16 Apr F! Weight

Real change is slow and hard.  It takes effort, and although it’s incredibly rewarding and edifying, it can be painful and frustrating at times. It can also feel very uncertain: “am I doing the right thing here? Am I headed in the right direction?” When starting a fitness program, we are right there in the midst of it–in the fight for change. If everything goes smoothly, we will  see a lot of change fast: we will feel better, perform better,  and look better, so we need no external measures to reaffirm what we know–that we are doing the right thing. But this is not always the case. Even the professional athlete will  sometimes feel stuck, like she is going nowhere–and will experience the same doubts, fears, and frustrations of the beginner. This is where  the value of external markers emerges. They offer us with some objective way of tracking our journey.

The marker most commonly used to evaluate the progress of a fitness program is body weight. And the vast majority of people want to see that marker go down. Unfortunately, weight is a very inaccurate and highly variable measure that can fluctuate immensely even during the same day. It can go up three  pounds by eating a lot of salt the day before, or it can go down by two  just by taking a big old dump. On top of that weight is super emotionally charged for most people. Years of cultural programming have convinced us that weight is the root of all our health problems and the direct result of being too lazy, eating too much, and moving too little. When most people see a number of pounds on a scale they feel like they are looking at a harsh and objective representation of how much they suck. The reality of why we get fat[1] is a little more complicated than that: it certainly includes our behaviors, but also our access to reliable information and education, our access to different food options, our legislators’ education, and a fair dose of corporate greed. Even so, the fact is that most people who start a fitness program do it because they want to see their weight go down, and so despite its being a problematic marker, it makes total sense that it should be the marker we track. But what “makes sense” intuitively and reality are often two completely different things. My experience has shown me that tracking weight is actually not the best path to fitness and health. In fact, tracking weight is not even the best way to lose weight. Check it out.

Let’s start by stating that extra weight is a symptom of some underlying metabolic and behavioral issues and not a problem in and of itself. This might seem like a subtle distinction but it is actually quite a powerful framework for thinking. Let’s change the context for a second, and let’s use an example from the people  working with addiction which might be illuminating. Imagine you have a person who smokes weed all day and even though he wants to stop, he can’t. One way to approach this would be to say, “hey man, you are smoking too much. Smoking is the problem, so let’s reduce it gradually. Start by smoking one fewer  joint per  day everyday for a month. Next month, we’ll decrease another joint per day, and so on until no more smoking, and problem solved.” Unfortunately, we all know that in reality  it’s just not that easy. It makes sense intuitively, but most of the time it does not work. What addiction counselors have discovered recently is that this type of thinking reduces the smoker habit to a matter of will –“just control your will and you will be good”. If it were that simple we would not have addicts of any kind. Nor fat people. On top of that this kind of thinking is disempowering, because it tells the person seeking change , “you have not stopped  smoking, gambling, eating, pulling out your hair, because you are too weak, and every failure is just a confirmation of how weak you  are”. This is not helpful, not effective, and actually it’s often counterproductive. What addiction counselors now do is switch their framework, first try to identify what  the addict is getting out of their addictive behavior, that is, what is the function that it has in her life, what genuine need is being met? The habit itself is certainly not the root. We want to stop the habit, yes, but we must focus our attention, our intervention, on the cause of the habit.  . The same holds for weight loss: if we only  focus on the weight itself, trying to force it down by eating less and moving more, we will end up bumping our heads against a big thick wall called homeostasis: the natural tendency of the body to stay were it is. We haven’t identified what behaviours and foods are causing your body to accumulate fat, we are just moving a little more and eating a little less. This means you are just using a little up more energy. But your body loves to be where it is and will find a way to make up for the difference. So you will take an extra nap, or you will rationalize your way into eating an ice cream after that 3-mile run, or without niticing your portions will just be bigger. And this, mis amigos, is why marathons are full of people trying to lose weight, and not full of people that have lost weight. Because the “eat fewer calories than you use”, though it follows the laws of thermodynamics, does not account for the fact that we humans are as much thermodynamic machines as psychological and hormonal machines. Weight is the product of our behaviors and habits, the well-being of our hormonal balance, and not merely of the calories we put in and use up each day.

Moreover, when we treat extra weight as problem we do it because culturally we believe this it is in fact the root of many diseases like type 2 diabetes, heart attacks, gout and whatnot. But every day more our data points to the fact that being overweight is just as much of a symptom as those diseases[2]. Because of that the medical literature is slowly changing the focus on weight to fat mass, or obesity. Obesity is defined as excesses of adipose tissue, this means excess of fat not of weight[3]. I’ll repeat that because is important, really important: obesity is the excess of fat not of weight! This means you can have a normal weight and still be obese, which is what the interwebs calls: skinny fat, I’ll call it being normal weight obese, NWO for short. And the problem with being NWO is that you still have all the risks associated with obesity, all 30 predispositions to metabolic diseases[4]. So you might be light, but in terms of your metabolic health you are in as bad of a place as a very heavy person[5]. And this means you can actually lose weight and be equally unhealthy as you were when you have those pounds and maybe a little unhappier. So your fitness regime could have made you lighter but not healthier, and that is a wasted effort.

There is one last thing that weight is very bad for: your level of self confidence and love for yourself. When we are new in a fitness program with the intention of changing our body for health or aesthetics reasons, we are in a situation in which we have to know that we are not where we want to be, but also grateful and proud of where we are: taking the necessary steps to change ourselves Hungry and Proud. It is true you are not as fit as you will be or want to be, but it is also true that does not mean you are [insert whatever negative thing you say to yourself here, generally a fat bastard]. Accepting our present state including our behaviours that are making change, and the opportunities we are creating for ourselves is fundamental to keep us going. It may sound cheesy, but it is a useful skill to learn. Imagine if you could approach life always like that, hungry and proud, imagine you could be proud of being a beginner because it means you are starting something new, not just excited of where you will get, but excited of starting, of being a novice. It is powerful and simple, yet not easy. But none of this means being satisfied with where you are, you should not, it means being confident, it means you are in control, and you know you are headed in the right direction. Well, nothing destroys self confidence like a weight scale. The kind of feedback it gives is poor and inaccurate and full of cultural beliefs and misconceptions. It is connected with that number you think you saw when you were 20 years old and drinking your ass off waking up the next day and doing it all over again and “getting away with it”. It might be connected with that number you thought it will be the one telling you you have gone too far, and fuck! you are already 20 passed that shit. Or, in the case of a lot of my skinny guys, is the number of how far away are you from being strong, and closer to whatever superhero body you have in your head. So yes, fuck the scale!

Despite all this nice talk, we still need markers, unit measures that can provide the feedback we are looking, than can help us decide if the changes we are making are in fact taking us in the right direction. It is true that to a very high degree any marker that I give you is susceptible of becoming a new ‘weight’, emotionally charged and inaccurate. Regardless of the marker, we might fall in the trap of confusing the symptoms with cause, the unit measure with the objective. Accepting that, and knowing you should be vigilant to not let external measures be the governors of your confidence, I propose you following these markers. I think they are better representatives of the underlying issues that can make our bodies sick and slow. Also they are not as emotionally charged as weight because they don’t have an underlying cultural narrative tied ou our personas. Most of them are fairly easy to measure and can be done on a consistent basis, and for all of them I recommend using up your spreadsheet ninja skills and doing yourself the favor of taking a super long way approach to this, looking not for day to day change but year to year. Measure daily, put it on your spreadsheet and evaluate the trends.

 

Body Fat Percentage

 

BFP is the measure of how much of your body is fat. If you remember our definition of obesity, is it clear that this number will reflect better if you are obese or not given that is an exact measure of your fat mass. The U.S. Department of Health and Human Services considers obese a male with a BFP over 25% or a female with a BFP over 30%.  BFP is important to us for this reasons:

• It is a much more better predictor of metabolic health than weight. It is independent of age, race, gender, and weight, if you have a high BFP, your risk of metabolic disease is higher, period[6][7].
• It provides excellent feedback to whether you changing fat mass for muscle tissue. Even if you don’t want to be a bodybuilder or look like Arnold in the 70’s, having more muscle mass  will provide you a plethora of benefits[8]. What the fitness industry of the 80’s invented as being more “toned”, it is just having more muscle mass and less fat.
• Most women have been culturally pushed into being skinny and not muscular, in other words: skinny fat or NWO. The route for that has always been: cardio like a mad hamster, and eat lettuce. And that life sucks, and it makes you unhealthy. But if you measure your BFP, and forget about your weight you will not be able to go away with that lifestyle. Track your BFP and your nutritional choices will be easier and more productive.

There are quite a few methods to measure BFP (read this). The good ones (DEXA, Densitometry, and MRI) tend to be expensive and not very accessible, although very, very accurate. If you can do one of these one time per year it would great. The most common method is the one used by fat loss monitors and digital weight scales. The technology behind it is called Bioelectric Impedance. It is somewhat inaccurate: it might say you have a 20% BFP when in reality you are more a 19% or a 22%, but the good thing is that is consistently inaccurate so it does track general trends. The practicality of this method makes it the more accessible and realistic, but if you want a more hands on approach you can always use calipers.

Although medical research has proven the importance of BFP as a predictor of metabolic disease, only fitness professionals seem to care about this marker, and so the standards for ranges are loosely based and poor. Based on my personal experience an average person with a solid fitness regime and decent eating habits should be in the range 15%-20%, this already lowers considerably risks of metabolic disease, and makes people feel great and look great[9].

Whether you chose to buy a monitor or some good old calipers, measure daily, in the morning after your first pee.

 

Resting Heart Rate

 

With the advent of the wearable technologies and smartwatches tracking one’s heart rate is easy and convenient. The marketing strategies of this devices unfortunately drive consumers to care more about “fat burning zones” –a die hard myth– than to the real useful marker: Resting Heart Rate (RHR). This number simply track the times your heart beats while at rest. The less times the heart beats at rest the more efficient your cardiovascular system is in maintaining the blood flowing thru your body, so we want this number to go down. Resting heart rate is important to us for these reasons:

• The influential research project “The Copenhagen Male Study” tracked the RHR of 2789 men during 16 years. It found that an  elevated RHR is a risk factor for mortality independent of physical fitness, leisure-time physical activity and other major cardiovascular risk factors[10]. More over, risk of mortality increased by 16% every ten beats! But there is recent emerging evidence showing RHR is a predictor of metabolic syndromes as we as diabetes[11].
• RHR is an excellent marker of aerobic fitness. It is commonly believed –just google it– that a RHR lower than 60 is reserved for very well trained individuals or elite athletes. In my experience a non-elite or a non-professional-athlete person can have a RHR lower than 60 if their fitness regime cares well for their aerobic capacity. This also means that RHR is good indicator if your fitness program is balanced, and that you are not favoring just some aspects of your fitness.
• Stress, sleep deprivation, and too much alcohol consumption all raise your RHR. Sometimes we don’t even notice we are stressed, or we are in denial, sometimes it gets hard to go to bed early even though is the best thing we can do to ourselves. RHR can be that wake up call you need to take it easy.

Basically any smartphone or smartwatch in the market will provide you with an accurate read on RHR, but you can do it yourself totally free. Do it daily before you get out of bed, and add it to your spreadsheet.

 

Blood Sugar

 

You might be surprised of how easy is to measure your blood sugar. Diabetes sadly is a very widespread disease, and so it has made the tools to measure blood sugar inexpensive and accessible. You can buy a kit on Amazon for something around $35. In this article Dr. Chris Kesser gives you a detailed account on how to read your blood sugar results and exactly when and how to test. For us blood sugar is important because:

• Fasting Blood Sugar (FBS) has long been  proven to be a independent predictor of insulin resistance, and its subproducts type-2 diabetes and obesity. What’s more important is that with more research and studies we are coming to understand that the levels set up by the American Diabetes Association (FBS>99 prediabetic, FBS>126 diabetic) are too high[12][13]. It is common for doctors to now want to see FBS levels below 86.
• Exercise and nutritional changes will have the most impact on your blood sugar. This impact can be so quick, it is common for doctors to recommend exercise snacking: short bursts of exercise after or before meals, to help lower blood sugar levels.
• Blood sugar levels are great indicators of how your body handles different foods. Most nutritionist on the interwebs will tell you that you have what is right for you. In my experience that is really hard to do. A simple glucometer can provide more information on this regard than anything else.

Although, I am all for having all the data, and the best would be to follow Dr. Kessler advice, we need to keep it practical. Drawing blood is going to scare most already, so let’s keep it to once a day, right after your BF measure and your morning pee.  We would like to see the numbers under 86, and we would like to see if there is any correlation with high numbers and foods, stress situations, traveling, or anything that changes impacts this number.

 

Fitness Markers

 

Along the previous markers you should track how well you can move both yourself and external load. We want to be able to produce work in the most varied domains, that is the best expression of our physicality. Can you actually use your body for what is for –moving? Can you run a marathon but are full of pain and cannot produce something as inherently human as squatting with good mechanics? Then there your body is certainly not healthy. You go to the gym five days have gorgeous muscles but cannot extend your arm fully, or cannot bend to the ground to tie your shoes.

Tracking your fitness improvement is fundamental. Bio-markers are slow to change, but if you can move more and do more, you are headed in the right direction. How to track fitness and athletic capacity is whole discussion in itself and we will address it in a following post. Hang on tight! It will be epic.

 

Advanced markers        

 

The above markers are sufficient and practical. They can be tracked by anyone at a very low cost. By no means they are the only ones or even optimal. The more information you have on your metabolism and how it is adapting to a new fitness regime, the better. I will list some extra markers that can be traced an it would be great to add to your bio-marker spreadsheet.

If you have the means, an advanced lipid panel that goes beyond the LDL/HDL, triglycerides and cholesterol levels would be ideal. It will give you a way more accurate description of how your metabolism is handling its fats. This kind of test does require you educate yourself to analyze the results because most doctors are not familiar with it –heck! Most doctors rely on what the lab says is a healthy range for a traditional lipid panel (read more here). Optimally you would check your lipids every 3 months, which would give you solid feedback and would tell us a lot about your diet. But again, this requires more effort and patience than the average person can put in. (Recommended reading: Fat and Cholesterol Don’t Cause Heart Attacks and Statins are Not The Solution)

Along these lines, you could take your testing blood sugar skills to the next level and follow Dr. Kressler’s recommendation above, or you could follow Rob Wolfe’s Carb test to see how your body handles different carbs, and thus deciding which are optimal for your health.

For tracking cardiovascular health, every day is more common to be able to track HRV, which stands for Heart Rate Variability, in simplistic terms how much differ your heart beats from one another. This number provides solid feedback on your recovery capacity and can inform you on how well your body is reacting to a fitness program. Devices that can track this have become more and more common, and available but are still somewhat pricey, and the technology is only developing.

In the past few years we have been starting to understand the importance of our gut’s biome (in other words the shit in your gut). Even though it is clear that is fundamental for our wellbeing information is still scarce and contradictory, just try to understand celiac desease, gluten sensitivity and gut health. In the past few years different companies that offer analysis of your gut have emerged, they provide advice on possible foods to eliminate or incorporate in your diet, as well as the use of probiotics. These tests are still very expensive, but if you have the money it can be very interesting.

DNA testing. Just like gut health we are just at the beginning of this technology, so apart to confirm things that you already know: like you are very white and so you ancestors are from europe, or you can smell asparagus pee, or you can’t, these tests still don’t provide a lot of actionable information, YET. The technology is developing fast and for sure we will learn a great deal from it. There are several companies that analyze your DNA results for you, for a price! And the truth is that they are just doing the googling that you are not willing to do. So don’t fall for that.

 

Track but don’t repeat your mistakes!

 

No matter what you track remind yourself that we are always at risk of confusing our unit measures with our goals. Don’t become another metric fixation case. You should always remember that a marker is just a snapshot of a very specific moment and does not represent more than that. The more you know your markers the better you can understand them and the less you will be a victim of its reports. If you try any of this, please let me know how it goes!

 

[1] The book in the link proposes an explanation more complex than the traditional energy balance equation we all have been taught: calories in>calories out. This is already a very controversial statement, the energy balance hypothesis makes a lot of sense, and it has been the reigning paradigm of our nutritional ethos for the past century. I remind my reader than knowledge is not constructed by the thoughts of one person, but by the dialogue of and analysis of different ideas; the more perspectives, the better. This book might not hold the ultimate truth you are seeking but it definitely opens some new ways of thinking about why we get fat. It is a highly recommended read. I think it can be very eye-opening especially for that person who  has tried time and time again to eat less and run more, with little to no success.

[2] Ibid.

[3] Obesity Society. 2016. “What Is Obesity?” Http://www.obesity.org. http://www.obesity.org/obesity/resources/facts-about-obesity/what-is-obesity.

[4] Romero-Corral, Abel, Virend K. Somers, Justo Sierra-Johnson, Yoel Korenfeld, Simona Boarin, Josef Korinek, Michael D. Jensen, Gianfranco Parati, and Francisco Lopez-Jimenez. 2010. “Normal Weight Obesity: A Risk Factor for Cardiometabolic Dysregulation and Cardiovascular Mortality.” European Heart Journal 31 (6): 737–46. doi:10.1093/eurheartj/ehp487.

[5] Oliveros, Estefania, Virend K. Somers, Ondrej Sochor, Kashish Goel, and Francisco Lopez-Jimenez. 2014. “The Concept of Normal Weight Obesity.” Progress in Cardiovascular Diseases 56 (4): 426–33. doi:10.1016/j.pcad.2013.10.003.

[6] Zeng, Qiang, Sheng-Yong Dong, Xiao-Nan Sun, Jing Xie, and Yi Cui. 2012. “Percent Body Fat Is a Better Predictor of Cardiovascular Risk Factors than Body Mass Index.” Brazilian Journal of Medical and Biological Research = Revista Brasileira de Pesquisas Medicas E Biologicas 45 (7). Associação Brasileira de Divulgação Científica: 591–600. doi:10.1590/S0100-879X2012007500059.

[7] Lang, Pierre-Olivier, Christophe Trivalle, Thomas Vogel, Jacques Proust, and Jean-Pierre Papazian. 2015. “Markers of Metabolic and Cardiovascular Health in Adults: Comparative Analysis of DEXA-Based Body Composition Components and BMI Categories.” Journal of Cardiology 65 (1). Elsevier: 42–49. doi:10.1016/J.JJCC.2014.03.010.

[8] Wolfe, Robert R. 2006. “The Underappreciated Role of Muscle in Health and Disease.” The American Journal of Clinical Nutrition 84 (3). Oxford University Press: 475–82. doi:10.1093/ajcn/84.3.475.

[9]  I know most people want to look like a person with 13% BFP, but have no clue of the work it takes to get there. Precision nutrition has an excellent infographic on the cost of getting lean, or the cost of lowering your body fat percentage.

[10] Jensen, Magnus Thorsten, Poul Suadicani, Hans Ole Hein, and Finn Gyntelberg. 2013. “Elevated Resting Heart Rate, Physical Fitness and All-Cause Mortality: A 16-Year Follow-up in the Copenhagen Male Study.” Heart (British Cardiac Society) 99 (12). BMJ Publishing Group Ltd and British Cardiovascular Society: 882–87. doi:10.1136/heartjnl-2012-303375.

[11] Hong, Jae Won, Jung Hyun Noh, and Dong-Jun Kim. 2016. “The Association of Resting Heart Rate with the Presence of Diabetes in Korean Adults: The 2010-2013 Korea National Health and Nutrition Examination Survey.” PloS One 11 (12). Public Library of Science: e0168527. doi:10.1371/journal.pone.0168527.

[12] Nichols, Gregory A., Teresa A. Hillier, and Jonathan B. Brown. 2008. “Normal Fasting Plasma Glucose and Risk of Type 2 Diabetes Diagnosis.” The American Journal of Medicine 121 (6). Elsevier: 519–24. doi:10.1016/j.amjmed.2008.02.026.

[13] Tirosh, Amir, Iris Shai, Dorit Tekes-Manova, Eran Israeli, David Pereg, Tzippora Shochat, Ilan Kochba, Assaf Rudich, and Israeli Diabetes Research Group. 2005. “Normal Fasting Plasma Glucose Levels and Type 2 Diabetes in Young Men.” New England Journal of Medicine 353 (14): 1454–62. doi:10.1056/NEJMoa050080.