Tuesday, October 26, 2010

aging and 'physiologic reserve'

maybe you think i'm afraid of aging because i cover it so often. the reality is, we're all doing it so i find its processes and progressions quite fascinating. kinda like following my newborns' progressions via the many books my wives (two divorces, so i credit each of them) had bought so we could benchmark their lives. also, much of my work with clients is with those who are experiencing age-related changes.

this piece in the ny times - http://www.nytimes.com/2010/10/26/health/26brody.html?_r=1&emc=eta1 - discusses the concept of physiologic reserve, a cool term i thought i'd share for those wondering why they no longer can do what they usta/coulda done. it refers to the extensive network of organic functions we have at our disposal that we rarely tap into. for ex, we use very few of the billions of brain cells we possess. this allows us to keep learning things, including new movements. we also have a lot of muscle fibers we hardly ever engage - except at the highest levels of training and conditioning. this is why even as we age and lose them we can still function relatively well into our later years.

but there is a tipping point for all systems. once that point is reached, declines occur, or at least become noticeable. without thinking too hard about it, we can readily note the memory lapses or physical deficiencies that plague those of us over 50, even those of us who stayed in shape most of our lives. this is natural aging and we can only do so much to keep it at bay. but i use this concept - now that i have a name for it, i'll use it more, just to sound smarter - when i explain to new clients why resistance training is so important.

personal example: when i was young and training hard, real hard, i topped out on push ups at 60. at 50, i'd start feeling tired. by 60 i was done. pretty good overall, compared to others, but it wasn't til i got over 40 that i realized how much of a wimp i was.

i had my second child, lydia, shortly after turning 40. so i set a goal for myself- i'd add one push up per week for her first year of life. it was easy at first but got hard at 90. so, when i had sophia 16 months later, i set a goal of 1/month. thus, sometime around my 42nd birthday i was able to do over 100 push ups. (today i can still pull off 80, but it's a very hard effort.) this proved to me that i had been undertraining while i was young and injury free for all those years i was stuck at 60. i had reserves but hadn't topped out on them when i needed them most.

nonetheless, the message i give new clients is this: if you can do 10 push ups at 30, and do them daily til you are 60, while it's a feat relative to your peers, because you've been losing muscle fibers all those years, you're now working at a much higher percentage of your overall capacity. so building up now - at WHATEVER age - will enhance your ability to maintain higher levels of function as your body starts to decline. you can always get stronger, at any age, but you have to work on it harder now while you can - at whatever age you begin. so, get started; start getting stronger; that way, your physiologic reserves are greater for that time in life when not enough is not an option.

Monday, October 25, 2010

the doctor-patient wt management plan

it's on everyone's mind, whether you're lean and fit or obese and diseased: why can't i/they/he/she lose weight? well, if you're a doctor administering to a patient whose health can be dramatically altered by losing wt, you have several options: talk nice, give orders, don't say anything, or present the data. this article in the Times addressing a recent bit of work that shows what any fitness professional knows...but many do not practice: http://www.nytimes.com/2010/10/26/health/26weight.html?ref=health

now, this is my take on the issue, just my philosophy, so it does not have any more power than my experiences over the 20 plus years i've been doing training. first, my clientele - bright, educated, wealthy, primarily caucasian. second, my personality - all of the former except for wealthy, plus a former philosophy major, liberal, caring. why do i mention the latter aspects? because they factor in on how i deal with clients for whom wt loss is an issue; esp how i deal with those over long periods of time for whom advice, guidance, support, education, and training don't have any measurable benefit.

as a philosophy major, i spend many years thinking about the human condition. while i have no profound answers to offer, the one thing i learned over time is that most people won't change. they can, but most won't. neither threats of impending doom nor promises of 72 virgins in heaven will change one's behavior....until the person really wants to change. this works for individuals, societies, cultures, and nations, so you can fret the small stuff but there's no need to fret the big stuff; we just have to deal with that which presents itself.

as a liberal, however, i believe mankind, and each individual, is responsible for his/her life and decisions as to how it's lived, but that there are mechanisms, or at least should be, that will enable us to find the 'right' way to live. but, go back to the previous paragraph and you will appreciate the fact that liberalism, tho well intended, does not often work. for one thing, 'right' differs from person to person. for another, it's complicated.

for example, it's 'right' to exercise. but it's wrong to over-exercise or mis-exercise to the point of injury. raise your hand if you're an athlete who's never suffered from either overtraining or injury. good - no hands showing. well, we espouse the principle of paying for our lifestyle sins - that the obese should pay more for insurance commensurate with their risks, but then shouldn't athletes? of course, our injuries don't cost as much - now - but it was 15 yrs after my tae kwon do career ended that i needed my hip replaced; and will be a few more til i need my knee replaced. you'll say there are fewer and less severe and less costly medical conditions that sprout from being chronically active but the reality is, not all obese people will cost the system and not all athletes will save the system from costs. so, taken individually, not all of us should be hard core athletes but neither should all of us be obese. there's got to be a mid point somewhere, but who is to say where that is. there is no right level of fitness nor mechanism for getting there.

that said, as a liberal, i do believe society can facilitate the approximation of right at the expense of neglecting it. in other words, government, acting on behalf of society, should spend more money helping us to get fit, be healthy, and live more productively. i just don't know how to do that....

finally, i really do care. i want my clients to be healthy, get fitter, and enjoy their bodies and their minds. i love what i do and do it with love. those who have tried to lose wt, tho, are difficult to manage beyond their first 20-100 sessions - i say this jokingly but when someone's been trying to lose wt for 3 months or years, then there's absolutely nothing i can do to help. i don't give up but i do resort to less accommodating coaching. after reviewing one's behaviors that repetitively sabotage their stated goals, i resort to supportive questioning: that is, regardless of their answer or offered statements about dietary or exercise patterns, i find a positive spin to apply but direct them back to the 'better' method or choices. by this point, i know them fairly well so i can play this game. the one thing i never ever do is put someone down for their choices. but i have, on occasion, let them know that their choice speaks loudly for their real intentions. most of the time, this goes without saying, so i don't.

now, back to the article. docs don't have these kinds of close relations with clients like trainers. they have minutes, tens of minutes at best. reminds me of a cardiologist i met 20 yrs ago. after the movie, he asked what kind of advice i offer for wt loss. after expressing my philosophy so as to avoid sounding like a know it all - i knew a lot less back then- he shared his. he told of how he sits next to the bed of a patient who had a cardiac event, or surgery, and discussed diet. years after spending half an hour with patient after patient, sometimes the same person a couple years apart, he boiled it down to three words: greens, beans and grains. then he walks, figuratively speaking. his point is clear: he cared, he cares, he shares...then he leaves, leaves it up to the person to make a choice. it may not be the right choice. if it isn't right, he'll see him/her again, maybe. but it's all he could do.

that's why the data is not strong enough to change the way docs talk to patients. most simply don't want to listen. be nice, anyway.

Wednesday, October 13, 2010

knees, arthritis, running: are they connected?

i've probably written on this before but this article in the ny times inspired tonite's blog: http://well.blogs.nytimes.com/2010/10/13/phys-ed-do-marathons-wreck-your-knees/?src=un&feedurl=http%3A%2F%2Fjson8.nytimes.com%2Fpages%2Fmagazine%2Findex.jsonp

i alert you to the concluding line: ‘There’s no strong evidence,’’ he said, that, if your knees are healthy to start with, ‘‘running a marathon will hurt them.’’

i think it's fair to say, as i've long held, that there are no wrong exercises for everyone but there are wrong exercisers for some exercisers. in other words, using myself as an example, having done tae kwon do nearly every day of the year for about 15 years, that my knee (only my pivot leg) is shot because i must have either trained wrong or had a propensity toward arthritis. (i also have a new hip on the same side and the knee will someday need replacing.) my friend, same age, same duration of youthful training, is still teaching, running, and sparring (gently, because we are, after all, old men) and is free of knee problems. (tho he's had both his hips re-surfaced. it's a tough sport...) my point is, some suffer consequences, others don't. same for knees and running.

the studies reported in this article are noteworthy for their longevity. rather than a cross sectional study of runners and non-runners, or runners and former runners, some of these in this piece followed runners over a period of time. what they generally found was that running did not cause arthritis, but it did alter the 'matrix' of the cartilage. however, that may be one of the many ways our body adapts to the stresses of long distance long-term running. obviously, some runners had to give it up because their knees did not adapt well. others are still running. thus, i think it's fair to conclude that, much as that last line says, running does not cause arthritis unless your knees are prone to arthritis.

now, many things can make you prone: genetics, previous injury, untreated training or footwear conditions (running on the same side of the street, or in the wrong shoes - old or inappropriate for your foot), or any number of nutritional or extra-activity variables that can't be determined. (for example, is my knee shot because i also tried to be a distance athlete? or because i worked out on tile floors 3 hrs/day? or because i needed orthotics for running but trained barefoot? who knows????)

so, in conclusion, let me state clearly my position and highlight that of the news piece: exercise however you wish. pay attention to your body. treat it like a living machine, providing it the elements of success under duress - fluids, nutrients, and rest. and maybe just maybe you will not be one of those who suffers cartilage damage from your activity of choice.

but maybe you will regardless.

Sunday, October 10, 2010

supplements, free radicals, and anti-oxidants

i have colleagues who, as trainers, wish to help their clients and friends by also supplementing their incomes passively. so they sell or market supplements, either muscle building or immunity-enhancing or disease-reducing "proprietary blends" that have an ounce of science and a ton of marketing behind them. just the other day, a close associate was discussing with me the prospect of getting involved in a multi-level marketing scheme of scientific-sounding anti-oxidants but was rightfully investigating its authenticity before jumping in. he wanted my opinion. that was before i read this article: http://well.blogs.nytimes.com/2010/10/06/phys-ed-free-the-free-radicals/?src=un&feedurl=http%3A%2F%2Fjson8.nytimes.com%2Fpages%2Fmagazine%2Findex.jsonp

my opinion was this: maybe it works but science has a way of isolating out of natural products or foods items or components of items believed to be the reason the natural products or foods are thought to be healthful. that is, take the C and E out of fruits and veggies, compress them into pills with megadoses way beyond those you can eat, and hope for miracle cures. but, studies just don't support most of these claims. in fact as i've reported previously, the latest data, based on multiple studies and combined data from multiple studies, shows that a multi-vitamin pill confers no health benefits vis a vis cancer or heart disease. (the only caveat here is, of course, when people eat restricted diets - vegetarians, for ex, need iron, zinc, and B12 from pills. and there are other limiters that might require supplementation.)

the article link above confirms that our bodies are pretty good at taking care of business. exercise, which produces tons of free radicals, that otherwise would be destructive, actually enhances our body's ability to manage them via internal mechanisms. and when you over supply the body with exogenous (outside the body) anti-oxidants, guess what happens: you become less adept at removing these by-products and also less adaptive to the benefits of the exercise itself.

it also confirms what those stodgy old dietitians have been claiming for eons: food is the best medicine. not supplements - which cannot be 'natural' because natural is food, and pills are super-concentrated versions of only one or a few elements contained in food.

so, once again, the age-old, 5 food group recipe stands firm: eat your fruits, eat your veggies, get your calcium from dairy - and don't try to tell me mankind can't get the nutrients from cows - we've been doing it since the first time a thirsty ancestor went up to a cow or camel and drank from its teat. very few of us are truly lactose intolerant and even fewer are allergic but the rest of us can handle it just fine. (in fact, low fact chocolate milk is now the premier post-workout beverage for strength athletes...and some would contend for cardio athletes, too.)

one last note. don't be surprised if you hear, soon, about the necessity if not the recommendation to eat more saturated fats. it's all aristotlean: everything in moderation. why is it we americans keep taking things to the extreme?