- Hardcover: 320 pages
- Publisher: Farrar, Straus and Giroux; 1 edition (May 1, 2003)
- Language: English
- ISBN-10: 0374204772
- ASIN: B0001OOTYS
- Package Dimensions: 9.6 x 6.4 x 1.1 inches
- Shipping Weight: 1.2 pounds
- Average Customer Review: 39 customer reviews
- Amazon Best Sellers Rank: #2,908,436 in Books (See Top 100 in Books)
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Ultimate Fitness: The Quest for Truth about Health and Exercise Hardcover – Bargain Price, May 1, 2003
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The bestselling science reporter for The New York Times reviews the last three decades of information about health and fitness, explaining the science of physical fitness and analyzing the various programs and prescriptions to discover what works and what does not.
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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.
After seeing Gina Kolata on a TV talk show, I expected a lot of useful information on fitness myths. Instead, the book consists of 5% fitness information and the other 95% percent are boring anecdotes about her personal life and fitness gurus, trainers, and doctors that I doubt anyone would care to learn more about.
Read this book if you literally want to learn the "history" of various fitness myths (in all it's arcane detail). For me, I just want the bottom line information.