Random Thoughts from a Restless Mind

Dr. Darrell White's Personal Blog

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Posts Tagged ‘fitness’

Sunday musings 8/26/18

Sunday musings…

1) Vicissitude. Fancy word for weather, especially if you need a particular weather pattern at any given moment.

2)) Hero. To be a hero one typically demonstrates courage in the face of personal danger, usually involving the selfless decision to put others before self. As a young man I find it hard to argue that this doesn’t describe John McCain. One could certainly disagree with the positions Mr. McCain took as a politician in the second phase of his life, but one would be hard pressed to argue that he hadn’t done enough in the service of his country over 60 some years.

RIP John McClain. Citizen. Patriot. Hero.

3) Health. CrossFit, Inc. has pivoted. Some among you will rejoice, for the direction that appears to be taken is in line with your own philosophy and goals. Those here who revel in the challenge of elite fitness will no doubt feel that this is a betrayal, a clear step backwards and toward mediocracy. I have a few friends who remain employed at CF, Inc. and they would doubtless like to hear me speak out in favor of this evolution. At the same time there are a few friends who are quite dear to me who would much rather I simply declare my days living in CF nation over and move on. CrossFit in all of its iterations has changed, and so, too, have I.

For many years I have written around this time of the year, just after the completion of the Games, about the peculiar and poorly understood triad that has comprised what we all know as “CrossFit”. It is a business, CrossFit, Inc., one that has as its charge the necessity to be self-perpetuating and to provide for the financial well-being of its owners. This should be self-evident, but over the years commentary has often come up that seeks to present CrossFit the business as some kind of public good. It is not, nor has it ever been. CrossFit, Inc. has succeeded over the years as a business, and in so doing it has made decisions that outsiders have both lauded and loathed. For many, how they interact with the company we call CrossFit is determined by who has been affected by these decisions and how. A pivot has occurred; you and I did not have a vote. CrossFit, Inc. will likely continue to prosper.

Second among the three traditional pillars of CrossFit is the Sport of Fitness. With the possible exception of aerobics competitions in the Denny Terrio age (the spandex!) and that old ABC series The Superstars (O.J. in a boat!), CrossFit likely deserved wears the mantle of the founders of fitness competition. Beginning with a friendly barbecue and leading up to a multi-day tiered competition shown on live network TV, there is no doubt that fitness competition is now here to stay. Early announcements suggest that the pivot will dramatically lower the direct involvement of CF in the competition season, but that CF will have the ultimate say at the highest level. No one you or I talk to has any real idea what this means, and supposition along those lines is wasted effort until we are all told exactly what CF has in mind by CF. The CrossFit Games have changed often over the years and they have changed again. Full stop.

Where most of us come in contact with CrossFit is in the third priority: fitness as a conduit to health. It surely seemed as if this was the least important of the three parts of CrossFit, at least until this past week, but it has always comprised the massively overwhelming majority of participants. Whether on CrossFit.com or in a local affiliate, almost everyone fell under this category;  most of those who thought they were part of the Sport of Fitness were fooling themselves at their own risk. With the creation of a CrossFit health movement and an L1 program for CrossFitting physicians, CrossFit, Inc. appears to be signaling that its public face will now be directed here. Note that I say “appears” because I am no more in the know about this than you or anyone else.

This is a good thing.  To de-emphasize the competitive aspects of CF is to re-emphasize the health aspects of CF that were outlined in “What is Fitness” in CFJ #2, the seminal thesis that brought so many of us here in the first place. I wish we could all go back and look at the threads on the old Message Board, 95% of which had to do with getting healthy. How will this affect the kind of CrossFit we see coming from CFHQ? Again, who knows. CVFMAHI has undergone countless lines of evolution outside of the direct umbrella of CrossFit. Individual trainers have gone out on their own and modified CrossFit in ways that reflect what they learned training people themselves (think James Fitzgerald, once known as OPT).  Entire movements with companies attached have been launched to provide clients with what they feel is a better way. A perfect example of this is The Brand X Method and the Martin family who are without a doubt the world leaders in youth fitness. Who will be right? Who will thrive?

Who knows?

In the end the entire conversation has changed over the last 10 years, and more people are sitting at the fitness table than ever. The line between healthcare and fitness continues to be a bright dividing line. Barriers continue to exist between the fitness world and both public health and public education. Will this pivot at CrossFit, Inc. start to blur those lines, or at least build bridges across them? Will we see some other organization, perhaps one that began within the CrossFit universe but now exists as a separate, growing galaxy like Brand X share the load or even take the lead?

The only constant in CrossFit in the years that I’ve been here is change. Change brings with it opportunity. My prediction: this turns out pretty well for CrossFit. The fitness world is much, much bigger than it was 10 years ago. One would do well to listen very carefully when CrossFit directly addresses this pivot publicly. This will also turn our pretty well for people who may have been part of the CrossFit world but are no longer associated with any of the 3 parts of CrossFit outlined above. One would also be well-advised to closely watch the direction taken by the Martins and others in the fitness world as well. There will be many benefits that come from that one, big original idea. They will come from many places.

After all the Theory of Relativity was simply the on ramp to what we now know as Quantum Physics. The highway of fitness progress is now fed by a growing number of on ramps that come from many directions.

I’ll see you next week…

–bingo

DNA Always Wins

DNA always wins.

In the fitness world, and sometimes even at that tiny intersection where fitness and health or healthcare cross paths, there is a recurring theme: you can’t out-train a bad diet. For whatever it’s worth, I think that’s true. Having said so there is a dangling little assumption that hangs off the back end of our axiom, that if you are fit and follow an evidence-based nutrition program that you will inevitably be healthy. Indeed, every worthwhile fitness program I’ve ever encountered pretty much says just that. “Fitness in 100 Words” on CrossFit.com was my first exposure to this as a mission statement. Loads of folks from the substantive (The Brand X Method) to the frivolous (The Biggest Loser) support this logic as the foundation of health-based fitness. For the most part it is true, and for most people the combination of general physical fitness and solid nutritional strategy results in health.

Except, you know, the whole Jim Fixx thing.

For all of you puppies and kittens out there Jim Fixx was the original running guru in the United States, the author of The Joy Of Running. You could make a case that only the late, great Jack Lalanne was a more influential historical figure when it comes to promoting health through exercise in the U.S. Jim Fixx was responsible for the surge in interest in running as both exercise and as sport, and his writing launched an era in which U.S. runners were competitive on the international stage in ALL distances from the mile all the way to the marathon.

As it turns out Jim Fixx may also be the single most influential non-medical individual in the history of the cholesterol theory of heart disease. You see, Fixx had hereditary hyperlipidemia. Despite his epic running history he was found one day in his running shorts at the side of the road, dead from a massive heart attack. Blood work at the time of his autopsy revealed a cholesterol of 750 or something like that, as well as other elevated serum lipids. His healthy diet, his outsized VO2 Max, and his prodigious training schedule were no match for his DNA. He died with epic fitness numbers, a single-digit bodyweight fat %, and coronary arteries that were so clogged red blood cells had to pass single-file. You can trace many of the USDA dietary guidelines and literally billions of dollars in research to the death of Jim Fixx.

Why bring up Jim Fixx now, in 2018, when we know that hyperlipidemia is a significant part of the cardiac risk story, albeit not the whole story? Well, we should harken back to the beginning of my thoughts: DNA always wins. While you can reduce your health risks by adopting a healthy, evidence-based diet and couple that with an exercise program that produces a comprehensive degree of fitness, you cannot escape genetics. Why at this particular moment? Yours truly just got all of his lab work back and despite 13+ years of a clean Zone diet and varying degrees of devotion to functional fitness, most of my serum lipid numbers have continued on their ever-upward march and have now reached a level where they simply must be addressed by modern medicine.

To do else wise would be madness.

I must confess that this is deeply disappointing. Quite frankly it feels like failure. At 58 I am relatively lean and strong, albeit a bit under-trained in the aerobic domain. Why didn’t this inoculate me from the need to take medication to lower my LDL? In the last couple of days I have chatted with my docs locally (both of whom are close friends who care about me) as well as really significant, nationally recognized experts in the science of health and cardiac risk mitigation. There is a consensus; nay, the voting was unanimous across the board. Don’t be stupid. Continue my program of fitness and nutrition and take the meds. We’ve now moved on the the minutia of choosing which one, a not-trivial discussion to be sure, but one that is less than earth-moving, you know?

Some years ago while proposing a unified theory of health on my personal blog I received an advance copy of Coach Greg Glassman’s definition: if fitness is WCABTMD then health is Fitness Over Time. As a physician and scientist I readily saw the value of this concept. However, I also saw and pointed out the deficiencies inherent in such a narrow definition. For example, any definition of health must explicitly address mental health. Over the years I have championed the term “well-being” and have suggested several metrics that can be used to measure this state of mental and emotional health. Mind you, I was openly mocked at the time for this, here and elsewhere. If you have followed the conversation in the CrossFit world since you will see an evolution of thought along this line, though. “Well-being” has been openly discussed in various ways as an integral part of health in most medical, health, and fitness communities. I like to think I played a small role in that.

I wrote before, then, and subsequently over the years that any definition of health must be more than a snapshot of how “healthy” you may be at any given moment. You may have a 2.5X body weight deadlift and squat, run a sub 5:00 mile and do “Fran” in under 3:00, but can you truly be declared “healthy” if you also harbor a malignant tumor in your gut or are running around with an LDL of 175? Like it or not, any comprehensive definition of health must be able to provide some degree of probability that you will remain healthy in the future. It must have some predictive value. Traditional health metrics–blood pressure, lipid levels, family history, etc.–added to a measurement of fitness and well-being do just that.

In practice such a value has proven elusive for a number of reasons, none the leasts of which is the difficulty in designing a truly measurable variable for fitness that would be accessible to the masses. Once such a measure exists the rest is just math, right? It will be necessary to determine the relative value of our three variables–fitness, well-being, and risk predictors–and then plug them into a formula to kick out something that we might call “True Health”. While this is still “pie-in-the-sky” stuff I am convinced that it is only a matter of time before it is a reality. To do my part I have tried to enlist new “partners” like my brother-in-law Pete, the cardiology savant, and others.

But for now there are lessons to be learned from Jim Fixx, and yes, once again there is a teachable moment in my little epiphany and “Sunday musings” this week. You can’t out-train a poor diet. A healthy diet of any type combined with a program of functional fitness meant to produce general physical preparedness that includes both strength and metabolic conditioning is the optimal strategy. Even here, though, you cannot escape genetics. DNA always wins. Good, bad, or in between, your DNA talks to you in the language of traditional health risk metrics.

Your DNA doesn’t care how fast you can run a mile or how much you can bench. I start my new meds tomorrow.

 

Fitness or Sport? A Proper Place For High Intensity Training

The CrossFit Games Regionals were on ESPN yesterday afternoon. What? Wait. No? No, I guess you’re right. It wasn’t ESPN, was it. As it turns out the Games have shifted over to CBS Sports. Totally missed that memo. Of course, I only surf to the Games site once or twice a week anymore so I can be forgiven. Thankfully I was marooned at home with nothing left on either my Honey-Do list or my own Wish List, and ESPNU was all kinds of messed up so I couldn’t watch the D1 Lacrosse quarterfinals. Surfboring around cable I stumbled on the Regionals and received my annual reminder about what CrossFit is and who is supposed to do it.

In short the CrossFit Games as exhibited in this year’s Regionals is to CrossFit as the Indy 500 is to your daily commute: almost everyone needs to do the latter, but almost no one can, or should, do the former.

You could certainly say that I am treading on thin ice by proclaiming that you and I have no business doing anything but gawking at Regionals athletes doing full-on Regionals WODs here on .com. Fine. Here is why I feel this way; the incessant urge to emulate Games-level athletes and to turn every CrossFit WOD into a training session for competition risks the undoing of what makes CrossFit (and other high-intensity offshoots) a potential solution (or integral part of an irreducible Rx, to coin a phrase) in solving the population health problem in Western societies. It really could be as easy as eating fewer processed carbohydrates, being stronger, and training at relatively high intensity for periods of time in the 8-20:00 range. Stronger and leaner with greater aerobic capacity is all pretty much any of us needs.

Everyone who has ever owned a Box or coached a CrossFit class has seen the danger of extending the “you vs. you” competition outward into the “Sport of Fitness (TM)”. Clients who leave a gym because the trainer refuses to teach them how to do a CTB butterfly PU when they can barely do a single dead hang PU. Fledgling CrossFitters who insist on rebounding box jumps instead of stepping down because their times suffer when they do. “Linda” or “Diane” done As Rx’d with rounded lower backs, chins held high because, you know, you gotta Rx the Open WODs if you want to go to the Games. It’s really hard to exaggerate how disheartening it is to listen to a client say they are leaving a gym because they don’t feel like you are the best fit for them. Then you look at their data and discover that they are down 15% BW fat, have doubled their 1RM Deadlift, can now do “Fran” Rx’d in half the time they first did it with an empty bar and a green band, all injury-free.

Form, then consistency, then and only then intensity. This is what you need for fitness. The siren song of competition is strong, especially during our Games season. Shout out to those trainers, both within the CrossFit business universe and out, who continue to hue to this orthodoxy. Functional movements, irreducible exercises performed properly at a level of intensity that is high for an individual, coupled with a diet that is designed to fuel performance in the gym and in life is what we 99.9%’ers need. Distilling this prescription into a measurable and repeatable program is the essential genius of CrossFit. That some of us get to do it as part of a community is that much better; friendships formed through shared experiences, especially shared strife (and what is “Fran” if not shared strife), are also an integral part of being healthy.

After my (ca. 2006) WOD I sat down with some left-over steak and a handful of nuts to see how Dani Horan was doing in the East. A little sore and energized, the only thing that was missing was another CrossFitter there to join me in watching the spectacle.

Mental Health is Part of Health

Some time ago I wrote about creating a way to measure health. Real health. Health that encompasses every aspect of what it means to be alive and well. As a CrossFitter I definitely included Coach Glassman’s Disease -> Health -> Wellness continuum, and I also acknowledged the critical importance of his concept of “Fitness over Time”. As a classically trained physician/scientist there is clearly a place for more traditional metrics like blood pressure, serum lipids and the like, although they may, indeed, be an variable that is ultimately tied to fitness.

Where my thoughts on defining and measuring health seem to depart from most current trends is in the recognition that mental health–emotional wellbeing—is as much a part of being healthy as any other thing we might examine.

Think about it for just a moment. Most of what we would classify as mental illness has as many outward signs that we can see as diabetes and hypertension. Which is to say, none. Yet we—all of us, not just CrossFitters—see nothing but the good in treating diseases like diabetes openly and aggressively. There is no stigma attached to seeking care for your hypertension or your elevated LDL. To the contrary, if someone who loves you discovers you quit measuring your glucose before you bolus your insulin, they are for sure gonna get in your grill.

For whatever reason, mental illnesses are looked at quite differently. No one is asking the person with chronic depression whether she is taking her life-saving medication, for example. We might notice an insulin pump on a friend or family member, but then it’s quickly forgotten. Everyone seems to be very uncomfortable around the young man who has very obvious hand tremors from the life-saving medication he takes for his Bipolar disease. We all seem to be so much more understanding when we have to wait for a response from someone suffering from Parkinson’s Disease than from the young women who has the same symptoms as a side-effect from the medicine that quiets the dangerous thoughts in her head from Schizophrenia.

It’s not even necessary to look only at these kinds of severe mental illnesses when we are examining the importance of mental or emotional wellbeing as an integral part of being healthy. What good does it do to have a 5:00 mile, a 500 lb. deadlift, and a 1:59 “Fran” if it was self-loathing that drove you in the gym to get there? You may be quite accomplished, the envy of your peers, at the peak of whatever life mountain you wished to climb, and yet you cannot feel joy. How is it possible to be healthy without joy? I look at Usain Bolt and what I see is quite possibly the healthiest man alive. My friend Tim, the writer, tells me that Justin Gatlin has nearly everything that Bolt has—youth, fitness, wealth—but the combination of failure to knock off Bolt, and the public disapproval reigned on him as boos from the Rio stands has left him emotionally broken. It’s subtle, but if you look at his face in the blocks of the 100M Final it’s there.

Our complex and conflicted attitudes and feelings about mental illness are especially evident when the topic of suicide comes up. Just typing the word makes me uncomfortable. Even how we describe suicide is fraught with hidden meaning that reflects our discomfort: someone has “committed suicide”. Right? Someone committed an act that we simply cannot fathom, one that leaves the survivors completely without any understanding whatsoever. How could someone DO that? It’s as if every suicide is the same as the suicide of the crooked prison warden in The Shawshank Redemption when he looks out the window and sees his fate arrive in the front seat of a State Trooper’s car.

In reality most of the time it’s simply not like that at all. Nothing about it is simple at all.

The outer walls at the periphery of my world have been breeched by suicide twice in the last couple of weeks. One of them actually does feel a bit like that prison warden. Frankly, I am too conflicted, too aware of the external circumstances and not enough aware of the internal life of the deceased to offer much right now. The other one, however, just stopped me in my tracks when I heard. The loss was profound.It has also introduced to me a new vocabulary that I truly believe provides a starting line from which we can change how we think about not only suicide, but all of mental illness. A friendly acquaintance lost his wife when she was killed by suicide.

We don’t need to know all of the details of the story. Suffice it to say that in the face of a child’s illness she suffered quietly. Too quietly to be noticed. Perhaps she didn’t realize how badly she was suffering, or maybe she was like so many of us and couldn’t bring herself to see her illness for the life-threatening entity that it was. No one will ever know. What is clear, though, is that this was not anything about commitment. Kidney failure may be cause of death in a diabetic, but it is diabetes that kills him. There is no difference here. The cause of death was suicide. Her disease, her depression is what killed this young woman.

Each of us has a very few moments in our lifetimes that forever change us. On the second Tuesday of July in 2006, unbeknownst to me, one of those moments was transpiring in a lonely, dark corner. Joyfully, the moment was a beginning, not an ending. Regardless, once learning of the moment I was changed forever. Now I knew. You cannot see any marks from mental illness, no swollen appendage or insulin pump. But it is there all the same, and it must be acknowledged and accorded the same degree of care as any other disease that may take our loved ones from us. Mental illnesses are real, and they can be deadly. There ought not be any conflict or discomfort in treating them.

We may stop losing so many of our loved ones when start to see emotional wellbeing as part of being healthy.

In Fitness Tracker Recovery

Hi. My name’s Darrell and I buy activity trackers.

Like most everyone else, I’m sure, it started off innocently enough. For me it was the Nike Fuel Band. Man…was that fun! Looking back it really didn’t do all that much to be honest. As far as I can tell all it really did was tell me how many steps I did, and maybe there was some other kind of movement it tracked. Heck, Nike made all kinds of a big deal out of the “social aspect” of the Fuel Band. How I could follow groups and compete to see who got how much Fuel and I never even did any of that.

It was the fireworks that got me, I think. When you made your Fuel goal, whatever that even meant, your band erupted into fireworks.

Thinking back that might have been enough. A Fuel Band, daily fireworks, and I might have stopped right there. Ah, but as is so often the case when you are an early adopter, my Fuel Band was not really a ready for prime time grown up product. It broke less than a year after I put it on for the first time. But me? I was hooked. I imagined all kinds of cool stuff you could do with a REAL tracker. A tracker that could measure something real and meaningful like…wait for it…WORK. I’m a CrossFitter after all. WCABTMD is my ultimate goal. Of course I’d want to track my work done.

So began my quest. The research wasn’t quite as in depth, my dive not as deep as my initial jump into CrossFit so long ago. Imagine how long it took to get through a few pages of CrossFit.com or the original CrossFitKids.com with a dial-up or early stage cable modem. No, this was a high speed/high churn journey. Next up was a Garmin Vivofit which taught me that I should care about sleep. Not just sleep of course, but the measurement of my sleep. Who knew? Years ago I’d researched sleep and I knew I should be getting some multiple of 90 minutes (cycles) each night, but now I could measure that, too.

Naturally the VivoFit was inadequate: no points for a PU. So, too, the Jawbone Up came up short. I gave some thought to the Athos wearable garment sensors, but my craving for measurements wasn’t deep enough to prompt me to buy something that only told me when and to what degree a particular muscle group was firing (although it would have been a cool way to dial in my deadlift and squat technique).

Over time it became clear that the entire fitness tracking industry was just one big shill for the endurance community. All of them were dedicated to measuring your aerobic activity. Period. [Note to Coach Glassman, and everyone in the functional fitness community: if you want growth in your part of the fitness world get a viable tracker of work capacity on the Apple Watch] I had great hopes for the Mio Slice and the BioStrap because you could dial in specific exercises and get activity credit when you did them, not just when you were running, biking, or rowing. Alas, although they were light years ahead of my beloved little Fuel Band they, too, were not ready for prime time. It was comical to see what they decided I was doing when I exercised.

Although my disappointment was painful I was in too deep to just give up. Surely, science would step in with something more meaningful than how many steps I got each day. Enter Heart Rate Variability as a proxy for autonomic nervous system health, ergo fitness. Could this be it? My BioStrap was now matched against both a Zoom HRV and a program on my phone that used the camera to measure HRV. The science was great.

The data was meaningless.

Now desperate I turned off everything except my alarm clock and my cheap little $15 Casio with a stopwatch. Yes, you read that right: I went cold turkey. I hit the pillow and woke up without any kind of measure other than “did you sleep well, dear?” from my wife Beth. 3-2-1-Go, start the stopwatch on my cheapo watch and go as fast and as hard as I could. Sweat angels instead of rushing to check my numbers. No plugging my results into Strava or Beyond the Whiteboard or anything else. It was hard. I couldn’t tell whether the shakes were from the WOD or from trying not to reach for my BioStrap and my phone.

But I made it through. I did give a thought to buying an iPhone when I saw it could do a one-lead EKG (an EKG on your wrist!), but I managed to resist. Recovery is hard, especially if you can’t watch your heart rate go down. No, no, no, I meant it’s hard to not want to put on one of my trackers. You know, just to check. The urge is getting weaker each time I go to the gym now, so I think I’m in the clear. It’ll be tough if something comes out that can really tell me what work I’ve done, what the area is under my curve, but I guess I’ll have to deal with that if it ever actually happens. For now I am free of activity trackers of any and all kinds.

Although I really do miss those Fuel Band fireworks.

The Enemy is the Couch

One of the repeating themes in all of my writings on fitness is that it is exponentially more important that one gets off the couch than it is what one does after getting up. To be sure, we in the CrossFit community have been reasonably and accurately accused of being zealous in our support of our chosen post-couch activity. Unlike “Fight Club” it has been observed that the first rule of Crossfit must be that you ALWAYS talk about CrossFit. Fair dinkum. Still, while we may be proven more right than not in the end, there exist other effective fitness options.

My nephew, a retired hockey and lacrosse player, has found his post-collegiate sweet spot in one of the cycling/spinning communities. His preferred version is “Soul Cycle”, but that’s probably more like saying Ben & Jerry’s when you really mean ice cream. You and I know all kinds of folks who swear by Pilates, Barre, various and sundry types of Yoga, and the legions of people who lace ‘em up and run at all kinds of levels at all kinds of times in all kinds of places. In the end even the most zealous among us has to admit that each and every one of these non-CF activities are substantially better than continuing in an unhealthy relationship with your couch.

Fitness, and by extension health, are profoundly complex entities. Hence my own personal difficulty in arriving at a single integer that can be used to measure relative health. It also explains the abject failure of the collective whole of the health wearables industry to come up with a single meaningful, actionable measurement. Still, we ought not dismiss the wearables industry entirely if for no other reason that putting on that Fitbit, or launching Health on your Apple Watch more often than not is like magic; it levitates your ass off that couch.

Simplifying our discussion about fitness and health along the straight line between relatively high intensity exercise versus what could be called long-slow aerobic exercise blinds us to both the essential value of forsaking the couch, while at the same time limiting our ability to explore why it is that there doesn’t seem to be that one, single best approach. Part of the genius of CrossFit is that it starts with a definition and then demands measurement. CrossFit proper has enjoyed explosive growth, growth which is now also occurring in a parallel universe of derivative programming offered by trainers who got their start owning a Box. Is it, are they, better than everything else out there?

Does it matter?

Zero sum games require that someone lose in order that another wins. Likewise, a zero sum grading of ideas means that one eventually must become axiomatic at the expense of the demise of another. Zone/macro quantitative strategies of nutrition vs. Paleo and similar qualitative strategies, for example. A complex system demands that we constantly assess not only the “games” themselves, but also the relationships between the various “games”. Perhaps the greatest gift that I have received from my discovery of CrossFit and the CrossFit community is my ongoing curiosity about all things fitness, and by extension my willingness and desire to pursue the inquiry. By extension I have learned that what works for me may not necessarily work for you.

Is it better to do my CrossFit Rx or my nephew’s Soul Cycle? The answer of course is ‘yes’. Should one do the “Taking Back Eating” macro program or find health in “The Paleo Solution”? Likewise: ‘yes’. Broad acclimations await better measurement followed by the evaluation of those measurements across very large groups of people. However, you and I need not await those conclusions because we can embark on a highly actionable study of our own, n=1.

All it takes is getting off the couch.

 

Contentment, Complacency, and My Fitness Tracker

Where does being content end and being complacent begin? As an older athlete this question is just dogging me. The parallel question might be where is the line between being content and capitulating? These are both, of course, extensions of some of my recent thoughts on balancing the effects of relatively high intensity workouts with the countervailing effects on recovery, plus or minus injury.

There might be a more scientific answer to these, at least in so far as fitness is concerned, and it would come from of all places the fitness tracker world. As it turns out my latest tracker(s) have the ability to measure the beat-to-beat variation in heart rate (HRV). This measurement is a proxy for autonomic nervous system activity. A lower HRV means autonomic stress. If correlated with the previous day’s workout that would argue for either a lower intensity session or rest.

Is HRV ready for prime time? Well, world class endurance athletes and many professional athletes in other sports certainly think so. How about for us, the regular folks hoping to improve our fitness and along with that our health? Dunno. I’m impressed and frankly a little depressed to find that my HRV responded so classically to what was for me an intense WOD yesterday. For this to work one must have the discipline to dial it back if your HRV is low on a particular day (be content with your work), but also the discipline to ramp it up when your HRV is high (fight complacency and go to work).

In a busy life it is likely the second part that will prove the more difficult.

Of Tradewinds and Science

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die.” –Max Planck

So very much of what we encounter as we seek any kind of guiding truth is not science at all, but strongly held opinion forcefully presented. Think about it for a moment. Think about a few of the really big issues orbiting the intellectuosphere. Climate change. Health. Fitness. The search for the cure for cancer. Heck, the decision on what to have for lunch. So many opinions…so much money…so little true science.

Even more than that, scientific truth is continually bludgeoned by the one-two punch of politics and commerce. True science has always been held hostage by those who have vested interests in what constitutes the prevailing truth at any given time. How many promising avenues of inquiry have been blocked, and how much time has been lost because of the failure to pursue additional lines of inquiry that ran counter to “consensus”? One need only think of inflammation in vascular disease or alternatives to “fat in the diet is unhealthy”, both squelched along with the careers and reputations of their proponents while the single consensus theory was pursued. Why? Alternate theories or parallel theories would siphon the spoils from those who fed at the consensus trough.

It’s quite tempting to hold that this is all relatively new, that it is a function of our highly developed Western societies. Tempting, but ultimately false. Has there ever been a time in recorded history when a new scientific truth has upended orthodoxy and there has NOT been an attempt by the entrenched to not only stop an new line of inquiry but also destroy those inquiring? Think Galileo. From where I sit it seems as if a substantial majority of truly disruptive new scientific truth has arisen from the ranks of those who stood aside the prevailing winds and charted their own course.

What does this mean for each of us as we sit in our own little boats and sail along? The trade winds of consensus are strong, and it seems the weaker the science behind them the stronger they blow. It’s fine to allow these to fill your sails, of course, for the majority of them do in fact propel us along a true course. The best course, however, may lie in the breezes that cross the trade winds. Those tiny little gusts that represent the true essence of real science–skepticism accompanied by inquiry, followed by proof–will ultimately propel us to the proper destination despite the power of the commerce attached to the trade winds.

Every now and again the Newport to Bermuda race is won by a rebel who went off alone and discovered a new truth about sailing. We should be open to the possibility of a new scientific truth in all parts of our lives, lest we find ourselves far behind, capsized in its wake.

Or worse yet gone, as Planck suggests, long before we ever had a chance to benefit.

CrossFit Programming and the CrossFit Open

CrossFit Open workout 17.2 will be announced tonight. This is a good time to reflect on the different aspects of CrossFit. There is a tension that exists between CrossFit, the strength and conditioning program and CrossFit, the Sport of Fitness.This tension is usually expressed in the guise of criticism of various versions of CrossFit programming. What’s very interesting is the lack of tension on this topic among the truly elite CrossFit athletes. If you look at their programming it looks like they are training to become…wait for it…really good at CrossFit.

Weird, huh?

What does that mean, anyway? Good at CrossFit? This is a perfect time for you to both re-read the seminal article “What is Fitness” in CFJ #2 and to recommend it to anyone who is either curious or unsure as to what constitutes CrossFit, and for the sake of this musings, CrossFit programming.

CrossFit is the pursuit of a broad, inclusive general fitness where fitness is defined as work capacity across broad time and modal domains. In the vernacular, CrossFit trains and tests us to move larger loads further over a longer period of time. In order to do this Coach has identified 10 Essential characteristics of Fitness as so defined, each of which needs to be equally expressed. Cardiovascular/Respiratory endurance; stamina; strength; flexibility; power; speed; coordination; agility; balance; accuracy.

Fitness as defined by CrossFit and Coach Glassman includes a precisely balanced degree of each of these 10 elements, with no one element being more of less important than any other. The CrossFit Games, and the athletes who take part, are simply an expression of the farthest right side reaches of the fitness Bell Curve. Look carefully and you will see that the events ask for equal competence in all 10 Elements; the athletes are simply better than the rest of us across the board. They get there because they do more work on all of the 10 Essential Elements.

While we here, and most folks in Affiliate gyms, can assume agreement on the benefits of seeking Fitness as defined by CrossFit, this is not to say that either our definition of fitness or our particular way of seeking it (expressed through our CrossFit programming) is appropriate for every individual. Some people just like to run really long distances, while others are happiest when they lift really heavy stuff. Still others are interested only in the appearance of their body, and their entire fitness program is geared toward achieving a particular vision or visual. There is nothing inherently wrong with any of these desires, nor anything inherently wrong with the programming necessary to achieve these outcomes.

It just may not be CrossFit.

Because of this, the issue of programming is always on the table. Is there an optimal version of CrossFit programming? People take turns at supporting and denigrating the programming on the Main Page and in Affiliate gyms. For example, I think there are legitimate criticisms that can be leveled against gyms that do not emphasize proper movement. Countless efforts are made to “improve” on the model you see here on .com. Some of these alternatives make sense, while others IMO are not really alternative CrossFit programming but alternatives to CrossFit itself. Most of these, indeed most of the conversations in general, have to do with strength and strength training. Are you (is anyone) strong enough? Will CrossFit.com or another version of CrossFit make you strong enough?

The 10 Essential Elements found in CFJ #2, “What is Fitness”, are also posted on 030530 ( ironically on a day when heavy Deadlifts were prescribed). Pretty much all of the conversations noted about programming revolve around the premise that strength is somehow more important than other elements of fitness. Reasonable people can disagree on this point, but as a premise in discussing CrossFit the notion that strength is a, or the, primary element of fitness has no standing. There are 10 elements of Fitness, each no more and no less important than any other if we are seeking a broad, inclusive general physical preparedness that we call “fitness”. Full stop.

Whoa, wait a minute there Mr. bingo, aren’t you the guy who co-wrote an article called “Strong Medicine” introducing a programming alternative called “CrossFit Strength Bias”? Didn’t your home gym programming have supplemental strength training per CFSB principals since the time it opened? Isn’t that statement there just a bit, oh, duplicitous? Forked-typing?

Nope. Not at all. You see, if you read the original article you will see that CFSB is one way to address a DEFICIT in strength relative to the other 9 Essential Elements, not a program meant to gain strength at the EXPENSE of the other 9. As such it, like some others, is a program for the masses, for a CrossFitter who perceives a hole in his/her fitness that needs to be addressed, not at all unlike a CrossFitter who does supplemental work on balance or flexibility. Additional Element-specific work, be it strength or agility or whatnot, that drives continued balance and improvement in all 10 Elements is very much CrossFit. All versions of CFSB (I am now using the  newest protocol, v3.2) are designed to be one way to address this imbalance. There are others that you may enjoy more (Wendler, Westside, etc.), and just like having personal goals, there is nothing inherently wrong with another supplemental strength program as long as it works without the need to sacrifice other competencies.

Whether you are looking at members of a CrossFit Box or competitors at the CrossFit Games, CrossFit is outcome based. The outcome desired is a broad-based fitness comprised of equal quantities of each of the 10 Essential Elements. What goes into the left side of the hypothetical Black Box should produce Work Capacity Across Broad Time and Modal Domains if the Black Box is a CrossFit athlete of any type. An increase in your Deadlift brought about by concentrating on strength training at the expense of cardiovascular/respiratory endurance will be accompanied by a decrease in your 5K run time and vice versa. This may be precisely in line with your goals, but it is not CrossFit as defined by Coach Glassman and expressed at its limits by CrossFit Games athletes.

Programming for CrossFit should be aimed first and foremost at CrossFit outcomes. What you find on CrossFit.com, and what you should probably expect to find as the primary goal in an Affiliate gym, is programming that seeks to balance all 10 of the Essential Elements of Fitness, increasing all of them in an effort to produce increased work capacity across broad time and modal domains.

A demonstration of CrossFit programming will be available online tonight. It can be used as a workout or a test.

 

Musings on “Exercise as Medicine”

The “exercise is medicine” movement is kind of a confusing thing. On the one hand we in CrossFit are the uber example of how exercise as an independent variable can enhance health. On the other we have the “Big Sugar” industry funding research and promoting the notion that exercise is all that you need, that there is no effect of nutrition on health. Train your way out of any kind of diet, if you will. This has led to the toxic effect of “BS” industry money supporting academic research that is in effect little more than marketing for their products. (Visit TheRussells.CrossFit.com for details). Indeed, the soda industry in particular has come in for some very pointed criticism which includes being accused of acting like the tobacco industry ( https://blogs.scientificamerican.com/food-matters/if-soda-companies-don-t-want-to-be-treated-like-tobacco-companies-they-need-to-stop-acting-like-them/ ). Pretty harsh, but probably deserved.

Here’s the rub: exercise really is a medicine equivalent for a very large number of medical problems. Heck, if it were only to work for cardiovascular health and Type 2 diabetes it would be considered, or should be considered, a miracle treatment. Not only that, but exercise very well might work independently of diet. While exercise should not be used as an excuse to consume a poor, dangerous diet, you may actually be able to at least partly out-train a poor diet to at least some degree.

In 2009 a study was published in the International Journal of Epidemiology (http://m.ije.oxfordjournals.org/content/39/1/197.full) examining the effect of aerobic exercise on longevity (hat tip to Michael Joyner, MD at Mayo). Mind you, the study was enrolled prior to the creation of the CrossFit fitness program (completed in 2003), so the definition of fitness (aerobic health) will be viewed as incomplete by CrossFitters since it includes only aerobic fitness. In addition, what is defined as an unhealthy diet would only partially pass muster here; we would agree that simple carbohydrates (sugars) are unhealthy, but there is a plethora of more recent data that strongly suggests that red meat and healthy fat do not render a diet worrisome in the least.

A careful reading of the study revealed a couple of nuggets that should not surprise even a little bit. Eating the unhealthiest diet was associated with a 40% increase in all-cause mortality in comparison with the healthiest diet. Those who ate that worst diet and reported that they did moderate or greater levels of exercise had a 13.5% decrease in mortality. That group of bad eaters who exercised and were proven on a modified cardiac stress test to actually have greater aerobic fitness levels had a 55% decrease in mortality. Let that sink in for a minute: people who ate a shitty diet who exercised to the degree that they were fit by the testing criteria in the study were half as likely to die in any period than those who were unfit.

Boom.

Frankly, I don’t care who funded this study. Eating a shitty diet that is high in sugar increases your risk of death by 40%. Proof. Exercise that produces improved fitness, even fitness that I would view as partial or incomplete, reduces all-cause mortality in people who eat a diet high in sugar by more than half. Proof. Yeah, sure, I get that this could be used to justify or excuse eating that way, but the reality has always been that most people don’t exercise at all. Nada. Bupkis. Those who do certainly don’t achieve much in the way of any kind of fitness because they don’t exercise effectively—saying you exercise only got you a 15% decrease in mortality, after all. These results only apply if you get fitness results, and let’s face it, working hard at exercise is not the default setting in the developed world. By comparison eating better is a breeze.

Studies such as this one are mint, man. Especially to people like me, people who follow the CrossFit Rx and other programs that ask you to work hard. It’s exercise AND nutrition. Says so in the study. Sure, we can pick at this one if we want, like I did above, but my bid is that we use studies such as this one as talking points to prove that our worldview is the gold standard by which all public health initiatives ought to be compared. We can turn the cynical “exercise is medicine” campaign of “BS” on its head and use their own data against them. Eat like a CrossFitter (protein, nuts and seeds, little starch, no sugar). Exercise like a CrossFitter (functional movements performed at relatively high intensity). Seek ever-higher levels of fitness (work capacity across broad time and modal domains) like we do.

“Exercise is medicine” is just fine as long as we continue to call BS on “BS”. Health requires both exercise AND nutrition. People who are fit, especially physicians, are just the right people to tell that story.