Aerobic fitness is your best health predictor. Should it be the focus of your time investment?

Aerobic fitness is your best health predictor. Should it be the focus of your time investment?

What would you say if I told you that there’s a health component that is more important for healthy ageing than the COMBINED effects of smoking, obesity, and  diabetes?? Yet, the average GP is unlikely to mention this to you, much less actually test it. Could they be missing one of the most important assessments they should be taking at your check up? and consequently, not giving you some of the best health advice you could be getting?? Ok, enough with the cryptic questions. This is going to be a short but powerful article, because I know you don’t have time to waste. The answer to these questions is aerobic fitness. That’s right, your aerobic fitness is your best health predictor and effector. Not sure how, or if, you should tackle this? Read on!

Aerobic Fitness is your best health predictor

The graph below shows the highly significant effect that cardio-respiratory fitness (CRF, or aerobic fitness) has on premature death, particularly with its effect compared to other more commonly discussed health issues. I am truly baffled that while this SHOULD be common knowledge to health and medical professionals, they rarely apply it as part of their assessment or targeted treatment!

Aerobic fitness is your best health predictor

Attributable fractions (%) for all cause deaths in over 53000 participants in the Aerobics Centre Longitudinal Study. This is an estimate of the number of deaths in a population that would have been avoided if a specific risk factor had been absent. That is, if all smokers were non-smokers or all inactive persons were
getting 30 minutes of walking on at least 5 days of the week.

Effect of increasing fitness

Sure, you have been advised by your health professional that you should exercise more… that you should get out for a walk or two during the week. The graph below shows us two critical things about this advice. First is the obvious difference in protective effect of general physical activity vs fitness. You are busy, and ‘exercise time’ is hard to schedule, so the last thing we want is for you to not get the best possible return on your time investment! This data show the multiplied protective effect that increasing your fitness has on your health compared to just ‘being active’. While your low level general incidental activity is important, having a focused and safe approach to improving your fitness will reap huge returns on your investment.

Second, if you don’t know where to start, this data show that just getting underway will give you great returns. In fact, as the graph shows, even if you shift the needle from being very inactive or unfit, to being just in the lowest quarter of either ‘active’ or ‘fit people’ you achieve the greatest return on your investment! For example if you are in the lowest 10% of either ‘active’ or ‘fit’ people, you get very little protective effect; but if you move to the 25th percentile in activity levels, you get about a 10% protective effect, but a whopping 40% protective effect for being in the 25th percentile in FITNESS levels!!

Aerobic fitness is your best health predictor

Estimated relative risk of cardiovascular disease by fitness and physical activity.
Williams, PT (2001) MSSE 33:754-761.

Let me summarise the point I’m trying to  make: While being generally active (such as going for regular easy walks, etc) is good for your health, spending time getting FITTER will give you multiplied returns, in body composition, general capacity, and primarily in health, so you can get the most out of life for as long as possible! So if you are short on time, and have high expectations on your investments, then this makes a lot of sense. NOW, if you are concerned about increasing the intensity of your exercise due to health issues, or risk of injury, please get in touch with us. We have proven systems to improve your fitness in a safe and progressive manner.

I’d like to thank Associate Professor Lance Dalleck from Western State Colorado university for presenting to the iNform team and sharing his expertise on this topic.

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Exercise your “blues” away!

Exercise your “blues” away!

Exercise to improve mental health and well-being comes across as rhetorical. And to throw a pun in: it’s a no-brainer!

A recent study published in the American Journal of Psychiatry has found exercise can reduce depression globally by as much as 15%! Now, 15% does-not sound like much. However, with data collected worldwide – with a population cohort of 266,939, 15% starts to sound pretty darn good; or for you statistical nerds out there: a neat reliable confidence interval.

 

Take me through the interrogatives and detail James!

The authors didn’t elude how much physical activity is required to elicit an anti-depressant effect. If you read my last blog, you would know what the recommended physical activity guidelines are. What is more important, is the neuroprotective effect(s) exercise has. And from interpreting the paper: participants were followed longitudinally over six to eight years, which correlates nicely that exercise has a protective buffer to continuous stress. Depression is highly complex; interacting with genes the immune system and the environment. However the solution is simple: all one needs to do is-to huff and puff a little bit – from day to day, to statistically decrease depression!

Tips for using exercise to improve mental health: 

Exercise needs to be enjoyable!

  • A brisk walk on the beach..
  • Kicking the footy with the lads/lasses..
  • Or, hitting the gym for a workout or group-fitness class..

The list goes on..

When you choose the exercise that resonates with yourself the likelihood for adherence is higher. Enjoyable activity results in more brain regions becoming active – and neuromodulators releasing sweet beneficial chemicals, affecting your mood, motivation – and thus well-being!

So what are you waiting for? – Lets get moving together!

James 👨🏼‍⚕️

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How much fruit should you eat? What the guidelines tell us

How much fruit should you eat? What the guidelines tell us

Many people don’t eat enough fruit and vegetables, and at a population level we seem to score under par. However, I’ve noticed an interesting seasonal trend with some of my clients over summer. One where if they tend to be prone to metabolic issues like weight gain and blood sugar control these tend to spike; and the common thread is fruit.

This got me to investigate, how much fruit should you eat? Is there such thing as consuming too much, and if so, what is it?

 

How much fruit according to the Australian Dietary Guidelines

Now back in the 2000s there was a relatively successful campaign called “Go for 2 and 5” which educated us on the Australian Dietary Guidelines. This tells us how much fruit and vegetable we should be consuming. The evidence seems to show that as a population we should be aiming for 2 serves of fruit and 5 serves of vegetables per day.

We know that it was a successful campaign, as over the campaign period the awareness of these ads went from 20% to 70% of survey respondents (Department of Health & Ageing, 2007). Interesting though, while 94% of respondents were able to correctively give the fruit consumption guidelines of 2 or more serves per day, only 32% correctly gave the correct response of 5 or more serves of vegetables.

This got me thinking. Do we have a confirmation bias when it comes to fruit and vegetable consumption? By this I mean that we tend to hear the message that we should be eating more of the lovely sweet stuff. But ignore the message regarding boring old vegetables.

Perhaps we thought the message was go for 5 and 2 rather than 2 and 5?

So does excessive fruit consumption matter to our health?

At least if we look at the report published on the success of the Go for 2 and 5 campaign we see that people were already consuming the guidelines of two serves of fruit per day on average. While the average serves of vegetables scraped in at just over half of the guideline at 2.6 serves. Interestingly, while we already succeeded as a nation at consuming 2 serves of fruit 43% indicated that they planned on increasing their fruit consumption. Only 28% planned on increasing their vegetables.

Certainly this appears as though the message of eating more fruit was much more palatable to survey respondents.

So it doesn’t surprise me then when I see a dramatic spike in how much fruit some of my clients eat over summer. This amount for some was up to 5-10 serves per day. Now clinically we saw increases in 1-2 kg of weight and spikes in blood sugar levels, even though these clients were doing what they thought was best for their health. They have listened to part of the message (the part which is most palatable for us sweet tooths!) and simply didn’t consider that you might be able to have too much fruit!

In summer we tend to have an explosion of seasonal fruit to the market. Stone fruits, melons, and tropical fruits all tend to hit our grocery stores at a cheaper price. Interestingly, all of my clients who have drastically increased their consumption of fruits over summer had a stone fruit tree such as peaches and nectarines in their backyard.

 

So how much fruit should you eat per day?

Well that depends on what you may want to prevent health wise, but somewhere between 2-3 serves per day seems to be the “sweet spot”. If you want to know the science to this conclusion, and what fruits tend to work best for you, please read part two of this blog!

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How much fruit should you eat? Looking at the evidence

How much fruit should you eat? Looking at the evidence

So we established in Part 1 of this blog that the guidelines suggest that two or more serves is how much fruit we should consume. However, for some of us, it’s really easy to over consume. And this may well be having a negative impact on our health. Now I finished the previous blog with suggesting that somewhere between 2 to 3 serves is most ideal. But what if I have metabolic issues? Are there better and worse fruits to consume?

 

How much fruit should I consume to protect the heart?

Interestingly, many studies have looked into this question. However, they tend to combine fruit and vegetables together making it hard to conclude. One study by Lai et al (2015) looked into this and found that in a group of UK women the risk of death from a cardiovascular event decreased with more fruit even with over 4 serves per day. It’s would be easy from this to conclude that more is better right?

Another UK study looked at the risk of death from cardiovascular disease or cancer in both men and women (Oyebode et al 2013). What they found was that increased vegetable consumption was more protective than fruit. When they looked at just fruit intake the greatest benefit was at 3 serves per day. Depending on the model used, an increase in serves beyond this either had no further benefit or increased your risk.

 

How much fruit should I eat for metabolic health?

So we know that 3-4 serves of fruit is good for the heart. But what about people who are at risk of or want to prevent diabetes?

We have a good amount of evidence here that perhaps we shouldn’t be eating too much fruit. In fact a very large meta-analysis of 7 studies by Li et al (2015) concluded that those who had a fruit intake of around 200 grams per day (about 1.5 serves) were less at risk of developing diabetes. While it certainly is not good to have no fruit in a day, having 3-4 serves increased your risk comparatively. And from there, things tended to get worse with increased fruit consumption.

Furthermore, a study by Zhang & Jiang (2015) tended to corroborate this finding with two serves a day being the “sweet spot” for reducing the risk of developing diabetes in a study of over 200,000 individuals. And similar to the Li et al (2015) meta-analysis, they found a similar U shaped curve when consumption increased above 2 serves with 4 serves being as high a risk as having no fruit at all.

So there may be such thing as too much of a good thing. And like most things we need to consume fruit in moderation, especially if we’re at risk of diabetes and metabolic conditions.

But are some fruits better than others? Well the short answer to this question is “yes”

 

Fruits that when you consume more to have a health benefit

Interestingly, most studies will show that vegetables have a stronger association in reducing premature death than fruit (Oyebode et al 2013). However, some fruits, when you consume more tend to reduce your risk of either cardiovascular disease or diabetes.

Lai et al (2015) found that a greater intake of citrus was associated with a lower risk of fatal stroke in women. While grapes were seen to be more protective against a fatal cardiovascular event. When we look at the risk of diabetes, Alperet et al (2017) found that temperate fruit such as apples was associated with a loser risk of diabetes in women.  Both citrus and grapes tended to lower the risk of diabetes for both men and women.

So it appears there are some common threads: citrus and grapes tend to reduce our risk. But what about fruits that perhaps aren’t so good for us to overconsume?

 

Fruits that may not be good for us when we over consume

Firstly, a common theme in most studies is that fruit juice is not fruit! Imamura et al (2015) found that while not quite as bad as soft drink (every serve a day increased your risk of diabetes by 18%), every serve of fruit juice increased your risk by 5%.

When it comes to increasing your risk of cardiovascular disease it seems that any canned fruit will do this (Oyebode et al, 2013). They found that every daily serve increased your risk by 17%.

Now there it appears that too much tropical fruits (bananas, mangoes, melons) will increase your risk of diabetes and these should be limited to less than one serve a day (Alperet et al 2017). Interesting Huang et al (2017) found that tropical fruit increased the risk of gestational diabetes.

Finally, Alperet et al (2017) also found that higher glycaemic index (GI) fruits had a greater risk than lower GI fruits. While these fruits tend to be more tropical in nature here’s a list of fruits with a GI greater than 50:

  1. Watermelon – 72
  2. Pineapple – 66
  3. Rock melon – 65
  4. Paw Paw – 60
  5. Canned Peaches – 58
  6. Banana – 56 (although increases with ripeness)
  7. Kiwi Fruit – 52

 

The take home message about how much fruit you should eat

  • The amount of fruit you eat is important. 2-3 serves per day is probably best for your long term health but more than 4 may increase your your risk of metabolic conditions such as diabetes.
  • Try and limit your consumption of high glycaemic fruits like tropical fruits and treat them as “treats”.
  • Don’t count fruit juice as a fruit, if anything it should be treated more like soft drink
  • Aim to get the bulk of your 2-3 serves of fruit a day from lower  or moderate GI fruits. Fruits like grapes, apples and citrus all appear to reduce your risk of health conditions as you age.

 

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3 Ways to Create the Motivation to Exercise!

3 Ways to Create the Motivation to Exercise!

Let’s start with hard facts:

Physical inactivity is the fourth leading cause of death due to non-communicable disease (heart disease, stroke, diabetes and cancers) worldwide – contributing to over three million preventable deaths annually.

Nearly one in three (29.7%) adults are insufficiently active (less than 150 minutes of physical activity per week), while 14.8% are inactive (no exercise in the last week).

We know exercise is good for us! Even if we don’t really know how or why – we all know it’s good for us, it’s almost in innate knowledge. So why aren’t more of us exercising?! I think it’s fairly safe to say our motivation to exercise is a pretty universal barrier for most of us, so let’s talk about that.

 

Motivation to Exercise and the F Word

I’m going to go a bit left field here, stick with me… I’ve just finished reading Mark Manson’s book and a lot of what he said resonated with me not just in life, but particularly toward our motivation to exercise.

Failure is a relative concept. It totally depends on how we’re choosing to measure our success towards our goals. And our goals should be driven by our values.

 

The Link Between Our Values & Motivation to Exercise

Sometimes, where we go wrong is that our values aren’t quite right to help foster a positive, successful experience that builds self-efficacy and growth.

For instance, if I measure my effort at the gym by “do I look like Jennifer Aniston yet?”, I will be self-critical and negative as this is something I don’t really have control over. We have different genetics, different body types, enjoy different types of exercise, have different time constraints (the list goes on). But if I adopt the metric “maintain a regular and consistent exercise routine”, I can live up to my value of “Live a healthy, balanced life”.

Toddlers learning to walk continually fail. They stand up, take half a step, wobble, fall over, and repeat that cycle a few thousand times before they can actually walk. Never do they think “my god, I suck at this, I don’t think walking is for me!”.

However, improvement on anything is based on thousands of tiny failures. And the magnitude of your success is based on how many times you’ve failed at something. If someone is better than you at something, then it’s likely because they have failed at it more than you have. (Or done it many more times, and therefore have refined the skill and have the capacity to do it better!)

Important note: Pain is part of the process! (mentally and physically). You can’t make a muscle without tearing a few fibers!

For most of us, our proudest achievements come in the face of our greatest adversity. I know that when I’m feeling lazy and I squat 20kg I feel alright…but when I manage to push myself and squat 55kg (closer to my 1RM), I feel like I just earnt athlete status! This usually involves some stern positive self-talk at the time, and some muscle soreness the next day. Neither are comfortable, but both build resilience, strength and capacity. Both also build my motivation to exercise!

 

The “just do SOMETHING” Principle

To come full circle; action isn’t just the effect of motivation; it is also the cause of it.

Most of us only commit to action if we feel a certain level of motivation. And we feel motivation only when we feel enough emotional inspiration. We assume it’s a chain reaction.

The thing is, it’s not a chain, it’s an endless loop.

If we start doing something, this sparks inspiration, and then before we know it, we have motivation, and so we keep doing that thing (all the while, improving and feeling more confident) and then we feel inspired to challenge ourselves a little further, and look at that – more motivation!

Tim Ferris (American author) spoke of a story he once heard about a novelist who wrote over seventy novels. Someone asked how he was able to write so consistently and remain inspired and motivated. He replied, “two hundred crappy words per day, that’s it.”

The idea was that if he forced himself to write two hundred crappy words, more often than not, the act of writing would inspire him; and before he knew it, he’d have thousands of words down on the page.

 

Take home messages to improve your motivation to exercise:

  • Pick small, achievable tasks or challenges
  • Do SOMETHING. Something is better than nothing! (and it breeds motivation to do more)
  • Make sure the way you’re measuring your success comes down to your actions and input (not other, external factors)

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Exercise and Anxiety, Part 2: A Healthy Relationship

Exercise and Anxiety, Part 2: A Healthy Relationship

Exercise and anxiety have a bit in common. They both cause increased heart rate and breathing. They both make you sweaty. And you can’t seem to think of much else at the time!

A little on anxiety…

Anxiety is something we all feel, at some point, in some way or another. It may look and feel slightly different for everyone! It’s a natural reaction to a ‘threat’ that happens at a certain point in our bodies stress response. When the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis shift into high gear (you may remember I touched on this in my last blog!).

When you’re preparing for a speech, this is great – because it sharpens your attention so you can rise to the challenge. Completely normal. But if you worry when there’s no real threat, to the point where you can’t function normally, that’s an anxiety disorder.

18% of the population suffers from a clinical anxiety disorder.

Introducing exercise…

A study done in 2004 looked at 54 sedentary college students with generalized anxiety disorder. Split into two groups, one group ran on treadmills at 60-90% of their maximum heart rate. The second group walked. Whilst both groups showed reduced anxiety levels, the rigorous exercise worked more quickly and effectively. Furthermore, students in this group reported less fear of the physical symptoms of anxiety.

So here’s the theory:

When we raise our heart rate and our breathing in the context of exercise, we learn that these physical signs don’t necessarily lead to an anxiety attack. We become more comfortable with our body being aroused, and we don’t automatically assume that the arousal is noxious.

We use exercise to combat the symptoms of anxiety, and thus treat the state. While your level of fitness improves, you chip away at the anxiety trait. Over time, you teach the brain that the symptoms don’t always spell doom and that you can survive. You’re reprogramming the cognitive misinterpretation.

A match made in physiological heaven

How does exercise do this?

As we start using our muscles, the body breaks down fat molecules in the blood stream to fuel them. These free fatty acids compete with tryptophan to catch a ride on our transport proteins, elevating its concentration in the blood stream.

To equalize its levels, tryptophan pushes through the blood brain barrier, and is used as a building block for our old friend serotonin (feel good hormone).

BDNF, which is also released with exercise, also increases levels of serotonin, which enhances our sense of safety.

Moving the body also triggers the release of GABA, which is the brain’s major inhibitory neurotransmitter (and the primary target for most anti-anxiety medications), which interrupts the obsessive feedback loop within the brain.

When our heart starts beating hard, its muscle cells produce a molecule called atrial natriuretic peptide. That puts the brakes on our hyper-aroused state.

Clearly there is a connection between how much you exercise, and how anxious you feel.

Scientists have shown that exercise helps the average person reduce normal feelings of anxiousness – next time you’re feeling stressed, overwhelmed, or anxious, try squeezing in 15-20 minutes of huff and puff exercise and see how you feel after. You be the judge!

References:

 Broman-Fulks, Berman & Webster (2004), ‘Effects of aerobic exercise of anxiety sensitivity‘, Journal or Behaviour Research and Therapy, vol. 42, no. 2, pp. 125-136

Ratey, John J.,Hagerman, Eric. (2008) Spark :the revolutionary new science of exercise and the brain New York : Little, Brown,

 

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