The Five Pillars of Good Health

March 22, 2013 By
When we talk about ‘fitness’ or ‘health’ definitions are often blurred. Inwardly the fitness industry tends to focus heavily on body composition, size, and strength, while outwardly our health service and medical industry have real concerns over obesity, diabetes, and the rapidly increasing elderly population.

There is still a major disparity between the two camps, though in reality the two are closely linked. The fitness industry by its nature seems to attract those who are younger and have less interest in the long-term health aspects of exercise and fitness. Through the rise in media surrounding how we look, rather than how we feel, it has become far more trendy to post pictures of six-pack transformations and large muscular physiques than case studies of improved health, daily function, or disease reduction.

Nevertheless, the two need not be mutually exclusive, although it is questionable that we should sacrifice the latter in search of the former. If our clients are truly in search of ‘feeling’ better, we need to take a wider look at their health and know that if they can get those aspects in line, they will not only feel they look better, but also feel better about how they look.

1) Emotional Health:personal trainer liverpool street

The increase in depression, eating disorders, stress-related illness, and dependence on medication is frightening. Our ability to change our habits and improve our health is built on a foundation of being able to emotionally cope with change, and the realisation of the need to do so. Obesity lives at one end of the eating spectrum, while obsessive eating behaviours and eating disorders occupy the other. Both are unhealthy but are all too easily formed. For many who feel a lack of control in other aspects of their life, eating habits can quickly become the anchor to which they attach a need for control. Of course, eating is not the only vice chosen. Alcohol, drugs, smoking, gambling, violence, and promiscuity all form conduits by which people try to find some escape from their unhappiness. For those wanting to make changes to their life, addressing emotional health is the place to begin. Recognising this and then taking steps to improve it is a necessary start to living a life free of unhealthy emotional attachments and destructive habits.

Tip: Many factors affect our emotional health and the reality is that we will all have to deal with difficult and unpleasant situations in our life. Adopting healthy habits and hobbies that bring us pleasure, be that owning a pet or taking up a sport, improve our ability to deal with these situations and minimise their impact on our overall health. Find something you’ve always wanted to try or experience and go do it. Searching out new and exciting experiences is always rewarding. Support this with a diet high in unprocessed foods and vegetables, healthy sleep patterns, and minimising substance/stimulant use that tend to have a depressive effect.

2) Joint Health:personal trainer shoreditch

While working out is often associated with building bigger muscles and improving muscular strength, it is far less trendy or sexy to talk about joint health. However, when our joints start to break down or are injured, the effects are debilitating. This is why we place such a large focus on flexibility when working with our personal training clients. While the benefits of resistance training are plentiful and well-established, it does carry the potential to increase wear and tear on the joints of the body. Of course, this may not manifest itself to some way down the training journey but, when it does, it will be much harder than muscle damage to recover from. Our joint structures turn over far slower than our muscles and once damaged will be hard to repair. Couple this with the effects of age, poor nutrition, and a sedentary lifestyle and the importance of attention to joint health is obvious.

Tip: Bodybuilder Reg Park (Arnold Schwarzenegger’s idol) recognised many decades ago that there was value in taking lay-offs from heavy resistance training loads. While this may be a bitter pill to swallow for those competing in strength sports, it shouldn’t be so hard to swallow for those for whom long-term health is a consideration. Breaks from high volumes of resistance training, coupled with a healthy respect for flexibility and nutrition should provide a recipe that makes weight training a lifelong pursuit. Similarly, so many people ignore the signs of poor joint health and continue to load joints through a fear of ‘letting go’ of their strength training schedule. Stretch tight areas, improve range of movement, and allow rest and recovery when joints start to tell you that they need a break. Activities like yoga, pilates, and tai chi can be a fantastic balance for heavy resistance training.

3) Digestive Health:

The digestive system is a powerful window into our health. Modern research is identifying the role of the various elements of gut health and are even starting to show links between digestive flora and obesity, plus we all know the effects that stress, anxiety, or excitement can have on our stomachs. Our digestion can also suffer when confronted with foods that provide a greater challenge than it was originally designed for. Diets high in wheat, gluten, refined/processed foods, all increase the burden on the gut to effectively break down and absorb nutrients, which can affect everything from our mental health (95% of our serotonin is found in the gut) to simply cramping our social life when suffering from bloating and stomach ache. It isn’t just our diet either that can cause digestive problems. Prescription medication often has detrimental impacts on gut health, ranging from the damage caused by NSAIDS to our stomach lining to the effect of antibiotic use on digestive flora.

Tip: If you suffer from poor gut health, an elimination diet can be a useful way to determine what causes you problems. Taking out key troublemakers such as high wheat foods can often have an immediate impact on improving digestion. Often including foods like pears, nectarines, and prunes can help smooth digestive transit along with a good intake of water. Try to avoid using over the counter medication where possible, in particular known gut irritants like Ibuprofen.

4) Metabolic Health: personal training shoreditch

With so many of our clients attending regular health screenings and operating in high stress environments it would be foolhardy to be ignorant of metabolic markers of health. From aerobic capacity through to blood lipid levels, these tests can provide insights into the possible risk of long-term health problems. It is a shame that these medicals give little attention to measures of inflammation and blood triglycerides, which to me would seem more pertinent as the paradigm surrounding heart disease risk gradually starts to shift. Aside from that debate, blood pressure, waist circumference, and resting blood glucose provide an excellent insight into our clients health and we have consistently seen these drop markedly in our clients with a bit of attention to diet, a reduction in alcohol intake (note total abstinence not required), and the addition of some cardiovascular exercise, which our clients enjoy both the physical and psychological benefits of despite its vilification in recent times by countless fitness experts and personal trainers.

Tip: Metabolic markers of health can often be considerably improved with simple and easily sustained changes to diet, lifestyle, and exercise habits. Reducing alcohol on several days of the week, lowering sugar and starch intake, taking some exercise over the weekend, and managing stress all combine to have a powerful effect on improving health.

5) Dental Health: 

The last part of this little post is to look at dental health and the emerging data linking heart disease and dental health. I won’t get into all the hubbub surrounding fillings and heavy metal poisoning etc; it’s way beyond the scope of this post and I’m way under qualified to comment on it. However, one thing is for sure and that’s that we only get one set of adult teeth so we had better look after them. Many habits that affect our health negatively can also impact on our dental health causing tooth decay, gum disease, discolouration, acid erosion, and bad breath. All equally bad news, but a very quick and easy way to get a window into someone’s overall health is to look inside their mouth. Stress, anxiety, and stimulants can cause teeth grinding (the official name is Bruxism) which also accelerates the wear and tear on our mouth. In a 2010 study, those participants with the worst oral hygiene routine were 70% more likely to develop heart disease compared to those who cleaned their teeth twice a day. Whether it is causative or simply correlation remains in debate, in a similar way to how we should be viewing cholesterol in reality. However, gum disease (gingivitis) is an inflammatory condition and modern health research is showing us that for many years inflammation has been the elephant in the room when it comes to heart disease.

Tip: Brush your teeth twice daily, preferably with a electric toothbrush and careful attention to teeth, tongue, and gums. Get teeth professionally cleaned by a hygienist twice a year, and avoid habits that damage teeth, such as smoking and fizzy drinks.

So, there you have it. Five pillars of health that when combined give an insight into our overall fitness outside of the now more mainstream measures of BMI, Body Composition, or muscularity. What’s more is that very few of these require much effort to monitor or measure, with the exception of some aspects of our metabolic health that can be easily tested with home kits or via private medicals. Address, and in turn improve in, all the above areas and it is highly likely that you’ll see an accompanying improvement in how you look, feel, move, and function as our body remodels itself to the demands placed on it.

Often health improvement is less of a consideration or motivation for many taking up exercise, but for those clients we see at our City of London studios it will often be a high priority as they notice their decreased ability to cope with the stresses of the modern workplace and lifestyle surrounding it. As with much of our work, simple changes can have profound effects. Tackling the ‘big rocks’ within our clients lives, and strengthening them through intelligently applied resistance and cardiovascular training provides a platform for them to continue to enjoy their work, families, and leisure time.

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Health Dreams vs Reality 2: Training Recommendations for City Guys and Girls

March 5, 2013 By
Health Seminar

Graeme at our latest successful corporate health and fitness seminar

In the first part of this little blog series Graeme Marsh, one of the few personal trainers who has spent over a decade working with desk bound workers in the City of London, talked about a few general recommendations for health and nutrition when working with the general population.  It seemed only natural to expand this into the actual training aspect; what we do in the gym with our clients and why:

First up, to avoid attracting the barbed quills of keyboard-based trainers out there, we should qualify a few things about our typical clients. They are usually over 30, or more commonly over 40 and have more interest in their general health than they do achieving ‘X’ % body fat or ‘Y’ Kg Bench Press. Most of our clients, but not all, do very little ‘training’ on their own, but often enjoy recreational activity. These girls and guys are also really smart, and can smell the kind of bullshit the fitness industry likes to peddle from a mile off, so we keep it simple, direct, and straightforward. Our clients are the definition of the time poor professional, so the training and the advice we give is designed to work with their lives, not against it.

As with the previous post, I haven’t bothered to find references to back everything up. So-called ‘bro-science’ is very out of vogue these days and if you aren’t referencing ten papers per statement you now risk being ostracised for being ‘non-scientific’. I’m all for sports science, I even got an MSc in it  7 years ago, but as usual the pendulum has swung the other way and we are forgetting that training people in the real world is a long way from studying university students in a lab. I spent a lot of time when I was younger writing from a position where my academics outweighed my experience, but with over a decade in the city training clients now I feel confident that a combination of the two is a good place to come from. Besides, you won’t find many studies on how to train a 45 year old banker, so you’ll just have to trust me on some of this. However, that said, I’m reasonably confident most of these conclusions are borne out in what evidence there is.

  • Most people do way more than they need to (particularly when starting out) and often way more than they should do when it comes to work sets. This is a double edged sword, not only does it seriously hinder recovery, it is inefficient, tiring, and usually done at the expense of other less-trendy fitness qualities (such as flexibility or endurance)
  • There is too much focus on how much weight is lifted and not enough on how it is done. Unless you’re competing in a strength-based event, the actual number on the weights is merely a tool to measure progression. Effective muscle recruitment demands an attention to technique often missing in the average gym member.
  • Much like nutrition, exercise is a lifelong habit, therefore long-term compliance to, and confidence in, your methods is of importance.
  • It’s really fine to stretch people first. Really, it is. They aren’t about to leap up and try for a 1RM snatch or 30m sprint so if people have restricted range of movement in the hips and shoulders don’t expose their joints to risk by loading poor movements. I’ve been doing it for ages without seeing any negative effects, to the contrary I’ve seen good improvements in clients movements and self-reported feelings of improvement and progress through making flexibility a focus in those that need it. Combined with an appropriate warm up this way seems more effective at building better movements. Once these movements are well established, less work is needed to maintain them.
  • The Tabata protocol is misunderstood, overused, and under delivers. If they aren’t on a wattbike hitting 170% of Vo2 max, then it isn’t ‘Tabata’ -Swings and Planks don’t cut it. Conventional interval training, adjusted to target the desired energy system, is though far more time efficient than steady state training both for fitness and body composition. This doesn’t mean that we should discourage people from doing any exercise that they actually enjoy and feel the benefits from. A bit of lower intensity CV work or recreational sport should be encouraged and most people are more likely to do this anyway.
  • I prioritise high intensity weight training with female clients, but I do so because it is the thing they are least likely to do on their own due to the atmosphere in most weight rooms around the city.
  • The fitter and stronger the client, the better the tolerance of both intensity and volume (and greater the need for adequate recovery when working at higher levels). You’d think this common sense but you still see people with a 4 week training history being pushed to max rep deadlifts……that’s a lawsuit waiting to happen
  •  Train their arms directly. I know, I know, chins train the arms – if you can do them for sets with good form. Most people can’t – so, if you want to get stronger and better looking guns start close grip pressing and barbell curling. How curls ever got relegated in favour of ‘functional’ training I’ll never know.
  •  Speed of movement is a really effective training variable when followed, but some people just don’t have the attention span. Slow and Fast works for them. Pick your battles.
  • Timing rest periods is a fundamental of any competent trainer or trainee. If you aren’t timing your rest periods then you may as well use random weights and reps for every set too.
  • Single Leg and Single Arm stuff can be great, but it doubles workout time and therefore reduces workout efficiency by 50%. I tend to use it sparingly and generally when people are starting out. So-called ‘unstable surface’ training is pointless and ineffective.
  • Making someone ‘really sore’ should not be used as a reference for the quality of the training session (same goes for making someone throw up).
  •  The Good Morning has to be one of the most underrated exercises out there for people who spend ages at desks and on planes.
  • Unless competing in a strength contest, your primary goal with resistance training is to recruit muscle effectively. Too often the movement and the load are given priority over the muscles used to achieve it. This is training for injury not injury prevention.
  •  It’s better to use exercises with short learning curves. You can often achieve the same results but with less time spent mastering technique than using more complex movements.
  • Sure, full squats and deadlifts are great, but new clients have a whole training life ahead of them so don’t feel like they have to be doing those movements from week 1, especially as most people who’ve spent 20 years at a desk will lack the muscle recruitment and movement patterns to perform them in a way that doesn’t make my teeth hurt when watching. Set an effective foundation from the start so when they start with the big movements they can experience success long-term.
  • Continually working to failure week-in, week-out is probably the fastest way to stall someone’s training. Time spent mastering reps at a level close to but below technical failure (or as Ian King coined the term, their ‘Technical Limit’) builds confidence and volume at higher loads. Cluster training is brilliant for this as is Progressive Wave Loading.
  •  Periodisation in it’s purest form is great for Olympians but a sledgehammer to crack a walnut for average city folks. Life itself provides a ton of natural variation. Have a basic idea of what qualities you want to focus on but be prepared to moderate/increase/reduce dependent on nutrition/rest/stress/mood.
  • As far as periodisation goes, we will sometimes focus on one quality more than another, but rarely at the total expense of another. Generalised training outcomes (lose weight, tone up etc) don’t require overly specific means.
  • Measures of health tend to mean more to us than measures of ‘gym fitness’ ie: body fat %, strength in certain lifts, or overall muscular size.
  • When people say their ‘core is weak’ they really mean ‘my back is weak and my glutes need to start working for me’. I barely do any ‘abdominal’ work with people, but we do a ton of back strengthening, particularly before we start squatting or deadlifting heavy. See earlier point on the Good Morning.
  • Most guys aren’t as obsessed about ‘getting big’ as the fitness industry itself is.
  • If someone struggles to even get to sessions on time due to work and life commitments, don’t bother trying to get them taking supplements – it’s a waste of your time and their money.
  • Yoga movements make brilliant warm ups, they’ve now become known as ‘dynamic warm ups’ in an American rebrand.
  • Every now and then mix it up and reverse ‘conventional’ exercise order, it creates a stimulus for adaptation and prevents imbalances in training developing.
  • High volume workouts tend to leave people too wiped out to go back to their desk, let alone come back and train two days later. Use volume sparingly as it will create a ‘recovery hole’ quicker than other programme variables. Doing large amounts of sets in one line of movement also requires balance with others and this can be difficult to achieve on 2-3 x week schedules. It doesn’t mean I never use it, but right place, right time is key.
  • City workers tend to work late, sleep late and poorly, drink regularly, and have high stress loads, but by some sort of Darwinian career choice they seem to thrive on this far better than most. Experiment to find the right balance of volume and intensity for each client. Women tend to tolerate greater volumes but this may be because they generally tend to spend less time training near their max. Performance can ebb and flow, tweak routines accordingly, sacrifice volume before anything else (both in terms of resistance training and interval/energy system work).
  • You don’t get to work in a highly paid city job where you can hire an expensive personal trainer twice a week without knowing a thing or two about determination, dedication, and motivation. But, they may not find exercising as fun or interesting as a PT does. It is the trainers job to bridge the gap and find a way to keep the client well-informed, accountable and motivated. Results are a good place to start, as is accurate empathy, honesty, and integrity. The ‘best’ way may not always be what the textbooks, training courses, or even people like me on the internet tell you it is. Find your own path.

Most of this is common sense but quite a bit of it seems to go in the opposite direction to what is currently popular within the fitness industry and media, so that’s about it before this turns into more of an essay than a blog post. . As the Philosopher John Locke said “I will not deny, but possibly it might be reduced to a narrower Compass than it is; and that some Parts of it might be contracted: The way it has been writ in, by Catches, and many long Intervals of Interruption, being apt to cause some Repetitions. But to confess the Truth, I am now too lazy, or too busy to make it shorter.”

You can read the first instalment of this series here: http://www.foundryfit.co.uk/blog/healthdreamsvsreality/

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East London Women’s Rugby Club scores help from RBS

January 22, 2013 By
personal training london rugby fitness

Neil Rudge (front row, right) presents the RBS sponsorship cheque to East London WRFC Chairman Dave Thomas (front row, left), Fiona Pocock Head Coach and the ladies team

January 2013 – East London’s newest women’s rugby club has received financial sponsorship from The Royal Bank of Scotland as it looks to capitalise on increased interest in the sport from the local community.

The club, East London Women’s Rugby Club (EL WRFC), is based a stone’s throw from the Olympic Park in West Ham and was started in 2012. Run by Dave Thomas, chairman of The East London Woman’s Rugby Football Club, and Fiona Pocock, England international rugby star and now coach of the new women’s team, it shares its ground with its male counterpart, East London Rugby Club. The club has long been connected with promoting equality in sport and giving back to the community and was the base of the world’s first openly gay and bisexual friendly rugby team – The Kings Cross Steelers.

Interest in women’s rugby has gained momentum in recent years – thanks in no small part to the success of Pocock’s England team – and is one of the fastest growing participation sports in the country. The RFU, governing body of rugby union in England, says that more than 13,500 women and girls now play ruby regularly – an 87% increase since 20041. With woman’s rugby confirmed as an Olympic event for 2016, EL WRFC is hoping to help grow the game’s popularity among young women in the heart of London. With 25 members already on the books of the club, the money from RBS will be utilised to purchase new equipment and help promote the side as well as raise awareness of the game among the local community.

Fiona Pocock, head coach of EL WRFC, said “I obviously love the game of rugby and am privileged to play for my country. It’s a fantastic sport for a number of reasons. It helps with your health, your self-belief and your self-discipline as well as much, much more. I jumped at the chance to work with Dave and coach the girls here. It is something I’ve always wanted to do, and it wouldn’t have been possible without the funding from RBS. The main focus for us right now is to grow the club’s numbers, to give the chance to women from all walks of life, from right here in West Ham, to those working in The City. We feel it is important to make rugby accessible for as many women as we can. Local universities have already provided a number of new joiners and with the help from RBS and the local council, I’m proud to see the club and the game continuing to grow.”

Dave Thomas, director of health and fitness business The Foundry and a trustee of the rugby charity School of Hard Knocks, a social inclusion scheme that uses the game of rugby to teach participants crucial life lessons and core values, has seen first-hand how sport can help a community, he commented; “Having played rugby all my life, I’ve been part of many teams throughout the UK, and with my previous work with School of Hard Knocks, have seen how much good the game can do for a community. As soon as this opportunity arose, I got in touch with Fiona and with the financial help from RBS we began this journey to help women play a sport we believe is not just fun to play but teaches you valuable skills that can be utilised in everyday life. We are absolutely delighted that RBS have chosen to support our ambitions – without them none of it would be possible.”

The RBS involvement was spearheaded by Neil Rudge, Managing Director, London Client Coverage who said; “Rugby has always been a sport associated with the bank, given our sponsorship of the 6-nations, but we are always looking for ways to help local communities and rugby clubs are a fantastic way of doing so. The team at EL WRFC are the sort of passionate individuals who we love to work with. They share our goal of giving back to local people who may not have the opportunities available to others. Not only is the club situated in the centre of Olympic territory, but being so close to the City – a place where open sporting fields are so difficult to come across – it is a fantastic place for people from diverse walks of life to come together and participate in a healthy atmosphere. We are absolutely thrilled to be helping the women’s game in the area, to be working with the club and with Fiona, and we are excited about the club and the sport in general continuing to grow.”

End

Notes to editors:

  1. Stats taken from official website of the RFU http://cms.rfu.com/takingpart/choose_play/womenandgirls

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Intermittent Fasting (IF) and the 5:2 Diets

November 19, 2012 By

lose weight personal training londonDieting dominates the popular media and it seems like every month the glossy magazines find another celebrity diet fad to report on. From Maple syrup to cabbage soup these are mostly ridiculous, unhealthy, impractical, and almost impossible for anyone with a normal life to follow.

Still, people do try, and they hop from diet to diet like a gym room newbie will hop from training plan to training pan in the hope of finding that magic solution. Most people end up depressed, with digestive and metabolic issues, and often worse than they were when they started out. However, in August, the BBC’s Horizon programme covered an approach to weight loss that is regaining popularity, and not without good reason.  The presenter, Dr Michael Mosley, who seemed in a rather poor state of health for a doctor at the outset, put himself forward as a human guinea pig to trial intermittent fasting (IF) with some remarkable results.

What Makes A Successful Diet?

fat loss personal trainer london

Chronic voluntary restriction of any sort is difficult if not impossible for most and it is generally only the most obsessive and neurotic that can maintain extended periods of dieting. It is no wonder that in diet studies the drop out rate can often be well over 50%.  This is also the reason that initial weight loss typically occurs over the first three months followed by a steady period of regain. In many ways the success of a diet isn’t really measured by how much lose, but about how little of it you put back on.

When it comes to successful weight loss, compliance is certainly 9/10th’s of the law and, as  a trainer, finding the right eating plan to suit your clientele is part of the biggest challenge. The research is clear that the lower people’s own confidence in sticking to an eating plan, the lower their chances of success, so it always merits looking at new (or not so new) ways to approach this and over the years I have experimented with just about all of them.

Quality Over Quantity?

Over recent years the trend has been more towards the quality of food, rather than the quantity, and ‘Paleo’ diets have been the popular weapon of choice. Caveman eating though presented some real problems for my typical client; traveling, socialising, work and family eating meant it was often difficult to maintain a truly paleo style of eating and lapses were inevitable. Without the need to get ripped for a magazine photoshoot or topless stage appearance it can be hard to maintain rigourous dedication to such diets in the face of corporate hospitality, work drinks or a dinner guest’s lasagne.

What’s The Role Of Psychology?

Another challenge of dieting, whether that is Atkins or Ornish, is the need for every single food choice to become a conscious one, which for most of us is a long way from what really happens. Dieting and weight loss as a process becomes one largely related to our psychology as much as our physiology as it is our thoughts, habits, and behaviours that tend to dictate how we eat.

Jane Ogden’s research at Surrey University discovered that we make most of our choices on food sub-consciously, which would explain why many people simply find dieting itself such a huge cognitive effort. All of a sudden they need to think about every single meal; how many carbs does this have? Is it paleo-compliant? How many calories are in my latte? Does that come with dressing on the side? It gets tiring. Aside from the tedious nature of continuous dieting, recent research suggests that it may be just as beneficial to diet for shorter periods interspersed with periods of maintenance or to first understand the skills needed to maintain weight, before embarking on a long-term diet.

So How Does Intermittent Fasting Differ?

Intermittent fasting (IF) approaches such as the 5:2 diet offer an alternative approach to the typical diet plans that require wholesale changes in how we shop, prepare, and eat our food. IF offers a potentially very simple way to improve our diet and health by introducing periods of low (or in some cases none at all) calorie fasts into the week. Some approaches, such as Fast-5 or Leangains prefer to use a daily format (fasting for 18-19 hours and then eating for the remainder) while others, such as Brad Pillon’s Eat Stop Eat or PhD Researcher Dr Krista Varady’s Alternate Day Fasting (ADF) combine cycles of ‘regular’ days with ‘fasting days’.The 5:2 diet is closer to ADF and E/S/E than the aforementioned methods and uses 5 days of ‘regular’ eating and 2 days of low-calorie ‘fasting’ where calories are limited to around 500-600 per 24 hours (or around 25% of basic daily needs). Eating on regular days is as per normal, and surprisingly early research shows that people don’t tend to binge the day after despite being free to eat as much as they choose. It may well even be that the reduction in ‘need’ to eat healthier means that people choose to eat better options more often without feeling compelled to have to do so at every meal.

More Importantly, What Does The Research Say?

Research is still quite young into these methods (I haven’t been able to find any specifically on the 5:2 format used by Dr Moseley in the BBC programme), with real long-term studies on large groups lacking, but what is there is indeed very encouraging and not just for weight loss but also for a wide range of health parameters including anti-aging and heart health. A thorough literature review and explanation of the science behind IF is well beyond the scope of this blog post although I have posted a few links below where you can find a lot more information if you are so inclined and here is a link to one of the studies authored by Dr Varady herself: http://www.nature.com/oby/journal/vaop/ncurrent/pdf/oby201054a.pdf

However, for the people that I train the real appeal of this style of diet is in the simplicity of it and the ease of application. Fasting days can be set up according to travel, work, and social schedules, and the reduction of emphasis on eating ‘clean’ at every single meal throughout the week increases the client’s belief in succeeding and sticking to the plan.

With many of my clients already eating a good quality of food, the biggest challenge has often been how to get them to eat (and drink) a little less and IF offers a possible solution to that challenge. Like any diet there will be those who try to take it to greater extremes, fasting for longer, eating less, combining it with another diet, etc and while I encourage you to experiment yourself with this I’d advise you stick to the simple 5:2 format to start with, and ensure you eat adequately on your ‘normal’ day. With exercise, it depends on your training goals to some extent although I will always prefer training fasted and aiming for a good meal post-training than the other way around. How and when you train will dictate how you set this up, along with your lifestyle and work etc. The ADF studies all began their fasted days at midnight but you may wish to move these times according to your training times or work shifts, the key is the 24 hour window on an intake of around 25% of your daily base calorie requirement.

In Conclusion

I could have written an epic on this topic and still not done it justice. I haven’t even looked at other cyclical diet methods or addressed the many potential problems and pitfalls surrounding any diet, that is an entire book in and of itself. However, IF offers a real alternative to the conventional approach to dieting that involves continued long-term calorie restriction and for most, as demonstrated by the patterns of weight regain seen, ultimately ends in failure.

IF also offers a range of other benefits in terms of simplicity and ease of compliance and while it may lack the evidence base of more established weight loss approaches, there is good scope for its future use in appropriate populations. Could IF also encourage unhealthy patterns of eating behaviour such as binging or purging? Perhaps, but there is no evidence, anecdotal or otherwise, to suggest this is the case.

There are already many different methods on how IF is used and the best bet is probably to select the one you will find easiest to integrate into your existing schedule and training plan.

Links:

John Berardi of Precision Nutrition put together an excellent ebook on the topic http://www.precisionnutrition.com/intermittent-fasting/summary
LeanGains and the various musings of the vocal Martin Berkhan can be found here http://www.leangains.com/2010/04/leangains-guide.html
Get yourself a copy of Eat, Stop, Eat here http://www.eatstopeat.com
Watch the BBC programme on the topic here http://www.bbc.co.uk/programmes/b01lxyzc
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Part 3 – Obesity Crisis – Is exercise part of the problem or part of the answer?

October 17, 2012 By
Much has been written by various experts, journalists, and researchers about the role of exercise in treating obesity and for weight loss in general. Some of it is close to the reality, while increasingly more and more of it is spurious, unfounded, non-evidenced, magic fairy dust rubbish created all too often to sell products, pills, supplements, or training methodologies.
In several articles exercise has even become the pariah of weight loss with some outlandish claims being made about all sorts of negative effects, again without any kind of substantive evidence to back these up. Read these sensationalist headlines with great care and scepticism. However, it isn’t just the Daily Mail behind this, even eminent science writer and author of Diet Delusion Gary Taubes has been quick to dismiss exercise for its effect on food consumption, asserting that exercise simply makes people eat more. An idea that is far less straightforward as it turns out when the evidence is reviewed. Taubes isn’t the only one; John Cloud’s provocative piece in Time magazine rubbished the benefits of exercise (mainly due to his own inability to resist eating a doughnut afterwards), and Emma John (Observer) and Sophie Morris (Independent) have both written pieces with a similar message.
Researching exercise*, its effect on weight loss and applying that research to the general population is a serious challenge. Studies that rely on self-reported data are immediately vulnerable to the sad truth that people tend to grossly overestimate their activity levels, while similarly underestimating their food intake.
Monitoring food intake, energy balance, NEPA (Non-Exercise Physical Activity), and other lifestyle factors makes getting truly meaningful research very difficult. This skews results horribly and may well be a reason that the role of exercise in weight loss has been so understated over recent years. Lab studies have shown a bit more promise but leave us with another problem when it comes to prescription, in that without supervision most people simply will not stick to such rigorous routines and protocols.
It was only a few years ago that the UK fitness industry jumped on the ‘Tabata Training’ bandwagon in an attempt to market a new form of training as being the magic bullet for, well just about everything including weight loss. Of course, Izumi Tabata never even measured body composition in his study, it was a study aimed at improving aerobic fitness using a 4-minute anaerobic training format that involved cycling to exhaustion for 8 x 20 second bouts. This didn’t stop all kinds of ‘Tabata fat-loss’ classes cropping up everywhere replete with misleading and incorrect information that tapped into that human desire to want to achieve more for less. As we will see, while it may be a more time efficient way for trained people to improve fitness, high-intensity interval training is of little use to the obese person. I’d venture that many of those who advocate these protocols have little or no experience of working with the obese population.
Contrary to the journalistic despair at the sheer pointlessness of it all, exercise can in fact positively affect risk factors for health irrespective of weight loss: blood pressure, insulin sensitivity, triglycerides, cholesterol, bone density, mood, anxiety, depression, stress reduction, self esteem, recovery from injury and illness, occupational performance, shorter labour times and improved pregnancy measures, fasting glucose levels, and reduction of chronic pain, have all been shown to be positively affected by the introduction of exercise. A sentiment further echoed by the Cochrane Collaboration report on Exercise for Overweight and Obesity (http://summaries.cochrane.org/CD003817/exercise-for-overweight-or-obesity)  that concluded that:
The results of this review support the use of exercise as a weight loss intervention, particularly when combined with dietary change. Exercise is associated with improved cardiovascular disease risk factors even if no weight is lost.
As we have already discovered in Parts 1 and 2, this subject is far more complex than the media and many of the pundits on the topic would like you to think, and I am about to illustrate that.
Exercise seems to have wildly different responses in different people. Unfortunately this information is often lost by people reporting (at worst) based on the abstract of a study rather than the entire study or (at best) a reporting of the mean data and not the individual results.
Luckily (and you might have just seen this coming) someone spotted this and decided to look a bit closer at the data and what actually happens. Here is a link to the complete study, the full text of which I have sitting in front of me (courtesy of the author himself, Prof. John Blundell). It is well worth a read:
Now, firstly this is a fascinating study with an excellent and very accessible discussion section that I encourage you to read in full yourself. In this study they took a group of 35 overweight men and women and got them doing 5 sessions a week of supervised exercise (in this case various formats of ‘cardio’ ranging from steppers to rowing and treadmills). Sessions were measured individually to produce an expenditure of 500kcal per session. According to energy expenditure vs intake calculations measured at week 0, it was anticipated that a weight loss of around 3.5kg could be expected over the 12 weeks.
Guess what, after 12 weeks the mean weight loss was 3.7kg (+/- 3.6kg) so about as expected. However, when the results were looked at on an individual level things got a lot more interesting. At one end of the spectrum subjects lost as much as 14.7kg of weight, while at the other end several subjects managed to gain weight (albeit very small amounts). Overall though, just about everyone (with the exception of four individuals) lost weight, some more and some less so than others…however, even those who gained weight tended to lose fat and mostly gain lean mass as the below chart from the paper shows, only three subjects in the entire study gained body fat.

The study’s authors go on to discuss some interesting theories and findings. One finding in particular was that those Non-compensators (those who tended not to increase energy intake in response to energy expenditure) tended to be heavier and fatter at the outset compared to the compensators (those who lost less weight than expected and tended to increase energy intake). One theory being that when exercise threatens lean mass (as it does in those only carrying a few extra pounds…) it drives the need to increase energy intake more than in those with an abundance of excess calories in body fat.

While this notion is an appealing explanation I am not sure it is only the mechanism behind this, although it does make intuitive sense. We do also know that in some people there is a tendency to ‘reward’ exercise by being less active throughout the rest of the day, which can reduce potential weight loss results. This reward mentality does seem prevalent and is a strong driver for the argument that psychology is a prime factor in obesity. Studies looking at eating behaviour, such as those by Jane Ogden at Surrey University have shown how certain environments and situations can influence eating, often unrelated to our actual hunger. Simply eating in front of the television has been demonstrated to increase overeating irrespective of actual reported hunger levels.

What this study does confirm is that in some people doing exercise and losing weight can serve to increase hunger, while in others this response is far less pronounced and in some non-existent. However, this does not mean that exercise makes you fat or even makes you eat more, far from it in fact. Firstly, even in the group who were compensators in this study, most of them still lost weight. Secondly, and perhaps most importantly, these subjects were allowed to eat as they pleased during the 12 weeks. Had their food intake been as strictly controlled and supervised as their exercise routine then I am very confident that the results would have been different (not to mention further proof that exercise does in fact work for weight loss when eating is controlled). Perhaps if this had been taken a step further and the study participants had been counseled on behaviours to avoid overeating, such as not eating in front of the television, then the results may have been even more pronounced. What if their sleep habits had been studied alongside the exercise? Would we have seen further improvements by attempting to improve this given the very clear relationship between poor sleep habits and weight gain?
What the studies are clear on, is that exercise is a key factor in the maintenance of any weight lost and that the addition of it to any dietary regime seems to be an overwhelmingly positive addition given its effects on mood, sleep, confidence, depression, fitness, health risk factors, bone density, metabolic rate, and stimulation of lean muscle mass.
What is capable versus what is optimal?
When it comes to working with the obese population and looking at exercise strategies it is really a case of what people will actually do versus what might be ideal. Given that the biggest benefits to the health of the population come from getting the sedentary folks moving and not from getting the already fit ones even fitter, we should be targeting the obese, in particular those who are totally sedentary, with far different strategies to what we advise an established trainee.
If our target is to address the public health aspect of obesity then a reduction of the continual emphasis on exercise as solely a weight loss tool would be wise and instead more efforts to promote the overall health benefits would be a better option. It seems to me that there are many who are relatively apathetic about their actual weight, but are concerned about their overall mental and physical health and approaches exclusively aimed at weight loss will alienate these rather than include them. Health related goals are also far more tangible and should not be viewed as a by-product of weight loss, but rather the other way around.
In terms of actual protocols, it seems conclusive that a combination of aerobic exercise, resistance training, and diet seems to have the widest reach in terms of overall health benefits and weight loss. Frequency of actual exercise is a key factor in predicting positive outcomes and has a strong inverse relationship with exercise intensity.
If advising someone to exercise who is unsupervised and currently sedentary then simple and achievable is the way forward, there is little need for complex interval training routines or resistance training formats. The less the participant perceives their own ability to complete the routine the greater the chance that they will give up and return to their former weight. In contrast as someone begins to exercise and experiences benefits their capabilities will increase and their perceptions will alter, then the training can be progressed accordingly.
It is all too often forgotten that the sedentary obese person will rarely have the joint and muscle integrity to withstand intense training at the outset anyway and any over-zealous routine could well be injurious, potentially setting the person back further than when they began. Despite this, many shredded fitness professionals (you know the types with their topless pics as avatars and disparaging attitudes towards anyone overweight) like to criticise simple approaches and continue to advise routines online that are inappropriate and show a poor level of both empathy and understanding. Expertise in bodybuilding does not constitute expertise at training obese people.
Although interactions at a biochemical level are complex, exercise has clearly been demonstrated to have a positive effect on those seeking to lose weight. Some types of exercise seem more effective than others, swimming for example has been shown to raise appetite and hunger substantially compared to running.
This effect though may be small in those who fail to give attention to other aspects of their lifestyle, while in others it may be more pronounced, albeit still below what people may be expecting for the time invested. Individual responses to exercise seem widely variable, and while it may cause some to eat more this view simply isn’t born out in the evidence as Professor John Blundell elegantly states in a meta-analysis on the topic:
Only 19% of interventionist studies report an increase in energy intake after exercise; 65% show no change and 16% show a decrease in appetite. Of the correlational studies, approximately half show no relationship between energy expenditure and intake. These data indicate a rather loose coupling between energy expenditure and intake. A common sense view is that exercise is futile as a form of weight control because the energy deficit drives a compensatory increase in food intake. However, evidence shows that this is not generally true.
As part of any nationwide intervention to address the obesity epidemic, exercise is a valuable and, in my opinion, an indispensable aid. By encouraging more sport and play in our young children we can help set a platform by which a healthful way of life becomes normal, without it always being connected to the images of ‘health’ in the media that tend to be only driven by the next skinny model or celebrity diet.
In adults, exercise can bring people together within communities and with the right prescription it can offer everyone a platform to succeed in improving their health and experiencing a better quality of life. It can have a massive effect on improving disease markers and can help with weight loss, although weight loss is not a pre-requisite for the health benefits. The actual what and when of the exercise aspect are very simple, it is getting people to do it and keep doing it that remains the complex part of the equation.
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Part 2 – Obesity, Where Do We Even Begin

October 10, 2012 By

In the first part of this series of articles, we took a look at the real extent of the obesity crisis and its worrying implications on the healthcare system. Even as I sat discussing this in my favourite Shoreditch eatery the other night it boggled my brain at the complexity and difficulty in finding a starting point for dealing with it. If nothing else you should hopefully have realised that the expanding waistlines of the UK population are not going to be fixed by any facile advice, no matter how well intended, to ‘eat less’ or ‘take more exercise’. You should also have realised that the standard (they might not like you to think they are standard, but they really are) mantras of the fitness industry probably aren’t going to do a whole lot of good either, again despite their generally good intentions.

If you had the time or the inclination to read the Foresight report you’ll also now have an appreciation of how this topic is at best vastly oversimplified, or at its worst how aspects of it are ignored. So many factors (Foresight identified 108 of them) can contribute to obesity in any given population and can often be entirely different across nations.

One of the paradoxes that we can see globally with obesity is its relationship to income. In developed countries like the UK and the US, obesity still remains highest in the lower socio-economic groups. However, in developing countries such as Brazil obesity is seen to rise as people can start to afford to increase food consumption, particularly of sugary, fatty, processed foods. This is particularly prevalent in kids as shown below, but it isn’t exclusive to them. As Brazil’s GDP increased the poorest women went from being the thinnest to the fattest in just 20 years. The speed of that transition is frightening. This has definite implications for strategies to try and prevent the increase of obesity, which I’ll expand on later.

Even the researching of these issues across populations is difficult. Meaningful numbers requires the use of large self-reporting surveys and it is widely acknowledged that people have a habit of overstating things like activity habits while understating nutritional ones. However, in one European country it does seem they are having some success in at least slowing the seemingly inevitable increase in obesity. If you read my first piece thoroughly then you may have noticed that while every country started moving inexorably upwards in the early 90‘s, Finland didn’t and their success with the North Karelia Project, which was actually aimed at reducing heart disease, shows that there is some hope. So, the question now is how we actually go about dealing with it.

What can we do about junk food?

McDonalds largest restaurant in the world was recently built on the site of the 2012 Olympics, right here in London and the signature golden arches of this global food giant have become a common feature on every high street in the UK. The spread of McDonalds into developing markets may well signal the beginning of a shift in those countries own obesity levels as the convenience, speed, and marketing of fast food becomes within economic reach of the poorer parts of the population.

There is even a ‘Big Mac’ index that can correlate the amount of labour hours required to be able to buy a Big Mac with the levels of obesity in that country. The less work required, the fatter the population. It is an indictment on the brand that only a few years ago attempted to introduce ‘healthier’ options onto its menu and whose latest ‘healthy’ addition is somehow classified as one of your ‘five a day’, despite the fact that a 500ml cup contains almost 50g of sugar. Needless to say, as the convenience food becomes even cheaper and even more convenient, less and less people are eating at home. The concept of a family meal now all too often revolves around a trip to the nearest fast food outlet.

Of course, it isn’t just McDonalds who are producing low-cost, high-margin, energy dense, nutrient poor, food for the population. As global demand for food has grown and consumer competition increased, the giant corporates behind food production and retail have striven to increase margins on their foodstuffs, robbing them of nutrients, driving intensive and non-sustainable agriculture practices, and indulging in all manor of nefarious practices. From loss-leading on known-products to blocking food labelling, the interests of these organisations currently sits at odds with the nations health. The brilliant journalist Felicity Lawrence has written about this in her excellent book Not On The Label; I’d urge you to read it.

The question is though, what can we actually do about it? Well, various options have been raised from increasing taxation on ‘junk’ food to restricting marketing and advertising. The latter is a major challenge, given that the food industry spends a voluminous amount on the marketing and brand positioning of their product. The recent Olympic games was a great example with some even suggesting that the games couldn’t run without the support of McDonalds and Coca Cola (both who contributed around £64m), Cadbury (good for £20m) and Heineken (another £10m) to name but a few.

Compared to the government budget on public food education, who in 2004 spent a grand sum of £7m, it is no wonder that the message of the fast food providers is taking precedent. However, this marketing is insidious and in places many of you may not even know exist. Take for example this website http://www.happymeal.com/en_US/index.html#/Games a blatant advertising site (you can tell by the trite warning to ‘kids’ in the top left corner) that is capturing children at an early age to identify with the fast food brand. This site for the nutritional powerhouse that is Reeses Puffs (http://www.reesespuffs.com) is even worse. Hit Mixer and get audibly assaulted with an incessant rap of ‘Reeses puffs, Reeses puffs..’ all set to a hip hop beat….catchy isn’t it? One area the government could target is junk food marketing aimed at children, yet they remain reluctant to do so.

The government did step up in 2009 launching the Change4Life campaign with a budget of £75m (still only 10% of what the food industry spent in 2004 marketing their products) only to pull the plug on it just a year later, rejecting the notion that children needed education and that instead it was the over-40’s men that was a better target. Originally slated to run through to the 2012 Olympics, the Change4Life campaign only made it a year. It is clear that the politicians prefer to see obesity as a social problem and not a government one that can be solved through legislation or regulation. Even the use of a watershed time for junk food advertising is an unpopular strategy with OFCOM highlighting the lost revenues to the broadcaster from imposing such restrictions.

There is little doubt though that the marketing and advertising of these junk food products to kids is at the heart of our obesity problem. Alvin F. Poussaint, MD of Harvard Medical School gives us a stark warning:

“Egregious advertising to children using toys to lure them to McDonald’s for low-nutrient, high-calorie Happy Meals is damaging to the well-being of children and their families. No doubt, it is one major contributing factor in the current obesity epidemic in the United States.”

Introducing taxes and regulations is one of the first arguments from the health and fitness industry but it is a solution fraught with problems and fundamentally it sits uneasily with me. San Francisco tried it, introducing a city-wide ban on giving away toys with Happy Meals. It attracted criticism from the libertarians who dislike this type of ‘nanny-state’ legislation (even the Mayor declared his desire to veto it) and McDonalds sidestepped it easily anyway, charging a token 10 cents for the toy in the price, an amount they then gave to charity. Clever.

Legislating how we buy our food is though a thorny area and I feel that top-down population wide legislative measures are likely to be as unpopular amongst the public as they would be with the food companies themselves. Handing over responsibility for choice in how we eat seems a radical and rather fascist solution and not one I am comfortable with. That said, some regulation over how such nutritionally poor food is marketed and advertised would seem a good step, still allowing free choice, but with limits on how it can be advertised, to children in particular. Obesity is ingrained into our culture, as are the fast food shops on every high street in the UK. If we are to truly reverse the current growing trend of obesity then we need to work out how we can encourage people to make better choices themselves, starting with our educational system.

Organisations like the School Food Trust http://www.schoolfoodtrust.org are trying to make inroads and in pockets of the UK there is certainly some green shoots, but against the might of the food industry it will be a tough task without some stronger support from the government.

Junk food will not disappear from the UK high street anytime soon; it will likely always be popular and some will always exercise their right to eat at these establishments. We have to tackle it from the bottom up, increasing customer awareness of the true ‘health value’ of something with clear disclosure on nutrient and calorie levels, improving food education so that young people can see what goes into these foods and learn how to cook properly, and we must work on offering alternatives that are as easily accessible and affordable, as the low-cost availability of junk food is one of it’s most alluring features.

Consumers do have the power to change it, simply by not eating there; however without the compelling desire not to, combined with the marketing efforts of these major corporations it is a big ask. More money needs to be spent countering the powerful marketing methods these companies use both through popular media avenues as well as front-line healthcare practices.

 

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Obesity, Where Do We Even Begin?

October 3, 2012 By

Where to start?

PART ONE
In 2007 the Foresight programme run by the Government Office for Science produced a report on tackling obesity. It makes for depressing and disturbing reading yet it seems to be relatively unknown in the fitness industry and to have had little impact on shaping government nutritional policy.

The report itself is captivating reading, for example the fact that of the €38 billion (yes, billion) that is directed through the EU’s Common Agricultural Policy the biggest amount, in relation to market value, is awarded to the tobacco industry. If that doesn’t worry you then let’s look at one of the report’s positive recommendations: that school sports fields be preserved and made accessible for communities. This idea was clearly rejected by that annoyingly smug-faced Michael Gove who has driven the recent sell-off of them across the UK, despite coalition ‘promises’ to the opposite. (http://www.guardian.co.uk/politics/2012/aug/17/michael-gove-school-playing-fields).

However, before I get stuck into this blog post, which admittedly could go on a bit, here is a direct link to the report so you can read it for yourself.

http://www.bis.gov.uk/assets/foresight/docs/obesity/06%20part%2002.pdf

Earlier this week I had the opportunity to listen to two of the UK’s leading experts in tackling obesity: Professor David Haslam and Professor Jane Ogden, both who presented very differing viewpoints on the whole calamitous issue. Dr Haslam is a GP and Chair of the National Obesity Forum, while Dr Ogden heads up Health Psychology at the University of Surrey.

Both were entertaining speakers, but it was Dr Ogden’s talk that seemed to resonate best with me. Her compelling research on how and why we over consume food was fascinating. You can read some of her papers here: http://www.ncbi.nlm.nih.gov/pmc/?term=jane+ogden.

It got me thinking that it is worth revisiting this topic with at least the hope of providing some kind of dim light at the end of what is looking to be a very deep, dark, and long tunnel.

Granted, you may well be thinking, why should I care? But you should because the financial impact of this alone was described by Prof. Haslam as a ‘ticking time bomb’ that will take up an estimated 17% of the NHS budget in 20 years time (http://www.diabetes.org.uk/About_us/News_Landing_Page/NHS-spending-on-diabetes-to-reach-169-billion-by-2035/).

Obesity is a one-way ticket to serious illness and disease and yet still we are a country in denial about the true extent of the problem. Short-term politics will never address long-term problems that can only be addressed through policies that will surely lead to the rapid ejection of any incumbent government. This is before we even get into whose responsibility it really is to deal with this. Should we even be relying on the government to tell us how and what we should be eating? I’m not so sure, but more on that later.

The fact is that despite all the wisdom and good intentions of the fitness industry, we are getting fatter. The UK is now the fattest country in Europe, with obesity growing here at a rate that will see UK females fatter than American males by the year 2030. Despite this the fitness industry and sadly most the trainers out there writing their sage wisdom on the topic fail to really understand this problem, what is causing it, and how we can deal with it. In fact, all too often those writing on ‘health and fitness’ seem to be creating more problems than they are solving in their ignorance.

The arguments, articles, books, movies, and musings over the drivers behind these rises though are plentiful and far too many to discuss in this post. They range from the most popular: over-consumption of foods (in particular refined carbohydrates), decreases in physical activity, and economic issues to those less discussed: environmental chemicals that can play havoc with our hormones, poorer sleep habits, and pharmaceutical obesogens. Gary Taubes recent book Diet Delusion did a commendable job in making the argument for refined carbohydrates as being the primary cause of the current obesity epidemic, although I can’t help but feel that it is as much effect as it is cause and that the drivers for this are what we need to understand if we are to effectively deal with it.

As part of the Foresight Report, an interactive map of 108 factors was created (of which only 16 are directly related to food consumption), which attempted to do exactly that. If nothing else, this map shows the total complexity of the problem. Check it out in an interactive format here http://www.shiftn.com/obesity/Full-Map.html.

Still with me? If you are then you will probably by now be realising that the advice we give to relatively lean athletes or exercisers looking to enter contests or sporting events is not the same advice we should be prescribing en masse to the overweight and obese population. Simply telling these folks to ‘eat green vegetables and lean meat’, ‘cut out the carbs’ or ‘have a high protein breakfast’ is not going to work. Atkins was giving that advice decades ago in what has become the world’s highest selling diet book and thousands more since have written books on it (including myself).

Just about every diet strategy has been tried, from low-carb to low-fat, points, blood types, food rotation, carb curfews, cabbage soup, maple syrup, and many many more. Still the obesity line climbs on the charts and graphs.

So what can we do? In the next part of this little series I’ll attempt to provide some solutions, along with the complex ethical and moral challenges each of those presents.

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