Exercise Found to Rival Meds at Lowering Blood Pressure

For people with hypertension, an exercise program may lower blood pressure (BP) almost as effectively as antihypertensive medications, conclude the authors of a meta-analysis of randomized controlled trials (RCTs).

In an analysis of studies that included almost 40,000 patients, evidence-based medical therapy was associated with a greater drop in systolic BP compared to interventions that consisted of exercises for endurance, dynamic resistance, isometric resistance, or both endurance and resistance. But the difference in average BP change was only 3.96 mmHg.

There was no significant difference in the extent to which BP was reduced in an analysis limited to persons with a baseline systolic BP ≥140 mmHg. The study by Huseyin Naci, PhD, London School of Economics and Political Science, United Kingdom, and colleagues was published online December 18 in the British Journal of Sports Medicine.

“These findings could be used to examine and improve the evidence base supporting exercise recommendations,” particularly in light of the fact that recommendations “are primarily based on observational evidence and highly variable across different settings,” the group writes.

On the other hand, the authors highlight the wide variation in sample sizes and methods used in the exercise RCTs. These variations “highlight the need for a more standardized approach to the design, conduct, analysis and reporting of exercise trials,” the investigators state.

Their meta-analysis included 194 studies of the impact of exercise interventions on systolic BP and 197 antihypertensive drug trials reported from 2012 to 2018.

“We need to be cautious about what types of data we’re looking at here,” especially inasmuch as not one RCT compared exercise and medications directly, Naci told theheart.org | Medscape Cardiology.

“We’re just starting to scratch the surface by providing this piece of information,” he said. “We may want to think about nondrug interventions as potential alternatives to drugs in some cases, and blood-pressure lowering seems to be a good start.”

Naci pointed out that recent guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA) lower the threshold for stage 1 hypertension from 140 mmHg to 130 mmHg, which “may result in more people being prescribed antihypertensive medication.”

It’s possible, he said, “that some of those individuals may be indicated instead for exercise interventions. But this is very much something that patients should discuss with their doctors, one on one, thinking about all the constraints, as well as their preferences and values and what they want to achieve with their therapies.”

The researchers stress that “it would be very important to evaluate the comparative systolic BP-lowering effects of exercise and medication interventions.”

Guidelines such as those from the AHA/ACC underline the importance of exercise and other lifestyle interventions in managing and treating hypertension, but they tend to consider pharmacologic and nonpharmacologic interventions separately.

The analysis covered 10,461 individuals in exercise-intervention RCTs and 29,281 patients in trials that evaluated BP-lowering medications. All medication trials included people with hypertension, defined as having a systolic BP ≥140 mmHg. People with hypertension were included in some of the exercise trials, which combined accounted for 3508 individuals.

Both forms of intervention reduced systolic BP levels from baseline in comparison with control interventions. Mean reductions were 8.80 mmHg for antihypertensive drugs and 4.84 mmHg for exercise.

Overall, medications achieved greater average reductions in systolic BP than the exercise interventions. The mean reduction difference was 3.96 mmHg.

The different forms of exercise intervention were associated with similar reductions in systolic BP, although endurance and resistance training combined were more effective in reducing systolic BP than dynamic resistance alone (mean reduction difference, 2.96 mmHg).

All classes of antihypertensive drugs were associated with similar reductions in systolic BP. Interestingly, the group notes, most classes of such medications yielded results that were not significantly different from those seen with isometric resistance and with the combination of endurance and dynamic resistance training.

Also of note, exercise interventions were associated with an average 8.96 mmHg greater reduction from baseline compared with the control intervention solely among persons who had hypertension at the start of the trials.

In that higher-risk group, there was no significant difference in reduction in systolic BP between the exercise interventions and medications (mean difference, 0.18 mmHg).

Further analysis indicated that the benefit of exercise interventions on systolic BP in people with hypertension was driven by endurance training, dynamic resistance, and their combination.

Exercise Preserves CV Function in Breast Cancer Patients

SAN ANTONIO — A year-long structured exercise program initiated 3 weeks after surgery for breast cancer significantly attenuated expected declines in cardiovascular (CV) function as patients continued through treatment, a Norwegian randomized, placebo-controlled study found.

The program, which took place outdoors and incorporated aerobics, weight bearing movement, and stretching, enabled almost full recovery of CV function at 12 months.

The study was presented here during the San Antonio Breast Cancer Symposium (SABCS) 2018.

“It is striking that for all [patient] groups — whether they received chemotherapy or not — there was a really good effect of being in the physical activity program,” said lead author Inger Thune, MD, PhD, Oslo University Hospital, Norway.

“Our study supports incorporation of supervised clinical exercise programs into breast cancer treatment guidelines,” Thune told Medscape Medical News at a meeting press briefing.

“CV function during treatment is a reflection of a patient’s physical function later on in life, because [poor CV function] is a marker of susceptibility to comorbidity and to overall survivorship, so its loss can be a very important issue in daily life,” she added.

Kent Osborne, MD, of the Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, wholeheartedly agreed with the idea of patients exercising throughout treatment as much as possible.

“You’d be surprised how little activity patients get after their diagnosis, and this is partly related to their families telling them, ‘You need to rest because you are on this chemotherapy,’ ” he told reporters.

“But patients need to be as active as they can. They will tolerate chemotherapy better and have better outcomes, so we have to convince the family not to treat the patient as if they are sick,” emphasized Osborne, who moderated the press event.

Study Details

The Energy Balance and Breast Cancer Aspect (EBBA-II) trial enrolled 545 women with stage I or II breast cancer following surgical excision of their tumor.

The mean age of patients was 55 years, and the mean body mass index was approximately 25 kg/m2. More than 70% of both groups had invasive breast cancer.

Approximately 22% of both groups also had lymph node metastases, and about 70% of women in both groups underwent breast-conserving surgery.

Slightly more than half of both groups underwent chemotherapy. About half of these patients received an anthracycline-based regimen, and some 40% received a taxane.

Of both groups, 80% also underwent radiotherapy, and almost 60% were treated with some form of endocrine therapy.

Three weeks after undergoing breast cancer surgery, patients were randomly assigned either to participate in a 12-month exercise program or to receive standard care.

Patients performed aerobic exercises of moderate to high intensity; there was also a weight-bearing and stretching component to the program.

The exercise program was tailored to an individual’s maximal oxygen uptake (VO2max), as assessed prior to their undergoing surgery. VO2max is a common measure of CV fitness.

Patients exercised together twice a week for 60 minutes per session and were instructed to exercise at home for another 120 minutes a week to achieve a total of 240 minutes a week of activity.

“CV capacity was assessed before surgery, at 6 months, and again at 12 months,” Thune noted.

“And at a mean of 31 mL/kg/min, the VO2max in both groups was basically identical at baseline,” she said.

Focus on Chemo Recipients

At 6 months, “the intervention group did much better at preserving their CV function than the control group, among whom there was an 8.9% decrease in VO2max,” Thune reported.

By way of comparison, VO2max in the intervention group dropped by only 2.7% at 6 months, the investigators noted.

At 12 months, CV function among those who participated in the exercise program had rebounded to almost the same VO2max levels as prior to surgery. On the other hand, those who received standard care had a 3.8% decrease in VO2max at 12 months relative to presurgical baseline levels (P < .001).

When investigators assessed VO2 levels among 242 patients who had not undergone chemotherapy, findings were again significantly in favor of the intervention group.

After 6 months of exercise, “patients in the intervention group had a 1.6% increase in the level of their VO2max, which was maintained at 12 months of follow-up,” Thune noted.

In contrast, patients in the control group had a 2.7% decrease in VO2max at 6 months. This loss persisted to 12 months, she added.

The researchers also analyzed changes in CV function for patients who had received any kind of chemotherapy as well as those who had been treated with a taxane.

Among 295 patients who received some form of chemotherapy, exercise participants experienced a 9% decrease in VO2max at 6 months, compared with a 14.2% decrease among control patients who received standard care.

Again by 12 months, VO2max had almost rebounded to presurgical baseline levels among those who exercised, whereas for control patients, VO2max was 6.4% lower than at baseline (P < .001).

A separate analysis was conducted for 212 patients who had received a taxane as part of their chemotherapy regimen.

For these patients, treatment effects were most pronounced. There was a 17.5% drop in VO2max at 6 months among control patients and a significant, though slightly less pronounced, drop among exercise participants.

However, at 12 months, VO2max had rebounded to only about 1.4% below presurgical baseline levels among exercise participants. For the control group, there was a 7.3% decrement in VO2max (P < .05).

“It is striking that for all these groups — whether they received chemotherapy or not — there was a really good effect of being in the physical activity program,” Thune noted.

“We believe that breast cancer patients receiving chemotherapy should be offered a tailored exercise program based on pretreatment levels of physical function,” she concluded.

Can Exercise Worsen Dementia?

Could exercise worsen dementia? The idea runs against one of the fondest hopes of patients with Alzheimer disease, their caregivers, and physicians. It contradicts some early research and tentative recommendations. But it is a key finding of one of the largest studies yet to examine the question.

In the Dementia And Physical Activity (DAPA) trial, the mean score on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog) worsened more for people with dementia who were assigned to a year of vigorous exercise than for people who kept to their usual routines.[1]

The difference was small but statistically significant, says Bart Sheehan MRCPsych, MD, consultant liaison psychiatrist at the Coventry and Warwickshire Partnership Trust in Coventry, United Kingdom. “It does raise the possibility that, at this point, vigorous exercise might be damaging for people.”

The finding has experts in the field taking a harder look at what they thought they knew about the way physical activity affects a declining brain. It comes as a particular blow because no one has found a way to halt Alzheimer disease. “People are desperate for a treatment,” Sheehan said.

Until the DAPA results came out, exercise was looking like one of the most promising possibilities—if not to stop dementia, then at least to slow its progression. “Among patients with dementia or mild cognitive impairment, randomized controlled trials (RCTs) documented better cognitive scores after 6 to 12 months of exercise compared with sedentary controls,” wrote the authors of a 2011 meta-analysis.[2]

Such results were enough to prompt the Mayo Clinic website, a health information website for consumers, to advise that “Exercising several times a week for 30 to 60 minutes may… improve memory, reasoning, judgment and thinking skills (cognitive function) for people with mild Alzheimer’s disease or mild cognitive impairment.”[3]

But these findings were from relatively small trials. And negative results have also cropped up in the literature for years, including in other reviews of the literature.[1] Funded by the British government, Sheehan and his colleagues set out to settle the question with the most authoritative trial possible.

They recruited 494 people with mild to moderate dementia according to the criteria in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). All lived in the community and were able to sit on a chair and walk 10 feet without assistance. The average age was 77. Sixty-one percent were men.

The researchers randomly assigned 329 to exercise and 165 to make no change in their physical activity. The exercisers attended group sessions in a gym twice a week for 4 months under the guidance of physical therapists. Each session lasted 60-90 minutes. The researchers asked them to work out for an additional hour each week at home during this period. The sessions included cycling in place for 25 minutes of moderate to hard intensity, as well as weight training such as biceps curls, shoulder forward raise, lateral raise, and sit-to-stand using a weighted vest or waist belt.

After the 4 months, the researchers prescribed a home-based program of unsupervised exercise of 150 minutes each week. They encouraged the participants to choose activities at home that they preferred and followed up with phone calls to encourage them. Eighty-eight percent reported continuing the exercises at home. Less than 1% of the participants reported doing structured exercise outside of the trial.

The people who evaluated the patients didn’t know which ones participated in the exercise programs and which ones did not.

After 12 months, the patients improved their fitness compared with the usual-care group. But when it came to cognitive function, the researchers recorded abysmal results. On the ADAS-cog, where a higher score means worsening function, the usual-care group went from 21.4 to 23.8, a worsening of 2.4 points, as might be expected with the progressive diseases that cause dementia.

But the exercisers fared even worse, going from a mean score of 21.2 to 25.2, a worsening of 4.0. For perspective, a normal score for someone who does not have dementia is 5, while the average score of someone diagnosed with probable Alzheimer’s or mild cognitive impairment is 31.2.

The difference was statistically significant (P =.03). It’s not clear whether it has clinical significance, Sheehan says. Still, it startled the researchers.

Despite their improved physical fitness, the exercisers did not improve in activities of daily living, behavior, or health-related quality of life.

“It didn’t come as a surprise that physical exercise was not effective as a treatment for dementia, because dementia is notoriously difficult to treat,” he said. “I think what was a surprise is the very strong signal that it may make dementia worse.” They ran the statistics again and again but found no mistake.

And the finding held up regardless of the patients’ sex or mobility and regardless of whether they were diagnosed with Alzheimer’s versus other kinds of dementia, or whether they had mild versus severe cognitive impairment.

Despite their improved physical fitness, the exercisers did not improve in activities of daily living, behavior, or health-related quality of life.

The finding should influence what clinicians say to people with dementia and their caregivers, said Sheehan, who has treated many such patients. He now tells them that exercise won’t help with such core features of dementia as memory or the ability to organize oneself, and that it might actually do damage.

People who are already exercising and enjoying it shouldn’t necessarily stop, he added. But they must weigh the enjoyment and other health benefits—which are many—against the risk for harm.

Not everyone interprets the results of the DAPA trial as pessimistically as Sheehan. “We don’t have the evidence yet to be able to say that exercise is going to improve cognitive function,” said J. Carson Smith, PhD, an associate professor of public health at the University of Maryland. “But there is more evidence of a benefit in mild cognitive impairment and in people at increased risk for dementia.”

He is among the researchers whose small studies have suggested that exercise can improve cognitive ability in people with mild cognitive impairment. Epidemiologic studies measuring the benefits of long-term exercise for preventing dementia are even more impressive.

This includes a recent sample of 191 Swedish women who were 38-60 years of age in 1968 when they underwent an ergometer cycling test. Examinations of dementia were done six times up to 2010 and supplemented with information from medical records. Women with high physical fitness at middle age were nearly 90% less likely to develop dementia decades later, compared with women who were moderately fit.[4]

Smith and others have found biological differences between more and less fit people that could explain a difference in dementia risk. Lower cardiovascular fitness is associated with a smaller brain volume two decades later, for example.[5]

It’s hard to explain why exercise in healthy people might protect against cognitive decline, but exercise in people with dementia might make it worse. Sheehan theorized that already weakened brains might be too fragile to withstand the temporary loss of oxygen that comes with vigorous exercise. But there isn’t much information yet to support or refute such ideas.

Such studies can’t prove cause and effect. Not only physical activity but also genes affect physical fitness. And people who exercise may have other healthy behaviors.

But even Sheehan has not given up on the idea that physical activity can help people in their declining years. Some kinds of exercise can improve balance, for example. “People say, ‘I wish my father could recognize me,’ but they also say, ‘I wish my father didn’t fall over,'” he points out.

Exercise an Antidote for Aging

If you want to counter the physical costs of getting old, regular exercise might be your best option, researchers report.

The findings “debunk the assumption that aging automatically makes us more frail,” said researcher Janet Lord. She is director of the Institute of Inflammation and Ageing at the University of Birmingham in England.

In the study, the team assessed 84 male and 41 female cyclists, aged 55 to 79. The men had to be able to cycle 62 miles in under 6.5 hours, while the women had to be able to cycle 37 miles in 5.5 hours.

Unlike a “control group” of adults who did not get regular exercise, the cyclists did not have loss of muscle mass or strength, did not have age-related increases in body fat or cholesterol levels, and their immune systems were as robust as much younger people.

Male cyclists also had higher testosterone levels than men in the control group, according to the study authors.

“Our research means we now have strong evidence that encouraging people to commit to regular exercise throughout their lives is a viable solution to the problem that we are living longer but not healthier,” Lord added in a university news release.

The findings were published March 8 in the journal Aging Cell.

Researcher Niharika Arora Duggal, also from the University of Birmingham, said, “We hope these findings prevent the danger that, as a society, we accept that old age and disease are normal bedfellows, and that the third age of man is something to be endured and not enjoyed.”

A daily walk ‘can add seven years to your life’

A daily walk 'can add seven years to your life'
Exercise brings benefits at whatever age the person starts.
Just 25 minutes of brisk walking a day can add up to seven years to your life, according to health experts.

Researchers have found that moderate exercise could halve the risk of dying from a heart attack for someone in their fifties or sixties.

Coronary heart disease is the UK’s single biggest killer, causing one death every seven seconds, and exercise has long been seen as a way to reduce the risks by cutting obesity and diabetes.

A new study presented at the European Society of Cardiology (ESC) Congress suggested that regular exercise can increase life span.

A group of 69 healthy non-smokers, aged between 30 and 60, who did not take regular exercise were tested as part of the study at Saarland University in Germany.

Blood tests taken during six months of regular aerobic exercise, high-intensity interval training and strength training showed that an anti-ageing process had been triggered and helped repair old DNA.

“This suggests that when people exercise regularly, they may be able to retard the process of ageing,” said Sanjay Sharma, professor of inherited cardiac diseases in sports cardiology at St George’s University Hospitals NHS Foundation Trust in London.

“We may never avoid be-coming completely old, but we may delay the time we become old. We may look younger when we’re 70 and may live into our nineties.

“Exercise buys you three to seven additional years of life. It is an antidepressant, it improves cognitive function and there is now evidence that it may retard the onset of dementia.”

The advice from experts is that everyone should do at least 20 minutes of walking or jogging a day, given the sedentary lifestyles and changes in diet that have contributed to high death rates from heart disease. Exercise can also improve brain functioning.

Exercise brings benefits at whatever age the person starts. People who start exercising at the age of 70 are less likely to go on to develop a condition that leads to irregular or racing heart rates in 10 per cent of people aged over 80.

“The study brings a bit more understanding of why physical activity has that effect,” said Christi Deaton, Florence Nightingale Foundation Professor of Clinical Nursing Research at Cambridge Institute of Public Health.

“It helps us understand the process of cellular ageing, as that’s what drives our organ system and body ageing, and the effects physical activity can have on the cellular level.

“The more active you are, and it doesn’t matter when you start, the more benefit you are going to have.”

Heart attacks are mainly triggered by coronary heart disease, which kills around 73,000 people in the UK every year and is the leading cause of death in both sexes. Heart disease generally affects more men than women, although from the age of 50 the chances of developing the condition are similar for both.

According to a separate study, hundreds of young people die every year from “electrical faults” in their otherwise healthy hearts triggered by intense sporting activity.

Sudden cardiac death (SCD) is a rare occurrence that affects one in 50,000 athletes, although most who die are men, researchers found. In the 35 year history of the London Marathon, only one woman has died compared to 13 men.

The study’s authors, from St George’s University Hospital in London, found that a large proportion of cases of SCD in sport occurred in people with anatomically normal hearts, but with inherited faults in the heart’s electrical system that causes them to miss beats and trigger death.

Take A Deep Breath To Good Health: 6 Conditions Yoga Can Treat

Yoga may not directly cure any diseases, but it can make a difference in treating certain conditions — from back pain to anxiety disorders. 

Yogis, hippies, and holistic medicine specialists have been touting the health benefits of yoga for years: it can improve your fitness level, fight cancer, diabetes, obesity, heart disease, and a variety of other disorders, they’ve argued.

But when it comes to the science backing up these claims, a lot is still left unresolved. For example, research has shown that yoga doesn’t necessarily help at all in treating asthma compared to other breathing exercises. And while yoga and mindfulness can improve quality of life, and reduce chemotherapy side effects, it hasn’t been proved to treat cancer in any way, according to the American Cancer Society.

That being said, let’s take a look at all the conditions or disorders yoga does treat — according to the scientific evidence that’s out there, at least. Maybe this way, you can give yoga a try, and better understand how it may benefit you.

Back Pain

Some 80 percent of adults will experience back pain at some point in their lives, and it’s something that can cause a lot of distress and distraction. But research has shown that yoga or simply stretching can alleviate chronic back pain. A 2011 study found that both yoga and stretching helped people with chronic pain — they were considered “safe options” for a condition that is normally treated with a regimen of painkillers. As long as you focus on yoga’s therapeutic effects (and don’t push yourself too much trying to perfect the crazy poses), yoga may relieve your chronic back pain.


Doctors still aren’t certain whether yoga directly improves arthritis; several studies have yielded different and conflicting results. However, it’s generally agreed that yoga can and does assist in reducing the stress and frustration caused by arthritis — and that incorporating yoga into an arthritis treatment program can only enhance it.

“While there is a great deal of anecdotal evidence of the benefits of yoga (just visit any yoga studio), to date only a handful of scientific studies have been conducted on persons with [arthritis],” Johns Hopkins University states. “These early studies have shown promising results with some improvement in joint health, physical functioning, and mental/emotional well-being… People with arthritis may also enjoy yoga more than traditional forms of exercise, and exercise enjoyment is an important predictor of adherence.”

Heart Disease

A recent study out of Erasmus University Medical Center found that yoga was beneficial for cardiovascular health. While yoga mainly works on flexibility and muscular strength, it’s not considered an aerobic exercise like running — so it’s an interesting finding.

The researchers note they’re not sure exactly how yoga improves cardiovascular health. “Also unclear, are the dose-response relationship and the relative costs and benefits of yoga when compared to exercise or medication,” Myriam Hunink, lead author of the study, said. “However, these results indicate that yoga is potentially very useful and in my view worth pursuing as a risk improvement practice.”

Indeed, yoga is unlike other types of physical activity in that it focuses more on slower poses, meditative breathing, and a calm approach. This trifecta can assist in reducing stress and lowering blood pressure, which can all have a good effect on your heart health.

Anxiety Disorders, Depression

You may enter a yoga class, your body tensed and tight from weeks and even months’ worth of accumulated stress. Our body holds emotion in it — and yoga can help unravel that. Just an hour’s worth of yoga can force you to leave all your stresses and anxiety behind, and this “yoga high” effect can last for hours afterwards.

Though there aren’t too many studies on this yet, one study found that “several studies of exercise and yoga have demonstrated therapeutic effectiveness superior to no-activity controls and comparable with established depression and anxiety treatments” such as cognitive behavioral therapy, sertraline, and imipramine. “High-energy exercise and frequent aerobic exercise reduce symptoms of depression more than less frequent or low-energy exercise. For anxiety disorders, exercise and yoga have also shown positive effects.”

Chemotherapy Side Effects

While there is no evidence that yoga can fight cancer, or lower a person’s risk, it has been shown to reduce inflammation and alleviate chemotherapy side effects in cancer patients.

In one recent study, scientists gathered breast cancer patients who were suffering from debilitating chemotherapy effects, and placed them in 90-minute yoga classes twice a week. They found the cancer patients had more energy, less fatigue, and slept much better than the patients who didn’t do yoga.

Sleep Disorders

This brings us to yoga and sleep: like most exercise, yoga can improve your sleeping patternsand fight insomnia. Stress and the “buzz” of external anxieties — and yes, a sedentary lifestyle — can keep us lying awake at night. Learning to breathe more slowly and deeply in yoga classes can ultimately improve our sleep. A 2004 study found that yoga treated chronic insomnia in patients

Weight training wards off age-related abdominal fat better than aerobic activity

Weight training for 20 minutes per day helped healthy men stave off age-related abdominal fat gain better than engaging in aerobic activities for the same amount of time, according to research published in Obesity.

Although aerobic exercise alone was associated with less weight gain than weight training overall, a combination of the two optimized waist circumference results, Harvard School of Public Health researchers and colleagues found.

“To combat sarcopenia that is inevitable with aging, older adults are recommended to engage in physical activities that achieve the most favorable changes in their body composition, such as loss of fat mass while preserving lean body mass,” Rania Mekary, PhD, of the Department of Nutrition at Harvard, told Endocrine Today.

“Because long-term weight training leads to this concomitant fat loss and muscle gain, this has been shown to prevent and treat many chronic diseases, including obesity, diabetes, heart disease and osteoporosis,” she said.

Mekary, with Frank B. Hu, MD, PhD, and colleagues, prospectively examined the effects of weight training, moderate to vigorous aerobic activity and replacement between the two on waist circumference and body weight in 10,500 healthy men (mean age 58±7) from the ongoing Health Professionals Follow-up Study over 12 years.

All participants were followed through mailed biennial questionnaires regarding medical history, lifestyle and health-related behaviors, including physical activity. Multiple linear regression models (partition/substitution) were used to assess associations; diet components known to predict weight gain, smoking status, antidepressant use, sleep duration and baseline age were considered.

With adjustments for potential confounders, an inverse dose-response relationship was seen between weight training and waist circumference change (P-trend <.001). Less age-associated waist circumference increase was seen when activity was increased 20 minutes per day; the benefit was stronger for weight training (–0.67 cm; 95% CI, –0.93 to –0.41) than for moderate to vigorous aerobic activity (–0.33 cm; 95% CI, –0.40 to –0.27), other activities (–0.16 cm; 95% CI, –0.28 to –0.03) or television watching (0.08 cm; 95% CI, 0.05–0.12).

The strongest inverse association with waist circumference change was seen when weight training for 20 minutes per day was substituted for any other discretionary activity. Moderate to vigorous aerobic activity showed the strongest inverse association with body weight change (–0.23 kg; 95% CI, –0.29 to –0.17).

“Incorporating weight training with aerobic exercise is crucial to maintain a healthy waistline,” Mekary said. “Further studies are needed among women, older men, and other ethnic groups to compare the frequency and volume of weight training on waist circumference change.” — by Allegra Tiver

Regular aerobic exercise may slow down dementia.

Regular aerobic exercise may help delay the progression of dementia in older women whose cognitive function has been affected by age, as indicated by a recent study.

A randomized controlled study tested the impact of different types of exercise on the hippocampal volume of 86 elderly women who were living independently at home but reported mild memory problems (or mild cognitive impairment [MCI]), a common risk factor for dementia. [Br J Sports Med 2013; doi: 10.1136/bjsports-2013-093184]

The women (aged 70-80) were randomized to one of three groups: the first group was assigned to a twice-weekly and hour-long exercise regime comprising aerobic training (brisk walking), the second group underwent resistance training involving lunges, squats and weights, while the third group was assigned to a balance and muscle toning exercise.

Participants were required to adhere to their respective exercise regimens over a period of 6 months. Hippocampus size was assessed at the start and the end of the 6-month period using an MRI scan, and participants’ verbal memory and learning capacity were assessed before and after using a validated test (RAVLT).

Out of the 86 women, 29 took the before and after MRI scans. The results revealed that the total volume of the hippocampus for the aerobic training group was significantly larger than the balance and muscle toning exercise group (p=0.03). There was no difference in hippocampal volume between the resistance training group and the balance and muscle toning group.

“Our study showed that aerobic training has significantly increased hippocampal volume in older women with probable MCI,” said co-author, Dr. Teresa Liu-Ambrose, Department of Physical Therapy, UBC, Vancouver, British Columbia, Canada.

The findings suggested that aerobic exercise seemed to be able to slow down the shrinkage of the hippocampus and maintain the volume in the group of women at risk of dementia at the minimum. The researchers also recommend regular aerobic exercise to stave off mild cognitive decline.

“However, more research is needed to ascertain the relevance of exercise-induced changes in hippocampal volume on memory performance in older adults with MCI,” elaborated Liu-Ambrose.

This finding is especially important as the researchers pointed out the rising toll of dementia worldwide – one new case is diagnosed every 4 seconds – and the number of those afflicted is set to rise to more than 115 million by 2050.

Clear Skin and Improved Mood—Two Oft-Forgotten Benefits of Exercise.

Story at-a-glance
Exercise helps normalize your glucose, insulin, and leptin levels by optimizing your insulin/leptin receptor sensitivity. It also releases mood boosting brain chemicals that help combat depression
Another side effect of exercise include clearer complexion. To improve your skin, you’ll want to focus on resistance training. Excessive cardio can actually cause your skin to lose its youthful elasticity
Research shows that the “secret” to increased happiness is a long-term investment in regular exercise, and a little each day appears to go further than a lot once or twice a week
There’s plenty of research validating the use of exercise for the treatment of depression. In one study, aerobic exercise was found to be as effective as Zoloft.



One of the primary reasons why exercise is such a potent medicine for chronic disease is because it optimizes your insulin and leptin receptor sensitivity. Normalizing your glucose, insulin, and leptin levels will have a beneficial effect on virtually every disease state you could ever acquire.

But exercise also promotes the release of mood-boosting brain chemicals that help combat depression, and more superficially, it can go a long way toward improving your complexion; clearing up acne and warding off signs of premature aging.

How is it that physical movement can achieve such effects? It’s easy to forget that your body is actually designed for more or less constant movement. When you do, all of your biological systems can work properly and efficiently, creating all-around beauty, health, and well-being.

It’s just not natural to remain seated for hours on end like we do today, courtesy of computers, cars, and other gadgets that remove our need to get up, stretch, reach, bend, and move from one area to another. In fact, we’re now starting to realize just how bad it is to sit for long periods of time.

I’ve previously written about this, and the importance of what I call “intermittent movement” throughout the day. That said, more vigorous exercise is equally important for optimal health, beauty, and happiness, and here’s why.

What Happens in Your Body When You Exercise?

As previously reported by the Huffington Post,1 a number of beneficial biological effects take place when you exercise. It quite literally affects your body from head to toe. This includes changes in your:

Muscles, which use glucose and ATP for contraction and movement. To create more ATP, your body needs extra oxygen, so breathing increases and your heart starts pumping more blood to your muscles. Without sufficient oxygen, lactic acid will form instead. Tiny tears in your muscles make them grow bigger and stronger as they heal.
Lungs. As your muscles call for more oxygen (as much as 15 times more oxygen than when you’re at rest), your breathing rate increases. Once the muscles surrounding your lungs cannot move any faster, you’ve reached what’s called your VO2 max—your maximum capacity of oxygen use. The higher your VO2 max, the fitter you are.
Heart. As mentioned, your heart rate increases with physical activity to supply more oxygenated blood to your muscles. The fitter you are, the more efficiently your heart can do this, allowing you to work out longer and harder. As a side effect, this increased efficiency will also reduce your resting heart rate. Your blood pressure will also decrease as a result of new blood vessels forming.
Brain. The increased blood flow also benefits your brain, allowing it to almost immediately function better. As a result, you tend to feel more focused after a workout. Furthermore, exercising regularly will promote the growth of new brain cells. In your hippocampus, these new brain cells help boost memory and learning. As stated in the featured article:
“When you work out regularly, your brain gets used to this frequent surge of blood and adapts by turning certain genes on or off. Many of these changes boost brain cell function and protect from diseases such as Alzheimer’s, Parkinson’s, or even stroke, and ward off age-related decline.”

A number of neurotransmitters are also triggered, such as endorphins, serotonin, dopamine, glutamate, and GABA. Some of these are well-known for their role in mood control. Exercise, in fact, is one of the most effective prevention and treatment strategies for depression.

Joints and bones, as exercise can place as much as five or six times more than your body weight on them. Peak bone mass is achieved in adulthood and then begins a slow decline, but exercise can help you to maintain healthy bone mass as you get older.
Weight-bearing exercise is actually one of the most effective remedies against osteoporosis, as your bones are very porous and soft, and as you get older your bones can easily become less dense and hence, more brittle — especially if you are inactive.

How Exercise Can Improve Your Complexion

Exercise can also go a long way toward “cleaning up” and toning your complexion. Makeup artist Michelle Phan has blogged about the beauty benefits of exercise.2 And, according to Dalton Wong, a celebrity trainer featured in a previous Telegraph article,3 engaging in the correct exercises will help you tone your skin in much the same way you tone your muscles. Katy Young writes:

“‘The key in training to tone your skin is to focus on increasing lean muscle mass,’ explains Wong. As we age, our skin naturally loses its plumping, youthful layer of fat. But if you exercise the right way, you can build up muscle which gives that same volatizing effect. As Wong explains; ‘it’s the lean muscle mass that sits just under the surface which can create a lifted, taught looking, skin.'”

According to Wong, to improve your skin, you’ll want to focus on resistance training, where you’re using your own bodyweight to challenge your muscles. Lunges, pushups, and planking are examples of resistance exercises. To tone both muscles and skin, and help eliminate cellulite, he recommends implementing a circuit routine consisting of three to four sets of weight bearing exercises with two to four minutes of cardio in between, repeated four times.

Excessive cardio training is not recommended if skin toning is your goal. It’s also one of the least effective ways to improve your fitness, as discussed in previous articles, as your body is designed for great exertion in short bursts, which is how our hunter-gatherer ancestors used to move. Conventional cardio or long-distance running can actually do more harm than good, and this extends to your skin as well.

Wong warns that excessive cardio can actually cause your skin to lose its youthful elasticity, especially if you’re over- or underweight. One of the reasons for this is because the stress placed on your body when you’re running long distances produces excessive amounts of cortisol, a stress hormone responsible for inflammation. This can take a heavy toll on your skin, as cortisol tends to break down collagen, resulting in wrinkling and sagging.

Stay Well Hydrated When Exercising

It should come as no great surprise that sweating and improving blood flow is good for your skin. Your skin is the largest organ for detoxification, and sweating not only helps regulate body temperature; it also helps eliminate toxins. Improved blood flow, in turn, helps shuttle oxygen and nutrients to your skin, which is key for beautiful complexion. Water is another key ingredient. As stated in the featured article:4

“One of the things Wong tells his celebrity clients – who include Oscar-winning actress Jennifer Lawrence – is to stay well hydrated. ‘It’s not just that it helps you train better – no one can work out if they’re not properly hydrated – it makes your skin look better, too. Conversely, if you’re training without drinking enough water, you’ll damage your skin pretty quickly,’ he warns. How to tell if you’re drinking enough? Try the hydration test by pinching the skin on the back of your hand; if it doesn’t spring back fast, you’re dehydrated.”

In addition to hydrating your skin from the inside out, increasing your water intake will also help flush out trapped toxins, oils, and debris that can contribute to acne. The combination of being well-hydrated and boosting blood flow can also benefit your hair, as it will naturally stimulate your hair follicles and promote hair growth.

Exercise Can Help You Feel Better from the Inside Out

Regular exercise is also one of the “secret weapons” to overcoming depression. Indeed, it is a recipe for both looking and feeling better. A recent article in The Atlantic5 tells the story of Joel Ginsberg who, as a college sophomore, struggled with feelings of “an all-consuming hopelessness” and immobilizing self-doubt. For Ginsberg, as for so many others who decide to try it, exercise turned out to be a key ingredient for recovering his joie-de-vivre.

“He thought getting some exercise might help, but it was hard to motivate himself to go to the campus gym,” Olga Khazan writes.6 “So what I did is break it down into mini-steps,” he said. “I would think about just getting to the gym, rather than going for 30 minutes. Once I was at the gym, I would say, ‘I’m just going to get on the treadmill for five minutes.'”

Eventually, he found himself reading novels for long stretches at a time while pedaling away on a stationary bike. Soon, his gym visits became daily. If he skipped one day, his mood would plummet the next. ‘It was kind of like a boost,’ he said, recalling how exercise helped him break out of his inertia. ‘It was a shift in mindset that kind of got me over the hump.’

There is plenty of research validating the value of exercise for the treatment of depression. As noted in the featured article, a 1999 study7 found that aerobic exercise was as effective as Zoloft. More recently, a 2011 study8 concluded that exercise led to a 30 percent remission in patients who had failed to get any relief from antidepressant medications.

Guidelines for Using Exercise as an Antidepressant

In 2006, a meta-analysis9 of 11 studies concluded that doctors would be well advised to recommend exercise to patients suffering from depression, anxiety, and eating disorders, as the evidence showed “substantial benefit.” Yet according to a 2009 paper,10 a mere 40 percent of depressed patients reported that their doctors suggested exercise. As noted in the featured Atlantic article:11

“Instead, Americans are awash in pills. The use of antidepressants has increased 400 percent between 1988 and 2008. They’re now one of the three most-prescribed categories of drugs, coming in right after painkillers and cholesterol medications.

After 15 years of research on the depression-relieving effects of exercise, why are there still so many people on pills? The answer speaks volumes about our mental-health infrastructure and physician reimbursement system, as well as about how difficult it remains to decipher the nature of depression and what patients want from their doctors.”

This is clearly a shortfall of modern medicine and psychiatry. Despite the evidence, many doctors still are not savvy enough to broach the subject of exercise and other lifestyle factors with their patients. And, of course, there’s the lack of financial incentive… It may be worth noting that doctors who do not accept insurance tend to be more likely to prescribe non-drug treatments for their depressed patients. The other side of the coin is that many patients are looking for a quick fix, and resist taking physical action to improve their own situation…

If you were to view exercise as a drug, how much would you need in order to reap clinical results? According to research12 by Dr. Madhukar Trivedi, a professor of psychiatry at the University of Texas Southwestern Medical Center in Dallas, depressed patients would do well to exercise for 45-60 minutes, three to five times per week. He also recommends raising your heart rate to at least 50-85 percent of your maximum, in order to reap results.

Keep in mind that major depression is typically associated with thoughts of suicide, and feelings of deep hopelessness or helplessness, making it critical to recognize and address such symptoms. (To assess your or a loved one’s risk factors, please review this previous article.) If you are feeling desperate or have any thoughts of suicide, please call the National Suicide Prevention Lifeline,13 a toll-free number 1-800-273-TALK (8255), or call 911, or simply go to your nearest Hospital Emergency Department.

How Does Exercise Alleviate Depression?

A number of cascading changes occur when you exercise that contribute to improved mood and mental health. For starters, it helps normalize your insulin and leptin levels, as mentioned earlier. It also boosts the production of mood-boosting hormones in your brain. According to Dr. James S. Gordon, MD, a world-renowned expert in using mind-body medicine to heal depression:

“What we’re finding in the research on physical exercise is that exercise is at least as good as antidepressants for helping people who are depressed… physical exercise changes the level of serotonin in your brain. And it increases your endorphin levels, your ‘feel good hormones.’

Also—and these are amazing studies—exercise can increase the number of cells in your brain, in the region of the brain called the hippocampus… they’re very important because sometimes in depression, there are fewer of those cells in the hippocampus. But you can actually change your brain with exercise. So it’s got to be part of everybody’s treatment, everybody’s plan.”

Aside from serotonin and endorphins (which are responsible for that feeling of euphoria you get with regular exercise), other chemical messengers also play a significant role.14 When you exercise, your brain recognizes the exertion as a fight-or-flight stress situation. To protect itself from stress-related harm, your brain releases a protective protein called Brain-Derived Neurotrophic Factor (BDNF).

This protein helps repair neurons, and acts as a “reset switch,” which may explain why solutions tend to come into clearer focus after a bout of exercise. BDNF also activates brain stem cells to convert into new neurons, and triggers numerous other chemicals that promote neural health. Recent research15, 16 has actually made it quite clear that exercise and brain health are inextricably intertwined. The evidence shows that physical exercise helps you build a brain that not only resists shrinkage, but increases overall cognitive abilities—and feelings of happiness.17

Aim for a Well-Rounded Fitness Program

Whether you simply want to look better, or actually feel better—physically and mentally, I strongly suggest carving out the necessary time to exercise. Ideally, you’ll want to strive for a varied and well-rounded fitness program that incorporates a variety of exercises. I recommend incorporating the following types of exercise into your program in order to truly optimize your results:

High Intensity Interval Training (HIIT): This is when you alternate short bursts of high-intensity exercise with gentle recovery periods. For more information, please see this previous article.
Core Exercises: Your body has 29 core muscles located mostly in your back, abdomen, and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and strengthening them can help protect and support your back, make your spine and body less prone to injury, and help you gain greater balance and stability.
Foundation Training, created by Dr. Eric Goodman, is an integral first step of a larger program he calls “Modern Moveology,” which consists of a catalog of exercises. Postural exercises such as those taught in Foundation Training are critical not just for properly supporting your frame during daily activities, they also retrain your body so you can safely perform high-intensity exercises without risking injury. Exercise programs like Pilates and yoga are also great for strengthening your core muscles, as are specific exercises you can learn from a personal trainer.

Stretching: My favorite type of stretching is active isolated stretches developed by Aaron Mattes. With Active Isolated Stretching, you hold each stretch for only two seconds, which works with your body’s natural physiological makeup to improve circulation and increase the elasticity of muscle joints. This technique also allows your body to repair itself and prepare for daily activity. You can also use devices like the Power Plate to help you stretch.
Strength Training: Rounding out your exercise program with a 1-set strength training routine will ensure that you’re really optimizing the possible health benefits of a regular exercise program. You can also “up” the intensity by slowing it down. For more information about using super slow weight training as a form of high intensity interval exercise, please see my interview with Dr. Doug McGuff.
Avoid Sitting for More Than 15 Minutes. Last but not least, while it may not have a direct effect on your mood or beauty regimen, there’s a lot to be said for avoiding prolonged sitting. Chronic sitting has actually been shown to take years off your life even if you exercise regularly.
To counteract the ill effects of sitting, I recommend setting a timer to go off every 15 minutes while you’re sitting. When it goes off, simply stand up. I usually recommend going a step further; personally, I stand up and do one legged squats, jump squats or lunges when the timer goes off. The key is that you need to be moving all day long, even in non-exercise, or as I now like to call them, intermittent movement activities.

Intense But Short Exercise Is All You Need to Boost Calorie Burning.


Story at-a-glance

  • Recent research demonstrates that high intensity interval training burns more calories in less time. Just 2.5 minutes, divided into five 30-second sprint intervals at maximum exertion, each followed by four minutes of light pedaling to recuperate, can burn as much as 220 calories
  • Anaerobic exercises also increase insulin sensitivity and glucose tolerance, and promote production of human growth hormone—all of which are critical components of optimal health. Previous research has shown that just three minutes of high intensity exercise per week for four weeks can result in a 24 percent improvement in insulin sensitivity
  • If you’re ready to take your fitness routine to the next level, you may want to consider skipping breakfast and work out on an empty stomach. This is a form of intermittent fasting that can greatly contribute to improved weight loss, as it shifts your body into fat burning mode
  • The combination of high intensity interval training, avoiding grain carbs and sugars, especially fructose, and exercising in a fasted state, can help you become increasingly fat adapted, which is the preferred metabolic state of the human body

If you have a difficult time fitting exercise into an already crammed schedule, you’ll be excited to know you can reap truly remarkable results in a very limited amount of time. Can you carve out 20 minutes two to three times a week?

If so, you can dramatically improve your overall fitness and health – as long as you engage in high-intensity interval training, that is.

Research presented at the Integrative Biology of Exercise VI meeting12 in Colorado on October 10-13 this year, demonstrated that high-intensity interval training burns more calories in less time – a mere 2.5 minutes, divided into five 30-second sprint intervals at maximum exertion, each followed by four minutes of light pedaling to recuperate, can burn as much as 220 calories.

According to lead researcher Kyle Sevits:3

“You burn a lot of calories in a very short time… Nearly all the calories are burned in those 2.5 minutes; you burn very few during the rest period.”

Besides burning more calories, high-intensity interval training, which is part of my total Peak Fitness program, has also been shown to produce greater health benefits overall than conventional aerobic training, such as increasing insulin sensitivity and glucose tolerance – both of which are critical components of optimal health. Back in April, I reported on a study that found doing just three minutes of high-intensity exercise per week for four weeks, could lead to a 24 percent improvement in insulin sensitivity.

Another important benefit of high-intensity interval training is its ability to naturally increase your body’s production of human growth hormone (HGH), also known as “the fitness hormone.” HGH is a synergistic, foundational biochemical underpinning that promotes muscle and effectively burns excessive fat.

It also plays an important part in promoting overall health and longevity. This too is something you cannot get from conventional, aerobic endurance training. Other benefits associated with high-intensity interval training include:

Decrease in body fat Improved muscle tone
Improved athletic speed and performance Ability to achieve your fitness goals much faster
Increase in energy and sexual desire Firmer skin and reduces wrinkles

Are You Maximizing the Health Benefits from Your Fitness Routine?

The key that unlocks the many health benefits associated with exercise is intensity. To perform anaerobic exercises correctly, regardless of how you do them (sprinting outdoors, using a stationary bike or elliptical machine, or using weights), you’ll want to raise your heart rate to your anaerobic threshold, and to do that, you have to give it your all for those 20 to 30 second intervals.

Different studies will use different intervals of exertion and recuperation. For example, in the featured study, 30-second bouts of exertion were separated by four-minute rest intervals. I use and recommend the program developed by Phil Campbell, where you go all out for 30 seconds, followed by 90 seconds of recuperation. If you do the recommended eight repetitions, you’ll be done in 20 minutes or less.

Depending on your level of fitness when you’re first starting out, you may only be able to do two or three repetitions of the high-intensity intervals. That’s okay. As you get fitter, just keep adding repetitions until you’re doing eight during your 20 minute session. Here’s a summary of what a typical interval routine might look like using an elliptical:

  • Warm up for three minutes
  • Exercise as hard and fast as you can for 30 seconds. You should be gasping for breath and feel like you couldn’t possibly go on another few seconds. It is better to use lower resistance and higher repetitions to increase your heart rate
  • Recover for 90 seconds, still moving, but at slower pace and decreased resistance
  • Repeat the high-intensity exercise and recovery 7 more times

Greater Intensity = Greater Need for Recovery

To optimize results, do these types of peak exercises twice or three times a week. Again, you only need about 20 minutes per session, and you don’t even need a gym membership to do them. If you have beach access, you may want to take to sprinting barefoot by the water’s edge. However, before you give it a go, make sure to review some basic safety guidelines, which I discussed in depth in my previous article, Proper Sprinting and Warm-Up Techniques to Optimize Your Workout and Avoid Injury.

You can also turn your weight training session into an anaerobic exercise by following the guidelines presented by Dr. Doug McGuff. The key that turns strength training into a high-intensity exercise is the speed. Reducing the speed increases the intensity.

Whichever way you choose to do them, you do not need to do high-intensity exercises more frequently than three times a week. In fact, doing so can be counterproductive, as your body needs to recover between sessions. The importance of recovery should not be overlooked, as your body needs time to rebuild itself in order to function optimally. As explained by Dr. Jeff Spencer:

“To achieve the most beneficial effects from your workouts in the shortest time it’s essential to understand the concept of total load. Total Training Load refers to the total amount of training ‘strain’ on the body over time. For example, one single super-hard workout can strain the body as much as several moderate intensity workouts done back to back can.

The Total Training Load can be increased by increasing the number of exercise repetitions, resistance, length of workout sets and by increasing the speed of repetitions and, also, by shortening the rest interval between exercise sets. If the Total Training Load is in excess too long, the body breaks down, and illness, over-training, burnout, and injury occur.”

Recovery also includes giving your body the proper nutrients it needs in the recovery phase, as your post-workout meal can support or inhibit the health benefits of exercise. For instance, fast-assimilating protein such as high-quality whey protein, eaten within 30 minutes of your workout, will essentially “rescue” your muscle tissue out of the catabolic state and supply it with the proper nutrients to stimulate repair and rejuvenation.

The Synergy Between Exercise and Diet, and Boosting Results with Intermittent Fasting

It’s well worth noting that your choice of breakfast food may play a significant role in altering your metabolic functioning, which can either improve or deter weight loss. For example, eating carbohydrates for breakfast will inhibit your sympathetic nervous system (SNS) and reduce the fat burning effect of your exercise. Instead, it activates your parasympathetic nervous system (PSNS), which promotes storage of fat – the complete opposite of what you’re aiming for.

Avoiding fructose and other grain carbohydrates is a critical element of a successful weight loss strategy. This includes sports or energy drinks and fruit juices (even if they’re freshly squeezed). Exercise cannot counteract the harmful effects of a high-fructose diet. It’s also important to remember that if you consume fructose within two hours before or after high-intensity exercise, you effectively negate the ability of the exercise to produce HGH – one of the MAJOR benefits of interval training.

If you’re ready to take your fitness routine to the next level, you may even want to consider skipping breakfast altogether and work out on an empty stomach. You can review the article I recently wrote on this here. This is a form of intermittent fasting and I believe it’s one of the most profound new developments in weight loss management. This can radically improve your ability to shift to fat burning mode and effectively burn fat rather than glucose.

Also, exercising in a fasted state can help your cells rebuild and repair, keeping them biologically young. I’ve previously interviewed fitness expert Ori Hofmekler on the issue of fasting and exercise. According to Ori, fasting actually has the surprising benefit of helping you reconstruct your muscles when combined with exercise. This is due to an ingenious preservation mechanism that protects your active muscle from wasting itself.

In a nutshell, if you don’t have sufficient fuel in your system when you exercise, your body will break down other tissues but not the active muscle, i.e. the muscle being exercised. That said, neither Ori nor I advocate starvation combined with rigorous exercise. It’s important to be sensible. And you need to consume sufficient amounts of protein in order to prevent muscle wasting. While most people need to address the foods they DO eat before considering skipping meals, intermittent fasting can provide you with many benefits, and is another tool you can experiment with to help you reach your goals. Research has shown that the combined effect of intermittent fasting (IF) with short intense exercise may help you to:

Turn back the biological clock in your muscle and brain Boost growth hormone Improve body composition
Boost cognitive function Boost testosterone Prevent depression

Being Fat-Adapted Can Help Improve Your Health

If you follow the recommendations mentioned above, which include:

  • High-intensity interval training
  • Avoiding grain carbs and sugars, especially fructose
  • Exercising in a fasted state

another side effect will eventually become apparent: you’ll become increasingly “fat-adapted.” Fat-adaption describes the ability to burn fat directly via beta-oxidation. It is the normal, preferred metabolic state of the human body, in which your body burns fat rather than glucose as its primary source of energy. Sadly, the bodies of many, if not most, Americans operate in a state of sugar-dependency, which is an abnormal metabolic state that inevitably results in insulin resistance and related chronic disease. Signs that you’re a sugar-burner and are heading down a path of disease include:

  • Low satiety
  • Persistent hunger
  • Carb cravings

As Mark Sisson explains in a recent article, if you are fat-adapted, you:

  1. Can effectively burn stored fat for energy throughout the day.

If you can handle missing meals and are able to go hours without getting ravenous and cranky (or craving carbs), you’re likely fat-adapted.

  1. Are able to effectively oxidize dietary fat for energy.

If you’re adapted, your post-prandial fat oxidation will be increased, and less dietary fat will be stored in adipose tissue.

  1. Can rely more on fat for energy during exercise, sparing glycogen for when you really need it.

Being able to mobilize and oxidize stored fat during exercise can reduce an athlete’s reliance on glycogen. This is the classic “train low, race high” phenomenon, and it can improve performance, save the glycogen for the truly intense segments of a session, and burn more body fat.

According to Sisson, once you can go three hours or more without feeling hungry, you’re on your way toward being fat-adapted. If you can handle exercising without having to carb-load, you’re probably fat-adapted. And if you can work out effectively in a fasted state, you’re definitely fat-adapted.

Source : mercola.com

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