22 thoughts on “WGOM Fitness: October 23, 2012, Complacency”

1. It is raining here. Not too hard, but pretty steadily. Hopefully it lets up so I can get to the gym today.

   1. I bit the bullet and walked to and from the gym already today. And now it has stopped raining. Effin' weather.

2. I am the same way, sometimes positive feedback makes me complacent.

3. I got some positive feedback today. Ortho PA is positive that I have bone spurs, thinning cartilage in the ball joint (osteoarthritis), tendonitis and probably some rotator cuff damage. MRI ordered. He thinks some meningitis injections and physical therapy might help, but I'm thinking surgery is on the horizon.

   1. Yuck.

   2. meningitis injections

      Does your PA work for the Twins' medical staff? I think I'd ask for a second opinion, or check your auto-correct, 'cause I don't think anyone would recommend this as a treatment.

      1. i think he's referring steroids. topical!

         1. bingo.

            1. 

               1. my Tour de France days are ovah!

4. This study is depressing, from a public health perspective.

   The study randomly assigned 5,145 overweight or obese people with Type 2 diabetes to either a rigorous diet and exercise regimen or to sessions in which they got general health information. The diet involved 1,200 to 1,500 calories a day for those weighing less than 250 pounds and 1,500 to 1,800 calories a day for those weighing more. The exercise program was at least 175 minutes a week of moderate exercise.

   But 11 years after the study began, researchers concluded it was futile to continue — the two groups had nearly identical rates of heart attacks, strokes and cardiovascular deaths.
   ....
   The study participants assigned to the intensive exercise and diet program did lose about 5 percent of their weight and managed to keep it off during the study. That was enough to reduce cardiovascular risk factors.

   “We showed that meaningful weight loss — let’s put ‘meaningful’ in quotes — could be established and maintained,” Dr. Nathan said. “To me that means we did a good experiment. We had a fair test of this hypothesis.”

   1. As best as I can ascertain, decreasing risk of cardiovascular issues has as much to do with food quality as food quantity. I meant to comment the other day when SBG was talking about sticking with his diet on the road, and sometimes needing to pay extra to get something a little healthier. I think that "you get what you pay for" is more true with food than I'd like it to be. Eating 1,200-1,500 calories a day of processed foods is probably cheaper and more convenient than eating 1,200-1,500 calories a day of unprocessed ("whole") foods, but I would guess you'd see fewer chronic health problems on the latter diet. And on top of that, aren't participants in these studies notoriously bad at self-reporting how much food they've eaten?

      It looks like the study is not yet published, so I couldn't check, but I am typically less than impressed by the exercise that is assigned for studies like this. No one ever seems to measure whether or not the exercise was effective at achieving any physical goals. Are the participants stronger than they were before? (Are they moving heavier loads than they were at the beginning of the study?) Are they faster than when they started the study? Has their cardiovascular endurance improved? (Can they exercise for longer periods at an above moderate intensity?) These seem like relatively simple things to measure, and to me, it seems like they would be more informative than counting up how much time the participants spent exercising.

      Shorter version: Not all calories are created equally, and not all exercise is created equally. This study might just be showing that calories are an insufficient measure of a healthy diet and minutes are an insufficient measure of an effective exercise program.

      1. all true, but at the same time, we are fighting a public health epidemic in this country of obesity- and fitness-related maladies. We keep hearing that any movement -- any -- is good movement, and that we need to be less sedentary. This long-term study appears to have been well-designed, and it was large and prospective. It looked at weight loss and modest exercise programs. And it was shut down by NIH because they didn't see any prospect that they would get any worthwhile results from continuing the study further.

         [NIH press release]

         1. I know that we keep hearing that any movement is beneficial, but I guess I've never really seen the studies on that. I'm sure there are some benefits to not being completely sedentary, but it's probably just the tip of the iceberg in terms of the benefits that you can get from having an active lifestyle. I've also become a big believer in resistance training, and it seems to me that you measure that more in sets, reps, and load rather than minutes. Using minutes as the measure of exercise in the first place suggests a bias towards walking/running/biking/steady-state-exercise of your choice.

            Even if I put that aside, I think the bigger issue is probably that of using calories to measure what is a healthy diet. Lowering caloric intake is a start, but I think there's more to it than that. I know that researchers have to make simplifications in order to run any kind of study, and I'm not against running studies like this, but I think that sometimes they are just more indicative of the limitations of running a simplified study than they are indicative of anything. It would be nice if it was as easy as "exercise X times per week for Y minutes," "eat Z calories," and presto chango, X*Y + Z = healthy adult, but it's probably not that simple. It doesn't make achieving a healthy weight impossible, either.

            I see from your link that the study was limited to diabetic adults between 55 and 75 years of age--is it fair to extrapolate results from this study to adults between 25 and 35? 35 and 45? Other age groups? Non-diabetics?

            I saw this report last week, which at least suggests that a drastic reduction in trans fats is having a positive impact on cholesterol levels on a national level. It's not an airtight conclusion, sure, but given that there are biochemical explanations for why trans fats are bad for your cholesterol levels, and we know that trans fat consumption has declined, I'm inclined to believe it explains some of the impact. I bring this up only as an example of how the quality of your diet can affect some of your health markers in addition to the quantity of your diet.

            1. One of the things I like about the NIH report (and the media coverage) is that they are actually highlighting a negative result. There is, I think, a tremendous media bias in favor of reporting positive results, just as there is a substantial publication bias in the peer-reviewed literature.

               You are absolutely right to ask probing questions about the generalizability of this (negative) result. I think that it highlights the common-sense notion that there are no quick-and-easy fixes for obesity-related health problems.

               I am inclined to believe that the Boss is on the right track. If you are obese or very overweight, you face significant threats to your health and longevity. To reduce or eliminate obesity/significant overweight (and, one HOPES, the fitness/morbidity/mortality threats associated with those conditions), you have to make a significant commitment to changing your lifestyle. It is not easy, and it is not quick.

               1. I, too, welcome the publication and exposure of negative results.

   2. Five percent of their body weight? How long were they on the program? Now, admittedly, I'm on a very strict plan, but I've lost over 15% of my body weight in less than three months. Losing 5 percent of your body weight when you are obese is not "meaningful" enough, I would think.

      1. Few, if any, studies of this size and duration have had comparable success in achieving and maintaining weight loss. Participants in the intervention group lost an average of more than 8 percent of their initial body weight after one year of intervention. They maintained an average weight loss of nearly 5 percent at four years, an amount of weight loss that experts recommend to improve health. Participants in the diabetes support and education group lost about 1 percent of their initial weight after one and four years.

         Maintaining a 5 pct (average) weight loss over a period of four years is impressive, I think. That doesn't invalidate your concern about what is required for significant effects. But good luck getting thousands of study participants to lose 15 pct of their respective weights and maintain that loss for 4 years.

         1. We are in harmonious agreement. My ultimate goal is to lose about 30% of my body weight and keep it off. I realize that both are quite difficult.

         2. They are also older than SBG (in some cases much older) and have type II diabetes, for what that's worth.

            1. Meaning of course that the damage is probably already done.

               1. That would be my intuition.

Comments are closed.