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November 04, 2009

It Takes Two

By Barbara Berkeley

I don’t know how many of you make it a habit to follow the glut of weight-related research studies that are released each day. I try to hone in on those studies that seem novel or important. Despite trying to be selective, I am often rewarded with a DUH! experience. So many of these studies seem to ask the same questions and come up with the same conclusions. It makes me wonder why we are spending so much money to prove the obvious.

Here’s an example. This week, a study from the University of Houston reported that fitness levels decline after age 45 (big surprise, right?), but that people who stay at normal weight, don’t smoke and are physically active stay substantially more fit. Researchers looked at data on 3,429 women and 16,889 men collected between 1974 and 2006 before releasing the following conclusion: "These data indicate the need for physicians to recommend to their patients the necessity to maintain their weight, engage in regular aerobic exercise and abstain from smoking," Excuse me, but….DUH!

While the conclusions of the Houston study seem obvious, they still present a problem. In my world view, it’s simply not enough to tell people to exercise and maintain weight. Let me digress for a moment to explain why.

Recently, I rejoined a gym. I’d been absent from this particular gym for quite a while after leaving to follow my favorite aerobics instructor, Joe, who had decided to work at another place. But when Joe decided to move out of town several months ago, I rejoined the original facility. It had been eight years since I’d been there, and when I returned, I discovered a mini research experiment laid out before my eyes. The women who had been in my classes eight years before were now almost all overweight and were significantly less fit. These women are all avid exercisers. They still take multiple aerobics classes weekly. Despite this, a significant majority no longer look fit, weigh much more than they did, and can no longer exercise at high intensity. I suppose you could look at the Houston study and predict this decline, except for one thing. This decline has not been true for me personally. I still run, play singles tennis, and take aerobics classes that are as vigorous as the ones I took 10 years ago. My weight has not increased. From this, I must deduce that a deterioration in fitness and an age-related increase in weight are NOT inevitable. (At least not up until age 61…my current age). What to make of this?

I believe that this is a case of “It takes two.” During weight loss, many of my patients will do everything that is asked of them to control food, yet will refuse to exercise. In the case of the women at my gym, they were happy to exercise, but probably were not vigorously controlling the foods they ate. Some exercisers simply “lean” too much on exercise. By this, I mean that they have the unsupported belief that exercise is a cure-all. Others believe that restricting calories is a cure-all. There is, indeed, a cure-all, but it is the consistent combination of proper fuel with proper body tone. These two elements are actually one. They cannot be separated. Because maintenance is supported by two equal pillars, it isn’t enough to counsel patients (as suggested by the Houston study) to exercise more and “maintain their weight.” For people like my gym companions maintaining weight equates with exercising more. This advice essentially gives the same direction twice. Long term fitness requires a tough two-pronged attack. Proper fueling. Proper exercise. Got to have both.

While the Houston study made me yawn, a second study that appeared this week provided the “Wow” experience. This fascinating research from the University of Alabama reported that as few as 80 minutes of either aerobic or resistance exercise stopped the reaccumulation of the specific kind of fat you want to avoid—visceral fat. Visceral fat is the highly dangerous adipose that accumulates inside the abdomen and lives around and inside vital organs. It is visceral fat that produces dangerous chemicals and which sends fatty acids into the bloodsteam. It is visceral fat which is responsible for the byproducts of obesity: hypertension, hyperlipidemia and diabetes. In this study, a group of 45 white women and 52 African-American women were treated with a weight loss diet and either aerobic, resistance exercise, or no exercise. After weight loss was achieved (about 24 pounds on average), the two exercise groups were instructed to continue their activities at a rate of 40 minutes twice weekly and the non-exercisers were told to continue being sedentary. At the end of one year, those who continued exercising (either resistance or aerobics) had regained ZERO visceral fat (!) Those who quit exercising, or never exercised to begin with had regained about 33 percent of their visceral fat.

It is worth noting that there was some regain even in the exercisers (perhaps related to the lower levels of exercise required by the study), but that none of it was inside the abdomen.
Once again, the case can be made that exercise is a vital element in weight maintenance. But it is not the only element. It takes two. We tend to rely too much on one side of the weight loss/maintenance equation, a rookie error that can lead to disaster. A balanced approach is needed because nature has designed us with bodies that seek balance. Proper Fuel. Proper Tone. It’s a beautiful thing.

http://refusetoregain.com/refusetor...-takes-two.html