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Ultimate Fitness: The Quest for Truth about Health and Exercise Hardcover – May 1, 2003
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"Rebound" by Kwame Alexander
Don't miss best-selling author Kwame Alexander's "Rebound," a new companion novel to his Newbery Award-winner, "The Crossover,"" illustrated with striking graphic novel panels. Pre-order today
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From Publishers Weekly
Everyone knows that exercise is a good thing. But when New York Times science reporter Kolata (Flu) set out to investigate the claims of various fitness regimens, she found that "the tiny pearls of good science are buried in mountains of junk." Much of the accepted wisdom about exercise, it turns out, is false-from the belief that endorphins cause an exertion-induced euphoria to the notion that all individuals, with sufficient effort, can become fit. An avid devotee of "spinning," a type of stationary biking that mimics actual road conditions, Kolata brings both personal enthusiasm and journalistic skepticism to her subject. She traces the history of the fitness movement from the ancient Greeks through the 18th and early 19th centuries, when feats of strength and endurance became a popular means of entertainment. By the 20th century, increasingly sedentary living prompted a new interest in fitness: the jogging fad emerged in the 1970s, followed by aerobics, weight lifting and other activities. Kolata looks at hard data about exercise, but also interviews enthusiasts and promoters, whose devotion to their regimens sometimes transcends the available facts. People exercise for different reasons, Kolata finds. For improving overall health, moderate exercise appears to be sufficient. To improve physical appearance, intense effort is required. To reach a sense of exhilaration and strength, however, one must actually love physical exertion for its own sake. The "truth" about exercise, Kolata concludes, may lie in the view of psychopharmacologist Richard Friedman, who suggests that "exercise is more often a marker of health than its cause." Illus. not seen by PW.
Copyright 2003 Reed Business Information, Inc.
Ever since baby boomers discovered they might not live forever, health and fitness, as well as looking young and svelte, have been major national fads. Whether one wants to develop six-pack abs or simply climb a flight of stairs without wheezing, sorting through the shams and quackery of exercise claims can be a full-time job. Kolata, science reporter for the New York Times and something of an exercise authority by avocation, takes on that task with the fervor of a marathoner. She deconstructs many assertions and myths, and much of the hyperbole of exercise enthusiasts trying to make fortunes off of an unsuspecting public. She reveals the truths behind several so-called scientific studies and asks why certain people will never exercise while some will never stop. Eighty-six-year-old exercise icon Jack LaLanne admits to vanity, but most exercisers like the feeling of control exercise affords. Having researched her sources and done her homework, Kolata also comes up with seemingly sound advice about exercise, weight lifting, personal trainers, machines, pills, and potions. Donna Chavez
Copyright © American Library Association. All rights reserved
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I disagree with one of the other reviewers who felt that Kolata doesn't stress the importance of exercise enough. She is clearly a hard-core exerciser who believes that most people would be better off doing more than the oft-prescribed after-dinner stroll. But she also acknowledges that some exercise is always better than no exercise at all. I don't see how this book, which is all about exercise, could possibly give the impression that exercise didn't matter.
I laughed out loud at the last "heart waves" mention (and that's all I'm going to reveal here--you'll have to read the book for yourself to get the joke).
The guidelines advise TLC first. That sets the patient up for failure. There is no diet that will consistently keep weight off for 10 years in the majority of people.
We don't know what we are talking about when it comes to dieting, yet we put the responsibility on the patient to lose weight.
Three items in the news demonstrate our ignorance in weight loss:
1- Jeffrey Gordon: A change in bacteria in the intestine makes it easier to gain weight and more difficult to lose weight
2- Interleukin Genetics Inc. under the name Inherent Health sells a test for $149 to determine if your patient should be on a low carb diet or a low carb and low fat diet.
3- Jerry Heindel is an expert in Endocrine Disrupting Chemicals (EDC's). These chemicals disrupt our weight thermostat.
The fat epidemic is not explained totally by video games and corn syrup in fast food.
It reminds me of how we treated HIV with one drug. Later we realized we did the wrong thing as it allowed resistance to develop in those patients.
If NCEP is evidenced based, lets leave diet and exercise out of it for now.
I am reading Ultimate Fitness by Gina Kolata. The history of exercise advice from physicians over the years is very interesting.
Exercise was popular before the depression and then it seemed silly to people.
Ken Cooper, George Sheehan and Jim Fixx helped make it popular again.
In 1960 if you jogged in the street, the police thought you stole something.
50 years later I look at my water aerobics class with other old folks and think we have come a long way.
The message about losing weight and exercise is already out there. Don't waste three months waiting to see if the patient will do it when a physician prescribes it. I would be upset as a patient to pay for an office visit to be told what I learned in the first grade. I have to pay for another visit to start meds?
If there was a diet that guaranteed permanent weight loss without staying in a semi-starvation state I would definitely put that at the head of the list of guidelines. There isn't one. We are asking patients to do what is impossible.
As for exercise, I learned while studying for the boards that weight loss maintenance requires 60 to 90 minutes of exercise a day. I lost 80 pounds and exercised 150 minutes a day and still have gained back 50 pounds.
As to weight and exercise advice, do we really know what we are talking about? I look at our history of advice and I wonder.
p230: Claude Bouchard is quoted as stating that "weight lifting has virtually no effect on resting metabolism. The reason is that any added muscle is miniscule compared with the total amount of skeletal muscle in the body. And the muscle has very low metabolic rate while at rest, which is most of the time. Skeletal muscle burns about 13 calories per kg of body weight over 24 hours when a person is at rest. A typical man who weighs 70 kg has about 28 kg of skeletal muscle, Bouchard says. His muscles when he is at rest burn about 22 % of the calories the body uses. The brain would use about the same number of calories as would the liver. If the man lifts weights and gains 2 kg of muscle his metabolic rate would increase by 24 calories a day. According to Jack Wilmore the average amount of muscle gained after a serious weight-lifting program that lasted 12 weeks was 2 kg. Women of course will gain much less."
The good news is on p.232:
"Weight lifting makes for more efficient muscles with more mitochondria and it is better at using fat for fuel. The cells are also more permeable to glucose , which, in turn, reduces the need for excess insulin in the blood. The result is a reduced susceptibility to diabetes."
Will the new guidelines include weight lifting?
I have gone easy on the intensity of exercise and have not had an injury for the last five years.
The 30 minutes of hard exercise is doable twice a week and I started with a trainer about one month ago.
I had aches and stiffness all week last week.
My trainer says people in her boot camp have been able to get out of their metabolic plateau.
Dr. Arrone says exercise is the way to get out of the plateau.
I have not found scientific evidence for this especially when I read that adding 4 kg of muscle only burns 28 more calories more a day.
But is that at rest?
If you have 4 more kg of muscle and exercise 2 hours a day, how many more calories is that?
In addition, intense exercise burns 10 calories a minute.
A 150 pound man burns 150 in 30 minutes of walking at a 20 min/mile pace.
Hitting the metabolic plateau after 7-10% weight loss which decreases metabolism by 42% in exercising muscles dramatically overrides an individual best attempts to burn calories?
Is all this for naught if genetically a person prone to the metabolic syndrome will only keep to his ideal weight or BMI by staying in a semi-starvation state?
I believe Dr. Porche has long term (>5 years) weight loss data maintained by bariatric surgery, but I have not found any diet study with that data.
It seems the NCEP should advise only a 5% weight loss and then concentrate on 90 to 120 minutes of exercise a day for diabetics and pre-diabetics to increase sensitivity to insulin with emphasis on weight training and cross training.
Where is the level one evidence to decrease mortality with exercise and with diet?
If there is no level one evidence, then it needs to not be the first therapy advised to our patients at risk by the NCEP.
If there is no diet that has shown weight loss maintained for > 5 years, then the NCEP is advising diet not based on evidence based medicine.
I think a good example of the strenghts and flaws in the entire book can be seen through the chapter on strength training. In that chapter, she provides some very interesting history on weight lifting, and does very well debunking a popular myth on weight lifting (namely, that weight lifting will increase your resting metabolism). But her own personal sacred cows go untouched: For instance, she reports how she started out using machines, but then she abandoned that for "the area that is reserved for serious lifting" -- free weights, mostly. Never does she touch on the mythology surrounding the "free weights versus machines" debate, which would have been a wonderful opportunity to explore exercise mythology. Instead, she embraces the mythology, without examination: "For years I used a machine ... . Now I do real squats. And I do real bench presses." Now, I'm no expert, but the only thing "real" about a squat or a bench press (absent training for a squat or bench press competition, which she doesn't do) is the ego manifestation in deciding that your particular way of stressing muscles is "superior." She then spends way too much of the chapter discussing weight lifting in terms of women -- again, some interesting history there, but it again belies the author's personal bias.
She does the same thing with Spinning -- she extolls the virtues of Spinning and the Mount Everest four-hour ride, and makes Spinning sound like the fitness event of the century. Then, in the final chapter on the marketing of the fitness industry, she reveals the certification to become a Spinning instructor has more to do with money than with training: she laments that a "chunky middle-aged man" tells her he's become a certified Spinning instructor and is now teaching six classes a week.
As a result, what is there for interesting reading in terms of history and science is overshadowed by the author's need to affirm all the time she spends at the gym: Unlike most mortals, she pushes her heart rate to incredible levels, far beyond what is recommended (because she just can't work up much of a sweat doing a mere 80 percent of her max heart rate); she works with real weights in the real part of the gym; she belongs to three different health clubs because she's just so damn serious about fitness.
The book walks a fine line: She's not obessive enough to give you a real insider's view of, say, a marathon racer or a competitive body builder. But she is obsessive enough to pretend to be one. As a result, there is no real "inside" information to share (unless you really want to learn about what it is like to train for a four-hour stationary bike ride, which itself was obviously a marketing ploy, complete with dry ice to simulate clouds in the moutains), but she's too obsessive about her own conceits to objectively report her subject. That's where the book fails. It is not inspiring, nor informative, nor even particularly interesting.
A better title for the book would have been "Hooray for Gina."