I always appreciate when patients ask me questions, it shows they care about their health and it is my job to educate them on their journey towards wellness. Through these interactions I have come to realize there are some blatant misconceptions about exercise. I’d like to address some of them in order to help hard working people achieve the results they deserve. I put together this post to guide the development of an exercise routine. However, this is a massive topic so please consult with your healthcare and fitness professionals to tailor your program specifically for your needs.
1. Push the intensity – Jogging on a treadmill for 1 hour 5 days a week and staying in the so called “fat burning zone” is relatively ineffective and can even be detrimental. Long distance cardio can result in increased cortisol, decreased immune function, and reduced testosterone levels. You’re essentially losing muscle (you’ll see why that’s important below) while the constant pounding from running does damage to your joints. Instead, if running is something you’d like to incorporate into your routine, focus mainly on high intensity interval training. This type of training allows you to work at a higher intensity in a shorter amount of time, creating a more efficient workout. Here’s a basic example, which can be adjusted based on your fitness level and also be applied to skipping, swimming, biking, etc –
Set 1 – Work at 90% of your max for 10 sec, recover at 50% of your max for 20 sec, repeat 10 times
Recover with light movement for 2 minutes
Set 2 – Work at 80% of your max for 20 sec, recover at 50% of your max for 40 sec, repeat 5 times
For a total workout time of 12 minutes!
This type of workout also leads to an increase in Excess Post-exercise Oxygen Consumption (EPOC). This refers to the amount of calories your body has to burn after the workout in order to recover from the “oxygen debt” that the high intensity workout induced. The more intense the workout, the higher your EPOC. If you’re going to run, and you’re not a competitive distance runner, focus mostly on high intensity interval training.
2. Lift heavy weights through compound exercises – weight training should be the focus of most exercise programs in order to build muscle. The more muscle you have, the more calories you burn at rest (i.e. a higher basal metabolic rate). This doesn’t mean you have to be big and bulky, and you likely won’t be, unless you have the right hormonal makeup to go along with a specific way of eating and training. To increase muscle activation, go through the concentric or “lift” phase of the exercise as quickly as you can and the eccentric or “lowering” phase of the exercise slowly (i.e. 1 sec concentric to 4 sec eccentric). By combining this tempo with heavy weights, you’re recruiting more muscle fibers (both fast and slow twitch muscle fibers vs. only slow twitch) for greater muscle activation. If you perform compound exercises that require more muscle, like squats, deadlifts, and pull-ups, you’re challenging your body even more, to which it responds with greater improvements so long as you…
3. Allow your body to recover – With the intensity of the interval training and weight lifting described above comes an equally important need to recover. But with the benefit of EPOC and the added lean muscle you can recover guilt-free knowing your body is still burning calories at an increased rate. This includes getting adequate sleep and nutrition, foam rolling, taking rest days but still staying active (i.e. walking for 20-30 mins daily) and taking contrast showers. You don’t build muscle during a workout, you break it down during a workout and build it back up in the hours and days to follow.
4. Find your motivation – I used to workout with the goal of playing professional soccer and I was able to push myself in ways I could have never imagined. Once my attention shifted towards medical school, my goals shifted towards demonstrating to those around me that a busy schedule was no excuse to ignoring your health. I also want to practice what I preach and set a great example for the patients I work with. Mixed in is the motivation to visit my nonna once a week who cooks incredibly delicious meals with no regard for portion control. Find whatever motivates you and build your plan around it.
5. Don’t make eating stressful – I’m not a big fan of counting calories, either burned or consumed, as there are very few instances where I see its usefulness. It becomes a process that is too tedious and time consuming, and too many variables exist (i.e. EPOC, the thermic effect of food, different foods with the same caloric content exhibiting vastly different effects on the body, etc.). I will get more into specifics of eating in future posts, but your main focus should be on eating healthy foods that have a high nutrient density. Start your day with a healthy breakfast and if it happens to be a workout day, consume your largest meal soon after the workout. When you happen to have an unhealthy meal or a dessert, don’t guilt yourself for it, make sure you savour and enjoy every last bite and get right back to eating healthy at the next meal.
Here’s a video from a workout challenge I did to win a ticket to race in Tough Mudder:
https://www.youtube.com/watch?v=KHGO4NLq-6Q
Rest assured my EPOC after this was insane, as I felt like I was huffing and puffing for the rest of the day even though the workout took me under 6 and a half minutes. Give this, or something similar, a try if you (and your doctor) think you’re up for it.
Workout instructions – As fast as you can, complete 5 one arm push ups, 30 wide-grip pull ups, 50 squat jumps, 25 pike push ups, 50 plank crawls, 50 in and out crunches, 100 mountain climbers, and 100 push ups.
References
1) Milanović Z, Sporiš G, Weston M. Effectiveness of High-Intensity Interval Training (HIT) and Continuous Endurance Training for VO2max Improvements: A Systematic Review and Meta-Analysis of Controlled Trials. Sports Med. 2015; 45(10):1469-81
2) Costigan S, Eather N, Plotnikoff R, Taaffe D, Lubans D. High-intensity interval training for improving health-related fitness in adolescents: a systematic review and meta-analysis. Br J Sports Med. 2015; 49(19):1253-61
3) Mackinnon L. Chronic exercise training effects on immune function. Med Sci Sports Exerc. 2000; 32(7):S369-76
4) Krüger K, Mooren F, Pilat. The Immunomodulatory Effects of Physical Activity. Curr Pharm Des. 2016; 22(24):3730-48
5) MacKelvie K, Taunton J, McKay H, Khan K. Bone mineral density and serum testosterone in chronically trained, high mileage 40-55 year old male runners. Br J Sports Med. 2000; 34(4):273-8
6) Greer B, Sirithienthad P, Moffatt R, Marcello R, Panton L. EPOC Comparison Between Isocaloric Bouts of Steady-State Aerobic, Intermittent Aerobic, and Resistance Training. Res Q Exerc Sport. 2015; 86(2):190-5
7) Roig M, O’Brien K, Kirk G, Murray R, McKinnon P, Shadgan B, Reid W. The effects of eccentric versus concentric resistance training on muscle strength and mass in healthy adults: a systematic review with meta-analysis. Br J Sports Med. 2009; 43(8):556-68
