrine organ, releasing hormones and signaling agents called myokines that communicate with the rest of the body to set the thermostat, so to speak, regarding the importance of muscle tissue and how it should be treated by the rest of the body.

Let me explain.

Go back to my first paragraph and the term “sarcopenic obesity.” The literature on this topic is totally interesting and the first thing that jumps out is that both muscle and fat tissue are very active endocrine tissues.  The second thing that stands out is that these endocrine actions are almost in direct opposition to each other, like colonies in competition for energy resources. This is different than the old “auto-regulation” model that the body would partition based on substrate and availability, like when the muscles were replete with nutrients, the fat was a dump for whatever was left. This is now turning out to be incorrect.

In this review of sarcopenic obesity, researchers lay out all of the signalling mechanisms that fat and muscle use to facilitate endocrine communication. If you wrote down all of the mediators and their effects in separate columns labeled “muscle” and “fat” you’d see that they’re in competition.  Age seems to dictate which tissue has the competitive advantage. When you are young, muscle has the competitive advantage over adipose tissue and the advantage slowly shifts toward fat as the years go by, largely because you pass childbearing years and your Darwinian Fitness reduces (or “evolution stops giving a damn” to quote evolutionary biologist Michael Rose). As you lose muscle, the signalling from fat mass becomes greater, begetting more fat mass, increasing the signal further as muscle continues to whither and reduce their signalling.

So the signalling from fat mass is largely due to the volume of fat mass. However, it turns out that muscle signalling is not due to the presence of the tissue itself (a sufficiency), but rather from the use of said tissue. This means that is actually a reduction in muscle quality, which means less strength, than correlates more with aging than merely having enough muscle tissue. The term for this is dynapenia which literally means “poverty of power.”  It is the loss of strength which reduces the quality of our contractions, which reduces the signalling for resources, which reduces the partitioning of nutrients to muscle tissue and increases the partitioning toward fat mass, which begets more fat mass. A recent literature review demonstrates that strength is lost more rapidly than mass as we age. Considering it’s the very strength that would, for example, help prevent a fall or maintain balance through aging, this fact of rapid loss is especially important.

Strength precedes the signal and the signal is in proportion to the use of said strength. If you’re using a high intensity of effort on a regular basis, you’ve set the stage to maintain your strength, muscle tissue, and tip the balance toward lean mass instead of fat mass as we age.

Iatrogenesis: A Response From Dr. Phillip Alexander

In the January 27th post entitled, “Small Health Habits Make a Big Difference,” I laid out the 10 leading causes of death in the United States according to the CDC. I recently received a response from Dr. Philip Alexander on this very topic:

Skyler…on the CDC’s own website, they freely admit that the list of the Top 10 Leading Causes of Death always leave out the real #3 cause. I’ve added it below. Sometimes hospitals can be very dangerous places!

 

  • Heart disease: 597,689
  • Cancer: 574,743

 

The medical profession: 225,000

Non-error drug adverse events 106,000

Medication errors in hospitals 7,000

Other errors in hospitals 20,000

Unnecessary surgery 12,000

Hospital-acquired infections 80,000

 

  • Chronic lower respiratory diseases: 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859
  • Alzheimer’s disease: 83,494
  • Diabetes: 69,071
  • Nephritis, nephrotic syndrome, and nephrosis: 50,476
  • Influenza and Pneumonia: 50,097
  • Intentional self-harm (suicide): 38,364

 

Incidentally, in 1990 Alzheimer’s Disease wasn’t even in the top 20. In 1999 it was #7, in 2004 it was #6, and is now #5. Medicare says that by 2020 50% of the long-term facility beds in the US will be Alzheimer’s Disease. It’s 50% now. All the others are stable or slightly improving (as in the graph below), but with a frightening increase in Alzheimer’s.

It’s all lifestyle, and we know how it happens and how to prevent it.

Disease Changes

So we’ve learned two things: 1) Dr. Alexander never does anything halfway and, 2) treatment is a serious killer. What Dr. Alexander is talking about is called Iatrogenesis, which is where harm comes from the healer. The human body is incredibly complex, as discussions with my physician clients always elucidates. Historically we’ve take a statistical approach to treatment and treatment methods, that is a clinical trial shows that X percent of patients respond to Y treatment, and side effects were less than the benefit, so the treatment is viable. No clinical trial, no matter how huge, can account for the ever growing number of patients physicians are seeing, especially as boomers age into Medicare. There will be somebody who, because of their unique makeup, responds exceedingly poorly to a treatment and becomes part of the statistic above.

However, there is also the patient side of the equation, expecting the physician to “Do Something” when they see them. This is made worse by social ranking systems like Yelp where a patient can boil a physician’s ability down to a 5 star rating system based on one visit. If you’re in a position where you’re effectively arguing with a patient who expects to be prescribed something, you may very well just write the most benign script available and move onto the next patient in your overcrowded day. That’s “Murica for you: give me drugs or I’ll have your head on Yelp.

The human body is not beholden to our temporal expectations as much as we’d like it to be. What may take weeks we want in days, and this leads to some of the ill-advised treatment that results in harm above. To quote my friend Doug McGuff:

My favorite mantra is….”Don’t just do something, stand there!”. We must always be cautious about intervening when mother nature is not taking her course as fast as we would like it. The greater your sense of urgency to act, the more you should wait.

This is not to say that you should do nothing, but that you should understand that not everything has a clean, linear treatment or recovery process and sometimes waiting is the most prudent course of action. That’s why they call it the “art and science of medicine,” folks.

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.

 

Health and Longevity: The Most Impactful Changes Are The Simplest

During this year’s PaleoFX conference, I had the opportunity to eat and shoot the shit with one Ben Greenfield. More importantly, I had the opportunity to do the same with his wife, Jessa. Great people, super passionate about helping people improve their lives and health, and a lot of fun to be around when fish skins are part of the menu.

Ben knows a LOT about the human body. He’s also part of a small cohort of people I know who have willingly had needle biopsies done just to see how many mitochondria their muscle tissue has added as a result of being in chronic ketosis (Ben has, if I recall correctly, triple the mitochondria in his muscle tissue as your average bear). He considers himself an “ancestral athlete” but doesn’t attempt to live in a cave or only train body weight because of it. He sums this up in his article: “The 10 Rules of the Ancestral Athlete.” Note, there are likely some borderline Not Safe For Work photos on that website. However, the article is great and is a long form version of something Doug McGuff likes to say:

Fred Flintstone diet with a George Jetson workout.

Ben has done a LOT of experimentation to push the limits of health and performance, much in the same way any Olympic athlete does building up to the Olympics every four years. However, Ben is curious about the outcome, as his paycheck isn’t nearly as large for all the noodling he’s wont to do. Truth be told, we’re all nerds about this stuff, but the reality is that very little of the nerding amounts to any significant improvements in health and longevity over getting the simple stuff done, consistently. Take a look below, where I plot the time/effect interval for a variety of health marker improvements that result from exercise:

Exercise per week

The curves are fairly steep: doing enough, regularly, leads to the largest changes in health outcomes. After that, it’s a lot of mental masturbation for a paltry change in outcomes. In numbers above, you have to train 350% more per week to achieve 28% more result over what 1 hour each week gets you. If you’re an Olympic athlete looking for performance, that’s worth it. But if you’re not, that’ s a waste of time, especially when you factor in all of the wear and tear that comes with that effort.

Ben even admits as much in the article. He talks about how his wife is very laissez-faire about her training and how much better it is for health:

I’m not arguing that there’s no value to rigidity, self-control, knowledge, and self-discipline, but I suspect that if we both stay on the same path, my wife will probably outlive me and have a higher quality of life in the process.

If you didn’t read the article, the context is that Jessa trains when she feels like it, eats real food when she’s hungry, and doesn’t stress about it. But she does these small things regularly with big result. She’s in great shape.

It’s the simple changes that result in the biggest health outcomes long term. This is why restrictive diets are an abject failure in the research world, why so many people hate “training,” and why this country is in really poor condition. It’s also why those who did the simple habits regularly in the Alameda 7 Study or the Blue Zones are those living the longest.

Simple is not easy, but it’s a whole mess easier than making things really complicated not much more gain.

 

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.

The Elderly Need More Exercise? Yes And No.

stephen-jepson

 

An interesting discussion over at Doug McGuff’s message board regarding exercise and aging. This comment was of interest:

I suggest that the sedentary elderly require more exercise, not less. I am one such. A few minutes a week is not going to do it for sarcopenia or anything else. If I train once a week I cannot maintain my condition, strength,metabolic benefit, motivation or momentum. Nor can you if the rest of the time you are inactive.

Here was my response to this statement:

And I disagree; I think the elderly need more activity, not exercise. Further, the health education research is clear: in the elderly, physical activity and self-efficacy track side by side. The more confident a person is in their abilities, the more physically active they are; the more physically active they are, the more confident they are in their abilities.

If you make a person stronger in your studio, they’re more confident in their ability to do other activities. This is what Doug talks about when he says people want to move more after training for a number of months. Get strong and you’ll get more active relative to your starting lifestyle.

I’ll even make it a nice soundbite: have you ever heard the phrase “a stronger athlete is a better athlete?” The same is true of human beings throughout aging, that is a stronger human is a better (more active, more healthy, more resistant to cancer/metabolic disease/disability) human. (Emphasis mine…just now!)

There is a nugget of wisdom in there that I want people to pay attention to: “relative to your starting lifestyle.” If a person is doing zip and they start a once per week strength training routine that then leads them to take leisurely strolls because they enjoy it, they’re going to do a whole lot better for themselves compared to where they started as far as disease prevention and injury risk reduction. If you had a crazy triathelte at the same advanced age add the same dose of exercise, it wouldn’t make much of a difference. There’s a survivorship bias discussion that will be addressed another time, but here’s my advice: don’t take advice from an endurance athlete who has been training “all of their life” as the gospel…there’s more at play than just hard work!

I digress; elderly individuals should look at their training as an upside-down oil funnel: the widest, part is going to be activity that is very low in intensity but very high in frequency. It seems this is where one can start making a semantic argument that this too is “exercise.” However, it’s really just being a good human animal and setting a functional path: if you move a certain way today, you’ve got a good chance of moving that way tomorrow. The middle part of the funnel is going to be mobility work as maintaining joint free range of motion is paramount for maintaining activity levels. When looking at barriers to exercise, the less mobile people are, the larger their barriers to exercising become. For example, those with mobility limitations cite “poor health, fear and negative experiences, lack of company, and an unsuitable environment as barriers to exercise…”. Performing joint mobility work for 10-20 minutes a day, hell even starting at 5 minutes per day, when mobility is still pretty good will go a long way to maintaining mobility, which maintains activity levels and exercise efficacy. Finally, the tip of the funnel is exercise training, preferably of a high intensity nature. Muscle is the most plastic tissue in the body, the largest endocrine organ we have, and creating a sufficient degree of demand will improve all aspects of a person’s physiology. By its nature, it cannot be sustained for very long and requires a prolonged recovery period. That’s fine, as it means more time for the activities the person would rather be doing, which is going to set the table for continuing to do the activities until the day they die. All good stuff!

So no, the elderly do not need more exercise; they need just enough exercise to produce a body that feels good doing lots of physical activity that a person would rather be doing. Maybe this advice will produce a few more Stephen Jepsons in the world and how cool would that be?

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.

Specificity

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.

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