Sun 28 Feb 2010
W.O.W. 2/27/10- Stress and Body Composition
Posted by Doug McGuff under Uncategorized
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.

Rick,
Go easy on Norm…he’s mine down here in two weeks!
Ed Garbe
Doc McG- I am a current AF ER doc and relatively newly committed to fitness for the first time in my adult life. (I am 35) I recently got back from Iraq, where I had limitless amounts of time in a gym and I picked up a high rep weight training program there that did help me shed some fat and put some muscle on in places I never had it. However, coming back to the real world, with schedule flip flops, and a family, the 6 day a week workout is simply NOT happening for me, and I am super distressed with the rapid deconditioning I am currently experiencing. I just finished your book, and I am hoping and praying that it is the answer to my strenght training prayers. As to weight and TUL, tomorrow will by my (and the wife’s) first foray into HIT. The weights we select will be relatively random. I understand that if we can go too long, we should increase weight until we fall into the 90 sec range for TUL. Is the converse also true? Say we can go for 45-60 secs tomorrow on a particular excercise. Next week should we decrease weight, or rather hold steady until our TUL increases to the optimum, then increase weight? Thanks for any input you may have. Also- my wife is in training for a 1/2 marathon. What advice should I give her as to her running days, which are 6 or so a week? Is a day recovery after the big 5 necessary, or is she OK to run. I know that distance is mostly slow twitch anyway, except for her speedwork days. Congrats on the success outside of medicine! If congress dosen’t fix this 21% paycut, you may need it! (And I may as well just stay in the AF!)
regarding the recent vitamin D discussion, I found the following Science News headline interesting:
http://www.newsdaily.com/stories/tre6261ix-us-vitamin-d/
Steve,
I was in the AF at Wright-Patterson AFB. Emergency Medicine in the AF was very tough. In a mostly socialized system, the ER was the only access point to the system for most patients. The specialty clinics would slot about 8 appointments per day (4 in the morning, 4 after lunch), the rest would just spill over in the ER. Unfortunately, it didn’t take long for civilian emergency medicine to follow suit.
I would begin using TUL’s between 60 and 120 seconds. Adjust your starting weights accordingly, then progress from there. Your wife would benefit by decreasing her running days to allow for a little more recovery. She will not decondition and the strength training will actually improve her hill-climbing and sprint capabilities. I would decrease distance runs to 3 or 4 per week and a BBS type workout about every 7-10 days. A recent study showed that road cyclists who added strength training to their mileage did not improve, but those that added resistance training while reducing their road mileage did show significant improvement in their time trial performances.
Doug McGuff
@Marc,
Thanks for this article. Vitamin D’s role in innate immunity is largely from its effect on T-cells (as discussed in the diet DVD).
Doug McGuff
I would have to say that Daniel Craig is the best James Bond of all times.;:,