This Saturday Ultimate Exercise manager Ed Garbe called to see if I could come down for a workout. Sort of a “can Doug come out and play” call. I was cleaning of the patio and was about to help Wendy clean out the garage. Wendy said “you should go…I’ll take care of the garage”. What a great wife! I had a great workout under Ed’s evil supervision. I did a “little 6” with modest TUL increases, but it felt much more intense with Ed’s supervision. I had a kink in my neck which I think was due to tapping on a computer screen (our new way of charting) for 4 straight days. I did the 4-way neck before may workout which seemed to eliminate the problem.

Heel Raise on MedX leg press
MedX abdominal
Nautilus plateload bicep
Tricep pushdown
Thick bar wrist flexion
Thick bar wrist extension

I have include another study about NEAT (non-exercise activity thermogenesis) that just came out. It appears that this observation holds true even in kids who have not yet developed the hormonal environment for what we believe is needed for optimal response to weight training. I see this in my own kids. On weeks where they ask to do their own workouts after I finish mine, they seem to crave physical activity in the days that follow. I truly believe that the epigenetic changes in skeletal muscle are the source for “the active genotype”.

For the next WOW, I would like to see if Doug Holland could send me a word file of the RT Edwards story. I think you all will find it interesting and inspiring.

Post your WOW’s and your thoughts
J Pediatr. 2010 Feb;156(2):242-6. Epub 2009 Oct 20.
High-intensity training increases spontaneous physical activity in children: a randomized controlled study.
Eiholzer U, Meinhardt U, Petrò R, Witassek F, Gutzwiller F, Gasser T.
Center for Pediatric Endocrinology Zurich, Mohrlistrasse 69, CH-8006 Zurich, Switzerland. urs.eiholzer@pezz.ch
OBJECTIVE: To test the hypothesis that resistance training may increase spontaneous physical activity in children. STUDY DESIGN: Two junior ice hockey teams were randomly assigned to unchanged training schedules (team ZSC, 21 boys; mean age, 13.2 years) or to participate twice weekly in guided resistance training for 4 months (team GCK, 25 boys; mean age, 13.4 years). Spontaneous physical activity energy expenditure (SpAEE; 3-axial accelerometry for 7 days), muscle strength, and body composition (dual energy x-ray absorptiometry) were measured at 0, 4, and 12 months. RESULTS: Baseline measures did not differ in the groups, except for higher leg and trunk strength in team ZSC. In the intervention group compared with the control group, SpAEE significantly (P < or = .02) increased at 4 months (+25.5% versus 0%) and 12 months (+13.5% versus -9.5%). Leg and arm strength increased because of training intervention; all other variables were unchanged. None of these variables correlated with changes in SpAEE. CONCLUSION: In boys who play ice hockey, spontaneous physical activity is inducible with resistance training; this effect seems to be independent of changes in body composition and strength. If this was confirmed in unselected children, resistance training might be a new strategy for childhood obesity prevention programs. Copyright 2010 Mosby, Inc. All rights reserved.

Due to scheduling issues, I worked out a day early (Saturday) with 6 days recovery. I could have waited until day 11, but this would have followed 4 very busy day shifts, which I find have a bigger impact on recovery than a workout with 1 less day of recovery but with less ER exposure. It turned out to be a good decision as I went up in weight and TUL on all movements. This was a repeat of the original workout where I inserted leg press in the middle.

Nautilus Pullover
MedX Chest Press
MedX Leg Press (seat reclined/squat position)
MedX Compound Row
MedX Overhead Press

Recently, I have been retaining more body fat than I would like. The Tanita scale still measures 9-11%, but I am retaining some periumbilical fat. I have been on a normal sleep schedule, and have kept a good diet, with 2 round of intermittent fasting in the past week. I was lamenting the situation to my wife, to which she replied… “It’s stress”. Even though I had not faced the usual ER stressors, we have been undergoing some recent repairs and updates to our home. This not only produced some financial angst, it also involved the usual parade of workers, repairmen, and installers.

Upon reflection, I have to give Wendy her due…she is right. The funny thing is that relatively minor stressors produced a physiologic response that I normally associate with more severe stress that I might encounter in the ER. What I think this demonstrates is that our physiology does not gradate stress reactions very well, it trends toward an all-or-nothing response. The little stressors seem to affect or physiology to a similar degree that our worst stressors do. The key then becomes not just trying to better manage our day-to-day stress, but learning to modulate our response to the worst stressors that we encounter, since that will be the watermark for our other stress responses.

I’m sure you are thinking that the worst stressors in the ER are things like cardiac arrests or major traumas. Quite the contrary, these are things that I am well trained for and know what to do about. The major stressors are an uncontrolled pace of work, and unfunded government mandates that give anyone and everyone a sense of entitlement to your work. Having a patient that will not pay you a dime curse you because they had to wait 2 hours is infinitely more stressful than dealing with a resuscitation that legitimately requires your help. This kind of stress is called “subjugation stress” and it is the worst kind of biologic stress. It is this kind of stress that pegs my stress-o-meter, and that I must learn to deal with better. Be on the lookout for subjugation stress in your own lives. Eliminate it where you can, and learn to modulate your response when you can’t.

As a final thought regarding stress and leanness, I find it amusing that James Bond (as played by Daniel Craig) was depicted as muscular and lean. Ditto for the Jason Bourne character (played by Matt Damon). Any person placed under the severe stressors depicted in these movies could never maintain the muscularity or leanness displayed by these actors. The last movie that correctly depicted how severe stress might make you look was “The Firm” where Tom Cruise’s character looked totally hammered by the end of the movie. So to add even more to the recovery side of your equation, learn to modulate your response to your worst stressors.

Post your WOW’s and your thoughts.

I did a “little 6” on Sunday before a day shift. I increased weights on several of the movements. A tiny increase on the formulator made for a large drop in TUL. Everything else was fairly stable in TUL even with a small jump. I am working a long string of day shifts for the next several days.

Calf raise
MedX abdominal
Nautilus plateload bicep
Tricep press on SS pulldown
Formulator wrist flexion
Formulator wrist extension

Due to time constraints I will not make a long post or discussion. It is exhausting to work on the other end of the health spectrum. It is truly amazing how bad things can turn when you don’t attend to your health. One of the nurses commented on one of the myriad of relatively young, morbidly obese and severely ill patients “What do these people do to get themselves in such bad shape?” My answer was… “It’s easy. All you have to do is…nothing”. In many ways it was not their fault. These people were simply consuming whatever was offered to them. This fact is a piece of wisdom that I am developing. Consuming whatever is given to you will most likely be the worst thing you can do. This is true with diet and exercise. It is true with your relationships, career, finances and all components of your life. Think how much going against the grain with diet and exercise has given you. Now consider all the other aspects of your life where this may prove valuable.

Post your WOW’s and thoughts

For Valentine’s Day I did the classic Big 5. I have had 5 days in a row of a normal sleep cycle and it really showed in my performance. I went up in weight and TUL in all but the overhead press where I went up in weight at a stable TUL.

MedX Leg Press
MedX compound row
MedX chest press
Nautilus Pullover- I love this machine. The SuperSlow retrofits make this classic even better.
MedX Overhead Press

I cannot come up with any deep or scientific topics for this week’ WOW. Instead, in honor of Valentine’s Day I would like to solicit your comments on “bringin’ the love” to your workout. Despite all of the “Exercise vs. Recreation” rhetoric in high intensity circles, and how your workout should not be fun, I personally love my workouts. On a previous post Doug Holland posted on the importance of attitude in the outcome of a workout. I really do believe there is joy to be had in doing hard things, and that this is one of the major intangible benefits of high intensity exercise. People that have learned to really push themselves physically seem to condition themselves mentally to be able to take on almost anything. This is a kind of personal efficacy that cannot be obtained any other way. This is why, despite major differences in philosophy on exercise technique, I feel a kinship with Crossfitters.

The best HIT facilities seem to communicate this to their members. The clients will complain how the “hate their workout…but it’s over quick and only once a week” but when they say it, the pride that they are able to do hard things shines through. That has been the best part of my HIT facility/book tour this past year. All of the facilities were very unique, some were very clean, sleek and modern, and others were primitive and dungeon-like. But what they all had in common was a clientele that had great pride in “doing hard things”.

I did my “Little 6” workout at around noon on Sunday. I am in the middle of a string of evening shifts at the ER and it has been very busy. As such, I made it a point to terminate each set immediately at the onset of failure. This turned out to be a good strategy as I feel fairly good today despite only 5 hours sleep.

Heel Raise
Med X abdominal
Nautilus plateloader bicep
Triceps pushdown
Formulator wrist flexion
Formulator wrist extension

Last night at work I went into our office/locker area for a mental health break and The Biggest Loser was on TV. I came in right at the introduction. I have never watched this show, as I assumed it would be ridiculous. I was shocked how much I had underestimated. I could not believe the amount and types of exercise these poor people were being put through. They even showed one contestant collapsing on a treadmill and being spit off the back of the machine by the spinning tread. Then there were multiple scenes of the contestants being screamed at by that Gillian lady in the tank-top/midriff shirt (talk about narcissistic) and some sadistic guy with tattoos all over his arms. The instructors’ contempt for the obese was obvious as they spewed insults (and saliva) in the faces of the contestants. I don’t care how fat or desperate I was, if someone did this to me I would punch them in the face and storm off the set. I checked in on the show between patients. The diet and exercise shown were prescriptive for ravenous hunger and ultimate failure. As I continued to work, I kept thinking about the importance of biologic signaling, and why it does not have to be this hard.

The key to turning around these sorts of metabolic disasters is to send the correct biologic and hormonal signals. If the correct signals are given, there is a disproportionate improvement in the metabolic state and body composition. This disproportionate response is courtesy of a second messenger system. Most hormones do not act directly on their target organ or tissue. This is usually because the hormone or chemical messenger is usually a protein that carries a charge which prevents it from being lipid soluble. Remember, cell membranes are a lipid bilayer. The fats that make up a cell membrane orient themselves so that the water soluble end of the fat faces toward the outside and the interior of the cell. The water repelling tails of these lipids face each other on the inside of the cell wall. Most hormones or chemical messengers cannot diffuse through the inner (water repelling) layer of the cell membrane. Instead, the hormone will have receptors that are fat soluble that traverse the cell membrane. These receptors bind the hormone on the exterior of the cell wall and transmit the signal to another chemical messenger inside the cell…this other chemical messenger is the second messenger. The unique thing is that the second messenger then activates a chemical cascade that multiplies the signal at the target. This way a single molecule of primary messenger can produce thousands of second messenger signals at the target.
This is why a proper signal is so important…the beneficial effect is hugely magnified. A brief, but intense workout that fatigues the musculature activates growth hormone, testosterone and adrenaline which all signal to empty glycogen and fat, both short and long-term. A hunter-gatherer diet creates a low insulin signal which triggers the body to defend a lower body fat set point. Overtraining (especially in the obese) triggers cortisol and other stress hormones. A low fat, high carbohydrate diet signals insulin release. These signals defend a high level of stored fat and drive huger…a true prescription for misery and failure. If these poor contestants could take advantage of the second messenger system they could achieve their goals without all the misery and without obnoxious fitness gurus screaming and sputtering in their face.

Post your WOW’s and your thoughts

I am feeling pleasantly sore and invigorated from my WOW performed yesterday. I again performed a Doug Holland by inserting the Leg Press in the middle of the workout. It was not as metabolically demanding as the last time, but I attribute this to more time off from the ER. I made modest improvements on all movements.

Pulldown
MedX Chest Press
MedX Leg Press
Pullover
Overhead Press

I couldn’t find any worthwhile studies to link to this week’s WOW, but I would like to continue the excellent discussions from last week’s thread on how making the stimulus more and more perfect can actually narrow the therapeutic window to a point of diminishing returns. When we reflect on the fact that we are an adaptive organism, we must acknowledge that a more and more perfect stimulus may not be the answer to continued progression. This is hard for a geek like me to accept because my interest was born out of the Arthur Jones experience and the idea that we were going to produce a more profound response by use of cams that would make the stimulus more perfect. I think we have pushed that end of the equation enough to know that we have approached a point of diminishing returns. While the response may not be that much more profound, I think what we have achieved is time efficiency. We are able to get the same response with less time commitment…sort of like tanning at the beach versus a tanning bed.

What this leaves us with is the fact that this tweaking of the stimulus actually creates an opportunity to see where we may be lacking in terms of the recovery/response side of the equation. This was driven home to me the other day when I picked up a workout journal from 2003 (which is around the time that I started experimenting with a paleo diet). At that time I weighed 176 pounds and had a body fat percentage that fluctuated between 13-15%. I was very strict with my diet up to that point (calories in-calories out) and was consuming between 1500-1800 Calories per day. I was hungry all the time. This week I weighed in at 171lbs and 8.7% body fat. Now I don’t weigh or measure anything and am never hungry. Recently, I have noted an almost steroid-like increase in my muscularity which I can only attribute to Vitamin D3 supplementation.

In conclusion, I think tweaking the stimulus is great. Heck, it is what most of us live for. However, as we tweak the stimulus side of the equation, we must be even more vigilant to tweak the recovery/response side of the equation. If, for whatever reason, we cannot make the recovery/response side as well-tuned as the stimulus, we might be well-served to let the stimulus be a little more lax as well. Remember, the perfect is the destroyer of the good.

Post your WOW’s and your thoughts

I worked out Sunday at 6am before going in to work a day shift in the ER. It was a good workout at my favorite time of day to work out. I did a “little 6” routine.

Calf Raise
MedX abdominal
Thick bar bicep curl
Nautilus Tricep extension
Thick bar wrist flexion
Thick bar wrist extension

After a busy day at the ER I had a dinner of stuffed Bell Pepper (with grass fed beef) and settled in for some channel-flipping. I came across a show on the Discovery Health Channel about the boy who was the first documented case of a spontaneous myostatin deletion in humans (the same child featured in the New England Journal of Medicine article that broke the story 3 years ago). I was particularly struck (as were the child’s parents, and the show’s producers) by how much the child enjoyed lifting weights and performing pull-ups. This activity was selected spontaneously by the child, as opposed to being pushed by the adults in his life. There were endless video clips of him lifting dumbbells, doing pull-ups, and carrying heavy objects. It was very clear that this 3 year-old was “lifting weights” because he was muscular. He was NOT muscular because he lifted weights. It struck me as a very clear representation of the cause/effect reversal that we discussed in the introduction of BBS.

After the show was over I went to the computer to peruse PubMed for an interesting article that I might post with this week’s WOW and found this:

Med Sci Sports Exerc. 2010 Feb;42(2):314-25.
Resistance training at eight-repetition maximum reduces the inflammatory milieu in elderly women.
Phillips MD, Flynn MG, McFarlin BK, Stewart LK, Timmerman KL.
Texas Christian University, Exercise Physiology Laboratory, Fort Worth, TX 76123, USA. m.phillips@tcu.edu
INTRODUCTION/PURPOSE: Inflammatory cytokines are associated with age- and inactivity-related diseases. We examined the influence of moderate- to high-intensity resistance trainings (RT) on inflammatory cytokines (interleukin 6 (IL-6) and 1beta (IL-1beta) and tumor necrosis factor alpha (TNF-alpha)) in circulation and lipopolysaccharide (LPS)-stimulated whole blood in elderly women. METHOD: Previously sedentary women (72 +/- 6.1 yr) were grouped according to their hormone replacement regimen: traditional estrogen/progesterone (HRT, n = 12), selective estrogen receptor modulator (SER, n = 7), no hormone replacement (NHR, n = 9), or nonexercise control group taking no hormone replacement (CON, n = 7). Participants in the HRT, SER, and NHR groups trained (three sets, 10 exercises at eight-repetition maximum (8RM)) 3 d x wk(-1), whereas participants in the CON group maintained their “normal” activity for 10 wk. Participants performed a bout of resistance exercise (RE at 8RM; HRT, SER, and NHR groups) or sat quietly (CON) before (BT) and after (AT) RT to assess the influence of training on the acute responses to RE. Blood samples were obtained preexercise (PR), postexercise (PO), and 2 h postexercise (2H; same time points for resting CON). RESULTS: Hormone status had no influence on dependent variables, so HRT, SER, and NHR groups were collapsed into one exercise group (EX, n = 28) and compared with CON. RT significantly reduced resting serum TNF-alpha level by 37%. RT also reduced LPS-stimulated production of IL-6, IL-1beta, and TNF-alpha at all time points (PR, PO, and 2H; per monocyte). Acute RE transiently increased plasma TNF-alpha, but blunted the circadian increase in LPS-stimulated inflammatory cytokines observed in CON. The blunting effect in EX was significantly greater AT compared with BT. RE also resulted in an increase in plasma IL-6, which was significantly reduced AT (BT: PR = 1.6 +/- 0.5, PO = 2.8 +/- 0.5; AT: PR = 1.8 +/- 0.3, PO = 2.4 +/- 0.3). CONCLUSIONS: We found that 10 wk of moderate- to high-intensity RT 1) reduced the systemic inflammatory milieu and 2) abrogated exercise-induced circulating IL-6 in previously sedentary elderly women.
This article demonstrated a very substantial decrease in the systemic inflammation of elderly women that was independent of their hormone replacement status. Here was a great demonstration of the profound benefit to be derived from high intensity strength training that is not immediately visible to the human eye.

My mind then returned to our 3 year old demonstration of cause/effect reversal. How many times do we seek advice from someone with a muscular physique who has self-selected weight training because of their muscularity? How many times have we seen someone give up strength training because they have not produced “P90-X” before and after type results? This is a very important concept that is discussed in great detail by Nassim Taleb in The Black Swan …sometimes that which is not visible to us is the most important thing. Many times we only realize the importance of something after the fact of it becoming visible (like the hassle of decanting tiny amounts of toiletries into zip lock bags, removing my shoes, and now having my underwear x-rayed and my wife ogled at by high school drop-outs), while we miss out on the more important fact that a vigilant citizenry will beat your ass down if you try to light your underwear or shoe on a plane, or that someone wearing a funny hat who checks no luggage on a transoceanic flight might be a problem. So what is the point of my rant? It is simply this: we in the field of high intensity exercise need to work hard to make the invisible visible. The people who don’t self-select for strength training are those who may stand to benefit the most. Arthur Jones was right when he said “it is too bad that bodybuilding is wasted on bodybuilders”.

Post your WOW’s…and your thoughts.

For my 48th birthday I decided to treat myself to a Doug Holland flourish to my WOW by inserting my leg press in the middle of my workout. I typically start with leg press because I like to get a big metabolic hit right out of the gate and then try to sustain it through the remainder of the workout. I thought the different approach may actually prove harder…I mean, why else would Doug Holland do it?

Pullover
Chest Press
Leg Press
Compound Row
Overhead Press

I must say that by the time I hit the Row, I was sucking wind. I traded 12 minutes of workout time for 15 minutes of carpet time. I was surprised how demanding placing the leg press mid workout was. I wonder if our metabolic adaptations are not also very specific, as this minor change in order produced a major change in metabolic effect. Perhaps it was the birthday effect, as I always want to do it better than the year before. One thing’s for certain, if you held my birthday cake in front of the compound row during this workout, I would have blown out all 48 candles.

Post your WOW’s

I did my WOW 1 day early on Saturday January 9th. I was meeting paleo blogger and BBS friend Jeff Erno at Ultimate Exercise to put him through a workout. I knocked out the following “little 6” at about 10am before Jeff showed up.

Calf Raise- Resistance increased by an unknown but significant amount. I was using the entire stack on the MedX Leg Press but the TUL was getting too long. I gapped the weight stack by 2 holes which significantly reduces the leverage of the movement arm. TUL now has plenty of room to grow.
MedX abdominal- stable weight and TUL
Nautilus plateloader bicep- stable weight and TUL
Triceps pushdown-stable weight and TUL
Formulator wrist flexion
Formulator wrist extension

It wasn’t until today (Sunday January 10th) that I realized my WOW was done on the 1 year anniversary of BBS’s release date. It has been a fantastic year. I shudder to think that I almost did not agree to John Little’s offer to collaborate on this book. At the time I had not written an article in 3 years and was hesitant to jump back in to swimming against the tide. I was also a little fearful of trying to put out our knowledge, knowing how much readers want “the truth” and how the evolution of facts and the development of new knowledge can make you look foolish or waffling. I did not want to enter into the realm of the expert (whose mascot should be a weasel sitting on a hedge eating a waffle).

The night after my WOW, Wendy and I went to dinner with friends, one of whom was a 70 year old woman who had recently lost her husband. Discussing her recent loss, she spoke to the importance of not passing up opportunities to enjoy what we love. She told of a bottle of Chanel perfume called Chance that her husband had given her as a gift. Because it was such expensive perfume, she had saved it for a long time and used it only on very special occasions. She admitted to wanting to use it more often, but remembering the cost, she would always resist the temptation. Recently, while trying to retrieve something off the shelf where she stored her treasure, she knocked it off the shelf. It fell into the sink and shattered. She watched the contents of the bottle swirl down the drain. All she had left was what was in the tube of the spritzer. As I heard the conclusion of this story, I was overcome by goose bumps. After hearing this story, I am even more glad I took John’s offer, and that I get to spray a little of my “Chance” every week with a WOW posting.

One of the elements of BBS that I am most proud of is a definition of health that John and I worked out that included “an appropriate balance between an anabolic and catabolic state”. There is an amazing technical discussion of this at www.nephropal.blogspot.com . It is a very technical discussion of the mTOR and Sirt1 receptors and how they relate to diet and exercise. If you can find some quiet time and a strong cup of coffee, I highly recommend it

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It was COLD today with temperatures in the 20’s. Ultimate Exercise is a building that was built in the 1800’s and the walls are old brick that is not insulated. Even with my high capacity air conditioning system, it took a while to get the temperature up to 61 degrees. I progressed the weight on all 5 movements today and broke even or a couple seconds down on all TUL’s. The workout was very tough from an effort and discomfort standpoint, but was only moderately hard from the metabolic standpoint. The Big 5 I did today was the following:

Leg Press
Compound Row
Chest Press
Pullover
Overhead Press

It is always fun to do the first workout of the New Year. Looking back over 2009, I am very happy with my progress. My main resolution for 2010 is to focus on form while blinding myself to my previous performance. I will project the resistance for my next workout well ahead of time and not look at my prior performance before performing the workout. Form and intensity should trump performance “on paper”. Also, I am going to try to wean off my only non-paleo indulgence…diet sodas.

I reviewed my diet DVD this morning and am happy with its content and quality. I made a few misstatements here and there, but nothing that would stop me from distributing it as-is. I have an initial run of 25 copies that I will sell through UE, and am trying to set up an Amazon store account for the remainder. I am setting the price at $45.00. If anyone is interested in getting the early copies you can leave your purchase information at UE by calling (864)886-0200 and following the prompts. I will make notification when the Amazon option is available or if we will offer additional copies through UE. For right now we are set up to process the first 25 orders.

Post your WOW’s and your resolutions