Posts Tagged ‘fitness’

Untangling Twisted Health Messages

October 12, 2012


I just finished reading a fascinating book published by Beacon Press entitled: The Cure For Everything: Untangling Twisted Messages About Health, Fitness, And Happiness.  It is authored by Timothy Caulfield, a health law and policy researcher who holds appointments at the Faculty of Law and School of Public Health at the University of Alberta, and challenges and invalidates many of the “myths” of health crazes. I wholeheartedly recommend picking up a copy of this very worthwhile read that I found to be educational, engaging, entertaining  and confirmatory of many of my own thoughts and feelings.

The following words are verbatim from pages 185-188 of the book, essentially a summary of his concluding remarks:

The results of my research point to a disheartening conclusion, which is, basically, that nothing works. Despite the immense diet, fitness, and remedy industries, very little actually does what it promises to do. A scan of your genes will not tell you what will happen in your future; for most of us, it’s no more useful than the numbers we get from a scale or blood pressure cuff. It is nearly impossible to transform your body through exercise alone. You cannot get sexy abs instantly or even after weeks of intense work.  There is no such thing as toning, and virtually every fitness gimmick is just that: a gimmick. To lose weight you have to eat fewer calories than you burn. Sadly, we don’t need many calories. There is no shortcut to weight loss.  And even if you can take off the pounds, keeping them off is the real challenge.  The failure rate is so high that some experts I interviewed thought that sustained weight loss is… sigh… impossible.

 Finally, most of the remedies offered by alternative practitioners work no better than a placebo, and the pharmaceutical industry has such a tight grip on the production of the relevant science that is difficult to trust any available information about any drug, when it comes from an advertisement, your physician, or even a respected medical journal.

 In short, there are no magical answers. This should not come as a surprise, of course. If it were easy, we would all be healthy. If alternative therapies worked, we would have verifiable data demonstrating their efficacy.  If losing weight and getting fit could be attained by utilizing a metabolism-enhancing, colon–cleansing yoga move, we would all be slim, cut, and have pristine innards. Alas, this is not the world we live in.

 On the other hand, there’s another way to look at the results of this inquiry. This is the glass half full view. If you want to optimize your health, the steps are, in fact, surprisingly simple. The steps are not easy – real effort is required – but they are straightforward. It isn’t complicated.

 This is a liberating realization. It means you can shut out most of the noise. Ignore the advertisements. Ignore the miracle–cure promises made by alternative practitioners. Ignore any marketing message that includes the word detoxify, cleanse, metabolism, enhance, boost, energized, vitalize, or revitalize.  Ignore the twist! Don’t get fooled by the sexy abs images that are such a huge part of Western culture. Don’t worry about the genetic predispositions that have been handed to you in the biological lottery of life. Unless you have one of the rare single gene disorders, like cystic fibrosis, or one of the relatively uncommon highly predictive mutations, genetic information is simply not that valuable.  Don’t get suckered into buying useless potions and practices that are wrapped inside an ideologically fuzzy and truth–obscuring blanket. It will only empty your wallet. And don’t get too excited when the media reports some big health breakthrough, especially if the story is based on a single study. True breakthroughs are rare.  Think of science as a slow and iterative process. As geneticist Jim Evans told us, science is a slog. Two steps forward, one and a half steps back. 

 What, then, are the straightforward steps to maximum health?  First, exercise often and with intensity (intervals work best) and include some resistance training. Second, eat small portion sizes, no junk food, and make sure 50% of what goes in your mouth are real fruits and vegetables.  Third, try your best to maintain a healthy weight – yes this is insanely tough, but we should at least try. Fourth, do not smoke, and drink only moderate amounts of alcohol. And fifth, take all the well-known and simple injury-prevention measures, such as wearing a seatbelt in the car and a bicycle helmet when you go riding.

Once you cut through the twisted messages that saturate our world, you find out all the available evidence tells us that these five steps are by far the most important elements of a healthy lifestyle. One expert I corresponded with for the diet chapter, Walter Willett from Harvard, figures that healthy food choices, physical activity, and not smoking could prevent over 80% of coronary artery disease, 70% of stroke, and 90% of type II diabetes.

 There are other measures, such as getting a good night’s sleep, that are important, and future research might compel me to add them to the list. And we should be conscious about eating certain other foods in addition to fruits and vegetables, like fish, berries, and whole grains.  Also, there are things that should probably be avoided, such as sodium and trans fats. But, in the big picture, these five actions remain essential. All the other stuff
– such as the alleged importance of various supplements and the craze for organic foods – will likely have only a marginal impact on individual health.  If you’re not doing all the big five, worrying about the details – such as a slightly increased genetic predisposition to some common disease or the cleanliness of your colon– is ridiculous.

There are no magical cures or programs. But the simplicity of the untwisted truth has an almost magical quality.


 Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:

Available on Amazon in paperback or Kindle edition

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Where’s Your 6-Pack?

January 28, 2012

Blog # 43 written by Andrew Siegel, M.D.


I posed this question to my nurse friend Jen and she replied “in the fridge.”  She made me laugh with that reply, but in reality she has a pretty hard body, especially for a woman who has given birth to several children.  However, if your answer to the question truly is “in the fridge,” then you might just want to read on!

If you would like the short version, skip to the end of this blog where you can read “10 pearls to help your washboard abdomen emerge”—itprovides nuggets of information that if heeded, will allow your to firm up your abdomen and start the process of unveiling the 2-pack, 4-pack or 6-pack that lies obscured within.  Read the full blog if you would like to know the more detailed science.  Although vanity may be an important driving force for wanting to develop that 6-pack, it’s really about living a healthy lifestyle—in brief, the aesthetics will follow a healthy existence and our internal health often mirrors our external physiques.

Sporting a six-pack is a badge of honor emblematic of one’s discipline, restraint and tenacity.   A “hard core” can only be earned through the combined efforts of healthy eating and vigorous exercise.  Chances are if you’re wearing a 6-pack, then you are fit and healthy and that in all probability you have rejected the Western diet of processed foods, lots of added fats, sugars and loads of refined grains and instead have chosen a healthy diet consisting of real food that comes from nature, rather than from a chemistry lab.

We all have 6-packs hidden beneath our winter-weighted physiques.  We may be flabbier and less toned than desirable, but somewhere within is a sinewy, tight, and lean torso.  The question is: what can we do to bring out this svelte body?  How do we reduce our shapeless stockpile of stored energy that is shrouding our underlying sculpted physique?

Michelangelo’s “David” was at one time a mere solid block of marble.  The master artist crafted this magnificent sculpture by knowing exactly what to carve away—what did not belong. In the words of Antoine de Saint-Exupery (author of Le Petit Prince): “Perfection is not when there is no more to add, but when there is no more to take away.”  The late Steve Jobs was a grand master at removing the unnecessary and superfluous to reveal the elegant simplicity that remains. In the words that follow, I will offer sound advice on how to peel away the nonessential to reveal your own magnficence that lies obscured.

Having some fat on our bodies is not a bad thing, as long as it is not excessive. Fat actually serves a number of useful purposes.  It functions to cushion our internal organs and as insulation to conserve heat.  Fat provides a means of storing energy and fat-soluble vitamins.  During periods of decreased caloric intake, fat reserves are broken down to release energy.  Fats are important parts of the structure of the brain and cell membranes and are used in the manufacture of several important hormones.  Fat has more than twice as many calories per gram than carbohydrates or protein.   Anybody who has barbecued any kind of meat with a high fat content and has witnessed their would-be dinner engulfed in flames realizes what a concentrated form of fuel that fats are.

As we age, many of us tend to slowly and insidiously gain weight.  A collection of fat often becomes apparent on our abdomens, particularly around our waistlines.  An accumulation of fat in our midsections not only is unattractive from a cosmetic standpoint, but also can have dire metabolic consequences.  It is important to distinguish between visceral fat and subcutaneous fat.  Visceral fat—also referred to as a “pot belly,” “beer belly,” or “Buddha belly”—is internal fat deep within the abdominal cavity.  Subcutaneous fat—also known as “love handles,” “spare tires,” “muffin top,” or “middle-age spread”—is present between the skin and the abdominal wall.  Although neither type is pretty, visceral fat is much more hazardous than subcutaneous fat since it increases the risk of diabetes, cardiac issues, and metabolic disturbances.  Subcutaneous fat is inactive and relatively harmless and does not contribute to the health problems that visceral fat does.

The good news is that by losing abdominal fat, the potentially bad health repercussions can be reversed and the six-pack within can become more unveiled.  The dangerous visceral fat submits relatively easily to diet and exercise whereas the less harmful subcutaneous fat at the waist is more stubborn and resistant to reversal measures.  It is this accumulation of belly fat that masks the underlying rectus abdominis muscle that is our 6-pack muscle.

And now a few necessary paragraphs on metabolism: Dietary carbohydrates are broken down to the simple sugar glucose, which is the “energy of life” and the fuel source of every cell in our body. When it is not used immediately for energy, it is stored as glycogen. The pancreatic hormone insulin is responsible for converting glucose into glycogen. Glycogen is present in our liver and muscles; when a state of saturation has been achieved and no more glycogen can be stored in our liver and muscles, the excess glucose is converted to fat.  There is a finite limit to the amount of carbohydrate stored in the muscles and liver—it amounts to about 1600-1800 calories.

When talking metabolism, it is helpful to think of our glycogen as our “small fuel tank.”  Once the fuel in the liver and muscles is exhausted, our “large fuel tank”—our fat—needs to be tapped to provide energy.  In contrast to the limited carbohydrate storage in our liver and muscles, our bodies abundantly store fat.  Depending on how much fat we have, many days to weeks of energy can be provided.  To reveal your 6-pack, you need to have as small a “large fuel tank” as possible, since it is these stored energy reserves that are obscuring the glorious sculpted abdominal musculature that lies beneath.

There are a few important facts that are fundamental to our understanding of the science of fat. First off, our fat stores are not static, but are dynamic.  In other words, there is continuous mobilization of our fat (as fatty acids) and storage (as triglycerides).  Secondly, fat storage is largely under hormonal control.  Hormones are chemical messengers that cause specific actions in our body.  The hormones involved in fat metabolism are insulin, cortisol, estrogen, and testosterone.  Thirdly, fat is not just fat—it is a metabolically active endocrine organ that does not just protrude from our abdomens in an inert state, but has a life of its own.  Fat produces pro-inflammatory factors, hormones and immune cells.  Fat has an abundance of the hormone aromatase, which converts testosterone to the female hormone estrogen.  One consequence of too much fat in men is excessive conversion of testosterone to estrogen, creating the potential for male breast enlargement.

Insulin is the principal regulator of fat metabolism. After a sugar and carbohydrate load, insulin is released to get the fuel into our cells. When we go without food, as happens when we sleep, insulin levels decrease and fat is released to be used as fuel.  Insulin levels are determined primarily in response to our carbohydrate intake in order to keep our blood sugar regulated.

Insulin has much to do with the way our bodies store or burn fat. You can think of insulin as our fat hormone. When insulin levels are elevated, we accumulate fat; when levels are low, we burn fat for fuel.  Insulin is all about increasing fat storage and decreasing fat burning—this is why diabetics on insulin injections typically get fat.  If we have a substantial amount of belly fat, then by definition we have insulin-resistance, a condition in which our pancreas works overtime to make more and more insulin to get fuel into our cells.  This is a precursor to diabetes, cardiovascular disease and all the havoc they can wreak.

Our insulin levels are determined by the carbohydrates we eat—the more carbs we eat, the sweeter they are, the easier they are to digest, the greater the insulin levels and the more that fat accumulation is driven.  Insulin secretion caused by eating carb-rich foods—flour and cereal grains, starchy vegetables like potatoes and rice, sugars and high-fructose corn syrup—is what makes us fat.  The sweeter the food, and the easier it is to digest, the fatter it will make us, and liquid carbs such as sodas, fruit juices and beer are the biggest culprits.

If we want to get leaner and reveal the 6-pack within, we must lower our insulin levels.   To lower our insulin levels requires carbohydrate restriction, meaning decreased consumption of sweets and starchy carbs.  Even if we don’t reduce our quantity of carb intake, we can improve the quality of our carb intake by eating healthier carbs—whole grains, fruits, vegetables, legumes, etc.  Aside from shrinking our waistlines, there are numerous other health benefits that accrue from a lower carb diet.  If we replace a high carb diet with a diet lower in carbs and higher in healthy protein and healthy fat, the consequences are the following: weight loss; HDL (good) cholesterol rises; triglycerides decrease; glucose levels stabilize; blood pressure decreases; heart disease risk decreases; body fat reduces; energy levels surge.

The adrenal gland hormone cortisol—releasedin response to stress—can stimulate our appetites and cravings for sugar, causing fat storage and promoting weight gain and obesity. This is the very reason people on corticosteroid medications tend to have enormous appetites, gain weight and have a central distribution of body fat known as centripetal obesity, even if they were very thin prior to starting on the cortisol.  Chronic stress literally can make us soft and flabby and sabotage our efforts to achieve that chiseled 6-pack.  So what can we do about stress, because we all have it, and it’s not going away anytime soon?  Stress busters include exercise, yoga, meditation, massages, getting into a Jacuzzi, aromatherapy, chamomile or other herbal teas, sex, etc.  Sounds nice…relax to help bring forth that 6-pack!

The sex hormones estrogen and testosterone play a key role in fat regulation. One of the key reasons that women have a different physical appearance and body fat distribution than men is because of the different levels of these two hormones in each gender.  Around the time of menopause, when the ovaries stop producing estrogen, central fat deposition is promoted and many women start packing on pounds in their mid-section.  Similarly, as men age, testosterone levels often drop, contributing to a loss of muscle mass and an increase in body fat. Low testosterone is present in about half of obese men.

Believe it or not, a good night’s sleep will help us on our mission for that elusive 6-pack.  When we sleep poorly and become sleep-deprived, we are often driven to eat. Sleep deprivation results in decreased levels of leptin, our chemical appetite suppressant, and increased levels of ghrelin, our appetite stimulant, in addition to increased levels of the stress hormone cortisol.  Furthermore, being exhausted can sabotage our exercise regimen.

Six-pack diet

Lean sources of protein including egg whites, wild salmon (or any other wild fish that is grilled or broiled), skinless chicken, turkey breast, fat-free yogurt and soy products such as tofu and edamame are money.  We need to be sparing with meat and dairy intake since they are rich in saturated fats and high in calories.  Vegetables—including nuts, avocados and olives—are a much healthier source of fat.

High fiber foods—vegetables, fruits, legumes (lentils, peas and beans) and whole-grain cereals and breads—are very filling and the fiber regulates the rate of carbohydrate absorption. Intake of a variety of brightly colored fruits and vegetables will ensure getting ample doses of phyto-nutrients and anti-oxidants. Dietary fiber (roughage) refers to the indigestible part of a carbohydrate.  Insoluble fiber, e.g., cellulose from plant foods, serves as plants’ armor against predatory pests and serves as humans protection against obesity.  Since we do not have the enzymes necessary to dissolve insoluble fiber, it increases stool bulk, decreases intestinal transit time, increases our satiety, reduces the rate of carbohydrate absorption and the conversion of complex carbohydrates to simple sugars, and decreases the absorption of some fats.  Soluble fiber binds cholesterol in the intestinal tract; for example, oatmeal can help lower serum cholesterol levels.

It is very important to minimize refined carbohydrates, substituting whole grain products for white bread, white pasta, white rice, etc.  Curtailing sugar intake is equally important since sucrose is a 50% fructose/50% glucose combination and fructose gets metabolized completely differently from glucose, pushing our bodies towards fat deposition.  The same is especially true for high fructose corn syrup (HFCS), that gooey liquefied sweetener abundant in processed foods and beverages in a 55% fructose/45% glucose ratio. Every cell in our body can metabolize glucose, but it is primarily the liver that metabolizes fructose. Fructose, more readily than glucose, replenishes liver glycogen, and once the liver is saturated with glycogen, fats are made and stored. So, HFCS gives us a fatty liver, a fatty body and a masked 6-pack.  Fructose does not suppress ghrelin (our hunger hormone), does not stimulate insulin, and is truly a toxin to our body in immoderate doses. Let fruits be the source of fructose for our bodies, not refined sugars and HFCS.

Nature is very clever—whenever it provides us with a nutrient that is potentially bad for our health, it limits access to that nutrient by adding lots of fiber to it.  So when nature has given us fructose, it has also included the antidote.  Did you ever try to get the sugar out of a sugar cane plant?  It is literally like gnawing on a piece of bamboo stick—you can’t chew it and have to suck it out!  Processing has allowed us to cheat nature by refining sugar, permitting consumption in unrestrained, unhealthy amounts, contrary to nature’s design.  For example, it is very easy to drink 12 ounces of orange juice, to the tune of about 170 calories of fiber-free sugar.  To get that kind of caloric load from nature’s whole product—the orange—you would have to eat almost 3 of them.  Can you imagine sitting down and eating three oranges?  I sure can’t.  So go easy on anything that comes in a bottle, box, carton or can…think whole foods that resonate with nature, not refined foods that are unfaithful to nature.

While at the dinner table the other evening, I found myself staring at a colorful salad on my left and a basketful of white Italian bread (not whole grain) on the right.  I pondered the “order” of eating in terms of insulin release—would there any difference if I had salad first followed by bread vs. bread first followed by salad, vs. eating them together and would the order of eating play a role in the way calories are burned or stored?

Salad first followed by bread (bulky, fiber-rich carbs then fiber-less carbs): This gives us a gradual, low-level insulin spike followed by rapid, high-level insulin spike.  It is likely that the bolus of salad slowly digesting in the gut will modulate (regulate) the insulin spike from the bread’s fiber-less carbs, resulting in less of a tendency for fat deposition.

Bread first followed by salad: (fiber-less carbs then fiber-rich carbs):  This gives us a rapid, intense insulin spike followed by gradual, lower-level insulin spike.  It is likely that this order will result in fat deposition, since by the time the salad gets to the gut, the bread has already been digested and absorbed.

Together: The salad mixing in the gut with the bread will modulate the insulin spike from the fiber-less carbohydrate load of the bread, resulting in less of a tendency for fat deposition.

Bottom line: If you are going to eat white carbs, you can minimize the intensity of the insulin spike and thus the tendency for fat deposition by mixing in some fiber-rich foods; better yet is to ditch the white carbs completely and eat the whole-grain product. If you are going to use the strategy of using the powers of fiber-rich food like salad to lessen the “damage” from fiber-less white carbs, be sure to go easy on the croutons, cheese and excessive amounts of salad dressing that can sabotage the strategy.

A very important principle in the acquisition of a 6-pack is not to drink calories, so avoid liquid calories such as soda, juices, processed iced tea, lemonade, etc.  These are particularly bad since they are essentially pre-digested, fiber-less carbohydrates that get “mainlined” into our bodies causing a massive insulin spike and caloric storage as fat.  A “beer belly” resulting from the carbohydrate alcohol and a “soda belly” resulting from the carbohydrate fructose are substantially equivalent. The best drink is water or seltzer—it can be jazzed up with a squeeze of lemon or lime.  Water keeps us well hydrated, dampens our appetite and will quell our thirst that is sometimes confused for hunger.

It is important to be careful not to overdo sodium intake as it can cause fluid retention, high blood pressure, bloating, weight gain and a number of potential cardiac issues, aside from thwarting the emergence of our 6-packs.

Six-pack exercise regimen:

A general rule of thumb is to think “athletics” and the “aesthetics” will follow.   The key to exercise is diligence—carving out the time—and variety—strength  (resistance) training, cardiovascular (aerobic) training and core (abdominal and torso) conditioning, and perseverance.  A core synergistic exercise regimen, which is a combination of the aforementioned three types of exercise, provides a terrific overall workout. Pilates, yoga, and martial arts are three great means of obtaining a hard core, although there are many other effective exercises as well.  Pilates, in particular, is an awesome means of developing core strength.  I have been taking Pilates lessons weekly for over a year from an amazing instructor, Catherine Byron, who has been instrumental in helping me achieve a toned abdomen, core strength, better balance, posture and muscle symmetry (  My friend and yoga instructor Ben Wisch, has also helped whip my core into shape (  I  enjoy and have derived great benefit from home exercise DVDs from  the P90x “ab ripper,” “core synergistic,” and “yoga” workouts and the P90x plus “abs-core” workout can’t be beat.

Muscles play a key role in our metabolism: they are extremely metabolically active, each pound of lean muscle burning about 50 calories/day.  With a sedentary existence and aging, there is a gradual loss of muscle mass and a resultant slowing in our resting metabolism.  By building and maintaining our muscle mass with strength training, we will raise our resting metabolic rate and burn more calories.  Additionally, exercise serves to increase the “insulin sensitivity” of muscle, which means that are muscles become more efficient at burning off carbohydrates as fuel. Exercise is also our endogenous stress reducer, lowering cortisol levels, suppressing our appetites and helping us burn carbs before they have a chance to be stored to fats.

We can measure our maximal heart rates by doing an aerobic activity, such as swimming, running or cycling full throttle until we can’t go on, and then taking our pulses.  In our workouts, if we can achieve a heart rate of 75% of our maximum rate and sustain that for 30-60 minutes daily, it is easily conceivable to burn 600 or more calories per day.   High intensity interval training—alternating between extremely intense exertion and regular “normal” exertion—can rapidly help propel us towards that sculpted body that lies within.
10 pearls to help your washboard abdomen emerge:

 1.    If you want a hard waist, you must incorporate exercise into your lifestyle, achieving balance between aerobic, resistance and core workouts.

2.    Eat high-quality, whole-grain, high-fiber carbs, lean protein sources (easy on meat and dairy) and healthy fats (vegetable and seafood-origin).

3.    Eat in accordance with nature’s design—meaning whole foods.  Avoid processed foods.  The best diet is an “anti-processed-atarian” diet.

4.    If you want to look good naked, don’t eat “naked” calories (stripped of fiber), so restrict sugar, simple white carbs, and liquid calories.  Aggressively steer clear of high fructose corn syrup.

5.    Soft foods (sugared drinks, white pasta, white rice, white bread, doughnuts, bagels, potatoes, etc., will earn you a soft core; hard foods (whole grain pasta, brown rice, whole grain breads, legumes, whole fruits and vegetables) will help earn you a hard core.

6.    Avoid giant meals in which the caloric load will be stored as fat; substitute with multiple smaller meals in which the calories will be used for immediate energy.

7.    Limit after dinner snacking since unnecessary calories at a time of minimal physical activity will be stored as fat.  If you restrict your evening snacking to one piece of fruit, you will wake up in the morning with less to pinch on your waistline.

8.    Drink plenty of water; use salt sparingly.

9.    Minimize stress; if you can’t eliminate it, manage it.

10. Get adequate amounts of quality sleep.


Andrew Siegel, M.D.

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food

Is There a Best Exercise?

December 3, 2011

Is it running, cycling, swimming, weight training, yoga, Zumba or spin class?  Does it need to be at a fitness center or at a gym?  Are personal trainers a necessity?

The short answer is that although any form of exercise is good, it is great to be able to exercise in a balanced fashion, as is addressed below.  It is desirable to get our hearts pumping, our chests heaving, our cheeks flushed and sweat dripping out of our pores.  It is also important to have fun!  We don’t need to be gym rats to get sufficient exercise, and although personal trainers are great, we can do without.

One of the main goals of exercise is to improve our physical fitness.  Physical fitness has a number of parts: cardiovascular or aerobic fitness in which the heart and lungs have adapted to endurance efforts; musculo-skeletal fitness in which our muscles and underlying bony framework have adapted to bearing loads and working against resistance leaving our muscles sinewy, strong and toned; core strength that implies fitness of our trunk muscles that allows us to have good posture, stability and a good sense of balance and coordination; additionally, our core strength serves as a platform for efficient use of our arms and legs; flexibility fitness in which our muscles are elastic, limber and supple and more resistant to injury. If we can find an exercise regimen that has all of the aforementioned components, we are on the right track.

Exercise is all about adaptation. Our bodies are remarkably adaptable to the stresses that we place upon them.  This is why both endurance and resistance exercises get easier the more effort we put into doing them.  The heart, lungs and muscles adapt and a “new normal” level of fitness is achieved.

Fitness attained through exercise is essential in helping to maintaining good health at any age.  Exercise has physical, psychological, and social benefits for which there is no substitute. Exercise helps control blood pressure, glucose, cholesterol and triglyceride levels and will lower the risk for angina, heart attacks, claudication (pain in the legs and buttocks associated with insufficient blood flow), strokes, and sexual dysfunction. Exercise will help the cardiovascular system, the lungs, muscle tone and strength, posture, and bone mineralization. Exercise promotes weight loss, makes us feel and look better, improves our well being and outlook on life, and helps us achieve peace of mind. It will help prevent injuries, help us deal with stress, combat depression, keep us alert during the day, and sleep more soundly at night. Exercise will help prolong our lives and maintain the highest quality of existence. Exercise is the miraculous, magical, life-saving tonic that can do all of the above and so much more.

Exercise “Rules”

  • Any activity is better than no activity: For example, tennis is better than table tennis but table tennis trumps sitting in the Lay-Z-Boy recliner.   Non-Exercise Activity Thermogenesis (NEAT) is the term applied to how we reap major benefits through thousands of minor movements each day.  Essentially, it is the body’s means of fighting inertia.  Certain people do not gain weight despite increased caloric intake because of compensation via subconscious movements including taking the stairs; trotting down the hall to the water cooler; bustling about with chores; even fidgeting in one’s seat.
  • Any time spent moving is better than no time moving: Working out for an hour or more is desirable, but even if you have only ten minutes, it is better than no minutes!
  • Shake it up: The concept of balance is a good one, mixing it up for variety, fun and cross-training purposes and to avoid stagnation and routine.  Remember, balanced fitness is aerobic (endurance/cardiovascular), strength, core, flexibility and balance.  It is nice to participate in a variety of different exercises.  For this reason, I think the P90x workout on dvd ( really passes muster—it simply covers it all.  If you prefer something outdoors, consider an activity that you initially might not think of as exercise per say.  Take “real labor”—such as cutting firewood—it has all of the aforementioned components.  “Synergistic” exercise, which emphasizes using multiple muscles working together in synchrony, is what we use in real life—it is really beneficial if we can simulate this in the gym versus doing isolated muscle exercises.
  • Carve out the time for it:  It is easy to find reasons for not exercising.  Common excuses are long workdays and time spent commuting that does not allow enough time in the day for exercise.  By making exercise time “sacred” such that it can only be interfered with under emergency circumstances, it will help ensure its happening.  Clearly, some of the time spent in our sedentary leisure activities, such as watching television, could alternatively be devoted to more active and healthy pursuits.  My attitude has always been that if I have the time to eat, shower and use the bathroom, then I have the time to exercise.
  • Persistence: Once we have established a routine and have allotted the time to exercise on a regular basis, the key is to persevere and not to allow complacency to mess with our regimen.  Once we are “cruising” along, it becomes so much easier to maintain our schedule than to stop and then start up again.  It is an astonishing fact to me that the Tour de France cyclists, arguably the most fit aerobic athletes in the world, generally engage in a three hour or so ride on their rest day! Why? Simply because too little activity on rest day would lead to a sluggish performance on the following day, a potential disastrous occurrence in a grueling three-week marathon.
  • Be an active spectator: I am an advocate of exercising while being a fan.  So, when I watch the Jet game, I might do so while on the treadmill walking up an incline for 30-60 minutes at 3.5 mph, instead of sitting on the couch munching on chips and dip.  It is really a painless way of getting in some exercise while enjoying a diversion.
  • Integrational exercise:  This is exercise that is incorporated into our daily activities.  So, park the car as far away from the shops at the mall as possible and walk to the stores.  Self-park instead of valet parking.  Power vacuum your home, mix batter for a cake by hand as opposed to using an electric mixer, open cans with a hand opener as opposed to an electric opener, walk the golf course instead of taking the cart, etc.  You get it—gardening, snow shoveling, mowing the lawn, sawing tree branches, walking the dog, carrying a heavy laundry basket, taking out the recycling, carrying your child on your back, dancing, anything at all that involves movement can actually be good exercise without the need for an expensive gym membership.
  • Tailor your exercise to your needs and desires: What is the right fitness regimen for you? Anything you like, as long as it gets your heart pumping, your lungs expanding, and your sweat glands secreting. Swimming, tennis, racquetball, jumping rope, kayaking, rowing, trekking, cross-country skiing, ice skating, team sports such as soccer, basketball, volleyball or hockey, aerobics class, spin class, kick-boxing or Pilates, martial arts training, salsa or belly dancing, gymnastics, clog dancing or ballet—all qualify. Playing Nintendo’s Wii Fit is another option to get you moving and off your derriere. What does matter is that you find some activities that you like and that you stick with them!                                                                                                                                                                                                                                                                                                                                                                                                                                Exercise needs to be customized to our individual personalities. Some people avoid exercise because they are not goal-oriented, they do not enjoy the actual exercise process, or because their self-image is at odds with the image of the models promoted by the fitness industry. “Conventional” exercise is typically goal-oriented and often competitive with an emphasis placed on performance, with the ultimate objective of achieving fitness, wellness, maintaining or losing weight, and a healthy physical appearance. The “holistic” approach is more focused on the inner experience and energy, the self-actualizing process and journey—with more emphasis on engagement, connection, and tuning “in.” It has a meditative and philosophical level to it with a goal of achieving a calm and relaxed state. Yoga, tai chi and qigong are good examples of holistic exercises.

So, whoever you are, what is most important with regard to exercise is that you actually DO some sort of exercise.  Tailor it your specific mindset, but be sure to that it’s not just your mind that is experiencing the workout!

Andrew Siegel, M.D.

Wealth Is Health: Your Exercise Savings Account

September 10, 2011

Your Exercise Account: Building Sweat Equity

Sadly, many people seek and ultimately obtain financial wealth at the expense of their health, not realizing the fact stated so clearly by poet/author Ralph Waldo Emerson:“the first wealth is health.”  Without health, having financial wealth is absolutely meaningless!

We do our best to save for retirement, although with our current economic crisis—high unemployment, slow gain in wages for those fortunate to be employed, falling house prices, our national debt burden and the strong possibility of a double-dip recession—it has become much more of a struggle to do so.  We earmark money for Individual Retirement Accounts and 401K plans, annuities, and other similar retirement vehicles that allow us to sock away resources in investments for the future.  Some day, we will no longer be working and will need to tap our savings to live.  And hopefully, we will be living for many years after retirement.

Sweat equity is a business term used to describe the non-financial contribution of time and effort that is fundamental to the success of a business endeavor. I borrow this term and extend its use to the fitness and health arena.  As many of us hopefully have retirement savings accounts, I propose that we all have a Sweat Equity Account as wellbasically, a Fitness Account.   It consists of time and effort put into exercising and maintaining fitness.  The tenets of obtaining and maintaining a fitness account run parallel to the principles of obtaining and maintaining a retirement account and are as follows:

  • Have a plan.   Understand the need for and the importance of your fitness account.  If you invest wisely in this account, it will pay you back in spades. 
  • Pay yourself first.   Carve out the time for fitness and commit to it automatically—this guarantees that it is a priority to be tampered with only under the most unusual circumstances.  This will ensure regular deposits to build your personal fitness nest egg.
  • Slow and steady approach.   A moderate amount of exercise, deposited to the account on a diligent and regular basis, will ultimately allow for complete funding of your fitness account.
  • Start early.   The earlier you begin the fitness account, the more time available to work the magic of compounding, when the investment returns themselves earn further returns. You will earn returns in the form of “interest and dividends” (improved quality of life), and “capital gains” (augmented quantity of life).   If you missed the boat on starting early, don’t waste another minute…start today.  It is never too late.
  • Long-term perspective.  The greater the investment in terms of time invested, the larger the fitness nest egg builds.  The commitment to this plan needs to be a lifetime endeavor.  No gimmicky investments!    No shortcuts!  No tricks or instant rewards!  No nonsense!
  • Seek investment counseling.   Not everyone is capable of managing his or her own fitness account—if not, seek the services of a professional personal trainer or fitness instructor.  Their services will be well worth their cost.
  • Diversify.   Deposit into your account all different forms of fitness investments, including aerobic and endurance activities, weight training, core, flexibility exercises, etc…. include lots of variety in your portfolio.  Shake it up a bit.  I personally like cycling, tennis, golf (always walking the course, if possible), yoga, Pilates, P90x, etc.—by doing something different every day you don’t give yourself an opportunity to get bored and you get the benefit of working different areas of your body and different aspects of fitness.
  • Eliminate debt.   Pay down and eliminate debt, of which one component can be thought of as the fitness deficit that you owe yourself from past exercise omissions.  The other component should be thought of as your current debt in terms of excessive body weight and the burden of bad lifestyle choices.  You will reap the benefits of becoming debt free through exercise and healthy lifestyle and eating habits.

Your contributions to your Fitness Account will ultimately make you wealthy; that is, “healthy wealthy”…it just takes time and tenacity.  And some day, when sickness or disease will inevitably surface, you will be equipped to strike a noble fight because of your years of investment in yourself. 

“Living is a pain in the butt.  Dying is easy.  It’s like an athletic event.  You’ve got to train for it.  You’ve got to eat right.  You’ve got to exercise.  Your health account, your bank account, they’re the same thing.  The more you put in, the more you can take out.”

Exercise is king and nutrition is queen: together, you have a kingdom.”

Jack LaLanne (2006)

Andrew Siegel, M.D.

To view my brief video on the merits of exercise, visit: