Musicians as athletes

I affirm this with the conviction of someone who knows these two universes well: musicians are high-performance athletes, but they do not treat themselves as such. Professional musical performance and high-performance sports require very similar levels of commitment, as well as physical and mental demands. The time, commitment and consistency required to achieve a high level of performance playing an instrument or performing a specific sport skill have much more in common than one might initially think. Some differences will lie in the fact that, in general, neuromuscular recruitment associated with playing an instrument has a greater focus on fine motor skills (i.e. short movements of greater precision and performed mainly with the limbs extremities) and less at the level of gross motor skills (i.e. larger movements involving larger muscle groups) that we normally associate with sports movements. However, it should be clarified that both large muscle groups play an important role, particularly at a postural level, in instrumental performance, and the smaller muscles associated with fine motor skills also play a fundamental role in most sports movements.

For example, if we establish a parallel between playing the violin and performing a given sport specific skill in tennis, we find that, although at different levels, a balance of fine and gross motor control is necessary for better performance in both activities. When we play the violin, we want to maintain a high and controlled posture so that holding the violin with the non-dominant arm and handling the bow with the dominant arm allows the fine work of the hands and fingers to occur as efficiently as possible. Now, if the musculature involved in the stabilization of the trunk and in the elevation of the arms is weak, fatigue sets in more quickly resulting in postural loss, in an execution carried out with greater muscle tension and consequently in a worse performance. In the case of the serve in tennis, due to the high demand for motor coordination and strength involving all the large muscle groups of the lower and upper body, there is also a need for high levels of fine motor skills coordination regarding wrist, hand and finger movements, in order to implement a given spin effect and the desired direction to the ball.

In fact, both musical and sports performance involve neuromuscular recruitment to produce movement and work that requires precision, speed, endurance and strength. In addition, and particularly at a professional level, playing an instrument and playing a sport are activities that require long hours of repetitive movements that, combined with poor physical conditioning, can lead to a variety of clinical conditions. It is unthinkable that a highly competitive athlete does not follow a training program targeting the development of his/her physical qualities which should be complementary to the practice of his/her sport. It is easy to recognize that a good physical fitness level will ensure greater resilience and longevity in sports. The same applies to musical performance. Musicians are high-performance athletes and should prepare themselves as such! Living and playing with pain is not inevitable, it is an option.

The prevalence of pain and injury in musicians

As the years go by and the hours playing their instrument accumulate, it is almost inevitable that professional musicians develop musculoskeletal and/or neuromuscular problems of varying severity at some point in their career. More so if they do nothing about their physical preparation. Review studies on the prevalence of injuries in professional musicians point out that 76% of musicians suffer or have suffered from physical problems that prevent them from performing at their usual level and 84% had injuries that interfered negatively with their musical practice1. Some musicians will develop tendinopathies and low back pain of varying intensity, which they will be able to manage with chronic intake of anti-inflammatory medications or simply by playing less frequently and/or just by enduring pain and discomfort. Others will develop more serious overuse injury syndromes that will become chronic and compromise not only quality of musical performance, but also quality of life, forcing them to periods of musical inactivity. Additionally, others will suffer from even more serious forms of injury that may result in abandoning their career as an instrumentalist musician.

In general, the most frequent injuries affecting musicians manifest themselves through pain and/or dysfunction, especially on the joints, tendons, ligaments and nerves of the upper limb, head, neck and spine. For example, in orchestral instrumentalists, injuries of musculoskeletal and/or neuromuscular origin are more common and affect about 64% musicians, of which 20% consist of peripheral nervous problems and about 8% of cases of focal dystonia2. It makes sense, considering that these are the most stressed areas of the body during instrumental practice. An exception would be the cases of focal dystonia, which, although it may be accompanied by pain and musculoskeletal injury, the root cause of the dysfunction observed at the peripheral level is actually central, that is, the dysfunctional neuronal circuits are at the upper levels of the central nervous system such as the cerebral cortex. Thus, the most frequent injuries in instrumentalist musicians can be summarized as follows3:

  • Musculoskeletal injuries – epicondylitis, tendinopathies (tendinosis, tendinitis, tenosynovitis), bursitis, arthritis, arthrosis, osteoarthritis, contractures, injuries to the temporomandibular joint;
  • Nerve trapping and inflammation – carpal tunnel syndrome, thoracic outlet syndrome, radial tunnel syndrome, ulnar nerve compression syndrome, ulnar tunnel syndrome, cervical and lumbar radiculopathies;
  • Hypermobility;
  • Focal dystonia;
  • Hearing loss.

The onset of injuries in musicians is due to an array of factors that naturally interact. Several authors have identified the following factors facilitating and/or causing the development of injuries in musicians1:

  • Physiological and biological factors such as gender and age. Women seem to be more likely to develop peripheral musculoskeletal and nerve injuries compared to men, and individuals who engage in high volume instrumental practice at an early age, at 4-5 years of age, are also more likely to develop injuries later in life4,5. In the case of focal dystonia, there is a clear higher prevalence in males (over 90%) and in women with menstrual disorders, which suggests that hormonal factors may be predisposing to the development of this disorder6.

 

  • Type of instrument. The characteristics of the instrument (size, shape and weight) and the time of practice imply different levels of physical demand, in which fatigue onset and an execution based on too much physical effort can lead to the development of injuries7. For example, the position needed to play the clarinet implies that the entire weight of the instrument is supported on the right thumb, and at the same time it requires a large amount of short and fast movements of the fingers of both hands8. Another example particularly special to me is the double bass. A bulky instrument with an air column of considerable inertia, which requires not only considerable grip strength to press on the strings, but also considerable whole body physical effort (which, can of course, be optimized with efficient technique) to move this column of air and make the instrument vibrate and produce sound. Anyone who has tried playing the double bass for a few minutes realizes the physical demands that playing this instrument encompasses.

 

  • Instrumental technique. A poor instrumental technique, with non-optimized positions, based on physical effort rather than on movement efficiency, associated with long hours of practice without rest, will naturally predispose the player to pain and injury, especially in the wrists, hands, neck and shoulders9 .

 

  • Specific technical demands. The technical demands of a particular musical piece that often requires high-speed and high-intensity execution, with fatiguing repetition of movements or maintenance of extreme hand positions for a long period of time. All of this creates high levels of mechanical stress and may cause injury10,11.

 

  • Body asymmetry. In the same way that an athlete of a one-side dominant sport will try to compensate for these asymmetries by working out both sides of the body, a musician is in a similar situation, because playing an instrument implies asymmetrical work in very unnatural positions for long periods of time, which will favor the occurrence of various muscular imbalances12.

 

  • Poor physical fitness. Good levels of strength and general physical conditioning are essential to maintain a good position to play an instrument for long periods of time. Most of these positions are very unnatural. Being in good physical fitness will allow to resist the onset of fatigue, recover more quickly between rehearsals or practice sessions, and in fact, it will allow to tolerate more hours of practice avoiding technique and performance deterioration7. Muscle imbalances and weakness resulting from long hours of sitting in certain positions and high volume repetition of short movements must be prevented through exercise programs aiming to strengthen the body globally, and at the same time to compensate for muscle imbalances induced by instrumental practice13.

 

  • Other lifestyle factors. We know that lifestyle factors such as smoking or smoke exposure, alcohol consumption, sleep deprivation, malnutrition, poor hydration and obesity have very damaging effects at a systemic level on our body. Regarding neuromuscular injuries, we know that all these forms of toxicity weaken the body’s connective tissue (cartilage, tendons, ligaments, membranes), muscles and nerve conduction, predisposing to the development of localized inflammatory processes as well as chronic injuries. For example, did you know that obesity is highly predisposing to development of carpal tunnel syndrome?14 Or that smoking is strongly associated with development of injuries and dysfunctions in the shoulder?15

Preventing and resolving injuries in musicians

Any elite athlete empirically knows something that has long been supported by science. That the most effective way to prevent (and also treat) overuse or overload injuries due to high volume sports practice is to ensure good levels of physical fitness combined with good recovery habits, adequate rest and nutrition. Regarding physical fitness, it is unthinkable for an elite athlete, not to follow a regular physical training program. An athlete knows that this will have negative consequences both on sports performance and on the susceptibility for developing injuries. The athlete knows that the weaker his/her musculoskeletal system is, the greater the vulnerability to injury. The question is, and if we consider that professional musicians are required to engage on activities requiring high physical and mental performance for long hours of daily practice, shouldn’t musicians treat themselves as high-performance athletes? I am certain that they should.

In fact, a 2019 systematic review investigating the topic of physical training for professional orchestra musicians1 indicates that following a structured physical training program of varying durations (from a few weeks to several months) has generally resulted in significant improvements in musical performance and in reducing (and even eliminating) chronic pain1.

To keep playing at the highest level for a long time, musicians would greatly benefit if they treated themselves as high-performance athletes and ensure that they maintain good physical shape combined with good habits of recovery, rest and nutrition. And to be clear, when I talk about staying in good physical shape, I don’t mean playing sports. In fact, playing sports as a mean to improve one’s physical fitness is not ideal and can even be harmful. More activity with asymmetric characteristics would be added on top of another, also asymmetric, which is playing a musical instrument. In general, all sports are constituted by specialized movements, and for that reason, also asymmetrical. So, except for purely recreational reasons (which can also be positive at a mental and stress release level), the practice of a sport as a strategy to improve physical fitness is not ideal and should not be the first choice particularly by musicians (I discuss this very topic in this article: Why musicians should not play sports).

General physical fitness is improved through the process of training our physical qualities. This should entail an assessment of the initial status in order to identify specific limitations and outline a specific intervention strategy. One should always start at the base and progress from there, just like the process of learning to play a musical instrument. Here, attention to detail is key. A well-designed training program implies the management of training variables specific to the profile and objectives of the athlete or, in this case, the musician. A correct selection of exercises is crucial, as well as close monitoring of their implementation regarding form of execution, training load and progression over time. As I mentioned, it is not very different from the process of learning to play a musical instrument!

For a musician, playing the instrument is the top priority. It can be obsessive, I know. But playing better in the long run does not necessarily mean playing more hours, but rather investing in taking care of the ‘’machine’’ that is our body. I reiterate once more that playing with pain or discomfort is an option and not an inevitability. Take care of your body and treat it well, because you will need it in the long run!

Train well to play well!

Nuno Correia

References:

  1. Gallego, C., Ros, C., Ruíz, L., Martín, J. (2019). The physical training for musicians. Systematic review. Sportis Sci J, 5 (3), 532-561.
  2. Lederman, R. J. (2003). Neuromuscular and musculoskeletal problems in instrumental musicians. Muscle & Nerve, 27(5), 549–561.
  3. Betancor Almeida, I. (2011). Hábitos de actividad física en músicos de orquestas sinfónicas profesionales: un análisis empírico de ámbito internaciona Tesis Doctoral. Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria.
  4. Fishbein, M., Middlestadt, S., Ottati, V., Straus, S., y Ellis, A. (1988). Medical problems among ICSOM musicians: Overview of a national survey. Medical Problems of Performing Artists, 3(1), 1–8.
  5. Viaño, J. J. (2004). Estudio de la relación entre la apariciación de lesiones musculoesqueléticas en músicos instrumentistas y hábitos de actividad física y vida diaria. En III Congreso De La Asociación Española de Ciencias Del Deporte. Valencia: Universidad de A Coruña.
  6. Rosset-Llobet, J., Candia, V., Fàbregas, S., Ray, W., & Pascual-Leone, A. (2007). Secondary motor disturbances in 101 patients with musician’s dystonia. Journal of neurology, neurosurgery, and psychiatry, 78(9), 949–953.
  7. Sardá, E. (2003). En forma: ejercicios para músicos. Barcelona: Paidos.
  8. Thrasher, M., y Chesky, K. (1998). Medical problems of clarinetists: Results from the U.N.T. musician health survey. The Clarinet, 25(4), 24–27.
  9. Wynn, C. B. (2004). Managing the physical demands of musical performance. En Williamon A. (Ed.), Musical excellence: Strategies and techniques to enhance performance (pp. 41–60). Londres: Oxford University Press.
  10. Bejjani, F. J., Kaye, G. M., y Benham, M. (1996). Musculoskeletal and neuromuscular conditions of instrumental musicians. Archives of Physical Medicine and Rehabilitation, 77(4), 406–413.
  11. Mark, T., Gary, R., y Miles, T. (2003). What every pianist needs to know about the body: a manual for players of keyboard instruments: piano, organ, digital keyboard, harpsichord, clavichord. GIA Publications. Martín.
  12. Ackermann, B., Adams, R., y Marshall, E. (2002). Strength of endurance training for undergraduate music majors at a university? Medical Problems of Performing Artists, 17(1), 33– 41.
  13. Frabretti, C., y Gomide, M. F. (2010). A saúde dos músicos: dor na prática profissional de músicos de orquestra no ABCD paulista. Revista Brasileira de Saúde Ocupacional, 35(121), 33– 40.
  14. Shiri R, Pourmemari MH, Falah-Hassani K, Viikari-Juntura E. The effect of excess body mass on the risk of carpal tunnel syndrome: a meta-analysis of 58 studies. Obes Rev. 2015;16(12):1094-1104.
  15. Bishop, Julie Y. et al. (2015). Smoking Predisposes to Rotator Cuff Pathology and Shoulder Dysfunction: A Systematic Review. Arthroscopy, Volume 31, Issue 8, 1598 – 1605.

 

The International Society of Sports Nutrition published in 2017 a position stand (see reference below) on the safety and efficacy of creatine supplementation in the context of exercise, sports and medicine.

Creatine supplementation, one of the most popular and studied nutritional supplements, has in fact been shown to be effective in improving athletic performance (especially in high intensity exercise) and inducing relevant training adaptations. The consequent increase in intramuscular creatine (and phosphocreatine) reserves facilitates the rapid re-synthesis of ATP, the so-called energy “currency” of the body, which is essential for almost every reaction in our body. Thus, the increased availability of creatine in the cell through supplementation contributes to improve performance because it increases the energy availability in order to exercise (i.e. muscle contraction) as well as a whole range of other muscle cell related reactions. Creatine supplementation can in fact enhance strength production, muscle work, accelerate recovery and help preventing injury.

Additionally, creatine supplementation appears to be highly safe and effective not only in athletes but also in non-athletes (such as the so-called exercise enthusiasts), as well as in various clinical populations. In fact, several studies (see ISSN article, reference below) point to benefits of creatine supplementation in various populations and clinical settings, such as:

– Accelerating injury rehabilitation (because it attenuates muscle atrophy);

– Protection of neuronal injuries (spinal and cerebral);

– Mitigation of debilitating consequences in people with congenital syndromes of creatine synthesis deficiency;

– Attenuating the progression of neurodegenerative diseases (e.g. Huntington’s disease, disease, Parkinson’s disease, mitochondrial diseases, amyotrophic lateral sclerosis);

– Prevention and / or improvement of bioenergetics in patients with myocardial ischemia or stroke victims;

– Improving metabolic and functional indicators associated with aging;

– Possible benefit during pregnancy for optimal growth, development and health of the fetus.

In conclusion, creatine does indeed appear to be a safe and beneficial nutritional supplement for a wide range of populations and ages. Indeed, this is a supplement that actually works!

Take creatine and power to you!

Nuno Correia

References:

Kreider, R.B. et al., 2017. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(1), p.18. Available at: http://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z.

 

In order to maintain physical function, recover better from injury, maintain lean mass and stay healthier overall, older individuals need a higher protein intake than younger individuals. Higher protein intake contributes for attenuating inflammatory and catabolic processes, as well as ameliorating the decreased efficiency in protein metabolism associated with age.

According to the recommendations advanced by the PROT-AGE Study Group (2013) (reference below), older individuals should:

– eat at least 1 to 1.2g/kg body weight of protein per day;
– eat MORE protein if suffering from acute or chronic illness, between 1.2-1.5g/kg body weight of protein per day;
– ingest EVEN MORE if malnourished and / or suffering from severe illness or injury, ~2g/kg body weight of protein per day;
– limit protein intake if suffering from SEVERE KIDNEY DISEASE and NOT following hemodialysis. These individuals are therefore an EXCEPTION concerning protein intake;
– use supplementation to the achieve desired protein intake levels;
– and, of course, DO the type of exercise that most effectively promotes the maintenance or increases in lean mass, which is strength training.

And no, kidney disease is NOT caused by protein intake. In a one-year follow-up study with resistance-trained men consuming ~2.51-3.32 g/kg of body weight per day for one year, there were no harmful effects on measures of blood lipids as well as liver and kidney function (Antonio et al, 2016).

Maintaining strength and lean mass (including muscle mass, bone and connective tissue mass) are identified as the first and most relevant biomarkers of health and longevity. Improving these markers produces a positive and powerful “domino effect” on most (probably all) of the other health markers. Proper protein intake and strength training is essential for building lean mass. And even more crucial as we age in order to counteract the inevitable progressive loss of efficiency in our metabolism.

Do not fear protein nor strength training. These are probably two of your best allies to live better and longer.

Don’t forget the protein at your next meal!

Nuno Correia

References:

Bauer, J. et al., 2013. Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the prot-age study group. Journal of the American Medical Directors Association, 14(8), pp.542–559.

Antonio, J., Ellerbroek, A., Silver, T., Vargas, L., Tamayo, A., Buehn, R., & Peacock, C. A. (2016). A High Protein Diet Has No Harmful Effects: A One-Year Crossover Study in Resistance-Trained Males. Journal of nutrition and metabolism, 2016, 9104792.

 

In previous articles (check Part 1 and Part 2) we discussed the fact that while all golfers will do everything possible to change their game (buying new clubs and new balls), many overlook one of the most decisive factors for their physical and mental success – their nutrition; we have identified some of the main reasons why golfers never change and, finally, we have pointed out five important links between golf and proper nutrition. In this article, I will share with you my concerns about the so called “normal diet” and the five most important habits you should create to start nourishing your body better.

The Western Diet

The western diet is generally used to describe popular eating habits in the USA. As these eating habits are still very popular in Europe and other parts of the non-Western world, it will probably be necessary to find a new name for this type of “diet” in the coming years (perhaps the killer diet is a good name!).

But what is the “western diet?” Well, this “diet” can be briefly characterized by a high intake of processed foods, refined carbohydrates, sugar and hydrogenated fats; and a low intake of healthy fruits, vegetables and fats. It is this “western diet” that has been associated with most western diseases or diseases of civilization (examples: cardiovascular disease, obesity, diabetes, cancer, Alzheimer, Parkinson). Interestingly, this diet may also be responsible for increased violence and decreased cognitive test scores in school-age children (attention deficit disorder) and adults. Finally, this “western diet” has also been linked to bone loss (osteoporosis) and muscle wasting (sarcopenia) in adult individuals.

Let’s look at an example of a “normal athlete” daily menu before working with me.

Breakfast: Bowl of cereals and milk + Natural orange juice + Coffee with sugar

Snack 1: Mixed toast + Chocolate milk

Lunch: Chicken salad with mayonnaise and ketchup sauce + soda + ice cream

Snack 2: Slice of cake + Juice

Dinner: Grilled fish with vegetables + Baked potatoes + Glass of red wine + Dessert

For most people, this may even be considered a good day (and indeed there are some good things in this menu), but in the long run this type of eating will greatly compromise your health and performance. For this reason, we have to discuss this situation with the person and meet their real physiological and functional needs.

The Habits you must create

Before changing their diet, it is important that people start with a firm and solid foundation, and then make the necessary changes to optimize their health and performance. Most people (athletes included) want to start building a house from the roof down or building walls without paying attention to the quality of the soil. Any of these habits are simple enough, but just like any habit you want to create, it takes time to practice to assimilate the foundations of proper nutrition.

Habit 1 – Drink more water

Sometimes we talk about so much about food and forget about water, the most important element our bodies need to function properly. It is water that regulates all the functions of our body, including the activity of all solutes (the solid materials) dissolved in it. It is water that will actually allow the nutrients we consume to reach our cells and our organs. Aim to consume 1-2 glasses of water after waking up and to drink about 2 liters / day.

Habit 2 – Eat a protein source at every meal

Eating protein at every meal is critical. Of course, some “experts” will make you believe otherwise, suggesting that protein is somehow harmful to the kidneys, unnecessary, etc. However, I want to highlight the fact that what I am looking for my clients / athletes is the best of these three worlds: better health, better body and better performance – it will be very difficult to achieve these three with a suboptimal protein intake. Some examples include: eggs, meat, fish, chicken, turkey and shellfish.

Habit 3 – Eat vegetables at every meal

Your parents and / or grandparents are right – you need to eat vegetables to prevent disease! Evidence has shown that in addition to the micronutrients (vitamins and minerals) contained in vegetables, there are also phytochemicals that are essential for optimal physiological functioning. Vegetables will help improve the acid-base balance in the body, so my advice is eating all the vegetables you can!

Habit 4 – Eat a healthy fat sources at every meal

Fat (such as protein) is an essential macronutrient and so we have to ensure proper intake every day through our diet. There has been a lot of misconception about the effects of fat on diet but the truth is that fat can be our best friend when the goal is to lose fat mass, optimize the body’s physiological response and our health. Some examples of healthy fats include: fatty fish, nuts, seeds, extra virgin olive oil, coconut and avocado.

Habit 5 – Eat more vegetables with main meals and leave the other carbohydrates to the post workout window

Another way of saying this is: if you have fat to lose, you have to earn the right to eat carbohydrates by doing vigorous exercise in the first place! Do you want to keep eating bread, pasta, rice, potatoes, crackers, sugary foods, pizzas, sweets, etc.? You can even eat them – just make sure you do it in the post workout window (1-2 hours after training) because this is the time when your body is most sensitive to insulin. As for the quality of carbohydrates, you will have more benefits if you choose gluten-free foods (rice, quinoa, chestnuts, sweet potatoes, yams, potatoes) than highly processed foods or gluten-free junk foods. Also, don’t use exercise as an excuse to treat your body like the garbage truck!

Good strokes!

Pedro Correia

 

Check Part 1 HERE

What mechanisms underlie the effects of calorie restriction or intermittent fasting on longevity and “age-related diseases”?

But after all what is “getting old” … and why …?

Aging has been characterized by several authors as a process of progressive deterioration of molecular, cellular and tissue structures and functions that is conditioned by genetic and environmental factors (Hu & Liu, 2014). This multifactorial and complex process resulting from this progressive loss of function makes the individual more vulnerable to disease and ultimately leads to death. The main determinants (resulting from genetic predisposition and environmental factors) that characterize the aging process at the cellular level have been identified as: free radical damage; mitochondrial dysfunction results in an accumulation of reactive oxygen species (ROS) and consequent oxidative stress; decrease and inefficiency of autophagy (an evolutionarily conserved process of recycling and “cellular waste removal” that is essential for cellular integrity, more details a bit ahead); changes in hormone-related signaling processes such as type 1 insulin-like growth factor (IGF-1), insulin and growth hormone; change in cholesterol and glucose metabolism; telomere shortening (Testa et al., 2014).

Now it seems that the aging process is indeed multifactorial. Probably the various aging theories (see part 1) are correct! In general, molecular processes are becoming more inefficient, slower and the system is progressively moving towards entropy. However, it seems that knowing the autophagy process (whose decline is associated with aging) may offer a “new” perspective on aging. Autophagy (or “self-digestion”) has been defined as an evolutionarily conserved (normal and important) catabolic process characterized by degradation in the lysosomes (cell organelle that functions as a “litter”) of damaged organelles, “defective” proteins and intracellular pathogens (Lavallard et al., 2012). Autophagy provides macromolecule degradation and recycling, not only providing new nutrients and energy during energy restriction (during calorie restriction or fasting), but also preventing the accumulation of cell metabolism by-products and protein aggregates in the cytoplasm. Therefore, autophagy is a protective and essential process for cellular homeostasis (Rubinsztein, Mariño & Kroemer, 2011) (note: rest assured that autophagy will “eat all the muscles” for a few hours without eating. That simply does not happen!). In fact, several authors have pointed deficient autophagic capacity as an important mediator of cellular senescence and consequent occurrence of “diseases or characteristics of old age” such as cardiovascular and neurodegenerative diseases; oxidative stress; weak immune system; chronic inflammation; osteoporosis; sarcopenia; diabetes; obesity; cancer (Pallauf & Rimbach, 2013; Pyo, Yoo & Jung, 2013). Specifically, reviews of mechanistic animal studies have indicated that loss of function in autophagy-related genes has resulted in intracellular accumulation of defective proteins and organelles and consequently in the acceleration of aging, while promoting autophagic activity increased life expectancy (Yen & Klionsky 2008)

(Note: Autophagy mechanisms have been in the mainstream news since 2016 with the Nobel Prize in Medicine 2016 awarded to the Japanese biologist Yoshinori Ohsumi. Their findings in autophagy mechanisms point in the direction that this cellular cleaning and recycling process is essential to prevent neurodegenerative and other diseases. This is the LINK for the news article).

Overall, and since the first rat studies by Dr. Clive McCay in 1935, calorie restriction has been extensively reviewed and recognized as a “potent” anti-aging strategy! Interventions in various types of animal species (from invertebrates to larger mammals such as primates) have shown that calorie restriction (without malnutrition) not only increases life expectancy (average and maximum), but delays the onset of so-called “age-related diseases ”(Martin, Mattson & Maudsley, 2006; Xiang & He, 2011; Lee & Min, 2013; Kitada & Koya, 2013b; Szafranski & Mekhail, 2014; Testa et al., 2014). The intermittent fasting regime (nothing more than another calorie restriction strategy as described in part 1 of this article) seems to offer the same kind of benefits (Martin, Mattson, & Maudsley, 2006; Robertson & Mitchell 2013).

Now the mechanisms by which calorie restriction or fasting induce health benefits appear to be (to a large extent) related to this antagonistic relationship between insulin signaling and autophagy. It is easy to understand, being autophagy a catabolic process (essential, normal and protective, I highlight that again) and the activation of insulin signaling pathways an anabolic process (equally important and essential in protein synthesis, insulin is not the “villain”), when one of these pathways is activated the other will be inhibited. Practically speaking, fasting activates the autophagy “machinery” and eating a meal (mainly containing protein and / or carbohydrates) activates the insulin signaling “machinery”. What seems to be essential is in fact that there are periods that allow the process of elimination and recycling provided by autophagy, and for this to happen it is necessary not to eat for a while. If there is no “room” for this process, due to constant food intake, it may lead to constant and “aberrant” insulin signaling state which may lead to many diseases that are usually associated with poor glucose and insulin metabolism which make the most of the so-called “age diseases”.

(Warning: the “less nerds“ should skip next paragraph)

Briefly, some of the mechanisms identified in animal studies that appear to underlie the health benefits induced by caloric restriction or intermittent fasting through regulation of autophagy and insulin pathway signaling are: 1) Inhibition of insulin / IGF-1signaling (due to the decrease in circulating amino acids and glucose) and its target pathways protein kinase B (PKB) / mammalian target of rapamycin (mTOR) ; 2) Activation of the sirtuin 1 pathway (SIRT1) due to the increase in NAD + / NADH ratio, which targets include activation of adenosine monophosphate protein kinase (AMPK), forkhead box O (FOXO) transcription factors, proliferator- activated gamma receptor-1-alpha coactivator (PGC-1α) (a mitochondrial biogenesis factor), and inhibition of the pro-inflammatory transcription factor NFkB; 3) Activation of the AMPK pathway due to the intracellular increase of the AMP / ATP ratio, which in turn induces up-regulation of FOXO and PGC-1α transcription factors and inhibition of the PKB / mTOR pathway. (Martin, Mattson & Maudsley, 2006; Han & Ren 2010; Rubinsztein, Mariño & Kroemer, 2011; Yen & Klionsky, 2008; Xiang & He, 2011; Pallauf, & Rimbach, 2013; Pyo, Yoo, & Jung, 2013; Hu & Liu, 2014; Szafranski & Mekhail, 2014; Amigo & Kowaltowski, 2014; Testa, G. et al., 2014; Madeo et al., 2015).

In humans, despite the smaller abundance of randomized controlled trials (for the reasons mentioned in Part 1 of this article), several reviews of intervention and observational studies (Yen & Klionsky, 2008; Marzetti, E. et al., 2009; Han & Ren 2010; Robertson & Mitchell, 2013; Testa et al., 2013; Madeo et al., 2015; Fan et al., 2016) indicate that the putative health benefits induced by calorie restriction or intermittent fasting are based on the same mechanisms related to insulin pathway signaling and regulation of autophagy. Some pointed benefits include: longer healthy longevity; better lipid profile; controlled blood pressure; optimization of diastolic and systolic function; better homeostatic control of insulin and glucose; better sensitivity to insulin and glucose; lower incidence of neurodegenerative diseases; lower adiposity; better mitochondrial biogenesis in the skeletal muscle; higher antioxidant capacity; lower levels of ROS and oxidative stress.

Can Calorie Restriction / Intermittent Fasting (CR / IF) alleviate age-related disease by regulating “aberrant” insulin signaling and autophagy?

In conclusion, the effect of caloric restriction or intermittent fasting on the regulation of insulin signaling and autophagy seems to emerge as a central regulatory axis that deserves attention (at least from me).

In the third part of this article I will then discuss what may be practical implications and applications of calorie restriction or fasting. Should we all do calorie restriction? Permanently? For how long? How much? What stage of life? Under what health conditions? Is the “intermittency” factor that delivers the best benefits?

Stay around!

Nuno Correia

References:

Amigo, I. & Kowaltowski, A.J., 2014. Dietary restriction in cerebral bioenergetics and redox state. Redox Biology, 2(1), pp.293–304.

Dröge W., 2009. Avoiding the First Cause of Death. New York, Bloomington. iUniverse, Inc.

Fan, J. et al., 2016. Autophagy as a Potential Target for Sarcopenia. Journal of Cellular Physiology, 231(7), pp.1450–1459. [Epub 2015 Dec 10].

Han, X. & Ren, J., 2010. Caloric restriction and heart function: is there a sensible link? Acta pharmacologica Sinica, 31(9), pp.1111–1117.

Hu, F. & Liu, F., 2014. Targeting tissue-specific metabolic signaling pathways in aging: the promise and limitations. Protein & cell, 5(1), pp.21–35.

Lavallard, V.J. et al., 2012. Autophagy, signaling and obesity. Pharmacological Research, 66(6), pp.513–525.

Lee, S.-H. & Min, K.-J., 2013. Caloric restriction and its mimetics. BMB reports, 46(4), pp.181–7.

Lee, S.-H. & Min, K.-J., 2013. Caloric restriction and its mimetics. BMB reports, 46(4), pp.181–7.

Lindeberg, S., 2010. Food and Western Disease: Health and Nutrition from an Evolutionary Perspective. Oxford, United Kingdom: Wiley-Blackwell.

Madeo, F. et al., 2015. Essential role for autophagy in life span extension. Journal of Clinical Investigation, 125(1), pp.85–93.

Martin, B., Mattson, M.P. & Maudsley, S., 2006. Caloric restriction and intermittent fasting: two potential diets for successful brain aging. Ageing research reviews, 5(3), pp.332–53.

Masoro.E. L., 2002. Caloric Restriction: A Key to Understanding and Modulating Aging. Texas, USA: ELSEVIER.

Pyo, J.O., Yoo, S.M. & Jung, Y.K., 2013. The interplay between autophagy and aging. Diabetes and Metabolism Journal, 37(5), pp.333–339.

Robertson, L.T. & Mitchell, J.R., 2013. Benefits of short-term dietary restriction in mammals. Experimental gerontology, 48(10), pp.1043–8.

Rubinsztein, D.C., Mariño, G. & Kroemer, G., 2011. Autophagy and aging. Cell, 146(5), pp.682–695.

Rubinsztein, D.C., Mariño, G. & Kroemer, G., 2011. Autophagy and aging. Cell, 146(5), pp.682–695.

Szafranski, K. & Mekhail, K., 2014. The fine line between lifespan extension and shortening in response to caloric restriction. Nucleus, 5(1), pp.56–65.

Testa, G. et al., 2014. Calorie restriction and dietary restriction mimetics: a strategy for improving healthy aging and longevity. Current pharmaceutical design, 20(18), pp.2950–77.

Xiang, L. & He, G., 2011. Caloric restriction and antiaging effects. Annals of Nutrition and Metabolism, 58(1), pp.42–48.

Yen, W.-L. & Klionsky, D.J., 2008. How to live long and prosper: autophagy, mitochondria, and aging. Physiology (Bethesda, Md.), 23(70), pp.248–262.

CAN CALORIE RESTRICTION OR INTERMITTENT FASTING HELP PREVENT “AGE-RELATED DISEASES” AND LIVE LONGER? – PART 1

 

Introduction

In this article I will look into the possibility of calorie restriction or intermittent fasting, which is just an alternative strategy to induce a caloric deficit, effective nutritional therapeutic strategies to prevent, alleviate or even eliminate some of the so-called “age-related diseases”, thus contributing for a better and longer life. It is important to note that most studies on the effects of calorie restriction or intermittent fasting (or intermittent calorie restriction) on life expectancy are mechanistic, and conducted in animal and / or in vitro models. It is understandable that there are fewer human intervention studies in this area. If we think about it, it is not easy to conduct studies with humans on calorie restriction to study its effects on life expectancy and the incidence of “age-related diseases”. Not only it is not easy to recruit people to voluntarily incur in a calorie restriction period, it is also not practical to study in humans (in a randomized controlled manner) the effects of calorie restriction or fasting on life expectancy, because they simply “live a long time”. ” In order to obtain timely results, it is essential to conduct studies on species with a shorter life expectancy. However, observational studies and some human intervention studies (discussed later) appear to confirm the same health benefits and molecular mechanisms as those observed in animals.

It should also be noted that, in the experimental context, caloric restriction is defined as “reduced food intake without malnutrition”. In other words, nutritional interventions imply a 10-40% reduction in daily caloric requirements in which only calories, and not nutrients, are restricted (in most controlled studies this is ensured with vitamin and mineral supplementation) (Kitada & Koya, 2013b; Robertson & Mitchell, 2013). This notion is important! Caloric deficit does not imply nutrient deficit and caloric surplus does not imply that nutrient requirements are met. Intermittent fasting will be no more than an alternative method of calorie restriction in which food intake is restricted for a certain period of time (usually 16 to 24 hours) followed by an unrestricted intake period and has been touted as producing beneficial health effects similar to more constant calorie restriction protocols (Martin, Mattson, & Maudsley, 2006; Robertson & Mitchell 2013).

Part 1
Should we accept being “sick” just because we get older?

It is recurrent to hear that the disease is something that “comes with the age package.” In fact, getting older is a drag! The general perception of a progressive decline of all our capabilities as we age is, unfortunately, not an illusion. There are several theories about aging. While certainly a very interesting topic, a detailed description of the various theories of aging is not the purpose of this article. These are some of mechanisms underlying the aging process which are generally pointed out as the main ones:

  • The “Hayflick limit” (phenomenon discovered by Leonard Hayflick) determines that human cells have a replication limit number, after which they become senescent. Telomeres (i.e. a kind of protective “helmets” at the end of each chromosome) become progressively shorter with each cell division (Shay & Wright 2000). However, DNA methylation (an essential and repairing process consisting of the addition of methyl groups to DNA and which can be promoted by the abundance of dietary methyl donors for example) is said to be protective of telomere length and that way to postpone cell death and aging. For example, in animal models, hypomethylation of the enzyme telomerase reverse trancriptase has led to the preservation of leukocyte telomere length (Zhang et al. 2003; 2014). In this example, it is plausible to infer that delaying leukocyte senescence (through methylation and consequent telomere length conservation) may contribute to a stronger immune system and thus positively influence longevity.
  • This theory suggests that unresolved chronic inflammation induces the human organism not to allocate resources for the functioning of other body functions (as they are permanently allocated to unresolved inflammation) and thus leading to early aging of various organs and tissues, and the early onset of “age-related diseases”.
  • This theory, originally proposed by Dr. Denham Harman in 1956, is based on the premise that the aging process is mediated by free radical damage. Theoretically, by reducing free radical accumulation (e.g. reactive oxygen species) and at the same time increasing the antioxidant capacity of the organism (increasing glutathione, and antioxidant enzymes such as SOD and catalase), tissue damage can be prevented (by slowing down aging process) and to prevent the occurrence of “age-related diseases” and consequently contribute to increase functional longevity (Harman, 1988; 2006).

Very well, getting older is inevitable! We already know that. However, if we give it a little thought, all the mechanisms mentioned have an environmental root, that is, we can, to some extent, control them through decisions that we make every day. Namely decisions about what we eat and how we move. And this is good news! It is in fact in our hands to slow down the process of senescence and prevent the onset of the so-called ‘’age-related diseases’’. Note that if for us (Westernized world) it is statistically “normal” to grow old with diabetes, hypertension, cancer, dementia, sarcopenia, osteoporosis, cardiovascular disease, insulin resistance, obesity and chronic inflammation (because the population studied incurs in a lifestyle that leads to disease), in other contemporary (non-Westernized) populations such diseases are rare or even non-existent. In this context, I invite the reader to consult what I consider to be one of the best books I know about nutrition and lifestyle, and its relation to the incidence of so-called “Western” diseases: Food and Western Disease: Health and Nutrition from an Evolutionary Perspective by Staffan Lindeberg. In fact, if we want to aim at maximizing health and lifespan potential, we should not just look at what is ‘’normal’’ in a given population, because that may be a sick population. Rather, we should look for what is “biologically normal” for a human being! A species that is designed (evolutionarily) to deal with a range of environmental stimuli that include certain levels of physical activity, nutrition, sun exposure and sleep. And, although aging is a normal process, it should not be “biologically normal” to age with chronic disease.

In this context, the Okinawa Centenarian Study is also frequently cited. The Okinawan population has the highest ratio of (healthy) centenarians on the planet (50 / 100,000 vs 10-20 / 100,000 in the USA) and as such is of greatest interest to study the factors that potentiate this kind of longevity. One of the factors identified (in addition to an appreciable level of physical activity and social interaction) was the fact that populations over 70 eat about 11% of calories below (about 1785kcal / day, which is a very moderate level of calorie restriction) than would be recommended for maintaining body weight (according to the Harris-Benedict equation), however on a nutrient-rich diet (Wilcox et al., 2006).

*Okinawan residents expected to have the highest ratio of centenarians worldwide with 50 / 100,000.

What we can do to live longer and better is one of my main interests. As I mentioned, our choices regarding the type of exercise, food we eat and other lifestyle factors can affect how long we live and, perhaps most importantly, how healthy and functional we live. In Part 2 of this article I will discuss some mechanisms by which nutritional interventions such as calorie restriction or intermittent fasting can lead to health benefits. And in Part 3 I will address the possible implications and practical applications of the practice of calorie restriction or fasting, as well as which populations can benefit most from these nutritional strategies and whoshould avoid them.

Stay around!

Nuno Correia

References

Dröge W., 2009. Avoiding the First Cause of Death. New York, Bloomington. iUniverse, Inc.

Harman D., 1988. Free radicals in aging. Mol Cell Biochem. Dec; 84(2), pp.155-161.

Harman D., 2006. Free radical theory of aging: an update: increasing the functional life span. Ann N Y Acad Sci. May;1067, pp.10-21.

Kitada, M. & Koya, D., 2013b. SIRT1 in Type 2 Diabetes: Mechanisms and Therapeutic Potential. Diabetes & metabolism journal, 37(5), pp.315–25.

Lindeberg, S., 2010. Food and Western Disease: Health and Nutrition from an Evolutionary Perspective. Oxford, United Kingdom: Wiley-Blackwell.

Martin, B., Mattson, M.P. & Maudsley, S., 2006. Caloric restriction and intermittent fasting: two potential diets for successful brain aging. Ageing research reviews, 5(3), pp.332–53.

Masoro.E. L., 2002. Caloric Restriction: A Key to Understanding and Modulating Aging. Texas, USA: ELSEVIER.

Robertson, L.T. & Mitchell, J.R., 2013. Benefits of short-term dietary restriction in mammals. Experimental gerontology, 48(10), pp.1043–8.

Shay J.W., Wright W.E. 2000. Hayflick, his limit, and cellular ageing. Nat Rev Mol Cell Biol. Oct;1(1), pp.72-76.

Zhang D. et al., 2013. Homocysteine-related hTERT DNA demethylation contributes to shortened leukocyte telomere length in atherosclerosis. Atherosclerosis. Nov; 231(1), pp.173-179.

Zhang D.H., Wen X.M., Zhang L. & Cui W., 2014. DNA methylation of human telomerase reverse transcriptase associated with leukocyte telomere length shortening in hyperhomocysteinemia-type hypertension in humans and in a rat model. Circ J. 78(8), pp.1915-1923.

Wilcox D.C. et al., 2006. Caloric restriction and human longevity: what can we learn from the Okinawans? Biogerontology  7, pp.173–177.

 

If you still exercise to “burn calories,” you have not yet realized the purpose of a physical training program and the importance that movement has in our lives. The least important thing about exercise is the number of calories you burn! And that’s what I’ll try to explain in this article.

The power of exercise goes far beyond calorie burning, caloric expenditure is just a (nice) side effect of the type of exercise we do. Exercise consists of potentiating the release of powerful molecules and hormones that “talk” to our body’s organs (it’s not just food that has this kind of influence), and that determines what’s going to happen. And usually, the higher the intensity, the more beneficial the hormonal response.

Therefore, a well-designed physical training program has more to do with increasing energy levels, movement precision, vigor, muscular strength, mobility, agility, speed, work capacity and with an improved hormonal profile.

The Calorie Fever

I still see a lot of people worried about the calories in their food, the calories they burn when they exercise, the calories they consume each day, and I ask: How did we get here? What kind of message is being propagated that made people so obsessed with calories? Is calorie counting that important? Let’s see.

In order to discover the amount of energy in food, scientists burn food samples in a bomb calorimeter. And, to my knowledge, a bomb calorimeter does not share the same physiology and genetic makeup as a human being. As far as I know, a bomb calorimeter does not depend on the functioning of the various systems in the human body which are the real players in the way energy is absorbed and used (examples: digestive, endocrine and nervous system). This way of thinking is most likely unsustainable and ineffective long-term. This way of thinking is too reductive and does not solve the main problem – people’s lack of education regarding the importance of what we eat throughout our lives. Is it just me who finds it strange that most people are more concerned about their cell phones, cars and computers than with the origin and composition of the food they eat?

In fact, just look around and you’ll acknowledge that this is not the path to follow!

It is true that if we have the goal of losing fat mass, we must create an energy deficit, that is, the balance between the amount of calories (energy) entering our body and the amount of energy (calories) burned, must be negative. That’s the number one rule in rigid weight loss programs and that’s why we see Biggest Loser contestants training several times a day.

(Note: I should remind you that the Biggest Loser is a contest in which the goal is to lose weight in the shortest time possible, it’s not a contest to see who gets out of there healthier – if this was the goal probably there was no audience).

However, there is a lot more to be said. There are good calories and bad calories. The foods we eat, besides having a certain number of calories (which can be very difficult to determine with accuracy and can be highly variable), also have different properties with respect to their composition of macronutrients (protein, fat, carbohydrates) and micronutrients (minerals, vitamins, phytochemicals). These bioactive properties and compounds are what makes the difference and what should be studied preferentially. In my way of looking at things, it is more logical to first check the functionality of food (i.e. how its nutrients work) and then look at its caloric density, which can also be more or less functional depending on the objectives, morphology and specific conditions of each individual.

(Note: If you still think low fat diets are the most suitable for weight loss check the following study published in 2003 in the New England Journal of Medicine here, where it was shown that people on a high-fat diet lost more weight as those on a low-fat diet, the diet generally recommended by leading health organizations. But, of course, adherence to the diet will be the most important factor).

Back to calories…

Because the absorption of these nutrients will depend on the functioning of our digestive system – which in turn is governed by the endocrine system (think of hormones) and the nervous system (think of neurotransmitters) – and the health of the organs involved in the digestion process (mouth, esophagus, stomach, pancreas, small intestine, large intestine, liver, gallbladder), it becomes easy to understand that the web of relationships in the human body is much more complex than simple calorie counting. Albert Einstein has a quote that fits perfectly here: “make everything as simple as possible, but not simpler.”

The Power of Exercise

Anyone that is minimally informed about exercise already knows that long distance aerobic training is not the best choice for improving body composition and may even have opposite effects (catabolic effects) due to the pronounced increase in cortisol levels.

This has been known for a long time but it’s always important to remember. This study published by Tremblay, Simoneau and Bouchard in 1994, showed that the group that did 15 weeks of interval training burned NINE TIMES more fat than the group that did aerobic training. And this was in half of the time period!

What you need to “burn calories” is to increase the intensity of your workouts for certain periods of time, it’s this type of stimulus that will increase your metabolism and accelerate fat loss. In this study, a 30-minute training session of metabolic resistance training caused a 38-hour increase in metabolism – the famous afterburn effect or EPOC (post-exercise oxygen consumption). Let’s put this into perspective. Let’s say you trained this way on Friday morning. With this training method your body will still be in a “fat burning” mode on Saturday night, when you’re having dinner with your friends or with your boyfriend / girlfriend.

And why do I insist on combining a good diet with good training? Because I’m aware of the evidence on this topic. This study  from 1999 showed that those who did aerobic training and strength training on a low calorie diet burned 44% more fat than those who merely followed dietary guidelines. As I’ve been saying, diet is the most important component for those people who want to lose fat, however, once that aspect is assured, only strength training and interval training can actually bring your results to a higher level. In my opinion, the fact that this study was based on a low-calorie diet combined with aerobic training is limiting, but we have to bear in mind that these are usually the guidelines of the American College of Sports Medicine (ACSM). The guidelines are intended to facilitate nutritional guidance offered by practitioners, but unfortunately that is not what I have observed when I discuss these issues with some colleagues.

I think you have already realized that the type of training you do can be a great ally to put your body in an energy deficit and consequently in fat burning status. Now I will try to explain why this is the least important of all. Stay with me!

Like nutrition, physical exercise is key to improve health, performance and body composition. You’re probably tired of hearing this. But it’s not any kind of physical exercise that works. Doing hundreds of crunches to lose belly fat, using all the gym machinery, running 10 miles a day, doing Pilates twice a week and doing 100 power cleans in the shortest time possible is not enough. You can call it physical exercise if you want, but it’s not just this kind of physical exercise our body needs. A more comprehensive approach is needed.

We need Good Movement (we shouldn’t start running in the first place)

The concept of “move more for your health” is insufficient for our real needs and to improve quality of life. We need good movement, we need to acquire movement competency in the first place. I am talking about the ability to perform fundamental movements with good form. Fundamental movement patterns such as squatting, hinging, pushing, pulling, throwing, carrying, walking, running and jumping.

 

 

From my point of view, running should be the last step in this process and yet what we most frequently see is people running all crooked and with an obvious deficit in muscle strength. But the problem is not theirs, they are trying to do something for their health (and probably that’s all they know), the problem is that most of them are not aware that running is a skill, which requires preparation, practice and training. Cristiano Ronaldo did not become the best player in the World over night, it took many hours of training (in the field and in the gym) to reach this level. Although it’s relatively easy and affordable for anyone to put on their shoes and just go out for a run, running also requires preparation, practice and training (technical and physical).

It is necessary to have stability, mobility, strength (every step we take on the ground is subject to the action of gravity and the speed we run, generating reaction forces of 2 to 5 times our body weight), symmetry, quality of movement and good musculoskeletal health. Running to get healthy or fit is one of the greatest physical distresses on our body if we don’t have a solid foundation. First, you need to be in good shape to run. If you don’t hone good movement skills, you are more likely to get injured. According to the available literature, the incidence rate of injury in runners may exceed 90%, this is more than any other sport. Plantar fasciitis, stress fractures, patellar tendonitis and patellofemoral pain are just a few examples. Check this systematic review if you’re interested in learning more.

Again, don’t get me wrong, I’m not anti-running and I admire the effort and suffering capacity of all runners. I think we should all be able to run (by the way, that’s how we evolved as a species), the problem is that most people who run are not properly prepared to run and there are fundamental learning steps that should not be overlooked in order to prevent structural imbalances in the musculoskeletal system and injuries. Cleary the simplistic idea of “move more” is not enough.

A new way to look at training

Different types of training can affect the way our genes work and how they interact with our cells. With good training it’s possible to decrease chronic inflammation, improve insulin sensitivity, strengthen the cardiovascular system, improve lipid profile, slow down normal aging, burn fat (as we’ve seen in more detail above), increase confidence and self-esteem, increase energy levels, increase mental strength, improve a number of physical skills that we need for our daily life activities or sports practice (such as strength, stability, mobility, balance, speed, agility) and our different energy systems (ATP-CP, glycolytic, and oxidative). As we age, these skills naturally decline, but the fact is that with a more comprehensive training program it is possible to reverse and / or at least mitigate this decline.

Most people think that genes are the brain of the cell, they believe that if genes don’t tell you what to do, the cell dies. But if you remove the genes from the cell, the cell is still alive, eliminating waste products and behaving just like another cell. So, instead of genes being the brain of the cell, think of genes as your instruction / repair manual. When a worn part of the cell needs to be repaired or when new substances need to be produced, genes will give instructions for doing so.

Every cell in our body is surrounded by a fatty membrane, which is filled with thousands of receptors. These receptors receive information from different parts of the body and pass this information into the cell to form / encode new proteins, burn more or less fat, etc. (Note: this is why it’s important to eat good fats and avoid the hydrogenated fats present in most processed foods so that the cell membrane is more permeable to nutrient delivery.) It’s this membrane with receptors the cell command center so if we remove these membrane receptors, the cells die. This means that cell function is highly influenced by external factors, namely through hormones and other molecules that bind to these receptors.

These messenger molecules are not randomly created by our body, they are created according to our lifestyle, diet, thoughts, behaviors, temperature, light, sound and… our type of training. It’s possible to be born with some defective genes – for example BRCA 1 and BRCA 2, which increase the risk for breast cancer – but it’s these messenger molecules / hormones that will determine the degree of activation of these genes. Therefore, controlling these hormones means controlling the body.

(Note: Don’t you find it strange that almost 90% of health care costs is related to treat health conditions, while 80% of health problems / diseases arise as a consequence of our lifestyle and the environment we’re exposed to? Check this TED talk from Dan Buettner to realize why we are walking in the wrong direction).

High-intensity exercise is the one that induces a more favorable hormonal environment, with an increase in hormones such as testosterone, growth hormone and IGF-1, interleukins with an important role in inflammation (IL-6), muscle tissue maintenance (IL-15) and growing of new blood vessels (IL-8), lactic acid (which has the ability to keep us young by stimulating the release of testosterone and growth hormone) and nitric oxide, a vasodilator which plays a key role in regulating blood pressure, muscle strength and erectile dysfunction. Unfortunately, long running does not produce the same effects. Compound movements, which require a combination of strength and stamina, in short periods of time, are those that will put your muscles to “talk” more with your body. Burning calories is only a minor side effect when compared to the amount of hormones and other signaling molecules that influence how our body works.

To be clear, we are talking about intensity coupled with movement quality. Intensity coupled with bad movement will have the opposite effect: INJURY.

Conclusion

It’s urgent to give rise to a new mentality on training the movement skills that we will need throughout our lives. And this is a serious limitation of most group classes in conventional gyms. The instructors are obliged to follow a certain beat and choreography. Individualized feedback is almost non-existent. People don’t have time to understand or to learn the movements. And no one learns anything if they don’t know what it’s for, no one learns anything if they don’t understand how it’s supposed to feel and its practical implications. In addition, most machines in gyms annihilate the sensory and body perception that we, humans, need. We live in a three-dimensional world, in a world of constant adaptation and spatial exploration, so it makes no sense that machines and choreographies of group classes dictate the rules of our movement.

And why is it important to learn efficient movements? First, an efficient movement happens when a body is able to produce force through a coordinated action between the various body segments without energy leaks and demonstrating a natural ability to exploit maximum range of motion. Second, it’s movement that will allow you to play more time with your children, change the furniture at home, improve your day-to-day performance and your performance in your recreational activities.

Look at this type of training as the foundation, the support you need to get stronger, faster, smarter, more agile, more competent in a series of physical attributes that will allow you to perform better in the activities you enjoy doing. Would you like to start playing tennis? golf? volleyball? Would you like to start surfing? paddle board? weightlifting? powerlifting? dance? climbing? triathlon? Would you like to be faster when you play football with your friends during on weekends? Obviously, each modality has its specific abilities, but they all share the same foundation: human being’s adaptability capacity. To improve these specific skills safely, you first need to improve your fundamental movement patterns. And to sustainably keep improving these fundamental movement patterns, you need to train better and respect the developmental stages of each one.

To sum up, the great advantage of better training (and I remind you what we learned about the power of exercise, good movement and a new way of looking at training) is to improve your quality of life, maximize your performance and, above all, giving you the freedom and autonomy to choose the activity / sport that you always wanted to try but never had the courage or opportunity to start off.

Think about these things next time you go to the gym to walk on the treadmill with your headphones on and watch some TV series for 40 minutes while looking at the calories burned on the monitor and at the workouts or exercises other people are doing.

See you soon!

Pedro Correia

References

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Gary D. Foster, Ph.D., Holly R. Wyatt, M.D., James O. Hill, Ph.D., Brian G. McGuckin, Ed.M., Carrie Brill, B.S., B. Selma Mohammed, M.D., Ph.D., Philippe O. Szapary, M.D., Daniel J. Rader, M.D., Joel S. Edman, D.Sc., and Samuel Klein, M.D. A Randomized Trial of a Low-Carbohydrate Diet for Obesity. N Engl J Med 2003; 348:2082-2090.

Houston, M. What your doctor may not tell you about Heart Disease. Grand Central Life & Style (2012).

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Influence of exercise training on physiological and performance changes with weight loss in men. Med Sci Sports Exerc. 1999 Sep;31(9):1320-9.

Schuenke MD, Mikat RP, McBride JM. Effect of an acute period of resistance exercise on excess post-exercise oxygen consumption: implications for body mass management. Eur J Appl Physiol. 2002 Mar;86(5):411-7. Epub 2002 Jan 29.

Tremblay A, Simoneau JA, Bouchard C. Impact of exercise intensity on body fatness and skeletal muscle metabolism. Metabolism. 1994 Jul;43(7):814-8.

van Gent RN, Siem D, van Middelkoop M, et al Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review British Journal of Sports Medicine 2007;41:469-480.