Book Ends: On Why the Rules are Wrong

Posted on May 15, 2012 by Dr. Katherine Hartmann

Gary Taubes’ Why We Get Fat and What to Do About It and Timothy Ferriss’ The 4-Hour Body are an unlikely pairing in both writing and personal styles. Taubes, a quintessential scholar-in-residence, big-picture thinker and policy-wonk, and Ferris the entrepreneur who has carefully cultivated a millionaire playboy-adventurer image, both provide engaging takes on crucial changes that need to happen in how we think about diet and fitness. And both rank on the New York Times Best Sellers list.

Taubes is a Science magazine correspondent who regularly makes carefully crafted intellectual jabs at established scientific wisdom, flawlessly finding the weak spots. His gift – which has garnered him multiple science writing awards and repeat performances in the New York Times magazine and editorial page – is in translating not only the science but also its logical flaws and inherent limitations into discourse that the reader wants to follow.

In Why We Get Fat, he describes the path that led us to low fat diets and calorie counting, maps the trajectory of the obesity epidemic, examines contemporary eating norms alongside historical trends, and scores a direct hit on the blind spots and at times intentional wishful thinking that have plagued the biomedical science and prevention research community. In a nuanced and well-documented dissection (integrating examples from the appetite of blue whales to insulin regulation of body fat), he pares away conventional wisdom until the facts lefts standing are:

  • Insulin regulates fat storage – more insulin, more fat storage.
  • Carbohydrate intake drives insulin levels. More carbohydrates (carbs), especially simple sugars, result in higher insulin spikes, this causes more blood sugar instability (rises and falls for the body to try to smooth out) and even greater propensity to store energy as fat.
  • More fat leads to greater appetite.
  • Because simple carbs satisfy more quickly – the deed is done, we turn to carbs to meet demands of tour appetite and the body’s innate drive to maintain stability.

Solution? Taubes conducts point-by-point rebuttals of concerns over protein rich diet and fats, including taking on cholesterol measures and chronic disease prevention, and lays a path to a scientifically documented Adkins flashback recommending:

  • Virtually no simple carbohydrates; fruits as an occasional (not daily) treat.
  • Less than 20 grams of carbs per day not including carbs from fiber.
  • Vegetables as nearly the only complex carbs; with occasional allowances for whole grain complex carbs.
  • Protein with every meal and fat counting be damned (but skip trans fats, aim at healthy fats from nuts, avocados, lean meats and the like).

But this is not another diet book filled with recipes and success stories. Practical advice is limited to a few dozen pages of appendices. This is a call to action, a treatise to make us all think more deeply about how we came to have the ideas we have about healthy diets and why some of the ideas might be what’s making us fat.

At the other end of the shelf put Tim Ferris weighing in at 9% body fat and baring his personal DEXA, BodPod, and 24-hour blood glucose and insulin measures for the whole world to see. Ferris’ spin on re-thinking our models and personally experimenting with what we’ve been told by diet and fitness gurus is in service to “rapid fat loss, incredible sex, and becoming superhuman.” He covers the gamut from supplements to training styles urging “please be skeptical.”

With laugh-out loud tales of testing methods for putting on muscle (GOMAD – the gallon of milk a day route) and goading friends on food binge days with texted photos of his consumption of horrifying quantities and varieties of dietary indiscretions, he delivers a remarkably similar subtext to Taubes: Protein is good; “fast carbs,” i.e. simple carbs are bad because of effects on insulin and fat reserves, and “slow carbs” (whole grains and vegetables) can be your friend in training and pacing your appetite.

He gleefully crosses over into territory that gets short shrift in Taubes’ dissertation and focuses on the value of muscle as a metabolically active tissue and how to get more of it. Bringing the tone of his prior NYT best-seller the 4-Hour Work Week to this mission, he mocks wasting time at steady state activities and lays out a mix of strength, core, and high intensity methods that are glossed up for kicks but would meet the approval of most current exercise physiologist. The emphasis on efficient work-outs with maximal results is a profitable thread – perhaps overstated if you aren’t on the cusp of being in great shape and younger than 35 but nonetheless would be a path for anyone pursuing fitness through the door of strength training. The explanations are suitable for the complete novice. Stories weave in NFL training camps and his own adventures in improving his vertical leap or “learning to swim effortlessly in 10 days” adding flavor that though testosterone drenched doesn’t exclude the female reader who is after changes in performance while overhauling lean body weight and definition. A refreshing relief from the pack of trade books designed to appeal to everyone who hopes to loose weight or get fit – his “burn it down” energy and reliance on evidence delivered in an irreverent style will call out to those who suspect there are better ways to stay focused on the goal, pack protein, avoid carbs, and check one more physical goal off their bucket list.

The joyfully obsessiveness of Ferriss’ accounts as he lays out why it is “obvious that the rules require some rewriting” is a pleasant convergence with Taube’s staid policy comments. Taubes notes that by following his advice “you may be going against your doctor’s advice, and certainly that of the health organizations and government agencies that dictate the consensus opinion of what constitutes a healthy diet,” advising giving the book to your physician so that “he or she, too can decide who and what to believe.”

Read, reflect, these ends meet in the middle.

K. Hartmann, MD, PhD

khartmann@thedelta.com

Posted in Aerobic activity, Calorie Restriction, Core Training, Diet, Energy, Fitness, Health, Interval Training, Metabolism, Muscle, Nutrition, Running, Strength Training, Weight Loss, Weight Maintenance, Well-being | Tagged , , , , , , , | Leave a comment

Optimal Intervals*

Posted on May 6, 2012 by Dr. Katherine Hartmann

In May 2011, University of Nebraska researchers reported detailed physiologic data from evaluation of 12 adult triathletes (7 men and 5 women) that suggests shorter intervals at 90% maximal effort result in: 1) more energy expenditure as measured by total and maximal oxygen consumption, 2) less lactic acid build up, and 3) ability to continue high intensity intervals for a longer period of time. They evaluated all four combinations of: short interval length (30 second) vs. long (3 minutes) along with 90% maximal effort vs. 100% maximal effort. In each instance, shorter intervals were superior to longer; and 90%, superior to 100% effort. Overall, the combination of shorter and 90% was superior to the other three possible combinations.

Perhaps the most intriguing finding was that when these athletes completed an average of five to seven minutes more total time in interval training using the 30 second duration at 90% effort, but they rated the perceived exertion of the sessions as equal to shorter sessions. They were biologically documented to have been making greater total metabolic demands during these sessions but were able to sustain it for longer.

Take home: while longer intervals at maximal intensity are often viewed as more challenging and effective for training, the capacity to extend the workout session and maximize aerobic/anaerobic training benefit while minimizing muscle fatigue and delayed soreness may be better for shorter intervals.

This May, investigators in Copenhagen reported outcomes of a seven week interval training running program among 18 moderately trained athletes, six women and 12 men who had been running an average of 137 minutes each week, and whose average age was 33. They randomly assigned half the group to an interval program with 1.2 k warm up followed by five minute interval training sessions in which they ran at 30% of maximal effort for 30 seconds, then 60% of maximal for 20 seconds, and 90 to 100% maximal effort for the final 10 seconds. They then rested for two minutes and continued to complete a total of four sets with a two minute rest between each. Average training volume was 14k per week for the seven weeks, 54% less than their baseline; the comparison group held to their usual baseline training program.

At the end of the seven weeks those in the interval training group had increased their oxygen consumption capacity by 4% indicating greater aerobic capacity, and decreased their times in the 1500 meter by an average of 21 seconds and their 5 k times by 48 seconds. Improvements were also seen in systolic blood pressure and cholesterol profiles. All these changes were statistically meaningful but the cholesterol changes may not be clinically important.

Take home: choose intervals that include brief high exertion and make your training more efficient while still making performance gains.

Regardless of what your choose for interval length, effort goals, or training volume, remember that interval training across the spectrum of parameters has been documented in many groups (deconditioned/elite athletes; normal /overweight; men/women) to be more effective at burning calories and building athletic performance and conditioning compared to comparable lengths of time in steady state exercise such as running or using an elliptical trainer at a fairly constant pace.

So get out the timer and add some variety – it’s proven to pay off.

K. Hartmann, MD, PhD

khartmann@thedelta.com

* This blog is not intended to provide medical advice.  Consult with your care providers and trainers to plan an appropriate program to help you reach you fitness and performance goals.

Featured Studies:

Gunnarsson, TP and Bangsbo, J. The 10-20-30 training concept improves performance and health profile in moderately trained runners. Journal of Applied Physiology 2012 May 3. [E-publication ahead of print.]

Zuniga, JM; Berg, K; Noble, J; Harder, J; and colleagues. Physiological responses during interval training with different intensities and duration of exercise. Journal of Strength and Conditioning Research; May 2011; 25(5): 1279-1284

Posted in Aerobic activity, Fitness, Interval Training, Metabolism, Research Evidence, Running, Weight Loss, Weight Maintenance | Tagged , , , , , , , | Leave a comment

Weighing in on Water

Posted on April 23, 2012 by Dr. Katherine Hartmann

Water drives biologic reactions in the human body that require energy. In the last decade, research has demonstrated that making more water available to the body subtly ramps up metabolism.  Studies with precise measure of metabolic expenditure, in carefully controlled experimental conditions, estimate that adding one liter a day of drinking water increases annual energy use by 17,400 calories or 2 kg (about five pounds) of fat.

This matches results of weight loss studies that find almost exactly this amount of weight loss in nutritional interventions can be attributed to increased water intake. This additional benefit is after taking into account total energy expenditure in exercise, calorie intake, and macronutrient distribution among carbohydrates, proteins and fats. The observed effects of drinking water in prospective study is almost identical to those predicted in the lab: an additional loss of 2.3±0.4kg over one year for those who sustained water intake above a liter a day.

Add these direct effects of water, to the benefits of replacing sweetened beverages with water, and replacing unsweetened but naturally caloric beverages like juice with water and the contribution to weight loss and maintenance of lean body mass is compounded. Averaging across studies, nutritionist estimate that calorie intake falls by an average of 8 percent when water displaces sweetened beverages and 15 percent when water displaces milk and juice.  That means that many individuals can cut 200 or more calories a day by replacing caloric beverages with water.

The last effect of water – contributing to a sense of fullness, moderating appetite, and reducing food intake is the most variable in research findings. Some studies find greater effect than others. Water before or with meals may matter more among those who do not plan their diet as carefully as many who are actively pursuing fitness and weight loss. Across studies, those who drank 8 to 12 ounces 30 to 60 minutes before a meal, consumed roughly nine percent fewer calories in the meal that follows.

What is ample water intake? For intensive training programs like Boot or endurance training, water intake targets may top 3.5 liters a day for women and 4.5 or more for men. Once at steady state the recommended intake is specific to age, gender, and calorie demands. For example the goal is 2.7 liters for a woman age 31 to 50 who maintains at 2,000 calories/day and 3.7 liters for a man who maintains at 2400 calories/day.

Overall the scale tips fully in favor of ample water intake at all times. Hydration helps all body systems function optimally; water tends to replace calorie-containing drinks and may reduce other calorie intake; and water directly contributes to enhanced metabolic rate.

Drink up!

K. Hartmann, MD, PhD

Posted in Calorie Restriction, Diet, Fitness, Metabolism, Nutrition, Research Evidence, Weight Loss, Weight Maintenance, Well-being | Tagged , , , , | Leave a comment

Massage Mystery: How Does It Work?

Posted on April 19, 2012 by Dr. Katherine Hartmann

You know you love it. But depending on the goal – improved flexibility, muscle recovery, athletic performance, chronic pain relief – the effectiveness of massage, as assessed in well-conducted studies, varies widely from ineffective to helpful.  Inconsistencies of research results are likely related to differences in the form of exercise, level of conditioning of the athlete, timing of massage, consistency of massage technique used, and training of the therapists. Studies also may not be measuring the right part of the process when the goal is recovery between training and a reduction in delayed onset muscle soreness after work outs.

Perhaps the perception of well-being and stress relief associated with massage, as healing touch, mediates biological changes that we aren’t measuring. Perhaps feeling restored translates to being restored? If the mind is able to assure the body that recovery is underway, does it make us willing to push harder? Does it change how we interpret soreness? Does it lead to other forms of taking care of ourselves that have benefits?

While the psychological and mind-body aspects of massage remain unclear. Clues about basic biologic mechanisms are appearing in the research literature. Removal of lactate after acute exercise is not the primary reason we feel better with massage, in fact deep tissue massage within minutes of exertion has been shown to reduce blood flow in the limb and potentially increase lactate. New clues about what is happening at the cellular level within massage are fascinating (Crane, 2012).

Researchers recruited 11 male recreational athletes and established baseline levels of inflammatory activity, gene expression (reflecting what cell products are being manufactured), and mitochondrial number (the cells power system) on the first day. The participants returned for a second day, ate a standardized meal, briefly rested, and exercised to exhaustion. The researchers then documented lactate, glycogen, gene expression, inflammation, and mitochondrial production using repeated muscle biopsies. The immediate post-exercise biopsies confirmed that the men did exercise to the point of muscle damage as measured by microscopic tears in the muscle fibers. Then 10 minutes after the exercise ended, one leg was massaged  for 10 minutes while the other leg served as an untreated comparison. Biopsies were then repeated on both legs at 30 minutes and 3 hours after exercise.

Comparisons of the massaged leg to the untreated leg showed that massage:

  • activated cellular pathways associated with stretch as early as the first measure, meaning the cells detected the stretch of the massage;
  • reduced activity in pathways that promote inflammation at both measures, significantly by 3 hours;
  • turned on cellular systems associated with reduced cellular stress and enhanced repair;
  • increased the number of mitochondria by the 3 hours mark; and
  • did not reduce lactate and or improve glycogen stores.

If this research is confirmed, one mystery may be on the way to a solution. Our muscle cells do make beneficial changes in response to massage after exercis. Capturing the optimal massage methods and timing for specific goals is the next mystery.

Until then, relax and enjoy. Is there a massage therapist in the house?

K. Hartmann

khartmann@thedelta.com

References:

R. Torres and colleagues. Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: Systematic review and meta-analysis. Physical Therapy in Sport, 2012 May;13(2):101-14. PMID: 22498151

J. D. Crane and colleagues. Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage. Science Translational Medicine, 2012 Feb (4)119: epub.  PMID: 22301554

T. M. Best and colleagues. Effectiveness of sports massage for recovery of skeletal muscle from strenuous exercise. Clinical Journal of Sports Medicine, 2008 Sep; 18(5):446-60. PMID: 18806553

A. Moraska. Sports massage:  A comprehensive review. Journal of Sports Medicine and Physical Fitness, 2005 Sep;45(3):370-80. PMCID: 16230990

Posted in Muscle, Research Evidence, Running, Strength Training, Well-being | Tagged , , , , , , , , | Leave a comment

Spin Your Core

Posted on April 6, 2012 by Dr. Katherine Hartmann

Spin gives you:

  • Complete control of level of exertion
  • Potential to burn through 500 kcals in single session
  • Benefits of interval training for igniting metabolism

If you’ve got the basics down you can get spin to give you even more by focusing attention on your core while you spin. You’ll gain good form and less injury risk at the same time.

Take on each of these challenges:

Level your shoulders: start with some stretches off the bike (shoulder shrugs, arms circles forward and back, pat yourself on the back – elbow to ceiling, palm reaching between shoulder blades), let go of any tension, and let your shoulders drop into a natural and relaxed position.  Once on the bike, look in the mirror and focus on holding your shoulders level.

Minimize the bounce: you are working harder including use of hip girdle, quads, glutes, and hamstrings when you steady your ride and grind out the leg work while keeping your body steady. At the extreme, sandbagging – shifting your body weight from pedal to pedal as you “hop” back and forth between pedals is robbing you of the work you came to do. Visual cues for avoiding the bounce include:

  • In each position (run, seated climb, sprint), aim to hold your shoulders level and steady in that position by minimizing up-and-down, and side-to-side movement.
  • Eliminate the hula motion. Look at your hips in the mirror and accomplish the same as for your shoulders. Level them through the stroke and keep them even and pointing forward – like headlights on a car.
  • If you get aching in the outer, lateral portion of your hip after spin, this focus on stabilizing can rapidly eliminate the discomfort while also increasing your ability to transfer power to your legs.

Think of spin as a plank at varied angles with only your legs in motion – draw in your abs more tightly and add chest and back alignment (below).

Focus on balance and maintaining even contact with the pedals through all the components of the stroke. Push and pull the full 360 degrees. Smoothing the bounce while using the full stroke requires you to lock in the core from ribs to hip.

Shoot your hips back for steep climbs or when hovering over the saddle (think deadlift), don’t let your knees take up the slack by putting more knee out over your toes. Hinging from the hips takes core and combined with steady hips will give you the immediate sense of direct and powerful drive.

Maintain your posterior chain: back alignment suffers for many cyclist and spin devotees. As we move into the work it is tempting to hunker down over the handle bars, rounding out the back.  Avoid letting the chest collapse, keep it open (maintain a “proud chest”), and remind yourself to do this with occasional cues to squeeze lats down and shoulder blades together.  Visually, you are aiming to maintain the same neutral spin alignment as pictured here with only the angle at the hip changing.

Adding these prompts to check your core performance will take your spin to a whole new level. We’ll know who you are in the spin room. Enjoy.

K. Hartmann, MD, PhD

khartmann@thedelta.com

 

 

 

 

 

Posted in Aerobic activity, Core Training, Fitness, Health, Interval Training, Metabolism, Muscle, Weight Loss, Weight Maintenance | Tagged , , , , , , | Leave a comment

Packing in Protein

Posted on March 27, 2012 by Dr. Katherine Hartmann

Protein won’t provoke an insulin response – meaning it doesn’t raise blood sugar and doesn’t promote storing energy as fat. Dietary protein is essential to getting and staying lean and is required for building muscle. But even with the best intentions it can be hard to maximize in your diet, especially when fish-and-lean meat fatigue sets in, or if you are a vegetarian.

Delta word-of-mouth suggests non-fat Greek yogurt is the favorite go-to for portable protein with 11 to 14 grams per serving and a modest carb load of 12 to 13 grams. Low and no-fat cottage cheese in mini-containers are similar. And at 50 to 60 calories each, low fat string cheese and Babybell’s with 9 grams of protein are a calorie bargain. Unsalted nuts including almonds, peanuts, cashews, and walnuts also make good portable sources if you pre-package portions into snack-size ziplocks to keep the associated calorie and fat contributions in line.

Protein bars may be a snack solution, but look carefully, the calorie and carbohydrate load can be high and those with fewer calories may use sugar-alcohol substitutes that can cause GI distress. Among the best for carb-to-protein ratio is the Cliff Builder’s Bar with 22 gms of sugars and 20 gms of protein, weighing in at 270 calories. Make the same considerations for gelatin-based protein products like Protica. Read labels carefully and remember not all “natural” sugar substitute are easy on the gut; start with a test serving before adding multiple servings to boost protein. To get a full 2o to 25 gm serving or more, protein powders (especially whey protein) are readily bioavailable and are ideal after work-outs in a smoothie or in skim milk.

Eggs are a common option with  6 to 7  grams for the average large egg (3 to 4 gms per white). Consider hard boiling a batch over the weekend to make them portable during the week. If you’ve got breakfast egg boredom and need speed in the mornings, flip an over-easy egg in a non-stick pan with cooking spray and drop it onto a hand full of prewashed spinach with 1/4 cup of non-fat feta crumbles – total time around five minutes for 14 grams. Add plain egg whites to increase protein without cholesterol.

Working protein into side dishes and meatless stir fries can also load in the grams. Tempeh, like wild rice or flax tempeh from Lightlife, is ideal. A 4 ounce serving has 21 gms of protein with 12 of carbohydrate of which 11 gms are fiber, and all the fat (11 gms) is “good fat” from vegetable sources. Beans are often the standby protein source in a vegetarian diet. For a speedy Italian twist that maximizes protein and amplifies complex carbs and fiber, lightly brown tempeh in olive oil flavored with basil or garlic, add jarred or fresh tomatoes (or low sugar/low sodium pasta sauce), and finish with canned organic cannelli (white) beans. Refrigerate overnight to let the flavors blend and serve hot or cold.

Then there are ways to sneak protein in:

  • Replace conventional salad dressings with grocery-ready options like tsaziki (a Greek topping with garlic and cucumber in yogurt) or raita (an Indian equivalent with cumin and cilantro) to add a gram or two of protein per salad with less than a third of the fat and often lower carbs. Trader Joe’s has good versions of both.
  • Stir protein powder or egg whites into oatmeal (wait for it to cool just a bit before adding half a scoop and stirring until smooth) or shake powder with skim milk before pouring over whole grain cereal. (Unfortunately most brands separate in coffee so can’t be added to low fat creamers or straight.)
  • Crumble egg (with or without yolk), low-fat feta, or low fat bleu cheese in salads or as toppings.
  • If you’re not curbing carbs look for cereals, waffles, and even tortillas with added protein.
  • Favor whole grain breads over those made with wheat or white flour because the protein content is higher and the glycemic index is lower (less blood sugar elevation).

The sources will add up over the course of the day and can contribute up to a serving more protein without big changes to meals. Have favorite strategies that help you eat more protein (other than meat and fish)? Pass it along in the comments below.

K. Hartmann, MD, PhD

khartmann@thedelta.com

 

 

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Fueling Your Body (Video Pick)

Posted on March 22, 2012 by Dr. Katherine Hartmann

Dr. Terry Wahls, physician researchers at University of Iowa, and previously a patient with severely progressive multiple sclerosis (now resolved – she believes by nutritional intervention*), lays out her concepts about how to meet nutritional needs from whole foods.

In the context of research evidence about nutritional needs, Wahls challenges her audience to abandon processed foods, eat fresh vegetables and fruits across three target categories for nutrients, and include fish as well as meat from grass fed animals. Indirectly she is describing an approach that has also been termed a paleolithic or primitive diet. This description of a paleo approach from a vantage point outside the weight loss and body building hype is inspiring and refreshingly clear while focusing on medical accuracy.

K. Hartmann, MD, PhD

khartmann@thedelta.com

*No published randomized trials documenting the effectiveness of this intervention for multiple sclerosis are yet available. Prelminary data was first reported in 2011. This blog is not intended to provide medical advice; always work with your health care providers when seeking to make changes to address specific medical conditions.

 

 

 

 

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Practical Prep for Boot

Posted on March 12, 2012 by Dr. Katherine Hartmann

Boot is a challenge – a full-on commitment to changing your lifestyle and achieving new goals.  Your best preparation is to have on hand the things you’ll need, aim for comfort and convenience, and simplify where possible.

 

1)      Start from the ground up.  Not sure if your work-out shoes can go the distance?  Get a consult at a local sporting goods store staffed by real trainers.  Explain you’ll be putting in 10 to 14 hours in cross-training each week and share information about any prior injuries or recurrent strains.  Consider adding inserts as stiffer insoles can reduce joint strain – too much cushioning can stress joints by requiring constant compensation for the padding.  Make sure your toes have room and take advice to go up a half size if it applies to assuring room.

2)      Pedicures ladies and gentleman.  See item #1 – you’ll be logging hours in motion on your feet.  Pressure on the nail bed, bruising under the nail, and loss of toenails can happen.  Prevention starts with a short trim.  Well-cared for feet will take you a long way towards comfort.

3)      Get familiar with a heart rate monitor.  Polar brand has staying power; high ratings in comparisons; and most models are pool worthy.  Get the basic settings programmed and play with the features – you’ll come to love the daily and weekly summaries of heart rate range, total time, and total energy expenditure.  While not the most user friendly software interface, the cradle that allows up-load to the web is a bonus for tech junkies who will appreciate the graphs and ability to manipulate and compile work-out data.

4)      Double up.  Have two of everything.  When you are tired or running late is when you’ll misplace or need replacements for key items.  An extra pair of shoes, work-out clothes, water bottle, and heart monitor transmitter batteries and strap in the car trunk will get used.  Duplicates of all your usual grooming products in your gym bag makes it easier to feel like you’ve had a normal start to the day.  Duplication also assures you don’t end up with favorite shaving gear or lipstick left in the locker room or the bag in the back of the car when you wish it was in the house or with you.  Cutting the hassle factor makes the real demands of Boot more manageable.

5)      Identify your supply line.  You’ll be hunting down healthy food, protein sources, and options for quality on the fly.  How it all fits your plan will vary with time and tuning.  No need to buy cases of anything.  Your needs and preferences will change.  But this is a good time to figure out among the fresh fruit; low fat string, cottage, and ricotta cheese; high protein bars; nut butter; steel cut oats; flavored whey protein, and Greek yogurt brands what has appeal.  Pre-boot is also a good time to figure out your favorite no or low-fat egg and egg-white; vegetable; fish, lean pork and beef; and salad recipes.  Practice making it portable by finding small portions (mini-raisin boxes; single serving tuna; frozen steal cut oatmeal); stocking up on re-usable containers; and pre-packaging from bulk to smaller sizes (almonds, high-protein cereals) for briefcase or purse. 

6)      Pack your tunes.  You’ll stay at it longer and harder with music that keeps you in the flow.  Make or find mixes that keep the beat at 120bpm and above and you’ll set a pace worth keeping.  Refreshing your music as well-as your work-out breaks boredom and maximizes intensity.

7)      Hang time.  If you’ve got weeks before Boot, consider ramping up with a strength trainer two to three times a week.  Add a graduated increase in target calories burned in aerobic activity and you can amplify your results.  For even more preparation talk about adding DeltaTrac for both diet and nutrition planning in the run-up to Boot.

K. Hartmann, MD, PhD

Boot changed my life – it was much, much more than 30 pounds in 1o weeks. The commitment and results proved anything can be changed. Before Boot I had given up walking stairs, blaming a bum knee; I put my purse behind the driver’s seat because it hurt my shoulder to reach it across to the passenger seat; believed that waning balance and lack of flexibility were age catching up with me; needed folks to move my luggage because of back pain; couldn’t get a good night’s sleep; knew I didn’t have time for serious exercise; and never expected to see my pre-pregnancy bodyweight again.

Three years from Boot I still live in a new body that can do so much more than I had ever asked it to do. Now I run stairs, love presses, deadlift more than my bodyweight,  exercise for the joy of playing, and sleep likc a rock. But yesterday I looked all the way over my shoulder to see behind my car without needing my old habit of taking off the seatbelt and it struck me that it was probably the more subtle gains from diet, and energy, and truly functional fitness that make it all worthwhile. Boot will give you gifts you never expected if you give it your all. Wishing you all the best as you work it out.

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Rowing Basics

Posted on February 29, 2012 by Dr. Katherine Hartmann

Want your whole body to be “all in” for your interval or endurance training? Leave the treamill and elliptical behind and pick the erg.* The ergometer or rowing machine is an ideal option for amping your calorie burn, promoting multijoint dynamic flexibility, focusing on core, building integrated back and shoulder strength, and adding variety.

A few technique pointers is all it take to transform the erg from a two-minute tool to jump up your heart rate during circuits to an exercise choice in its own right. Before strapping in, set the tension on the damper (which at The Delta is a water resistance system) this is on the right side of the water fly wheel. Starting between 6 and 8 is a good all purpose starting point for longer rows if you are already fit; start lower if you are building aerobic capacity. Assure your heel is seated well in the foot plate and that the strap is adjusted comfortably over the ball of the foot or mid-foot (not out over your toes or too close to your ankle so that it either falls off or rubs). Turn on the monitor and you are set to begin to establish your stroke which is made up of the drive (working component and the recovery). This video breaks down the technique clearly including range of back motion, position of shoulders, and proper form throughout the stroke.

 

Remember not to over-reach when you are moving towards the fly wheel. Your shins should remain vertical and motion of the upper back and shoulders stays between the 11 o’clock and 1 o’clock position. The ratio of the drive (work phase) to the recovery (sliding forward) is easily established as one count for the drive and two counts for the recovery. The conventional breathing pattern is to exhale on the drive (during the maximal effort and lock in off the core) followed by deep inhale on the recovery.

You can adapt virtually any interval workout to the erg. For higher intensity increase your SPM (strokes per minute) which are shown in the upper right hand corner of the monitor or focus on a shorter split which is shown in minutes and seconds on the left middle side of the monitor as time to complete 500 meters. Conventional ranges for long distance/low intensity are 17-19 SPM, low moderate 20 to 24, moderate 25 to 30, with “sprint” interval and competition rates above 30 SPM. But watch the power output and splits, you don’t want to shorten the recovery to 1:1 ratio and frantically increase rate while not increasing output. More intensity comes from a quicker, stronger drive not humingbird speed strokes.

A few last cautions. Do dynamic flexibility warm-ups and don’t start rowing cold. At any point if you body is telling you that an isolated joint or your back is not happy, stop and get a consult from a trainer. Don’t set out to row 5,000 meters on your first row – build up technique and endurance as you determine your tolerance for higher intensity segments followed by recovery. The first few uses that you plan of 10 minutes or longer, stop half way through your planned row, stretch and return to the erg. Over 3 to 5 sessions you will likely be able to build to a similar duration to other forms of interval training that you do within a single, no-breaks row.

Load you play-list and away you row. Looking forward to seeing the erg in consistent demand.

K. Hartmann, MD, PhD

khartmann@thedelta.com

More video links on technique:

More on getting started: http://www.ehow.com/video_2346818_rowing-machine-exercises-beginners.html

Common errors: http://www.concept2.com/us/training/technique.asp#error

Building intensity: http://www.concept2.com/us/training/technique.asp#intensity

* This blog is not intended to provide personal medical or training advice. Consult with your care providers and trainers to plan an appropriate program to help you reach you fitness and performance goals.

Posted in Aerobic activity, Core Training, Diet, Energy, Fitness, Flexibility | Leave a comment

Protein for Intensified Endurance Training

Posted on February 26, 2012 by Dr. Katherine Hartmann

Carbohydrate loading before and during periods of intensified training or competition is ubiquitous among endurance, team sport, and other athletes like tennis players whose training demands fluctuate. Increasing carbohydrate intake before, during, and after exertion has been shown to partially protect against physical and psychologic stress associated with increasingly demanding training or competition schedules. Carbohydrate loading also buffers against decreases in performance and rapidly restores glycogen levels in muscle.

The downside is the difficulty of maintaining stable or only modestly increased calorie intake while increasing carbohydrates. Pasta, rice, bread, juice and energy drinks add up and calorie intake can easily overshoot the need for increased calories associated with heavier exertion in training. Carbohydrates also consistently trigger an increase in insulin which directly cues the body to store any excess calories as body fat. Carb loading is the explanation for why novices preparing for half or full marathons can put on rather than loose weight during training. Carb loading and remaining weight neutral with a nutritionally balanced diet is a challenge.

Scientific evidence may support an alternate strategy to cabohydrate loading for endurance activities. Based on compelling data about the short term benefits of protein supplementation around the time of exercise, researchers extended the model to look at effects during a three week training cycle in endurance trained cyclist. The cyclists completed three weeks of training which were: 1) normal intensity, 2) increased intensity, and 3) recovery. Among the athletes who participated, their usual prestudy diet was 2,882 kcal a day including on average 1.6 grams of protein per kilogram of body weight a day, 5.4 grams/kilogram carbohydrate, and 1.3 grams/kilogram of fats. During the three week training test, this was modified to assure the same number of calories in both a normal diet and higher protein condition without the athlete’s awareness of which set of standardized meals they were receiving. During the increased protein three-week training test, the research participants consumed almost twice as much protein: 3 grams per kilogram of body weight per day.

In this proof of concept study with multiple physiologic and psychologic measures, the research team found that the increased protein diet did not reduce training volume or intensity. The increased protein condition was associated with <1% risk of worse performance than the standardized usual diet and was associated with 30 to 48% higher probability of improved performance during the high intensity and recovery weeks. No difference in heart rate patterns or stress hormones was observed across the two diets and the protein enriched weeks were not associated with greater subjective sense of fatigue or stress, or with adverse changes in sleep quality.

Take home message: early evidence suggest protein loading (at levels similar or even higher than those recommended in Delta Boot) while holding calories constant can improve performance in conditioned athletes with no adverse effects. We know protein consumption near the time of exertion restores and builds muscles. It’s worth keeping an eye on this literature. If protein has consistently proven performance advantages it is worth a individual test during your windows of increased training and recovery to find out if you are among those who do even better with more protein during intense training.* If so, the best news is that you can avoid the potential costs of repeated carbohydrate loading while still ramping up training intensity with great results.

* This blog is not intended to provide medical advice.  Consult with your care providers and trainers to plan an appropriate program to help you reach you fitness and performance goals. High protein intake can be harmful to those with kidney, liver, or other chronic diseases.

References:

Witard, O. and colleagues. Effect of increased dietary protein on tolerance for intensified training. Medicine and Science in Sport; April 2011, Epublication ahead of print.  PMID: 20798660

Phillips SM and  Van Loon LJ. Dietary protein for athletes: from requirements to optimum adaptation. Journal of Sports Science. 2011;29 Suppl 1:S29-38. PMID: 22150425

K. Hartmann, MD, PhD

khartmann@thedelta.com

 

 

 

Posted in Aerobic activity, Diet, Energy, Fitness, Health, Metabolism, Muscle, Nutrition, Research Evidence, Running, Weight Maintenance | Tagged , , , , | Leave a comment