Health in the City: Dreams vs Reality

February 27, 2013 By
Graeme at our latest successful corporate health and fitness seminar

Graeme at our latest successful corporate health and fitness seminar

I recently went back to the city law firm where I gave my first ever talk here on nutrition and training, almost ten years ago and while the faces are different the questions tend to remain the same.

The public now seem more confused than ever, and it isn’t just them – the over-sciencing of nutrition by those seeking to become gatekeepers of information on this topic is making the waters more muddied instead of less. Meanwhile, the obesity bandwagon marches on, with British women on target to be fatter than American men by 2030.

As with most things Occams Razor can be applied to 99% of nutritional and weight loss cases. Very rarely is their problem down to some kind of spurious ‘imbalance’ or a deficiency in some sort of magical amino acid. In fact, all too often it is their psychology that we need to consider ahead of their physiology in all but the more extreme clinical cases involving specific and diagnosed pathology.

Looking at the folks I’ve worked with here in the City for over a decade now I’ve come to a few fairly solid conclusions. These have been borne out by practical experience rather than studying the books, although I’m reasonably confident that current research into the psychology of behaviour change will back most, if not all of them up.

So, in no particular order here are a few thoughts…..
  1. Compliance is everything. Consider this first. The likelihood of someone’s ability to change their behaviour to your recommendations is directly related to their perceived ability to do it. If it all sounds too much like hard work then it isn’t likely to happen at all. Personality type is rarely ever considered, but for example, entrepreneurial and very creative people struggle with organised routines requiring high levels of self control, whereas a highly organised lawyer or trader may seek that exact approach.
  2. Where and how people eat is as important as what and why. The first two tell you a lot about the reasons behind the latter two. Changing diet is about changing habits, eating in front of the TV and social eating are two environments prone to overindulgence, irrespective of actual hunger. Look at where and how people eat first.
  3. Sleep and recovery drive the ability to train and eat well. Without good sleep both our food and training suffer. It builds reliance on sugar and stimulants, reduces work capacity, impairs how we feel and function, and generally makes us feel crap. It is the first and easiest way to break people down by depriving them of sleep. If sleep is poor then fix it first and if prone to long days travelling then build in strategies to help deal with it.
  4. Temptation is the hardest thing to avoid and all too often clients are faced with the temptation to drink and eat when if left to their own devices they probably wouldn’t. Try to build in some solid plans of action for when these scenarios come up “If we go for drinks I”ll keep to non-alcoholic till I’ve eaten” or “I’lll ask for a vegetable option instead of chips or pasta”. Keep away from the unhealthy choices, if there is cake in the office, keep it in the kitchen rather than next to your desk where you are more likely to succumb to a piece (and if you are breaking a diet, you’ll probably go right off the rails and have several).
  5. ‘Dieting’ requires almost constant conscious thought and willpower to maintain, only those with the highest motivation and strictest level of self control are likely to stick to them. Those who fail tend to gain back more weight than they started with. Instead look at simple habits that over the course of a longer period of time (think in terms of months and years rather than weeks) that can be more beneficial. For example, trying to just give up bread consumption can often be achieved and often can bring great results. Once ‘not eating’ something becomes a habit it is much easier to maintain.
  6. Use simple and easy methods of tracking weight and body. No need for complex measurement systems, regularly measure weight and waistline and you won’t go far wrong. Unless you are preparing for a competition – and even then, how you look will be more important than any numbers on a chart. For my clients in the city I am more interested in their blood lipids, resting heart rate, and blood pressure as a guide to their health.
  7. Seek out habits that bring happiness. Dieting is miserable, just ask any pre-comp figure athlete or bodybuilder. Instead look for habits that make you happy and your capacity for improving your food and lifestyle will raise too. Dancing, walking the dog, playing sport, or simply taking a stroll with a friend – they may not burn the same calories as an hour of interval training but they bring many other far more wider ranging benefits (and are a lot more fun too!).
  8. Give yourself a break, you don’t have to eat cake every day but you’re far more likely to stick to your habits if you know that in a couple of days you are out with friends and able to relax and enjoy a piece of cake with them then. This has been proven time and again to be a more effective strategy than total abstinence. It is naive of any trainer working with the population that I do to think that they will live saintly in your absence. They will more likely just hide this information from you, especially if it is received with condescension and a telling-off. Work with what you have got, find solutions WITH the clients that they feel confident and happy to try and over the longer-term you’ll see a progressive improvement in health, fitness, and happiness.

We’ve been working with these approaches for years now at The Foundry, and while we may not specialise in putting people on stage in their swimwear, we do know how to ensure that our clients go to their medicals and achieve results that would look good for people half their age. As with anything, there are universal truths about training and nutrition, but how you communicate these will often need to be measured and delivered differently.

There is no one right-way, though there are many wrong ways. As a trainer, I look for every little win and I am sure to do my best to highlight it and focus on it with the intention of creating a habit. I am also realistic about the lifestyles my clients lead and believe that the first stage to achieving better health is an honest appraisal of current health and a desire to want to improve that, without that well-intended advice is too often wasted.

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A healthy outlook is for life, not just for Christmas

January 2, 2013 By

With New Year resolutions around the corner Foundry Director Dave Thomas looks at the preoccupation with constantly improving our physical shape and discusses whether this can be detrimental.  We also share a wonderful client success story 

The Rise of the Body Composition Expert

Phyical Obsession

At what point does physical obsession contradict health goals?

The current fixation in the personal training industry is with ‘body composition’ and it’s not hard to see why. Our quick fix culture wants immediate results, we are bombarded with carbon copy physiques in the media and as trainers we know before and after pictures are the shop window to our business. We are also an industry populated with bodybuilders and fitness models. There is absolutely nothing wrong with either of these groups as it takes unbelievable commitment and work to compete in these activities, however it also takes an obsessive preoccupation with the physical aesthetic. Very few clients will ever have the potential or opportunity to show this level of commitment.

At The Foundry we are sportspeople first and foremost. As such we often find our core values differ to others in the industry. Take a quick look at our testimonials and you’ll see international sports people, Olympic gold medallists, world champions and leading fitness professionals and coaches. You won’t see many celebrities or models. A cursory glance at social media will tell you this is an industry which spends half its time criticising other trainers’ physiques, whose members have topless profile pictures on their business profiles and which, worst of all, actively belittles the very people it’s supposed to help, all in the name of ego. If we treat our potential clients like this is it any wonder society is so dismissive of anyone who doesn’t confirm to a physical ideal? We then top this off as a collective by creating completely unrealistic expectations through the use of performance enhancing drugs and photo-shopped pictures.

The Foundry Philosophy

As I have said before, “Size is not a component of fitness”. Our job is not to judge our clients’ goals but it is also not a trainer’s job to project their/society’s physical ideals upon clients. We can help people change their shape to feel better about themselves, benefit their health, play with their children, improve their sporting performance and (I say this with no hyperbole) extend their life. But we should also recognise that being slightly overweight or unable to put on significant muscle mass is not prohibitive to these goals. In fact several studies have demonstrated that carrying some padding as we age is correlated with longer life and better health. I know I would much rather my clients were fitter and fatter than thin and unfit.

Take a look at our transformation pages and you’ll see we have many clients who have achieved quick and dramatic results. We don’t populate our website with these pictures (we have 100s we haven’t published yet) because they do not always explain the context. They are a strong visual sales tool which inevitably elicits an emotive response, however it’s not always realistic or ethical to recommend that this is what every client should aspire to.  (We’ve often had to refer people to our affiliate psychologists before commencing training as it would be unethical to ignore the underlying reasons for wanting to change their body shape.) This is why we try to include such transformations as blog posts or with a write up explaining our clients’ motivations, whether just wanting to look good on the beach or training for a wedding, a photo shoot, an approaching sports event, rehabbing an injury or suffering from a serious illness. Our role as a coach very rarely finishes once these photos have been published.

Which is the perfect link to showcase the 2012 Foundry transformation of which I am most proud. I was very cautious about not exploiting this story to shout about our company but I felt it was a very powerful example with which to make a much wider point.

A Remarkable Story

Personal Training LondonMeet John. 4 years ago he was a young sporty individual with whom I had played rugby for many years. John was such a good athlete that in 2009 he ran the infamous 150 mile Marathon de Sables through the Sahara desert. In doing so John raised several thousand pounds for charity but also nearly became one of its victims. After completing the race he suddenly fell very sick with Guillain–Barré syndrome. This is a rare disorder in which a person’s own immune system damages their nerve cells. John ended up paralysed in ICU.

The first thing to highlight is the amazing treatment he received from the often maligned medical profession, in particular at The Royal London Hospital in Whitechapel. I visited John and despite being his usual chipper self it was clearly a traumatic and difficult experience. He eventually made steady progress and with the support of his neurological physiotherapist and his family and friends he moved first to using a wheelchair, then crutches and finally ankle supports.

This is where we come in. I was very impressed with the tremendous progress he had made but at this point John was feeling a little down about hitting a plateau. He has permanent nerve damage in his lower legs which means he cannot dorsiflex his feet (lift them towards his shins). This means he is unlikely to ever be able to participate in many of the sports he used to.  It would have been very easy to give up and settle at this stage but after lunch one day we made a plan to take his training to the next level…from rehabilitation to performance.

John initially started working with the brilliant team downstairs at The Foundry: Victory Health & Performance.  Here he had regular sessions with rehab director Nell Mead and the sports therapy team who are absolutely essential to our clients’ success and are amongst the most principled therapists I know.

It’s always interesting deciding who clients should train with, however I realised Fiona Pocock, our resident England rugby international, not only had the patient personality for the job but also the requisite personal experience after rehabilitating herself from a career threatening 20 month injury.

Like many clients John also wanted to drop some weight, particularly as he’d been in great shape before his illness. Initially however there was the job of relearning individual muscle contractions so we all agreed body shape would not be a main goal. When I saw John’s first workout with Fiona in May, the primary work sets were gentle one leg knee bends using a squat rack for support.  From there to now has been nothing short of astonishing.

With careful guidance and reassurance from Fee and Nell, John has not only made remarkable performance gains but also dropped several kilos of body fat. This incredible story conveniently saw him deadlifting over 50kg for reps in November, just before I decided to write this article. 3 years ago he was paralysed. I have been humbled by the hard work Fiona and Nell put in with John, the brilliant medical team who helped him initially and also his excellent commitment to continually refusing to accept his circumstances.

So how does this fit in with your New Year resolutions?

If you want to look like a fitness model in 12 weeks we can help you, as can the majority of excellent personal trainers out there, because despite what the industry tries to convince you with hormonal based supplement plans, renaming age-old workouts and pseudo-science aplenty, the truth is that the key to getting the kind of impressive transformations which training websites have is mostly down to choosing the right client: one who is prepared to follow some form of strict nutritional intervention and a challenging training regime and who can manage this commitment around their current lifestyle and circumstances. Not everyone can do this at every point of their lives and this is a reality which should be embraced.

However if you also want to achieve something truly remarkable, be it patiently spending a year gaining the flexibility to squat, (another article coming soon) running up the stairs without being out of breath, or deadlifting 50kg 6 months after you couldn’t bend your knees, and still drop a few lbs then please give us a call.

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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.

 

Filed Under: Blog, Health, Nutrition Tagged With: , , , , , , , ,

HIIT me baby one more time

September 26, 2012 By

There probably isn’t a personal training company or studio in London that hasn’t already written about interval training and cardiovascular training for fat loss. That drum has already been soundly beaten, although there is all too often a bit too much spurious information out there disguised as science that is distorting exercise prescription.

In this blog post Foundry Director Graeme Marsh looks at a recent study on interval training for fat loss in men and gives us his views on the topic.

So, it’s over to Graeme…

—–

Here is an interesting little study from the Dean of research into High Intensity Interval Training (HIIT), Stephen Boutcher and his colleagues from the University of New South Wales. Boutcher has produced some fairly convincing evidence over recent years that has shown the overall superiority of HIIT over the more conventional methods of ‘cardio for fat loss’ and its led to a vilification of steady state exercise within the industry. His latest paper, published in the Journal of Obesity this summer is unsurprisingly no different.

The training protocol was a repeat of that used in previous studies consisting of 8 seconds of sprinting on a cycle with 12 seconds recovery. Repeated for 60 intervals. This was done 3 times a week over a period of 12 weeks, so a fairly achievable schedule for most people. This study used a group of exclusively male subjects, but a previous study by the same author using females had found similar results over a 15 week period. These studies have focused on the exercise aspect of fat loss more than nutrition with no actual nutritional intervention used, although one of the proposed benefits of HIIT over conventional steady state work seems to be a reduction in post-exercise appetite, an effect I would certainly support anecdotally.
Now, we could look at this a bit more in depth, but I know it is mid-week and you are probably thinking “Get to the point already” so here is a summary of the key points:
  • Over 12 weeks subjects lost a total of 2kg of fat training 3 x week for 20 minutes per session (not including a 5 minute warm up and cool down). 8 second sprints were performed at 80-90% of maximum heart rate with a 12 second recovery bout in between.
  • Reductions in body fat came from both fat under the skin and that around organs, showing a positive impact on cardiovascular disease risk factors. There was also a significant reduction in waist circumference.
  • There was an increase in fat free mass over the course of the study and improvements in aerobic fitness alongside the reductions in fat mass.
  •  These results were achieved without any changes to dietary habits.
Overall the numbers involved were still relatively small for a 12 week commitment to changing body composition so it would be interesting to see these protocols combined with a nutritional intervention also to see if the effect can be enhanced. While the exact reasons behind the effectiveness of HIIT as a method are still unclear it would seem that the intensity of the exercise is key, stimulating the release of hormones that stimulate fat loss and also helping to retain fat free mass. Shorter, more intense exercise like this also seems to have a suppressive effect on appetite rather than the stimulating effect so often seen with longer bouts. It would be particularly interesting to see the individual results in this study, similar to those reported recently by Blundell and colleagues in Leeds, who have demonstrated that exercise responses can be highly varied from person to person.
So, what do these studies mean in practice when moving from lab results to the ‘real world’?
Here is where we stand on HIIT training methods and the much maligned steady-state cardio that still remains popular today.
  • Interval training is psychologically tougher. It requires a high level of motivation, despite the shorter duration, the intensity must be high for it to be effective.
  • The leaner you are, the less effective this method seems to be for losing fat. This to me suggests that lean people may well already be adapted to this style of training. However, it’s benefits for stimulating muscle mass retention during dieting should not be ignored.
  • Long duration cardio such as jogging or cycling for 40-60 minutes offers poor return for fat loss and may also stimulate appetite (although this seems to vary a lot between individuals). It is best used either for those who require it for specific endurance sports or used as recovery and/or recreation.
  • Instead of simply ‘burning calories’ HIIT seems to work more through stimulating hormonal changes in the body that favour increased fat oxidation.
  • Overall HIIT offers a more efficient solution to improving body composition, CV risk factors, and aerobic fitness than conventional steady state methods.
Anecdotally, we have found that adherence to these protocols outside of supervised training sessions is probably the biggest limitation to the use of HIIT. As with the many resistance training protocols championed on the internet for their fat loss benefits, these are only effective when performed at an intensity level high enough to stimulate change.
As an aside, steady-state exercise is often criticised for inducing high levels of stress hormones but this needs to be better qualified as it would seem that increased catecholamine release is one of the reasons behind the effectiveness of HIIT. Boutcher states in this paper that “it is feasible that the significant levels of catecholamines generated during acute HIIE [27] could elevate postexercise fat oxidation. The significant catecholamine response to HIIE is in contrast to moderate, steady-state aerobic exercise that results in small increases in epinephrine and norepinephrine [28]. Also the high levels of catecholamines produced by HIIE may underlie its ability to reduce visceral fat, as catecholamines have been shown to drive lipolysis and are mainly responsible for fat release from visceral fat stores “
It would be my opinion that if reducing stress hormone release in a client is a primary concern (in such cases that exercise tolerance is negatively affected by an inability to react to physical stressors) that neither HIIT or long duration CV exercise would be appropriate.
Instead a focus on relaxation and restoration methods combined with recreational activity, such as walking, cycling, swimming, etc would seem more apt. While it is true that duration of exercise can influence stress hormone release (certainly I wouldn’t advise marathon running as an activity unless planning to run a marathon) it is also true that intensity of exercise will have a pronounced effect. Individual factors such as age, emotional state, lifestyle stresses, sleep habits, and nutritional status, will all have an impact on this. This detail is often left out of the many criticisms circulated on methods of CV training.
As with any training or indeed nutritional approach, it is simply a case of selecting the right tool for the right job. HIIT has rightly gained popularity for its effectiveness in reducing fat mass over relatively short-term studies. However, there is no reason why modes of exercise such as walking and cycling should be actively discouraged, as has become popular for many to do. Well motivated subjects or those performing supervised sessions may well get good results with HIIT, while poorly conditioned and more ‘reluctant’ exercisers may find the levels of intensity a demotivating factor. Any exercise or nutritional intervention is only effective if compliance is high so individualisation of programming should be the key determinant in selecting what method to use.
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One week in at Foundry:east, our elite performance gym in East London

September 12, 2012 By

We’ve decided to go old school with an 80s montage to give you a snapshop of our first week at Foundry:east. Read more on the inside scoop from Foundry Director Graeme below. We hope you enjoy watching this as much as we enjoyed making it!

 

Seven days in and finally the ‘new car smell’ is starting to fade a little, along with the shine on all our brand new IWF approved Werksan plates, barbells, and heavy duty lifting racks. Foundry:east is open, albeit non-officially in the style of a super trendy Shoreditch bar. Our first clients are through the door and enjoying the perks of being one of our ‘Founder’ members, inclusive classes, workshops, and coaching from our expert team.

A bit like peeling back the wallpaper in my old Victorian terrace, more jobs are appearing with each day that passes. Sorting our membership systems, dealing with equipment hiccups, ordering all those little things we forgot about, and getting to grips with taking on new team members to help deliver our various classes and courses. However, the main thing is that our new members are loving it, here is what a few of them had to say after our first Saturday Furnace group training session of sled drags, prowler pushing, farmers walks, squats, presses, and much more:

Rebecca Ball : Just headed home after another amazing session with the chaps at foundry:east. Highly recommend!

Alexa Mason ‏: S&C fans must check out the new @FoundryFit training facility at West Ham. Just did a fab, brutal circuit inc. tyre flips, prowlers & sleds.

Kate McIntyre : Just had my first taste of strongman training at the new Foundry East. Tyre flipping, pushing and pulling, you name it we did it.

James Murphy : The Foundry have pulled out all the stops with their state of the art facility, Foundry:east, only a stone’s throw away from the Olympic stadium. The facility is second to none and the strongman clases are awesome – perfect for anyone serious about training.

We’ve already been helping rugby players with pre-season work, powerlifters to learn olympic lifting, rowers to get faster, and some of our new female members to squat a bit differently from their body pump class, and that’s just in week one! For several of us it is a great opportunity to get into a different training environment and putting to work some of the best training equipment available anywhere in London.

We will be having our official launch party in just a few weeks on October 11th, and if you act fast you can still get on board with one of our exclusive Founder memberships. Our schedule of regular weekly classes and courses kicks off at the start of October and will increase through 2013. Already we have confirmed two workshops with The Strength Academy covering kettlebell training and olympic weightlifting. Please follow the links for more information. 

Don’t forget you can find us on Facebook and Twitter to keep up to date with what’s happening and if you’d like to experience the benefits of training with elite coaches in the kind of high level training facility normally reserved for professional athlete, contact george@foundryfit.co.uk
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