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How Many Steps to Stay Healthy?

A: Good question. Carol and I have wondered about this for some time. She goes over 10,000 steps on most days, while 7000 works better for me.

The goal you hear most often is 10,000 steps, a nice round number, easy to keep in mind. But is it a doorway to health?

A new study led by researchers from Harvard appears to be the first to address this issue scientifically.

The 10,000-step target for health originated decades ago in a marketing campaign to promote a Japanese pedometer. "The original basis of the number was not scientifically determined," lead researcher I-Min Lee, MBBS, ScD, Division of Preventive Medicine at Harvard Medical School, told the media.

The study found the 10,000 number to be off on all sides. Benefits were found to begin at about 4400 steps and topped out at about 7500 steps.

The researchers equipped 16,741 women, average age 72, with accelerometers during waking hours for 7 days to measure steps per day and step intensity.

A 4.3 year follow-up found that women who averaged approximately 4400 steps were 41% less likely to die than those who took 2700 steps or less. At about 7500 steps, mortality benefits leveled out at 58 percent.

"Purposeful steps" reflecting higher intensity were associated with lower mortality rates, but were not clearly related to lower mortality after adjusting for steps per day. 

This is good news for those who find it difficult to log 10,000 steps a day. This finding will motivate them to get out and walk a comfortable distance, knowing that they will benefit.

No question about it, physical activity of all kinds--gardening, carrying groceries, cutting grass, climbing stairs, on and on--helps to keep us healthy. The miracle of movement casts a wide net, benefiting anyone willing and able to partake.

You'll find many more examples in our Fitness and Health category: https://www.cbass.com/fitness_health.htm 

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The researchers added that they would like to know how much walking may affect other health factors such as quality of life, memory, and cognitive function. It is possible that walking a greater number of steps each day could influence these outcomes.

The new study was published May 29, 2019, in JAMA Internal Medicine. You can read the details online: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2734709

July 1, 2019

Can Too Much Sitting Override Exercise?

A: We have two new studies suggesting that may indeed be the case. One involves older women and the other healthy and physically active graduate students. The first study is large, high tech and comprehensive; the other is small, short-term, and narrowly focused. Both carry an important message for people who are inactive for long periods during the day, regardless of their level of fitness or other cardiovascular risk factors. What you do throughout the day is consequential.

Published February 19, 2019, in a special "Go Red for Women" edition of Circulation, the first study equipped 5,638 healthy women, aged 63 to 97, with accelerometers to record their movement and periods of inactivity for 4 to 7 days. It was the first study to objectively measure the impact of patterns of inactivity on cardiovascular disease.

"There's problems with self reported measures," lead investigator John Bellettiere, MD, University of California, San Diego, told TCTMD.com. "People have a hard time recalling how much time they spend sitting, so there's a lot of error in those measures...We found significantly larger effect sizes than what was found previously in studies that relied on self-reporting."

Five years of follow up found that both daily sedentary time and long uninterrupted periods of inactivity were associated with increased risk of fatal and nonfatal cardiovascular disease. Women with the most prolonged periods of sedentary time had a 54% increased risk of cardiovascular disease. 

Risk was lower when sedentary time was interrupted by physical activity. 

The stunner was that the association of prolonged inactivity and cardiovascular disease held up regardless of the women's overall health, fitness, diet, weight, and other cardiovascular risk factors, as well as exercise. Moderate or vigorous exercise made no difference. 

Keith Diaz, PhD, Columbia University Irving Medical Center, New York, NY, who was not involved in the study, told TCTMD that the new analysis drives home the important message that not only does the total amount of daily sedentary time matter, but also sitting without moving for extended periods of time.

"They both matter," said Diaz. "If you're a person that has to sit all day at work, just taking a break every 30 or 60 minutes and walking around could be one health-behavior change you make to reduce your future risk."

Diaz stressed that the risk of sedentary behavior is independent of physical activity. "You can't just exercise in the morning and think you've checked off your activity box and sit the rest of the day," he continued. "We're learning that optimal physical activity is someone who is moving throughout the day. And yes, more intense activity is better, but even light intensity still has benefits. It's about moving and moving throughout your day. It's not just about exercising for 30 minutes and thinking you're done."

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The second study comes from Professor Edward Coyle's Human Performance Laboratory at the University of Texas in Austin. The findings were published February 14, 2019 in the Journal of Applied Physiology and discussed at length in the New York Times by health and fitness writer Gretchen Reynolds.

Healthy, physically active graduate students who sat for long periods developed metabolic problems that appear to override the benefits of exercise. These data suggest "that people who exercise in compliance with general activity guidelines but remaining inactive for prolonged periods during the day are still at increased risk for cardiovascular disease and premature death," the researchers concluded.

Ten students (5 male and 5 female) completed a crossover protocol to determine the impact of an intense bout of exercise on their metabolism after prolonged sitting. Four days of prolonged sitting (~13.5 hours a day) without exercise were compared with 4 days of prolonged sitting with a one hour bout of treadmill exercise on the evening of the fourth day. On the morning of the 5th day (with and without exercise), the students were given a large breakfast shake composed of half-and-half cream and melted ice cream, following which blood was collected over a six hour period and analyzed for triglycerides, glucose, and insulin.

"No differences between trials were found in the overall plasma triglycerides, glucose, or insulin responses during the high-fat/glucose tolerance tests," the researchers reported. "These data indicate that physical inactivity (sitting ~13.5 h/day and <4,000 steps/day) creates a condition whereby people become 'resistant' to metabolic improvements that are typically derived from an acute bout of aerobic exercise."


Gretchen Reynolds talked with Professor Coyle about the study and concluded her report with the following observations:

[The study] does not explain how inactivity might be undercutting the benefits of exercise, although Dr. Coyle suspects that lengthy sitting increases the body's production of certain undesirable substances and may hinder the release of other, beneficial substances that normally would be produced during exercise.

He and his colleagues hope to explore some of those issues in future studies. But even now, he says, the data indicate that "it is a very good idea not to sit all day."

June 1, 2019

What's New in Physical Activity Guidelines?

A: The 2nd Edition of The Physical Activity Guidelines for Americans issued on November 12, 2018, is more welcoming to efficient exercise. Not only does it recognize HIIT as an aerobic option, it conveys a more practical understanding of healthful physical activity. It gives the 80% of Americans who are sedentary more reasons to adopt the guidelines and get moving.

First and foremost they emphasize that regular physical activity is one of the most important things we can do to improve our health and prevent chronic disease. The benefits begin with childhood and grow with age.

The new guidelines retain the earlier recommendations of 150-300 minutes a week of moderate-intensity or 75-150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of the two, with at least two days a week of muscle strengthening activities of moderate or greater intensity involving all major muscle groups--all in order to stay healthy. Older adults are urged to include balance training.

They also make some uplifting changes.

A piece on the Cooper Institute website by Steve Farrell, PhD, FACSM, emphasized several upgrades.

Every minute counts. The 1st Edition stated that aerobic exercise had to be performed in bouts of at least 10 minutes in order to count toward the minimum recommendation of 150 minutes per week. The most current evidence clearly shows that the total volume of physical activity is what’s important for health benefits. This is good news because it means that if you walk up a few flights of stairs in one minute, or take a three-minute walk at work, this now counts towards your 150-300 minutes per week. In other words, the 10-minute requirement no longer exists.

Reap immediate benefits. We now know that a single bout of moderate to vigorous physical activity can improve sleep, reduce anxiety, improve brain function, reduce blood pressure, and improve insulin function on the day that the activity is performed. That means that taking a short walk can show immediate improvements in your mood, stress levels, blood pressure, and more.

Dangers of sitting. There is now a much stronger focus on reducing sedentary behaviors such as prolonged sitting. While there is no specific guideline in this regard, individuals are urged to break up sitting duration during the day. For example, you might choose to stand instead of sit during phone calls while at work and take short walking breaks throughout the day instead of sitting for long periods of time.     

You'll find more significant changes on The Cooper Institute site: https://www.cooperinstitute.org/2018/11/16/new-update-to-physical-activity-guidelines-for-americans-15845

See also: https://health.gov/paguidelines/ 

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I've been asked if my current protocol of once-a-week high-intensity strength and aerobic workouts, along with Morning Motion and walking satisfy the requirements of the New Guidelines.

Indeed it does. I'm an example of what the Guidelines promise--what a lifetime of exercise can produce.


A lifetime of exercise can make you look and feel like this at 60.

Photo by Pat Berrett

February 1, 2019

Top Performance Supplements?

A: A 2018 review of "Evidence-Based Supplements" in the International Journal of Sport Nutrition and Exercise Metabolism led off the "Established" category with the two I use: caffeine and creatine. These and the other reviews are the most detailed and wide ranging I've seen. I'll summarize the top two and then provide the link to the rest of the supplements in the "established" category along with those listed as "equivocal" and "developing."


Caffeine (coffee for the vast majority) has well-established benefits. It improves alertness and reduces perception of exertion during exercise. "There exists a lengthy research history on caffeine supplementation across a range of performance protocols, including endurance-based situations, resistance training exercise, short-term supramaximal [overload] efforts, and/or repeat-sprint tasks." In short, from treadmill running to exhaustion to resistance training to failure.

"Of note, larger caffeine doses do not appear to increase the benefits to performance. In fact, such doses are likely to increase the risk of negative side effects, such as nausea, anxiousness, insomnia, and restlessness." So more is rarely better.

"In summary, low to moderate doses of caffeine, consumed 60 minutes preexercise, appear to have the most consistent positive outcomes on sports performance in research situations."

So my double strength coffee 30 minutes to an hour before workouts is on target. My coffee is made with two-thirds whole milk, along with a tsp of canola oil and a Tiger's Milk bar to slow absorption and prolong the benefits. This combination puts me in the mood to train and helps keep me motivated. My workouts are usually an hour or less and I almost never have trouble staying motivated. More coffee before or during my workout is unlikely to help, and would likely be counterproductive.


Creatine is another widely-researched supplement, with creatine monohydrate (CM) being the most commonly used form (found naturally in meat). No bells and whistles are needed. Moreover, big meat eaters are unlikely to benefit--like pumping gas into an overflowing tank.

Most benefits are seen in resistance and interval training, leading to greater gains in lean mass and muscular strength and power. Little or no gain is likely in endurance sports. (see exception below)

"Numerous reviews of CM supplementation identify performance benefits in single (+1-5%) and repeated bouts (+5-15%) of high-intensity exercise of less than 2.5 minutes, with the most pronounced effects being seen during tasks of less than 30s."

There is, however, some evidence of benefit in late stages of endurance events. "In fact, recent evidence has shown that a combination of creatine...and carbohydrate...loading may results in increased power output during repeated high-intensity sprint efforts during late stages of prolonged...cycling events." (My first experience of the performance benefits of creatine was at the end of a long climb up the eastern slope of the Sandia mountains; see my article linked below.)

The usual strategy is to begin with a "loading phase" calling for three or four doses a day for 5-7 days, followed by a smaller "maintenance phase" of a single daily dose.

Research suggests that creatine uptake is best when taken with sources of carbohydrate; see above. (I always take my creatine with meals.)

Importantly, no negative effects have been reported with use of CM for up to 4 years.

"In summary, when accepted CM supplementation protocols are followed, the expected increase in intramuscular creatine stores are likely to enhance lean mass, maximal power/strength, and the performance of single and repeated bouts of short-term, high-intensity exercise."

*  *  *

My impression is that the doses called for on labels are almost always excessive, especially for those of small stature like me. I currently take 1/2 level tsp before and after workouts--and nothing on rest days.

For many more details, see my article written soon after I began taking creatine: https://www.cbass.com/CREATINE.HTM

*  *  *

You can read the entire 2018 supplement review online: https://journals.humankinetics.com/doi/10.1123/ijsnem.2017-0343

February 1, 2019

Flexibility: Stretching vs. Strength Training?

A: When I started training more than 65 years ago athletes were told not to lift weights, that it would make you muscle bound. It wasn't true, of course. Olympic weightlifters were and are some of the most flexible athletics in the world. Athletes in practically all sports now train with weights. The question remains, however, whether athletes should lift and stretch. "There's an old notion that if you do resistance training, you have to stretch those muscles too," James Whitehead, EdD, a researcher at the University of North Dakota, told WebMD. "It's a hangover to the myth that muscles lose flexibility as they get bigger." 

Many athletes, perhaps most, combine stretching and resistance training. That may not be necessary if you lift through a full range of motion. New research calls into question the idea that stretching improves flexibility more than resistance training.

My experience is that a general warm-up, a form of dynamic stretching, is helpful. Helpful in preparing your muscles and joints to lift. Improving flexibility is another matter.

Testing at the Cooper Clinic some years ago graded my flexibility "very good" to "excellent."

I attribute this to decades of lifting weights through a full range of motion.

I've never done static stretching.

Photo by Justin Joseph

An event years ago forever changed the role of weight training in athletics.

The Karpovich Conversion

Weight Training in Athletics (Prentice-Hall, 1956) a book by Jim Murray, a former Managing Editor of Strength and Health magazine and Peter V. Karpovich, MD, Research Professor of Physiology at Springfield College (MA), marked the turning point. I read it as a teenager; it still has an honored place in our library. It exposed the muscle bound myth and turned the tide of weight training in athletics. 

When Dr. Karpovich was a boy, he heard a story that a professional wrestler and strongman could not reach between his shoulder blades to scratch and had to pay a penny to a little boy to do the scratching. When Karpovich became a physician, he was strongly opposed to weight lifting as a result. An event some years later presented him with the opportunity to test the story.

Bob Hoffman, the publisher of Strength and Health magazine, visited Springfield College to give a lecture and a demonstration of weight training. He brought with him two-time Mr. America John Grimek and John Davis, a world champion Olympic weightlifter. During the question and answer period, Karpovich politely asked Hoffman to ask Mr. Grimek to scratch his back between the shoulder blades. After a stunned silence, Hoffman asked why he wanted Grimek to scratch his back. Dr. Karpovich explained that he had been told that weight lifters are so muscle-bound that they can't scratch their backs.

Murray and Karpovich wrote in their book what followed: 

"Well, John," said Hoffman, addressing Grimek, "oblige the doctor and scratch your back." And Grimek did, first with one hand, and then the other. He scratched from above the shoulder and then from below. Davis did the same.  The audience roared with laughter at the expense of Dr. Karpovich. 

Just getting started, they proceeded to do a series of gymnastic moves, including splits, backbends, handstands, and elbow touches.

This photo of John Grimek displaying amazing flexibility is taken from the Murray-Karpovich book.

The book was widely used as a college textbook for many years. Murray acknowledged that its success with educators and coaches would've been unlikely without Dr. Karpovich, who from then on promoted weight training in athletics.

Study Finds Resistance Training as Good or Better than Static Stretching

Only recently has there been a challenge to the common practice of combining RT and SS.

Finding no research pitting strength training against stretching for improving range of motion, Dr. Whitehead and colleagues compared the two techniques on key muscles and joints in 25 college-age volunteers and reported their results in the Journal of Strength Conditioning Research (December 2011).

Participants were randomly assigned to strength training or stretching programs focusing on hamstring muscles and hip, shoulder, and knee muscles and joints over five weeks. A control group of 12 other students did neither type of exercise.

The joint and muscle results are online. Here's the researcher's bottom line:

The results of this preliminary study suggest that carefully constructed full-range RT regimens can improve flexibility as well as the typical SS regimens employed in conditioning programs. Because of the potential practical significance of these results to strength and conditioning programs, further studies using true experimental designs, larger sample sizes, and longer training durations should be conducted with the aim of confirming or disproving these results.

Time to rethink stretching routines? I'd say so.

Grimek and Davis are gone, but the impact of their demonstration at Springfield College lives on. It's time for coaches and athletes to revisit the need for static stretching in strength training regimens.

December 1, 2018

Lifestyle Factors Influencing Testosterone?

A: Integrative Sexual Health (Oxford University Press, April 2018) a new book in the Weil Integrative Medicine Library, offers interesting insights in this area. Integrative medicine takes into account the whole person and all aspects of lifestyle. The stated goal is to combine the best ideas and practices of conventional and alternative medicine. In keeping with this concept, the authors come from different fields: Barbara Bartlik, MD, is a board certified psychiatrist; Geovanni Espinosa, ND, a naturopathic doctor; and Janet Mindes, PhD, a research psychologist/neuroscientist. Series editor, Andrew Weil, MD, is a Professor and the Director of the Arizona Center for Integrative Medicine at the University of Arizona. Many others also contributed: https://global.oup.com/academic/product/integrative-sexual-health-9780190225889?cc=us&lang=en&#

The book may go a long way toward explaining why my testosterone level is in the upper range of normal (240-1035), while the average 80-year-old man will see his testosterone drop by 50 percent.

While the integrative approach to sexual health involves many factors that affect testosterone, the focus is on three.


The authors don't pull any punches, pointing out that all forms of exercise are not equal. Endurance exercise such as running marathons actually lowers testosterone, while strength training involving the large muscles of the back and legs can increase testosterone. "Deadlifts and Squats are excellent for this purpose," Dr. Espinosa told CNN contributor Ian Kerner, a licensed couples therapist. My thought is that sprint intervals also help to increase or maintain testosterone level. This would include running, rowing, the Ski Erg and the Airdyne, and other short duration, high intensity forms of exercise involving the large muscles of the body.


Diets that promote fat accumulation lower testosterone, according to Dr. Ronald Hoffman, who wrote the chapter on diet and testosterone. Fat cells soak up testosterone and make it less available, he explained.

"For peak testosterone production, some carbs are necessary, but preferably the slowly metabolized kind from high-fiber fruits, vegetables, whole grains and legumes," Hoffman told CNN's Kerner. As I wrote in Ripped many years ago, a balanced diet of whole foods is the key to staying lean.


Sleep is important for optimal levels of testosterone, most of which is produced after 5 hours of sleep, according the authors. This could explain the recent surge in my testosterone level. With the help of my Fitbit, I am now averaging more than eight hours of sleep. Some nights I sleep better than others, but my average is the best since my teen years.

For a long time I read in bed until sleep came, ignoring the advice to use the bed for sleep and sex only. I now read in a comfortable chair in our bedroom until I feel sleepy. If I can't go to sleep, I get back up and read some more until sleep comes. IT WORKS. I should've tried it long ago.

I also try to go to bed and get up at the same time. It doesn't always work, but I'm getting pretty good at it.

Another key is to choose your night time reading material carefully. I'm now reading Tom MacDonald's Murder In The Charlestown Bricks, the fourth in his Dermot Sparhawk crime series. It makes me happy and puts me in the mood to go to sleep. I'm careful to find an appropriate time to put the book down and go to sleep. If it upsets me I read on until I come to something that calms me.

Tom asked my permission to include a character with my name. I've just come to that section. I won't spoil it for those planning to read the book, but I will tell you that he describes me and lays out my background--and then massages the details to fit the story line. He does a marvelous job using his imagination and storytelling ability to create the profile he wants. It's hard to go to sleep when you're smiling ear to ear. 

*  *  *

Finally, Integrative Sexual Health tells us that low T is no longer just for older men. It can happen at any age. Strength training, healthy eating, and good sleep habits work at any age.

Testosterone replacement therapy should be a last resort. It can have worrisome side effects, such as decreased sperm production and shrinkage of the testicles. "Testosterone, like all hormones, has multiple action on many body functions and on the mind," Dr. Weil tells us. "In my opinion, it should be taken--and prescribed--only to correct a deficiency documented by appropriate blood tests."

December 1, 2018

Why Is Strength Training So Complicated?

A: That may be a problem if you dwell on all the different forms and methods of resistance training. But not if you look on the different approaches as options--a good thing--keeping in mind that the key factor in building strength is overload or exerting yourself beyond what you are accustomed. We have a new study from the UK that illustrates that point. Another study looks at the effort required to combat the effects of sedentary living late in life.

Both studies show that effective exercise does not have to be complicated. Overload is the overriding factor.

The first study evaluates Time-Under-Load (TUL) as a variable in strength training; it refers to repetition duration, how long it takes to lift and lower a weight.

A team of U.S. and British researchers, led by Professor James P. Fisher, Southhampton Solent University in England, tested the effect of TUL on strength, body composition, muscle size, and fasting blood sugar. "The purpose of this study was to compare load, and TUL matched groups performing resistance exercise using different repetition durations," they wrote in introducing the study. In other words, they zeroed in on the duration of each repetition.

Fifty-nine male and female participants were randomized into 3 groups: a control group lifting at a normal speed, a slow group, and a very slow group.

Following two different routines emphasizing the chest press, leg press, and pull down, the subjects performed nine exercises to "momentary failure," which took about 12 reps in the control group, four or five in the slow group, and only one lift in the very slow group. The total TUL was 90 seconds for all three groups.

All participants were experience trainers and lifted twice a week.

After 10 weeks, subjects in all three group showed significant strength increases in all exercises, but no between-group differences in strength or other variables.

"Repetition duration does not affect the increase in strength in trained participants where exercise is performed to momentary failure," the researchers concluded.

"Our paper showed that you don't need to spend two hours in the gym five times a week, as many people think," Dr. Fisher told Washington Post writer Amby Burfoot. "Even trained individuals continue to make gains with less than an hour a week," he continued. "My own workouts take less than 20 minutes, twice a week."

"The main message," Fisher told Burfoot, "is that resistance training can be relatively simple and still effective. It doesn't have to get complicated by various training methods and protocols."

Overload is the key. You can lift at any pace you enjoy--short of heaving the weight--but it is important to continue each set until you can't do another rep in good form.

Exercising for LIFE

The Lifestyle Interventions and Independence for Elders (LIFE) Study by Tufts University Professor Roger A. Fielding and colleagues is the largest and longest randomized study of older adult exercise.

Participants ranging in age from 70 to 89 years, considered at high risk for mobility disorders, were randomized to exercise or study groups. Exercise sessions involved 30 minutes of walking, strength training focused primarily on the legs, 10 minutes of balance training, and flexibility exercises for large muscle groups. A goal of 150 minutes weekly was set for the exercise group. Initial results showed a significant reduction in risk of physical disability in the exercise group, even in those with a lower level of functioning at the start of the study. This prompted a follow-up analysis to determine the amount of exercise required to achieve improvements in physical functioning.

The secondary study showed that participants whose physical activity increased the most had the most improvements in outcomes such as mobility and walking speed. A pleasant surprise was that clinically meaningful reductions in risks of physical disability occurred with an increase of just one exercise session per week. A fraction of the 150 minute standard.

"Our analysis showed that the required amount of exercise to achieve substantial benefits for older adults at risk for physical disability is relatively small--only 56 minutes weekly," Fielding told Tufts Health & Nutrition Letter. "Even a small increase in the amount of weekly exercise can have substantial benefits," he continued.

"When it comes to getting moving, it seems there really is no such thing as too little, too late," the Health Letter concluded.

For inactive oldsters almost any amount of exercise constitutes overload--activity beyond what they are used to. The first step leads to another and another. Progress brings more activity and more mobility.

November 1, 2018

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