Squish!

I love the smell of new fitness gear in the morning.

Last week I started a new early boot camp--7:30 a.m. on Sunday--and found out that apparently that's the very hour that the stealers are lurking around, snatching exercise equipment. Because when we came down the stairs after our last round of Mt. Tabor, the little five pound dumbbells that I'd stashed at the foot of the stairs were gone. But since I had actually gotten them for free, it was not an epic tragedy.

Instead it was an opportunity to invest in a piece of equipment I had wanted for a long time--a medicine ball.

The one I chose was a petite 8-pounder, filled with sand and covered with rubber. It irresistible--heavy for it's size and squishy. Unlike a firm medicine ball, running with it is not pure torture.

Which is a good thing, since I ended up running with it quite a bit this past Sunday when it got its try out during two back-to-back boot camps.
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We used it for medicine ball chops, tricep extensions. squat-to-toss, and just plain games of catch. And when we did our loops (up the 200+ stairs of Tabor, jog around the top, and back down the path on the backside), either me or some participant was carrying it since I wasn't going to take a chance someone would steal it.

Shoes Can't Give You a Shapely Ass--It's What You Do While You're Wearing Them

The Federal Trade Commission has disciplined Reebok for saying that their EasyTone shoes could "shape a behind 28 percent better" than regular athletic shoes. Turns out the research they based their claim on was totally bogus.

This is no surprise. Longtime readers know how skeptical I am of anything that claims to get you in shape without you having to actually work at it. Reebok sold a lot of $100 pairs of EasyTones. Mostly to EasyMarks.

Rehabbing and the Fear of Fat

I'm sitting at the kitchen table with my feet on a bag of frozen green beans (we were out of peas). I ran 17 miles this week in three days (not each day--9.0, 4.1 and 4.3.) This is an achievement. I have been struggling all summer with swollen painful feet that I'm assuming are caused by plantar fasciitis.

I've tried a lot of cures, from digging/rubbing a golf ball into the afflicted area to buying more padded running shoes to Dr. Scholls gel pads. Nothing really helped. But recently, someone made a casual comment about arch supports and a light went off. I had flat feet as a child and wore corrective shoes. Sage wore over the counter shoe inserts for foot pain last basketball season. Maybe my problem had something to do with fallen arches. So I put her "Superfeet" inserts into my running shoes, and my feet started to feel better.

My current running protocol starts like this: Monday, Wednesday, and Friday, up at 5:15 a.m. I've cleverly put on clean running clothes to sleep in, so I'm already dressed. Dry-swallow 750 mg of ibuprofen, put on running shoes with inserts tucked inside, and head out for 45-50 minutes of jogging. When I get home, I ice my dogs before climbing into the shower and getting ready for work.

Crazy, I know. Why am I so obsessed that I risk injury and sleep deprivation just to get a run in? Well, it's like this. As I've written about here before, the odds of keeping lost weight off for five years are not good. Only about 17 percent of people keep a 10 percent weight loss off for a year. I know that I have trouble restricting my eating, so I need to be very active to maintain my 40 pound weight loss.

As most everybody who knows me knows, lately I've been freaking out because of my desk job. I love my work (at a corporate wellness company) and I love my co-workers. But I hate sitting all day every day. I have made some modifications (stability ball as a chair, creating a part-time stand-up desk). But I know that if I don't get at least four hours of cardio in per week, I'm a goner. Hence the 5:30 a.m. jogs on broke-ass feet.

I'm not sure what will happen this winter when it starts to rain. But I've decided to just relax into my current workout and take it a week at a time.

Woody Allen Was Wrong

In Annie Hall Woody Allen's character Alvy Singer notes that " Everything our parents said was good is bad. Sun, milk, red meat... college." And in the 1970s, we thought that was true. For me, however, all of those things actually are good. Given that I live in the Pacific Northwest, spending time in the summer sun is an important way to stock up on vitamin D--low levels of which have been linked to cardiovascular disease. Milk's easy to defend. Non-fat milk has protein, calcium, and just enough carbs to make it one of my favorite post-workout drinks (whirred in the blender with a frozen banana and some cocoa powder of course). Red meat? I could go for a nice, lean buffalo burger right now.

Which brings us to college.

I graduated on Saturday with a Bachelor of Science degree. Ironically, it was 30 years exactly after I graduated high school, so that was amusing. I'm pretty grateful that I was able to take two and a half years out of my life and get this degree. Even though I often complained bitterly, it was a privilege to be able to wake up every day and be immersed in thinking and reading and studying.

College also gave me something very important aside from career training and a degree. When I entered PSU, I was a bit beaten down. The previous few years had not been kind to me careerwise (or, some might argue, in other respects. But I'm not going there). The process of earning my degree helped me get my confidence back. The path to excelling at college is very visible when you have the perspective that middle-aged adulthood gives: Show up for all your classes. Read the syllabus. Study for tests. Work up a passion for what you're learning. Because it was easy to see how to do well, I did well. Gradually, I began to rebuild a sense of self-esteem about my abilities. It didn't hurt that I was also getting stronger and fitter physically.

PSU's gym was where I first got my hands on personal training clients. What a high to be able to earn money while helping others find the fun in fitness.

And perhaps most importantly, college provided me with a community of people who are as in love with exercise, health, and wellness as I am--I made what I hope are lifelong friends at PSU.

So, you see, Woody, college ended up being the ultimate good thing for me. In fact, I might have to change your quote to "Everything the hippies said was good is bad. Sprouts (cuz of salmonella), carob, dropping out of college, communes ...."

Last Paper of My Undergrad Career

Here's the last paper I will write as an undergrad. It is for my class on the physiology of aging. Please excuse any typos, bad grammar, or stylistic weirdness. I finished it on Tuesday at about 1 a.m and had to be up to train my 6 a.m. client, so the last part is prolly a little disjointed.

But enough with the prefacing! (Let me know what you think, and I'll disclose what the grade is when the professor hands them back in the next week or so.)

Vigorous vs. Moderate Activity in the Elderly

or

Don't Let Granny Lift Weights that Weigh Less than Her Purse

The American College of Sports Medicine asserts that “exercise is medicine.” If that is true, can one overdose on it?

For many years, it had been thought that moderate activity is as good as vigorous activity for reducing risks brought on by “lifestyle diseases”. People were advised that walking for 20 minutes three times per week was all that was necessary to keep them healthy. Older adults, especially, were not encouraged to perform vigorous exercise. As recently as 1992, the journal American Family Physician in an article on “Promoting and Prescribing Exercise for the Elderly” noted that “...sedentary patients should begin at a very low level and gradually progress to a goal of moderate activity” (emphasis mine) (Nied & Franklin, 2002, p. 421) .

Perhaps this is because hard exercise is, well, hard. It hurts. As Bruce Grierson puts it in a New York Times Magazine article on 90-something track star Olga Kotelko (2010), “Exactly how exercise affects older people is complicated. On one level, exercise is a flat-out insult to the body. Downhill running tears quadriceps muscles as reliably as an injection of snake venom. All kinds of free radicals and other toxins are let loose.”

And there is some evidence that, at least for some markers of disease, moderate walking can be as protective as more vigorous exercise. Risk of cardiovascular disease, for instance, seems to decrease

almost as much with moderate exercise as it does with more vigorous exercise as reported in 'Walking Compared with Vigorous Exercise for the Prevention of Cardiovascular Events in Women.” (Manson et al, 2002). The study concluded “Although vigorous exercise should not be discouraged ... our results indicate that moderate-intensity exercise confers substantial health benefits for post-menopausal women.” (p. 724) However, the authors also observed that there was a strong dose-response gradient between the physical activity level and the reduced risk of cardiovascular disease. (p. 723). In fact, the women in the study who had the best outcomes were those who did both moderate walking and more vigorous exercise.

But while heart disease and stroke are still widespread and potent enough to number among the top five causes of death in the U.S. (CDC, 2008) , cardiovascular disease is not the only challenge to the health of the elderly. Increasingly metabolic syndrome, a cluster of risk factors that, when they occur together, increase the likelihood of coronary artery disease, stroke, and type 2 diabetes. Two of the most important risk factors for metabolic syndrome are excess fat around the midsection and insulin resistance.

Studies in middle-aged adults have shown that high-intensity exercise is beneficial in reducing abdominal fat. Irving (2009) found that compared to low-intensity training, high-intensity exercise training “significantly reduced total abdominal fat, abdominal subcutaneous fat, and abdominal visceral fat.” (p. 1863). And, indeed, with regard to body composition, it appears that older adults react the same way to high-intensity exercise as other adults. In a study that looked at high-intensity exercise in men and women aged 65-90 years, the researchers split the participants into three groups. The control group did nothing. The low-intensity group exercised at 50 percent of their VO_2PEAK; the high-intensity group at 75 percent of their VO_2PEAK. Although both groups were standardized to work off 1,000 calories a week in exercise, only the high-intensity group enjoyed decreased levels of abdominal visceral fat. (Coker, 2009)

Despite the benefits of high-intensity endurance exercise, trainers are often loath to prescribe it for their elderly clients. Perhaps this is due to the fear of injury. A 1991 study, however, looked at high-intensity treadmill incline walk training and incidence of injury and noted that while injuries did occur, they seemed to be more related to fast walking than incline or intensity. (Carroll, 1991)

The benefits of high-intensity vs. moderate training seem to be even more pronounced as we move from endurance training to strength training. Human aging is associated with losses in lean muscle tissue, especially in type II fast-twitch fibers. Losing muscle mass leads to a changed body composition with a lower percentage of muscle and a higher percentage of fat. Therefore, holding on to muscle as we age is crucial (as is starting in the aging process with a healthy body composition that includes a high percentage of lean muscle mass).

In a study of previously untrained men 60-75 years old who underwent an 18-week strength training program featuring high-intensity lower-body weight training, the subjects derived many benefits from this high-intensity work, including significant gains in strength and concomitant decreases in percent body fat. The authors note that “Although recommendations of exercise training intensity and duration for aging subjects have been, for the most part, quite conservative, it is clear that not only is it possible for elderly people to tolerate resistance training of high intensity ... but that a regiment of this type may be necessary to elicit optimal physiological responses in this age group.” (emphasis mine) (Hagerman, 2000, p. 336)

In fact, the benefits of high-intensity strength training and aging are not limited to the young-old. A study of frail nonagenarians subjected to high-intensity quadriceps training developed increased muscle mass and increased strength. (Fiatarone, 1990)

But aging successfully doesn't just mean maintaining the correct body composition. The elderly often struggle with activities of daily living, whether it's putting a bag of cat food into their grocery carts or hustling for the bus. In addition, successful aging also requires maintaining cognitive function as well as positive emotions. High-intensity exercise can help with that, too. When Spanish researchers gave 62 women older than 65 a high-intensity strength traiining regimen to follow five days a week for five months, they not only increased their strength considerably (and lowered their resting heart rate), they also gained in cognative ability, reduced their anxiety, increased their internal locus of control (especially important in the elderly, who may feel others are controlling their lives), and gained social resources. In fact, the subject's quality of life was not even lowered by training fatigue or muscle soreness.(Cancela Carral, 2007, 544)

Conclusions

As the population that is in middle-aged now (and struggling with the many health challenges that come with the greater levels of obesity prevalent in the population) ages into senior-hood, society will continue to feel the burden of a population that is skeptical of vigorous physical activity.

Increasingly, researchers are finding that, when it comes to exercise, less isn't more. In many of the studies examined for this assignment, benefits of exercise rose on a curve that was twinned with the intensity, duration, or volume of exercise.

Health officials have long been tentative in their recommendations for exercise. Maybe that's because they believed if people know that exercise should be somewhat difficult in order to make gains, potential exercisers would be scared off of exercise before they even started. Yes, three or four half-hour walks a week is better than sitting on the couch, but letting people think that they can lose significant amounts of weight or gain significant amounts of strength with those walks is not really fair.

Because of the physiological decline in muscle mass that occurs as we age, the elderly perhaps stand to gain the most from honest encouragement toward more vigorous activity, and yet, ironically, no group has received more tentative exercise prescriptions than the aged.

Of course, the potential for overuse injuries and other disabling bodily problems is always there when you partake of high-intensity exercise. But in the U.S., in 2010, a far, far greater proportion of the population is ending up with bad health outcomes from exercising too mildly than from exercising too vigorously.

References

Cancela Carral, J.M., Ayan Perez, C., (2007) Effects of high-intensity combined training on women over 65. Gerontology, 53, 340-346.

Carroll, J.F, Pollack, M.L., Graves, J.E., Leggett, S.H., Spitler, D.L., & Lowenthal, D.T. (1991) Incidence of injury during moderate- and high-intensity walking training in the elderly. Journal of Gerontology, 47(3), M61-M66.

Center for Disease Control. (2008). Mortality Rates [Data File]. Retrieved from http://www.cdc.gov/nchs/fastats/deaths.htm

Cooker, R.H., Williams, M.S., Kortebein, P.M., Sullivan, D.H. & Evans, W.J. (2009) Influence of exercise intensity on abdominal fat and adiponectin in elderly adults. Metabolic Syndrome and Related Disorders, 7(4), 363-368.

Fiatarone, M.A., Marks, E.C., Ryan, N.D., Meredith, C.N., Lipsitz, L.A., Evans, W.J. (1990) High-intensity strength training in nonagenarians. Journal of the American Medical Association, 263(22), 3029-3034.

Grierson, B., (2010, November 28) The incredible flying nonagenarian. New York Times Magazine. Retrieved from http://www.newyorktimes.com/2010/11/28/magazine/28athletes-t.htm

Hagerman, F.C., Walsh, S.J., Staron, R.S., Hikida, R.S., Gilders, R.M., Murray, T.F., Toma, K, & Ragg, K.E. (2000) Effects of high-intensity resistance training on untrained older men. I. Strength, cardiovascular, and metabolic responses. Journal of Gerontology, 55A(7), B336-B346.

Irving, B.A., Davis, C.K., Brock, D.W, Weltman, J.Y., Swift, D., Barrett, E.J., Gaessner, G.A., & Weltman, A. (2008) Effect of exercise training intensity on abdominal visceral fat and body composition. Medicine and Science in Sport and Exercise, 40(11), 1863-1872.

Manson, J.E., Greeland, P., LaCroix, A.Z., Stefanick, M.L., Mouton, C. P., Oberman, A., Perri, M.G., Sheps, D.S., Pettinger, M.B., Siscovick, D.S. (2002) Walking compared with vigorous exercise for the prevention of cardiovascular events in women. New England Journal of Medicine, 347(10), 716-725.

Nied, R.J, & Franklin, B., (2002) Promoting and prescribing exercise for the elderly. American Family Physician. 65(3), 419-427.

We're Tired

I know there's been radio silence in here for a few weeks--it's been a bit of a steep learning curve getting used to the new schedule. Sage just fell asleep fully clothed in the hallway. She'd frolicked all day in Oaks Bottom wildlife refuge at nature camp, then went to the library and did her two hours per week volunteer job. Then waited for me to get out of class with some friends at a concert in the park.

My schedule is no less gnarly, with some days including training clients at 6 a.m., P.E class (STILL!), workin' at my fancy new office job, and then topping the day off with my night class or a shift at the MAC until 11 p.m.

Although I am not performing well athletically (ask my running partner), I still think it's lucky that I'm pretty fit. This is not a lifestyle you want to attempt if you are suffering from low energy.

It's a good day if I only have to go downtown once. Some days I go over the Hawthorne Bridge three times.

But enough belly-aching. In just about three weeks, everything will change. I'll graduate and go full time at the office job! (Still gonna keep my shift at the MAC though and try to train clients on the weekends.)

P.E., con't

Chipping away at those p.e. classes I have to take (just to refresh your memory, I have to take 34 hours of p.e. classes in 8 weeks.) The week I had to take four p.e. classes a day for four days in a row was great. At the end of the week, I felt like I was in the best shape of my life.

Now, however, because of a NEW JOB I just happened to get, I am down to only one P.E. class a day, and in an ironic twist, the class offered at that time slot is Abs/Low Body. Ironic because I've always paid much more attention to my upper body. I blithely train my chest, back, shoulders, and arms, and let whatever cardio I'm doing (running, cycling) take care of my legs.

Now, four days a week, I go in for a punishing class filled with lunges, squats, lunges, squats, and more lunges and squats (not to mention lunges and squats).

The sad thing is that my my awesome new job is an office job, so the rest of the day after p.e., I'm sitting. This is stressing me out because I know that sitting = dying. I feel like I'm deconditioning a little bit every single day. And who knows what will happen to my fitness when I finish up my p.e. requirements and go to a 40-hour sitting week.

The job is all about talking to people about their own wellness challenges--among the greatest of which is getting enough exercise when you work full time! Luckily, I will have plenty of empathy for their situation...