The Elderly Need More Exercise? Not Exactly.

An interesting discussion over at Doug McGuff’s message board regarding exercise and aging. This comment was of interest:

I suggest that the sedentary elderly require more exercise, not less. I am one such. A few minutes a week is not going to do it for sarcopenia or anything else. If I train once a week I cannot maintain my condition, strength,metabolic benefit, motivation or momentum. Nor can you if the rest of the time you are inactive.

Here was my response to this statement:

And I disagree; I think the elderly need more activity, not exercise. Further, the health education research is clear: in the elderly, physical activity and self-efficacy track side by side. The more confident a person is in their abilities, the more physically active they are; the more physically active they are, the more confident they are in their abilities.

If you make a person stronger in your studio, they’re more confident in their ability to do other activities. This is what Doug talks about when he says people want to move more after training for a number of months. Get strong and you’ll get more active relative to your starting lifestyle.

I’ll even make it a nice soundbite: have you ever heard the phrase “a stronger athlete is a better athlete?” The same is true of human beings throughout aging, that is a stronger human is a better (more active, more healthy, more resistant to cancer/metabolic disease/disability) human. (Emphasis mine…just now!)

There is a nugget of wisdom in there that I want people to pay attention to: “relative to your starting lifestyle.” If a person is doing zip and they start a once per week strength training routine that then leads them to take leisurely strolls because they enjoy it, they’re going to do a whole lot better for themselves compared to where they started as far as disease prevention and injury risk reduction. If you had a crazy triathelte at the same advanced age add the same dose of exercise, it wouldn’t make much of a difference. There’s a survivorship bias discussion that will be addressed another time, but here’s my advice: don’t take advice from an endurance athlete who has been training “all of their life” as the gospel…there’s more at play than just hard work!

I digress; elderly individuals should look at their training as an upside-down oil funnel: the widest, part is going to be activity that is very low in intensity but very high in frequency. It seems this is where one can start making a semantic argument that this too is “exercise.” However, it’s really just being a good human animal and setting a functional path: if you move a certain way today, you’ve got a good chance of moving that way tomorrow. The middle part of the funnel is going to be mobility work as maintaining joint free range of motion is paramount for maintaining activity levels. When looking at barriers to exercise, the less mobile people are, the larger their barriers to exercising become. For example, those with mobility limitations cite “poor health, fear and negative experiences, lack of company, and an unsuitable environment as barriers to exercise…”. Performing joint mobility work for 10-20 minutes a day, hell even starting at 5 minutes per day, when mobility is still pretty good will go a long way to maintaining mobility, which maintains activity levels and exercise efficacy. Finally, the tip of the funnel is exercise training, preferably of a high intensity nature. Muscle is the most plastic tissue in the body, the largest endocrine organ we have, and creating a sufficient degree of demand will improve all aspects of a person’s physiology. By its nature, it cannot be sustained for very long and requires a prolonged recovery period. That’s fine, as it means more time for the activities the person would rather be doing, which is going to set the table for continuing to do the activities until the day they die. All good stuff!

So no, the elderly do not need more exercise; they need just enough exercise to produce a body that feels good doing lots of physical activity that a person would rather be doing. Maybe this advice will produce a few more Stephen Jepsons in the world and how cool would that be?

Strength is a Skill

The subtitle of the post should be “…that doesn’t always lead to mass.”

I’m in the midst of writing a research review of publication and I came across a study on exercise volume and hypertrophy & strength changes. The study is titled “Strength and neuromuscular adaptation following one, four, and eight sets of high intensity resistance exercise in trained males” and is found in the Journal of Applied Physiology. Click above for a preview.

The study used 32 resistance trained males in a 10 week study of the squat at 1, 4, and 8 sets per workout performed twice a week. The authors concluded ” The results of this study support resistance exercise prescription in excess of 4-sets (i.e. 8-sets) for faster and greater strength gains as compared to 1-set training.” Yup, that’s true. No beef there. But let’s look at the numbers.

Strength Stats

So the numbers are cut and dry: the 8 set group saw an average increase in 37kg in their 1 rep max squat over the course of the 10 week study, compared to a 17kg increase from the 1 set group. Here’s the thing: when you compare the lean tissue changes, the result is much, much smaller. The 1 set group gained 2.03kg lbm over the 10 weeks, while the 8 set group gained 2.69kg lbm. So for the 8x increase in time spent training, and a 1 rep max 20kg higher over the same period, the trainees gained…0.66kg more? Really?

Strength is a skill and all of that time spent under the bar is practice. It just also happens to contribute to hypertrophy but not in a linear fashion. The fact is that if you want to get strong as fast as possible, more practice will get you with the movement pattern will allow a larger exertion to be controlled when performing that movement pattern.

The problem with these studies is that they cannot, due to funding, account for the long view of time. I’ve shown this crude sketch before but it’s relevant here.

Rate Of Gain vs. Injury Potential

While reaching one’s “absolute” potential is something very few are in danger of achieving, the fact is our progress slows down as we get closer to that absolute max. Understanding that each one of us has a limit, it must be asked that does doing more sets merely get us to that limit faster, only to coast longer? Given a time frame of say 5 years, would the 1 set group and the 8 set group be moving very nearly the same weight, all things being equal? I’d suggest that they’d be very close, with the reduced set group having spent less time in the gym and reduced occurrence of injury. There’s only so much recovery to go around and the tolerance for error becomes smaller under heavier loads.

So what’s your goal? If you want to powerlift, more time under the bar is better (though 8x the sets only got a bit more than 2x the strength gain…4 sets is a nice compromise in that regard). If your goal is lean tissue gain, strength improvements are important, though a side effect of quality contractions under sustained load with sufficient metabolic distress and enough rest and calories. Oh, and there’s that whole genetic thing to be discussed in another post! Finally, if your goal is robust health, improved function, and a better looking naked body, 1 set with a sound set of eating habits centered around real food is hard to beat. The time investment is paltry and the return is profound.

Body Criticism: It’s Turtles All The Way Down

Yesterday on Facebook, Krista Scott Dixon posted this:

Stump

She’s right: if you are otherwise free of pathology, there is nothing wrong with your body. This is a fitness industry-wide trap, to make you feel bad about your body as a means of motivation. Unfortunately it’s as big a trap as the one the Rebels encountered and far less entertaining.

It's a trap

The sort of self-talk that comes with this self-criticism is reactive in nature. Let me give you an example: if you decide, for some reason, that your deltoids are too small and “need” fixing before your physique is “perfect,” your goal is inherently about how imperfect you are and thus are in need of fixing. After you “fix” your deltoid size, you’ll find something else that is “wrong” and “needs fixing.” And you can do this forever, endlessly finding more and more that is wrong with you in the face of the recent “fix” you achieved, hence turtles all the way down. You may end up with a more beautiful body, but your journey there was on a wagon of self-loathing. In men, this is the root of the Adonis complex; in women, anorexia nervosa among others.

Your body is exactly the way it is; nothing to be fixed. One way to realize it is to actually do things with it that you’ve not done before. This is a proactive framework, where you add to the foundation that is you, not chip away at it. You lift more, learn to handstand, juggle, or some other skill. You take up a sport, take up yoga, take up tai chi, explore everything that you body can do. You come to realize that you’re a pretty rad machine; look at all you can do! If you were “broken” you’d never actually be able to do these sorts of things. Your body may change as a result, but that’s a side effect of learning all of the cool stuff you can do.

In Health Education, there’s a lot of discussion about intrapersonal theories. How do you teach a person a set of skills that allows them to rationalize better health decisions over their lifetime? Now omitting that there are a host of others factors that are likely more important (e.g. interpersonal factors, community factors, cultural factors for instance), these theories identify where people are in how they think and some of them point to how they think and aim to modify these behaviors. One in particular that is relevant to this discussion is the Theory of Planned Behavior (TPB). The theory states that a person’s attitude toward behavior, subjective norms, and perceived behavioral control, together shape an individual’s behavioral intentions and behaviors. Especially in fitness, it often goes like this: behavior (“working out = punishment for cake”), subjective norms (“everyone is so much fitter/prettier/skinnier/harder working than me”), perceived behavioral control (“But I can fix me! I can control everything and look like that!”), together shape a person’s behavioral intentions (“I’ll find every flaw, and until I do, post myspace angle photos hiding that which I perceive as such”). I’m sure I don’t have to elaborate, but a negative affect from the start will only lead to misery.

Here’s a suggestion: find something you want to do with your body (not to your body), really work at getting better at it, and stand back and be amazed at how far you were able to get when you didn’t worry about what was wrong with your body, but how many great things your body can do. It’s astonishing.

“Aging with Strength” is live!

This past spring, I was presented with the opportunity to speak at PaleoFX 2013 on strength training and aging. This was a fun challenge, as I was given a small block of time with which to fit a 40+ minute talk. This meant that I had to hit the big-picture points without leaving people in the dark and I think it came out well. I hope you enjoy it, especially the addition at the end with how little exercise it takes to cement these health outcomes.

So PaleoFX 2014 will be happening April 11th through the 14th here in beautiful Austin, Texas. Tickets for this event are now live, as is the preliminary list of speakers. I’ll be presenting a new talk on skill acquisition in high level athletics, so if you’re just plain tired of me talking about how awesome you can be when you’re old, you won’t want to miss this talk.

Get your tickets now!

Exercise Science is a Translational Science

My wife likes to take the piss out of me. While I’ve been working through my graduate degree, and people ask her what I’m studying, she likes to say, “Exercise science. I know, it sounds like a made up degree.”

She’s not wrong; “exercise science” does sound a bit nebulous to the point of gnostic wisdom. However it’s important to understand that most people think they have a clue about exercise and they simply do not. It’s a bit like Parkinson’s Law of Triviality: people have bodies, therefore they think they know how to exercise said body. Given the state of health in the United States, it should be clear that we have little in the way of cultural norms to maintain fitness, and even less cultural wisdom to get people on the right track.

Frankly, exercise is complicated stuff by the simple fact that you have to account for so many variables in so many subjects (body of knowledge subject, not human being subject). This is why exercise science is actually a translational science, a cross disciplinary, scientific research driven by the need for practical applications of science.  This type of science is often used in medicine and pharmaceuticals, because you need people to figure out how to take lab discoveries to trial as quickly as possible, and also to take these discoveries into best practice perhaps even faster. This came about because it takes an average of 24 years for a lab discovery to primary care setting, so long that “breakthroughs” that can save many lives leave so many dying before they can be applied.

The same seed is what has created a movement in health and human performance departments at universities to move away from terms like “exercise physiologist/biomechanist/kinisiologist” toward a unifying umbrella of “Exercise science.” This is because those are all part of what you study at the graduate level and then some. I made a picture with a mouse to illustrate the breadth of subject matter I learned in my studies (click for full size):

Exercise Science DIagram

Now if I walked into a lab that was devoted to any of those pursuits, I’d be dangerous. In the context of the human body and how it responds to an exercise stimulus, I’m better than any of those experts. I’m taking what they’re studying, mixing it with what others from totally different fields are studying, and attempting to mold a best practice that gets at the good stuff as efficiently as possible. I’ve been trained to be the ultimate generalist when it comes to understanding the human body and its response to exercise, which is exactly what an exercise science curriculum should do.

Yes, it sounds made up, but it’s really the shortest description of what it is we do!

Examine.Com Fire Sale – Last Chance For A Steep Discount On The “Supplement Goals Reference Guide”

My buddy Sol is celebrating a couple things this week:

  • He has established an amazing team over at Examine.com to help further improve his product and to give you more confidence in the information you’re getting that influences your supplement buying choices. These additions include:

-Dr. Spencer Nadolsky, a primary care physician
– Kamal Patel, MBA MPH PhD(c)
– Gregory Lopez, pharmD
– Bill Willis, PhD (biomedical)

  • He previously funded the website with Amazon affiliate links from the supplements being reviewed. This has been eliminated; the supplement guide is what they do and how they support themselves.

In celebration of this, he’s dropped the price of the Supplement Goals Reference Guide from $39 to $29. Here’s the thing: the sale ends tonight at midnight!

If you’ve been on the fence about picking up this incredible tool, now is the time. You’re not going to find a lower price, as it goes back up tonight.

Pick up your reference guide today!

More Lessons from Health Education: Leverage your Strengths

In Health Education, there is a set of principles and methods called Community Organizing. This is where a community is helped to identify problems within a community, mobilize resources, and implement strategies for reaching the collectively-set goals. Now, often this process is similar to how a consultant works in a business: they come in, determine what the “problems” are, and drop that on your desk for you to figure out. You can imagine how helpful that is.

However, there’s a flipside version where a person acts not as an outside “other” but rather engages the community, asking questions and seeing what they identify as the “problem.” Often, this is not what it seems to be, and an outsider would not peg the problem as such. Further, this person engaging the community is a facilitator, helping people to help themselves with resources identification, and community representation. But more than that, the facilitator aims not to problem solve but to leverage strength. Often, when a community can identify what they are good at and aim to get even better, things that were “problems” organically work themselves out.

There is a lesson here. So often in our drive for more “health and fitness and function” we look at all the things we aren’t doing or aren’t doing well. There is some good in this (see my last post about the low hanging fruit). However, if you only go around inside your head looking for all the things you’re not good at, you’re not going to think you’re good at anything. Instead, why not look for the things you do well and look to maximize that?

A personal example: I am an exceptionally elastic human being. That is I have always been very, very good at jumping, sprinting (once I get going), and the like. I had a 39″ vertical leap in high school in spite being rather weak. After realizing I was “weak” I spent 12 years trying to become brute-strong and, though I am stronger, I am also less explosive than I once was. In an effort to turn a weakness into a strength, I diluted the strength. I’ll paraphrase a Charlie Francis quote:

You don’t plow a field with a Ferrari

Learn from my mistake! If you’re good at something, push that “thing” as far as you can go. If you’re good at not eating after 6pm and are reasonably lean, don’t worry about some dietician who says you “need” to eat 6 meals a day. If you’re an explosive athlete, keep pushing that instead of what some bald, goatee’d powerlifter thinks of your deadlift strength. Find your strength and focus on that rather than anything you may be “weak” in!

Put In The Work

One of the things I stress with clients is that the low hanging fruit should be picked first. It’s fairly standards in this field for clients and trainers to “go for broke” and set up really complicated programming to reach their goal. To keep running with the metaphor, that’s like climbing to the top of the tree to pick fruit. Sure there might be better fruit up there but wasn’t the goal to eat?

Recently I’ve been dabbling in doing handstands. Sure I found all sorts of complicated programming and poorly written tutorials. After getting them I didn’t use them. When I finally came back to the goal I decided that I’d just practice every day. Even if that meant just one attempt upside-down, that was enough.

After a couple weeks of this I can kick up into a 5 second handstand. I can’t do this every time but I can certainly do it every day. And every day that I do it I get a little better at it. So there was no magic routine, just a bit of consistent “imperfection” toward the goal. Often, by the time a person needs a routine tune-up, they’ve surpassed their peers and need far less coaching all because they were consistent with something appropriate and intelligent but perhaps imperfect.

Consistent imperfection beats inconsistent perfection in this game.

Here’s a shake idea

From the “holy crap this thing is loaded to the gills with nutrition” file:

-1/3 cup coconut milk

-3 raw eggs

-2 level tablespoons of cocoa powder

-1 tablespoon of almond butter

-1 tablespoon of resistant starch (I used tapioca flour)

-1 banana

-8 ice cubes

Load into a blender and HIT PUREE!

You could replace bananas with blueberries if you want the nutrition to go to infinity and beyond, but I have a lot of bananas on hand so they get called up.

 

Added: A New Testimonial

Last weekend I had the opportunity to have a chat with local physical therapist Brad. We talked Body By Science, physical therapy, went on like total exercise nerds about unique equipment I have in my studio, and after all of that he got a workout out of the whole thing. He was kind enough to write about his experience and you can read that in the testimonial button to the top right.

I’m noting this because I really like helping facilitate quality changes in their lifestyle/training style. Sometimes people need specific suggestions, which I have no problem doing. Other times, people have a good idea of what they might do to move toward their intended goals and want to bounce ideas off of someone to help them zero in on their most effective next move.

Basically, if it falls in the realm of exercise or health science. I can help and I’d love to help you, too.