Tuesday 21 January 2014

Waist-to-weight ratio vs. body max index


The optimal waist / weight ratio (WWR) theory () is one of the most compatible with evidence regarding the lowest mortality body mass index (BMI).

But why do we need the WWR when we already have the BMI? This was a question that a reader asked me in connection with a post on the John Stone transformation ().

The montage below shows photos of the John Stone transformation with the respective WWR and BMI measures.



Well, which one is the most useful measure, WWR or BMI?

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Sunday 12 January 2014

Public Talk at the University of Virginia on Friday, January 17

This Friday, I'll be giving an invited lecture at the University of Virginia, my undergraduate alma mater.  I was kindly invited by a medical student named Robert Abbott, and it worked out well because I was already traveling to Charlottesville.

The talk will be titled "Why Do We Overeat?  A Neurobiological Perspective".  Here's the teaser:
Obesity is a leading cause of morbidity and mortality in industrialized nations, yet this is a relatively recent phenomenon.  In the United States, increasing obesity prevalence has paralleled a gradual increase of daily energy intake.  Why do most Americans eat more than we used to, and more than we need to maintain a lean state, despite negative consequences?  This presentation will touch on the neurobiology of action selection, the neurobiology of energy homeostasis, and why our central nervous system hardware may not be up to the task of constructively navigating the modern food environment.
The talk will be attended by medical students, but I also hope to have some doctors and researchers show up, as well as people from the broader Charlottesville community.  It will be a thought-provoking talk regardless of your background, and it will touch on some of my own work.

The talk will be held in the main medical school auditorium, MEB 3110, on Friday, January 17 at noon.  You can find driving directions and parking information by following this link.  You'll probably have to park in a parking garage, either the Lee Street or Central Grounds garage (directions in the link).

For a map of the UVA health system, follow this link.  The Medical Education Building is number 44 on the map, and the talk will be in room MEB 3110 on the 3rd floor of the building.

See you there!


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Monday 6 January 2014

Doing crossfit and looking like a bodybuilder?


Top crossfit athletes like Annie Thorisdottir and Rich Froning Jr. (pictured below; photos from Crossfitthestables.com and List09.com) look like bodybuilders even though their training practices are markedly different from those of most top natural bodybuilders. It is instructive, from a human physiology perspective, to try to understand why.





First of all we should make it clear that what makes Annie Thorisdottir and Rich Froning Jr. look the way they do is not only crossfit training. Genetics plays a key role here. Some people don’t accept this argument at all. Can you imagine someone arguing that top basketball players are generally tall because the stretching and reaching moves inherent in playing basketball make them tall? Top basketball players are not tall because they play basketball; the causality is stronger in the opposite direction: they play basketball because they are tall. The situation is not all that different with top crossfit competitors.

Often people will point at before and after photos as evidence that anyone can achieve the level of muscularity of a champion natural bodybuilder, if they do the right things. The problem with these before and after photos is that one can “go down” in terms of muscularity and definition quite a lot, but there is a clear ceiling in terms of “going up”. For example, if one goes from competitive marathon running to competitive bodybuilding, after a few years the difference will be dramatic if the person has the genetics necessary to gain a lot of muscle.

In other words, those who have the genetics to become very muscular can lose muscle and/or gain body fat to the point that they would look like they don’t have much genetic potential for muscle gain. Someone who doesn’t have the required genetics, on the other hand, will also be very effective at losing muscle and/or gaining body fat, but will be much more limited at the upper end of the scale.

The table below is from a widely cited and classic study by Fryburg and colleagues on the effects of growth hormone, insulin, and amino acid infusion on muscle accretion of protein. The article is available online as a PDF file (). The measurements shown on the table were taken basally (BAS) and at 3 h and 6 h after the start of the infusions, one of which was of a balanced amino acid mixture that raised arterial phenylalanine concentration to about twice what it was before the infusion. Phenylalanine is one of the essential amino acids present in muscle ().



There were four experimental conditions, two with only amino acid infusion, one with insulin and amino acid infusions, and one with insulin-like growth factor 1 (IGF-1) and amino acid infusions. Protein synthesis and breakdown numbers are based on phenylalanine kinetics inferences. The balance number is based on the synthesis and breakdown numbers; the former minus the latter. Note that at BAS the balance is always negative; this implies a net amino acid loss from muscle. At BAS the measurements were taken after a 12 h fast.

All infusions – of insulin, IGF-1, and amino acids – were continuously applied during the 6 h period. There was no exercise involved in this infusion study, and the amino acid mixture was balanced; as opposed to focused on certain amino acids, such as BCAAs.

The numbers in the table suggest that insulin infusion brings the balance to positive territory at the 3-h mark, with the effect wearing down at 6 h. IGF-1 infusion brings the balance to positive territory at 3 h, with the effect increasing and almost doubling at 6 h. Amino acid infusion alone brings the balance to positive territory a bit at 3 h and 6 h, and much less than when it is combined with insulin or IGF-1 infusions.

The effects of these infusions were due to both reductions in breakdown (amino acid loss) and increases in synthesis. We see that insulin exerts its effect on the balance primarily by suppressing breakdown. IGF-1 exerts its effect on the balance primarily by increasing synthesis. The effect of IGF-1 on the balance is significantly stronger than those of insulin and amino acid infusions, even when these latter two are taken together.

While this is an infusion study, one can derive conclusions about what would happen in response to different types of exercise and nutrients. Under real life conditions, insulin will increase in response to ingestion of carbohydrates and/or protein. IGF-1 will increase in response to growth hormone (GH) elevation, of which a major trigger is intense exercise.

The type of exercise that leads to the highest elevation of GH levels is intense exercise that raises heart rate significantly and rapidly. Examples are sprints, large-muscle resistance exercise, and resistance exercise involving multiple muscles at the same time. At the very high end of GH secretion are exercises that use large upper and lower body muscles at the same time, such as the deadlift. At the low end of GH secretion are localized small-muscle exercises, such as calf raises and isolated curls.

Anecdotally it seems that, at least for beginners, those exercises that lead to the highest GH secretion are the least “comfortable” for them. That is, those are the exercises that cause the most “huffing and puffing”. So next time you do an exercise like that, use this as a motivator: these are the exercises with the biggest return on investment; whether you are looking for health improvement, muscle gain, or both.

Competitive crossfit practitioners tend to favor variations of high-intensity interval training (HIIT), with an emphasis on a blend of endurance and strength exercises. Endurance and strength are both needed in crossfit competition. Competitive bodybuilders tend to focus more on strength, often exercising with more resistance or weight than competitive crossfit practitioners.

Extrapolating from the infusion study, one could argue that high GH secretion exercises are critical for amino acid accretion in muscle. Both groups mentioned above – competitive crossfit practitioners and competitive bodybuilders – exercise in ways that lead to high GH secretion. Surprising as this may sound (to some), if you do chin-ups, you’ll probably have better results in terms of biceps hypertrophy than if you do isolated bicep curls. This will happen even though the overall load on the bicep muscles will be lower with the chin-ups. The reason is that the GH secretion will be significantly higher with the chin-ups, because more muscles are involved at the same time, including large ones (e.g. the lats).

It is interesting to see competitive crossfit practitioners talking about needing to lose some weight but not being able to (). The reason is that they do not have much body fat to lose, and the types of exercise that they do create such a powerful stimulus toward positive nitrogen balance () that they end up gaining weight even as they restrict calorie intake.

Carbohydrate ingestion prior to exercise may raise insulin levels, but will blunt GH secretion; protein without carbohydrate, on the other hand, will raise insulin levels without blunting GH secretion (). Whether ingesting protein immediately before exercising is necessarily good in the long run is an open question, however, because GH secretion is likely to be greater for someone who is exercising in the fasted state, as GH secretion is in part a response to glycogen depletion (, ). And, as we have seen from the infusion study, GH secretion is disproportionately important as a positive nitrogen balance factor.

Compensatory adaptation applied to human biology () suggests that the body responds to challenges over time, in a compensatory way. Which scenario poses the bigger challenge: (a) high GH exercise with more amino acid loss during the exercise, or (b) high GH exercise with less amino acid loss during the exercise? I think it is (a), because the message being sent to the body is that “we need more muscle to do all of this and still compensate for the loss during exercise”.

Maybe this is why top crossfit practitioners end up looking like bodybuilders, and cannot lose muscle even when a slightly lighter frame would make them more competitive in crossfit games. Their bodies are just responding to the stimuli they are getting.

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Wednesday 1 January 2014

Free e-Book and Ideal Weight Program 2.0 Announcement


I'm happy to announce that we're releasing a free e-book titled Why do We Gain Fat, and How do We Lose it? An Introduction to the Science of Body Fat, by Dan Pardi and myself. This is a slimmed-down version of the longer, fully referenced e-book we offer as part of the Ideal Weight Program. In it, we provide a succinct overview of the science of body fat gain and loss, and the evidence base for our program.  It also contains a schematic that ties together the various concepts in visual form. You can download it from the Dan’s Plan site by following this link to our program overview page.

Ideal Weight Program 2.0 Upgrades

Over the last year, Dan and I have been working hard to improve the Ideal Weight Program, both in response to user feedback and our own ideas for development.  Here are some of the new features we offer in 2014:
  1. Four-week meal plans and shopping lists for the FLASH diet and the Simple Food Diet, as requested by Ideal Weight Program users.  This is in addition to the recipes and cooking guides we already provide.  
  2. The Protein Unit system.  Research suggests there's an optimal amount of protein for appetite control and fat loss, depending on your height, weight, gender, and physical activity level.  Our fat loss diets are high in protein, but how do you know you're getting the right amount?  We've created a calculator that does it for you automatically, and explains how to apply your personalized Protein Unit value easily and intuitively using real food. 
  3. Diet plates.  These are visual guides to following our diets, based loosely on the intuitive USDA MyPlate design.  
  4. Cheat sheets.  Put these on your fridge to remind yourself of your diet and lifestyle guidelines, and daily protein unit goal.
  5. Updated guidance.  We've refined a few things in the diet guidance documents. 

At a time of year when many people want to shed excess holiday pounds and start down a leaner, healthier path, we offer the Ideal Weight Program 2.0.  The program comes with a 30-day no-questions-asked refund policy so you can try it without risk.  We think you'll love this program, but if it doesn't work for you, we're happy to refund your purchase price. 







Financial disclosure: I receive a portion of the revenue from the sale of the Ideal Weight Program.  I do not receive revenue from the sale of other products associated with Dan's Plan or the Ideal Weight Program (such as the Fitbit, cooking tools, and other programs).

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