2. Physical Activity: Targeting better health

In it’s entirety, health was defined by the World Health Organisation (2002) as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Health and fitness (the ability to perform physical activity) are not one in the same thing. Now that that distinction has been made - how can we optimize our health? The same organisation (i.e. the WHO) who made this definition moved on to publish conceptual guidelines on how to achieve this perfect state of zen through:

  1. Nutrition - “the food pyramid” (WHO/FAO, 2002)

  2. Exercise - “Physical activity guidelines by age” (WHO, 2010)

Increasing Health Issues

Our problems with health erupted as a side effect of our technological and scientific success in that our basic evolutionary functions as animals have been practically eliminated. We do not need to (nor would want to) stalk, hunt and kill prey when we can just… buy spicy chicken wings from our local supermarket. The Paleolithic human used to hunt when hungry, kill out of necessity and if he didn’t, he would starve and die, paving the way for a Paleolithic human who is stronger and more relatively fit. Nowadays, people eat sandwiches and snack on Oreos when they’re bored. Just because they ‘feel like’. This side-effect of our accelerated scientific success meant the beginning of the end for human health, and this is partly due to a drastic rise in the incidence of obesity. With relation to physical activity, obesity can be caused by a lack of training but also by excess of training (as is evident in overweight athletes who burn a lot of calories, just too few in the form of fat). In essence, anyone can be unhealthy - even athletes. This leads most athletes to ill-perceived concepts of training which can theoretically cause over-training (because of that frustrating build up of anxiety they get when they just don’t see results); when in actual fact they are just… doing it wrong. A healthy approach to fitness doesn’t even start with properly conceived workouts, not even properly conceived warm ups. It starts with a properly executed sleep each night. And I mean a proper deep sleep for a good amount of time. When you read this you’re probably thinking that this is a hunk of crap - but if this notion applies to you - ask yourself, do you get a proper nights sleep before you go about your daily fitness goals?

Another issue impacting our health stems from the increased incidence of chronic sarcopenia (low muscle mass) and this is a significant predictor of mortality due to:

  1. weakness around the bones, ligaments, joints and tendons

  2. poorer blood circulation (and lymph circulation)

  3. reduced immune function

  4. reduced fat burning capacity

  5. impaired hormone function

This poses the dilemma of whether higher intensity training is superior to lower intensity training in the pursuit of health attainment. When worded this way, the answer may seem obvious but the reality may surprise you. Fat burning is actually enhanced by lower-intensity activity and is relatively hindered by high-intensity activity.

From experience, I’ve met many people who decide “now is the time to get fit”. This epiphany normally materializes during December or January but has been known to happen at other times too. Following this, they tend to do 1 of 3 things:

  1. they enroll in a gym (standard gym)

  2. they hire a trainer (with no knowledge of his certification or registration coverage)

  3. they submit themselves to intense workouts (for instance - Cross-fit, insanity) in hopes that their fitness issues will be resolved quickly

Point 1: Gym

This activity is possibly the most common option. Probably because it is the cheapest. You can also surround yourself with fancy equipment in hopes that you can squeeze in that majestic selfie of you “about to achieve a new dead-lift PB”, eagerly yearning for that social justification that keeps the ego going. However, the reality is that most people don’t know what they’re doing. And I’m not tooting my horn in any way, because even despite my experience and my education, I won’t have perfect form in all my technique. For instance, I certainly won’t try to perform a snatch by myself unless somebody supervises me - because I’ve never done it. Though, I digress. The problem is that gym time has its misconceptions, and that more training can be done in 30 minutes, than what I’ve seen most people do in 2 hours if only there was appropriate knowledge and guidance.

Both factors are needed because nowadays we, as humans, enjoy ignorance. We download some fitness app which we heard about from Dave at work whilst at a Saturday night pub gathering and decide to try it out and stick to it every single day at the gym. We then notice that we haven’t achieved any results after a month. No weight loss, no toning, no decreased abdominal-fat. Nothing. Damn you Dave. The answer is this - you don’t know what you’re doing, and that’s OK. But if that’s the case, you need help. Firstly - to correct your nutrition. Then and only then… you correct the exercise. Why? Because otherwise you can kiss your goals goodbye. If you are overweight and think that starting Cross-Fit 5 x per week whilst retaining a 600 g daily intake of carbohydrate will change anything in your life then you’d better think again. Even if you cut your calories, you will plateau, and there are only so many calories you can cut before you start tearing your hair from your head. Correct nutrition will adequately promote and retain a consistent fat metabolism within the body. The next step, therefore, would be to undertake activity which, not only compliments what the nutrition started, but enhances it. Therefore we need to consider the following basic exercises:

  1. Cycling (on a stationary bike)

  2. Walking

  3. Swimming

  4. Learning an Active skill

These activities all have something in common. They are aerobic, which is to say they are going to allow your body to break down internal fats. Light, sustainable movement is the key. This means that the movement per se shouldn’t be particularly exhausting, otherwise you will be stimulating exercise pathways of the body which require carbohydrate breakdown. You want fat breakdown. The big ‘BUT’ here, is that it needs to be coupled with proper nutrition. An attack on obesity has to be tackled from two fronts, and the nutrition front has bigger guns. Learning an active skill (for instance a martial art) can also be used to this effect. This type of training (for a basic student) is particularly given emphasis on flexibility, technique and mobility and can also be categorized in the same bracket as the exercises which fall under aerobic training umbrella (that is, unless it’s performed at athlete level). It also carries the additional benefit of being a social activity and a learning activity capable of promoting consistency. This is a great quality because you are triggering a multi-rewarding sense of accomplishment which humans inherently crave. I’ll give you an example. Back in secondary school I hated Maltese literature. I mean, really. I failed my ordinary level exam three times before successfully scraping through my 4th attempt. Had my Maltese teacher back then told me that I’d be getting sick gains as a side effect for studying Maltese poetry, I guarantee I’d have read that stuff every single day. Because as humans, we like to achieve, and if we are going to achieve two positive outcomes with a single effort, then cheers to that.

Point 2: Hiring a trainer

Many persons find a personal trainer with the intention of losing weight. He then tells them “OK bro, so you gotta drop your total calorie intake to 1000 kcal per day, keep the carbs high - for energy, then we’ll train cardio 3 x per week”. My answer: “thanks professor, I just paid you €250 for some information that I could have gotten from a standard google search littered with outdated but conventional research. Tell me, when I give up after 3 weeks, do I get a refund?” Honestly, you don’t even need exercise to lose weight and you don’t need to starve yourself either. It’s true - you do not need exercise to lose weight. The best part is when personal trainers put obese persons through arduous routines. Arduous training which they shouldn’t even be doing if they’re obese! PERIOD. The answer to this point mirrors the opinions I stressed on already. Light activity; the kind that can keep you moving, and of course, compliments your nutritional strategy. If you are overweight and your personal trainer gives you sprints - find a new personal trainer. Yes sprints are effective for weight loss. Should you be doing them if you are overweight? Obviously not.

This brings me to another point - fitness classes. Are they fun? No. Are they useful? Also No. Perhaps the only advantage you can find from a generalized fitness class for “generalized health” is the social element which, again, humans inherently crave. This is notably important as it can dramatically increase the chances of retaining your training agenda. But as far as results go - I am very skeptical. You see… we live in a society where knowledgeable personal trainers are very few and very far between. I hate generalizing, but most would-be personal trainers I’ve seen attend courses and graduate and then call themselves fitness gurus. They advertise their classes and bring in a host of different individuals with different goals. Some obese, some underweight, some sedentary, some active. They then shove them in the same class and give them a circuit they can just as easily find from a mobile fitness app. They are literally being taken for a ride. We see desperate, obese individuals take these classes to no avail as there is no weight loss, meaning that the journey only puts them at risk of injury and failure. This is because the reality is that you do not even need exercise to lose weight, especially not the type of exercises which stimulate the incorrect pathways for weight loss. You need someone who understands your holistic situation and its physiology (because your situation is different to that of another person) and based upon your standard nutrition principle, works with you closely to achieve a specific goal.

Point 3: Initiation of intense workouts

Nowadays sprint-interval training is frequently recommended for weight loss in that it provides you with more or less similar outcomes as traditional endurance but in less time. This was proven time and again. One study showing this was that of Gibala et al. (2006). The issues with most modern day studies is that they are undertaken with subjects still retaining their normal eating habits, meaning that whilst weight loss is present, you will not permanently correct the damage the body has sustained through several years of poor nutrition and chronic sedentary activity (we are talking of problems such as cholesterol, hypertension, metabolic disorder, insomnia diabetes, Alzheimer’s and many more). In effect, you may still not be “healthy”. However, I used to get nutrition clients asking me to provide them a high-carbohydrate plan for their new fitness journey. They are at least 10 kg overweight but want to start Cross-Fit 5-6 x per week. In the past, I used to advise against this but do it anyway, because that is what the client requested and I had to deliver. These days, I would ask you to take your money and leave. If you’re 10 kg overweight, Cross-Fit is the last thing you should do. How can you go from binge-gaming and chronic sedentary work to that kind of activity from one day to another? You are risking damage to your body from a cardiovascular, respiratory and musculo-skeletal aspect. Especially the latter (vis-à-vis injuries); most of which are associated with muscle imbalance probably also affecting the tendons and ligaments too.

You want to work out effectively and achieve results? The only thing you need to do is walk. Walk or cycle or swim or anything along those lines. Don’t jump the gun - you are only risking making a bad situation, worse.

Aerobic VS Anaerobic Training for Health

These are two crucial exercise pathways all humans have at their disposal. Referencing the paleolithic human once again - these two pathways are important for their own reasons. The aerobic pathway is used most of the time, journeying, stalking, hunting, building). This activity metabolizes fat. Then you have anaerobic activity used typically in fight/flight situations (such as killing). This pathway is characteristically considered a special energy reserve and metabolizes carbohydrate in the form of glycogen.

Aerobic training was described by Dr Phil Maffetone as being responsible for health, longevity and endurance enhancement and it develops over the long term. He stressed that modern training prescribes some form of anaerobic training to become fit, though people undergo this form of training and note no real change in fitness. Basically, this is because they are utilizing different energy pathways and not the energy pathways needed to promote fat loss. Maffetone states that “A very important philosophical component of aerobic training is to internalize the notion that the aerobic system is the foundation for the correct functioning of the body’s entire physiology — meaning that true fitness must begin by improving the health and power of the aerobic system.”

A basic structure for training was introduced by the Ivan Rivera (2015) formula. Attempt to retain to this kind of training for three months and assess improvement thereafter.

  1. Warming up (12 minutes) - this is not stretching. This is a period of very low intensity activity whereby one allows the heart rate to rise (slowly) thereby promoting adequate blood circulation, increased lung function, fat burning and flexibility

  2. Exercise (20-30 minutes for beginners) - Maintain a consistent duration of activity using a heart rate monitor in keeping your heart rate at 180 - your age (i.e if you are 50 years old, that means 130 beats per minute). This is called the MAF formula

  3. Cool down (12 minutes) - this is the reverse of a warm up and when correctly executed, the body begins the important process of recovery, allowing it to obtain the many benefits of exercise.

  4. Recovery - occurs during rest and sleep. The physical benefits of exercise develop during recovery (when the body adapts to the workout)

On occasion, people also ask me when the best time to work out is and the answer they would expect me to give them is that working out in the morning, prior to breakfast is the best option (because of increased fat burning etc, etc). The reality is that that there is no real evidence to support that training pre-breakfast has any difference to training post-breakfast. Especially if you are adhering to a nutritional plan which supports consistent fat oxidation. However, theoretically there are some hormonal issues which pertain to the ideology that working out any time during the day (i.e. not early in the morning and not late at night) but I wouldn’t say it would play a crucial role in your fitness or health journey.

Resistance Training

Our ancestors way back in the Paleolithic era did not look like Justin Bieber. They often looked like they could kill you just by looking at you and I assure you that this was not due to them having a solid pre-workout with 9 g of BCAAs and creatine. Believe it or not, the only reason they looked like that was because they worked very hard. They built their own houses, they farmed their own crops, hunted their own food, mated regularly, confronted competition with violence and carried very heavy tools (and used them). Their bodies (and muscles) were in use literally all the time. I know you shouldn’t assume but one can assume that their sleeping routine was on point too. When a muscle is regularly used to lift heavier weight, the nervous system responds by stimulating more fibers, resulting in greater strength and hypertrophy (increase in muscle size). The one thing we can discern from comparing the impression of our ancestors with athletes nowadays is that bigger muscles do not necessarily mean more strength. Maffetone (2015) states: “It’s our brain and nervous system that dictates power. Muscle contraction involves the brain stimulating nerves that innervate individual muscle fibers to contract. The more fibers stimulated and contracted, the more strength. Just having a large mass of muscle does not assure more fibers will be stimulated to generate power”. Muscle fatigue can also limit the muscle’s ability to contract properly, which is a sound argument against the ‘lifting to failure’ bodybuilding concept introduced a long, long time ago. Sustaining this concept with a personal experience, I had actually recruited two African adults in my taekwondo club. Without prior training, they were already fit as a fiddle, and were able to withstand the long duration of high-intensity activity I carried out with my already seasoned athletes. The reason why? Both worked in construction for as long as 12 hours per day at least 5 x per week. At that stage, a gym membership would be redundant to say the least. The key principle here is sought through lifting heavy objects in the course of natural movement, and avoiding more than slight muscle fatigue during the process.

Many recreational athletes today train with a ‘to failure’ approach which, in accordance to what we highlighted earlier, means that you are going to incorporate a glycolytic (anaerobic) element to an otherwise aerobic one, hindering fat loss. Moreover, you need to keep your eyes on the prize. If the goal is building strength, then forget the ancient ‘no pain no gain’ ideology which will lead you to a different result all together (more towards hypertrophy). The introduction of fatigue during your set will slow you down vis-à-vis reducing muscle fiber work and introducing stress hormone activity. Eliminating the ego is the key principle here and it should leave you fresh enough to be able to carry out the workout again even upon completion. Instead, focus on maintaining a good speed of the lift, in order to promote more action from the fast-twitch fibers of the muscle. The ones responsible for explosive movements (i.e natural movements). It’s what your ancestors would do. Try to consider reps of 80-85% of your 1 RM and lots of rest time. 3 minutes max. Measure your improvement with increased weight and not reps. In the end, the crucial component is recovery. The damage that takes place during a workout is repaired and rebuilt during rest (i.e. sleep).

There are many other programs for resistance training which can and should be used as frequently as can be. In many cases, I would say, resistance training is actually more valuable than, say, endurance training. This is particularly due to the fact that in can improve and maintain bone density. This characteristic antagonizes the adverse effect of prolonged endurance training which can unfortunately make bones more brittle with time. This means that resistance training could be the worst enemy for osteoporosis. How many elderly females with osteoporosis used to undertake regular resistance training in their youth? Ask them.

References

Gibala, M., Little J., Van Essen, M., Wilkin, ., G, Burgomaster, K., Safdar, A., Raha, S., Tarnopolsky, M. (2006). Short term sprint-interval versus traditional endurance training: similar initial adaptations in human skeletal muscle and exercise performance. The journal of physiology, 575(3).

Joint WHO/FAO Expert Consultation (2003). Diet, Nutrition and the Prevention of Chronic Diseases (PDF). WHO Technical Report Series. 916. Geneva. ISBN 978-9241209168ISSN 0512-3054Archived(PDF) from the original on 2013-10-31. page 56 table 6

Maffetone, P. (2015). An athletes impasse: building fitness without health. Retrieved from: https://philmaffetone.com/an-athlete-s-impasse/

Maffetone, P. (2015). Simple and safe strength training for bones and muscles, Part 1: The natural paleo principle. Retrieved from: https://philmaffetone.com/articles/page/13/

Rivera, I. (2015). Aerobic Training Guidelines. Retrieved from https://philmaffetone.com/aerobic-training-guidelines/

World Health Organization.Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. In Grad, Frank P. (2002). "The Preamble of the Constitution of the World Health Organization". Bulletin of the World Health Organization80 (12): 982.

World Health Organization. (2010). Global recommendations on physical activity for health. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/44399/9789241599979_eng.pdf;jsessionid=009576107B914D41E6803ACAD202A6F7?sequence=1