Sunday, November 13, 2011

Intermittent Thoughts on Intermittent Fasting - Programing Success: Stocktaking, Goal Setting, -Tracking & -Resetting to Achieve a Healthy Weight & Shed Excess Body Fat

Image 1: You need to know exactly where you are and where you want to go. Read on to learn how your very own PPS can help you in achieving the goal you set as a homework from the last episode.
Assuming that all of you did your homework from the last installment of the Intermittent Thoughts, you should by know know the general direction into which you want to be heading. The first thing we are going to do today, is to revise these meta-goals. As I promised, I am going to try to tackle this in an as concrete, yet non-prescriptive manner as possible. So let's say you are "chubby" and want to "get lean" (please bare with me, even if that is not you, I will address gaining muscle and increasing performance in the next installments) Let me ask you a few questions, then. What is "chubby" and how would you define "lean"? I mean with your meta-goal being "going from chubby to lean", you are about as lost as with the idea of going from "New York" to a "less crowded place". Is it "New York" as in "New York City" or "New York", the state, from which you want to escape? And that "less crowded place", would that be the South-American rainforest, or rather the tidy world of the American suburbs?


PPS - The Personal Positioning System

To assess "where" chubby or whatever you are coming from is, you cannot simply whip out your shiny iPhone and use the GPS map. What you will need is a PPS system, a "Personal Positioning System" that will not only tell you were you are, but - if programmed correctly (and this is what you will learn in this and the following episodes) - also where to go next in order to achieve another step towards your destination goal. Contrary to the GPS, where the reference points are the many base stations of the system, your unique reference point is you! This fact has one very important implication: Just as the accuracy of the real GPS system is limited by its knowledge of the exact position of the base stations and satellites (EU's Galileo system will provide a whole new dimension of exactness in this regard, being about 5x more accurate than the old GPS) the goal-directedness of your everyday efforts in the kitchen and the gym will depend on an unbiased accurate assessment of your starting point.
Figure 1: So you are "chubby", yes? What kind of chubbiness are we talking about here? Is it the American Dad "Stanley Smith goes Anorexic" kind of imaginary chubiness? The Peter Griffin "Well I am a little too well-fed" kind of overweight chubiness or rather the "King Size Homer" kind of morbidly obese chubiness?
It does make a significant difference, whether you are "chubby" like in slightly overweight chubby or as in "chubby" as in morbidly obese chubby and it can become a life-and-death issue if you are "imaginary chubby", as Stan Smith in one episode of season 2 of American Dad, where he stops eating, because he believes that he was "chubby". Obviously, each of these points of origin would require different lifestyle interventions.
Image 2: Not to a pair you can identify with? Well, maybe not yet... and no matter how your goals may change (for many health and longevity become increasingly important with age), diet and exercise will always be essential parts of the life-style that will help you to achieve them.
Note: I am consciously talking about "lifestyle interventions" here and in the course of the whole serious, because the results you may get from a "dietary and/or exercise regimen" are only sustainable, if you make them a vital and appreciated part of your life - a part of a new life-style! This does not mean that you have to eat the same foods or train the same way that helped you achieve your aims for your whole life - in fact, this could well be counter-productive - but it does mean that in one form or another they will accompany you for the rest of a life. where the way you look and perform (the things usually associated with exercise and nutrition) are only two of the sides of the "health & longevity, savoir-vivre, performance and body composition" rhombus from the last installment (figure 2).

King Size Homer: Wait loss at all costs

Let's start with "King Size Homer", a victim of the sedentary Fast-Food Society. No matter what his dreams for the future may be and how much he may suffer from the way people react to the way he looks (Lewis. 2011), Homer's first and foremost concern must unquestionably be his health... interestingly, though, the latter will automatically improve with every pound of body fat King Size Homer is able to shed off his morbidly obese body. A 2002 study by Kopp et al., for example, showed that weight loss (unfortunately induced by a debilitating crutch that is known as "gastric surgery") alone led to significant reductions in circulating IL-6 and CRP and major improvements in insulin resistance. Now, those of you who read yesterday's news on the benefits of HIIT as a supplement to the already intense training regimen of 29 judo players, may remember my remark on how "classic cardio training" such as walking on an inclined treadmill turns into high intensity interval training for people like King Size Homer, after all, they are carrying a weight "normal" people would if they were doing a farmer's walk. It is thusly not surprising that regardless of the type of exercise, and even in the presence of "the crutch" (bariatric surgery, cf. Egberts. 2011), exercise has been shown time and again to promote weight loss above what fasting, medication and even surgery (all of which can become necessary in some really extreme scenarios) alone can achieve (Chaput. 2011). Moreover, and this is probably even more important, constant revision and adaptation of his exercise and nutrition regimen are going to be the decisive factors which will keep Homer from falling back into his morbidly obese state once he has cut his body weight in half and achieved an astral body like Peter Griffin, already has it.

King-Size Homer's PPS-Cheat-Sheet:
  • Goal(s): Lose weight at all cost, your health demands it!
  • Tracking: In your case each pound counts - a standard scale will suffice to track your progress
  • Resetting: Achieve "normal obesity", BMI ~30kg/m² before resetting your goals

Family Guy, Peter Griffin: Feed the Muscle, Cut the fat

When King Size Homer arrives at the "just" obese "Peter Griffin"-stage, things will change. He will by now have at least a minimal amount of fitness and in view of the 100+lbs of fat he has lost, simply using the stairs instead of the elevator will no longer suffice as his high intensity exercise for the day. The traditional hours on the treadmill in the "magical", yet factually non-existent fat-burning zone, on the other hand, will at best make him lose equal amounts of muscle and fat mass and thusly set him (or the now "just" obese Homer) up for the imfamous YoYo-effect. And as if this was not already enough Peter will hit a  weight loss plateau after about 1-2 months, anyways. By then, his body will have have succumbed to the chronic level of low grade stress and will no longer respond to further reductions in calorie intake and / or increases in training volume. Peter will lose faith, give up and... eat. He will end up fatter (not necessarily heavier) than before, will feel miserable and like the "biggest loser".
Figure 2: Changes in fitness, insulin levels (lower levels indicative of higher insulin sensitivity), carbohydrate and fatty acid oxidation after no more than 6 HIIT sprinting sessions on an electromagnetically braked cycle ergometer (data based on Whyte. 2010)
A better alternative for Peter, and anyone out there who can identify with him, would be to perform a 6x30s all-out-sprinting HIIT regimen (4.5 min active rest in between the bouts) three times a week. A regimen like the one that reduced the waist-lines of 10 "Peters" (BMI 31kg/m², waist circumference 101.3cm) in a recent study by -2.4 cm (highly significant, p<0.004) within no more than 2 weeks (Whyte. 2010). The six HIIT sessions also significantly improved their aerobic (VO2Max, p<0.013) and anaeropic (mean power, p<0.04) performance, reduced their elevated insulin levels and shifted their metabolism towards the oxidation of fatty acids instead of carbs (cf. figure 2). 
Image 3: You eat nutrients not calories. Weight loss comes with a nutrient dense, not a calorie deficient diet.
Note: If you are not (or no longer) morbidly obese it is absolutely imperative not to go on a starvation diet, if you do not want to starve for the rest of your life. A recent study by Sumithran et al. shows pretty conclusively that even one year after a 10-week weight loss intervention on a very-low-calorie diet, "levels of the circulating mediators of appetite that encourage weight regain after diet-induced weight loss do not revert to the levels recorded before weight loss" (Sumithran. 2011)! In this context, it is also noteworthy that the subjects in the Whyte study did not reduce their habitual calorie intake, all they did is HIIT 3x a week. Other than the "King Size Homers", who will have to dramatically cut down on their caloric intakes, the "Peter Griffins", i.e. sendentary obese people, should not decrease their calorie intake, but increase their nutrient intake (more often than not the former will be a necessary consequence of the latter, because you will feel stuffed and satisfied with far "less" quality food). The first step here would be to cut out all pre-processed foods from one's diet and start preparing your meals from whole foods. And while 1-2 servings of fruit like the ones in image 3 won't harm you (high fructose corn-syrup is and absolute no-go, though), vegetables, fish, eggs, meat, and milk products (if you tolerate them) should make up the major part of your diet, which must provide you with adequate amounts of protein >1g/kg and fats (poly-, monounsaturated and saturated fats!). Instead of calories you will begin counting the number of eggs, the tablespoons of coconut oil, the cups of broccoli etc. This goes against the mainstream calories in vs. calories out paradigm, but once you see the difference it makes if you cut out 1x tablespoon of coconut oil vs. 2 x tablespoons of sugar in your diet, you will understand that foods with identical "caloric values" can have very different effects on your body composition. The use of an intermittent fasting regimen, as well as the reduction of the carbohydrate intake to <=120g/day can be facilitative, as well - but we will discuss that and possible supplemental fat-loss adjuvants in a separate issue with concrete advice on programming dietary success.
Peter will yet have to acknowledge that those benefits subside about as quickly as they came, whenever he reverts to his previous sedentary lifestyle. If you look at the data in figure 2 you will notice that the pronounced immediate metabolic benefits, i.e. the increased insulin sensitivity and the increased fatty acid oxidation begin to wear off within 72h after the last training session. Not only for the Peter Griffins out there, it is thus of utmost importance to train regularly, at least 3 times a week (ideally 3x HIIT + 2x full-body resistance training), consistently and intensely to "keep the mitochondria from clocking back up" and your muscle primed to suck up superflous glucose from your blood stream (on a side note: a recent study confirmed a relationship between exercise-intensity, not frequency or total volume, and improvements in insulin sensitvity, cf. Dubé. 2011)

Peter Griffin's PPS-Cheat-Sheet:
  • Goal(s): Lose fat, keep (or build) muscle
  • Tracking: A simple measuring tape to measure your waist circumference and your training log, in which you will record the weights you are using on the (optional) weight training days
  • Resetting: Get your waist down into the <36" inch zone before you even remotely consider dropping the loss of body fat as your primary goal; at the same time set out to increase weights or reps on your major moves (squats, bench, deadlift, pull-up) every 2nd week

Anorexic Dad, Stanley Smith: Skinny fat no more

Image 4: Already lean?
Then forget about the scale!
Our third example, American Dad, Stanley Smith in the "Anorexia episode", is particularly near and dear to my heart, because I see way too many "almost anorexic" trainees (not only women!) whose life is dictated by the number the scale is showing them in the morning. Among the men in this group many actually went through either one or even both of the previously discussed stages, where each pound they lost on the scale did actually make a difference in how they looked - a correlation (not causation ;-) they have internalized in a way that they cannot grasp the idea that with a body fat percentage in the ~15% range (for men), the scale is probably your worst adviser when it comes to evaluating your progress and programming success.

Probably due to the unreasonable and (if you asked me) utterly unsexy ideal of the "beautiful" female model, whose major features are skinniness and a severe lack of skeletal muscle tissue, this obsession not with how much, but rather with how little you weigh, is rampant within the community of female fitness junkies. Based on the misunderstanding that weight loss (at least for females) would equal improvements in body composition, thousands of women starve themselves into what Dr. Connelly often refers to as an "reduced obese state" (also read the study on the changes after starvation diet in the red box above) - and that despite the fact, that many were "too skinny" (remember skin = fat + thin dermis) to begin with.

Image 5: When you have achieved a "normal" degree of leanness, building a beautiful body has little to do with losing weight, it's all about modulating the ratio of lean to fat mass (photo originally shared on Facebook by Erika Rice).
As it happens, Carl Lanore's significant other, Alisa Profumo, the "lovely and talented co-host" of the Casual Friday Episodes on Super Human Radio, reposted two images of a woman on her facebook page, which are so exemplary of the phenotype of the "imaginary obese" that I must repost them, although I do not even know who the lady is. What you see here, ladies and gentlemen is the exact opposite of what 99% of the women's magazines are still propagating:

Gaining, not losing weight makes you sexy!

Toning up, ladies and gentlemen, is about building muscle and losing fat. Regardless of whether you want to look like a goddess or just "look good naked", the concept of overall body "weight" has no significance in this context. It is thusly only consistent to give away your scale to the "King Size Homers" in your neighborhood (or anybody you do not like ;-) and to rely on progress pictures, like the lady in image 5, who gained 9lbs and finally overcame the "skinny fat" physique that tricks so many women (and men) into believing that they got to lose weight to achieve the physique of their dreams.
For the "skinny fat" and anybody who wants to improve his physique beyond simply being lean, progress pictures are thusly a must. In that, it is yet not necessary and probably not even advisable to take daily pictures like the ones that made John Stone (watch his transformation video) world-famous (you will just stress yourself about how "slow" your body changes and the increased cortisol certainly won't help with the progress). One picture each week, taken in underwear in the morning, standing upright (no posing) on a specific spot in a room, where you can ensure that the lighting is always the same, is enough to objectively track your progress.
Being fit and healthy, the Stanley Smiths out there will keep or reduce (depending on how lean they already are) their HIIT exercise and increase, split and periodize the resistance training component of their exercise regimen from two to (initially) three sessions per week, while keeping a constant eye on the volume - after all, you should always remember you are not in the gym to burn calories! While the other idiots may be, you are in the gym to achieve your goals and I assume none of you has set "burn 1,000,000kcal" as his long-term goal, right?

Stanley Smith's PPS-Cheat-Sheet:
  • Goal(s): Lose fat, build muscle
  • Tracking: Weekly training pics (optional: a body-fat caliper) and your training log, in which you will record the weights you are using on the obligatory weight training days
  • Resetting: Especially for the women the next long-term goal may be "hold what you achieved", for the men it is likely that the focus will shift from losing fat to building muscle  
Image 6: Plastic models illustrating the different densities and consequent volume differences of fat and muscle tissue (img from onemorebite-weightloss.com)
Still not convinced that your scale is worthless? Then have a look at the image on the left. What you see are plastic models of 5lbs of fat (yellow) and 5lbs of muscle (red). Now, imagine how a 7.5lbs muscle strand would look like (+25% in size) - obviously still less bulky and than the 5lbs of fat. And now, think about what the scale will tell you when you exchange the ugly 5lbs of fat for the aesthetic 7.5lbs of muscle: It will tell you that you have gained 2.5lbs of ... body weight. Something you could hardly care less about, because your progress pics don't lie. You are 2.5lbs heavier look a hell lot better than before ;-)

Ah, and before you ask. As a physicist I can tell you that the body-impedance scales you can buy at every turn, which claim to give you exact numbers on your body-fat and body-water content, are about as exact as the weather forecast for the next week. They may be able to give an account of general trends, but the "exact" numbers they display are pretty random.

(Now) I am (already) lean - what do I do?

With all this thinking about goal setting, -tracking and -resetting for "healthy weight loss" and the first steps on the long way to an astral body, the time flew by so fast that I did not even have the chance to address the excellent "homeworks" Jahed, Pablo, RF and Angimal submitted in response to the last installment of the Intermittent Thoughts. I will make good for that in the next installment, when we will discuss goal setting, -tracking and -resetting for those who are already past the Stanley Smith state (anorexic or not ;-) and finally want to add some serious muscle to their now ripped, yet still undermuscled physique.