What is the most important factor in weight maintenance? Level of physical activity, caloric intake, or other factors? About 80% of people who lose weight gain it back. How can we keep the weight off?

An article in the Journal of Strength and Conditioning Research reviewed the research addressing the amount of exercise necessary to prevent weight gain².  Low physical activity was found to account for about 77% of weight gain in one year. Exercise and physical activity play a primary role in weight maintenance. The other 23% may be affected by diet and metabolism.

A study in International Journal of Obesity assessed differences in activity between weight-gainers and weight-maintainers⁴. Gainers were defined as subjects who gained more than 13 pounds in one year and maintainers were defined as subjects who gained less than four pounds in one year.

Physical activity was calculated based on intensity level using a concept called METs which stands for Metabolic Equivalents. The energy expenditure at rest is 1 MET. This is the effort of someone sitting quietly. A person walking at 3.0 mph on level ground is working at an intensity of 3.3 METs which is 3.3 times the energy expenditure at rest. They measured how much time subjects spent in exercise and activities where the intensity was 4 or more METs. This intensity level is equivalent to any moderate intensity activity such as yard work or walking at a 3.5 mph pace.

Researchers found that maintainers spent more time in moderate intensity physical activity than did the gainers. On average the maintainers spent an average of 79 minutes a day while the gainers spent less than 16 minutes a day performing moderate intensity activities. Supporting these results Schoeller and associates³ estimate people need to spend 80 minutes every day in moderate physical activity to prevent weight gain. These findings are similar to the American College of Sports Medicine (ACSM) guidelines. The ACSM guidelines recommend 50-60 min/day for a total of 300 min/week¹.

Eighty minutes of physical activity a day requires commitment and may not be achievable for everyone. There are realistic ways to achieve weight maintenance if you can’t reach those 80 minutes of continuous exercise. Options include incorporating short bouts of exercise (10 minutes or more) throughout the day. In contrast you can perform higher intensity exercise which requires only 30 minutes a day/5 days a week. This involves an intensity level greater than 6 METs such as jogging.  Another high intensity training option is interval training.  With interval training, short bouts of high intensity exercise are alternated with brief periods of recovery when exercise intensity is moderate. 

In addition to exercise it is important to live an active lifestyle and follow a healthy diet to help maintain your weight. There are simple ways to increase your activity throughout the day. This includes taking the stairs whenever possible, walking over to a co-worker rather than shooting him/her an email, or taking ten minute walking breaks throughout the day. For more ways to work physical activity into your day, check out Achieving and Maintaining a Healthy Lifestyle- What Really Works? And finally, following a nutrient-filled food plan with lots of fruits, veggies, and lean protein adds to your success. What are some lifestyle activities excluding traditional exercise you use to maintain your weight?

1. American College of Sports Medicine. (2009). ACSM's Guidelines for ExerciseTesting and Prescription. Lippincott Williams & Wilkins.

2. Hunter, G.R. & Byrne N.M. (2005). Physical activity and muscle function but not resting energy expenditure impact on weight gain. Journal of Strength and Conditioning Research. 19, 225-230.

3. Schoeller, D.A., Shay, K., & Kushner, R.F. (1997). How much physical activity is needed to minimize weight gain in previously obese women? Am. J. Clin. Nutr. 66, 551–556.

4. Weinsier, R.L.,Bracco, D., & Schutz, Y. (1993). Schutz. Predicted effects of small decreases in energy expenditure on weight gain in adult women. Int. J. Obes. 17, 693–700.

Toning shoes, wellness shoes, fitness shoes, rocker shoes—whatever you want to call them, their use, especially among women, is on the rise. As a matter of fact, some experts predict that this segment of the footwear industry will grow into a $1 billion market in the next few years¹. And while they are all the rage now, toning shoes, as we will call them for the rest of this discussion, have been around for quite some time. Even podiatrists use this style of shoe to help treat a variety of problems. Toning shoes are characterized by a curved sole, which is designed to alter normal walking gait. Manufacturers claim that the unstable nature of the shoe helps to burn more calories, tone muscles, improve posture, and reduce joint stress.  Some go as far as saying that these shoes can take the place of a gym!

So do these shoes stand up to the manufactures’ claims? Researchers at the University of Wisconsin La Crosse decided to put toning shoes to the test by conducting two studies, one evaluating exercise responses to walking in traditional athletic shoes compared to some of the more popular brands of toning shoes². The second looked at muscle activation, again while walking in traditional athletic shoes versus the toning shoes.  Some of the things they measured included caloric expenditure, perception of how hard you are working (RPE), oxygen consumption, and EMG activity. Both studies found no significant differences in either exercise response or muscles activation between any of the shoes.

Manufacturers disagree with these results, faulting the studies for their small sample size (12 physically active females, ages 19-24 for the first study described above and 12 physically active females, ages 21-27 for the second). They cite their own research as proof the touted benefits exist. Experts warn, however, that research funded by manufacturers are often not peer-reviewed and often have a poor research design. Most believe that further, independent, long-term study is needed before the book is closed on toning shoes.

One search on the Internet and you will see numerous articles and blogs with varying opinions on the effectiveness of these shoes. Some people feel that, in deed, they have experienced many benefits from their toning shoes while others claim pain and injury resulted from their use.

So what do you think? Have you tried toning shoes? What has been your experience? Why do you think people feel they see results or vice versa?

1 Sitek, T. Healthy Feet. Footwear Insight. Formula 4 Media, March/April 2010.

2 Porcari J, Greany J, Tepper, S, Edmonson B, Foster C, Anders M. (2010, July 21). Will toning shoes really give you a better body. Accessed August 8, 2010, from the American Council on Exercise Web Site:  http://www.acefitness.org/getfit/research.aspx.

Summer is upon us and everyone is looking for ways to stay cool. The pool is a haven for most during the summer months to stay cool. Water splashing here and there, but have you thought about using the water for a place to get a workout.

Water resistance has long been used for rehabilitation, but what about using it for a regular resistance training workout. While I was in Korea recently, they had water resistance workout equipment as depicted in the picture above. Can a workout in the pool provide just as good of a workout as using resistance training equipment in the normal gym although?

A 2009 study published in the Journal of Strength and Conditioning Research looked at this and found the following results(1). The study used 12 fit young men in the study. During the 8 week study they used water devices that increased drag force.  After the eight week study they found a significant increase in upper body and leg power maximum strength and power. These results show that water resistance exercises can be used to produce improvements in muscular strength, power and reduction in fat mass.

Another interesting component of water resistance compared to normal resistance training in the gym is the amount of muscle damage that occurs. In another study that was also published in the same journal as above, they looked at the amounts of muscle damage when doing bicep curls and triceps extensions in the water compared to in a normal gym(2). When comparing the two environments, it was found that the water environment had much lower levels of muscle damage.

All of this to say that a good workout can even be achieved in water, just like in the gym, and might not produce as much muscle damage. So consider using the pool for a place to workout on a hot summer day when your muscles need some extra time to recovery. What type of exercises and apparatuses can you think of using in the pool for an effective workout? As long as you use proper technique and safe body mechanics, your imagination is the limit!

1Pantoja, PD, Alberton, CL, Pill, C, Vendrusculo, AP, & Kruel, LF. (2009). Effect of resistive exercise on muscle damage in water and on land. Journal of Strength & Conditioning Reseach, 23(3), 1051-1054.

2Colado, JC, Tella, V, Triplett, NT, & Gonzalez, LM. (2009). Effects of a short-term aquatic resistance program on strength and body composition in fit young men. Journal of Strength & Conditioning Research, 23(2), 549-559. 

Are all cardio machines created equally? Studies have shown that when individuals exercise on different pieces of cardio equipment at the same self-selected effort level, some pieces of equipment result in greater calorie burn. For example, at the same self-selected effort level, most individuals burn more calories exercising on the treadmill compared to the rowing machine, stair stepper, cycle ergometer or cross-country ski machine. However, until recently, newer forms of exercise equipment like the elliptical machine have not been investigated.

A study published in Journal of Strength and Conditioning Research¹ examined whether you burn more calories on the elliptical or the treadmill when you self-select your exercise intensity as moderate. In this study 18 untrained college-aged subjects performed 15 minutes of exercise on both the treadmill and elliptical machines. They exercised at the same effort level as determined by their Rating of Perceived Exertion (RPE). The scale is a numerical scale used to rate overall exercise effort level. The scale uses numbers ranging from 6 (no effort - rest) to 20 (maximal effort) as shown in the RPE chart below. Each subject exercised at the same moderate-intensity rating of 12-13 on both machines.

This study found no difference in caloric expenditure between the treadmill and elliptical at the same RPE. Worth noting, although subjects burned the same number of calories, heart rate was higher when exercising on the elliptical compared to the treadmill. They found heart rates were an average of 16 – 18 beats/minute higher on the elliptical machine at the same RPE level. Reasons for this may include a lack of familiarity with the elliptical machine and/or the arms may contribute more work than the legs during elliptical exercise compared to the treadmill. Other studies which examined the heart rate response to combined arm and leg exercise showed that as the amount of work contributed by the arms increased that heart rate also increased² even though total workload did not change.

These results suggest that when individuals self-select exercise intensity based on rating of perceived exertion, they burn an equal number of calories on the elliptical and treadmill. The elliptical machine is a great cross training alternative to the treadmill as it reduces impact and provides more conditioning for the arms. However, expect higher heart rates on the elliptical machine compared to the treadmill for the same calorie burn. Which cardio machine do you prefer and why?

1. Brown, G.A., Cook, C.M., Krueger, R.D., & Heelan, K.A. (2010). Comparison of energy expenditure on a treadmill vs. an elliptical device at a self-selected exercise intensity. Journal of Strength and Conditioning Research, 24(6), 1643-49.

2. Mayo, J.J., Kravitz, L., & Wongsathikun, J. (2001). Detecting the onset of added cardiovascular strain during combined arm and leg exercise. Journal of Exercise Physiology, 4(3), Retrieved from http://www.asep.org/journals/JEPonline.

Year after year national guidelines urge Americans to do physical activity and eat a healthy plant-based diet. And year after year Americans become more sedentary and choose more highly-processed foods high in fat and calories. So what's the disconnect? Are our healthy messages too complex? Do Americans not see the benefits of a healthy lifestyle? Or, perhaps, are Americans trying to change, but just not using the right strategies?

This week the American Heart Association released a Scientific Statement titled, Interventions to Promote Physical Activity and Dietary Lifestyle Change for Cardiovascular Risk Factor Reduction in Adults. After reviewing dozens of physical activity and dietary behavior change interventions conducted from 1997 to 2007, the panel of authors determined the most efficacious and effective strategies for lasting lifestyle change. The key strategies (for individuals) are briefly described below. As you read through them, note whether you do or don't use each skill. 

• Set specific, attainable but challenging short-term physical activity and healthy eating goals
• Self-monitor, or keep track, of physical activity and foods (e.g., minutes of physical activity or calories consumed per day) to determine what changes are needed and monitor progress
• Frequent and long-term follow-up with healthcare providers or peers (in-person, oral, written, electronic) to assess goal attainment or progress toward goal(s) and provide support
• Problem solve barriers to physical activity and healthy eating (e.g., lack of access to affordable healthier foods, lack of resources for physical activity, or no time)
• Use incentives or rewards to induce or support behavior change
• Observe others performing healthy behaviors (e.g., engaging in physical activity or preparing healthy food)
• Recognize and plan for risky situations that may lead to lapses in healthy behaviors (e.g., vacations, injuries, or holidays)

Which of these do you do most often? Which might you start doing?

In addition to these individual behavior change skills, the report outlines policy changes like providing healthcare providers with the skills to assess and provide counseling around lifestyle change and calorie labeling on menus that should be implemented to assist Americans in adopting and maintaining a healthy lifestyle.

As a healthcare provider it's frustrating to tell people over and over that there's no magic bullet. Americans need to clearly understand that it's not about the latest diet or fitness fad. Changing one's lifestyle is about making healthy foods and physical activity part of their daily routine - that will be continued forever. And to do this, one must use strategies for change (as described above) to be successful. It's not necessarily easy and it's not quick. But if someone wants to reduce their risk for disease that's what they need to do.

How do you help people realize that achieving and maintaining a healthy lifestyle requires more than a meal plan and list of exercises to do?

Artinian, N.T. (2010). Interventions to promote physical activity and dietary lifestyle change for cardiovascular risk reduction in adults. a scientific statement from the American Heart Association. Circulation. Retrieved from http://circ.ahajournal.org doi: 10.1161/CIR.0b013e3181e8edfl.

Each exercise workout and sport competition can result in various magnitudes of physiological and psychological changes such as increased soft tissue damage (causing muscle soreness), increased fatigue, increased core temperatures, and altered mood.  How rapidly one recovers is influenced by factors such as genetics, diet, fitness level, sleep, environment, and winning or losing.  The exercise demands and the recovery processes are specifically related to the stressors the athlete is exposed to.  Recovery is so important that historically legal and illegal restoration techniques have been used by athletes; anything to get an edge. Examples are the use of anabolic drugs, over-the-counter medications, electrical stimulation, dietary supplements, vibration, massage, and hypnosis therapy. Recently compression garments have been viewed as a potential “tool” in the wide array of restoration techniques.

Study Focus:
In this particular study conducted at The University of Connecticut, the objective was to evaluate the influence of a whole body compression suit on recovery from a typical heavy resistance training workout.¹ The subjects were 11 men and 9 women who were highly resistance trained for the past 2 years.  They were given an 8-10 repetition maximum load for each exercise.  Furthermore, subjects were trained with the protocols and loads for several workouts during the familiarization phase to reduce novelty and assure similar physiological responses each day.  Three sets of the following 8 exercises (in order) were performed: back squats, bench press, stationary lunge, bent over row, Romanian dead lift, biceps curl, sit-up, high pull from a hang. The Control Group would not wear a compression suit post exercise.

Pre-Study Details:
A registered dietitian screened each subject for dietary habits and instructed them on replicating diet profiles for the 2 days before the study and during the 24 hour recovery.  Proper water behaviors were address to ensure normal hydration status for all testing as hypohydration (low hydration) has been shown to impact physiological responses and performance.

A variety of testing was performed such as Ultrasound Analysis to discern swelling, Psychological Questionnaire and Corresponding Scales for (soreness/pain, sleep quality, fatigue, vitality, and mood), Blood Samples, Circumference Measurements, Movement Reaction Time, Countermovement Vertical Jump, Bench Throw and Squat Jump.
Each subject was fitted for a whole compression body suit. The compression suit was applied after a shower post exercise and keep on for a 24 hour period. The control group took a shower post exercise and put on non compression clothes like a t-shirt and running shorts.

Results:
In both the men and the women the 10 point generalized muscle soreness scale, ratings were significantly lower with the use of compression garments.
The amount of swelling was significantly lower as measured by ultrasound, and the test results demonstrated that fatigue was also significantly lower in the compression garments groups. Vitality ratings were significantly higher with compression use compared to control group. No differences were statistically significant in any of the mood states, nor were the sleep quality differences compared to the control.  There were also no significant differences in the countermovement vertical jump of peak power, average power, and maximum performance decrement. 

It is important to remember that these were trained subjects accustomed to hard training and the experiment protocol was used to elicit both mechanical and chemical stressors to the body’s recovery process.  Yet this was thought to be the populations most in the need of recovery enhancements (e.g. training athletes and active individuals).  The women’s compression suit was Women’s Recharge ™ Suit and the Men’s Recharge ™ Suit.

1 William J. Kraemer, Shawn D. Flannagan, Brett A.Comstock,Maren S. Fragala, Jacob E. Earp, Courtenay Dunn-Lewis, Jen-Yu Ho, Gwendolyn A. Thomas, Glenn Solomon-Hill, Zachary R. Penwell, Matthew D. Powell, Megan R. Wolf, Jeff S. Volek, Craig R. Denegar, and Carl M. Maresh. Effects of Whole Body Compression Garment on Markers of Recovery After A Heavy Resistance Workout in Men and Women. J. Strength Cond. Res 24: 3 804-814.

I was running up and down the street in front of my house one day because I had to stay close to home. A neighbor down the street was out washing his cars so every time I passed him we would exchange some quick words about this and that. During one of my passes he made the comment that he should be out running. I didn’t have time to respond but I thought about this comment for the next few minutes. He had been out washing his cars (as well as the neighbor’s) as long as I had been running and I think he actually was out there before I was. And he just wasn’t washing his cars; he was WASHING his cars.  When I passed him again, I pointed out this observation to him. I started reflecting on the fact that many people do not realize how important lifestyle physical activity is on our health. One of our recent blogs, “Physically Active with a Sedentary Lifestyle: Are You at Risk?” explored the effects of inactivity on cardiovascular death rates¹. As a reminder death rates were highest in those who spent most of the day sitting even if they met their recommended physical activity requirements. So being active during the day provides protection different than structured exercise. And being more active during the day also yields higher calorie expenditure which helps with calorie balance. As I continued my run I thought about how many don’t realize that small activities throughout the day really do add up. Modern conveniences have taken much of the activity out of life and it is important for us to find ways to put it back like my neighbor washing his own car versus going to a automated drive-through service.  And unfortunately for many the perception about physical activity is that you have to be training for something. Yes, some structured exercise is important (and doesn’t have to entail training for something) but really the goal should be to decrease our sedentary behaviors and simply move more.

So how much do you know about the caloric expenditure of various activities? Let’s test your activity calorie knowledge.
*all questions are assuming the person weighs 150 pounds (68.2 kg)

1. How many calories would a 150 pound person burn putting boxes away in the attic for 10 minutes?
      a.     40 calories
      b.     85  calories

2. Which burns more calories?
      a.    washing dishes for 30 minutes
      b.    walking the dog for 15 minutes

3. Which of the following activities would burn 270 calories if done for an hour by a 150 pound person?
      a.    gardening
      b.    washing a car
 
4. Which burns more calories?
      a.    vacuuming for 20 minutes
      b.    carrying an infant for 20 minutes

5. Taking the stairs burns how many more calories than standing in an elevator?
      a.    about 3 times more
      b.    about 6 times more

How did you do?
Here are the answers. Question number one: 150 pound person would burn 85 calories putting boxes away in the attic for 10 minutes. The vertical challenge of climbing up a ladder with a weighted box is quite an intense activity. Question number two: washing dishes for 30 minutes (85 calories) will burn more calories than walking the dog for 15 (50 calories). Question number three: Gardening burns 270 calories in an hour while washing a car burns about 205 calories. And for many gardening brings enjoyment, although the same could be said about washing a car especially in my neighbor’s case! We should all strive to find activities that are fun for us. Question number four: Vacuuming and carrying an infant for 20 minutes both burn 80 calories. Question number five: Taking the stairs burns about 6 times more calories than riding in an elevator.

My challenge to you is to find ways to put activity back in your life. Oh and if you are curious as to how many calories those different activities will burn, check out this calorie calculator. It is based on the Compendium of Physical Activities which was developed to assess the intensity and energy expenditure of 605 physical activities². The site will calculate caloric expenditure for 222 of the activities. For a complete listing, check out the Compendium of Physical Activities itself. Report back to us what you come up with. You may just be providing a great idea to another reader.


1 Katzmarzyk, P.T., Church, T.S., Craig, C.L., & Bouchard, C. (2009). Sitting time and Mortality from All Causes, Cardiovascular Disease, and Cancer. MSSE, 41(5),998-1005.

2 Ainsworth, B.E., Haskell, W.L., Whitt, M.C. et al. (2000). Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 32 (9 Suppl): S498-504.

It’s time to make physical activity as routine as brushing our teeth! Did you know that research is starting to show that oral hygiene along with exercise may help reduce cardiovascular (CV) disease?

A recent blog, “Physically Active with a Sedentary Lifestyle: Are you at risk?,”explored the effects of prolonged sitting on all-cause and CV death rates in individuals who exercised and those who did not¹.  Researchers reported the highest death rates in persons who spent most of the day sitting and those who spent more time sitting.  And this was true even if they met their recommended PA requirements.  In fact, death rates were similar for exercisers and non-exercisers who sat during the day.

So moving throughout the day is seen as a way to lessen the risk of CV deaths, but it’s time to add more teeth brushing too. de Oliveira and associated (2010)² investigated whether the number of times individuals brush their teeth is correlated with the risk of developing heart disease.

In the 8+ year study, just over 11,000 individuals were tracked through to hospital admissions and deaths. During the study, 555 cardiovascular events occurred. Those that brushed less had an increased risk for CV disease than those that brushed twice per day.

The stats from the study compared to twice per day brushers:
• Once per day  - 1.3 increased risk for CV events
• Less than once per day - 1.7 increased risk for CV events

So keep those pearly whites nice and clean (at least twice a day) for a longer and healthier life!  And don’t forget to walk to the water cooler for an extra swish.

¹Katzmarzyk, P.T., Church, T.S., Craig, C.L., & Bouchard, C. (2009). Sitting time and Mortality from All Causes, Cardiovascular Disease, and Cancer. MSSE, 41(5),998-1005.
²de Oliveira, C, Watt, R, & Hamer, M. (2010). Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish health survey. British Medical Journal, 340(c2451), Retrieved from http://www.bmj.com