on February 22, 2011
Most of the 5-star reviews for 4HB came up on the first day. Given that Tim Ferriss has previously endorsed outsourcing in his Four Hour Workweek, I wonder how many of those 5-star reviews were from his personal assistants abroad.
Let me start with my bona fides: I am a currently practicing and licensed physician in the state of California. I graduated from Stanford University School of Medicine. I am a black belt and a lifelong athlete, and I have been weight training for over 20 years-- and unlike Mr. Ferriss, without injuring myself in any way, ever. I have no financial interest in his book or any other product discussed here.
Regarding the depth of my review of The 4-Hour Body, I spent over [...] on the equipment, supplements, and ultrasound machine recommended in the book. I bought the BodyMetrix Professional ultrasound and software he recommends by Intelametrix ([...] after discount for mentioning 4HB book), and completed the 1-on-1 online training despite the fact I am previously certified in performing ultrasound. I engaged my friends and colleagues in a "Fat off" competition with obsessive and objective weight and body fat measurements and followed the routine for 5 weeks as perfectly as I was able. I also experimented (like Mr. Ferriss) using continuous glucose measurement (CGM) to assess minute-to-minute glucose responses to food and exercise using both the DexCom system he recommends as well as the MiniMed Guardian system. I plan to upload a photo of the nutritional supplements I bought, which nearly cover my kitchen table. I downloaded apps to my phone for recording each workout obsessively, and more importantly to help with the very slow rep time he recommends.
My basic finding is that after trying the diet, supplements, exercise routines and lifestyle changes recommended in the 4-Hour Body that I found no change, whatsoever, in body weight or competition. Nor did any of my other friends trying the book.
Why doesn't the 4HB work?
(1) It takes more than 4 hours a month in the gym to have a great body. I'm sorry, it just does. Mr. Ferriss recommends performing 2-3 SETS, for a total of less than 30 reps, per WEEK, to get a great body. Ask any athlete, bodybuilder, trainer... not enough. Not even close. It's hogwash. I actually could feel my body dwindling despite eating as much protein as I could stomach.
(2) Almost all the supplements recommended in 4HB have never been scientifically proven to do what Mr. Ferriss claims they do. Take cissus quadrangularis (page 110), costs about $30 for 120 capsules. He discusses that he took CQ in China while eating a high volume rice diet with sweets and states "CQ preserved my abs". Really? If that's the level of evidence that you're comfortable with, great. But with simultaneous exercise, multiple other ongoing supplements, lifestyle changes, etc., who can tell whether it was CQ or just dietary changes from his being in rural China?
(3) The diet is just a mishmash of other diet routines, basically Atkins plus paleo with a dash of South Beach Diet. There are important flaws in the diet that should be pointed out. He recommends carbohydrates from beans instead of "white carbohydrates", hence the "slow-carb" diet. This relies on a bunch of old data regarding glycemic index. The reality about carbohydrate digestion is very different. Carbohydrate digestion is so important that it begins IN THE MOUTH with salivary amylase. Whether you eat a slice of Wonder Bread or a handful of garbanzo beans, the breakdown of these sugars into the body's currency of glucose is extremely rapid and effective regardless of which form you ingest it in. I have tried this myself using continuous glucose monitoring as recommended in the book. The only way I have found to blunt the sugar rise is simultaneous ingestion of a good quantity of fat. Also, can a diet really be paleo without milk or dairy? And did early Homo sapiens farm for beans and lentils?
(4) The blood sugar response data in the book is flawed by a misunderstanding of how continuous blood glucose monitoring (CGM) works. He notes "it turned out foods and liquids took much, much longer to get to my bloodstream than one would expect." But the DexCom SEVEN implant he was using has a 20-30 minute delay between the blood sugar reading you get on a finger stick, and the blood sugar reading on the machine sensor. That is, there is a BUILT IN DELAY (check some online diabetic forums for more info on this) because capillary blood from fingersticks shows changes much faster and more accurately than the interstitial fluid surrounding the implant. So, as noted in (3), sugar responses are actually very fast. Drink that protein shake right before or after the workout, not 1 hour prior like he says.
(5) Measuring body fat before and after interventions is much less easy than implied in the book. Body scans using DEXA are really great, but it's hard to convince all your friends to do it with you given inconvenience and expense. I have used the ultrasound unit he recommends and even with training it is very difficult for me to get reliable, repeatable data. This is true even when I have switched it to expert "M" mode and done my own curve fitting of the actual ultrasound output. It is also very dependent on the body type you select for yourself when you calibrate the machine.
(6) The sex improvement section seems out of place in this book, and is not terribly original to boot.
Here's what you can learn from 4HB without buying the book:
---Measure your body fat (!) before and after any change you make in your diet.
---If a book makes unrealistic claims, don't believe it.
---Have your friends join you in challenges and short contests.
---Exercise consistently over years...and be more careful with your body than Mr. Ferriss is.
on January 2, 2011
WEIGHT LOSS SECTION
Last summer I lost 18 pounds, getting down to 6% body fat. This enabled me to finish 29th in the Pikes Peak Ascent, which climbs nearly 8000 feet in 13.5 miles and was the 7th Annual World Mountain Running Association (WMRA) Long Distance Challenge. I received the award for 1st place in the 45-49 age group.
Ferriss advocates keeping your blood sugar even, i.e., avoiding spikes and drops by eating low on the glycemic index. I've done this for nearly 25 years and I believe it's the most important dietary advice. Ferriss should have mentioned that Barry Sears' Zone Diet books go into more detail on low-glycemic eating; there are more health benefits besides losing weight. Sears' website also sells products that help with this diet, e.g., high-protein, low-glycemic index pasta. Ferriss recommends lemon juice or cinnamon to lower the glycemic index of foods, something I'd never heard of. He could have mentioned that Celestial Seasonings makes a cinnamon tea, called GingerBread Spice, that you can drink with a meal instead of putting cinnamon in foods.
Even though I've eaten low-glycemic foods for nearly 25 years my weight had crept up a little each year. Last summer I tightened up my diet but lost only 3 pounds in 7 weeks. I then discovered a technique that Ferriss doesn't mention: "Eat breakfast like a king, lunch like a queen, and supper like a pauper." A thin French friend told me this is how Europeans stay thin. I ate big breakfasts with protein (fish, lean meat, eggs, etc.), protein shakes with spirulina around noon, big lunches around 3pm, and then just a green salad or fruit salad in the evening, enough to not go to bed hungry. I then lost 15 pounds in 12 weeks.
Ferriss has good advice for eating low on the glycemic index: not eating white sugar, white flour, and other refined carbohydrates; and not drinking calories, e.g., fruit juice packs a lot of sugar. He also says to eat the same few meals over and over. This makes staying on your diet easy.
Ferriss recommends not eating fruit, because fructose converts to glycerol phosphate that facilitates fat storage. I'm skeptical of this, because fruits are more than just fructose, e.g., they have fiber. Just because a reaction occurs in vitro (in a test tube) doesn't mean the same thing will happen in vivo (in a living person). Given his huge fan base maybe he could ask a few hundred of his blog readers to divide into two groups, one of which eats fruit and the other doesn't, and see who loses more weight. I'll bet the non-fruit eaters will substitute another sweet that is more fattening and lose less weight.
Ferriss recommends taking one day off a week from your diet and eating anything (and everything) you want. He says that this "binge" day will support weight loss by keeping your metabolism high. Again, I'm skeptical and I'd like to see a clinical trial. However, last summer I did a "binge day" every week without realizing it. I had a race every week and after each race ate whatever I wanted the rest of the day.
Ferriss recommends not eating dairy, as it has a high insulinemic response despite its low glycemic index.
When Ferriss advocated a high-protein diet, recommending that I eat almost 200 grams of protein per day, my first reaction was "What about the China Study?" This book, by Colin and Thomas Campbell, correlated animal-based diets with cancer, and recommended eating a plant-based (vegan) diet. Ferriss's website has a link to Christopher Masterjohn's critique of "The China Study." Colin Campbell's study with rats fed aflatoxin (one of the most potent carcinogens) found that a diet with 20% casein (one of the proteins in milk) led to every rat developing cancer, when none of the rats whose diet was 5% casein developed cancer. Apparently casein signals your cells to grow, which is good if you're a baby but not good if you have cancer. Masterjohn then shows how the Campbells extrapolated this one study to say that all milk proteins facilitate cancer growth, when whey (another milk protein) doesn't facilitate cancer growth, and to say that all animal protein facilitates cancer growth (also not true).
Ferris says that canned and frozen foods are just as good as fresh. I agree with him regarding canned beans, but I believe that fresh fruits and vegetables are necessary for my health. Ferriss correctly points out that my grandmother, born in Poland in 1904, ate one orange each year, on Christmas. But my grandmother was tiny compared my cousins and myself. One of the clerks at the natural foods supermarket near my house is 25 and was diagnosed with cancer, diabetes, and heart disease. He switched to a raw foods diet and all of his health problems disappeared. He told me that previously he ate a "standard American diet," i.e., packaged processed foods. I've always eaten big salads, both green salads and fruit salads. If I don't eat raw foods, e.g., when traveling, after a couple days I crave raw foods. I don't know whether raw foods diets work due to something in raw foods, e.g., enzymes that are destroyed by heat, or if these diets work because of what's not in them, e.g., packaged processed foods. Ferriss recommends eating slowly, and raw foods take time to eat. When I make a big salad for breakfast with greens, beans, and smoked salmon it takes me all morning to finish it.
Ferriss doesn't mention spirulina. I put two tablespoons in my mid-day protein shake. Spirulina is arguably the perfect food, if you can handle the swamp taste. It's high in protein, with balanced amino acids; includes essential fatty acids; vitamins, especially the B vitamins lacking in vegetarian diets; minerals; and photosynthetic pigments, i.e., it's really green.
Ferriss suggests cold exposure (cold showers or ice baths) to lose weight, gain muscle, treat insomnia, boost immunity, treat depression, and increase testosterone and sperm count. Dathan Ritzenhein used a cryosuana, exposed to -275 degree nitrogen vapors for 2.5 minutes, the day before the New York Marathon, where he finished 8th in 2:12. At first I was skeptical of Ferris's claim that cold exposure aids weight loss because I keep the house cold all winter and exercise outside 2+ hours a day, often in sub-zero temperatures, and I gain weight every winter. Then I realized that Ferriss is right. Cold exposure makes me crave peanut butter sandwiches and other high fat, calorie-dense foods. In the summer I resist cravings relatively easily but in the winter the cravings are more powerful. I'm sure that if I resisted cravings brought on by cold exposure I'd lose weight fast.
I like this book because it's a collection of new ideas that Ferriss personally tried. 25 years ago I felt like Diogenes with his lamp, except instead of looking for an honest man I was looking for new ideas. In the 1980s new ideas were few and far between. Now with the Internet I feel blessed to live in an age in which new ideas circulate rapidly. Typically each new idea has a single advocate so it's hard to compare whether this idea is better than that idea, unless you take the time (and expense) to try several ideas. Ferriss did just that and is reporting his experiences. In contrast, Andrew Weil writes about the same materials but with an affect of authority, as he's a doctor and reads scientific studies. Ferriss's affect is "I'm a regular guy just like you, I'm not an expert, but I'm intelligent and I can read scientific studies too, and here's what happened when I tried this..." Another reviewer said that Ferriss's book is his new "bible." I don't agree with that. If you want a "bible," read Andrew Weil. If you want interesting ideas and personal experiences, read Ferriss.
ADDING MUSCLE SECTION
I'm not interested in body building so I skimmed this section. However, this section made me realize how different bodybuilders are from outdoor athletes. Or at least how different Ferriss and I are. Later he talks about learning to run and to swim, i.e., these are new skills for him. He doesn't mention cycling or playing team sports. Before reading this section I hadn't realized how many drugs bodybuilders take! (Ferriss suggests googling "Andreas Munzer autopsy".)
Ferriss doesn't include a chapter about integrating exercise into your daily life. E.g., riding a bike to work instead of driving, or joining a mixed-gender softball team to meet singles. I don't like going to gyms, I only exercise when it's fun or there's a purpose.
IMPROVING SEX SECTION
This section starts with how non-orgasmic women can learn to masturbate, e.g., by reading Betty Dodson's book. I watched Dodson's video about ten years ago and one item remains with me clearly: Dodson tells women to schedule three to four hours when they want to masturbate!
Ferriss shows some improved positions for couples. My wife and I tried these and she was unimpressed (but then she's never had problems with orgasms).
The next chapter explains how Ferriss increased his testosterone 2.5 times: vitamins, ice baths, and cholesterol (egg yolks and steaks). I nearly tripled my testosterone (from barely over 300 to just under 900) by taking a contact improv dance class. Three times a week a dozen sweaty young women and I rolled our bodies over and under each other. (Contact improv is like gymnastics except you use your partner instead of vaults and balance beams.) The pheromones in young women's sweat increases men's testosterone. Someday someone will make a fortune collecting young women's sweat and selling it to middle-aged men. There were also young men in the class, whose sweat literally made me weak and nauseous until I showered. Ferriss doesn't say that lifting weights in gyms surrounded by sweaty young men might lower your testosterone.
Ferriss doesn't discuss why you might not want to increase your testosterone. Testosterone causes baldness, and your hair doesn't grow back if you later lower your testosterone. Testosterone doesn't make you faster: gelding race horses are just as fast as stallions. Ferriss says that when his testosterone was high he literally turned women's heads in restaurants. My experience in the dance class was that the young women literally jumped in the laps of the gay men at the start of class. If they couldn't partner with a gay man then they partnered with women. Every class I'd look around when the instructor said to find a partner, and the only available partners were the other two straight men. We'd do the first exercise together half-heartedly and then ask women to partner with us. Testosterone may have made the women avoid us.
Ferriss doesn't mention that women might want to increase their testosterone. I've read that testosterone is the most effective anti-depressant for women. It also increases their libido. Listen to This American Life's podcast #220: a transgender female-to-male talks about what it was like to receive testosterone injections; and a man who had a medical condition that eliminated testosterone in his body, with the result that he achieved a Buddha-like state of desiring nothing. I performed these two characters in a play, my favorite line was from the transgender man: "Testosterone makes life challenging, but it makes you love the challenges."
The next chapter is about declining sperm count. Ferriss suggests getting your sperm frozen before you're 35, which I did. His other advice is to not carry your cellphone in your pocket (I don't). He barely mentions other ideas such as not drinking out of plastic bottles, avoiding soy foods, and wearing loose boxer shorts instead of tighty whities.
The next section is about insomnia. He suggests all sorts of gadgets, cold baths, foods, etc. but doesn't suggest cutting out caffeine. Getting back to cold exposure, I support Ferriss's claim that cold exposure aids sleep. In the upper Midwest people say "good sleeping weather" to describe cold nights. I sleep well when I let the house drop below 50 degrees and pile blankets on my bed.
Next is a section on reversing "permanent" injuries. My massage therapist (whose wife is a physical therapist) was impressed with this section, esp. the Egoscue recommendation.
Next is a section on medical tourism (saving money by going to foreign countries for medical treatment).
Next, Ferriss recommends preventing injuries by getting a Functional Movement Screen (FMS) test. FMS measures left-right differences in strength and balance. I'm putting this on my to-do list.
I'm 48 and this year ran a 5:08 mile, an 18:09 5K, and a 37:48 10K. I qualified for All-American in a 3000-meter race and I win an age group award in most races. I only run about 3 hours a week: two 45-minute track workouts plus a 1.5-hour club run. An exercise physiologist was amazed that I have a VO2-max of 59 and run this fast on 3 hours a week. Then I said that I walk my dog 2 hours a day, plus we hike twice a week, mixing speedwalking, easy jogging, and stopping to pee every 30 feet. The exercise physiologist said that I have the perfect training plan: a base of daily easy exercise with a few short but intense workouts.
Ferriss recommends running with the Pose technique. I've done this for five years and this has been the best thing I've ever done to improve my running, both for increasing speed and minimizing injuries. Ferriss doesn't mention that the same technique has other names, including Chi Running and Evolution Running.
Ferriss' description of the Pose technique is excellent but he only has photos of himself (before and after). His "before" photos are clearly wrong but his "after" photos aren't much better, likely because he just doesn't run fast. (His 24-minute 5K is what we politely call "mid-pack".) He should have included photos of faster runners who do the Pose Technique better.
Ferriss' 12-week workout schedule is good. The main workout is 800-meter repeats, beginning with two the first week and moving up to six in later weeks. Ferriss doesn't explain why this workout is so important. Running workouts (to oversimplify) either train leg speed or cardiovascular (heart and lungs). 800 meters is three minutes for Ferriss. If you run intervals longer than 3 minutes you don't maximize leg speed. If you run less than 3 minutes you don't maximize heart rate. 3-minute repeats are two workouts in one, training both leg speed and cardiovascular. Ferriss should have explained that you run three minutes, not 800 meters, i.e., a slower runner could run 600 meters, when I run 900 meters and a pro might knock off 1200's. Do two of these the first week and gradually build up to five, or six if you're an animal like Ferriss. All should be equal distance, which means that your first interval feels easy and the last interval is maximum effort.
Ferriss' schedule also includes 100-meter and 200-meter leg speed workouts. This is excellent advice for slow runners trying to get faster. Too many joggers run for miles at a slow pace and never get faster. He also did longer 5K and 10K runs to build endurance, and did some hill repeats to build the strength necessary for trail running. He doesn't mention that the 100-meter repeats should be barefoot on grass, to teach you good form.
Ferriss recommends Inov-8 running shoes. I use Nike Frees. He rightly denigrates Newtons and warns against running barefoot (e.g., Vibram Five Fingers), except for strides on grass.
Fueling during long races is an important subject that Ferriss doesn't adequately cover. But I'll give you a tip that'll make your next race faster. Clear your gastrointestinal tract by not eating solid food for at least 12 hours before the race (i.e., drink only juice and energy drinks). Digestion demands up to 40% of your blood so not having anything in your gut at the start line will provide more blood to your muscles.
Here's where Ferriss presents weightlifting for runners, based on Barry Ross (coach of Olympic gold medalist Allyson Felix). I don't do weightlifting so these ideas were all new to me.
Ferriss gives two reasons why runners should do strength training (weightlifting). First, distance runners have weak sodium-potassium pumps. The sodium-potassium pump is what enables muscles to return to relaxation after contracting. The discoverer of the sodium-potassium pump won the Nobel Prize. Strength training improves the sodium-potassium pump.
Second, greater ground force support (applying force to the ground at landing) is more important than moving your legs faster.
The recommended strength training is in three stages. First, speedwalking 15 minutes three times a week. I do speedwalking because it gives me leg speed without wearing me out. Ferriss says to start with four weeks of speedwalking.
The second stage is weightlifting. Three times per week you do dynamic stretching, then bench presses or push-ups, then deadlifting, in which you lift the weights only to your knees. Ross's athletes deadlift three times their bodyweight! Finish with an exercise called the Torture Twist to strengthen your core muscles.
The third stage is speedwork on the track. The distances are short. Ross's sprinters, who don't compete in distances longer then 400 meters, don't run more than 70 meters in training. No advice is given for distance runners, but Ferriss's other coach telling him to run 800-meter repeats to train for a 50-kilometer race sounds similar to Ross's short interval speedwork.
Ferriss doesn't mention the one type of weightlifting I do, which is essential for avoiding calf injuries when running with the Pose Technique. Some people call these "toe lifts," I call them "heel lifts." Stand barefoot on a stair on your toes. Lower your heels below your toes. Then raise yourself as high as you can. This strengthens your calf muscles. Start with both feet, then go to one foot as you get stronger.
Ferriss recommends Total Immersion Swimming. I did Total Immersion Swimming about five years ago and agree with Ferriss. Before, I panicked and tried to swim fast to avoid drowning. I could swim only two lengths of the pool before reaching anaerobic fatigue. Total Immersion Swimming first taught me to float in the water without panicking. Then you learn to paddle around slowly. Then you improve your form step by step to become more efficient (hydrodynamic), so effortless paddling actually moves you through the water easily. Eventually you're swimming back and forth across the pool completely relaxed.
Another chapter teaches you to hit baseballs harder. Another chapter explains how to hold your breath for three minutes.
LIFE EXTENSION SECTION
First, Ferriss rejects calorie restriction as it's a miserable life. He similarly rejects restricting ejaculations (i.e., Dr. Strangelove). He rejects resveratrol because it interferes with estrogen. I stopped taking resveratrol because it interferes with thyroid function (I'm hypothyroid). He rejects some other life extension drugs. He recommends creatine monohydrate for preventing Alzheimers, Parkinson's, and Huntington's if your family has a history of these diseases. He also recommends intermittent fasting or just not eating protein for a day. He also recommends that men donate blood to reduce iron.
Ferriss doesn't talk about DHEA, the anti-aging hormone I take. DHEA is the most abundant hormone in the body. It's related to testosterone and estrogen but men and women have it equally. It peaks at 25 then gradually declines. Low DHEA is associated with many diseases of old age, and many studies have found DHEA supplements reverse these diseases in older people.
Ferriss recommends having SpectraCell Laboratories test you for nutritional deficiencies. He doesn't mention that they also have a telomere test. This tests your body's biological age, in terms of cell reproduction (i.e., how close your cells are to being unable to reproduce and your body wearing out). Lifestyle, e.g., diet and exercise, affect this. I'm going to get both of these tests done.
This book isn't perfect or complete. But I'm giving it five stars because it gave me new ideas. I'm sure that an expert could pick apart any chapter and find mistakes or missing info. But that's OK. This book isn't the Bible; Ferriss doesn't want you to blindly repeat what he did. He investigated interesting ideas and saw what worked or didn't work for him. That's how you should use this book.
P.S. Several commentators have suggested that I write a book. I've written three books. Two are about stuttering therapy. My third book is "Hearts and Minds: How Our Bodies Are Hardwired for Relationships." It's written somewhat like "The 4-Hour Body" in that I present scientific research about relationships and then describe my experiences applying these ideas to dating and in relationships. Amazon sells all my books.