HIIT and Fat Loss

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One of the “facts” exercise professionals will tell you is that there is no such thing as spot reduction; by that I mean you cannot target a specific area of your body, let’s say your abdominal area, and lose fat by doing a targeted exercise such as sit-ups or leg lifts. You can make the muscles underneath the skin stronger for sure, but there doesn’t seem to be any evidence that you can reduce the amount of fat in that area.

With 35 years of experience in the field, I would say that requires a qualified answer—it needs to be qualified with the word yet. There hasn’t been a study that proves that you can reduce fat in a specific area yet. Is it theoretically possible? Yes, I think it is. The problem is this: who would do the high quantity of exercise focused on one area long enough per workout session to do themselves any good? It may be that we’ve approached it all wrong by focusing on resistance exercise. Let’s take a look at another study that compared high-intensity interval training (HIIT) on a cycle ergometer versus a treadmill.

Researchers began with two questions. Is there any difference in the fat mass in specific areas of the body after training using a cycle ergometer (an exercise bike that measures the energy output of the cyclist) or a treadmill? In addition to that, is there any change in beneficial microbes in the microbiome after training?

Let’s take a look at what they did. Researchers recruited 16 men with a mean age of 54 and initial BMI of 29.9. After assessing initial fitness level, body fat, and body-fat distribution using the DEXA scan, and taking an initial stool sample for analysis of the microbiome, the subjects were randomly assigned to the bike or the treadmill. To make sure that there were no significant changes in diet, the subjects were required to maintain their typical diet and do seven-day diet records periodically during the study.

Think of this as intervals for the everyday exerciser. The HIIT bike program required them to do ten intervals for 45 seconds each at 80–85% of the maximal heart rate (MHR), and then a 90-second active recovery, or a HIIT running program which were nine intervals for 45 seconds at 80–85% of MHR and again with 90 seconds of recovery between intervals. They were to do this exercise under supervision three times per week for 12 weeks. The goal was to have all exercisers use the same number of calories during the workouts, whether cycling or running. The subjects were then retested to examine the differences if there were any. What did they find? I’ll tell you on Saturday.

What are you prepared to do today?

        Dr. Chet

Med Sci Sports Exerc 2024 May 1;56(5):839-850.

Spot Reduction? Maybe

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Researchers collected data from four prior studies that put a group of sedentary overweight and obese men and women on a walking program. To determine the distribution of muscle, fat, and bone, they took MRIs of their entire body. That gave the researchers not only the amount of muscle and fat mass, but exactly where that muscle and fat were located.

Once researchers assessed the fitness level of these subjects, they developed an exercise prescription for them that had them exercise at 60% to 75% of their maximal aerobic capacity for 30 minutes a session, five days a week, for six months. Their heart rates were monitored throughout the exercise session to make sure that they did not exercise above those levels; that also allowed subjects to increase the speed or grade of the treadmill as they got fitter. The subjects used a food log to track all the food they ate.

Results

Did the subjects lose some weight? Yes. Even though they were trying to maintain what they ate, they were using more calories in exercise than they had been, so they did lose some weight—in this case, just a little over two pounds in the exercising group. The controls actually gained about half a pound in the six-month study.

Now to the good stuff. The results of the MRI showed that there were definitely regional differences in skeletal mass and fat mass. As was expected, the exercising muscles, primarily the hips, thighs, and legs, saw maintenance of the skeletal muscle mass but a decrease in the fat mass. In the upper part of the body, there was a slight decrease in muscle mass in the arms and upper torso with a very slight decrease in fat mass compared to controls.

The Bottom Line

So what does this all mean? First, because the mean age was around 55, maintaining muscle mass is critical—this is the time of life when age-related muscle loss starts to occur.

Second, if this were confirmed in several clinical trials, it would mean that there should be a focus on weight training or aerobic training that utilizes the entire body. Elliptical trainers and recumbent cross trainers come to mind as something that would use both the arms and the legs, so that may be part of the solution. And from personal experience, I can say that dance classes can have a similar effect.

In order to preserve muscle mass, exercising all your muscles is important; 60 to 75% of maximal fitness would be classified as moderate exercise. That means you don’t have to kill yourself in order to obtain the benefits of regular exercise to your cardiovascular system. Add to that some weight training a few days a week, and you have your own prescription for sustaining muscle mass and maybe losing just a little bit of fat mass along the way. But what if I told you that you could increase the loss of fat mass, especially in your abdominal region, by changing up the intensity of your workouts for a few weeks? Next week’s Memos will look at that research.

What are you prepared to do today?

        Dr. Chet

Reference: MSSE. 2024. 56(5):776-782.

Is Spot Reduction Possible?

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One of the questions that I’ve thought about over the years is what happens to the skeletal muscle and fat mass in non-exercising parts of the body. If you’re a runner or a walker, what happens to your upper body? What happens to your lower body? Do you retain or even increase the muscles in your thighs and calves? Do you lose fat from your legs? How about your upper body? Do you maintain the muscle mass that you had, or do you lose some? What about the fat mass? Lose or gain?

When I was a graduate student, I ran the body composition laboratory. Over my years in the lab, I underwater weighed probably 5,000 people, from five-year-olds to 90-year-olds, from those who were underweight to morbidly obese, from tiny little gymnasts to a Big 10 hockey team. While underwater weighing was the gold standard at the time, it used some assumptions about the distribution of skeletal muscle, bones, and fat mass that weren’t as precise as they should be. These days, state-of-the-art is dual X-ray absorptiometry, which is called DEXA for short. But that doesn’t give us a precise analysis of body composition to answer those questions either.

We now have that technology in magnetic resonance imaging. Using MRI can begin to give us the answer to those questions about muscle and fat mass. Can you get rid of that stubborn belly fat? We finally may have some answers, and I’ll tell you about the latest research on Saturday.

Don’t forget to send me your list of vegetables and fruits you ate over the weekend—and remember the ketchup!

What are you prepared to do today?

        Dr. Chet

The Holiday Challenge

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I hope you all have a safe Memorial Day weekend. Here in the northern hemisphere, it’s the official kickoff of the summer season that ends with Labor Day. I alluded to a challenge, so let me lay it out for you: I want you to keep track of all the vegetables and fruit you eat beginning today.

Expand your horizons and try some new veggies. Challenge yourself to eat something other than Romaine or iceberg lettuce for salads, although they certainly count. Try arugula or bok choy, or switch it up and grill some radicchio. For this challenge, corn on the cob counts as a vegetable instead of a grain. Melon, tomatoes, berries of all types, as well as bananas and apples count. I may even try grilling avocado for the first time.

Need some ideas? Paula found this intriguing recipe online, and we’re trying it this weekend.

The goal is to increase your phytonutrient intake by a massive amount. Vegetables and fruit all have some nutrients you need, and the summer is the easiest time to get them. You can prepare them any way you want; grill watermelon or pineapple or caramelize onions for your burgers. The method doesn’t matter because cooking may change the form of phytonutrients but doesn’t destroy them. As I said in Tuesday’s Memo, condiments count. Ketchup, mustard, and relish—sweet or dill—all have specific phytonutrients in them.

Using the honor system, send me a list of everything you ate from these groups—just the names, not the amounts. For the person who gets the most, I’ll offer a free six-month Insider membership or the digital Optimal Performance program. Have fun, be safe, and I’ll be back next Tuesday.

What are you prepared to do today?

        Dr. Chet

Exercise Is Relative

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The title of this Memo is a concept that can be difficult to understand, especially when you read the studies I’m going to cover after the Memorial Day weekend. I’m going to talk about high intensity and even higher intensity exercise. What I don’t want to happen is for you to begin to read them, make a mental decision that you could never do that, and miss an opportunity to get fitter.

When I say exercise is relative, it’s relative to the physical condition you’re in right now. If you regularly complete 100-mile bike races, you’re in a different category than someone who does 20 minutes on an exercise bike with no resistance. If you’re 25, there will be a difference compared to someone who is 65. Bodyweight also plays a factor. You want the effort to be relative to your fitness level now. If you can’t run, maybe you can walk fast. If you can’t walk fast because of joint pain, perhaps you can ride an exercise bike. If all you can do is put on some music and boogie a little bit, that’s a start. The mode of exercise won’t matter; just the relative effort you put into it.

Keep that in mind as you read the Memos. As long as you’re cleared to exercise by your physician, you can try some of the higher intensity effort exercises to see if they can fit into your workouts.

In Friday’s Memo, I’m going to give you a challenge for the Memorial Day weekend. Without giving you too much information, ketchup, mustard, and relish do count. Count for what? Friday…

What are you prepared to do today?

        Dr. Chet

Where’s the Proof?

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A series of articles and studies published recently have called into question the use of statistics in examining large health databases. It’s especially pertinent to nutrition research because placebo-controlled trials are virtually impossible.

See if this sounds familiar: eating meat is associated with an increased risk of colorectal cancer. The “association” is calculated by considering variables that may impact the development of cancer and estimating the hazard of eating various quantities of meat. Recent articles have called into question whether enough variables are being considered, because only a few people decide what else could impact the development of cancer other than meat. Then the analysis is run and the results reported.

What if they didn’t pick the correct variables or enough variables that could impact cancer? What if they didn’t use the correct statistical methods to analyze the data? That could be why one study shows fish oil lowers the risk of cardiovascular mortality and another says it does not. Let’s look at an example.

“Ultra-Processed Food is Bad”

Eric Schlosser is an author and filmmaker who wrote Fast Food Nation and made the movie Food, Inc.; Food, Inc. 2 has come out recently. As a guest on Real Time with Bill Maher, he commented that ultra-processed food (UPF) is the leading cause of obesity and other diseases, but he offered no evidence to support that position. He suggested that it was the artificial ingredients found in UPF that make us crave them and eat them without restraint. Again, no evidence.

Several epidemiological studies have suggested that UPF is related to obesity. The question that remains is how? If it’s the artificial ingredients, how do they do that? By stimulating appetite? Or turning off satiety signals? Or some other mechanism?

That data isn’t collected in most large studies. When the researchers select variables that could impact the results, are they considering the correct ones? It makes a difference because at the end of these large observational studies, that’s the question that remains: How?

The Bottom Line

There is no conclusion at this point. That’s not usually my style, but this is complicated. There are too many observational studies and meta-analyses that are being used as the foundation of medical care and health and nutrition education, because as I see it the data are incomplete. For now, there are some changes we know will work and can prove: Eat less. Eat better. Move more.

What are you prepared to do today?

        Dr. Chet

Today!

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I’ve said before that in my opinion, the single most important thing you can do to limit the problems of aging is to get to a normal body weight and maintain it. If you’ve been overweight most of your life, as I have been, that can be a real challenge. While the research on what’s called Blue Zones is somewhat controversial, all we have are the observations of different researchers over the years. What seemed obvious to me, as a professional observer, is that people who lived longer seemed to be a normal weight for their height. And to me, that is the absolute goal to work towards.

It’s not easy, and it’s not going to happen overnight. But whether you’re 20, 50, even 70, if it takes you five years to get there, you’re still relatively young. That means that when you do get to be 80, you’ll actually be 80 instead of having died when you were 77. When do you begin to eat less, eat better, and move more to get to that normal weight for height?

Today. No matter how long it’s going to take, you begin today.

Insider Conference Call

I’ve been asked about cyanocobalamin, a synthetic form of vitamin B12. That’s the topic of the evening along with answering personal and product questions. If you’re not an Insider, become an Insider by 8 p.m. Wednesday evening and you can join in the conversation.

What are you prepared to do today?

        Dr. Chet

I’m Alive: V2.55

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When I opened my eyes this morning, I knew I had another year to do what I was created to do: teach people how to be healthy and fit. For those of you who are new readers or those who need a refresher, here’s the story: when I wake on May 10th every year, my superstitious belief is that I have at least one more year to live. My dad died on May 10, 1969. In case you’re wondering, I’m version 2.0 (my father was the first Chester John Zelasko), and it’s been 55 years since my father died. It makes no sense in the real world, especially for a guy who’s a scientist, but every May 10 is a milestone for me.

Last weekend as I pulled into the parking lot where I work out, there was an SUV with a number of plastic bags on the roof arranged in no particular order. As I walked past it, I couldn’t help but notice the car was packed to the ceiling, including the passenger’s seat. In fact, it encroached on the driver’s seat. I don’t know how anyone drives without being able to see the rearview or sideview mirrors, but I guess that person somehow managed. I could speculate whether they were moving or living in their car, but here’s how I saw it.

We all carry the baggage with us—memories of every time we didn’t complete a goal we set, especially health goals. We know the foods we should eat and the ones to avoid. We know that exercise will make us fitter, stronger, and more flexible. We know we have supplements and/or medications we should take for our health or to deal with conditions we may have. In retrospect, we ask ourselves why? Why don’t we do that?

It may not be the only reason or reasons, but I think we carry the baggage of past failures with us. And we continue to lose fitness, strength, and on and on. You know the worst sentence I can think of? “What difference will it make now?” It will make a huge difference. Can you walk your daughter down the aisle, or will you need a walker? Will you need a wheelchair in five years, or can you postpone that? Will you still have the flexibility 15 years from now to take care of your own personal needs, or will you need someone else to bathe you and clip your toenails? In 20 years, will you still be chugging along, or will you be so heavy you can’t stand up without help? I can think of hundreds of examples, but insert your own. It matters.

The important point is that you can change your trajectory. Joining a workout group or taking charge of your diet can make a world of difference in your future, so stop putting it off till next month.

I have my own baggage to deal with, so this version is going to overcome as much of it as I can this year. I’m going to spend the year encouraging you to do the same. We have things to do, and we just have to find a way to drop the baggage and get out of our own way to be the next version of ourselves. All the people who need you will be glad you’re making the effort.

What are you prepared to do today?

        Dr. Chet

Reflections on Family

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I’m going to tell you a story you’re going to find hard to believe. My in-laws, Don and Ruth Jones, were married for over 70 years. Mom died on May 7, 2014, ten years ago; we got the call about 9:30 p.m. Exactly three years later on May 7, at the same time, Dad passed away. I never felt sad about his passing because he was exactly where he had wanted to be for the prior three years—back with Ruthie. But exactly three years, almost to the hour?

Those who knew Ruth and Joner, which was his nickname, knew how close they had been all their adult lives. Ruth shaking her finger at Joner was such an iconic image, their granddaughter, Lori, recreated the scene with her new husband in one of her wedding photos. So it’s easy to imagine Ruthie up in heaven shaking her finger and saying, “Okay, Joner, three years is long enough. Get up here now!” And he went.

Two more short stories. Years ago I had been talking with them about a study on aging. Statistics showed—and still do—that women over 70 can’t lift 10 pounds over their head. As they were unloading groceries, Mom picked up a 10-pound sack of flour and lifted it over her head several times saying, “Look, Chet, I can do that.” It still makes me smile 20 years later. Paula says it was always a waste of breath to tell her she couldn’t do something.

Dad had a number of sayings that he accumulated over the years, but my favorite has to be this one: “Don’t force it—get a bigger hammer.” Spoken like a truck mechanic. Ruth and Joner were a hoot, and I miss their sense of humor. They were all about laughter and unconditional love. I hope the same can be said of us all.

What are you prepared to do today?

        Dr. Chet

Eat Less, Eat Better, Move More—for Life

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In Tuesday’s Memo, Dr. Donal O’Shea suggested that there’s compelling evidence that eating less and moving more won’t result in permanent weight loss because the set point theory is just too strong and will defeat the effort of 90% of the people. However, he didn’t provide any evidence that’s true. I’ll give him the benefit of the doubt, because every study done on diets shows that people do gain back some or all of the weight they lost. He attributes that to the complexity of obesity.

The Complexity of Obesity

Take a good look at the graphic used in the heading. What you can’t read are the 198 determinants (all those gray lines) that contribute to obesity. He narrows them down to just seven categories, five of which are not under the control of people once they are fat. In case it’s difficult to read, here is the list.

  • Societal influences
  • Food production
  • Activity environment
  • Biology
  • Individual psychology
  • Food consumption
  • Individual activity

He also gives a compelling argument that the immune system, working in conjunction with fat cells, causes inflammation in a variety of ways which prevents people from losing weight.

The problem that I have is two-fold. First, it seems the last three are under the control of the individual: eating, moving, and deciding to do so. The exterior forces are what they are, but biology can change. Aging is the perfect example of that.

As for immunity, here’s the real question about the immune system: is it cause or effect? The increase in inflammation is remarkably similar to the increase in cortisol found in people who are obese. Is it the cause of obesity or is it the result of being obese? It makes a difference.

Why Medication Won’t Be the Permanent Solution

Before I get into this, I think that medications may play a role in the solution for some, maybe even most severely overweight people. But they will not be a permanent solution, and the reason may be found in the proteome. You may remember that those are the proteins coded for in our DNA; they range from hormones such as insulin to catalysts for other chemical reactions. There are about 5,000 proteins that are the most researched, but with about 20,000 genes, there may be at least 15,000 more genes that are not researched. That doesn’t count the post-translational modifications, modifications made to the protein as it’s being made; the total could get into the millions.

It’s unrealistic to think that a combination of three, five, or even ten receptor agonists will solve obesity and not cause issues elsewhere in the body by interfering with the production of other necessary proteins. I’m not suggesting that temporary use to get the bulk of weight off an individual won’t be a good way to start, but it’s not a permanent solution as I see it, even if you can afford to take it the rest of your life.

The Bottom Line

The issue with O’Shea’s approach is that it comes from a strictly medical perspective. A nutritional solution isn’t considered and somewhere along the line, just like with gastric bypass, people will exceed their desired caloric intake and regain weight. Why? Because they haven’t learned anything.

Remember, in those seven categories he cited, food consumption and activity levels are under the control of the individual. That means both the quantity and the type of food as well as the amount of activity are under the control of the individual. I’ll say it again: it was, it is, and it will always be about the calories—how much you take in versus how much you use. Take in more than you use, and you gain weight. It’s that simple.

Obesity is complex because our bodies are complicated, but this is still my recommendation: eat better, eat less, and move more. If I were to add two more words that I’ve implied but haven’t stated, they would be “for life” because the only way to hold on to your progress is to keep working on your lifestyle.

What are you prepared to do today?

        Dr. Chet

References:
1. SETU. Understanding Obesity: Rethinking Diagnosis & Treatment. 2024.
2. Nat Chem Biol. 2018 Feb 14; 14(3): 206–214.