Monthly Archives: January 2012

Why I’m not giving up my morning coffee, but you should still consider giving up yours

A recent article in the New York Times discusses a new study of the effects of caffeine on young women’s estrogen levels.  I being a) female and b) a bit of a crackhead when it comes to coffee, I clicked on this link before looking at anything else involving things like the presidential race or whatever the hell  is going on in the world right now.

What interested me about the article was not that they found that caffeine affected women’s estrogen levels in an infinitesimal and possibly insignificant amount, but that it affected their estrogen levels differently depending on their race: Asian and African American women saw a slight increase in estrogen levels with moderate caffeine intake, Caucasian women saw a slight decrease. 

More to the point: the study illustrates that one food or substance can affect two people in totally opposite ways. 

There’s a recipe for crockpot chicken stew that’s been circulating through the gym recently.  One of my close friends put it together, and I’ve watched her throw the ingredients in her crockpot countless times. Now, she’s a great cook—she regularly makes lunch or dinner for the two of us, and it’s always spectacular in the way that you try to go home and recreate it but it’s just not the same.  (This is not a one-sided friendship.  Sometimes I cook, too—usually things I don’t actually know how to make, like steak, and then I ask for advice [cough cough] and she conveniently helps out and whoops!  Looks like somebody ended up in charge of making dinner again.)  (I’m a lovely friend.)

Her crockpot chicken soup, needless to say, has been a hit with everybody who’s replicated it.  There’s the usual chicken and celery and carrots, but there’s something magical that happens with the addition of sweet potatoes and bones and—Oh my God, people are saying, this soup is so satisfying.

Except, of course, it’s the one thing I don’t find at all filling. I can take a bigger serving, add extra chicken or fat or sweet potatoes, and, plain and simple, I will not feel like I’ve had a meal. It’s not just my friend’s recipe, either. I’m enchanted by this whole idea of soups and stews and crockpots, and regularly try to convince myself that this chili or this kale and white bean soup will be the comfort food meal for me.  But it never is.  I long for something more and, after the first or second time, start dreading the meals that include the soup and wishing it wouldn’t be wasteful to just toss the damn stuff.

How a body processes caffeine and how much a person likes soup differ in that the former is biochemical and the latter is arguably a matter of preference, but they both illustrate that how our bodies and minds respond to food is very individual.  We see this often with food intolerances, but if you talk to your friends, you may find other things as well—some people have to have a fair amount of fat or protein in their meals to feel satiated, while others may need some carbohydrates to keep them from turning into a groggy, disoriented mess.

Yet every year, new health plans come out touting that this food regimen is the key to real health.  Some call themselves diets (South Beach, Atkins, Dukan), some are touted as lifestyle changes (eating Mediterranean, Paleo, or vegan), but all imply that one style of eating trumps all others. 

I’m sure you get where I’m going here: if our bodies and minds respond to food so differently, then how can one plan or lifestyle stand out above the rest?  It’s a question that’s come up before, and I like how Michael Pollan responds to the concept of following a particular eating lifestyle in his book Food Rules: “Eat more like the French.  Or the Japanese.  Or the Italians.  Or the Greeks.”  He explains: “Any traditional diet will do: If it were not a healthy diet, the people who follow it wouldn’t still be around.”   Oftentimes we focus on a specific regimen as being the best when it actually just one of many that gets rid of some of the trash in our day-to-day eating. 

But my main point isn’t simply that people need to find the healthy lifestyle that works for them rather than following the latest trend.  Instead, I’m interested in how cyclical our definition of “healthy eating” is.

When I was growing up, my whole family got to a point where we were struggling with our weights.  My mother went the route that’s generally advised by doctors and nutrition experts, which was to change our current meals and snacks for the better and to teach my brothers and I about making healthier choices.  I picked up some invaluable practices at this point that I’m seriously thankful to have as an adult—I don’t struggle to get enough fruits and veggies in my diet, prefer whole grains to white, prepare most of my meals from scratch—and, more importantly, these things are actually what I prefer and enjoy the most. 

But in the process of figuring out what was healthiest, our family went through countless iterations of “the best” diet.  Sometimes it meant we ate a lot of tofu, for a long while we were vegetarian (my parents still are mostly vegetarian, actually), but there were times where we were eating lots of protein and few carbs, and there were times where we lived without gluten or casein, and there were times when our cabinets overflowed with Omega 3 pills, buckwheat, coconut oil, or xylitol.

Working in the fitness industry, I’ve seen this same fascination with others—focusing on “super foods” or reducing grain intake or following anti-inflammatory eating plans.  You can see the shift in how processed foods advertise themselves; current foods tout that they’re “All Natural!” when before they may have low-sugar or low-fat (Remember how Snackwells cookies shifted from being low-fat, high-sugar, to higher in fat and lower in sugar when Americans became more carb-conscious?).

It seems like many of us view health in the way that others view technology: we want the latest, the best.  And yes, there is a great motivation to live the healthiest life possible; we’ll last longer with a higher quality of living for however many years we do get on this plane of existence. 

Our fascination with latching on to the latest trend stems from our cultural fascination with maximizing profit and being as efficient as possible—what will get us the most results, and how do we streamline the process to get the most results for the most people?

Ironically, however, our manner of one-size-fits-all healthy living is really only a stone’s throw away from the same environmental factors that have caused the rising rate of ailments caused by excess.  Just as we’d rather buy a sandwich on the go than make a meal from fresh ingredients at home, we’d rather try out a pre-packaged program for health than take the time to figure out what our bodies need specifically.  Because these programs rarely work one hundred percent for anyone, we continually “fall off the wagon,” and then search for new evidence of a different lifestyle or diet that would work better.  Sometimes we place the blame of our fickleness on the changes in research, on new evidence that refutes the past lifestyle that didn’t work. 

If our fascination with efficiency and profit is both causing our general habits to become more unhealthy and keeping us from developing healthy lifestyles that are maintainable, then perhaps the issue is larger than the foods we eat or how much or little we exercise.  Perhaps we need to shift our entire perspective on living, to stop trying to be so efficient. By trying to make our everyday lives quick and to the point, the shape of our lifespans have followed suit. If we want to live longer lives, then we must do just that: take the time to find the things that we specifically enjoy and need, be it caffeine or career.


Is your workout attire affecting your health?

“What should I wear?”: It wasn’t the most common refrain I heard when I started as a Membership Advisor at the gym where I now train (That was, bizarrely, “The whirlpool’s cold again. Can you fix it?” I learned a fair amount about plumbing in those days.  Practical life skills, really.), but it came up often enough.

Usually, the person posing the question would be a woman in her forties or fifties, entirely new to gyms or only having belonged to co-ed facilities by technicality, never entering the centers after signing the initial membership contract.  Occasionally a younger girl would ask, if she hadn’t frequented a school gym or her family hadn’t belonged to the Y when she was growing up.  Sometimes the question regarded sports bras, or types of sneakers, but many times it was simply whether wearing a t-shirt from a recent trip to Hawaii would be okay instead of seeking out the latest in designer fitness tank tops.

I never thought about gym fashion much before working at our club.  My favorite exercise attire is some form of men’s basketball shorts and Fruit of the Loom ribbed a-line tanks (the kind you buy in bags of four).  I’m a classy broad.

So at first, when I heard my coworkers talking about Lulu Lemon versus Lucy versus Athleta, it was just another manner of girls being girls.  Sex and the City meets the fitness industry and what have you. Some would couch it in terms of practicality—one group exercise instructor would soliloquize on how her Lulu pants from five years ago had the same elasticity and color as those she purchased recently.  Others just liked how certain pants make their asses look. One of the most recent ongoing discussions between the trainers and the corporate office has been whether we can incorporate legwarmers into our uniforms (Verdict: Yes, if they’re black, and not in the summer.)

Truth be told, though, attire is an integral part of gym experience, and not just in the sense of keeping up with the Jones’s.  And there’s something to be said that, particularly for women, clothing inadvertently impacts our health—for many, it affects how we feel when we workout, and thereby how well and how often we perform.

Perhaps the best way I can explain it is with this anecdote: a year and a half ago, we got a new trainer, a strikingly beautiful woman whom we lovingly nicknamed “our Polish Barbie.”  When around her, men have this compulsive need to stare or even talk to her—she’ll walk through a bar and you’ll see a line of heads turn as she passes, or men who normally keep their game face on and don’t greet others will shout hello to her or tell her she has nice glasses when they pass her in a hallway (side note: She’s also an extremely talented coach and possibly a marketing genius. That thing adults tell you as a kid about people who are good looking being able to get by on their looks so they don’t have to be smart or try hard? Lies. Damn lies.)

 Anyway, point is, girl is pretty.  When she started working at our gym, she often talked about how freeing working at our club was—in part, because she didn’t have to worry if she made her clients deadlift with their butts facing a room full of guys, but also because she knew she could wear the clothes she wanted to wear.  As one of the people who lobbied for the ability to wear legwarmers to work, she’s someone who enjoys dressing up, even if her “business attire” is workout gear.  At the coed gym where she used to work, however, anything besides baggy t-shirts and sweats were viewed as an invitation by the male clientele to flirt with her. She couldn’t wear her favorite clothes and be taken seriously as an athlete training in the gym.

Something similar holds true for the women I mentioned in the opening, on a more basic level—knowing what to wear at the gym makes them feel less like an outsider, more like they belong.  These same women often say, “I’m just not a gym person,” and regularly going someplace that you feel clashes with who you are is near impossible.  You wouldn’t expect a person who feels out of place drinking and dancing to go to a club to meet their significant other; when you aren’t a “gym-person,” you end up with the workout equivalent of sipping a vodka tonic in a corner while watching twenty-somethings grind their crotches on one another—you lazily ellipticize and watch Kardashians. Walking into a classroom full of LuluLemon pants and tops when you’ve got your hubby’s old shirt on can make you feel like leaving before the warm-up starts.  Knowing what to wear can make you feel like you at least fit in partially.

Plus, others argue, the right workout gear can create motivation in and of itself. Rachel Cosgrove, one of the fitness gurus who regularly designs routines for health and fitness magazines, tells her readers to stop wearing baggy sweats to the gym so they can more closely gauge how their bodies transform—both in how their clothes fit and what they see in the mirror.  Think of it as “dress for success” in the fitness arena.

Ultimately, clothes become representative of the larger question of how one becomes comfortable in the gym environment.  But then we run into a follow-up question: do the latest in fitness fashions further the rift of those who belong and don’t?  Fitted pants and revealing tanks can make someone with body image issues more self-conscious, setting her up in between a rock and a hard place: wear clothes that make her feel uncomfortable, or feel like an outsider when she wears something that doesn’t feel too showy?  And even for those without body image issues, the hefty price tag of most designer togs may be prohibitive, creating a conflict of class.

If something as simple as getting dressed can raise so many issues, what else is affecting women’s ability to make a place for themselves in the gym?



Hate Exercising? Join the Club

One of my clients tells me every time we meet how much she hates our workouts (despite, you know, having trained for nine months and having told me she only stays at the gym for me). It’s a nerve-wracking statement nonetheless, in part because you don’t want a person to despise the things you do with them three hours a week.  Plus, with a desk job that keeps her stuck on day-long business trips and fourteen-hour meetings, a new relationship that gets her side-tracked nutritionally, and the usual health risks that come with excess body fat and a sedentary lifestyle, she needs the physical activity. 

Still, I don’t really think there’s a point to doing a form of exercise if you hate it.

Hear me out: I am not saying that you should avoid all cardio if you hate getting your heart rate up, or it’s a-ok to skip strength training if counting reps bores you and you’d rather be on the elliptical watching The Wire.  But there are a number of trainers and other health professionals who create a dogma out of what types of exercise you should be doing for optimal health.  Fitness magazines are constantly showing off the latest fad, be it CrossFit or ballet-barre-what-have-you or non-seizure-inducing yoga. On the other end of the spectrum, I’ve heard colleagues denounce everything from morning runs to Body Pump. 

Now, maybe it’s a question of target audience.  When you’re talking to someone who has been working out regularly for a while, then discussing the semantics of “the perfect exercise routine” is probably a little more likely to create the desired effects, since the person may actually enjoy exercising for the sake of exercising and be at a place where they geek out and get excited by modifying what they do. 

But 60% of Americans don’t meet recommended daily activity requirements, and 25% get none at all.  This group, folks like my client, is the one that needs help getting into a routine period, and worry about the fine tuning later.  One of the blogs I read regularly belongs to Yoni Freedhoff, a bariatric doctor who’s helped many people make lasting changes that improve their health; he explains the matter very well: if you don’t like a change you’re making to your lifestyle, chances are you won’t keep with it.

Back to my client: What does it mean when she, like many Americans, “hates” to exercise?  In her case, I become particularly confused because, despite all other factors in her lifestyle, she’s very athletic.  She was active growing up and has the fluency of movement that comes with that early introduction to exercise.  Without much thought, she can perform various feats of balance, speed through complicated agility drills, and lift weights that dwarf the ones other women use.  On the off chance I underestimate the level of challenge in an exercise I give her, she’ll let me know, because she doesn’t want to slack and has no fear of strenuous activity or discomfort.  So why, if she’s so talented at exercise, does she dislike it so much?

In part, I know, it’s because she first associates exercise with weight loss.  She’s put on enough body fat over the years that, now in her thirties, she’s on track for serious health issues if she sticks with her mostly-sedentary lifestyle.  At risk of making this blog sound like a broken record, it seems that the lack of enjoyment comes, in part, because she’s choosing her exercise based solely on what she’s supposed to do to shed pounds—even though she prefers things like playing in team sports and going for hikes.  And while, yes, it is important to consider the effect excess body fat has on disease risk, it seems like it would be hard for anybody to stick with a program if your main purpose in doing it is because you see it as a way to fix something that’s “wrong” with yourself. 

You know what it reminds me of?  I had this friend in college who was interested in the same guy as me; he and I ended up dating, and she would make comments to me like, “Well, I see now that he and I couldn’t date, because people usually end up with partners who are about as attractive as they are, and he really isn’t that attractive.  Like dates like and all that.”  Needless to say, we didn’t stay friends much longer after that.  If you wouldn’t hang out with a person who calls you ugly, why would you spend your time doing an activity that makes you think about how fat you are?

 I could tell myself that the friend was invaluable to talk to about school stuff, or good to go to for advice about what to wear, but, ultimately, there’s only so many passive-aggressive comments you can take before they override the benefits of the friendship.  Similarly, I can tell myself that working out will make it easier to get to my third floor apartment in my walk-up, or I’m doing it to protect me from the heart disease that plagues my family, but if the primary reason I’m doing it is because I think I’m fat and don’t want to be fat anymore—and, worse, I sort of feel like this thing with my weight is a losing battle because I’ve always thought I was fat—those other points will get drowned out. 

Studies have shown time and again that exercise is imperative for improved health, although it may or may not lead to weight loss. But what drives our fascination with finding a routine that is most effective—whether in burning fat or developing long, lean muscles— and is this quest for the best really helping us?

As personal trainers, we’re told to help our clients reach SMART goals: specific, measurable, attainable, relevant, and timely.  Basically, you don’t say, “I want to have more endurance,” you say, “I want to run the entirety of a 5k by the end of summer.”  The stickler here is this concept of attainability: running a 5k may be an attainable goal for, say, a woman who’s been walking regularly with little spurts of jogging here and there; it may not be attainable for someone who recently tore all the ligaments in her ankle and is relegated to an air-cast for the foreseeable future.

An attainable goal, then, is finding a routine that will sound almost as appealing as sitting at home watching the latest episode of Chopped and harassing the cat with a laser pointer—even if that routine means going to Zumba class three nights a week, when a program involving strength training, cardio intervals, and corrective work would be “better.”  You break everything down into manageable steps for the best overall success.

Yet there is a “go big or go home” school of thought with goal-setting, and it seems to be where the hatred of working out can creep in.  If someone’s trying to alter multiple habits that tie together, some health professionals argue that it’s best to attack them all at once.  The theory is that if you tend to drink excessively, smoke, and nosh on bar food all at once, it’ll be near impossible to break one habit without giving up the other two. Others say that if you set the goal high—exercising five days a week—you’ll achieve more than if you set a more modest goal, even if you don’t get as far as you’d hoped.

And thus, many, many people exercise because they “have” to rather than they “want” to—they set up their Mount Everest-size goal of “becoming healthy” by exercising in the best way possible.  And, honestly, a significant portion of them do stick to their routines for years on end.  Yet why does this mentality of “well, you just have to suck it up and do it” work for some people, but not for others? In one of her early advice columns, Hungry Girl Lisa Lillien, a blogger who’s made a niche out of developing low-cal recipes for junk food, told a reader, “I feel your pain. I, too, HATE to exercise. But while I hate to exercise, I force myself to do it. A lot. Because it’s the key to losing body fat or maintaining weight loss when you want to splurge and eat the foods you love. To get myself through tedious workouts, I try to make myself forget what I’m doing.”

Perhaps this mentality stems from the general work-a-holic tendency that drives America.  Making sure to exercise to stay healthy isn’t that far from making sure you have a job, paying your rent on time, or doing anything else that’s generally expected of you.  You may not like it, but that doesn’t mean you won’t do it, because you enjoy some of the consequences—having money to spend on collectible Lego people and groceries, having a place to store said collectible Lego people and groceries, or, with exercise, not getting sick all the time and having more energy and sporting killer guns. 

But then we come back to those like my client, who know they should work out, but can’t stay motivated—because we have too many things we should be doing.  Oftentimes, exercising falls low on the priority list, and changing priorities can be as difficult as changing religious beliefs.

Which is why we need to spend more time focusing on the message that it’s okay to choose exercise based on pleasure.  If you enjoy it, then it is something you will turn to when you want to have fun.  It will be something you make time for, like all those shows you have DVRed, to help you unwind after a stressful day at work.  It becomes a habit in and of itself, not “successful” or “failed” based on a scale or tape measurer, and, thus, you get one step closer to being healthy.

13 Ways of Looking at Obesity

1)      Before 1983, obesity was defined as being greater or equal to one’s ideal body weight, or a hundred pounds over one’s ideal body weight. Since 1983: A body mass index of over 30.  A waist size over 35 inches for women, 40 for men.  Body fat percentage over 25 percent for men, 32 percent for women. An estimated 66% of Americans are overweight, 33% obese.

2)      Obesity is linked to high cholesterol, high blood pressure, high blood sugar, cancer, gallstones, osteoarthritis, gout, sleep apnea, asthma, heart disease, strokes, polycystic ovarian syndrome, hyperinsulinemia, dyslipidemia, congestive heart failure, enlarged heart, pulmonary embolisms, gastro-esophageal disease, fatty liver disease, hernias, erectile dysfunction, urinary incontinence, chronic renal failure, lymph edema, cellulitis, and depression. On average, obesity reduces life expectancy by six or seven years. The total economic cost in the United States is estimated at $270 billion per year.

Obesity is like: tobacco, drunk driving, brains on drugs, breast cancer, forest fires, throwing away recyclables in the regular trash. Public service announcements will alleviate the problem.

4)      “[Self-medicating practices like drinking, video games, and overeating] provide opportunities to become absorbed in the present, opportunities that suffuse people with the pleasure of engaged appetites and enable  people to feel more resilient in the everyday…. We will learn nothing about how to cure self-induced ill health from appetitive excess if we don’t understand its mental health function.  Sure, addictive behavior is associated with depression, but it also discharges stress.  Legislating more consciousness won’t fix it.  Shaming patients won’t fix it: they’ve already learned to dread ‘health’ as a pleasure buzzkill.  Knowledge is not really power where the appetites are concerned.” – from ”Risky Bigness: On Obesity, Eating, and the Ambiguity of ‘Health’” by Lauren Berlant, in Against Health: Biopolitics, Medicine, Technoscience, and Health in the 21st Century (NYU Press 2010).


Is this entertainment , a source of motivation, or the source of unrealistic expectations?

6)      “The best ways to measure health involves noticing how you feel in your body. Do you have energy? Are you less stressed? How are you sleeping? How is your mood? Weight and body mass index (BMI) simply are poor predictors of health and longevity. A study comparing the Health at Every Size approach to a diet approach showed that both groups initially had similar improvements in metabolic fitness, activity levels, psychological measures and eating behaviors, though only the dieters lost weight. But after two years, dieters had regained their weight and lost the health improvements, while the Health at Every Size group sustained their health improvements.” – Marsha Hudnall, M.S., R.D., in an interview with Darryl Roberts for Huffington Post



Obesity is the result of a lack of portion control a poor choices.

8)      “As many of [Barbara] Ehrenreich’s working poor could attest, poverty and ill health are often part of a vicious cycle. The challenges of eating healthfully don’t simply disappear when you gain access to groceries. You need a clean place to cook, some basic tools, and reliable sources of water and heat. Moreover, you need to know what to do with the legumes, grains, vegetables, and budget cuts of meat that form the staples of wholesome, economical meals. A recent Columbia University study in nutrition education points out the not-surprising fact that it’s not enough to give people data about the risks of obesity. To create real changes in the way Americans eat, we need to link data with actual behavioral practice and environmental support.” – from “Obesity Epidemic: Spurring a Revolution,” by Linda Novick O’Keefe on Huffington Post.


  The fat acceptance movement.

10)   “In a study of large Canadian men and women, Joanisse and Synnott (1999) identify three categories of strategies that people use to respond to and resist the stigmatization of obesity.  The first category, which the authors term passive resistance, includes internalization and anger.  Internalizers accepted the negative view of being overweight and continued to try to lose weight, while the angry respondents rejected the negative view, but rather than fight back, tended ‘to seethe internally.’  Second, respondents used four techniques of active resistance, including verbal assertion, physical aggression, flamboyance, and activism.  Verbal assertion involved responding verbally to others’ prejudice and discrimination, while physical aggression usually consisted of minor acts of vandalism.  Respondents who used flamboyance proudly and flagrantly displayed their size, for example, by wearing brightly colored clothing.  Activism involved joining advocacy groups.  Finally, respondents described two strategies of reflective resistance, self-acceptance, and enlightenment, whereby they realized they could still live happy, productive lives despite their weight.” – from Women and Dieting Culture: Inside a Commercial Weight Loss Group by Kandi Stinson (Rutgers UP, 2001)

11)   Of Americans with normal BMIs (under 25), as many as 20 to 30 percent have unhealthy body fat percentage.  Much like their higher body-weight counterparts, they have altered blood lipid profiles, four times the risk of metabolic syndrome (which includes hypertension and high blood pressure), and higher amounts of leptin (a hormone responsible for appetite regulation). (Mayo Clinic; Wall Street Journal)

12)   “For years, the advice to the overweight and obese has been that we simply need to eat less and exercise more. While there is truth to this guidance, it fails to take into account that the human body continues to fight against weight loss long after dieting has stopped. This translates into a sobering reality: once we become fat, most of us, despite our best efforts, will probably stay fat.” Tara Parker-Pope, “The Fat Trap,” The New York Times.

13)   “Tara picture though is definitely the incredibly strict life that typifies society’s eye view of “dieting”.  But even if severity’s what’s required, why can’t people just stay hard core?  Superficially you might think people would in fact be able to remain hard core, because people really, really, really want to keep the weight off and I imagine this confuses many folks, including Tara.

“How badly do people want this?  In a now classic study, Rand and MacGregor revealed that formerly obese, bariatric surgical patients would rather be of normal weight and deaf, dyslexic, diabetic, legally blind, have very bad acne, have heart disease or one leg amputated, than return to being severely obese. If you felt that way about something, for whatever the reason, don’t you think you’d do whatever it took to keep that weight off, even if it were a hardship?” – Yoni Freedhoff, a Canadian bariatric doctor, in a blog response to “The Fat Trap.”

I wanted to put together something that displays many of the discussions currently going on around the issue of obesity, in part because I don’t this site to seem dismissive of the rampant health concerns that are linked with excess weight.  The above quotes, pictures, and clips are meant to show the many definitions of obesity, how varying the viewpoints about obesity are, and how many contradictory views come up.

If you look closely, though, there are patterns.  The one I find most interesting is the concept of culpability and control:  Yes, behaviors need to change to have a healthier lifestyle.  We say the debate is how to respond to the obesity epidemic, when, in fact, we’re asking a more basic question: how much control is in the hands of the individual, and what is standing in their way of making healthier decisions?  How we answer this question affects our actual reaction to obese people—if I see it as purely personal, then I can judge or moralize, react to obesity as unattractive and a sign of a personal defect.  If I see it as societal or part of some larger issue, then obesity becomes an issue of marginalization, and judging a person based on size becomes akin to judging her based on race or sexual orientation.  Responding to the “obesity epidemic” depends on finding where in between the two extremes the cause (or causes) fall.

BMI: A Primer

It’s time for some incredibly riveting talk about numbers, kids.  If you stick around, I promise I’ll say something funny at the end of the post.

Let’s get started: I’m really fascinated by this question of how we quantify health, and it’s a topic I’ll be coming back to frequently on this blog.  Today we’re going to start with the basics, though.

If you read much about fitness or health (which I’m guessing you do, if you’re reading this), you’ve inevitably heard of Body Mass Index (BMI). You’ve possibly even heard that it’s not a great measure of overall health, despite the fact that the medical community continues to use it to gauge individuals’ likeliness towards illness.  The simple version of the problem is that the number, which is derived from a ratio involving a person’s weight divided by her height squared, can be skewed to say someone’s unhealthy if she carries a lot of muscle on her frame, or to say someone’s healthy even if she is generally slender, but too much of her composition is fat.

(Thus, the concept of “skinny fat.” No, it’s not just another way for chicks to talk about their frenemies behind their backs. Although it makes you wonder about this general idea of catty remarks overlapping with actual health issues. What disease are badly done hair extensions a sign of?)

Going back in time to the early days of BMI’s inception, you’ll find some interesting tidbits.  Like: the formula was developed 200 years ago, by a mathematician who didn’t actually have any medical background.  He figured out the formula for BMI to help study large populations of sedentary people—so, in other words, yes, the general population of people with BMIs between 25 and 30 should have a less healthy average than those with BMIs under 25.  That is, if the formula were accurately derived.

See, the mathematician in question was working with a group of people that he already had the results on, so he jerry-rigged a formula so it grouped the people in the way he wanted them grouped.  Ever read Hitchhiker’s Guide to the Galaxy trilogy?  Most of the series, the characters know that the answer to the question of life, the universe, and everything is 42.  They set out to find the question, and in the process start considering what questions might lead to that answer, like, “How many roads must a man walk down?”  Eventually they find the true question **25-year-old-spoiler-alert**: “What do you get if you multiply six by nine?”

In other words, the problem with developing an equation that leads to a specific answer is that many formulas can come up with the same answer.  (And, like in the case of HGG, there can be miscalculations that mean you don’t even get the numbers you want). This conundrum is actually the issue with BMI: the formula’s just plain wrong.

It works for the majority of the population of sedentary individuals, but as you study taller groups, the equation becomes increasingly inaccurate.  And not just because “they carry more muscle,” like we read in our health magazines, either.  This is true for your skinny-fat tall people as well. Here’s the explanation from Wikipedia, because I honestly don’t know how to explain it any more simply than they have it:

“For a given height, BMI is proportional to mass. However, for a given mass, BMI is inversely proportional to the square of the height. So, if all body dimensions double, and mass scales naturally with the cube of the height, then BMI doubles instead of remaining the same. This results in taller people having a reported BMI that is uncharacteristically high compared to their actual body fat levels.” (Link)

Basically, as you begin looking at taller people, their mass/weight actually increases at a steeper rate than BMI allows for—the weight ranges you see on BMI charts should be skewed a little higher.  And the people being studied back in 1840 or 1850 when the BMI formula was created?  ­At least on average four inches shorter than today.

Of course, we know these problems.  Researchers have been aware of these problems for quite some time as well.  Yet we continue to apply BMI to individuals—when it’s completely bunk in that situation—and use it for statistical measurements when we know that there are some major flaws in the equation.  It makes a lot more sense why we have this whole debate over “fit and fat”—we’re trying to figure out the point at which a person’s size is going to affect her health, but we’re plugging our numbers into an equation that isn’t working.  And we see it not working, with the number of contradictory studies we have gracing the headlines. Still, BMI remains one of the most-used variables in research.

To study health, though, we need a means of quantification to compare groups.  Some say body fat is the answer—but do we need to consider what this article in the New York Times suggests: that even fat may differ in sedentary versus non-sedentary individuals? Or should we consider cholesterol, VO2 max, white blood cell count? Turning human beings into numbers ends up being a philosophical quandary as much as a statistical one.

Oh, crap.  I’m supposed to say something funny now.  No pressure, right?  How ‘bout I give you a rain check on that one?  Go check out Hyperbole and a Half  in the meantime.

Study Says Men Can Be Fat and Healthy; Fitness Bloggers Retaliate.

A few weeks ago, while perusing one of the many fitness blogs I read on a perhaps overly-compulsive basis, I came across an article titled “New Study Says You Can Be Fat And Healthy; We’re Not Totally Buying It”

This is the type of headline that always catches my attention, in part because I usually fall under the category of “fit and fat.”  Technically speaking—in the random situation in my day-to-day life someone references my physique, they usually say something along the lines of, “Clearly you work out,” although I do get an occasional, “You’re not what I’d expect a personal trainer to be like.”  If you’re looking at me by the numbers that represent me, though—my weight, my height, my body fat percentage, resting heart rate, cholesterol levels, running speed and endurance, maximum weight I can squat, etc—I’ve always been overweight (ranging from five to twenty-five pounds) but have stellar health markers otherwise.  Plus I’ve got some street cred in the gym (except, you know, with anything requiring coordination, like Zumba.  Then I like to think of myself as a positive reminder to other class-goers to not be self-conscious, because even fitness professionals can suck at exercise sometimes.)

So, in short, I’m interested in blog posts like the one on Blisstree because if you consider me as a human statistic and not as a flesh-and-blood individual, I’m fit and fat.  And, like most people reading health and fitness articles, I’m trying to figure out if my lifestyle is sending me on the fast-track to the cardiac unit or if I feel like I’m doing okay, I can trust that feeling. The article on Blisstree argues that this new study will just give people a false sense of security and leaves out too much information regarding obese individuals and overall diet.

To be honest, I don’t want to go into a deep analysis of the study here.  An overview: one of the recent issues of Circulation: Journal of the American Heart Association published a study of 13,000 men that tracked the men’s cardiovascular fitness and their BMI over a six year period. Everybody studied was normal weight to overweight (in other words, nobody obese).  When tracking the risk factors for cardiac-related and other types of death, the study found that increasing overall fitness was actually more important than losing weight or body fat; in fact, the study participants who only lost weight or body fat but did not improve fitness didn’t even see an improvement in their overall likelihood of dying of various health issues. The general conclusion was that a person who’s a little overweight and struggling to lose the pounds should probably focus more of his efforts on improving his fitness instead. (You can find a release on the story here and the abstract/original study here.)

The findings were interesting, but it’s difficult (if not impossible) to make a debate of this-study-versus-that-study.  Research exists that states that exercise isn’t enough.  One of the biggest problems with how we study health is that we don’t necessarily know which variables throw the results of two similar studies in opposite directions.  It would probably be easier for the average reader to go into a river and catch a fish bare-handed, ninja-style, than to pick out the most accurate reports of research from the media.

The frustrating part of the Blisstree article for me, then, lies in the time spent erroneously attacking the particulars of the study: the author argues that the study doesn’t take into account obese individuals, but the study authors say that.  The study is not of obesity, it is of the middle ground—of figuring out how to draw the line between “healthy” and “unhealthy” in a sandy beach with regular tides that obscure the markings.

The blogger’s other argument is equally frustrating: “We also know that food consumption is a major factor in their overall health, and the participants’ diets were not taken into account here. Because even if we have good vitals and good physical fitness, a poor diet will likely catch up with us.” Valid point, although the study is stating that vitals improved with increased physical fitness (although, yes, we don’t know how much, or if it was from unhealthy to borderline unhealthy).  Are we supposed to assume that vital signs are going to improve until they suddenly plummet because those five extra pounds smothered the person’s heart in a midnight coup?

Essentially, she spends too much time trying to debunk the parts of the research that don’t really need to be debunked– at least, if you consider the entirety of what the study authors say.

The post seems to me a good example of the major problem of our discussion of health and fitness today: We spend an abundance of time discussing particulars that don’t match up, which is wrong and which is right, and not enough time discussing why those particulars don’t match up.  Our research practices seem to be proof of the adage, “The definition of insanity is doing the same thing over and over again and expecting different results.”  Our research is consistently contradictory.  Rather than pointing fingers and saying, “No, that person over there with the 26.5 BMI can’t be healthy because I’ve got research saying the opposite,” we need to be considering what’s going wrong with our standards of measurement. Clearly, we’re missing something in our calculations of health.  The difficulty of using numbers to study people is that the math often doesn’t add up.

Vote for 2011’s Fittest Female Celeb—Without Knowing Her Exercise Routine?

Fitness blog FitSugar rounded out 2011 with an annual poll for the fittest female celeb of the year.  They created a list of 64 “inspirational” celebs and created a bracket for readers to vote on who’s fitter—Jessica Biel versus Eva Mendes, say, then Cameron Diaz versus Reese Witherspoon. 

The fun catch?  For the first round of voting, you didn’t get any information about their workouts when you’re voting.  Hell, half of the photos don’t even show said celebrities engaging in fitness activities.  Yes, that’s right, you get to vote on who’s fitter based on—what?  Facts you memorized from your careful perusal of the year’s gossip rags?  Likely not.

Once the blog whittled the competition down to a slim 25 (pun intended), you’re giving insightful blurbs about the contestants’ workouts like

  • “Mom of three and actress Jada Pinkett Smith is always on the move, but a busy lifestyle doesn’t keep her from scheduling in gym time, often at 6:30 a.m. in the morning.” 
  • “[Gwen Stefani] doesn’t shy away from sweat — in fact, she says she’d rather work out ‘like a man’ than set foot in a yoga studio.”
  • “If this picture of Cameron Diaz’s guns isn’t a clue that she take fitness seriously, maybe this leg-toning workout from her trainer Teddy Bass is. In 2011, Cameron bonded with then-boyfriend Alex Rodriguez with couples workouts that were no joke.”
  • “There are many good reasons why Jessica Biel constantly takes our Fittest Female crown. There’s her 2010 hike to the top of Mt. Kilimanjaro, her fit-and-fun lifestyle (including biking around town with Justin Timberlake in August), and her enviable toned physique.”

Using FitSugar’s logic, the Boston Athletic Association can ignore tedious lists of qualifying times and choose runners for the marathon based on who has the most attractive legs. Have you ever watched the Boston Marathon?  It’s a bunch of skinny guys (and a few chicks) with sunburns, looking generally uncomfortable.  Clearly, they’re not made for that kind of exertion.  Cameron, though.  She’s got some killer quads.  She’d totally beat out those weeny Kenyans.

But seriously—let’s look at the assumptions FitSugar’s encouraging readers to make in their “competition”:

  • Form follows function (in other words, to look fit, you have to be fit)
  • We have certain ideal physical traits
  • If you don’t have said physical traits, you’re just not working hard enough
  • Certain types of fitness are better than others
  • Certain amounts of fitness are better than others
  • It’s okay to judge someone if you say you’re judging them based on health

Perhaps most clearly, this article brings up a major question about fitness in general: At what point do we stop talking about health and we start talking about appearance?

In the book Against Health: How Health Became the New Morality, editor Jonathan M. Metzl writes about the excessive focus on appearance in health and fitness publications; most of the articles focus on issues like getting flat abs or clear skin or finding jeans that make your ass look good.  He argues that “calling [this focus on appearance] health allows these and other magazines to seamlessly construct certain bodies as desirable while relegating others as obscene.”  Basically, we can’t say you’re ugly because you’re fat, but if we say that a thin, muscular body is healthy and a body with some extra cushioning is unhealthy, then we can still judge you as inferior based on your appearance.

Even though there’s a growing amount of evidence that a person can be above-average size and healthy, or normal weight and unhealthy (See here  and here  and here), the media continues to perpetuate the myth that there is a particular body type that represents ideal health.  And this kind of ideology ultimately keeps people from being healthy more often than it helps or motivates them.

I’m not just talking about those girls who want to lose “those last ten pounds” when they’re already able to run a marathon or lift a car over their head or hang out in Bird of Paradise pose for twenty-four hours.  Imagine how hard it is to get started in a exercise routine if you know that the ultimate goal is something you’ll never achieve—which is how it can feel when you’ve been overweight your entire life, or were always chosen last in gym and have never been an “exercise person”, or just straight up don’t have a body that’s constructed like good ol’ Cameron’s.  I mean, seriously, why bother?

Plus you have issues like one I experienced the other day: A girl, a long-time runner, came in for an introductory training session at the gym where I train.  She’d been doing everything “right”—running three to four miles three days a week, lifting weights for her upper body and doing some ab stuff to build muscle definition and boost her metabolism, but she can’t shake the knee pain that’s creeping into her runs or the neck stiffness that shows up after she’s been huddled over her desk all day. 

Even though she reads countless articles on fitness and nutrition, she hasn’t been given the information she needed to actually be healthy and prevent the issues she was experiencing: she knows a whole lot of exercises to give her sculpted arms, but has never done an exercise to strengthen her upper back.  She’s probably read a dozen or more articles on treadmill routines that blast fat in 15/30/60 minutes, but nothing about foam rolling IT bands or crosstraining to prevent injury.  Because you know what?  IT bands ain’t sexy.  Which is why, if you’re reading this and not in the fitness industry, or have never been to physical therapy, you probably have no clue what I mean when I say, “IT band” or “foam roll.”

Perhaps appealing to appearance is simply more marketable.  Perhaps the media’s just catering to the lowest common denominator, the folks who can’t or don’t want to be reading about the way their bodies work and would rather be reading Us Weekly (Not that there’s anything wrong with Us Weekly.  I mean, Katy Perry.  Divorced.  What?!) Perhaps it’s easier to discuss and judge health if we give ourselves a standard for measurement, even if that standard doesn’t include a lot of people.  Whatever the reason, our current means of comparison clearly aren’t helping us.

Which leaves me with my question(s) for you:  How do you judge a person’s fitness? If all other measures of health end up the same, is it possible to compare two people’s fitness and say one’s better?