Not Making Progress? New RCT: 'Personal Training' Sheds Twice as Much Body Fat and Quadruples Muscle Gains...

Certainly not a photo from the study.

I have to admit that I have never even remotely thought about hiring a personal trainer or coach. A mistake? Well, unlike the lives of the obese subjects in a recent study from the Western State Colorado University (Dalleck. 2016), my life does not depend on it and still, with my tendency to always do too much instead of too little, I am almost certain that I would have made similarly larger strides towards my personal training goals as the sedentary male and female subjects in the previously alluded to recently published study.

One important feature of both training protocols is that they implement periodization schemes.

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The 46 subjects were randomly assigned to one out of three experimental groups: the standardized program group (STD), the ACE IFT group (ACE) and a control group (see Figure 1):

Figure 1: Flow chart of the experimental procedures (Dalleck. 2016).

All underwent the same baseline tests and the subjects in the std. program (according to the guidelines of the American College of Sports Medicine | ACSM) and ACE IFT group trained at the same volume of 150 min/week. What exactly they did and how intense they were training, on the other hand, differed. More specifically...

• the STD group was prescribed a standardized progressive cardio workout based on the previously determined HR-max (maximal heart rate) values
• the ACE group was prescribed the same cardio workout, but with the intensity being based on the ventilatory threshold, i.e.the point during exercise at which ventilation starts to increase at a faster rate than VO2. In that, we distinguish between VT1 and VT2, with the former, the First Ventilatory Threshold marking the intensity at which lactate begins to accumulate in the blood (it's also the point where the breathing rate begins to increase and you cannot talk comfortably anymore). VT2, i.e. the Second Ventilatory Threshold, marks the intensity when lactate has already accumulated in the blood and the person needs to breathe heavily - it's also called the anaerobic threshold or lactate threshold.
• the resistance training program for the STD group was likewise designed according to the ACSM guidelines and involved bench presses, shoulder presses, lateral pulldowns, seated rows, biceps curls, triceps pushdowns, leg presses and extensions, prone lying leg curls, and seated back extensions. Two sets of 12 reps at a moderate intensity of 5-6 on the modified Borg rating of perceived exertion scale (RPE). Resistance was progressed every 2 weeks by ~3-5% for the upper and ~6-10% for the lower body exercises.
• the resistance training program for the ACE group was designed according to the ACE guidelines (Bryant. 2014) and consisted of multijoint/multiplanar exercises with both free weights and machines (still allowing for free motion during the exercise). The following exercises were performed: stability ball circuit (hip bridge, crunch, Russian twist, plank), lunge matrix, kneeling/standing wood chops, kneeling/standing hay bailers, dumbbell squats, one-arm cable row (standing), step-ups w/ dumbbells (onto 15 cm step), pull-ups (assisted), dumbbell bench press. For each exercise two sets of 12 reps were completed with the resistance progressing by 5%  of the 5-RM every two weeks from 50% in week 1 to 80% in the last week (for the circuit and other exercises where you couldn't change the resistance the same progression model was adapted to the volume).

Do you notice something? Yeah, you can do the ACE program without a personal trainer, as well. As different as it may be, it does not provide any of the individuality a personal trainer who's not following yet another cookie cutter approach (in this case the ACE personal trainer manual | Bryant. 2014) would ideally provide. 

Figure 2: Overview of the pre-post changes in control, STD and ACE (% of baseline | Dalleck. 2016)

This doesn't make the study superfluous or its results invalid (see Figure 2), but it does make the scientists' conclusion kind of confusing, and that despite the fact that...

• the STD protocol produced 35.7% VO2max non-responders, while the ACE program produced none (all subjects saw increases of 5.9% or more)
• the STD protocol had only 42.9%, 50%, 85.7% and 42.9% of the subjects achieve meaningful improvements in blood pressure, HDL, triglycerides, and blood glucose, while the corresponding figures for the ACE protocol were 100% for BP, 100% for HTL, 85.7% for trigs and 92.9% for blood glucose - and that in spite of the fact that potential influencing factors such as age, baseline value, exercise adherence, and sex didn't differ
• the ST program produced improvements in waist and body fat in only 78.6%, while 92.9% and 100% of the subjects in the ACE group saw their waist trim and their body fat melt.

After all, the authors write in their article in the Journal of Fitness Research that their "novel findings [...] underscore the importance of a personalised exercise prescription to enhance training efficacy and limit training unresponsiveness" (Dalleck. 2016) - well, and in all honesty, I cannot see how the ACE program is more "personalized" in the sense of being adapted to the individual than the training according to the ACSM guidelines.

Figure 3: Individual variability in relative VO2max response(%change) to exercise training in (A) the STD and (B) the ACE group (Dalleck. 2016).

So what do we make of the results, then? While you can debate whether the ACE program is more "personalized" than a program that's designed according to the ACSM guidelines, there's no debating its efficacy. As you can see in Figure 2 and 3, the ACE program is not just more effective (sign.so  for body fat, lean mass, VO2max, blood pressure, and all balance and strength parameters), there were also no non-responders (see Figure 3 | I personally would have excluded the one individual that regressed significantly; there are probably different reasons than the ACSM program for that) in the ACE group while 5 of the subjects in the STD group saw no or non-significant VO2 improvements.

Overall, the authors of the study at hand are thus right. Their study does "underscore the importance of a personalised exercise prescription to enhance training efficacy and limit training unresponsiveness" what you have to keep in mind, though is that we're not comparing an actually personalized to a standardized exercise prescription, but rather prescribing according to different criteria (cardio: heart rate vs. ventilatory threshold/strength: RPE vs. 5-RM).

Now, one could assume that everything was thus only a result of higher intensities in the ACE group. The actual heart rates, however, didn't differ sign. between the two groups: 107-120 bpm vs. 104-127 bpm for the STD and ACE group respectively. If you're a trainer or a trainee who's not happy with his clients or his own results, trying to train according to the allegedly "personalized" ACE guidelines may well rekindle/promote your progress | Comment!

References:

• Bryant, Cedric X., Sabrena Newton-Merrill, and Daniel J. Green, eds. ACE personal trainer manual. 2014.
• Dalleck, Lance C., et al. "Does a personalised exercise prescription enhance training efficacy and limit training unresponsiveness? A randomised controlled trial." Journal of Fitness Research 5 (2016).

Step By Step Guide to Your Own Workout Routine - Part I: Fitting the "Right" Number Training Days, Rest Days, Strength and Conditioning Workouts Into Your Schedule

Image 1: The foundation of every training plan is a realistic schedule. Your work, your private life, your training experience, your goals, all must be taken into account, when lay this foundation.

I have been talking with Adelfo about his new training plan earlier today. In the course of our conversation I did realize that even for someone with his expertise it is not always easy to come up with a plan. In fact, his first "blueprint" reminded me of my post on the "(Over-)Motivational Roots of Overtraining" from last Sunday and your frequent requests for more practical information here at the SuppVersity. So, without forestalling Adelfo's up-coming blogpost with all the details on his new routine, I want to provide you with a more general guide on how to structure your workouts. As with the "Three Simple Rules of Sensible Supplementation", I will try to take you through a number of steps of which I believe that they are more or less universal. Ready? Well, then let's go!

1. Find / make time for your workouts

It may sound funny, but one of the commonest reasons a given training program fails actually is a real or perceived lack of time. The first step to a functional routine is thusly to take stock of how much time you actually have available, how much of this time you are actually willing to invest into your workouts and how much time you actually need to achieve your goals. 

Let's first take a look at the time you will be spending on an actual workout:

• Strength training: 20-60min
• High intensity interval training: 10-25min
• Steady state "cardio" training: 35-60min

Image 2: I know, if this is you at the age of five it may be difficult to imagine that it is not normal to watch TV at least 2.7h of TV per day (figures according to United States Department of Labors. 2010)

Depending on where you perform your workouts you will obviously have to add somewhere between 5min, for say a HIIT session in your backyard, and 30-60min, for a weight lifting session at you local gym (including driving to the gym, showering etc.). This means that the minimal time you will have to invest on a workout will be ~20min for a brief HIIT conditioning workout. In view of the fact that three "workouts" per week are an absolute must if you want to make changes to the way you look, feel and perform, this means that you do not even need to read further if you are not willing to invest at least 3x20 minutes of the valuable time many of your fellow human beings will be wasting in front of the television or on social networks into your health, your performance and your physique.

Tip #1: Don't discard working out before you go to work and don't fool yourself into believing that it would be normal to go home after work and watch TV for the rest of the evening. Setting the alarm clock and switching off the television are the best ways to make time for your workouts. On the other hand, you will have to acknowledge, that there will be days, where you will really have no time and if you have to decide between doing a 60min workout and getting 5h vs. 6h of sleep your choice should be easy: SLEEP!

2. Schedule your training and rest (!) days

Before you even think about what type of exercises you do, you will have to actually decide on the days on which you want to train and the type of training you are going to perform.

It stands to reason that you will resort to the results of (1) and don't schedule a training day on Tuesday, when you know that you have to work the 24h shift at the hospital. That being said, it is of paramount importance to try and spread your workouts evenly across the week. Now with the aforementioned "minimalist" approach of three workout days per week this could look as follows:

Image 2:If you are still not convinced that resting two days too much is way better than resting one day too little, you better read up on the "(Over-)Motivational Roots of Overtraining"!

• Workout days: Monday, Wednesday, Friday
• Rest days: Tuesday, Thursday, Saturday, Sunday

A 5-day workout routine for someone like Adelfo, on the other hand would look like this:

• Workout days: Mon, Tue, Wed, Fri, Sat
• Rest days: Thursday, Sunday

You probably did not notice that, but I deliberately chose the words "rest day" instead of "day off" or something like that, because the latter implies that those days would be unnecessary or even counterproductive, when the exact opposite is actually the case.

The margin "between not enough" and "already too much" is very narrow and according to my personal experience, the amount of strenuous exercise (strength training or high intensity conditioning work) that will yield "optimal" results is above all a function of your individual conditioning and training experience, with the following rule of thumb applying in a situation of at best minimal caloric restriction and adequate (we will address that in a future installment) protein and carbohydrate intake:

• 3x per week - less than one year of training experience and no previous engagement in any physically demanding athletic activities like football, basketball, track and field etc. (no, not on the Playstation)
   
• 4x per week - more than one year of regular training or previous engagement in physically demanding athletic activities
   
• 5x per week - more than three years of regular training and a lifestyle that prioritizes further progress in the gym over your other hobbies
   
• limitations (updated 25-03): ProudDaddy reminded me that I (once again, and I am sorry for that) forgot about the "older" trainees out there. It stands to reason that a young body does not need as much time to recover as an older one (although I assume that ProudDaddy has a better recovery time than many Pizza eating, Coke binging twens). If you belong to this group of "golden agers", it is important to
1. to keep intense (strength & HIIT) workouts short
2. to increase your training volume by increasing workout frequency not duration
3. to cycle metabolically demanding and recuperative workouts*
4. to have 24h+ of (active) rest after every intense workout*

Assuming that you are still really fit, an adapted 5x a week workout could look like this:


1. Upper body (<30min),
2. LISS cardio (30min), 
3. Lower body (<30min),
4. Rest
5. Full body / functional movements (30min)
6. HIIT or LISS (10min or 30min)
7. Rest

If you would conduct an interview at your local gym, I would estimate that, according to these criteria, at least 50% of the trainees are overtraining. If you add another 10% for the week-end warrior faction and consider the ~15% of people who are going "whenever they feel like training" you know why 75% of the people in the gym stagnate after the initial adaptation phase.

Tip #2: If you want to do more, go on a bike ride with friends or family. Go to the basketball court in your neighborhood. Take the stairs, go for a walk in the park and lead an active life. Trust me, nothing will promote your overall health, your performance and the improvements in your physique more than these leisure time activities.

3. Allocate specific workouts to your training days

Now that you know on which days you are going to train and how much time you have available you will eventually envoke your personal aims, of which I will exemplary discuss general health, weight loss and muscle/strength gain.

We will again start out with the most fundamental distinction, i.e. the one between strength and conditioning work, with all types of weight lifting belonging to the former and all types of "cardio" training belonging to the latter realm, this reduces the first step in this process to a simple decision on ratios:

• focus on general health - ratio of strength to conditioning work: 3/2
   
• focus on weight / fat loss - ratio of strength to conditioning work: 2/3
   
• focus on gaining muscle/strength - ratio of strength to conditioning work: 4/1  

This is obviously another rule of thumb and one of which I would believe that its implications become clear only if I give you a couple of examples:. Based on what you have learned so far, ...

Image 3: Unless you are in identical shape and condition as Adelfo you'd better not simply copy his routine.

• a trainee who starts to work out and has a focus on overall health will train three times a week and perform two strength and one conditioning workout
   
• a trainee with 2 years of training experience and a focus on losing fat will train four times a week and perform two strength and two conditioning workouts
   
• a trainee with 4 years of training experience and a focus on building muscle will train five times a week and perform four strength and one conditioning workouts

For all trainees it is possible to add some "classic cardio" training in the form of either 15 minutes walking on an incline treadmill (or similar) to the end of any strength workout that is <60min or to do a similarly paced type of regenerative exercise on "rest days". Within the bodybuilding and fitness community, the recuperative aspect of modest physical activity is unfortunately still largely overlooked, and that despite the fact that it is a staple of almost every other group of professional athletes, where the day after a match or meeting is a "rest day" in the sense that you do not train intensely, but still give your muscles a chance to clear the metabolic waste from the day before.

Tip #3: If you have a "hypertrophy and fat loss" focus (please be aware that if you are doing everything right, the scale is not going to move!), you may want to consider adding in an additional workout day, and/or performing your conditioning workouts, either in the morning or right after your workouts. While the former option is probably best for the "rookie", the latter one, i.e. cardio either in the morning or right after your strength workout is the most reasonable option for the highly advanced trainee, who will still need his two days off to recuperate.

Coming up next: Training splits, exercise selection, set and rep schemes

To decide how you pair individual muscle groups and how to place the conditioning and strength workouts within the framework you have worked out today is going to be the next step on your way to a workout that has been custom-tailored to your individual demands by the word's leading expert in your belongings - you, yourself! So, don't forget to come back tomorrow for the second part of the "Step By Step Guide to Your Own Workout Routine" series, here at the SuppVersity.