From CNN.com.

It should surprise no one in the health or medical field that the diabetes drug Avandia is linked to an increased risk of heart attacks (at least, not after Steven Nissen’s 2007 study of Avandia).  Unfortunately, for most doctors, Plan B is to simply prescribe another drug.

“Don’t worry about the Avandia scare, Mrs. Jones; here, just take Actos or Glynase instead.”

Until some “rogue independent researcher” publishes a meta-analysis showing those drugs will kill you as well, that is.

There is an alternative solution to this problem.  Beware: It’ll require some critical thinking on your part.

1) Understand and acknowledge the role insulin resistance has in diabetes.

2) Understand which foods and foodstuffs raise insulin levels.

3) Avoid eating said foods and foodstuffs.

4) Move around a little bit.  It’d be better if you exercised. It’d be even better if you strength trained.

There you have it.  No 342 page report or dubious drug prescriptions required.

Either you hate the new Watchmen movie or you love it.  Some people won’t be able to get past the violence.  Some will be turned off by the full-frontal nudity and the laugh-out-loud ridiculousness of scoring a sex scene with Leonard Cohen’s “Hallelulah.”  And some people just flat-out won’t get it.

If you’re attentive (or a fanboy, like me), you’ll understand that Watchmen isn’t a story about superheroes, but a morality tale on the nature of good and evil.  You’ll not only get it, you’ll see how necessary the shocking bits are to the narrative.

Same is true for exercise and eating right.  Some will accuse you of unnecessarily depriving yourself.  You might be frowned upon for vanity.  Some people might try strength training but be scared off by the discomfort or the effort or the fact that you tend to make really funny faces when exerting said effort.

Those people don’t get it.  And sadly, they won’t reap the benefits of exercising, either.

For a while, fitness was all about health.  All the writings from the early days of Physical Culture pay tribute not just to the prodigious amounts John Grimek and Abbye Stockton could lift, but to their glowing skin, radiant spirits, and general exuberance of health.

Then, in the 60s and 70s, fitness became all about pushing the envelope.  More miles are better, said Dr. Kenneth Cooper.  2 hours in the gym lifting weights (for one bodypart!) became the norm, then twice a day workouts.  If 30 sets for chest was good, then 60 must be twice as good, right?

Next, the pendulum swung the other way.  Exercise became all about how fast you could get in and out of the gym.  We had fartlek training, Spinning, and wind sprints.  Mike Mentzer preached the efficacy of doing only three sets total (total, for your whole body) per workout.  Did I mention you were only supposed to work out once every two weeks?

The trend is now swinging back towards Olde-Tyme methods of building your body:  Kettlebells, sandbags, keg lifting, bodyweight workouts (to put this in perspective for non-fitness industry types, it would be as if all the contractors in the world threw out their nail guns and mechanical screwdrivers and went back to using hammers and hand-held screwdrivers).   Luckily, the emphasis is back on health.

If you ask me, exercise for health’s sake never went out of style.  The methods may change, but what we wanted was always the same – the look, feel, and expression of vibrant health.

(I’m a notoriously poor soothsayer (my UFC picks always lose) and not all that great of a pundit.  So you’ll have to go with my knowledge and experience on this one.)

Last week I posted on the JUPITER study and the media hoopla surrounding it.

Well, looks like they’re not done yet:

Eat Your Statins.

“Eat Your Statins?“  For heaven’s sake.

There’s not much in this article that hasn’t been discussed or debunked at length on this and other blogs, but a couple of lines are worth highlighting:

The drugs have side effects, including muscle weakening, that can be dangerous in some cases. Nobody is advocating putting really healthy patients on statins.

Really?  Consider these selections, taken straight from the article:

1. But low-risk people would need to be treated to make a dent in the one-third of American deaths (that’s 800,000) caused by heart attacks and strokes.
2. Sidney Wolfe of the watchdog group Public Citizen says “the message that has come off Jupiter is that people who are otherwise very healthy can benefit from statins.”

If you redefine “healthy” to mean high levels of inflammation, that is.

But like all articles of this kind, you can find a diamond in the rough if you look hard enough:

Hunter-gatherers, who fed on fish, lean meat and fibrous veggies, had levels of low-density lipoprotein, or bad cholesterol, between 50 and 75 milligrams per deciliter, half the level for the average American. (emphasis mine)

So maybe the headline should read, “Eat Your Meat and Leaves” instead; it’s a whole lot cheaper – and a whole lot tastier, to boot.

The problem.

The cure:

Can you condense your health and fitness philosophy into 3 sentences or less?  Post it to comments.

In light of recent events and client queries, here are some quick blurbs about how aging affects exercise:

Greater chance of injury. As I wrote about in a recent post, injuries tend to accrue rather than occur.  In other words, by gradually wearing down your joints due to activity and as an inevitable result of aging, you set the stage for injuries to occur (particularly if you don’t strength train to strengthen your joints).  Well, a decreased sense of balance and imperfect joints set the stage for a spectacular accident to occur.  And if you don’t stop listening to your inner 20 year old?  Then you get the dubious pleasure of explaining to your doctor how you broke your scaphoid while arm-wrestling with your friends.

Impaired hormonal tone. With aging, the production of several key hormones decreases.  Decreased growth hormone secretion makes it harder for your body to repair damaged muscle, burn stored fat, and synthesize new muscle.  Decreased testosterone production impairs muscle mass, impacts insulin regulation, and increases the risk for osteoporosis in men (testosterone is important for you gals as well – it protects brain function).  Cortisol, your body’s main stress hormone, affects you more when you age (especially if you’re female).  Higher cortisol levels are associated with greater amounts of abdominal fat (and, unsurprisingly, are associated with increased death).

Longer recovery. Related to the previous point of impaired hormonal tone is the reality that healing takes longer.  Because testosterone and growth hormone production are impaired as you age, the processes that rely on these hormones (i.e., muscle rebuilding) are delayed as well.

As if all that weren’t enough, as the old adage says, “If you don’t use it, you lose it” – namely, muscle tissue.  Every year.

Enough of all the doom and gloom.  Is there anything that can be done?

As it turns out, continuing to exercise (in particular, strength training) is the key to healthy and vibrant aging:

Turns back the clock. Making sure you maintain your muscle mass is perhaps the best thing you can do to insure a long and active life.  Best part is, it doesn’t matter when you start – old muscle is as trainable as young muscle, and even moreso in women – but it is important that you do it.

Delays death. In short, the stronger and fitter you are, the longer you’ll live.  Period.  Much ado is made about how important “keeping fit” is and making sure your “heart and lungs are in shape”, but this advice is slightly off the mark – what’s key to warding off age-related decline is maintenance of skeletal muscle.  Don’t worry – if you work to keep your muscle, your heart and lungs will take care of themselves.

Bonus tip: Exercise, to some extent, is anti-aging.  But only to a point.  Taken to an extreme, exercise accelerates aging because exercise generates free radicals, molecules that cause oxidative stress to cells.  That’s why in training circles marathon runners are oft picked upon – not because the ability to run 26.2 miles is useless, but because developing that ability often comes at the expense of your health.

…in almost every single case.

Take this picture from Regina Wilshire’s blog, for instance:

While corn isn’t the best of all possible choices for you (it is a cereal grain, after all), you can easily see how eating the actual foodstuff is far, far better than its synthetic counterpart (that’d be high fructose corn syrup).

Corn growers would have you believe that high fructose corn syrup isn’t bad for you.  In fact, “it’s made from corn, has the same calories as sugar, and it’s fine in moderation.”

Well, that would be great if:

1. Corn were “good” for you in the first place (being a cereal grain, it’s not).
2. Sugar were “good” for you in the first place (it’s not).
3. Eating things in moderation were “good” for you in the first place (would they say eating lead paint chips was fine “in moderation”?).

All this skirts the issue of whether or not high fructose corn syrup is worse for you than sugar – and it is (I’ll go through the specifics in a detailed post later).  It has more to do with the metabolic effects of high fructose corn syrup (effects on hormonal tone, proteins, and the liver) than mere calories.

Jonny Bowden gives some sage advice: When shopping for food at your local supermarket, stick to the perimeter (where the meat and produce are) and avoid the center (where all the processed and manufactured items are).

Are you surprised at the amount of confusion and mixed messages that you get from the media and health professionals (such as doctors, nurses, etc.)?

“It’s good to strength train but don’t lift anything heavy; walk everyday for 30 minutes for “exercise”, but anything you do can be considered exercise; eggs are bad for you; eggs are good for you; carbs are good for you; carbs are bad for you; some carbs are good, some carbs are bad…”

It’s no wonder most people are confused as to what to do to ensure good health and keep off fat – the authorities they trust don’t seem to know what’s going on either.

Almost nothing is as frustrating to me as trying to deprogram a new client who was told by their doctor “not to lift anything heavy”, or to “avoid fat, red meat, eggs”, or that “you need to do 30 minutes of cardio everyday.”

This isn’t as arrogant a statement as it seems at first blush.  Doctors do wonderful and amazing things for sick people, but they haven’t the slightest clue how to attain (or maintain, it would seem) health.  My cousin, a practicing doctor in Canada, wrote this in an email to me just yesterday:

Believe it or not, we never learned any of these in Med School… We focus on treating diseases, and leave the rest to other health professionals like yourself.

Doctors are the most unhealthy health professionals. Doctors don’t necessarily know how to maintain and promote health other than treating diseases. That’s why we really need to learn about everyday healthy lifestyle from our non-disease-focusing health professionals. Some med schools are adding courses in nutrition so that doctors know how to “eat properly”.

Of course, if the nutrition courses tout the party line of lower fat, more whole grains, I’m not exactly sure they’ll be eating properly.

Make no mistake; if you have severe health issues, go right ahead and work with your doctor, get clearance on all interventions taken.  But don’t take your doctor’s word as gospel, especially when it comes to nutrition and exercise – as unfortunate as it might be, your doctor might not know what he or she is talking about. Keep informed, and remember that the decision is always yours in the end.

*** Warning – Spoilers ahead! ***

Pixar’s Wall-E is cautionary tale; not just of the environment and planetary stewardship, but personal stewardship as well. Although a work of fiction, the film is scattered with reminders of how lack of movement and poor diet (and lack of self-responsibility) can lead to obesity and early death in real life.

Some takeaway lessons from the film:

1) Use it or lose it:
Over the course of 700 years (and many generations) of overfeeding and sloth, the nomadic human race has not only grown fat, but has lost most of its bone and skeletal structure. In fact, the average person has lost the ability to stand (which makes for a funny scene when Wall-E accidentally knocks “John” over).

All’s not lost, however; humans regain their ability to stand and walk (somewhat unbelievably, but hey, it is an animated film) and farm and fish – more on this later.

2) Drinking your calories is a bad strategy:
A perennial in top ten fat loss tip lists is not to drink your calories; i.e., don’t drink caloric beverages as it’s all too easy to consume hundreds of calories (and sugar) without realizing it. The future humans in Wall-E take this to the extreme with drinkable meals (pizza?) served up in 7-11 Big Gulp-sized cups.

3) The less you move, the less you’ll move:
The human body, made up predominantly of third-class levers, is designed for movement. Often, pain (and immobility) occur from disuse. The classic example?

Your job becomes all-encompassing and you forego exercise, thinking, “I don’t have the time or energy.” Over time, the muscles in your back begin to atrophy and you start to experience back pain. This new development makes you less inclined to move around at all (much less exercise) since even bending over causes discomfort, so subtly, you begin to curtail your general activity. All the while, of course, your lower back muscles continue to deteriorate (the pain increasing accordingly). Before long, it hurts to walk. You begin to walk differently, placing more stress on your knees. Then, one day, you start to notice a painful ache in the lateral side of your right knee…

Physical therapists call this “The vicious cycle of pain.” Pain from disuse atrophy makes you less inclined to move, which further exacerbates the atrophy, which further exacerbates the pain. The solution? Use your body. Better yet, lift heavy things.

4) There is a silver lining:
The humans eventually return to Earth, harkening a return to subsistence farming and the consumption of real food – and progressively get skinnier and skinnier (according to the credits). It’s notable that the skinniest incarnation of human is the one depicted as fishing for subsistence. Is it possible Andrew Stanton recognizes the impact of food selection on obesity?

Mr. Stanton’s motives aside, the point still rings true: If you go back to eating real food and moving around once in awhile, there’s still hope, no matter how far overfat you are. Hey, if Manuel Uribe can lose 55% of his body mass (about 670 lbs) through diet and exercise alone, I’d say there’s hope for everybody.

P.S. – While I hate to admit it, I liked Wall-E a great deal, and not for the reasons listed above (my wife always says I’m a sucker for great design).

Or do they? (Check out Dr. Eades‘ great post on this study)

Most of the China studies I’ve read deal with rural Chinese and appear to show that their low-fat, high-grain diet is superior for health. This, of course, flies in the face of all Western research, which clearly shows a link between carbohydrate consumption and diseases of civilization.

I’ve often heard this criticism from peers and clients alike:

“If carbs are so bad, why aren’t the Chinese all fat? Don’t they eat a lot of rice? And shouldn’t there be a tremendous diabetes epidemic in China?”

There are generally two responses I give:

1) Traditionally, the amount of rice/grain eaten in China (and Asian cultures as a whole) is slight – generally a cup or two a day. This is the equivalent of roughly 45-90 grams of carbs, which is a far cry less than the daily carb consumption of the average American.

2) There is a diabetes epidemic in China.

If only they’d seen pictures of my extended family in Malaysia. Or my Taiwanese godmother, who is obese and has Type 2 diabetes (and has been forbidden by her doctor from eating a mere grain of rice – smart guy).

During my trip to China last summer, I was struck by the number of diabetes treatment clinics we passed by on the 20 minute drive from the airport to my parents’ apartment in Shanghai (three, if you were curious).

The bottom line: China has a BIG public health problem on its hands; one that will cost them dearly if they don’t manage to get it under control. But how?

• Place greater emphasis on real food instead of manufactured foods (say, yu choy vs. prawn chips).
• Given China’s improved economic status, deemphasize grains for more nutritionally dense fare, i.e., meats, cruciferous veggies, etc.
• Educate Chinese on what constitutes “healthful eating” (for example, not yu tiao).

What are your thoughts? Got any stories? Post to comments.