Exercise - Waste of Time ?

Time Magazine must be delighted with the storm of protest generated by their cover story - Why Exercise Won't Make You Thin.

The writer is John Cloud who asks "I still have gut fat that hangs over my belt when I sit. Why isn't all the exercise wiping it out?"

John Cloud is no stranger to storms of protest threatening his existence but he has an excellent turn of phrase.

As a Personal Trainer I really liked John Cloud's line:
"On Wednesday a personal trainer will work me like a farm animal for an hour, sometimes to the point that I am dizzy — an abuse for which I pay as much as I spend on groceries in a week."

As it turns the answers to John Cloud's questions about how avoid over-eating can be found on the Time web-site. Look at this video of nutrition advice (good advice) made in the Time & Life cafeteria.

The American Council on Exercise (one of my personal training qualifications is through ACE) took John Cloud's article very seriously and published almost a peer-reviewed journal article.
Lots to read - all of it good:

Editorial: Why Time Magazine’s Article on Exercise and Weight Loss Could Be Harmful to Your Health

By Cedric X. Bryant, Ph.D., F.A.C.S.M., Chief Science Officer, American Council on Exercise

The cover story of the August 9, 2009, issue of Time magazine featured an article entitled, “Why Exercise Won’t Make You Thin.” In this piece, author John Cloud made several inaccurate and unsubstantiated claims regarding the value of exercise, particularly as it relates to weight loss. What follows is a summary of some of the most misleading assertions made in this highly publicized article, as well as the American Council on Exercise’s response to these assertions:

• First and foremost, the article categorically implies that exercise has no meaningful role in weight loss. Such a conclusion is as false as it is reckless. The author’s “evidence” is the fact that he has “gut fat that hangs over his belt when he sits,” despite maintaining a regular exercise habit. In all likelihood, his unwanted abdominal girth is probably a by-product of genetics and/or consuming more calories than he expends


• Weight loss and maintenance are a matter of simple accounting that is dependent upon energy balance. In order for weight loss to occur, individuals must burn more calories than they consume. Regrettably, many individuals who regularly exercise are unable to meet their weight-loss goals because they eat too much. In reality, however, their “personal weight situation” and overall health profile would be far worse were it not for the extra calories they expend while exercising.


• An overwhelming body of scientific evidence exists that confirms the positive role that exercise plays in weight loss and maintenance (Hill and Wyatt, 2005; Jakicic and Gallagher, 2003; Jakicic et al., 2001). These findings refute the notion (advanced by the author) that exercise impairs weight-loss efforts by substantially and uncontrollably increasing appetite. Recent research suggests that appetite may be suppressed for 60-90 minutes following vigorous exercise by affecting the release of certain appetite hormones. It also appears that aerobic exercise is more effective at suppressing appetite than non-aerobic forms of exercise (Broom et al., 2009). In general, individuals who participate in moderate exercise tend to eat approximately the same number of calories (or only slightly more) than they would if they did not exercise. Elite-level athletes typically consume high volumes of food after their exercise workouts, but they almost always expend more calories than they consumed (Blundell and King, 1999). It is important to keep in mind, however, that appetite is influenced several factors and is a very complex process making it difficult to generalize the impact of exercise on appetite. The bottom-line is that exercise and diet go hand-in-hand with successful weight management.


• Surprisingly (and disappointingly) the author failed to mention the tremendously important role that exercise plays in the maintenance of weight loss. According to data from the renowned National Weight Control Registry, consistent exercise participation is the single best predictor of long-term weight maintenance. In others words, if individuals want to be successful in getting off the weight-loss rollercoaster (i.e., repeatedly losing weight and regaining it), they need to regularly engage in physical activity.

Read all of the ACE position.

The Pennington Biomedical Research Center had John Cloud visit for a day and I'm thinking they regret the invitation - Pennington put out this correction !


Much outrage about John Cloud but my vote for the best rebuttal is this one:

• On studies that have a diet only, exercise only, and exercise plus diet groups, the exercise plus diet groups (with scant exception) come out on top when it comes to weight/fat loss. Diet only, almost always beats out exercise only.
• One very well conducted 12 week study by Kramer et. al., which included both aerobic, strength training, and a dietary control, showed the following results. Fat mass losses - diet only: 6.7kg, diet/cardio: 7kg, diet/cardio/resistance: 10kg. Most noteworthy - the D+C+R group lost almost no lean tissue whatsoever, whereas the diet only group lost almost 3kg worth of lean tissue.
• Putting on and saving muscle tissue will have a lasting impact on your body's ability to lose fat. Plus you will look much better.
• Exercise becomes more important once you have lost the weight. Exercise should be a central strategy in preventing a re-gain.
• Pertaining to the above, the National Weight Loss Registry (which tracks those who have lost and kept off at least 30 lbs), shows that high levels of physical activity are a primary predictor of success.

Osteoporosis - It's a long road to hard, solid bones

If there is ever a good time to take Boniva then this was it. A beautiful Sunday morning in Hilton Head, South Carolina.

A few energetic people out on the beach early,  dogs being exercised and pelicans flying overhead in formation.  

Boniva is a once a month medication to try and improve bone density. It's not that difficult to take - a little difficult to swallow but then you have to stay on your feet for at least an hour. This is to guard against partically digested particles of Boniva coming back up into the esophagus and causing irritation and possibly ulcers.

Walking is a great way to take up the precautionary hour.

News had just come out that Amgen's Prolia ( refered to scientifically as denosumab) has had the next stage of FDA approval. The committee which advises the Food and Drug Administraion voted 15 to zero that denosumab should be approved to treat menopausal women with osteoporosis. The committee voted (12 to 3) against recommending denosumab for treatment of moderately weak bones (osteopenia). 

The big advantage of denosumab is that you get an injection every 6 months. So far I've been taking Bonivia on schedule exactly as recommended but the general experience is that within thefirst year most people stop taking the medication because it's both unpleasant and you have to keep track of when it's time to take the tablet again.

Listen to the video of Professor Stevens talking about the denosumab trial which lead to the FDA committee saying yes. The New England Journal of Medicine paper mentioned in the video is this one.

Are you drinking too much ? One question for you.

One hard or easy question on your drinking habit:
For women:
How many times in the last year have you had more than 4 drinks in a day ?


For men:
How many times in the last year have you had more than 5 drinks in a day ?

Men tend to be bigger than women so that is why they get an extra drink.

If you answer 2 (or more times) then you might have an unhealthy alcohol problem.

How accurate is this one question ? The researchers think it's about 80% right.

The idea is that Primary Care Doctors, who usually have a lot of conflicting information to deal with, can have one simple to understand question to see if heavy drinking might be something to factor in.

So it's a question for yourself before you feel so bad that you just have to drag yourself to the docs.

Of course there is then the question of what exactly is a drink ? Try this.

Don't forget, alcohol has a great deal of positive benefits, read this, if you avoid the negatives.

Eating too much and still staying healthy

Punching out Padma Lakshmi - would you really do that ?

If you don't watch Top Chef none of this is going to make any sense but the New York Times had an excellent article about how to stay healthy even if your job involves eating - even if it involves a lot of, lot of eating.


Top Chef is in the genre of reality show. This links explains.

In the article Padma reveals that she puts on maybe 15 pounds during the filming of the series but after filming ends she stays away from red meat, chesse and alcohol until her weight is back where it should be. See the results in her nude photo shoot for Allure Magazine.

Only click her if you want to see Padma naked.

By the way, Tom Colicchio is an equally important component of Top Chef and he has an outpost of his restaurant chain Craft here in Atlanta ( Buckhead to be exact - near Lennox on Peachtree St.). I've eaten there and can recommend it.