Category Archives: 13. Fitness

LifeSpan versus HealthSpan

LifeSpan Versus Healthspan

References:  WEForum 2017Compreh Physiology 2012,  Med Sci-Fi Sport Exercise,

We are living longer. But are we living better? In the 20th century, we doubled our life expectancy with the miracle of antibiotics, clean surgical technique, X-rays, immunizations and clean water.  Babies being born today in advanced societies have a 50:50 chance of living to be 100. But living longer isn’t necessarily better. There have been some disturbing trends lately. Obesity has managed to reverse the climb to longer lifespan in some societies, namely the USA.

As we live longer, we have more choices about lifestyle, making research into factors affecting confoundingly complex. It becomes impossible to do “randomized, placebo controlled” studies over decades without limiting free choice and spending more money than could be allocated. This article, from the World Economic Forum this year, offers insight into the laboratory of fitness, namely masters athletes. I have a dozen or so men and women older than 60 in my practice who would qualify as exceptionally fit. And I see their lab results and their vitality. They are aging differently than those of us who are less active.

Sedentary behavior is being increasingly recognized as the driver of many of our modern conditions. Part of this discernment comes from the recognition that athletes, (high end performers) have a disproportionately share of good health. They don’t get in trouble. They still die, but their time of end-of-life disability is markedly compressed, compared to the majority of the sedentary population. They become a unique research cohort, one that we couldn’t duplicate with “randomized research”. In effect, what happens with athletes is that they reach their peak in their 30s, like all of us, but then don’t show much decline until close to the very end. The rest of us show inexorable, linear decline. “Patch, patch patch, after 40!,” we say.

At every age in life, starting exercise of any kind has benefit. And the risk of complications from exercise is far lower than the risk of remaining sedentary. The real risk is sitting. Considering computer games at home, TV, computers at work and cell phones in-between, we are mesmerized by electronic distractions that leave us sedentary. In fact, research in 2009 of 17,000 Canadians of all ages showed a dose relationship of sedentary behavior to all cause mortality, regardless of levels of exercise. That means 30 minutes in the gym does you no good if you are sitting the rest of the day. Bother.

The Author cites four strategies with references on each: 1) Move More (Just get started and move more), 2) Move Slow, (Aim for 10,000 steps a day) 3) Move Fast (Add some high intensity something, even for just 10 minutes) and 4) Move Heavy (Add some weights). Read those hyperlinks. It’s the best of our knowledge.

WWW.What will work for me. Sedentary behavior is the new smoking. If you want to live better, longer, you have to do it. Build it in every day. A day without exercise is as bad as a day of smoking.

Pop Quiz

1. Our grand-kids are likely to live to be 90+. T or F Answer: False if they are sedentary, but true if they get the exercise bug and take care of their diet.
2. Our society is becoming more active. T or F Answer: Mixed picture. But as a general rule, false. Bless those who make the answer slightly true.
3. 30 minutes at the gym has beneficial effects? T or F Answer: Sure, it helps. Its benefit may be completely erased by an 8 hour day of sitting.
4. There is a dose relationship between exercise and good health. T or F Bingo
5. Getting sweaty isn’t necessary. T or F Answer: False, if you want optimal results. Getting sweaty 3-4 times a week is much better for you.

 

H2 – Hydrogen to Your Health!

H2 – Hydrogen to Your Health!

Reference: Nature Medicine,

Elemental hydrogen is 75% of the universe, so it’s not actually very rare. But on planet earth it’s so light that as a gas, it evaporates and escapes off into space. In our atmosphere, it’s rare. Attached to other chemicals, like oxygen, however, and it’s abundant. Note, water is H2O. Earth has a lot of water. And all life has hydrogen bound up in carbohydrates. It’s the “hydrate” part of carbs.

Now, we are discovering that the gas, H2 is actually a pretty dynamic and interesting compound. Oxidative stress is a major part of many illnesses. When you have excess free radicals or ROS (reactive oxygen species) you get all sorts of damage from them. A dangerous sequence of events involves the production of O2 as leakage from the Krebs cycle of making energy. That gets converted into hydrogen peroxide (H2O2) by superoxide dismutase. Glutathione’s job is to convert that back into harmless water but excess H2O converts iron and copper into their “reduced forms” which react with peroxide (H2O2) to make the hydroxyl atom, OH. That’s a lot of chemistry you don’t need to memorize (except for the quiz). You do need to know that OH is a wicked and dangerous oxidant.

Your cells actually use a bit of peroxide to help kill bacteria. NO (nitrous oxide, another oxidant) is an important regulator of artery stretchiness. So you need a delicate balance of oxidants and antioxidants. But there is no safe place of OH. And this is where H2 comes it. It combines with it and neutralizes it, turning it into harmless water. It sounds complicated, but it’s implications are almost bigger than you can imagine.

H2 selectively reduces OH. Having it around could be very useful. The question is, how to get hold of it and where might it actually work. That’s what this review article details. A variety of experimentally induced forms of OH, the dangerous hydroxyl molecule were produced and then H2 was added. Voila, it neutralized it brilliantly. It was demonstrated that it efficiently diffuses into cell nuclei and mitochondria and does so without damaging or altering the good ROS that your body uses to manage arterial stretching and immune response.

There are beginning to be research studies showing that it works in humans in a variety of situations. Metabolic syndrome, (combination of being too fat, too much sugar, too many lipids, high blood pressure, etc) is favorable affected in all venues with elemental H2. It helps folks getting radiation therapy recover from the bad side effects of the radiation therapy. But it also make 5-FU work better in colon cancer patients getting it for colon cancer. Folks who have sports related soft tissue injuries recover much faster. Peak exercise increases with hydrogen rich water. These are just early studies but they suggest a pretty broad library of beneficial effects, all of which congregate around the mechanism of helping reduce runaway oxidation. This is cool!

WWW. What will work for me. I’m ordering a bunch of the stuff for my office and I’m going to try it on folks. Radiation therapy, sports injuries, chemotherapy, metabolic syndrome, arterial disease might all be sensible candidates. If I get injured on my running, I’m going to give it a try.

Pop Quiz

‪1. Hydrogen is not commonly available on planet earth. T or F

Trick question. In it’s free form, that’s right. It’s not in the atmosphere. It weighs so little it flies off into space. But it’s abundant on earth. It is chemically the key ingredient in making energy storage in either carbs or fats when attached to carbon. It is the other half of water. So, in combination form, it is abundant.

‪In its free form as a gas, dissolved in water, it soaks of strong oxidants in our bodies. T or F

That’s it in a nutshell. Remember that and you got it right.

‪Our bodies use oxidants to kill bacteria, stretch arteries and lots of important physiological functions. T or F

True. We do need them in balance.

‪Early research shows that Hydrogen enriched water helps folks get better faster from the side effects of radiation therapy. T or F

We need this!

‪5. Soft tissue sprains and strains from sports and daily living get better faster too with hydrogen enriched water.

Yup. Hope you don’t need it, but it’s there if you do.

How To Live to be 100 – Make a Blue Zone

Blue Zone Solution – How to Live to 100

Reference:   Blue Zone Solutions by Dan Buettner

August 31, 2015

What’s a Blue Zone?   It’s the places in the world where people live up to 100. This is a research-based book that looks at those little “hot spots” where there are the most centarians and tries to ferret out just what got them to 100.

The places listed are Ikaria, Greece, Okinawa, the Ogliastra Region of Sardina, Loma Linda, California (7th day Adventists), and Nicoya, Costa Rica.

Dan Buettner has done more than list the common findings that appeared to contribute to their long lives. His core thesis is that it’s not just one thing that makes for healthy life style, it’s the totality, the ecosystem.   He has started a project of creating Blue Zone communities in America.   He has found four towns in Iowa that have agreed to participate in the key feature of being a Blue Zone: changing the overall environment to make “healthy” choices something that enough people do that your ecosystem supports it naturally.   Waterloo, Cedar Falls, Spencer and Mason City have all signed up. In each of those communities up to 40% of the residents thave agreed to participate in moving more, eating differently and focusing on community and relationships.

The list of what Buettner says makes for longevity include his “Power Nine”.   First, Move More Naturally. Add walking, gardening, less driving. Two, have a purpose when you wake up. Three, find a way to let go of stress. Downshift.   Four: Hara Hichi Bu – eat till you are 80% full, with your smallest meal late in the day. Five: Plant Slant – more vegetables, beans, soy, lentils with meat here and there. Six: Have Wine at Five.   Seven: Moais – social groups of support that connect regularly and have your back. Eight: Community – 258 of 263 centarians belonged to some faith community. Attend some sort of faith community and add 4-14 years to your life. Nine: Loved Ones First. Commit to a life partner and add 3 years. Take care of frail elderly in your home.

Eating is a big part of it.   In all the varied cuisines, he found some commonalities.   The Mediterranean diet was 50% fat, but that was from almost all olive oil. It also included daily doses of greens right from the garden. The Seventh Day Adventists were almost vegans with only tiny amounts of meat.   None of the diets had sugar, or modern vegetable oils, or trans fats, or high glycemic grains. The Sardinians had dense durum wheat but ate much more barley. The Okinawans had tons of sweet potatoes. A sprinkling of meat here and there, or fish.

What the book doesn’t address is that all these societies had women spending all day making food, not in careers or jobs.   They were all of “modest means” in “traditional societies” with clearly defined gender roles, on the margin of modern society.  Even the Seventh Day Adventists  fit the description of being pretty “traditional”.  What to make of that?

This book might be your pathway on what to do once you have lost weight and reversed the toxicity of our modern American diet, rich in sugar, processed fats and grains and abundant in fake chemicals and mass produced vegetables picked for shipping and handling, not directly from a local garden.  Certainly, the strong emphasis on friends, stress and environment is something we should all pay attention to.

WWW. What will work for me.   I’m eager to see what lab testing shows on folks who do this. I’m completely on board with the community data. We all need and yearn for love and connection in our lives.   Our American suburbs isolate us into lonely cells walled off by green lawns.   Now I understand the wonderful role played by my church community, my hiking club, my bridge club, my fishing buddies. They have my back. They check in on me. They are my Moais.   Can you create your own Blue Zone? Can we encourage one another by our group participation? Check out your next potluck dinner, see what you can create. Find someone else’s back to cover.

Pop Quiz

  1.   A Blue Zone is an place of unusual “excellence” in biological survival – where more of us humans live longer, better and well.   T or F

True

2.   All the Blue Zones in this book showed that aging folks woke up with something to do and look forward to, a purpose.  T or F

True

3.    All long lived societies have food emphasizing vegetables, locally grown foods, less sugar, less meat and no modern trans fats – fats being animal origin or olive.   T or F

That seems to be the general trend.

4.    The Blue Zone experiment in America involves 4 towns where up to 40% of people are participating in making a “healthier” environment that includes exercise, friendships, social belonging and reinforced food choices.   T or F

That is the premise.  That we need to change our whole environment.

5.   Participating in a faith community once a month appears to add time to your life.  T or F

Well, it may, but the data seems to be four times, and that adds from 4 to 14 years.

Raising Growth Hormone with Exercise

Raising Growth Hormone with Exercise

Reference: Godfrey Sports Med

Date July 27, 2015

You want muscle. More is better (up to a point). And we lose a bit every year as we age. We also lose growth hormone as we age.   Growth hormone is your repair hormone. Yes, it makes you grow when you are a little tyke, but it also fixes you.   And it helps you grow muscle.   It peaks when you are about 15-20 years old.   Growth hormone is actually quite elusive and difficult to measure because we secrete it at night in tiny pulses that only last a few minutes.   It is a pretty big molecule, with 191 amino acids weighing about 20 kilodaltons (not much). Now, when you exercise, you secrete a slightly altered form that weighs 22 kilodaltons and can be detected by the ratio of the 20 to the 22. The change in this ratio is how you can tell an athlete is cheating and taking extra on the side.

Growth hormone stimulates your body makes a hormone in your liver called IGF-1. We can measure IGF-1 easily as it hangs around in your blood a bit longer. It becomes our defacto measurement of growth hormones.   An IGF-1 of about 450 is what you have as a teenager.   It progressively declines as you age, hitting 150 by age 50 or so. Once you are below 100, bad things start to happen with reliable frequency.   And at virtually any age, low IGF-1 will sort out those who are doing well, or those who aren’t with any given illness/condition/malady.   And, best of all, growth hormone helps you modulate your fat/muscle ratio.

Ok, if you have such importance with growth hormone, IGF-1, how can we control it and keep it higher?   That is the holy grail of wellness.   Keep my growth hormone up there!   This is where exercise comes in.

Turns out exercise has some of its magic mediated through growth hormone.   But it takes a specific kind of exercise. Not just any will do, at least by our current standards.   You have to get to the point of lactate.   That means walking around the park, which will burn some calories and help you feel better, isn’t enough.   You have to get to the point of “failure”, meaning pushing yourself to the limit of what you can do.   One way of doing that would be to run like crazy for 30 seconds, then rest for 90 seconds. Then run like crazy for 30 seconds…..repeat, repeat, repeat for 6-7 reps. Another method would be weight lifting to the point of “failure”.   Take any given weight that feels a bit heavier than you can manage, and curl it up with your biceps. Repeat the curl until you can’t do anymore. If you can do more than 10, you need a heavier weight. If you fail at about 8 or so, that’s what we want. We want your muscle to be pushing to the point of failure, because that’s when you make lactate.   Lactate is the product of glucose being burned without oxygen – and is the final desperate step of making energy when all else fails.   Rest and repeat. Go for at least 10 minutes. That’s it!   10 minutes. And then, growth hormone surges for a couple of days.   Rest for a day or two.

Longer, aerobic type exercise doesn’t do it. Nor will just one single bout. You need repeated bouts over 24 hours. Sounds like Cross Fit to me.

WWW. What will work for me.   I walk quite a lot. There is good evidence that walking does good things for you. But intense exercise is the magic for growth hormone release.   You have to get sweaty. And you have to “fail”.   I need to add high intensity to my jogging.   I’ve started 3 bouts of intense sprinting in my 2 mile jog. The nice thing is that I get to walk for 45 seconds after the sprint.   (Definition of sprint is very, very loose here.) Or, how about Yoga till “exhaustion”, or Crossfit, or spinning, or…..? You pick.

 

Pop Quiz

  1. Growth hormone declines with aging. T or F

True.   The IGF – 1 measure drops from 450 to 100 or less by age 60

  1. Growth hormone is a protein hormone, 191 amino acids long.

True. That’s the main one, but you make several others when you exercise. The 191 model is the synthetic

  1. Walking around the park at a 4 mile clip will release my growth hormone. T or F

Not much. It might help a little but current research methods suggest that is not enough.

  1. Running 5 miles a day will raise my growth hormone. T or F

False. It will more likely lower it.

  1. Weight lifting to the point of failure damages my muscles. T or F

True, and that’s what makes you make growth hormone to repair them and make them stronger.   That little bit of damage is what you want.

Biohacking Vegetables 101

Biohacking Vegetables101

Reference:   Wikipedia, Biohacking Conference,   PBS,

What is Biohacking?   If I may give the simplest explanation, it’s figuring our how to do what you were designed to do, in the best and most satisfying fashion. Well, when we talk about our own health and life style, it’s all about creating choices with food, sleep, brain health, relationships, activities and exercise that gives us the best chance at being the best we can be.   Some of “biohacking”s proponents are about research on the cheap, outside of the traditional academic world and without the constraints or ethical guidelines developed in those venues.   Research that may harm people should be monitored and restricted.   There is a fine boundary with lifestyle choice and making decisions that could harm people.   For example, is it harmful to tell people to eat more vegetables cut out carbs from their diet? That would be the basis for the Bulletproof Diet.   Considering the massive failure of modern medicine to provide us with smart food guidelines, and the confounding ability of our food and pharmaceutical injury to create dangerous and harmful products, it’s no wonder the biohacking world has developed. My interpretation is that it is “us” figuring out for ourselves, what works best.   This email column is a “biohacking” exploration.

How would we apply biohacking to vegetables?   By way of example, this is how I would consider it.  I would first explore what vegetables do to our bodies. Most green vegetables like spinach, kale, cucumbers, asparagus and broccoli are actually quite high in protein, and relatively low in free sugars.   Broccoli, as one example, has as much protein as steak when it comes to protein content per 100 calories.   Our bodies respond to them without much insulin release because the sugars are released so slowly that we don’t need to release insulin. We metabolize the sugars as fast as they are digested.   That is a nice example of first understanding core biology and physiology. Do the research about how your body functions.

A good biohacker would come to the conclusion that the majority of human food should be from vegetables that are green and have a slow insulin response. Insulin lasts for 6 to 8 hours.   To have the main hormone that controls weight gain, appetite, glucose control be one that last 6-8 hours must mean that for 60 million years, the main diet for humans and their ancestors must have been foods that matched that and provided calories in a fashion that lined up with that endocrine need.   That means green vegetables should be core to our diet.

Then think about root vegetables like potatoes and carrots, or grains like corn, rice and wheat or fruits like apples and pears and you find foods that are filled with many more carbohydrates and mature in September and October. They have a lot of sugar, and less protein. They stimulate insulin. They encourage your body to secrete insulin to store calories for the winter.     A good biohacker would conclude, knowing that about when these foods ripen (fall – or just before winter or just before dry season) that they should be limited to those times of year we seek to gain weight.   You want to gain weight if you are aiming to go into a period of starvation.

The challenge of our time is to figure out how to lose weight, not gain weight. We have been inundated with food filled with high calorie, carbohydrate laden foods. And we have gained weight.    Get the drift?   You can be a biohacker too.

WWWW. What Will Work for Me. (AKA: Biohacking) A good biohacker would conclude that the proper way to lose weight would be to back off completely from all foods that simulate insulin. That comes down to avoiding sugar, grains, root vegetables and too much meat.   What’s left is green vegetables and fat, and a bit of meat.   Want to lose weight? Salads with olive oil, spinach with bacon,……. Read the Book, The Bulletproof Diet by Dave Asprey. He lost 100 pounds. Look up the Bulletproof Diet Cookbook by Chris Kane.

 

Pop Quiz

  1. Biohacking is the attempt by people in every walk of like to be the best they can be. T or F

That about sums it up.

  1. It’s detractors claim it can be unethical? T or F

Possibly true if you are doing research without informed consent on things that can be dangerous.

  1. Our medical food guidelines represent a massive experiment that has caused immeasurable harm, without informed consent. T or F

True. So what’s the deal? We all got fat, diabetic and high cholesterol on those guidelines.

  1. We can trust that we will soon be following the biohacking crew with food guidelines.   T or F

True.   Institutional medicine will gradually get there.

  1. Want to lose weight, biohack yourself and get off carbs. Watch the weight melt away.

Of course your Do

  1. Want to biohack a bit further and see if avoiding some foods helps you feel better?

Give it a try.   Avoiding some foods is not unethical behavior. Just common sense.

 

Know your Basal Metabolic Rate

Do you know your Basal Metabolic Rate?

Reference: Wikipedia,  Physiology Reviews

June 8, 2015

We use about 60% of our calorie needs each day just staying alive.   The fuel needed to keep us warm, to keep our brains functioning, our heart pumping, our hair growing, our gut moving – all of that, is your basal rate.   Measuring it exactly is a bit tricky because one needs to measure the amount of carbon dioxide you exhale, (how much you are burning) when you aren’t digesting food, aren’t alarmed, angry, upset, in an environment of supportive temperature – and each of those elements has proponents and arguments. Finally, fat tissue needs to be extracted. Because women biologically have more fat, their weight is a bit higher so in general, a correction needs to be made for that.   As we age, our muscle mass declines, and our rate of exercise declines.   We need less fuel, or we gain weight.

There are several schools of thought with varying formulas.   I will refer you to each of them with links so you can calculate your own.

It should be noted, however, that in every review, they find as much as 25% inter-subject variability, even in the most controlled environment.   Some of us just need less. (So we get fat, faster. We survive starvation, longer.) And now, the literature on underreporting of calories is starting to ramp up too.

The Mifflin St. Jeor Equation is as follows: (My favorite)

For men: BMR = 10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) + 5

For women: BMR = 10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) – 161

The Katch-McCardle Formula depends on knowing your percent body fat.

BMR (both men and women) = 370 + ( 21.6 x lean body mass in kg )

Harris Benedict Formula simply converts your activity level with a predictive formula.

To determine your total daily calorie needs, multiply your BMR by the appropriate activity factor, as follows:If you are sedentary (little or no exercise) : Calorie-Calculation = BMR x 1.2•   If you are lightly active (light exercise/sports 1-3 days/week) : Calorie-Calculation = BMR x 1.375

•   If you are moderately active (moderate exercise/sports 3-5 days/week) : Calorie-Calculation = BMR x 1.55

•   If you are very active (hard exercise/sports 6-7 days a week) : Calorie-Calculation = BMR x 1.725

•   If you are extra active (very hard exercise/sports & physical job or 2x training) : Calorie-Calculation = BMR x 1.9

Each of these has proponents and detractors. Depending on what you want to do. If you want to lose weight, you need to be eating less than you are burning – and you need to be getting access to your fat energy. The only way to do that is to turn off insulin.   Without insulin, your fat cells open up and share freely. With insulin, your fat cells are shut and you only have 1500 calories of carbs to burn before you are starving hungry, hypoglycemic and ready to eat the furniture.

WWW. What will work for me.   I like the Mifflin St. Jeor Equation the best.   I had a monster exercise day on Saturday, biking 18 miles in the Tour de Marsh in Horicon. That allowed me to have 800 extra calories for the day, without gaining weight.   But the Harris Benedict formula comes close.   It also explains to me why petit women (say, 5’3”, who are overweight (say 165)) gain weight when eating 1600 calories a day, with little to no exercise.   We all aren’t the same, and taking into account our age, body fat and exercise level gives us a reality check. Or maybe, as we get older, our denial of what we are eating increases as patterns deepen. This getting older stuff and needing less calories is a drag!

Pop Quiz:

  1. My basal metabolic rate is the calories I burn doing nothing but staying alive. T or F

True

  1. As we age, we need fewer calories because our bodies shrink, our muscles shrink, we aren’t as active. T or F

T (See, it’s easy to get an A)

  1. The formulas can vary depending on your body fat percentage and gender. T or F

True

  1. Activity allows you to consume more calories. T or F

True. Makes it almost worthwhile

  1. Despite all our careful measurement, there remains a 25% error rate in our prediction of what our calorie need is. T or F

True

  1. This variability may be because we underreport our calories when asked to recall what we ate. T or F

True

Get a Grip on How Long You Will Live

Get a Grip! Live Longer

Reference:   Lancet April 2015,  Economist May 2015

Want to get an accurate measure of how long you will live?   Give a handshake. Your grip strength will convey your prognosis. This is your most accurate gauge of longevity. How do we know?

Published this week in the Lancet, Darryl Leong from McMaster University in Canada reviewed his data from the PURE (Prospective Urban Rural Epidemiology) study and found the accuracy of this prediction. They measured grip strength in 142,861 people, ages 35-70, in 17 countries who were willing to be followed prospectively for longevity, mortality, cause of death, injuries, falls, fractures, hospitalizations, the works.   They used a very simple and reproducible measurement with the Jamar Dynamometer to measure grip strength.

The study used data from rich, poor and in-between countries.   Canada, Sweden and the Emirates were considered rich.   Bangladesh, India, Pakistan and Zimbabwe were poor and Colombia, South Africa, Poland and 7 others were considered in-between.

They did find cultural differences. Apparently the Swedes take delight in squeezing hard, and Pakistani’s are very gentle but the prognostic value of the strength still pertained.   On average, a person’s grip strength is about 300 newtons.  For every 50 newton drop in grip strength the participants showed a 17% increase in risk of dying, mostly from heart disease.   It also showed an association with stroke and heart attack.   The researchers corrected for age, education, alcohol and tobacco consumption.

Now, grip strength did not predict hospitalization for pneumonia, or mortality from falls.   One would think falls would be correlated, as weakness would seem to be predictive of risk.

Now, this news has raised quite a ruckus on the Economist web site because there are cultural differences between societies. In South Asia, you greet a person respectfully with two hands in front of you – no touching. Shaking hands is a western thing. But the data still holds.

My interpretation is that heart disease is strongly correlated with mitochondrial health. Your heart cells are 33% mitochondria by volume and their health is central to heart health.   As you get fit, the number of mitochondria both increase and get healthier.   Regular muscle cells go from 200 mitochondria to 400 when you get “in shape”. And your fitness overall is transmitted in your handshake.

As research gets down to the nitty-gritty of how fitness benefits us, we will get more details. The topic of taking care of your mitochondria will become the means of coalescing this body of knowledge. For now, you can rest comforted if you supplement yourself with a bit of CoQ10 to help protect your mitochondria, and get fit. This is where statins yield their havoc, they deplete CoQ10 dramatically. I don’t care if you aren’t skinny, I do want you to be fit.

WWW. What will work for me. Because I’m over 50, my CoQ10 is starting to fall. I take 100 mg a day. And I exercise. Mostly walking, but some running, and some gardening, some tree lopping, some mulching.   I need to find a means of getting sweaty more often so that I get a bit more fit. And I’m going to start measuring your hand strength in my office.   Come on down, crush my fingers.

 

Pop Quiz

  1. Grip strength is the best predictor of how long I will live? T or F

That’s it in a handshake

  1. Fitness all over probably correlates with strength of handshake. T or F

True

  1. Exercise increases the mitochondria in our cells. T or F

Exactly right. See where I’m leading you?

  1. Number of mitochondria means my cells can produce more energy and do their function better, aka, squeeze harder. T or F

Bingo

  1. The strength of my hand squeeze isn’t what’s making me live longer, it’s the fact that I’ve gotten fit all over, and that is just plain good for me. T or F

Bingo

Carb Back Loading (CBL) – Weight Loss Magic?

Carb Back Loading – “Weight Loss Magic?”

Reference: Mol Cel Endo, Int Journal of Sports Medicine 2012, How CBL Works

John Kieffer is the training guru who worked out CBL on his own as a means of building strong muscles and losing weight. It appears to be the latest fad, which is not to say that it might actually work!

The question is, “How can I lose weight, and really lose fat, not muscle?” We are becoming aware that our body has a variety of tissues that have different sensitivities to glucose and insulin at different times of day.   In the morning, fat cells and muscle cells are both quite capable of taking up sugar.   If you eat carbs in the morning, you will induce insulin, which has an effect of 8-12 hours and your fat cells get fatter. Hence, the argument is to eat and exercise in a rhythm that matches your natural human physiology.

The method of carb back loading is as follows.   Eat only fat for breakfast, or skip it all together.   Have a light protein, fatty lunch.   Then, do a resistance training workout in the gym for an hour at 4 pm. Get sweaty. THEN, have all the carbs you want!

The physiological argument is as follows. The glucose transporters GLUT4 and GLUT12 are actually hidden inside the cell. They become activated and actually move to the cell surface of muscles with intense exercise. Kieffer claims that once they are activated, energy (glucose specifically) moves into muscle cells but not fat cells. Your muscle cells get bigger and stronger, your fat cells don’t.

His argument is based on several research studies about eating later in the day. In one, 10 women were given standardized calorie meals with either 70% of calories in the morning, or in the evening.   The evening schedule lost more weight from fat.   The problem with the study (though well designed and controlled) was only 10 subjects – with fat content measured by electrical impedance – not DEXA scan. The second study was on 78 police officers who were overweight and on a weight reduction schedule – either eating throughout the day or eating mostly at night.   The night schedule folks lost more weight. That study had tons of problems too. Calorie intake was self reported as proven by a protein intake that was way too low. And the evening group only lost 5 pounds over 6 monhts. That’s not much more.

What’s my read of carb back loading?   It’s interesting physiology, and there likely is some benefit, particularly if you burn 500 calories a day with an intense, one hour work out. But, I believe that’s the benefit of one hour of intense muscle work.

What I do believe is that in the rest of us folks, to lose fat weight, you have to get rid of insulin, and the only way to do that is to cut carbs AND protein.   Yes, protein. Protein is very insulogenic when you get too much of it. In fact, too much protein is just as insulogenic as white bread.   So, to lose weight, you don’t want to eat too much protein, or two many carbs. That leaves fat.   Yes, fat. Delicious, appetite satisfying, satiating fat. And that’s what the Adkins, low carb diet is, a low carb, modest protein, butter, egg and bacon diet.

WWW. What will work for me.   I’m currently making FAT BOMBS. Little snacks of pure fat. Delicious.   Well, some of them are. But I’m now down 20 pounds in three months and I haven’t really been hungry.   My diet is about 70% fat when I track myself on the LoseIt App.   Most days, for me, it’s two jumbo eggs for breakfast and two for lunch. Then a varied, most fatty meat supper. Not very interesting, but only 360 calories by supper time. I walk an average of about two miles a day and eat 70% of my calories at supper. I getting about 1,650 calories a day. That’s something you can do too.  (My abs, well, are not photogenic)

Pop Quiz

  1. CBL or Carb Back Loading is claimed to be the best way to build muscle and lose fat on the market? T or F

That’s his claim

  1. The method is to eat very little carbs in the morning, work out heavily at 4 pm and then eat carbs in the evening.   T or F

In a nutshell

  1. Physiological fact is that exercise induces the activity of glucose transporters in muscle that induce intake of glucose only after intense exercise. T or F

That’s the physiology John Kieffer claims makes his method work.

  1. Some people seem to succeed massively with this method. T or F

Just like every other method out there in media land.

  1. Randomized controlled trials are thin with CBL. T or F

None exist.

  1. It’s reasonable for you to consider this method.

Sure: just fat in the morning, a huge workout and then MODEST calories afterwards, and you will lose weight. Burn 500 calories and you can eat 500 extra, and then still lose weight if you only get to a net of 1500 calories a day.

The Glucose Effect of Standing

The Glucose Effect of Standing

Reference: Thorpe Med Sci Sports 2014, Alter, Annals Internal Med 2015Glucose is the problem.   There is pretty clear evidence from the Whitehall study and others that you start making vascular lesions when your blood sugar is more than 86.   That’s a tall order. Most of our doctors tell us our blood sugar is normal when it is under 100, and that all we need to do is exercise more and lose weight if our glucose is under 124.   We aren’t officially “diabetic” until our fasting glucose is over 124, twice.

Then, we find out that 50% of us are going to have Alzheimer’s by the time we get to age 85.   Pleasant thought, isn’t it? That may be all right with you, but seeing the misery my own mother is in, it’s not so good with me. And if my mother is in it, my turn is next. I don’t want to wait for that to happen, I want to do something that makes my risk different.

Well, Alzheimer’s is now being called Type III diabetes. The argument here is that our brains get used to glucose, then gradually resistant to it over time.   Perhaps the key concept here is prolonged exposure to glucose over time.

Well, that raises the question, is there benefit to lowering my glucose?   Considering the demonstrated effectiveness of lower glucose on heart disease, I suspect it’s not unreasonable to posit the same effect for our brains. I make the leap that disordered glucose is damaging, wherever it is and vascular disease just happens to be where it shows up first. But expose the human brain to it for long enough and it will give way too.

So, what is the standing thing all about?   In this study, the researchers took 29 overweight office workers (mean age 49, BMI 29) and put them in a work environment that had them either sitting all day long, or sitting and standing all day, 30 minutes at a time at an electric, height adjusted standing desk.   (Nifty idea!). Guess what happened! Their blood sugar dropped 11 percent.   That’s huge! Just from standing for 30 minutes at a time.

Now, there is increasing research showing that going to a gym for 20 minutes has t’s benefit largely erased by 8 hours of sitting. Dr Alter did a review of all the research out there and shows that prolonged sitting is independently associated with bad health outcomes, regardless of exercise.   Exercise helps over no exercise, but prolonged sitting adds risk back and largely negates the benefit. What should be a louder clarion call is for all of us who get little exercise and have prolonged sitting as part of our jobs.

That leaves the high priest of sitting behavior (The CEO of Apple Computer) saying that prolonged sitting is the new cancer.   And right he is.

WWW. What will work for me.   I’ve got a job that involves prolonged sitting.   All day long, I sit. I get up to greet folks and walk a little bit here and there, but mostly I sit.   I have put my greaseboard up for demonstrations, and used it once or twice. And I’m having a small podium built so that I can put my computer up and stand when I need to.   And as I typed this letter, I realized I was sitting. I’ve typed the last half of it standing.   I’m determined to learn different habits.   Join me.

 

Pop Quiz

  1. Prolonged sitting each day is independently associated with bad health outcomes. T or F

True

  1. If I stand half the day, my blood sugar may be as much as 5 % lower. T or F

Nope, 11%.

  1. Modestly high blood sugar with subsequent brain resistance to it may be the ultimate mechanism for Alzheimer’s.

That’s the current thinking.

  1. The majority of Americans sit most of the day.

Yup! That would be me and you, (mostly)

  1. Many of us can make modest adjustments in our workplace that would allow us to stand. T or F

Took me one minute to lift my lap top off the table and stand up. I put a few books underneath it to raise it up for me.

 

Sitting Too Long is Bad for You

Sitting Too Long is Bad for You

Reference:   Annals of Internal Medicine Jan 2015

How bad?   This is a big problem. I spend all day sitting. I’m a “knowledge worker”. You know, indoor work, no heavy lifting.   Computer, desk, phone and intellectual work.   Eight hours a day. Sound like you?  (Then I go home and slump over on the lazy boy in front of the TV – at least in winter.)

Ok, these guys took a serious look at the literature and found 47 studies that looked at mortality, hospitalizations, cancer, diabetes, heart disease against the variable “how long you sit”.   They did admit to quite a bit of variability in the studies, and listed that as one draw back. But regardless of physical activity outside of the sedentary time, there was fairly dramatic strong associations with sedentary time and all the list above: heart disease, diabetes, cancer, hospitalizing and just plain not living as long.  It was across all studies.  This is what we call a “Meta-analysis”, combining the data of all pertinent research to answer big, hard questions.

What were the numbers?   Their data shows numbers like a hazard ratio of all cause mortality of 1.24. That basically means you die 24% faster.   Get it? Hazard ratio for heart disease was 1.179.   That’s about 18% more heart disease. No matter how much you go to the gym, exercise outside of work or work out on weekends, you get heart disease 17.9% more just by sitting too much.    Cancer mortality? Also 17%.   Cancer incidence was 13%. Type II diabetes? 91%.   And that may be the key link. Your diabetes risk goes up, meaning your blood sugar goes up and that leads to higher blood fats, inflammation and glycation which are the real cause of heart disease.

The authors did note that the effect was more pronounced in those who spent more time being completely sedentary, but going to the gym for 30 minutes was not protective if you then sat for 8 hours.   There was about a 30% variability in risk between those who didn’t exercise at all with those who did, do it’s not completely accurate to portray this as a complete disqualification of exercise. But it is a risk to sit. In fact, you can put it on a par with smoking. It might be the one other most serious risk to us, besides eating diets of sugar and carbohydrates and getting fat from that. Going to the gym is very noble, it’s just not enough when you erase the benefit by sitting the rest of the day.

What’s not known yet is just how much sitting can we really get away with. The authors suggest that we should aim for a two to three hour reduction.   Maybe you don’t need to do it all at work. How about learning to stand more at home. Use your imagination. Create a hobby at a work bench where you can stand, instead of sit.

WWW. What will work for me. Ok, I’ve been talking about this forever.   I need to get over my putzing around, doing nothing. The data is there and it’s powerful. Neither you nor I can let ourselves sit every day, all day.   Find a way to re-craft your work environment so that you stand part of the day. Make a grease board on your office wall.   Put in a higher counter so that you can stand while your work. Make your phone calls standing.   Express support and admiration for those early adaptors who have already done it. Talk to your office design company!   They’ve got ideas.   But most of all, ask me what I did in my office next time you see me. I’m determined to get over my lazy ass attitude and get a grease board so that I can stand. I draw a lot of pictures on pads of paper. Time to do on the wall, so I’m standing.

 

Pop Quiz

  1. Sitting a lot has the ability to increase your risks for cardiovascular disease, cancer, diabetes, early mortality, more hospitalizations. T or F

Yup

  1. Sitting 8 hours a day may be almost as bad as smoking. T or F

True.

  1. Exercising has some benefit, much of it undone by 8 hours of sitting.

Yes, it appears that the good exercisers do decrease their risk by about 30% over those who never lift a finger. That means their risk is only 70%. That’s still up.

  1. We know how much you need to stop sitting. T or F

Not yet.

  1. Reasonable goal would be to cut down 2-3 hours a day of sitting.

That’s the author’s advice.