Month: November 2009

Holiday Reading: Obesity, Wacko Cookie Diet, Strength Training, Running Research, Ice vs. Heat for Injuries

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Artwork: St. Petersburg Times, FL

Artwork: St. Petersburg Times, FL

A day of severe gluttony is headed our way like a runaway chuck wagon.  Therefore, how about a discussion of two articles on obesity?   For the Overweight, Bad Advice by the Spoonful was published back in August of this year in the New York Times Health Guide. The other, Energy Gap Useful Tool for Successful Weight Loss Strategy is from early November in Science Daily.  The two articles present very daunting insights into our fight against obesity.  The Times piece tells us the following:

  • Weight control is not simply a matter of willpower. Genes help determine the body’s “set point,” which is defended by the brain.
  • Dieting alone is rarely successful, and relapse rates are high.
  • Moderate exercise, too, rarely results in substantive long-term weight loss, which requires intensive exercise.

The article further states:

“…the notion that Americans ever ate well is suspect. In 1966, when Americans were still comparatively thin, more than two billion hamburgers already had been sold in McDonald’s restaurants, noted Dr. Barry Glassner, a sociology professor at the University of Southern California. The recent rise in obesity may have more to do with our increasingly sedentary lifestyles than with the quality of our diets.”

Our bodies are remarkably stubborn in their ability to keep us at our current weight (discussed further here).  We eat smart and healthy one day, a little less so the next.  In contrast to the Times article, from everything I read and understand, the food component of weight loss is far more powerful than the exercise component (suggested here, and here).  In fact the issue is poor eating plus a sedentary lifestyle that’s gotten our nation so heavy.  Things like this are never isolated to one cause.  (By the way, body weight isn’t the only measure of health.  Look here for more on the issue of fit vs. fat.)

There are two things not mentioned in the Times article that we should consider.  First regarding the way we ate decades ago vs. how we eat now is the presence of processed foods.  I don’t have statistics but I think it’s safe to assume that in the 1960s we were eating more fresh, unprocessed food. We now eat gobs of food every day that is packed with calories but contains very little actual nutrition.  For a sober, practical, in-depth look at our nation’s obsession with “nutritionism” you must read what Michael Pollan says in Unhappy Meals.  Another comment on Pollan’s work is found at Disease Proof.  (For truly fascinating insights into the American food system, you must read Pollan’s The Omnivore’s Dilemma and/or In Defense of Food.)

The second component of our eating we must consider is portion size.  Portion size is a tremendous component of obesity.  In recent decades past, our overall calorie intake was lower than it is now, thus there was far less obesity.  The article notes the billions of McDonald’s hamburgers that were sold but do you know what those hamburgers looked like?  You can still buy it today.  If you look at a McDonald’s menu they actually have something simply called a hamburger; not a Big Mac, Quarter Pounder, Titanic Monster Burger, or whatever.  It’s a small thing with one meat patty, pickles, onions and ketchup.  A customer in the ’60s may have gotten fries and a soft drink, but the fries came in a small paper envelope, not a cardboard crate, and the soft drink was an eight ounce cup rather than an industrial drum.

For more on portion sizes and our consumption habits, the Centers for Disease Control provide a report called Do Increased Portion sizes Affect How Much We Eat? It’s amazing to see how we can unconsciously eat a lot more than we need to if it’s sitting there in front of us.

The Science Daily article tells us that once one is obese, the body fights extra hard to stay there.  In contrast, one who never becomes obese seems far less likely to become obese.  The article discusses the Energy Gap, a term used by the American Dietetic Association to estimate the change in energy balance (intake and expenditure) behaviors required to achieve and sustain reduced body weight outcomes in individuals and populations.  We’re told that the energy gap to prevent weight gain is about 100 calories.  That is, someone can prevent weight gain with a combination of reduced energy intake and increased physical activity that amounts to 100 calories.   The news isn’t so good for those trying to lose significant amounts of weight.  The energy gap may be 200-300 calories for someone looking to lose 10%-15% of their body weight.  That means serious eating modification and quite a bit of time exercising.

According to James O. Hill, PhD,

“This analysis indicates that to create and maintain substantial weight loss (ie, obesity treatment), large behavioral changes are needed. This is in stark contrast to primary obesity prevention in which small behavioral changes can eliminate the small energy imbalance that occurs before the body has gained substantial weight. Because the body has not previously stored this ‘new’ excess energy, it does not defend against the behavioral strategies as happens when the body loses weight.”

What does all of this mean?  First, obesity is much like any other disease in that preventing it is much easier than treating it once you’ve got it.  (This makes the topic extremely relevant to the current health care debate.  Preventing obesity will result in prevention of obesity related illnesses, and we’ll all spend less on health care.)  Second, there’s much evidence to suggest that losing weight is a complex battle that is more than simply making a decision.  We have a very tenacious system wired into us (likely rooted in some prehistoric survival strategy) that makes dropping pounds extremely difficult.  It’s akin to telling the drug addict to just stop.

Just stopping–a conscious decision to change a behavior in other words–is still the heart of the issue.  Weight loss still comes down to willful decisions to make changes.  There’s no way around it.  I learned a little bit about human psychology and behavior in graduate school.  It seems that most of us adhere to changes if they’re made in small, gradual steps.  Just one healthy decision made today is one more than was made yesterday.  That’s a step toward whatever healthy goal we have in mind.  Keep making healthier daily decisions and over the course of a year, two years, 10 years and you’ll have made a lot of them.  Guess what’s around the corner though: the New Year’s Resolution.

We’re getting close to the time of year when many people will make the big decision to lose weight this year.  Gyms will be packed with people exercising like they’ve never done before–at least not since the beginning of the previous year.  They’ll make attempts to banish their favorite foods from their plates and replace it with food they’ve never much liked.  Most of these noble attempts will be abandoned by the end of February.  This is the perfect example of people making drastic lifestyle changes which cannot be maintained.  As a personal trainer, I see this happen every year.

Speaking from personal experience, I look back to childhood, high school and college and see what I ate and/or drank–and in what amounts–and I’m amazed at the amounts of junk I once consumed.  I’ve spent over a decade making changes here and there and I’ve found that it hasn’t been too terribly painful at all.  Of course I can’t extrapolate my experience out to everyone else, but it seems to me a strategy of small changes in both eating and exercise made over time, plus the decision to stick with these changes is still the best strategy to lose weight and get healthy.  If there’s a better strategy, please let me know.

Beyond that, here’s more to read on a variety of topics:

  • Are we Insane? Part II: the Cookie Diet.  Does this even need any explanation?  Cookies and dieting….  I think I’ll try breathing underwater later today, or maybe flapping my arms and flying.  (Ever notice how everyone who was on a diet… WAS on a diet?  No one stays on any of these things.)
  • To thrive longer, get stronger.  The Washington Post discusses Consumer Reports’ findings on various clinical trials of strength training.  Turns out picking up heavy objects is good for you in many ways.
  • Runners: Train less and be faster.  OK, this will be controversial to some and I’m not saying this is true for everyone all the time.  However the findings here help support some of the arguments made at Power Running that running fewer miles (low volume) while running faster (high intensity) may increase race performance.  Science Daily profiles a report in the Journal of Applied Physiology on the topic of running less but running faster.  Again, do not assume this is the be-all-end-all for everyone, but it might be exactly the strategy that will work for you.
  • Ice or Heat?  The topic of icing or heating an injury is often debated.  Like many issues of sports conditioning and rehabilitation, the jury is still out.  The following is a reprint of a comment by the late Dr. Mell Siff from the Supertraining forum:
    ICE OR HEAT?
    by Dr. Mel C SiffThe use of ice treatment may not be universally superior to the use of heat
    in enhancing recovery or rehabilitation.

    THE PROBLEM

    The use of localised or more extensive ice or cold treatment has been well
    authenticated over the years and there is little doubt that, in many cases,
    it is a highly effective and cheap method of restoration and rehabilitation.

    However, any literature searches for definitive studies that compare the
    effectiveness of ice cold versus very hot treatment of the same sort of injury are not as common as one would believe.

    It seems as if we have all accepted that heat is contraindicated largely on
    the basis of theoretical considerations or extrapolations form cases where
    bleeding is apparent. We know that heat causes blood vessels dilatation,
    temporary increase in inflammation and the decrease in blood viscosity, but
    does this necessarily imply that it will be detrimental to the course of
    restoration or rehabilitation of all sore, bruised and fatigued soft tissues?

    Why I am saying this is because I have been experimenting, much against my
    education and scientific traditions, with the use of very hot water as a
    restorative means with myself and several other athletes, some of whom are
    top pro footballers and basketballers.

    Surprisingly, this seems to diminish muscle soreness and speeded up recovery
    in many cases, especially if we use alternate hot and cold bathing. I have an
    8 ft deep jacuzzi and long lap swimming pool and have my athletes alternate
    between hot and cold immersion. Interestingly, I have found that the water
    has to be almost unbearably hot (about 108 deg F or 41C) to be optimally
    effective. Movement under these conditions also seems to be valuable
    (‘cryokinetics’ for ice old immersion and ‘thermodynamics’ for hot
    immersion).

    Certainly my comments on this controversial topic merely constitute anecdotal
    evidence at this stage, but I am curious to hear if anyone else has had
    similar experiences or come across scientific research which legitimately
    shows that dedicated ice treatment is significantly better than very hot
    treatment or ice-heat contrast methods. Failing that, is there any evidence
    that the use of heat is a general contraindication for musculoskeletal
    recovery and rehabilitation, other than cases where there is obvious bleeding
    or serious pathology?

    Are we promoting ice therapy far too liberally to the exclusion of heat
    therapy, when the latter may well also play a very helpful role in
    musculoskeletal rehabilitation? Are we unfairly proclaiming that heat is
    potentially harmful for treating any soft tissue repair? Does this attitude
    go against our recent attestations to the value of ‘holistic’ treatment?

    There have been a huge number of studies on the effect of stretching,
    jogging, supplements, heat, cold, drugs, you name it …. and virtually
    nothing has yet been found that appears to make some significant and
    consistent difference to the dissipation of DOMS. Do a Medline search
    and you will see what I mean. Many higher level weightlifters and
    ppwerlifters rarely if ever suffer from DOMS even after very heavy
    workouts, which afflicts mainly newcomers to a given exercise or
    routine – or certain more susceptible individuals. For general recovery,
    I have found it difficult to beat sensible program (or periodisation) design and
    hot-cold contrast bathing, as I have written in previous letters. Your
    recommendation to do some mild post-exercise activity probably is
    a sound idea for general relaxation and recovery, but it has not been
    shown to have any real effect on DOMS.

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Attn Runners: Check Out This Site (Powerrunning.com)

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Hey, if you’re into reading, Power Running looks to be a very in-depth site with lots of thoroughly thought out information on the physiology of running and how to train according to your abilities.  The writer has really done his homework and he’s got some interesting theories that sort of go against some of the conventional wisdom.

For instance, he asks the question of whether or not more and more mileage is good for everyone.  He notes that the elite runners improve as their mileage improves but he theorizes that the elite runners have the genetics to run more and more and to benefit from that large workload.  Many of the rest of us though may well benefit from much lower mileages.  He talks about the FIRST running program which is a three-day-a-week program and why it may be the best program for the most people.  Check out the site to learn more.  I’m finding it to be a very informative and interesting read.

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A Little Bit on Stretching: Part II

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So where are we?  We’ve covered the different flavors of stretching.  I now need to go back to something I said in Part I: No human movement is possible without stretching.  This is going to get a little more complicated before it gets simple–but I promise to give you information that you can actually use outside the game of Jeopordy!

Look at the stride--the STRIDE!--not the filthy habit.

Look at the stride--the STRIDE!--not the filthy habit. Photo by Ed Yourdon / CC BY-SA 2.0

Each time we move, we use energy stored in stretched muscles to drive our limb into movement.  When I take a step forward for instance, I hit the outer part of my heel and it rolls inward (calcaneal eversion).  The arch of my foot pronates a bit, and it pulls my calf muscles (soleus, gastrocnemius, posterior tibialis, among others) inward which takes my lower leg (tibia) inward into internal rotation.   At the same time, my body is moving forward over my ankle which creates dorsiflexion.   The tibial internal rotation also causes my knee to flex and internally rotate.   Once the knee moves in, it pulls on the IT band which is attached to my glute complex and now my glutes lengthen both forward and inward and my hip flexes–and if my hip is functioning properly it will move sideways into adduction in the direction of this leg that just took a forward stride.  So all these muscles have worked and stretched to keep my foot and leg from collapsing into the earth.  Now these muscles have all been turned on and with the energy stored inside them like stretched rubber bands they will propel me forward into my next stride.

Without going into every single action, the muscles and limbs of the opposite leg are contracting and creating extension, external rotation and abduction (though the adductors are stretching and slowing external rotation of the femur) at the hip, extension and external rotation at the knee, and plantarflexion and external rotation at the calf and ankle, and supination at the foot.

WOW!!!  Are you kidding me!!  What a lot of stuff!!  And that’s the story from just from the waist down!  All that and this lady can still manage to smoke a cigarette.  Did you notice how many muscles were stretched in this process, and in what directions?  Parts were moving forward, back, inward, outward and sideways.  As Gary Gray terms it, this is 3-D loading to exploding.

In all seriousness, this sequence of events must happen in order for our bodies to efficiently produce force and absorb shock.  Each stretch of each muscle in turn activates muscles up the line.  If this process is inhibited (could be due to injury, sitting too much, doing the same thing over and over and over, or who-knows-what) then we tend to get knee pain, back pain even shoulder or neck pain.

These movements aren’t just important for walking and running.  Proper movement in all three dimensions is vital for cyclists, skiers, dancers, even swimmers–even though their movement patterns are different from walkers and runners.

In Part III I’ll build on this whole process and show you an effective way to mobilize some important regions of the body via dynamic stretching.

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A Little Bit on Stretching: Part I

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Artwork for the cover of Fantastic Four vol. 3, #52 (Apr, 2002). Art by Mike Wieringo.

Artwork for the cover of Fantastic Four vol. 3, #52 (Apr, 2002). Art by Mike Wieringo.

I’m all over the place here!  I’m tremendously excited over some new concepts that I’ve been learning; concepts concerning human movement and how we function.  A lot of it has to do with stretching but not necessarily the type you automatically think of (more on that in a little bit.)  My difficulty is in how to write about all this without putting out a some sort of treatise. Maybe I’ll make it more than one part…  Here’s the start.

A recent Washington Post MisFit column tackles the issue of stretching.  Is it beneficial or is one of those things that we do just because we’ve always done it?  What’s the evidence that there is any benefit to doing it?

I’ll tell you that I’ve done just about a 360 and then a 180 back the other way on stretching.  Like most people I was taught that stretching was important so I did it but I didn’t really understand it.  Then, several years ago I was persuaded to change my view.   I became convinced that dedicated (static) stretching was not effective and not safe.  Now I will tell you without hesitation that stretching absolutely must be done–in fact no human movement is possible without it! Remember that fact because it’s enormously important, and I’ll discuss it more later.

First, let’s figure out what stretching is.  Most people have an idea what it looks like to stretch but most likely there are other methods that might not come to mind immediately.  So let’s look at what might qualify as “stretching.”

  • Static stretching: This is probably what first comes to mind when you think stretching.  This involves moving a limb into a position to the point where a slight burning is felt in the muscle and the position is held for anywhere from several seconds to a minute or so.  Static stretching addresses passive flexibility.
  • Dynamic stretching: This is stretching with movement.  Maybe the best examples of dynamic stretching are found in the animal kingdom.  Ever see a cat or dog wake up from a nap?  Essentially, dynamic stretching involves moving limbs or the trunk through its available range of motion.  You often see athletes do this prior to a game.  Examples include kicking the legs, swinging the arms, twisting the torso, lunging and other such movements.  Dynamic stretching often involves swinging an implement such as a golf club, tennis racquet, or baseball bat.  Dynamic stretching addresses active flexibility.
  • PNF Stretching –  Proprioceptive Neuromuscular Facilitation: I won’t go into much detail on PNF as there’s a lot to it and I’m not terribly well versed on the topic.

The popular perception of (static) stretching says it’ll reduce likelihood of injury, increase range of motion, decrease muscle soreness.  Is any of this true?  Well, the evidence is not entirely clear.  There’s very little evidence that static stretching prior to exercise or competition decreases injury.  In fact it very likely contributes to injury.  Why?  I won’t go into every single physiological detail of stretching here but I’ll try to explain the big ideas as best I can.

Static stretching actually weakens the ability of a muscle to contract.  Though you may gain range of motion (ROM) from static stretching it also results in a less-active muscle and thus a less stable joint or joints which that muscle crosses.  This phenomenon has been shown by testing athletes strength and/or jumping ability pre- and post-stretch.  So if you stretch statically prior to your soccer or softball game what you’ve done is create weaker muscles and less stable joints.  That’s not what you want.  Dynamic stretching is safer and more pertinent to real-life situations.

Dynamic stretching is now generally recognized as an appropriate activity prior to a workout or athletic even, as research (see ch. 3 of Siff’s Supertraining) has shown that active flexibility is more closely correlated to sporting proficiency than is passive flexibility.  In this way, you wake up the nervous system and prepare the body for action.  A dynamic stretch routine should include movements that you will perform in the workout or game.  Examples include body weight squats, various lunges, twisting the torso and swinging and reaching the arms in various directions.

How’s that for part I?

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Exercise Demo: Squat to Press

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Preparation:

  1. Stand in good posture with feet shoulder width apart and feet facing forward.
  2. Hold a barbell, dumbbell(s) or kettlebell(s) at clavicle height.

Execution:

  1. Perform a squat as low as you can while maintaining good form and posture.
  2. Drive back upwards with the legs then press the weight or weights fully overhead.
  3. Return weight(s) back to clavicle height.

Tips:

  1. You may use one dumbbell or kettlebell to create an asymmetric load, and thus a different exercise.
  2. You may vary your foot position: feet wide/narrow, staggered stance with one foot slightly ahead of the other, toes in/out, or any combination of these positions.  Again, this will create a slightly different exercise.
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Distance Running and Human Evolution

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running shoes

With the recent running of the New York City Marathon, some information on distance running seems appropriate.  The Human Body is Built for Distance is a recent story in the New York Times Health section.  Part of the discussion includes the theory that humans are unique among animals in our distance-running abilities. It seems that we might indeed be the fastest of earth’s land-based creatures over the long haul. Some of our advantages include our foot structure, spring-like connective tissue, our cooling system, our glycogen storage capacity, and even our sense of balance.

Of further interest is the discussion on running injuries and footwear.  Christopher McDougal author of Born to Run suggests in the article that many of our ancestors as well as some of our less-advanced contemporaries ran and do run many more miles with far fewer injuries than we do with our fancy modern running shoes.  The idea that primitive running is better running has been suggested  here, and here.  It’s also the driving idea behind shoes such as the Nike Free and Vibram Five-Fingers.  About 90 percent of runners training for a marathon experience injury according to statistics in the article.

Sort of makes sense right?  How long have modern running shoes been around?  Nike started business in the late 1970s.  Meanwhile, humans were running around a lot longer than that, their feet shod in some very minimal items. So what’s going on here? As our running shoes evolve are the wearers actually devolving?

I know enough to know that I definitely don’t know the answer to this question. I’ve gone back and forth on the issue and I’ve moved from running in Nike Frees to running in Nike Frees with Sole Supports in them. Isn’t that odd?  From what I’ve read and experienced though, the issue of high-tech running shoes vs. low-tech running shoes vs. barefoot running is an extremely personal matter. What works miracles for one running may wreck havoc on another. It can be a maddening process trying to find the ideal way to address your feet.

If this topic is of any interest to you, I recommend strongly that you read the Science of Sport’s series on running.  It’s remarkably in-depth in its analysis of shoes, feet, and running technique.

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