The Importance Of Exercise and How To Incorporate It Into Your Lifestyle

a

by Jeffry S. Life, M.D. Ph.D.

The United Nations, the World Health Organization, and 37 countries including the United States have proclaimed 2000-2010 as the Bone and Joint Decade to promote the importance of a healthy musculoskeletal structure for a lifetime. The number of people older than 50 will double between 1990 and 2020. Advances in medicine continue to make it possible for more people to live longer, but today most want to live stronger and maintain their quality of life. Each year, musculoskeletal conditions and injuries account for about 102.3 million visits to physician offices, 10.2 million hospital outpatient visits, 25 million emergency department visits, 3 million hospitalizations, and 7.5 million procedures, and they cost an estimated $300 billion.1 As the baby boom generation ages, people in their 50s begin to notice more aches and pains after performing the same activities that were painless in their 40s, and those in their 60s can't do as much as they did in their 50s. Roy Shephard, MD, PhD, professor emeritus of applied physiology at the University of Toronto, points out that, "Both aerobic power and muscle strength decline by as much as 10% for every decade of adult life, but a progressive exercise prescription can enhance function by 10% to 20%; thus, in terms of functional capacity, conditioning can reduce biological age by 10 to 20 years."2 In 1998, the American College of Sports Medicine issued its first position statement on aging and exercise,3 in which it recommended strength training for frail older people. Petrella says, "We now know that older patients can perform to very high levels, so exercise prescription does not differ for older and younger persons, and training effects for the elderly can exceed those of younger people at the upper end of VO2max." Exercise is the key to maintaining quality of life, as well as extending the number of years of life expectancy. It's never too late to start, and an early start is better. Even 90- and 100-year-olds can do strength training. Exercise is really a form of medicine that can prevent or treat many disabling or fatal diseases. Seventy percent of deaths (1.5 million) each year in the United States are a result of eight killers: heart disease, cancer, stroke, hypertension, chronic obstructive pulmonary disease (COPD), diabetes, and osteoporosis4. Other diseases treatable with exercise--obesity, arthritis, depression, and dyslipidemia--contribute considerably to disability and premature death The health rewards of exercise extend far beyond its benefits for specific diseases. Exercise reduces blood clotting, enhances self-image, elevates mood, reduces stress, improves appearance, increases energy, gives the feeling of well-being (probably by stimulating endorphins). It reinforces other positive life-style changes, such as healthier eating habits and smoking cessation5. It also stimulates creative thinking 6. Furthermore, the ability of exercise to restore function to organs, muscles, joints, and bones is not shared by drugs or surgery. Paradoxically, conventional medical practice favors physical rest and inactivity during recovery from illness. Aerobic Exercise vs. Resistance Training For many years doctors have advised middle-aged and older people to get plenty of aerobic exercise—that is, exercise that requires the rhythmic movement of their arms and legs. This form of exercise, which includes walking, jogging, swimming, bicycle riding and so on, has always been thought to be the best exercise to help prevent and/or treat heart disease. Doctors have traditionally discouraged people with heart disease or older people from engaging in strength training with weights or exercise machines because they believed that this would put dangerous stress on their hearts. Recently, an expert panel of scientists, organized by the American Heart Association, has finally put to rest that age-old myth that weight training and other forms of resistance exercise are bad for the heart. In fact, this committee has advised doctors to actually start recommending this form of exercise for their healthy older patients, as well as those with heart disease, including some people with recent heart attacks as long as they are closely monitored and supervised by experienced health professionals. Aerobic exercise and resistance training clearly work hand-in-hand to prevent, reduce, or even eliminate heart disease by preventing or controlling diabetes, high cholesterol and high blood pressure. Aerobic exercise does a great job lowering systolic blood pressure, and both aerobic and resistance exercise help reduce diastolic blood pressure. This makes it much easier for the heart to do its job of pumping blood throughout the body. Both forms of exercise also strengthen the heart muscle making it work much more efficiently. Obviously, this is great news. Now doctors can encourage their patients with healthy hearts (no matter what their age or gender) and those with unhealthy hearts (under medical supervision) to start using resistance training along with their aerobic training as an integral part of their heart-disease prevention and/or treatment program. The following table, by Pollock and Vincent, from The President’s Council on Physical Fitness and Sports Research Digest, is found in my article entitled “Why Everyone Should Lift Weights” in this website. This table helps us better understand the differences in aerobic (cardio) training and resistance training. Comparison of the Effects of Aerobic Endurance Training to Strength (Resistance) Training on Health and Fitness Variables Variable Aerobic Exercise Resistance Exercise Increases Bone Density Decreases Body Fat Increases Muscle Mass very little effect Increases Strength Decreases Insulin Response to Glucose Decreases Basal Insulin Levels Increases Insulin Sensitivity Increases HDL very little effect Decreases Resting Heart Rate very little effect Increases Stroke Volume of the Heart very little effect Decreases Systolic Blood Pressure very little effect Decreases Diastolic Blood Pressure Improves Cardio/Vascular Fitness Increases Endurance time Improves Physical Function Increases Basal Metabolism Dr. Kenneth Cooper, who coined the term aerobics in 1968 and a staunch advocate of aerobic exercise, now believes a mix of aerobic conditioning and strength training is the best exercise program for aging adults. He proposes an “aerobic-strength axis” with the balance changing depending on how old you are. At age 40 and younger, he suggests 80% aerobics and 20% strength; age 41 to 50, 70/30; 51 to 60. 60/40; and at 61 and older, 55/45. So he still favors aerobics, but the bias practically disappears after age 60. “A good rule of thumb, “ says Cooper, “is that you should always include at least 50 percent aerobic/endurance work in your personal fitness routine, regardless of your age and sports interest.” As individuals age they need more strength training. In Regaining the Power of Youth At Any Age, Cooper writes: “Up to age 50, people lose about four percent of their strength and muscle mass per decade. After that, the loss increases to about 10 percent per decade.” “By age 60”, he goes on to say, “the average man will have lost about one third of his muscle mass—unless he makes an effort to reverse the process through weight training.” Women have a similar decline as they age. Cooper still leans toward aerobics because he believes the supporting evidence at this time is stronger. He cites a number of impressive studies showing that endurance training slows the steady erosion of oxygen uptake capacity with age that appears to occur for both trained and untrained individuals. He cites one study, which indicates that it may even be possible to stop the decline with hard consistent training. That study, reported in the Journal of Applied Physiology, followed a group of track athletes, age 50 to 82, who remained highly competitive for 10 years – and found that their aerobic capacity remained unchanged during the entire time. Individuals who aren’t satisfied with a moderate level of fitness can take heart from a study published March 14, 2002, in the New England Journal of Medicine. The researchers concluded that exercise capacity is perhaps the most powerful predictor of mortality. They found a direct relationship between greater fitness and longer survival. Most previous studies have emphasized that the least fit have the most to gain from exercise, that the most striking reduction in mortality results when one becomes active and moves out of the poor fitness category. An earlier study reported in 1989 by the Institute for Aerobic Fitness in Dallas highlighted that those in the high-fitness group were only slightly less likely to die than those in the medium-fitness groups, but this study shows that people benefit in proportion to their level of fitness. As in other studies, the researchers found a "striking difference" in mortality rates between the least fit 25 percent and the next quintile of fitness. "This observation concurs with the consensus," the researchers wrote, "that the greatest health benefits are achieved by increasing physical activity among the least fit." They also demonstrated that there is a nearly linear reduction in risk with increasing quintiles of fitness. With each 1-MET increase in exercise capacity there was a 12 % improvement in survival. Participants whose exercise capacity was less than 5 MET were roughly twice as likely to die as those with exercise capacity of more than 8 Met. Absolute exercise capacity measured in METs predicted risk of death better than percentage of age predictions. In both healthy participants and those with cardiovascular disease, peak exercise capacity was found to be a stronger predictor of death than risk factors such as hypertension, diabetes, obesity, heart arrhythmia, high cholesterol, and even smoking. Poor fitness proved to be the deadliest risk factor of all. Lead author Jonathan Myers, a professor of medicine at Stanford University, told the Washington Post "No matter how we twisted it, exercise came out on top." Exercise pays big dividends. It’s even more important than smoking in its impact on life span. Greater fitness means longer life. What could be a bigger dividend than that? Doctors who don’t encourage their patients to exercise are missing the boat. Gary J. Balady, M.D., summarized the message in an editorial which accompanied the report: "The data from the study compel the clinician to go beyond the identification of risk to the initiation of interventions, such as the prescription of increased physical activity and exercise, in order to modify risk, particularly in patients with low levels of fitness." Benefits of Exercise Therapy for the Common Serious Diseases Coronary artery disease7-11. Coronary artery disease (CAD) is our number one killer, responsible for 2,000 deaths in the United States each day. About twice as many heart attacks occur every day. CAD claims many people who are at the peak of their career. Exercise combined with diet therapy can reverse established heart disease. Furthermore, exercise improves heart function, reduces several coronary risk factors (hypertension, high cholesterol, low high-density lipoprotein (HDL) cholesterol, and obesity), enhances psychosocial wellbeing after a heart attack, and improves survival. In summary, exercise is an effective strategy for preventing heart disease, and it is a beneficial, low-cost, pleasure-giving treatment without the side effects of drugs or the risks, pain, and expense of surgery. Cerebrovascular disease12-14. Vigorous exercise in early adulthood confers considerable protection from strokes in later life. This effect is independent of other risk factors. Furthermore, exercise is essential for restoring function following a stroke--again, a benefit not shared by drugs or surgery. Hypertension15-19. Substantial evidence shows that exercise is an effective treatment for mild and moderate high blood pressure and is a useful adjunct for the treatment of severe hypertension. Many patients who adhere to a regular, specifically prescribed aerobic exercise program can reduce their blood pressure without taking drugs. Thus, they avoid the potentially toxic effects and considerable expense of long-term drug therapy. Drug and exercise compliance are reported to be similar. Postexercise blood pressure reduction in normal and hypertensive patients disappears 2 weeks after exercise stops. The degree of blood pressure reduction depends on the type, duration, and intensity of the exercise, as well an individual's genetics. Therefore, the prescription must be carefully individualized. Among non-pharmacologic means for lowering blood pressure, physical activity provides better patient compliance and quicker results than weight reduction or alcohol and salt restriction. Diabetes20-22. Exercise can prevent or delay the serious complications of diabetes, namely, the vascular disease of the brain, heart, kidney, eyes, and legs that commonly occurs in diabetics who are under age 40. The same benefits of exercise are seen in those who develop the disease in later life. Exercise improves the abnormal blood lipid pattern and reduces the high blood pressure common in people who have diabetes. In addition, exercise increases insulin effectiveness and the metabolism of sugar, thereby reducing the insulin requirement, which in turn reduces the risk of vascular disease. Elevated blood insulin has been implicated in the pathogenesis of arteriosclerosis. The complexity of diabetes treatment requires a combination of methods to achieve healthy blood sugar levels and to prevent or reduce the serious complications of the disease. An exercise regimen, properly taught and followed, helps accomplish this goal and allows diabetic patients to lead healthy, active lives. Arthritis23-26. In patients who have rheumatoid or degenerative arthritis, exercise improves endurance, strengthens muscles, and increases joint flexibility and range of motion. These, of course, are benefits that drugs or surgery cannot achieve. Osteoporosis27-29. Osteoporosis affects 20 to 24 million postmenopausal American women and an unknown number of men over the age of 80. It results in musculoskeletal weakness, loss of height, bone fractures (primarily spine and hip), and painful disability. Two hundred fifty thousand hip fractures occur each year in the United States, resulting in 12,000 deaths and $11 billion in medical expenditures. Research indicates that regular exercise can prevent and control the disease. Dyslipidemia30-32. Abnormalities of blood fats (high total cholesterol and triglycerides and low HDL cholesterol) are major risk factors for vascular disease of the heart, brain, kidney, eyes, and legs. Regular exercise reduces total cholesterol and triglyceride levels and raises HDL cholesterol. Obesity33-36. The amount of body fat is a useful indicator of health and fitness, as well as an early warning signal of many serious diseases. Excess body fat is a risk factor for heart disease, hypertension, diabetes, many cancers (breast, prostate, colon, uterus, and gall bladder), and premature death from other causes. It appears that being overweight aggravates a very wide spectrum of diseases and is also a handicap to getting a job, obtaining admission to a university, and forming social relationships. The magnitude of the problem in the United States is greater than in any other country. Estimates of the number of overweight Americans range from 50 million to 200 million. The average American is said to have 20 to 30 lb of excess body fat. Daily, lifelong exercise is an essential strategy for achieving and maintaining optimal weight. Diet, though essential, cannot be relied on exclusively for successful weight loss and maintenance. Depression37-39. Depression, the most common mental disorder in America, affects approximately 5% (about 12 million) at any given time. Psychologists have observed that walking or running has both physiologic and psychological benefits for people who are depressed. These forms of exercise reduce depression and anxiety, increase feelings of wellbeing, improve tolerance to everyday stress, and improve the self-image of depressed patients. It is difficult to sustain depressed feelings while one is physically exercising. Furthermore, exercise stimulates the release of the "feel good" hormones (endorphins). One report38 concluded that walking or running while talking with depressed patients was more effective than talking and listening to them in an office because (1) the walking approach is non-confrontational--the patient and therapist are side by side, looking ahead rather than looking directly at one another; (2) the talking is being done in a less threatening setting; and (3) the patient is actively experiencing life rather than passively observing it in a chair. Cancer. There is evidence that physical activity reduces the risk for cancer of the left side of the colon40 and the breast41. COPD. Recent data42 suggest that adding an exercise component to the rehabilitation program for patients who have COPD results in physiologic as well as psychological benefits, even for those with severe air flow obstruction. A Plan for Therapy To be maximally effective for therapy or health enhancement, an exercise program must fulfill certain basic requirements: It must be a daily activity (7 days a week), it must be fun, not painful or excessively fatiguing, and it must fit an individual's preferences5-6. The selected activities must be readily available, not distant or difficult to reach, and preferably be close to the home or workplace. The clothes, equipment, and/or club membership associated with the activity must be inexpensive. Ideally, the activity should not depend on other people (team, class, or partners), but should permit group participation if desired. And finally, the activity must be suitable for lifelong participation. The major form of aerobic exercise should be (walking, running, cycling, swimming, or cross-country skiing). Variety is an important part of the prescription: At least two or preferably three different activities are recommended, for example walking-running-tennis or walking-cycling-swimming. The choice of exercise should be guided by individual preference and previous experience. Walking and running are most often recommended because they do not require special training or skills. They are inexpensive, readily available, safe, and suitable for doing alone or with others. The acronym DF ALIVE is helpful to guide one’s exercise program: Daily, Fun, Available, Lifelong, Independent, Variety, & Endurance. Encourage Lifelong Habits The daily goal is to exercise for at least 30 to 60 minutes (2% to 4% of the day) and to make a conscious effort to do body movement throughout 16 hours of the day (i.e., doing household chores, working, shopping, gardening, running errands, visiting, or socializing in an active manner5-6). Everybody should have an individualized lifelong exercise program designed to fit his or her lifelong situation and preferences. In recent decades, research has validated the effectiveness of regular exercise as a way to reduce and/or prevent age-related functional decline and reduce the risks of a sedentary lifestyle43. Most medical groups recommend regular physical activity44. People over age 65 carry the highest load of chronic disease, disability, and healthcare utilization45. Though many of these problems are preventable, primary care physicians rarely provide their older patients with an appropriate exercise recommendation that includes an individualized motivational message, a pre-participation evaluation to ensure a safe exercise program, and a tailored exercise prescription46. The first step in a pre-participation evaluation by your physician is to be evaluated for reasons not to be involved in exercise testing and training and to identify any risks or limitations relevant to an exercise program. An efficient screening questionnaire addresses previous exercise programs; present activity (frequency, duration, and intensity); existing chronic or acute disease(s), especially chronic obstructive pulmonary disease, cardiovascular disease, and extreme motor limitations because of severe arthritis; family history of cardiorespiratory disease; and coronary artery disease risk factors. Though most of the risk of exercise-related morbidity and mortality is associated with preexisting cardiac conditions, contraindications to exercise testing and training are the same for older and younger adults. Absolute contraindications to formal exercise testing include recent electrocardiographic changes or acute myocardial infarction, unstable angina, third-degree heart block, and acute congestive heart failure47. Relative contraindications to exercise testing include elevated blood pressure, cardiomyopathies, valvular heart disease, complex ventricular ectopy, and uncontrolled metabolic diseases. Physical Examination and Lab Tests The physical exam and laboratory tests focus on a patient’s functional abilities and/or limitations. A medical assistant, nurse, or other midlevel practitioner under a physician's supervision can usually accomplish most of the steps of the pre-participation exam. The average office-based evaluation takes about 20 minutes, though additional time is required if treadmill testing, bone mineral density scans, or respiratory function tests are needed. The physical examination should include vital signs and cardiorespiratory and musculoskeletal evaluation. Cardiovascular fitness. The American College of Sports Medicine (ACSM) recommends cardiac treadmill stress testing before commencing vigorous exercise (exercise intensity greater than 60% of maximal oxygen uptake) for men over age 40, women over age 50, and all patients who have cardiac risk factors with or without symptoms47. Treadmill tests, which can be used to estimate the patient's aerobic capacity, are useful for prescribing exercise intensity. If a treadmill test is unavailable, the Kasch pulse-recovery test can be performed in the office to give physicians a general idea of a patient's functional and aerobic capacities. The test is based on the principle that the better one's level of fitness, the sooner the heart rate returns to baseline after exercise. The patient's pulse and blood pressure are measured at rest and 1 minute after he or she has stepped up and down (with both feet) a 12-in. step 24 times per minute for 3 minutes48. To help patients adhere to this pace, setting a metronome to 96 bpm may be helpful. Respiratory function can be determined simply by measuring the patient's forced vital capacity and forced expiratory volume in 1 second. The Role Physicians Play in Prescribing Exercise Programs Medical students spend a year learning about pharmacology and they receive instruction on drug prescribing throughout their training. Often, the drugs they study will no longer be recommended by the time they are in practice. On the other hand, medical students are not instructed on how to prescribe exercise (or, for that matter, nutrition)—the best medicine of all. Physicians need more training in how to make best use of this powerful therapy. Physicians can successfully encourage increased activity by giving their patients a written exercise prescription along with printed advice on how to design a safe, enjoyable routine. Prescribing exercise is like prescribing medications, surgery, or other therapy—It is a thoughtful compromise between potential benefits and side effects. After careful consideration of these factors, the physician and the patient reach an agreement on the most effective plan. Important considerations include the goal of exercise (e.g., osteoporosis prevention, weight loss, strength improvement, marathon training) and patient preferences. Expanding on his or her current exercise habits is a good starting point because choosing activities the patient already enjoys improves adherence. Setting goals. The ACSM recently published separate position statements on exercise for healthy adults56 and older adults57. Kligman et al.58 have adapted these recommendations, combined with those from the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH)59, into a very helpful chart that outlines basic exercise prescriptions for a range of health and fitness goals. Basic Exercise Prescriptions for a Range of Health and Fitness Goals for Older Persons, Adapted From Federal Exercise Guidelines Fitness Dimension Disease Prevention Basic Health Fitness Performance Cardiovascular capacity Accumulate 30 min of physical activity most days Large-muscle repetitive exercise or equivalent sports activity, 20 min, 3x/wk Aerobic exercise or equivalent sports activity, 40-60+ min, 4-6x/wk Add competition and/or interval training Strength Include weight-bearing activity "Core four"* or equivalent program, one set, 8-12 or 12-15 repetitions at challenge weight,** 2x/wk, Pilates work*** Balanced whole-body free weights or machines, 1-3 sets, 8-12 repetitions reaching functional failure,++ 2-3x/wk, Pilates work Add ascending and descending pyramids+++ and muscle endurance or power training, Pilates work Flexibility Maintain range of motion by bending and stretching in daily activities 2-4 stretches after activity, 1 repetition, hold 30 sec 6-10 whole-body stretches before and after activity, 1-2 repetitions Add yoga, Pilates, and/ or facilitated stretches with a partner Body composition Men -- >5%-<25%>125-150 lb 12%-20% fat; maintain lean body mass at >125-150 lb 8%-15% fat Women -- >14<38%>90-110 lb 20%-30% fat; maintain lean body mass at >90-110 lb 17%-25% fat Balance and agility -- "Act like a child"; balance line; "Don't step on a crack"; brush teeth while standing on one foot Recreational sports (eg, tennis, biking); tai chi; social dance; therapy ball training Agility or skill sports (ie, surfing, skiing, skating); martial arts; performance dance; agility drills *Core four: double-leg press, chest press, latissimus dorsi pulldowns, abdominal crunch. **Challenge weight: the lift is difficult but can be accomplished. ***Pilates: a series of stretching and strengthening exercises performed on a mat without equipment, developed by Joseph Pilates in the 1930s. ++Functional failure: unable to complete another repetition without sacrificing form. +++Ascending pyramids: more weight is added to each set to cause fatigue with fewer repetitions; descending pyramids: weight is removed from each set to allow more repetitions until fatigue. Like the pre-participation medical evaluation, the exercise prescription should address the five major fitness components: cardiovascular fitness, muscle strength and endurance, flexibility, body composition, and balance and agility. Many older patients have low muscle mass and/or decreased strength, underscoring the importance of strength training. The ACSM recently added formal strength training recommendations to its exercise guidelines for adults56. Within the five categories, an individual and his or her physician should select the desired fitness level. The objective is to allow people to indefinitely maintain their current level of function and, ideally, help them reach the next category. The types and dosages of exercise will change as the patient's physiologic function changes. Selecting activities. An exercise program prescribed by your physician should address the type, frequency, duration, and intensity of physical activity for each fitness component. Though the type of exercise is often determined by available facilities and equipment, your preference should carry considerable weight. For example, if you enjoy golf you should be encouraged to occasionally substitute this activity for a treadmill and resistance training session. Your physician should balance the benefits of each exercise mode with the your health goals and physical limitations. For example, walking, bicycling, and swimming provide excellent cardiovascular benefits, but the weight-bearing nature of walking provides a greater stimulus for bone mineral deposition than cycling or swimming does. On the other hand, swimming is better tolerated by people who have joint limitations. Cross-training is an effective compromise among several appropriate options. You can mix exercise modes within any given week or within a single session. Cross-training programs help prevent boredom, condition more muscle groups, and reduce the risk of overuse injury. Determining frequency, duration, and intensity. Exercise variables can be manipulated to enhance compliance, but the dose-response relationship must be considered. Though exercising more often, longer, or harder affords greater conditioning, the relationship between effort and outcome is rarely linear. The point of diminishing return is often reached even before individuals approach levels that pose a risk of excessive fatigue or injury. Surprisingly little exercise is required to meet the recommendations for disease prevention (CDC-NIH recommendations)59. Physicians and exercise physiologists often make frequency and duration recommendations at minimal and optimal levels, with instructions to perform the minimal exercise during the busiest weeks and meet the optimal criteria on all others. Exercise intensity is always prescribed as a range (e.g., a target-heart-rate range of 120 to 145 beats per minute or muscle fatigue in 8 to 12 repetitions). Using an age-predicted target heart rate has limited value and is often misleading, especially as patients age, because 70% to 85% of age-predicted maximal heart rate is often off by 15 to 20 beats per minute. Physiologic change occurs when the body is exposed to stimuli greater than it can currently handle, a concept called “teasing the physiologic threshold.” The concept is useful even in balance and agility training. Many people underestimate their exercise capacity, considering physical activity to be uncomfortable, hazardous, or medically unwise. However, Fiatarone et al60 demonstrated the safety and effectiveness of a strength training program even for nonagenarians. The quantity and load of an exercise should be adjusted as function improved. An exercise prescription should involve monitoring or teaching patients to assess their own progress. MET levels are useful for setting exercise goals. A list of common physical activities classified by intensity in METs is available61. I have attached this article at the end of my article to help you design your exercise program. The Borg perceived exertion scale, http://www.cdc.gov/nccdphp/dnpa/physical/measuring/perceived_exertion.htm, is frequently used to evaluate aerobic exercise intensity; it can also be used to rate the intensity of resistance training and stretching. Maximal exertion on the Borg Scale is 20. Exercise physiologists often recommend aerobic exercise in the moderate to heavy range (13 to 15 on the Borg scale) for healthy young adults, and may modify their recommendations to light to moderate (11 to 13 on the Borg scale) for older adults. As function improves, increasing the intensity or duration of exercise should raise the challenge. In strength training, a common recommendation is to lift to muscle fatigue (inability to complete another lift while maintaining good form) in 8 to 12 repetitions. For older adults, 12 to 15 repetitions using slightly lighter weights may be more appropriate. Weight is increased when the patient can consistently complete 13 repetitions; then he or she repeats the process. The rate of improvement varies among individuals and may be slower in older adults. We have no control over our genetics and very little control over environmental factors, but the things that we can control—diet and exercise—can profoundly affect our longevity and quality of life. Exercise may be the closest thing we have to the fountain of youth. All we have to do is to “just do it.”

Eating Fat To Lose Fat

by Dr. John Berardi

To lose fat, sometimes you have to eat fat. I know, I know, this statement just "feels wrong." After all, years of anti-fat campaigning have convinced us that fat is what makes us chunky. But did you know that monounsaturated fats and certain polyunsaturates actually speed up the metabolic rate?

Eric Noreen, a lipid researcher at the University of Western Ontario, believes that the best of the fat burning bunch are the highly unsaturated omega 3s called EPA and DHA. According to Eric, these omega 3 fatty acids can potentially help burn blubber through 3 different mechanisms.

1. Allowing the body to burn fat in situations where fat oxidation (or fat burning) is normally turned off. Normally, when you eat carbohydrates, fat burning is slowed or turned off. Also, during high intensity exercise, the body prefers burning carbohydrate to fat. Therefore in both scenarios, fat burning is dramatically reduced. However, cells that receive a high daily dose of omega 3s actually burn more fat in both situations. The net result — more fat burned each and every day whether you're exercising or not.

2. Increasing your sensitivity to the hormone Insulin. Insulin is both a storage hormone and an anti-breakdown hormone. When insulin goes up, a consequence of eating, ingested nutrients are stored in muscle cells and in fat cells. Likewise, nutrients already in these cells (especially the fat in our love handles) are retained as a result of this insulin boost. Since omega 3 fatty acids can make your body more sensitive to insulin, meaning that less insulin will be released each time you eat, a diet high in omega 3s helps prevent large insulin increases with eating. If insulin is properly managed, more stored fat is released each day. And guess what happens to that fat. You got it... it's incinerated.

3. Increasing the heat of your cellular furnaces. In your cells, there are two metabolic organelles responsible for burning fuel to make energy. The most well known is the mitochondrion while the lesser known one is the peroxisome. Omega 3 fatty acids have been shown to increase the size of both metabolic fires, leading to an increase in the amount of energy burned in each organelle. What this means is that a diet high in omega 3s can make you a fat burning machine.

In a series of investigations conducted by Eric and his colleagues at the University of Western Ontario, Eric showed that a diet supplemented with omega 3-rich fish oil promotes losses of body fat with simultaneous gains in lean mass. That's right, more muscle and less fat, baby.

In addition to omega 3 fatty acids, several other fats have been shown to reduce body fat. The polyunsaturated fat CLA (conjugated linoleic acid — a conjugated omega 6 fat) has shown promise, as have foods high in monounsaturated fats — like olive oil. MCTs (medium chain triglycerides) are also noteworthy. These unique fats have a shorter chain length than many of the other fats discussed in this article. As a result of their unique structure, they are more readily burned than the other types of fat, meaning more energy with less fat storage.

Of course, if you overeat on any macronutrient, you're going to store body fat not lose it. So pay careful attention to your total energy intake and, as Walter Willett suggests, try to get somewhere between 25% and 35% of your daily energy from fat.

Santé des os: calcium ou activité physique?

26 novembre 2008 – Un supplément de calcium
aurait pour effet d’augmenter la densité osseuse des hommes de 40 ans
et plus, selon les résultats d’une récente étude néo-zélandaise¹.Durant
deux ans, 323 hommes de 40 ans et plus - âgé en moyenne de 57 ans - ont
pris des doses quotidiennes de calcium (600 mg ou 1 200 mg) ou un
placebo. Les chercheurs ont mesuré la densité osseuse des sujets au
début, durant et à la fin de l’essai clinique. Selon les résultats, la
dose de 1 200 mg de calcium était associée à une augmentation d’environ
1 % de la densité minérale des vertèbres après six mois, et de la
hanche après deux ans. La dose de 600 mg a été sans effet.Les
sujets du groupe placebo n’ont montré aucune perte de la densité
osseuse au cours de cet essai. Un résultat surprenant puisqu’il est
normal que les os faiblissent après l’âge de 40 ans et que ce résultat
pourrait signifier que l’apport en calcium n’est pas le seul facteur
qui pourrait nuire à la santé osseuse.Les auteurs ont également observé une légère augmentation, non significative toutefois sur le plan statistique, du nombre de troubles cardiovasculaires
chez les sujets qui prenaient les suppléments de 1 200 mg de calcium.
Des données préliminaires récentes indiquent en effet qu’il pourrait
exister un lien entre un apport important en calcium et le risque de
souffrir de troubles cardiovasculaires².Des preuves insuffisantesSelon Guy Thibault³, conseiller en recherche à Kino-Québec qui a participé à la rédaction d’un avis sur la santé osseuse⁴,
l’efficacité des suppléments en calcium pour augmenter la densité des
os n’a pas encore été clairement démontrée. « Les résultats de cette
nouvelle étude sont en contradiction avec d’autres études. L’ensemble
des résultats accumulés à ce jour laisse perplexe sur la possibilité
qu’un apport supplémentaire en calcium puisse, à lui seul, réduire
significativement le nombre de fractures chez les personnes de plus de
40 ans. »Les récentes recherches permettent par ailleurs
d’affirmer que la pratique assidue de certains types d’exercices
(course, saut, musculation) contribue à augmenter la résistance des os,
affirme Guy Thibault. Ces exercices permettraient aussi d’améliorer
l’équilibre – donc d’éviter les chutes – ainsi que de se faire des
muscles qui protègent les os lors d’un choc et, par conséquent,
diminuer le nombre de fractures osseuses. « Les données scientifiques
actuelles nous permettent même d’affirmer qu’un accroissement de
l’ordre de 1 % de la densité osseuse résultant d’une activité physique
adéquate se traduit par une résistance osseuse accrue de 10 %. À ma
connaissance, il n’existe aucune donnée indiquant qu’il en va de la
même manière pour une augmentation de la masse osseuse survenant à la
suite d’une supplémentation en calcium », précise-t-il.La santé
osseuse dépend de facteurs multiples, notamment le bagage génétique de
chacun, les apports en vitamines et minéraux, la latitude à laquelle on
réside (l’exposition aux rayons solaires agit sur la santé osseuse) et
l’activité physique. « Parmi ces déterminants, les apports en
nutriments et l’activité physique sont les seuls sur lesquels on peut
intervenir concrètement sur le plan clinique afin d’avoir un effet
mesurable sur la santé osseuse », ajoute Guy Thibault. Pierre Lefrançois – PasseportSanté.net
D’après Reuters Health.
1. Reid IR, Ames R, et al. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med. 2008 Nov 10;168(20):2276-82.
2. Sailam V, Karalis DG, et al. Prevalence
of Emerging Cardiovascular Risk Factors in Younger Individuals with a
Family History of Premature Coronary Heart Disease and Low Framingham
Risk Score. Clin Cardiol. 2008 Nov 12;31(11):542-545.
3. Guy Thibault est aussi titulaire d’un doctorat en physiologie de
l’exercice et conseiller à la Direction du Sport et de l’Activité
physique du ministère de l’Éducation du Québec.
4. Activité physique et santé osseuse. Avis du Comité scientifique de
Kino-Québec. Ministère de l’Éducation, du Loisir et du Sport, Canada,
2008. [Consulté le 17 novembre 2008]. www.kino-quebec.qc.ca.

http://www.passeportsante.net/fr/Actualites/Nouvelles/Fiche.aspx?doc=2008112699&xtor=RSS-19

Bodybuilding's Best Kept Secret by Don Alessi

Olympic Gold

Bodybuilding may never make it to the Olympics, but I believe that Olympic lifting will make it to bodybuilding. In fact, I've always recommended that bodybuilders use Olympic lifting at certain times during the training year.

I don't recommend this because I think bodybuilders need to be able to overhead press a Hummer. I recommend it because in order to master Olympic weightlifting technique you must, in the process, develop galvanized kinetic chains and strength-muscle balance. These training effects do transfer, in part, to bodybuilders and represent a plethora of untapped mass building potential.

Think you don't need Olympic lifting? Try this, Brutus: Load a scrawny 50% of your body mass on an Olympic bar. Position your stance with feet hip-width apart and toes pointed out slightly. Grasp the bar with a clean grip and press it over your head. Lock the elbows out and pull the shoulders and arms back so they're in alignment with your ears. Now T-boy, squat to parallel without bending your elbows, displacing your arms, or riding up on your toes. Can't handle it? That's too bad. Maybe it's not too late to join Curves.

So what does that prove? It proves you lack minimum strength and flexibility requirements in the posterior chain, shoulder chain, and shank. That means any prime mover that fires off of those chains and relies on them for stability (biceps, triceps, pecs, delts, calves), will never reach their potential!

In the same way that creatine was originally passed over as a bodybuilding supplement because it was considered strictly an aid for power, Olympic lifting is the bodybuilder's "best kept secret" as it has even more potential as an indirect developmental tool.

Why Olympic Lifting?

The secret is out: supplemental periods of Olympic lifting can build a strong, great-looking body. There are many training effects that stand out as particularly helpful. Let me break it down.

Every trainee that lifts weights is looking for a training effect. That training effect may be increased muscular strength, increased mass, better endurance, etc. In order to gain that training effect, the structures involved must undergo unique changes that align the development of that specific skill. In the case of Olympic lifting, the following adaptations (previously thought of as exclusive only to Olympic weightlifters) will transfer to bodybuilding:

• Increase contractile force, i.e. shifts the tension-over-time curve up and to the left.

• Reveal and iron out weak links in the kinetic chains (aligns the body balance).

• Increase the frequency and intensity of micro-trauma (anabolic stimulus).

• Increase the range of motion to the posterior chain and shoulders.

Olympic lifting will also have the following neural, chemical, structural, and technical effects:

Neural — Increased neural drive to the muscle (the rapid display of force in order to overcome inertia, i.e. strength-speed.) It's kinda like the ability to go from 0 to 60 in a Porsche rather than a Yugo. Quicker fast-twitch firing speeds allow Olympic weightlifters to accelerate large masses. This means that both the minimum load and minimum speed thresholds required to excite fast twitch fibers are met more easily. This will ultimately expose more type II fibers to hypertrophy.

Chemical — The ability to store increased amounts of high energy substrates i.e. adenine tri-phosphate, creatine phosphate, etc. For example, this has an additive effect on top of loading creatine. It allows the trainee to store even greater amounts of these substrates. In the gym, this will allow the bodybuilder to squeeze out two extra reps.

Structural — The development of the contractile and non-contractile components. This includes an increase in the quantity and strength of connective tissue as well as increased stability and mobility of the various joint structures.

Using the example of a snatch, this movement causes the dynamic strength balance between the lower traps stabilizing the scapula and the deltoids mobilizing the shoulder joint. It's this musculo-skeletal rhythm that drives strengthening of the entire kinetic chain and ensures muscle balance between groups. This enables the bodybuilder to focus maximal contraction on the prime movers like the biceps instead of wasting that tension on the stabilizers of the scapula, i.e. the lower traps.

Technical — The development of dynamic flexibility and proprioception. It's a fact that Olympic lifters are the most supple of all strength athletes (as you probably realized if you tried the overhead squat example I gave above).

The Bodybuilder's Olympic Lifting Program

My focus is on the physics behind the lifts and to bust plateaus for long-term bodybuilding success. The following is a specific example of how to take advantage of Olympic weightlifting's training effect to force bodybuilding success.

Who's this program for? If you're at a plateau with 8 to 15 reps training, H.I.T. training, or super-slow type training, this will work well. If your extensors are weaker than your flexors this will kick ass. And if you're post-rehab but still encounter low back, knee, or shoulder pain, this program is likely your answer.

The following is based on my experience in targeting untapped motor units and future mass potential in the posterior and scapular chains. It corrects basic alignment and flexibility flaws developed by all bodybuilders at some time or another. It also lays the groundwork for progressively technical Olympic lifts such as the clean and snatch. (See my Meltdown Training II article for additional applications and technical descriptions of Olympic exercises.)

Muscles strengthened:

Back and neck extensors

Knee medial rotators, stabilizers and flexors

Rotator cuff external rotators

Scapular stabilizers

Lumbar stabilizers

Elbow extensors

Terminology

Clean grip: A clean grip places the hands on the bar slightly wider than shoulder width apart.

Snatch grip: A snatch grip is wider than other grips; it's the distance from elbow to elbow when the arms are straight out to the side.

Hook grip: A hook grip is a pronated grip where the thumb is tucked under the index and middle fingers on the same side of the bar. It provides additional power. I didn't include it as a requirement at this level, although it's good to get used to it.

The Program

Alternate day one and day two. Train twice per week for five weeks. For best results, additional flexibility work must accompany this routine.

DAY 1

A) Wide stance, Romanian deadlift + shrug + calf raise

Tempo: 41X (See FAQ section if you're unfamiliar with tempo prescriptions)

Rest: 3 minutes

This exercise is designed to strengthen the medial leg muscles along with teaching the proper initiation of the posterior chain into the more technical hang clean. The bar is grasped with a clean grip. Use a wider than hip width stance, elbows extended, knees slightly bent.

Start the eccentric (negative) movement with the bar against the body. The bar is lowered to just below the knees with the backwards push of the hips and buttocks. Note: This deadlift eccentric phase should take up to four seconds and the center of mass should be positioned on the heels in the bottom position.

Explosive shrug + calf raise: Like a bungee cord, the hips and loaded hamstrings contract concentrically as the lifter begins to stand erect explosively. When the bar touches mid-thigh the lifter shrugs dynamically and extends the ankles, knees and hips.

Set to set breakdown:

Set 1: 10 reps, using a light, 15 rep max load

Set 2: 6 reps to failure

Set 3: 4 reps to failure

Set 4: 6 reps, using a light 12 rep max load

Set 5: 6 reps, using 10 to 20% more load than set 2

B1) Reverse one-legged squat on step

Start by holding a barbell with a clean grip. Keep elbows tucked directly under the bar at all times. Stand in front of a 12 to 18 inch step. Position the toes of the planted foot on the step. Dorsi flex the ankle of the free leg so that only the heel makes contact with the ground. Using the active contraction of the vastus medialis and quads, concentrically contract and elevate the free leg to bench level. After knee extension, follow through by extending the hips.

Sets: 4

Reps: 8, 5, 4, 6

Tempo: 10X

Rest: 90 seconds

B2) Seated, single leg hamstring curls, femurs medially rotated (turned in)

Sets: 4

Reps: 8, 5, 4, 6

Tempo: 30X

Rest: 90

C) Overhead squat, heels elevated using one inch board

Position your stance with feet hip-width apart and toes pointed slightly out. Grasp the bar with a clean grip and press it over your head. Lock the elbows out and pull the shoulders and arms back so they're in alignment with your ears. Squat to parallel without bending your elbows, displacing your arms, or riding up on your toes.

Sets: 3

Reps: 10-12

Tempo: 311 (Pause is in bottom, stretched position)

Rest: 120

D) Lateral trunk extension and flexion, elevated on bench

This strengthens the side bending muscles of the obliques and quadratus lumborum while also stretching the typically tight illiotibial band. Assume a side lying position with one arm elevated and placed on a flat bench. Feet are on the floor.

Flex the stabilized elbow into 90º adduction. The other free arm is placed overhead or on the pelvis. Extend the body so that the ankles, pelvis, shoulders and ears are aligned. To begin eccentrically, lower the pelvis into a fully stretched position. Concentrically, raise the pelvis through the midline in a coronal direction. Be careful not to rotate the pelvis or flex the hips.

Sets: 3

Reps: 10-12

Tempo: 202

Rest: 60

DAY 2

A) Front squat + push press

Tempo: 30X

Rest: 3 minutes

In this exercise, one rep equals one full front squat and one full push press. Example: Perform one full front squat, reset in the upright position, then go into the quarter squat to set up the push press. Let's break it down:

The front squat is similar to the back squat except with the bar in front of the body, above the clavicles, while actually resting on the deltoids. Elbows should be pointed up and palms should be facing the ceiling (reverse supinated grip). Feet may be slightly wider than shoulder width and toes out slightly.

Additionally, it's helpful in the case of trainees with tight calf muscles to elevate the heels with a one inch board. This increases squat depth. Many trainees also report painfully tight wrist flexors. Keep the load light and suck it up for three sessions as this will vanish.

For the push press part of the movement, use the same grip as described in the front squat. Position the bar in front of the neck resting on clavicles; lower the elbows so they're pointed down. Standing with the torso erect and chest expanded, bend the legs until the body is in jump position. Next, explosively dip and drive the bar upward going up on your toes. Let the heels come back down as you lock out the bar with your arms.

Set to set breakdown:

Set 1: 7 reps, using a light, 15 rep max load

Set 2: 5 reps, maximal voluntary contraction

Set 3: 3 reps, maximal voluntary contraction

Set 4: 6 reps, using a light 12 rep max load

Set 5: 5 reps, using 10-20% more load than set 2

B1) Chin ups with a plus

This exercise adds scapular adduction and abduction. Grasp a chin up bar with a shoulder width grip with the palms facing you. Begin at the bottom, stretched position. First, forcibly pull together and separate the shoulder blades for one second each. Next perform the concentric portion of a traditional chin up, forcing the elbows down and back as the chin passes the bar.

Sets: 4

Reps: 7, 5, 4, 6

Tempo: 30X

Rest: 90

B2) Standing, partial triceps extension in rack

Begin by setting the safety bars just above head level. Stand with the torso erect, head level, and chest expanded. Grasp the bar using a clean grip. Press the bar overhead, locking the elbows out and pulling the arms to the posterior of the head (in alignment with the ears).

Sets: 4

Reps: 7, 5, 4, 6

Tempo: 30X

Rest: 90

C) Snatch grip barbell external rotation

Using extended elbows, grasp a barbell with a snatch grip and place at mid-thigh level. Explosively shrug the shoulders concentrically. Once they're maximally contracted, use that momentum to bend the elbows and rotate the shoulders until the elbows are locked. The overhead "catch" position once again extends the shoulders and pulls the arms to the posterior of the head (in alignment with the ears). Note: Keep the bar traveling as close to the body as possible.

Sets: 3

Reps: 4-6

Tempo: 10X

Rest: 120

D) Elite sit-up, elbows to knees, feet unanchored

Lie on the floor, knees flexed and feet flat in typical sit up position. Don't anchor the feet. Cross the arms over the shoulders and grasp the deltoids. Begin by firing the transverses abdominis towards the spine and then flexing the trunk until the elbows touch the patella. The rep doesn't count if the feet don't remain flat or the hands come off the shoulders at any time.

Sets: 4

Reps: 10

Tempo: 301

Rest: 60

Conclusion

There you have it: an Olympic lifting program to help the bodybuilder break out of a training rut! Keep in mind there is a learning curve here. It takes time to learn the patterns, so be patient, this isn't a "get big instantly" program. Start stretching and keep learning and progressing so you make continual progress and don't develop bad habits.

Note: My specialty isn't training future clean and jerk or snatch champions. I'm only a student of competitive Olympic lifting. If you're seeking the best Olympic weightlifting coach, contact USA Olympic coach Jim Schmitz at Schmitzjim@earthlink.net or phone him at 415- 648- 7231.

About the Author

Don Alessi is the founder of Alessi Personal Fitness Inc. and the North American Training Certification Ltd. His clients include various professional athletes and a number of hotshot Fortune 500 executives. His specialties are mass development and body transformation. For information on a telephone consultation, e-mail him at D_Strength@hotmail.com. Please visit AlessiFit.com for info on his book, The Promise.

© 1998 — 2002 Testosterone, LLC. All Rights Reserved.

http://www.t-nation.com/free_online_article/sports_body_training_performance/bodybuildings_best_kept_secret

7 Tips for Long Term Leanness Getting shredded ain't that tough. Staying that way is! by Chris Shugart

The fitness magazines are full of them. The bodybuilding rags are full of them. Even T-Nation is full of them: articles about how to lose fat and discover your abs. What's missing? Simple: Info on how to stay that way once you've reached your goal.

Sometimes we resistance-trained gym rats make fun of housewife-types for their yo-yo dieting ways. Yet don't many of us do the same thing, only give it different names like "mass phase" or "cutting phase?" Now, there's nothing wrong with getting your bulk on during certain times of the year, but this desire for size sometimes results in a guy who basically just looks fat 300 days of the year.

Nice traps, but nice love handles too. Nice life-shortening central adiposity you've got going there, buddy.

These days, I prefer to stay under 12% year around. Right now I'm sitting at 9% and feel incredible. This, by the way, isn't a natural state for me. I was chubby during most of my childhood and rode the fat-ass express train in college. With hard training, trial and error nutrition strategies, and some good supplements, I was able to win the battle of the bulge. Win the battle? Yes, but the war is never over.

How come no one talks about the struggles of staying lean? Probably because most people are fat, and there's just a bigger audience (no pun intended) for how-to-lose-it articles than how-to-keep-it-off articles. This article may change that.

Here's how I've learned to stay in the single-digit body fat zone in spite of my fat boy genetics and hungry-man ways. There's not a lot of deep science here, just practical strategies to help you stay ripped for more than a couple of weeks at a time.

Tip #1: Strategically vary meal size.

Here's the scoop: Eat a big breakfast. Eat medium sized, frequent meals during the day. Eat a very small meal at night.

Science has backed up this style of eating, but I want to focus on the common sense stuff. A big breakfast does two things:

1) It breaks the fast of sleep. You need a lot of good food in the morning because you haven't eaten all night. Eat breakfast every day, and eat a big one!

2) Breakfast fuels you for the rest of the day. Basically, you can "burn up" almost anything you eat for breakfast because you'll be awake for the next 15 or 16 hours. Studies have shown that breakfast skippers tend to overcompensate later in the day. In other words, they skip breakfast and pig out on crap at lunch and at night. Not exactly the key to long term leanness.

Okay, so a big, honkin' breakfast is a good idea. So why a small dinner? For almost the same reason: you're about to go to bed; is your body going to use that caloric energy or store it? Store it, of course.

I like eating strategies that have been supported by both science and in-the-trenches lifters, and this meal sizing trick isn't new. Bodybuilder Lee Haney used it back in the day, and nutritional studies support it today.

Tip #2: Strategically time carb and fat intake.

I'm going to keep the language here real simple: Your body handles carbs much better in the morning. It handles carbs poorly at night, but tends to handle fats better.

So go with your body's natural flow: Have a good shot of carbohydrates for breakfast and consume fewer at night. Likewise, keep the dietary fats low in the morning and higher in the evening. Dr. Lonnie Lowery refers to this as Temporal Nutrition, and it works, especially if you're in a phase where you want to stay very lean and avoid excess fat gain.

Based on Tips #1 and #2, here's what a typical breakfast and dinner will look like for me:

Breakfast (big, low fat, high carb, high fiber)

Two servings of Quaker Old Fashioned oatmeal, Fiber One, or Post Shredded Wheat 'n Bran

Two servings of Grow!

One serving of Hood Carb Countdown milk beverage

Two servings of fruit (mixed berries, banana, pineapple, etc.)

Dinner (last meal of the day, small, low carb, higher in good fats)

Tuna filets or chicken breasts

Green salad with olive oil based dressing

This basic strategy keeps me at 9% body fat without sacrificing good, anabolic nutrition. In other words, I don't feel deprived and I'm not giving up muscle gains, although obviously I'm not going to gain muscle as fast as I would in a traditional "bulking" cycle. And that's fine when my primary goal is leanness.

Now, the exception to the above guideline is post-workout. I train around noon so this strategy works out for me. However, if you train at night, don't sweat a high carb post-workout drink. As Dr. Lowery has stated, the post-workout period is the "great corrector." Carbs consumed after training are "put to work," so have them, even if you train at 9PM.

Tip #3: Increase your NEPA.

When I dropped from around 12% to 9% body fat, one of the strategies I used was a daily walk. I know, I know, I've teased these chubby "walkers" in the past myself. "Get a real workout!" I wanted to yell from my pick-up truck window. But if you're already weight training and maybe doing some sprints, an early morning or nightly walk will really take you to the next level of leanness, and keep you there.

Increased NEPA (non-exercise physical activity) is a powerful tool when you want to keep your abs fully visible. You may only be in the gym three to five hours per week; what about the rest of the time? For desk jockeys, actively increasing NEPA could be the difference between single-digit body fat and "muscular guy with fat gut syndrome."

To boost my NEPA, I take stairs whenever possible, I park far away from stores so I'll have to walk more, I refuse to roll my luggage at the airport, and I generally try to take more steps per day. You can do that or you can just take a scheduled walk. I usually pop in an audio book, leash up my Labrador, and take off either early in the morning before breakfast or late in the evening after my last meal. The pace is fast, but it's not exactly "cardio."

I never thought this made much of a difference until a few months ago when I stopped doing it. Although my diet and weight training stayed the same, my body fat climbed slowly back into the double digits. After two weeks of getting back into the walking habit, I was back to single-digit delight; all from the ridiculously simple activity of walking more.

Tip #4: Stop it with the cheat meals (or most of them anyway).

My philosophy used to be this: Eat clean all week; reward myself with piles of garbage on the weekend. Here's what woke me up. One day I'm at a seminar in Canada with Dr. John Berardi. We're shooting the shit and I mention my "pig out on the weekend" philosophy. JB looked me up and down, his eyes pausing on the gut I had at the time, and said, "It's not working though, is it?"

Oh man, I cussed that cocky bastard for days. But he was right.

In the years that followed, I cut back to Saturday-only pig-outs, then a "one cheat meal per week" strategy. I slowly became leaner and leaner. These days, cheat meals come rarely, if at all. After the Velocity Diet I lost my taste for most cheat foods. I simply stopped liking most of them and developed a taste for healthier fare, an unexpected but much appreciated side effect of that strict diet.

A couple of weeks ago I had the chance to go to The Cheesecake Factory, a restaurant that used to be my ultimate choice for a cheat meal. I'd planned to pig out too; it had been months since I'd dove into a big 1000 calorie dessert. I got there and, much to my surprise, I just didn't want it. The habit was finally dead. (I had a great Thai steak salad instead.)

For those that still blow the hell out of their diets at least once per week, I only ask that you examine both your goals and your physique. If you're a skinny guy trying to gain weight, well, a whole pizza on Saturday night may not be a bad thing.

But if you're like I was, a "fit" guy with a gut, then maybe it's time for a change. I'd suggest a step-by-step approach. Have only one cheat per week if you're currently having two. If you're having one, go to one every two weeks.

Step it down. Break the cycle. You'll feel better, you'll look better, you'll be healthier in the long run, and women will grab your butt.

Tip #5: Don't eat too late at night.

Long story short: For years I worried about "going catabolic" as I slept at night. I visualized my hard-earned muscle atrophying away as I dreamed about leopard skin thongs.

To prevent this, I had a big meal right before bed. I mean, right before. I'd swallow the last bite as my head hit the pillow. Guess what? I could never stay really lean doing this. Single digit body fat defied me.

In short, I stopped doing it. Now I don't eat in the two hours or so before bed. Now I can easily stay at 9%. Coincidence? I don't think so.

I still worry a little about losing muscle, but as long as my last meal is high protein and slow digesting, and as long as I wake up to a big, equally high-protein breakfast, then I don't lose muscle.

Now, if you're a hard-gaining, skinny-as-a-rail teenager, go ahead and eat before bed. Maybe chug a protein shake in the middle of the night too. But if you've struggled to stay lean and have "fat boy tendencies," don't eat right before bedtime.

Tip #6: Don't eat quite as much on off days.

This is pretty straightforward. You need more fuel to get through a tough workout, and you burn up more fuel (calories) during it. So on your off days, eat a little less to match your lower energy expenditure.

How much less? Play around with it. There are a lot of variables involved but try 100 to 300 calories less and see what happens.

If you use a quality post-workout drink like Surge, then you may already be following this tip since you only ingest that supplement on weight training days anyway.

Tip #7: Use Carbolin 19.

Carbolin 19 is an interesting supplement because it can give you an edge in mass phases and cutting phases. Long story short, what you'll notice is a shift in body composition toward lean mass. I consider Carbolin 19 to be a staple for the person who wants to gain muscle while staying lean. For more detailed info, click HERE.

Long Term Leanness

These strategies aren't for everyone. They're for the guy or gal who's lost a lot of fat and wants to keep it off. If you're the type that gets shredded for summer and bulks up in the winter, then these tips should help you easily stay lean all summer long.

These strategies may also help you if you're a guy like me: a former fatty who got lean, loves it, and refuses to get fat again. For you, these tips may be your key to long term leanness!

© 1998 — 2005 Testosterone, LLC. All Rights Reserved.

Ab Training From the Inside Out by John Romaniello

Breathing isn't one of those things we normally think about. Being the morons that we are — according to the general public, at least — bodybuilders generally prefer to devote our limited brain power towards things which seem more pertinent, such as calculating food intake or figuring out which tank top will make our guns look the biggest (okay, maybe that one's just me).

Actions like breathing, blood flow, and the like are functions of the autonomic nervous system, which places them under the category of "Cool Stuff My Body Does When I'm Not Looking." I know, I know... that sounds very scientific, but try not to get too lost in the industry jargon.

The take home message is that breathing isn't generally a topic on the forefront of most minds... unless you suddenly stop, in which case you probably start thinking about it a lot. It's kinda' like that chick you keep on the back burner and only call when you're really desperate — not really a concern until it seems like a life or death situation, is she? Wait... I think we're talking about me again.

Moving on, if you guessed that this is the part where I tell you how important breathing is, you're right. Yes, yes, very good, Cap'n Obvious. You probably also know that breathing is pretty essential for life, so I guess I should just skip that part, too, huh? But, fear not, my ever so deductive friend. I am not going to discuss "cleansing breaths" or anything. I shall leave that to Yoga teachers and Lamaze coaches. Instead, this writing will be concerned with something called Power Breathing. Yeah, that sounds a lot more manly, doesn't it? We'll be discussing breathing methods that'll get you strong, stable, and build some abs you can use to grate cheese. (If you're lactose intolerant, you can grate something else. Carrots, probably. I think people grate carrots.)

Power Breathing: What It Be

The phrase is used in various circles to describe how to structure breathing patterns to enhance the performance of a specific task. While the task will generally vary greatly with the group, it seems that the terminology doesn't. A few keystrokes on virtually any internet search engine will reveal that singers use their methods of power breathing to enhance projection, range, and even depth of voice. Similarly, alternative medicine gurus recommend their brand of power breathing to promote relaxation and an overall sense of well being.

While these goals and usages of different types of power breathing are certainly worthy of note, they are decidedly not reasons which would influence the people of T-Nation to incorporate such a practice into their overall training methodology. I make mention of these uses only because "power breathing" is a fairly generic term. As such, it's one that can be applied to different methods (depending on the group), and it's necessary to realize that not all "power breathing" is the same. Brief acknowledgement of such use also serves as a way to clarify that while power breathing can and does have relevance in innumerable circumstances, we'll focus exclusively on its applications to weight training and physique enhancement.

With regard to our purposes, power breathing is essentially a method of breathing through resistance, sometimes punctuated by brief periods of breath-holding (known as the Valsalva maneuver). Often prescribed by Russian strength coaches and other mad scientists, the goal of power breathing has generally always been to allow for increased power output during a lift. This occurs by way of improved stability resulting from the intra-abdominal pressure created when the technique is applied.

For the duration of a power breath, nearly all lower trunk muscles contract with significant force as oxygen leaves your body. The tightening begins internally, with the transversus abdominus and diaphragm contracting dynamically as you "push" the air out. Externally, your rectus abdominus and spinal erectors simply contract isometrically. Keep in mind you're applying resistance, so the breathing itself is actually quite a workout for those internal muscles. This is actually one of the primary uses of power breathing and I'll discuss it later in greater detail.

Overall, the practice will strengthen all of the muscles used for trunk stabilization. This is true to such an extent that world renowned sport biochemist Vladimir Zatsiorsky has said that he considers power breathing to be the best "core" exercise. We'll give ol' Vlad the benefit of the doubt and assume he meant "core specific," which is why he mentions breathing over squats and deads in terms of effectiveness.

So, How's It Done?

With all that basic, introductory information out of the way, it's time to discuss the proper execution of a power breath. You can actually do this at your computer right now to get a feel for it. Here is how it's done: Stand up. Now sit down. Good, now stand up again. Touch your nose. Put one hand on your head. Okay, okay, none of that is related to power breathing, it's just more evidence that if I ever took over the world I'd make everyone dance the Macerana for my own sick amusement.

Here is the real way to do it. In either a standing or sitting position, take a deep breath into your abdomen. Place your tongue along the ridge in your mouth just behind your teeth. Next, flex your abs and your glutes, and contract your rectal sphincter; then exhale forcefully through the 'blockage' created by your tongue and teeth; you should hear a noise that sounds like, "hsssst." You should feel a contraction internally, and if your deep abdominal muscles are relatively untrained, it won't be long before a burning sensation sets in. Continue to exhale until all of the air is expelled.

You've just completed one power breath!

Be sure to inhale into your belly, not your throat — a good way to spot yourself on this is to practice in front of a mirror. If when you inhale your shoulders rise, you're breathing into your chest and throat. When you exhale, the air will travel back the same way; unfortunately, forcefully exhaling in that manner may actually cause your head to explode. Seriously; I saw it in a movie once.

Who Can Benefit?

Now you know what power breathing is and how it's done. All we have left to cover is who power breathing benefits and how to incorporate it into your training regimen.

There are a multitude of reasons to incorporate power breathing into your training, but we'll just focus on some of the more impressive ones.

1) Imbalanced? Fix it!

Abdominal imbalances occur quite frequently in bodybuilding, much more often than would be expected. The most common of these imbalances results from years of improper training and usually shows up in people who used to be overweight. Sadly, many misinformed overweight people mistakenly believe that by doing hundreds of crunches and sit-ups, or by using ab do-dads with fancy "resistance bands," they'll lose the gut. Obviously, we know this will never work out the way these people want it to, as spot reduction is impossible without a bit of surgical aid. One unfortunate side effect is that (in many people) such training will — over time — create an imbalance between the rectus abdominus and transversus abdominus.

Without getting too far into an anatomy lesson, we'll just give a basic (very, very basic) overview of how this happens. The visible muscle of the abdomen, the rectus abdominus (RA), lies just superficial to the internal muscles of the abdominal cavity. The most important of these is the transversus abdominus (TA), to which the rectus is partially attached to and supported by. So over the years, all those crunches and the like (which target only the RA) will have a cumulative hypertrophic effect. The RA will grow bigger, stronger, and heavier, while the TA remains relatively unchanged. The result is that, eventually, the RA will be so overdeveloped that the TA simply cannot support the weight of its superficial counterpart — a sort of sagging is the final consequence.

The majority of individuals who experience this phenomenon never notice; however, those that finally get their training and nutrition in order certainly will. Once these trainees lose a considerable amount of fat, they find that no matter how lean they get, they still have a distended belly. That's right, folks: a GH gut without the GH; pregnant with a six pack. Normally, these people would have one of two choices: circus freak or professional bodybuilder... well, that's actually one choice. However, in this situation, power breathing earns its stripes and can be of great use.

As mentioned earlier, power breathing places great emphasis on the TA and other inner abdominal muscles, but not much on the RA. Applied properly, power breathing can be used to strengthen the transverse abdominal wall, correcting the imbalance by allowing the formerly weak TA to hold up that hypertrophied rectus. Neat, eh? Now you'll finally be able to leave the circus! No one will ever call you "Cletus the pregnant dog boy" again!

2) Slice n' Dice

Keeping on the topic of using power breathing purely for the purposes of achieving physique goals, we come to our next use. As stated previously, the act of performing a power breath causes the transversus abdominus to contract dynamically while the rectus contracts isometrically or statically. For vain guys like us, this works out perfectly. You see, regardless of whether you suffer from the aforementioned ab imbalance, having a strong TA will improve the over all appearance of your precious six pack, as it will help you achieve a more muscular midsection.

That aside, the important thing here is the static contraction of the RA. You may not think of this as "work" for the very visible rectus, but in actuality the reverse is true. While the RA will certainly receive little to no hypertrophy-inducing stimulus from power breathing, it will be exposed to a substantial amount of time in a flexed state. Why does this matter? Well, because it'll help you get so ripped you'll have to scotch tape your skin on, that's why.

Maximally, statically (isometrically) contracting a muscle will improve its neurogenic muscle tone through two pathways. First, by sensitizing the alpha and gamma motor neurons communicating with that muscle; and second, by improving the intensity at which that muscle will be able to contract isometrically. Resultantly, contractions of this type have been shown time and again to greatly improve vascularity, density, separation, and overall appearance in muscles which are highly exposed to them. While static holds have a host of benefits, I'd be remiss if I didn't mention this one: assuming you're already lean, isometric training is second to none for bringing out the cuts!

This is exactly the reason practically every pro bodybuilder incorporates intense posing into his contest prep regimen — the constant tension being applied isometrically helps immensely with getting into stage-worthy shape. Not that I often put much stock in training tips from the pros, but if there is one thing these guys DO know about, it's flexing in the mirror!

Having said that, a few sessions of power breathing each week can help build some purty lookin' abs, so all you narcissists out there should be happy. I'm not getting down on you — a little narcissism never hurt anyone. Uh, except that Narcissus guy... but other than that it never hurt anyone.

In addition to all that jazz, though, power breathing can greatly increase strength, which brings us to...

3) Stability as Strength

As previously alluded to, the main — and most traditional — use of power breathing is for increased strength. It's been long known that power breathing can be used as one method of increasing poundages in lifts which require stabilization from the core. Off the top of my head I can think of two: the squat and the deadlift. Heard of 'em?

It's already been mentioned several times over, but it should be reiterated that frequent power breathing will increase the strength of just about all core muscles. These muscle work to stabilize the trunk during our favorite lifts and also serve as protection for the spine. Since you'll be able to handle greater loads for longer periods of time, there will be a concurrent increase in the amount of weight that can be used in various exercises requiring a great deal of trunk stabilization.

Power breathing increases not only the strength of the core muscles, but also allows you to increase overall strength by making use of intra-abdominal pressure (IAP). By creating and lifting under increased IAP, we can greatly amplify both stability and strength. This phenomenon occurs by way of reflex action taking place due to the excitation of various receptors in the abdominal and thoracic cavities. This in turn sends signals to your brain to increase muscular tension throughout your body. All of this ultimately culminates in you lifting more weight and feeling pretty spiffy about it. This is a good argument for using power breathing and the Valsalva maneuver during a lift, although that topic has been hotly debated. Overall, though, it should be pretty obvious that incorporating power breathing into your training should yield some strength gains.

So, in short, who can benefit from power breathing? If ya got abs, you can.

Ninjas Beware!

I just want to offer the caveat that performing power breathing or the Valsalva manuever may not be the best idea for people who practice certain types of martial arts, particularly those that involve a lot of grappling. In a recent interview with T-Mag, Coach Scott Sonnon said the following:

"I have no doubts that 'power breathing' allows people to put on more pounds to their lifts. However, try Valsalva in Judo or Jiu-jitsu and you're more easily choked unconscious; try it in wrestling or Sambo and you lose kinesthetic sensitivity and reactive strength; try it in boxing or NHB/MMA and it'll slow punch speed as well as increase your susceptibility to knock-out; try it in baseball, basketball, or football and you'll decrease your swinging, shooting, and throwing accuracy."

The extent of my martial arts experience is pretty much limited to whuppin' some serious ass on my Xbox, and while I know how impressive that is, I'd have to say that I am not really qualified to speak much about martial arts. That being the case, you'd probably want to take Coach Sonnons' advice.

Making it Happen

One of the greatest things about power breathing is its utter simplicity. Once you have it, you have it. Because you need no equipment and the exercise is pretty unobtrusive, you can do these nearly anywhere at any time; at your desk, at the gym, or while you're stuck in traffic. Now you'll never have an excuse to be unproductive again.

However, many people prefer to take a much more structured approach. That being the case, I've included a few programs below. These sessions should be done on off days, or following workouts where you performed squats and/or deadlifts. As a general rule, don't do a full power breathing session the day before one of these movements; your core will be too fatigued for you to perform properly. That being said, here are some programs to help get you strong, stable, and shredded.

Beginner

Sets/Reps/Duration: 5x5x5

Frequency: Three times per week

Rest: 30-60 seconds between sets

This is pretty self-explanatory. If you're just beginning power breathing, perform three sessions each week, with each session consisting of 5 sets of 5 breaths, each lasting 5 seconds. You should be exhaling fairly forcefully, but not at full intensity. You'll probably still have some wind left, but terminate each breath at the 5 second mark.

Intermediate

Sets/Reps/Duration: 5x10x5-7

Frequency: Twice per week

Rest: 60-90 seconds between sets

Basically, the same as above, except that each session will be 5 sets of 10 breaths. You should be exhaling with enough force to last until around 7 seconds towards the beginning of the session and as you progress, you'll probably start to "fail" at around 5 seconds.

Advanced

Sets/Reps/Duration: 10x5x[X]

Frequency: Once per week

Rest: As needed

This program is very difficult and is best suited for the purposes of getting those shredded abs we discussed earlier. You're to perform 10 sets of 5 reps, but the duration is as short as possible. Essentially, you should expel the air with as much force as possible, which will cause both the TA and RA to contract maximally. Keep in mind this is an advanced program and should only be undertaken when you've really mastered the form. If you're still relatively new to power breathing, you may wind up breathing into and out of your throat rather than your belly as you begin to tire. This could be potentially dangerous, so you must be certain to maintain perfect technique the entire time.

T-Man Modifications

After you've done all of the above routines a few times, you may feel that you have outgrown them and want something more challenging. Rather than simply increasing the volume and or frequency with which you perform any of the programs, it's much more effective in terms of strength gains to increase the difficulty. Essentially, you must add resistance.

Although you can probably find a host of gadgets which will add resistance to your breathing, it's much cheaper and more practical to just use something that's abundant and effective: water. To make use of this complicated bit of training equipment, you may have to visit your local hardware store.

Remember when you were a kid, and your parents never let you blow bubbles in your chocolate milk? Well get ready to taste sweet revenge! Get yourself a piece of piping, rubber hose, or the like, and simply immerse it in a bucket of water or even your bathtub. This technique is exactly the same, except that you're breathing through a hose rather than through your teeth. Generally speaking, the longer and thinner the pipe or hose you're using, the harder it will be to blow.*

*Author's note: I am quite aware of the opportunity for some pretty terrible humor here, but the editors have placed a limit on the amount of completely predictable and unfunny jokes I may use per article. I used up the last of them with that chocolate milk thing. That is all.

Conclusion

If you're not satisfied with the rate at which your numbers are (or aren't) going up, or the general look of your midsection, add some power breathing into your training and you'll be pleased with the results. Give the above a try, even if you're skeptical — especially if you're skeptical. At the very least, it'll take your mind off trying to pick out a tank top to wear, ya' bloody narcissist.

About the Author

John Romaniello may actually be the biggest loser, ever. It was recently revealed to the Testosterone Inquisitor that Romaniello actually took up weight-training in an attempt to look more like his Advanced Dungeons & Dragons character, "Fangor the Barbarian" so the Harry Potter fans would stop taking his lunch money. What a dork! You may email insults to FatSnooky@aol.com

References

1. Leonard, Charles. 1998. The Neuroscience of Human Movement. Mosby, Inc. St. Louis.

2. Tortora, Gerard J., and Sandra Reynolds Grabowski. Principles of Anatomy and Physiology. New York: John Wiley & Sons, Inc., 2000.

© 1998 — 2003 Testosterone, LLC. All Rights Reserved.

http://www.t-nation.com/free_online_article/sports_body_training_performance/ab_training_from_the_inside_out