A Penny for My Thoughts?

What follows is a transcription of about 3/4 of an interview I did with a book publisher. Hopefully I make it into the book because people should probably hear the truth rather than a watered down version of it by better salespeople. The questions are in bold and italics. What do you think?

 

Does a person have to check with their doctor before beginning a workout program with a personal trainer?

It is recommended that everyone check with their primary care provider before beginning an exercise program, especially if they were previously inactive, injured, or have a pre-existing condition like high blood pressure, exercise induced asthma, or a history of syncope. It’s just a precautionary, but it’s a little piece of mind since we’re not trained to be able to assess someone’s risk upon starting a workout program.

What types of shoes should people wear when working out?

The answer to this question depends on the context of the phrase “working out”, as that means a lot of different things to different people. For classical weight training like squats, presses, deadlifts, and variations of these movements, a pure weightlifting shoe is the best option. These shoes have either 1 or 2 metatarsal straps, an incompressible sole, and an elevated heel (0.5″-1.125″ usually). When lifting weights this is advantageous because none of the force generated by the trainee is dissipated into a “cushy” sole that is commonly found in both cross-trainer type shoes and running shoes. Additionally, the trainee usually finds these shoes to be much more stable. Finally, these shoes allow for proper form that is repeatable and “groovable”. That is, each time you squat-for instance- in a running shoe it might feel and look a bit different because the forces generated are allowed to travel in many directions and they are comparably less stable than a weightlifting shoe. I’ve found that those who bite the bullet and purchase these shoes have much more success when it comes to resistance training. The down side is that there are literally zero retailers that stock these shoes, so they must be ordered online-which can lead to sizing issues. Also, they tend to run between 70-200 dollars depending on the materials used. Fortunately, these shoes are purpose built lifting shoes and will generally last 10+ years with no issues if their use is limited to just the gym.

On the other hand, if “working out” includes things like jump rope, monostructural cardiovascular exercise like rowing, running, cycling, or other modalities (yoga, agility training,etc) then a good cross-trainer type shoe seems to be a nice compromise. These shoes are increasingly becoming more and more minimalistic, which can provide the trainee with more “feel” and proprioceptive feedback from the ground. Moreover, they can aid in strengthening the musculature, tendons, ligaments, and other soft tissue of the lower limb by allowing for slightly increased forces and feedback to be dealt with by the trainee’s foot. A full-on running shoe should be reserved for actual running training as their design does not lend itself well to resistance training or multi-modal type exercise. Chuck taylors are making a large comeback in the training world- and generally I recommend that these be reserved for weight training in those that do not possess weightlifting shoes for various reasons, but they are not appropriate for mutli-modal training sessions.

In short, let your training dictate your footwear. On a resistance training focused session get a weightlifting shoe, they will change your life the first time you squat or clean in them. On days with a more diverse exercise selection a decent cross trainer will suffice. Finally, for road-work and pure cardiovascular training a properly-fitted running shoe is probably the ticket.

Is it true that it’s good to have a “cheat day” where people can eat whatever they want once a week?  Why is this a good or bad idea?

As with most things in the realm of exercise-related questions, the answer is “it depends”. Let me cover two situations here, one in which a cheat day or meal is appropriate and one where it is not. Before I do that we need to define our term “cheat day” just so we’re clear on what it actually means. When I program the implementation of a cheat day/meal into a client’s nutritional protocol I’m usually talking about a day or meal that we’re using to go from a hypo-caloric state to a hyper-caloric- or overfed state. I sometimes refer to these meals/days as “refeed” days. There are occasions where I’ll plan to implement a “day off” from the nutrition program. This is not necessarily a cheat day, but rather break from thinking, measuring, and logging food intake. This latter option may or may not be hyper-caloric, but that’s not the point. The point of this day off is to just have a period of relaxation from being accountable 24/7 and I use it to maintain a healthy relationship with food. There is always a potential for some people to develop neurotic tendencies with their food and these days off prevent that from happening and allow for increased compliance in the long term.

In the first example let’s say we have someone who’s been on a specific nutritional protocol for a few weeks and has been spot-on in their compliance. They are getting great results and leaning out nicely. I will likely incorporate a refeed day or meal, depending on how much work we have left to do, the amount of progress we’ve made so far, their gender, age, weight, and training status. Typically in a client embarking on a long term body fat reduction plan we’ll address food quality initially and then move to food quantity once that has been taken care of. The goal for most trainees isn’t really weight loss, but rather body recomposition. If they’re losing 1lb of muscle with every 1lb of fat that isn’t a compromise I’m willing to make since they likely won’t be happy with their results at the end of this transformation. To mitigate this potential muscle loss I employ a few techniques. One is keeping protein levels adequately high so as to provide enough raw amino acids to the body in hopes that any protein metabolism for fuel that does take place is from dietary intake and not muscle tissue. Another technique is to alter the training to a lower volume, higher intensity type. What this means is that I will program the training to involve heavy weights (relative for the person) and decreased sets and reps. Because we are likely in a caloric deficit when we’re looking to drop body fat it’s important to train relatively heavy to give the muscle a reason to stick around. The whole notion of increasing the reps and dropping the weight is precisely the opposite of what someone should be doing when it comes to leaning out. I’ll likely also increase the frequency of conditioning sessions like walking on an inclined treadmill, moderate intensity cardiovascular exercise, and a perhaps some higher intensity intervals- which of course depends on the person. After all of this, week in and week out a person may warrant a cheat day in order to spur progress and prevent stagnation. A few things that can happen when one is compliant with this strict regimen of training and nutrition is that the thyroid can become less active and metabolism can slow down a bit due to the decreased caloric intake and lower dietary intake of carbohydrates -which happens to be the go-to macronutrient for manipulation in most coach’s body recomposition repertoire- and additionally the trainee can become glycogen depleted to the point where training sessions are flat and unproductive. This is where a cheat day or refeed day comes into play. This cheat day will likely include things not typically seen in the diet like pizza, ice cream, burgers, etc or could be what I refer to as a “clean refeed” day where the meals are still comprised of good quality foods like rice, chicken, fish, oats, potatoes, eggs, whey protein, etc but just in larger quantities. At any rate, the cheat day refills glycogen stores in the muscles, bumps up the metabolic rate due to the higher caloric intake, and generally provides a reprieve from the grind of being on strict diet and training program. I generally like these cheat days to fall on heavy training days, or if it’s a single meal, the final meal of a heavy training day.

For someone who hasn’t quite hit the mark when it comes to compliance on a nutritional protocol and is still struggling with consistently hitting the requisite macronutrients,  conditioning workouts, and has unplanned deviations from the diet anyway a cheat meal/day is not warranted. For this person we still need to find the correct protocol to get the consistency up when it comes to their diet. When, or if, they do become consistent and start seeing consistent progress then it might become apparent that they need a cheat meal/day or refeed day to keep things rolling. However, I tend to think of a cheat meal as a reward for putting in consistently hard work. You don’t get a pizza just for showing up.

Overall a cheat day or meal can be a very effective tool to mitigate potential metabolism slowing, empty glycogen stores, and psychological burnout from the grind of a legitimate transformation type diet and training program. For more general trainees I like to have unplanned cheats -like a dinner out on the town, a birthday party, etc- where it’s just life being lived. Of course, these things can’t start popping up too frequently otherwise progress will be stalled or even reversed. For this reason it’s important to take a close look at each individual based on their lifestyle, goals, and training status and then go from there.

What are the best types of exercises for getting the fastest results in the shortest period of time?

Again, the answer to this question depends on the context is – IT DEPENDS. What kind of results are desired? Fortunately, there is some common-ground here with respect to exercise selection. As it turns out, compound barbell exercises like squats, presses, deadlifts, cleans, snatches, their variants and compound bodyweight movements like dips, chins, glute-ham raises and situps tend to get the best results in the shortest period of time with respect to lean muscle mass acquisition, strength, coordination, joint health, etc. These movements allow for infinitely scalable loads- from a light PVC pipe to a heavily loaded barbell- and also benefit from being incrementally loadable (as little as 0.5lb increments). These characteristics allow for progressive overload of the trainee throughout their career. Progressive overload is the unifying tenet of all exercise science with respect to results. In short, every time you train you need to introduce a little more stimulus than the previous time while still adequately recovering from the session. Other exercises and training modalities do not feature these characteristics. These exercises also incorporate the maximum amount of musculature possible and have a very large (and SAFE) range of motion- especially compared to other training modalities. This lends itself well to training efficiency. Instead of doing a leg extension for quadriceps, leg curl for hamstrings, hip abduction and hip adduction for the hip complex, and calf raises for the calves- just squat. The squat not only employs all these muscles at the same time, but loads them in a more natural manner to how they’ll actually be used in daily life- in a system- not in isolation. Finally, the use of these movements can be appropriately implemented in any number of repetitions that reflect the goal of the trainee. A squat can be done for both heavy singles or lung-burning widow maker sets of 20. The rep range along with the exercise selection are two of the more easily modifiable variables in exercise programming. Multiple repeated sets of 8-12 with limited rest are optimal for hypertrophy whereas fewer sets of 3-5 with adequate rest are optimal for strength. Few movements meet all of the following criteria for what constitutes a “good exercise”: involvement of large amounts of muscle mass, the weight is infinitely scalable, a broad usable rep range, a high degree of coordination is used/required, and a high degree of safety is seen when good form is present.

I would be remiss if I didn’t include some conditioning exercises as people will certainly want to know about that. It seems that in society there is an unmistakable and unshakable connection between the amount of cardio done and the level of body fat someone has. To the lay person you simply MUST do large amounts of cardio to get lean and if you don’t you’ll carry more bodyfat. This is simply untrue. Bodyfat is merely a reflection of someone’s dietary habits. Abs are made in the kitchen, not on the treadmill. However, there is some level of baseline conditioning frequency that is required to activities of daily life (ADL) and to maintain adequate cardiorespiratory endurance levels. Notice I said adequate level, as that is determined by one’s own personal goals, athletic endeavors (if any), and genuine beliefs about what health and fitness entails. For pure conditioning you just can’t beat rowing or an airdyne bicycle like the old Schwinn’s that used to be ubiquitous in health clubs. These trump any elliptical, stair master, or treadmill you can find for the same reasons the barbell movements we discussed above are so useful- they use more muscle mass over a larger range of motion. Sprinting is also a great modality but I caution the readers of this to employ them with reckless abandon- they require that the extensibility of the tissues in your hamstrings, quadriceps, hips, and calves are up to the task of dealing with large forces and high joint impacts. That is why for most, I recommend rowing or an airdyne for pure monostructural cardio conditioning. Other great but less available options include sled pushing, pulling, weighted carries-like a yoke or farmer’s walk, tire flipping, etc.

Of course, there are other goals that would warrant other exercises or the exclusion of these exercises. Additionally, these exercises do require a good trainer or coach to instruct the movements and those are hard to come by. Also, these movement also require the access to proper equipment (barbells, weights, squat racks, etc) which is just not feasible for some people. Finally, these exercises are just plain hard. There is something to be said about the willingness to undergo a legitimately hard workout for the sake of getting results. Those willing to seek out the knowledgeable coach or trainer and actually put in the work are the ones who will get the results they desire and those who won’t will be sitting on the hamster wheel year after year trying to find the secret to getting results.

Is it true that people with diabetes have a harder time losing weight?  If so, why is this the case?

Generally, yes. While there are certainly multiple underlying physiological reasons behind this it has been my experience that their lifestyle tends to be the biggest hindrance to weight loss. We should delineate between type I and type II diabetics here, of course. Type I diabetics (IDDM) use insulin to regulate their blood sugar as they do not produce any (or insufficient) amounts of insulin from a very early age. Type II diabetics (NIDDM) may or may not use insulin to regulate their blood sugar, depending on the severity and duration of the disease. At any rate, it is very difficult to get compliance with their nutritionist’s or RD’s nutritional recommendations and this kind of attitude towards lifestyle modification tends to bleed over into getting them onto a training program, especially one that will actually lead to long-term results- as these programs are usually predicated on consistency, hard work, etc. Type I diabetics tend to be a bit easier as since they’ve usually had the disease for a longer time and have a more intimate relationship with their health care provider. This allows for a more open communication between the doctor, nutritionist, and fitness professional so they can work together as a team to get the person results. With intelligent exercise programming and compliance with a sound nutritional program, type I diabetics do quite well- results wise. The difference between them and the unaffected public is not significant in my experience. Type II diabetics, on the other hand, tend to have more issues in the way when it comes to lifestyle change. Frequently their disease is a result from long term dietary and activity (lack thereof) habits. For some type II diabetics the news of having the disease is extremely motivating and this can spur them into action. Unfortunately, a greater percentage of these folks tend to feel like victims and will not take the appropriate actions to reclaim their health. Additionally, both type I and type Ii diabetics might be dissuaded from joining a gym or working with a trainer in the first place due to intimidation or concerns of the trainer having enough knowledge to help them- which is true in some cases. Ultimately, type I and type II diabetics have the potential to lose just as much weight (and even more in some cases) as their normal counterparts if they’re willing to put in the work.

If someone needs to quickly lose a few pounds for a special occasion, what’s the best way they can do this?

The easiest way to drop body fat quickly is to start earlier than necessary from a fairly lean starting point. If this is not possible then we can employ a few tricks to expedite the process. First off we need to modify the nutrition. Most nutritional consultants involved in preparing people for physique competitions and showcases would agree that carbohydrate and fat intake are usually the first things to be tweaked when it comes to weight loss. If we’re given a period of two weeks to “peak” for a special occasion the first thing I would do is set the macronutrients for the person like this : protein= 1.5g/lb bodyweight, carbohydrates= 0.25g/lb bodyweight, fat=0.25g/lb bodyweight. For a 150 pound person this turns out to be 225 g of protein, 37.5g of carbohydrate, and  37.5g of fat. I will have them weigh and measure everything because now IS the time to be very precise. I also only “count” the main macronutrients in each food, so for instance oatmeal definitely has some protein and fat in it, but I’m only counting it as carbohydrates. This is just how I do it. I have them run this nutritional protocol for 4 days straight, and then on the 5th day (a Friday usually) which is also a training day (hopefully) I allow a slight refeed in which the macronutrients change to the following: 1.25g protein/lb bodyweight, 1.5-2g carbohydrates/lb bodyweight, and only trace amounts of fat on this day. The next 4 days I put them back on the lower carbohydrate template only this time with half of the carbohydrates they were taking in before, 18.75 in this case. Finally on day 10 they do another refeed, the final refeed-done the same way as before. Then it’s the same half carbohydrate template we just did until the big event. I also increase water intake during the entire duration to eliminate water storage from under-drinking. I also keep salt in the diet to prevent glucose uptake problems, being flat, and bloating up when salt re-enters the diet. Also I like to include cardio done either first thing in the morning or right after a workout at a moderate intensity for 30-40 minutes every day since we don’t have much time. On average people can lose anywhere from 5-10 lbs in 2 weeks of both fat/water on this plan. It obviously helps to start out lean when employing this protocol, but it works.

In addition to working out, what are some of the most beneficial activities to participate in and why are these activities so beneficial/healthy?

I really like to see people getting out and being active period. So starting a habit of going for a long walk in the morning or in the evening would be great just to add in some non-formal energy expenditure (NFEE). This is great for two reasons, one it adds to the calorie deficit for the day, week, or month, and two- it gives you something else to do with your time besides sit around the house where you’re just lounging and maybe thinking about doing some mindless snacking. I also love when people join a club or organization for a sport or activity. This provides additional activity, makes them accountable, and can provide some meaning for their training. If someone signs up for an adult cycling group, they likely will seek performance gains and this is a positive feedback loop for motivation to not only train, but to continue training and improve.

Why do people say, “Breakfast is the most important meal of the day”?  Is there any truth in this?

It seems that in our society certain “truisms” get passed down from generation to generation regardless of their scientific validity. This happens to be one of them. While it is true there is observational evidence supporting breakfast’s role in weight loss, it simply doesn’t matter when you eat, how often you eat, and certainly not when during your sleep wake cycle, scientifically speaking. When it comes to lifestyle changes, however, the same people who will commit to eating breakfast everyday are the same people who will comply with an exercise program and nutritional intervention and thus get better results. So it’s not actually the act of eating breakfast that’s magical but there appears to be a “compliance” effect.

In my personal opinion, I like the idea of doing three main meals a day and then adding or subtracting layers to these meals or adding another meal altogether if we need to for calories or macronutrients. For instance if someone requires 250g of protein/day, it would be hard to try and get that in three meals per day. At any rate, the three meals a day thing fits nicely with modern conventions of society- and eating a proper breakfast might mentally prepare you to stick to your nutrition plan for the rest of the day, even if it doesn’t really matter.

-thefitcoach
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About thefitcoach

An aspiring physician, I've been involved in the strength and conditioning world for over 5 years now in a professional sense. I started this blog with some like-minded individuals to share our thoughts on training, nutrition, lifestyle, medicine, health, and everything in between.

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