FAQs

Some Frequently asked questions on Vitamin issues:

1) If aerobic exercise doesn’t help me to lose weight much faster, then why should I spend the extra time and effort running, stair climbing, cycling, etc.?

Despite its limitations with regard to promoting weight loss, exercising aerobically provides several important health benefits. Among the major health benefits of aerobic exercise for overweight/overfat individuals are the following:

• Improved aerobic capacity. All other factors being equal, an individual with a high aerobic capacity will have a high physical working capacity.

• Reduced risk of developing obesity-related diseases such as diabetes, coronary heart disease, and hypertension.

• Improved blood lipid-lipoprotein profile, specifically decreased triglycerides, and increased high density lipoprotein cholesterol (HDL-C) — the “good” form.

• Improved psychological status, particularly enhanced self-esteem, general well-being, and decreased anxiety and depression.

• Increased fat loss to weight loss ratio (i.e., more of the weight lost is fat).

• Enhanced long-term weight management. Regular exercise is the most powerful predictor of long-term weight loss success. It helps to ensure that individuals not only lose weight, but also keep it off.

2) What basic steps can I take to minimize the risks associated with exercising?

Unfortunately, no human endeavor is totally free of risk—including exercise. The risks of exercise, however, can be minimized by adhering to certain principles and guidelines. The first step is to ensure that you are medically safe to exercise. This process involves seeing a physician and undergoing a physical examination and evaluation before you initiate your exercise program. The extent of your evaluation depends on your age, health status, and the anticipated exercise intensity. For example, all older asymptomatic individuals (males 40 plus, females 50 plus) or at high risk (e.g., having one or more risk factors, including smoking, hypertension, high blood cholesterol, obesity, stress, family history of medical problems, diabetes) should undergo a physician-supervised, graded exercise test. Healthy individuals under age 40 for men and 50 for women are usually cleared for exercise upon completing a medical/health status questionnaire, if the answers don’t reveal any possible contraindications to exercise.

The next step is to develop a sound exercise program based on scientifically documented information. Such a program should involve starting at an intensity appropriate for you and then progressing gradually to a point where your body must respond to increasingly higher physical demands. The temptation to do too much too soon should be avoided. Moderation is essential. The point to remember is that a major cause of musculoskeletal injuries is overuse—placing demands on your body that your body simply is not designed to handle. A sound exercise program always includes provisions for stretching the major joints of your body before and after exercising. It also ensures that you get proper rest (sleep). Rest enables you to better recover from the demands placed on your body by exercising.

The final step is to listen to your body. You should respond accordingly to common exercise termination signals (e.g., dizziness, light-headedness, abnormal heart beats, pain or pressure in your chest, musculoskeletal trauma, prolonged fatigue, etc.). These signals are your body’s way of telling you that something is amiss and that you must decrease the level of stress to which you are subjecting your body.

3) What is the best method for determining an individual’s ideal body weight?

To determine ideal body weight, individuals should not rely solely on a bathroom scale, height-weight tables, or percent body-fat measurements. Sound nutrition and exercise science principles, along with common sense, mandate that individuals should avoid setting “hard and fast” body-weight goals. Rather, they should strive for achieving a level of body weight that is compatible with a healthy life-style (e.g., sensible eating, regular exercise, etc.). All factors considered, the body weight that results from adopting such a life-style should ultimately be considered as the ideal union between an individual’s wellness level, genetic potential, and a state of reality. What represents a safe, realistic, and, perhaps more importantly, attainable body weight for an individual will depend (to a large extent) on the following factors:

• Medical History. An individual’s current medical history, to include a thoughtful review of personal health-risk factors, should be taken into account when attempting to define ideal body weight. For example, if an individual’s blood pressure is elevated, a modest weight reduction (e.g., as little as 10 lbs.) has been shown to be quite beneficial. Extra body mass means that the heart must work harder to pump blood through miles of extra capillaries that feed that extra tissue. Type II diabetes and blood lipid-lipoprotein profiles are further examples of medical conditions that can be positively affected by weight loss.

• Family History. Body weight, like most other physical characteristics, is strongly influenced by genetic factors. If an individual’s parents and siblings are extremely overweight, it is highly unlikely that such an individual will ever be “model-thin.” As unfair as such a judgment might first appear, such a limitation should be kept in mind when establishing ideal body-weight goals.

• Body Composition. Leaner bodies are more effective calorie burners. The more muscle or lean body mass individuals have, the more calories they burn. Men naturally have more muscle mass than women, and, as a result, have higher metabolic rates. Furthermore, individuals who exercise on a regular basis tend to have more muscle mass and higher metabolic rates compared with their sedentary counterparts. Accordingly, although individuals who have a relatively high amount of muscle may weigh substantially more than others of similar heights, their body-weight levels may be entirely appropriate given their lean muscle mass.

• Body-Fat Distribution. Body fat located in the upper-body region is very risky in terms of health profiles. If individuals possess a high amount of upper-body or abdominal fat, they should consider losing weight (specifically body fat) through a combined program of sensible eating and exercise. One commonly accepted method of determining whether individuals have excessive amounts of upper-body fat is to look at their waist-to-hip ratios. The waist-to-hip ratio (WHR) is a simple, yet accurate, method for determining body-fat distribution patterns. WHR is determined by dividing the waist circumference by the hip circumference. Waist circumference is defined as the smallest circumference between the rib cage and belly button. Hip circumference is defined as the largest circumference of the hip-buttocks region. Men with WHR values exceeding .95 are considered to have an excessive amount of upper-body fat, while those with less than 0.95 are deemed to have an acceptable level of upper-body fat. Women with WHR values above 0.80 are considered to have an unhealthy amount of upper-body fat, while those with scores less than 0.80 are designated as having a reasonable level of accumulated adipose tissue on their upper bodies.

• Functional Ability. If the ability to effectively and efficiently perform activities of daily living and to comfortably engage in a variety of recreational pursuits is impaired, an individual should strive to attain a level of body weight that will support a healthy, functional life-style.

4) What is the significance of the waist-to-hip ratio measurement from a health-risk perspective?

Recent data indicate that the pattern of fat distribution throughout the body is an important predictor of the health risks of obesity. Exercise scientists have classified where the fat is deposited on the body into two basic categories: male-pattern (or apples) and female-pattern (or pears). Despite their names, each type of fat pattern can occur in both sexes, although men tend to be apples and women tend to be pears. Apples characteristically deposit high amounts of fat in the abdominal and trunk regions, while pears deposit high amounts of fat in the hip, buttocks, and thigh regions.

The waist-to-hip ratio (WHR) is a simple, yet accurate, method for determining your body fat pattern. WHR is determined by dividing the waist circumference by the hip circumference. Waist circumference is defined as the smallest circumference between the rib cage and belly-button. Hip circumference is defined as the largest circumference of the hip-buttocks region.

Men with WHR values exceeding 0.95 are considered apples; those with less than 0.95 are deemed pears. Women with WHR values above 0.80 are considered apples, those with scores less than 0.80 are designated as pears. Research has shown that apples are at a greater risk for developing a number of health-related problems, the most prominent being hypertension (i.e., high blood pressure), type II diabetes (i.e., non-insulin dependent diabetes), and hyperlipidemia (i.e., elevated levels of fat in the blood).

Scientists believe that two characteristics of abdominal fat cells are probably responsible for the greater health risk associated with being an apple. Abdominal fat cells tend to be larger than those located in other regions of the body. Relatively large fat cells are associated with insulin resistance (i.e., reduced tissue responsiveness to insulin), which means body cells will take up less glucose (sugar) from the blood, causing the blood sugar level to rise. In response to the elevated blood sugar level, the pancreas secretes more and more insulin (hyperinsulinemia). Full-blown diabetes (type II) can develop if blood sugar rises enough.

Hyperinsulinemia, by promoting sodium reabsorption by the kidneys and stimulating the sympathetic nervous system, can predispose an apple to hypertension. Also, the rates of enzyme-initiated chemical reactions are higher for abdominal fat cells, thus making them more metabolically active than fat cells located in other regions of the body. The more metabolically active abdominal fat cells can be easily released into the blood stream resulting in hyperlipidemia.

All the news is not bad for apples, however. Research has shown that weight reduction tends to be easier for them, as they benefit from the high turnover rate of abdominal fat. For pears, however, weight loss is more difficult because fat cells in the hip, buttock, and thigh regions do not easily relinquish their fat. This tendency for pears to stubbornly hold onto their fat helps to ensure that nursing mothers maintain sufficient energy reserves. While it is true that apples are at a greater health risk and pears are at a disadvantage with regard to weight reduction, exercise training and a prudent diet (regardless of your body shape) can help to counteract many of the negative health consequences of obesity and result in a weight loss that can be maintained.

5) What causes cellulite, and what, if anything, can be done to eliminate it? Do any of the creams, herbs, wraps, antitoxins, or special exercises actually work?

When the fibrous strands within ordinary fat tissue become stretched, they produce a dimpling effect on the overlying skin. The dimpled appearance, often seen on the hips, thighs, and buttocks, is commonly referred to as cellulite by the plethora of manufacturers, marketers, and sellers of the various gimmicks and gadgets that purportedly work to remove it. However, nothing unique exists about that kind of fat on the body. Short of liposuction, no special or “secret” methods — including creams, foods, diets, drugs, machines, or exercises — will selectively eliminate the so-called cellulite.

6) I’m interested in losing weight. What type of exercise is best?

It takes two different types of exercise to help you most effectively lose weight and keep it off: one to burn a high number of calories (aerobic-type exercise), the other to build and preserve muscle tissue (strength-training exercise). Muscle tissue enables you to lose weight and keep it off because it helps you maintain your resting metabolic rate, thereby allowing you to burn a greater number of calories when you’re at rest. An analysis of the available data indicates that, in general, the combination of a conventional aerobic exercise program with a severely calorie-restricted diet does little (if anything) to help preserve lean body mass during weight reduction.

It is important to keep in mind that the less lean body mass you have, the lower your resting metabolic rate will be. As a result, it is more likely that you will regain some or all of the weight loss you may have achieved. On the other hand, if you engage in exercise designed to improve your muscular fitness level at the same time you are losing weight, you will enhance the likelihood that you will be able to maintain your level of lean body mass. As a consequence, the optimal exercise prescription for sound weight management is one that combines aerobic conditioning and strength training.

7) Will I lose body fat more efficiently by performing my aerobic workouts at a low, rather than a high, intensity?

Many aerobic exercise programs and videos feature low-intensity workouts which purport to maximize fat burning. The argument behind such an alleged theory is that low-intensity aerobic training will allow your body to use more fat as an energy source, thereby accelerating the loss of body fat. While it is true that a higher proportion of calories burned during low-intensity exercise come from fat (about 60 percent as opposed to approximately 35 percent from high-intensity programs), high-intensity exercise still burns more calories from fat in the final analysis. For example, if you perform thirty minutes of low-intensity aerobic exercise (i.e., at a level of 50 percent of maximal exercise capacity), you’ll burn approximately 200 calories — about 120 of those come from fat (i.e., 60 percent). However, exercising for the same amount of time at a high intensity (i.e., 85 percent of your maximal exercise capacity) will burn approximately 400 calories. Using a 35 percent fat utilization yardstick, 140 of the calories you’ve burned will have come from stored fat.

Although the more vigorous exercise burns both more total and more fat calories, the less intense form of exercise has its benefits as well. For example, because many overweight people tend to find that lower-intensity exercise is more comfortable, they may, therefore, be willing to engage in such workouts. The point to remember is that low-intensity workouts do, in fact, promote weight and fat loss. You just have to do them for a longer period of time.

Low-intensity aerobic exercise, however, is not a better or more effective way to lose weight than more intense physical activity — the idea of a “fat-burning zone” is simply a myth. Keep in mind that you lose weight and body fat when you expend more calories than you consume, not because you burn fat (or anything else) when you exercise.

Why does aerobic exercise have minimal effect in accelerating weight loss when combined with a low-calorie diet?

Several possible reasons exist for why aerobic exercise does little to accelerate weight loss when combined with a low-calorie diet. Among the more commonly cited reasons are the following:

• Many overweight/overfat individuals are unable to perform high amounts of exercise without subjecting their bodies to an undue level of orthopedic stress — thereby incurring an injury. High amounts of exercise are needed to promote weight loss, but the risk of orthopedic injury limits the amount of exercise that can be safely performed by many overweight/overfat individuals.

• The “net caloric expenditure” of moderate aerobic workouts is relatively small. The net calorie cost of exercise is equal to the number of calories expended during an exercise bout that are used beyond the number of calories expended by an individual’s resting metabolism (RMR) and other activities that the individual might have engaged in had he/she otherwise not been exercising (refer to Table 8).

• Some individuals who exercise tend to reward themselves by resting and relaxing more after their workouts are over. As a result, the net change in their total 24-hour caloric expenditure levels may be virtually unchanged.

9) Does aerobic exercise counter the decrease in lean muscle mass associated with dieting?

In general, the combination of a moderate-intensity aerobic exercise program with a low-calorie diet does little to protect lean muscle mass during weight loss. During weight loss, the percentage of weight lost as lean muscle mass increases in direct proportion to the magnitude of the calorie deficit encountered by the body. As a result of rigorous fasting, the total body weight that is lost is approximately 50 percent fat and 50 percent lean muscle mass. During a very low-calorie diet (with adequate protein intake), the proportions improve to 75 percent fat and 25 percent lean muscle mass. During a low-calorie diet (approximately 1200-1500 calories per day), the proportions improve even more to 90 percent fat and only 10 percent lean muscle mass. Moderate-intensity aerobic exercise, on the other hand, has been found to have a very limited effect on these body composition proportions. Resistance training during weight loss, however, has been shown to provide a sufficient stimulus to offer protection against the loss of the lean muscle mass during sensible dieting.

10) Is there a quick and easy “weigh” to lose weight?

In a word, no. Almost all diets share at least one common trait — eventually, they don’t work. To lose weight and keep it off (the really difficult part of controlling your weight), you must be willing to incorporate permanent changes in both your eating habits and your physical activity level. In addition to a formal exercise program, physical activity must be increased in your daily living.

11) Is beer a good post-workout drink ?

It may taste good when you’re thirsty, but beer is not an effective way to rehydrate after exercising. Alcohol has a diuretic effect. As a result, instead of replenishing fluids, beer promotes additional water loss via urination. In reality, the diuretic effect of beer can lead to hypohydration or, in severe cases, dehydration. Some individuals believe that beer gives them a carbohydrate boost plus extra potassium. An urgent need for these nutrients immediately following a workout doesn’t exist, however. Even if an individual needed these particular nutrients, beer is a relatively poor source. For example, compared to orange juice, beer has only 13 grams and 89 milligrams of carbohydrates and potassium, respectively, versus 39 grams of carbohydrates and 700 milligrams of potassium in orange juice.

12) Several people at the gym that I go to say that creatine supplements will increase the size and strength of my muscles. Is this true?

Creatine is certainly one of the hot supplements among fitness enthusiasts. A growing body of evidence exists to suggest that taking creatine supplements may improve a person’s ability to perform short-term, intense exercise. All skeletal muscle tissue contains creatine, and dietary creatine is found in meat and fish. During exercise, a portion of the muscle’s creatine is depleted. Creatine phosphate plays an important role in resynthesizing ATP during short bursts of high-intensity exercise. Creatine supplements have been shown to increase the total creatine content (creatine and creatine phosphate) of muscle on an average of 20-30 percent. Several studies suggest that ingestion of 20-25 grams of creatine monohydrate per day for 5-6 days improves muscular performance during activities that require high levels of strength and power (e.g., weight lifting, sprinting). Sufficient evidence exists to state that, under certain conditions, creatine supplementation can enhance performance in activities that require short periods of high-intensity power and strength. If individuals can train at higher intensity levels, it follows that they may be able to add strength and power at accelerated rates over a period of time. Creatine can also lead to weight gain, but the mechanism responsible for the added weight has not been adequately investigated. Before you run out and start taking creatine supplements, consider the following precautions:

• The long-term effects of taking creatine have not been studied. The majority of studies have examined the effect of the short-term (30 days or less) use of creatine.

• All the studies conducted have involved adults only. Creatine’s effects on children are unknown.

• Consuming large quantities of creatine (greater than 30 grams per month) may encourage fat to accumulate in the liver.

• Stomach cramping and diarrhea have been cited as adverse side effects of creatine supplementation.

13) Are there any risks associated with excess protein consumption?

The human body is unable to store extra protein. Protein consumed in excess of the body’s needs is not used to build muscle; rather, it is used for non-protein bodily functions. If individuals consume protein in excess of their caloric and protein needs, the extra protein will not be stored as protein. Unfortunately such extra protein is converted to and stored as fat. As a result, if individuals consume large amounts of extra protein, in addition to their regular dietary intake, any weight gain would very likely be in the form of fat.

Another important point to keep in mind is that the potential for harm exists if protein is consumed in excess. Such harm is most likely to occur in the individual who consumes protein or amino acid supplements. For example, excess protein may lead to dehydration, because protein metabolism requires extra water for utilization and excretion (i.e., elimination) of its by-products. Since exercising individuals are already at an increased risk for dehydration, the additional strain of protein waste excretion may further promote dehydration. Excess protein has also been shown to lead to an increase in the loss of urinary calcium. A chronic calcium loss, due to excess protein intake, is of particular concern because it may increase the risk of osteoporosis, especially in women.

In reality, with regard to serving as a source of energy, all carbohydrates are not all the same. Some release energy quickly. Others do it over a longer period of time. To determine which foods provide quick energy versus those that will keep energy levels high until an individual’s next meal, it helps to understand the Glycemic Index (GI) which assigns a value to each food indicating how fast energy will be released.

White bread — the standard by which foods are judged — is assigned a GI of 100. Foods with a relatively low GI rating (i.e., 75 or less) release energy gradually. On the other hand, foods with a rating of greater than 75 provide a comparatively faster energy boost that tends to fade fairly quickly. (Note: the higher the GI rating, the faster the energy is released.) A list of the GI ratings of an average serving size for some commonly consumed foods is provided in Table 9. When selecting the food choice for a “carbo load,” individuals should decide when they want the energy to kick in — sooner or later?

14) How much improvement in aerobic capacity can a person typically expect to experience, and how long does it take?

Increases in cardiorespiratory fitness with exercise training generally show a positive correlation to the frequency, intensity, and duration of exercise. The amount of improvement in aerobic capacity (i.e., VO2 max) that can be expected from training is very individualized and is inversely related to each individual’s level of fitness. In other words, the more fit an individual is the smaller the degree of improvement in VO2 max associated with training. For example, an untrained individual may experience approximately a 25 percent increase in VO2 max after roughly 8 to 12 weeks of conditioning. A trained individual, on the other hand, may experience only a five percent improvement over the same period of time.

15) In the health and fitness column in my local newspaper, the physician writing the column wrote that in order to get something out of your aerobic conditioning efforts, you have to work out within your “aerobic training zone.” To what was she referring?

Aerobic training zone refers to the training intensity range that will produce improvement in your level of aerobic fitness without overtaxing your cardiorespiratory system. Your aerobic training zone is based on a percentage of your maximal heart rate. As a general rule, your maximal heart rate is measured directly or estimated by subtracting your age from 220. (It is important to note that the method involving subtracting your age from 220 may be associated with considerable error.) Depending upon how physically fit you are, the lower and upper limits of your aerobic training zone are then based on a percentage of the maximal heart rate — approximately 60-90 percent, respectively.

16) I want to exercise aerobically, but I absolutely do not like running. Is running the best aerobic activity?

The best aerobic exercise is one that you take pleasure in, one that is safe for you, and one that you will engage in on a regular basis. Keep in mind that one person’s trash is another person’s treasure. In other words, even if you don’t want to jog, you can still develop and maintain an adequate level of aerobic fitness. Just pick an aerobic activity that you personally like — exercising on a stair climber, walking on a treadmill, cycling, swimming, etc. — and make it a regular part of your workout regimen. Make sure that your body likes it as much as you do (i.e., the activity doesn’t expose your joints and muscles to undue stress).

17) Do certain types of strength training significantly enhance a person’s level of aerobic fitness?

A type of strength training known as circuit training has been shown to increase aerobic capacity by an average of approximately five percent — this will vary depending upon the individual’s fitness level and how hard the person trains. For example, one study reported that three 20-30 minute circuit training sessions a week for a period of 20 weeks improved aerobic capacity by approximately seven to eight percent — one-third the improvement that might otherwise be expected from a conventional aerobic conditioning program. Some evidence exists; however, that circuit training can be used to effectively maintain improvements in aerobic fitness achieved through traditional forms of aerobic training (i.e., running, cycling, stair climbing, etc.).

18) What is cross training and does it offer any significant benefits?

Cross training is typically defined as an exercise regimen that uses several modes of training to develop a specific component of fitness — in this instance, aerobic fitness. A relatively sound argument can be advanced to support the premise that using two or more types of aerobic exercise in your training regimen is in your best interest. While no evidence exists to support the often stated claim that cross training somehow induces a better aerobic conditioning response, research indicates that using several modes of training can provide an exerciser with positive musculoskeletal and orthopaedic benefits. By combining different exercise modes, you prevent the same bones, muscle groups, and joints from being stressed over and over. As a consequence, cross training tends to reduce the likelihood of your being injured as the result of exercising “too much.” In addition, cross training has also been shown to have a positive effect on cardiovascular function (principle of training specificity) and an individual’s long-term adherence to a training program.

19) How fast should my heart beat rates at times of aerobic work sessions?

At times of exercise sessions how  rapid your heart beat should be is dependent on your fitness as well as the age factor. According to the American College of Sports Medicine (ACSM), aerobic fitness can best be made improvement  by doing exercise  at an intensity level between sixty to ninety percent of your maximal heart rate. If you are just starting your workout program, you should exercise at the lower end of the intensity scale (i.e., 60-70 percent). When this level becomes less challenging (usually after three to six months), you should gradually increase the level of exercise intensity until you reach the middle of the range (70-80 percent). As your level of aerobic fitness continues to improve, you may then decide to adjust your exercise intensity rate up towards the higher end of the recommended range (80-90 percent). You should avoid exercising above your target heart rate range, since this could place you at risk for overtraining and/or injury. As a general rule, if you are unable to comfortably carry on a conversation while exercising, you should reduce your exercise work rate regardless of your heart rate response. Because the “talk test” tends to err on the side of conservatism, and it can be very helpful in ensuring that the intensity of an exercise bout is not excessive for you.