Category: Wellness

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.

 

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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:

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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

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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.

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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.

“Why do you keep it so COLD in here?!”

At my studio, we keep things pretty cold. Anywhere from 64 to 68*F throughout the year. You’d likely wonder what’s the point, as most places seem to be encouraging more heat: hot room yoga, Xfit boxes with the bay doors open in summer, boot camps in the screaming summer sun, etc. It’s rather different compared to these other places, so what’s the deal?

During my first certification and job, it was basically “People work harder in the cold.” That was the answer I got, and while true, it didn’t tell me why they were able to work harder in the cold. It was sort of a “handed down from on high” commandment; I wanted the science. And during graduate school I found it.

While probably not the first researcher to study this, the man whose research work is most focused on exercise and environment is Lars Nybo. His research has dealt with how hyperthermia (exceedingly warm conditions in the human body) changes muscle function, brain function, and human performance. I’m going to discuss a little slice of his research and then provide the bigger picture for EE clients.

In his study, “Hyperthermia and central fatigue during prolonged exercise in humans” Nybo demonstrates how hyperthermia changes force output, regardless of fatigue. Two groups of trainees cycled for 1 hour in either a thermoneutral environment, or a hyperthermic environment. After 1 hour of exercise, the trainees were then put on a knee extension machine and encouraged to exert as hard as possible to measure the force output of the thigh musculature. Take a look at the result:

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So what the heck are you looking at? The top graph (“A”) shows the rate of force output decline difference between the hyperthermic group and the thermoneutral (control) group. Also in that graph, you can see lines that spike up from the trending measure line, which is where the researchers actually electronically stimulated the tissue to measure it’s true maximum force output. Remember: muscle force is not just what the tissue can actually produce, but also what the central nervous system will allow or is capable of at the moment. You can see this difference in graph B, where the hyperthermic group is significantly less forceful compared to the control, as far as a percentage of what the tissue is capable of producing. Finally, the third graph (“C”) shows the surface measure of muscle activation; again, a clear reduction, thus reduced force.

So what this shows is that the hotter the environment is, the less forceful the muscular contractions are, NOT because the tissue is less capable but because the central nervous system is reducing force output or work. This makes sense: the harder (or more) the work, the more heat produced. The already hyperthermic environment means that hyperthermia is a very real threat, so your body “turns down the volume” to keep that from happening.

In the context of training, there are a LOT of variables that are trying to be optimized during a session. If you’re going to only train once or twice per week in a “formal” fashion, the environment needs to be optimized as best as possible for the task. By keeping the room cool, not only are we able to appeal to those who don’t like sweating, we’re also able to facilitate harder work. This deeper stimulus is what allows us to have less frequent workouts with the same, or better, result. It’s not arbitrary: the cold is a big reason why we’re so efficient.

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 Healing Power of Touch

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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.

On Alcohol And Longevity

111 year old woman beer

Ethanol, aka “alcohol”, is likely the most widely consumed drug on Earth. With the exception of its effects on heart disease, which I’ll address in a moment, few people would claim it is good for you. But, because of its legality, omnipresence, and just the fact that it is so much fun, most think very little of having a few beers or even bottles of wine. Yes, bottles.This includes EE clients.

It is far from being a harmless vice. Even if you’re not a functioning alcoholic, ethanol affects numerous neurotransmitters, metabolic processes, and hormones — and many of these effects go beyond the time period of intoxication. To keep this part from being a semester of biochemistry, let’s make it simple: excessive ethanol screws with these processes, increasing body fat storage and reducing health. Full stop. Do not pass go, do not collect your red wine because it’s “high in antioxidants.”

Dose-response relationship

But what about that woman in the photo above? She’s having a cold one on her 111th(!) birthday. Yes, a cold one. Uno, singular, one.

If you search the internet for terms like “centenarian + whiskey” you’ll find all sorts of claims from people living over the age of 100 that part of their success was due to alcohol. Upon further examination these people aren’t drinking much, a drink or so per day.

When you look at the studies that have been done on alcohol and health, the studies typically follow a J-curve; that is, there is an initial steep drop for your first “dose” of alcohol and a small reduction in benefits for each dose after that until you eventually are harming yourself with consumption.

In perhaps the most widely cited study on the subject, the authors fitted nonlinear functions to the data; that is instead of trying to find a perfectly straight line that you see in some studies, they were able to find the J-curves I discussed above. Due to this being a meta-analysis, there are a variety of curves based on the data and the statistical analysis used in each study.  As a result, you get a wide variety of “maximum” drinks per day before health benefits are lost. Take a look:

DiCastelnuovo_etal_2006_F01

However, what doesn’t vary amongst the studies are that the J-curves botttom out, that is the health benefits are maximized, at roughly 5-7 grams of alcohol per day. That’s about half of a drink per day! No, you can’t save it up for a night of partying and get the same benefits. Nice try!

So the benefits of alcohol are seen in regular, tiny doses. Alcohol, like exercise, is a hormetic agent. It irritates the body that adapts in ways that correlate with reduced mortality risk. Too much irritation leads to problems.

Antioxidant Nonsense

But what about the antioxidants that we “need” that wine gives us? If we’re going to drink, shouldn’t we drink more wine instead of random other booze? First of all, the notion that you’re not getting enough antioxidants from your food and would then hope to make up the difference with wine consumption really means you need to fix your damn diet! Besides, if you’re drinking coffee, you’re already getting a ton of antioxidants. But if you’re really concerned, just drink grape juice. Seriously.

Or maybe you’ll use the resveratrol argument, that this compound found in wine is the secret to longevity…why restrict that? Well, here’s the thing: in order to get the benefits of resveratrol in a dose that makes any sort of benefit, you’d need to drink eight liters of wine per day! Good luck ever getting out of bed after that dose!

 

Small regular doses

Go back to the health habits I’ve spoken about before; one of the habits was “reduce intake of alcohol.” There is benefit from a little bit of alcohol regularly, in this case that sweet spot happens to be about one half of a drink per day. For the sake of measurement, and since the curve doesn’t really drift that far, one drink per day is a good choice. What does that look like? A 5 ounce glass of wine, a 12 ounce beer, or a shot of liquor. Yes, that’s it.

I’m not suggesting you drink if you don’t already; I’m saying that it’s time to get real about the health benefits and how little it actually takes to manifest these benefits. The answer is: not as much as you think, but only when regularly consumed.

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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