Aim First, Before You Shoot.

Do you lift weights? If you do, do you also take a statin (such as Zocor or Lipitor)? If so, you may be shooting yourself in the foot (from a muscular standpoint), and not doing yourself a whole lot of good from a health standpoint. In fact, you’re likely worsening your health.

Bold words; I know. Read on.

If you’re a regular reader of this blog, then you’ll know I’m no fan of the lipid hypothesis (namely, that cholesterol/saturated fat/LDL cause cardiovascular disease such as heart attacks).

Often, clients, trainers, friends, and random internet folk question how I can take such a hard-nosed stance on this issue since it’s widely accepted by doctors that the lipid hypothesis is true, i.e., high cholesterol/saturated fat intake/LDL causes heart attacks. The answer? If it’s true, then you should be able to prove it. But, when examining the so-called evidence for the lipid hypothesis, you quickly discover several things:

1) The data don’t support the hypothesis.

I’ve previously blogged about how major studies dealing with cholesterol and mortality show a higher risk of death with lower levels of cholesterol. This trend holds true across the board. And if you think about the etiology of heart disease and the different functions of fat and cholesterol in the human body, then this makes sense. After all, humans have been eating stuff like eggs, animal flesh, and animal organs almost since our origins. If we really weren’t supposed to eat this stuff, how would we have survived?

2) There are too many “black swans” for the hypothesis to be true.

Nassim Talib has a great book out now called The Black Swan, the subject of which is a classical fallacy from logic. Talib doesn’t use it in this way, but a black swan is that one example that renders your theory invalid. The classic example:

Your theory is “all swans are white.” To defeat your theory, I merely have to produce one black swan. If one black swan exists, then logically all swans cannot be white.

Similarly, if your hypothesis is, “high consumption of saturated fat causes heart disease”, then I merely have to say, “The French eat more fat than us, and they have much less incidence of heart attack. So do the Swedes (who eat a completely different diet from the French). The Masai and Inuit eat fat almost exclusively, yet incidence of heart attack is virtually nil.”

That’s a veritable flock of black swans, if you ask me.

3) When looking at interventions that are supposed to help (i.e., by lowering cholesterol), they end up killing more people.

This article from the NY Times caught my attention, and it’s been the most discussed topic between my clients and I. Some of them are confused – how can a drug that lowers cholesterol cause an increase in arterial plaque? – but many of them have heard the soapbox tirade before (See #1).

Dr. Eades, in his usual way, wrote an incredible blog post about the ENHANCE study, so I won’t bore you with the details. As usual, the quick hits:

The most telling facet is that the effect was most dramatically seen in those who took Vytorin vs. just Zetia; those who had the lowest LDL levels (the lower the LDL level, the more plaque was present).

The ENHANCE study was completed in 2006. And it’s….2008? Why did they delay publication? Is it because Merck and Schering-Plough went looking for some white swans and came up with a whole bunch of black ones?

“‘LDL lowering, however it occurs, delays development of coronary atherosclerosis and reduces risk for heart attack,’ Dr. Grundy said this week.” Does it really, Dr. Grundy? Or are you just sidestepping the data?

and finally,

“Because the link between excessive LDL cholesterol and cardiovascular disease has been so widely accepted, the Food and Drug Administration generally has not required drug companies to prove that cholesterol medicines actually reduce heart attacks before approval. They have not had to conduct so-called outcome or events trials beforehand, which are expensive studies that involve thousands of patients and track whether episodes like heart attacks are reduced. “

In other words, shoot first, apologize later – if they apologize at all, that is. Seeing what happened in the VIOXX case, that apology’s not likely unless it comes from the business end of a court docket.

Does this kind of stuff make you want to tear your hair out too? Post to comments.

Muscles, On The Cheap.

Seen today in the local sporting goods store:

A mere $60 for the “travel” version.

I’ve got a better idea – how about you do some honest-to-goodness, old-fashioned, non-accessorized pushups in your hotel room and save yourself $60?

Every year, hundreds of gizmos and gimmicks are invented to purportedly improve fitness and make exercises more effective – and most of them fall far short of expectations.  One thing is certain: Good ol’-fashioned hard work on the basics works – no need for a money-back guarantee, either.

Cholesterol is Necessary…For Building Muscle.

Thanks to Chris from Conditioning Research for this article:

Surprise – Cholesterol May Actually Pose Benefits, Study Shows.

Yes, indeed; surprise, surprise. 

Chris has already done a very thorough write-up of the study’s results; let’s reference his comments and explore this topic a bit deeper:

1) “The team studied 55 men and women, ages 60-69, who were healthy non-smokers and were able to perform exercise testing and training.

Three days a week for 12 weeks, participants performed several exercises, including stretching, stationary bike riding and vigorous weight lifting. All participants consumed similar meals.

At the conclusion of the study, the researchers found that there was a significant association of dietary cholesterol and change in strength. In general, those with higher cholesterol intake also had the highest muscle strength gain.”

Case pretty much closed right there. Now, it shouldn’t come as a surprise that higher dietary cholesterol should result in greater muscle gain – being that cholesterol is a precursor to steroid hormones (one particular hormone, testosterone, immediately springs to mind), it should play a vital role in the rebuilding of muscle tissue.  This aspect of cholesterol is well known and has been studied before (by Dr. Riechman, no less).

2) Here is a shining example as to why you should read the entire text of a study as opposed to just the abstract:

“Serum cholesterol and the serum cholesterol lowering agent statin were also independently associated with greater increases in lean mass.”

Which reads “those who took statins had increased muscle mass from resistance training.”  But is this really so?

“Riechman said that subjects who were taking cholesterol-lowering drugs while participating in the study showed lower muscle gain totals than those who were not.”

Until I get my hands on a copy of the full study, I won’t be able to say for sure.  But since Dr. Riechman conducted the study, we’ll have to take his word for it.  So which is it: more (as the abstract says) or less?  The full text will reveal all…

3) Lastly, this from the abstract:

“Dietary cholesterol was not associated with serum cholesterol…”

shows how pervasive the low-fat doctrine has become in academic circles (at least, among researchers who study nutrition and human health).  This point shouldn’t be a revelation, as study after study (particularly the major ones, like Framingham) show that there’s no connection between the cholesterol you eat and the cholesterol that shows up in your blood work.  But what’s the first thing your doctor will tell you if your cholesterol level tests high?

After “I want to put you on Lipitor”, I mean.

He will likely tell you to stay from foods that are fatty and contain a lot of cholesterol.  Anyone else see the mental disconnect here?

In short, don’t shy away from the cholesterol.  No, it won’t drive your bloodwork numbers through the roof, and yes, it is essential to your health.

Predicting Your One-Rep Max.

“Hey, whadduya bench?”

What if you never tested your max?

What if you didn’t care to?

One of my clients asked me recently what I thought he could maximally lift in bench press based on his current level. While it’s impossible to know what his true one-repetition maximum (the maximal amount of weight he can bench just once – abbreviated as 1RM) is without testing it, here are two ways you can get a reasonably accurate guesstimate:

1) Calculate it. One of my old professors, Matt Brzycki, published a pretty good formula for guesstimating a 1RM performance based on reps to fatigue in a given exercise. The formula is as follows:

Predicted 1RM = (weight lifted)/1.0278 – .0278x
where x = number of reps performed (must be a number between 1 and 10)

Example: You test lift 190 for 8 reps. Using Brzycki’s method, your 1RM would be 236.

Don’t like math? exrx.net has an online 1RM calculator based on Brzycki’s equation. Thanks, Coach Matt!

2) Tables. If you’re looking for a bit more accuracy without the inherent danger of 1RM testing, using Mike Berry’s Table method for estimating 1RM might be in order. This would be applicable for athletes (as opposed to your run-of-the-mill gymgoer or weekend warrior) for whom it’d be nice to know 1RM – for programming purposes (kinda tough to design mesocycles without an assessment of what your athlete can do).

Berry’s method uses your 6-10RM (weight that fatigues you in 6-10 reps) weight load. By plugging the test results (actual reps performed and test weight) into his 1RM chart, you can quickly see a guesstimate of 1RM. He also makes coefficient factors for each rep total available, so if you test using a weight not on the chart, you’d simply multiply that weight by the coefficient factor that corresponded to the reps performed.

Example: You lifted 297lbs for 5 reps. Your 1RM is 341 lbs (297 x 1.148).

I’m certain some bored strength coach (or intern, more likely) calculated out every single possible value for a range of weights and posted them in tables on the web somewhere. With a bit of looking, I’m sure you could easily find such a table.

What Rocky IV Can Teach You About Exercise.

Ignore the use of isokinetic (read: useless) equipment. Ignore Dolph Lundgren’s atrocious form (especially on those power cleans – yuk). Ignore the behind-neck pullups (ouch).

What’s truly interesting about this montage is this:

While both men are using vastly different methods and equipment (can snow be considered “equipment?”), both have two common things with their training methodology:

1. High levels of effort – On whatever implement/exercise each man is performing or using, they are both being pushed to their momentary limit (to expand that limit, of course, being what exercise is all about).

2. High levels of motivation – Both men are driven to push harder and harder in their training, because they each have one outcome and one outcome alone fixed in their heads – a burning desire to come out victorious (since, in this bout, there is a real likelihood that victorious = alive). That sounds like a pretty good motivator to me.

Because both men have both these key elements firmly entrenched in their training, they both arrive at the fight in their respective top condition, ready to fight for their lives (Spoiler Alert: although one could argue that Rocky wins because he has more will to survive than Drago).

Watching the Rocky montage reminds me of all the in-fighting that occurs within the exercise and fitness industry: “Sports-specific? No, high intensity! No way – Westside Barbell all the way! Anyone say weightlifting?”

In the end, it all comes down to the same thing – a truly determined individual willing to work to a high level of effort consistently enough to reap the (major league) benefits of their exercise effort. Of course, that’s not to say that all’s fair in love and exercise programs, but if the program is scientifically-based and proven in practical application (has a track record), then there’s high likelihood a motivated individual will succeed on it.

In other words, your program doesn’t have to be “perfect” (or even near perfect) to get you great results – but your level of motivation better damn well be.

An aside: Just for comparison’s sake, Rocky IV was released in 1985 – more than 20 years ago. And yet, you’re as likely to see Drago’s scientific training in the research rooms of UConn today as you are to see Rocky’s workout being performed by Chuck Liddell down at The Pit. Those cliches ring truer nowadays more than ever: History repeats itself; and there’s nothing new under the sun.