Friday, July 19, 2013

High Intensity Resistance Training to RESOLVE Weight & Health Problems. Hitting the Weights Hard + Walking Yields Better Results Than Endless Jogging & Light Weights

After 90min of cardio at 70% of your HRmax your body tells you that this is not beneficial - why don't you just listen to it?
You may remember a recent Facebook post of mine in which I wrote about a recent study that showed that sedentary primary care physicians are less likely to prescribe exercise as a treatment to their overweight patients than those who work out, themselves.

Well, according to a recent study from the Gordon and Leslie Diamond Health Care Centre in Vancouver, it appears as Canada would be in store for seriously more exercising overweight patients in the future... well, that's probably a little too optimistic, but in view of the fact that "fourth-year UBC [University of British Columbia] medical students engage in more strenuous PA [phycical activity] than average age-matched Canadians" (Holtz. 2013), there is still hope that the next generation of obese patients is not going to get their scripts that effortless any longer.

Exercise? Yeah, but what is the ideal exercise prescription?

What remains to be seen, though is whether or not this new generation of MD is willing and able to prescribe anything but the moribund standard protocols. Something like the high intensity resistance, moderate endurance exercise protocol (HRME) European scientists dared to test against the way more prevalent moderate intensity resistance, moderate endurance exercise (MRME), and moderate intensity resistance, high intensity endurance exercise (MRHR) protocols in their most recent ramdomized trial.
When I see this stupid protocol, I wish the scientists had read my article "How to Burn 27,300 Kcal Extra W/out Losing a Single Extra Pound of Fat!" (read it), before starting the study.
"The participants were coached daily individually, within the context of their assigned group. The same time (15–20 h/week) was spent by all groups in endurance (90 min daily) plus in resistance (90 min four days a week). Exercises differed only in intensity, from 30% to 70%. Participants' heart rate was monitored by Polar™ S810 with instantaneous recording and storage of heart rate values. Endurance training included aquagym, cycling and walking. Resistance training consisted of 8 exercises with free weights and traditional muscle building equipment. Each exercise [e.g. bench press, leg extension, biceps curl] was performed for three sets of 10 repetitions." (Dutheil. 2013; my emphasis)
The experiment was part of the so-called REverse metabolic SyndrOme by Lifestyle and Various Exercises (RESOLVE) trial, and consisted of a combined dietary + exercise intervention, in the course of which 100 participants, aged 50–70 years, underwent a diet restriction (protein intake 1.2 g/kg/day) with a high exercise volume (15–20 h/week).

When you start out with 3kg of pure fat around your wasteline, ....

Too much volume for the real world! Just in case you are one of the future doctors mentioned in the introduction you can take my word for it: your patients are not going to be 85% compliant to an insane workload like this. If you get your patients to complete 4 resistance training workouts with subsequent 15min of cardio training lasting for a total of 60 min each and have them take the stairs instead of the elevator that would be more than enough, anyway.
... how much can be lost on a -500kcal/day diet with a minimal protein intake of 1.2g/kg per day and an exercise program on a daily endurance (90min) and four times a week (90 min) resistance training regimen?
"Exercises differed only in intensity, from 30% to 70%. Participants' heart rate was monitored by Polar™ S810 with instantaneous recording and storage of heart rate values. Endurance training included aquagym, cycling and walking. Resistance training consisted of 8 exercises with free weights and traditional muscle building equipment. Each exercise was performed for three sets of 10 repetitions." (Dutheil. 2013)
While this was not the exact research question the scientists put into their paper, it is essentially what the study that has been funded by the Heart and Diseases Foundation was designed for. Whether or not it is realistic to assume that anyone would actually do 90 minutes of cardio everyday is yet questionable and since that was not controlled for during the 1-year at-home follow up, I hardly doubt any of the participants was stupid enough to do that.

Apropos, the dropout rates of the individual groups were 10/34 for the HRME, 8/32 for the MRHE and 4/34 for the MRME groups. In other words, the less intense the training program the more likely the subjects were to stick to it.
Figure 1: Changes in central fat, lean and fat mass; expressed relative to baseline (Dutheil. 2013)
If you look at the actual study outcomes in figure 1 it should yet be clear that it would make more sense to cut back on the training volume to increase the adherence to the protocol, than to cut back on the intensity. After all, the latter appears to be the main determinants of the success of the exercise intervention in both the high intensity resistance training (blue) and endurance training (yellow) groups...
Figure 2: Fat/lean mass ratio, changes in HbA1c (longterm blood glucose marker), and strength (maximum load of 10 repetitions from three prescribed exercises, i.e. bench press, leg extension, biceps curl) over the course of the study (Dutheil. 2013)
..however, after taking a look at figure 2 there is no debating that the high intensity endurance program is significantly inferior to its weight lifting training counterpart: greater strength gains, persistent improvement in HbA1c even at the end of the 12 months follow up and, most importantly, the largest fat-to-lean-mass ratio loss of all three protocols.

Bottom line: You do really want to know the bottom line? Well, eat clean, hit the weights hit the weights hard combine that with yet by no means so much moderate cardio training as the subjects in the study and the nasty blubber and the associated health problems are problem of yesteryear... ah, and when I write "yesteryear" this implies it may well take a year or longer to reach your goals.

Don't be afraid to take a week off, it will reset the protein anabolic response to your training (learn more)
Persistence is key, but just as you've learned in Wednesday's SuppVersity article with the telling title "Do Chronic Energy Deficits Make Athletes Fat? The Longer & More Severe You Starve, the Fatter You Are. Irrespective of What the Calories-in-VS-Calories-Out Formula May Say, going all out day in and day out will, just like dieting hard, day in and day out, knock you out.

Make sure you get adequate rest and take a week off every 6 weeks, when you are switching from one iteration of your training program to another one.

And if you really have to make it happen fast, do it as the subjects did, make sure you get your 1.5g/kg protein (or better 30g+ with every meal) ramp up the volume, overreach for three weeks, look great at your high-school reunion, photo shoot, wedding or whatever the reason for the urgency was and resume your training at a low volume after a full week of binge-free rest.

  • Dutheil F, Lac G, Lesourd B, Chapier R, Walther G, Vinet A, Sapin V, Verney J, Ouchchane L, Duclos M, Obert P, Courteix D. Different modalities of exercise to reduce visceral fat mass and cardiovascular risk in metabolic syndrome: the RESOLVE* randomized trial. Int J Cardiol. 2013 May 25.