The fitness industry has been failing to make a dent in the crisis of obesity. We can point fingers at the food industry, but we haven’t been motivating enough, and, frankly, we have been prescribing the wrong exercise.
When I first (officially) studied exercise physiology—completing my M.S. degree in 1986—we were taught the high-carbohydrate diets and aerobic exercise were the way to health and longevity. In the process, I think we have seen an increase in skinny fat people with inflammation issues. Not that aerobic exercise is bad—it is important. Rather, we promoted more long-slow distance (low-intensity steady-state, LISS) cardiorespiratory and, at best, moderate resistance training. With a lack of intensive muscle use, the carbohydrates we were eating had little place to go, since the muscle glycogen is not significantly depleted at such low intensities. So, we converted the excess glucose to fat to be stored for the next workout. (I was measured at 5% body fat in my Master’s program, but never had appreciable abdominal muscle—no six-pack.) Those who were heart conscious bought into the “low-fat” marketing and continued to gain weight (and to lose muscle mass).
There seems to be a change in the tide (albeit, perhaps, to the opposite extreme—e.g., “keto”). We are recognizing that a high-carbohydrate diet—particularly a diet in highly processed carbohydrates and sugars—contributes to inflammation (and, subsequently, vascular disease) and obesity (i.e., insulin resistance). There seems to be a much greater focus on eating few carbs (and healthier carbs) and more healthy fats. Moreover, there is a shift in the nature of exercise (give some credit here to programs like CrossFit, Orange Theory, and the like). People are finally being taught to lift weights and do more interval training (e.g., high-intensity interval training, HIIT). I am having to use air-quotes more as I speak of “keto” or “Tabata” (because what people is told is a ketogenic diet or Tabata exercise—i.e., the IE1 protocol—is not), but that is okay. A move toward this is a good move for combating obesity, insulin resistance, and the hypokinetic diseases that follow.
Last year, I wrote about my epiphany at the American College of Sports Medicine when I noticed how frail the senior members appeared. It occurred to me that these were the academics who push the physical activity and dietary guidelines on us so many decades ago. It was not how I envision myself in another 20-30 years. I felt reassured that I was on the right path—the path leading away from the old exercise prescriptions toward more aggressive resistance training, HIIT, and a more nuanced approach to macro balance.
Many, still, think the first steps in losing weight are walking steps. These are also the same who will likely cycle up and down in weight—gradually losing muscle mass and gaining fat mass (perhaps all the while staying relatively close to their “goal weight”). Unfortunately, the first lifestyle changes need to be dietary, and exercise needs to emphasis muscle mass. The first steps are always “baby steps” (i.e., small, lasting changes), but they aren’t necessarily steps recorded using activity monitors.
Diet should be relatively simple for the vast majority of us. It really only gets complicated if one is a physique athlete or an athlete needing to fuel performance. For most, simply reducing our average daily caloric intake will be sufficient to lose weight. On top of this, monitoring macro (protein, fat, and carbohydrate) balance will be enough to refine the effectiveness of the diet in improving body composition. Simply: estimate the daily caloric needs (tweaking regularly to assure that one is on track with the weight loss goal), determine the number of daily meals, and distribute the macros fairly well-balanced across the meals (this can be more nuanced with nutrient timing, but, for most, timing will be less important—though, one might determine to have one larger meal during the day). Macros can be determined rather simply by setting protein goals at 1 g per pound of body weight (generally, lean body weight, if known); carbs according to activity level (e.g., 0.5 g, 1.0 g, 1.5 g, and 2.0 g per pound of body weight for non-exercising day, light exercise days, moderate exercise days, and heavy exercise days, respectively); and fat (healthy fats) can fill the remaining calories. With regards to exercise intensity, I think most of us are going to fall into the light category—so, don’t over estimate. It is better to err the carbohydrates on the low side as one is trying to lose body fat. The body will be getting some carbs from the fat that is being burned (via gluconeogenesis). High carbs are only necessary for lean individuals who are trying to gain muscle mass and/or are training intensely.
Start lifting weights. It doesn’t have to be anything to complicated or too aggressive, but a minimal goal should be to maintain muscle mass (if not increase muscle mass) as we age. Resistance training benefits insulin sensitivity. Muscle consumes energy. A more muscled body is less likely to be a fat body.
Ignore the scale (for the most part). Don’t think of losing weight as much as losing fat. BMI (body mass index) is another concept we have erroneously pushed on people. While, possibly, a reasonable index of body composition for people who are quite sedentary, BMI (in my humble opinion) is a useless instrument. A measure of body weight in kilograms divided by the square or the height in meters (kg/m2), BMI does not account for changes that might occur in body composition—e.g., increases in muscle mass relative to losses in fat. Most athletes, for example, are likely to be “overfat” (or, in many cases, “obese”) based on BMI. The scale, as well, will not be as good an indicator of body composition changes as will be the mirror and the fit of clothing. Having a goal weight is important, but focus on the body changes over changes on the scale. We don’t necessarily have an “ideal weight”. More likely, we have an “ideal body composition” (and that need not be excessively lean to be healthy).
Changing the diet and exercise habits are not as much about appearance as they are about health. There are plenty of healthy people sporting a bit of body fat, and there are as many “skinny fat” people who are unhealthy. Diet and exercise should be considered as medical treatments. Live to be healthy, and be healthy to live.
Be your best today; be better tomorrow.
Carpe momento!!