Over the years I have worked and consulted in a wide variety of health care settings. Over and over, regardless of the setting or patient population, I have heard a rather large number of exercise and diet myths. And I keep on hearing many of these same fables, thus making them into mantra-like declaratives, almost devoid of any passion or substance.

Some time back – too long to remember, I’m afraid to say – I started compiling them. At any given time, some will become the favored wisdom du jour and then fade back, only to reemerge when conditions become ripe.

So, without any further ado, or perhaps I should say obfuscation, here are my current top five favorites:

1. You should never eat before a workout.

In fact, eating is beneficial before most exercise and in some cases lack of eating could be harmful. Think early morning workouts, especially strenuous routines. In general, I would recommend having a small meal or snack anywhere from 1-2 hours before your workout. Of course you should load up the tank with high quality foods, generally those with a low glycemic load. I may be giving away my age, but do you remember being told not to go swimming right after eating? I lived in fear of that one for so long. By all means, please go swimming after eating. It is one of the most beneficial types of exercise. Now if you have just downed a rather gluttonous meal, you might feel sluggish, but rest assured, nothing but your ego will be in any danger.

2. Exercise turns fat into muscle.

Here is another one that might date me, as I have not heard it as much in recent years. I sure wish this were true – it would be akin to some sort of biophysiological alchemy. The cells that make up fat and muscle tissue are of two entirely different types and one type just can’t turn into another. Now it is true that you can lose one type of body cell and gain another type of body cell, there is no such thing as a conversion.

3. You can eat as much food as you want as long as it is healthy, read “organic” food.

Repeat after me: a calorie is a calorie is a calorie. And you can add up calories just as easy eating so-called health foods as easily as with regular processed foods, sometimes more, especially if you believe this myth. Your body just does not care where those pesky calories came from and will convert the excess to stored fat, read pounds. The bottom line? You must limit caloric intake in order to lose weight, although even this does not guarantee success. And what is the biggest drawback in today’s environment to cutting calories? The answer is portion control. This is the secret behind any successful diet. See this previous post for more about the devilish trickery and outright fraud that is part of magnifying portion sizes over the years.

4. Restricting calories is the best way to lose weight.

Did I really mean what I said in the previous myth? You bet. Folks who take drastic measures, such as severely cutting down their food intake for some number of days, or even weeks, are not only hurting their overall health, but are doomed to failure. Since your body can’t meet normal energy requirements, it goes into starvation mode and cuts down basal metabolism. This effect is often referred to as the “plateau” effect and has been observed frustrating countless numbers of dieters over the years. The answer is to cut back on caloric intake, utilizing portion control, and increasing energy expenditure to boost metabolism through extra activity. Not all of this energy output needs to come from scheduled exercise. While of course that is beneficial, if not necessary, it is also very helpful to increase movement of all types. Examples abound such as taking the stairs instead of an elevator, walking four blocks to the store instead of driving, and so forth.

5. No pain, no gain.

This is another one I believed for the longest time. But gradually this old canard has been has been seen on its last quacks. Evidence upon evidence has been piling up about how seemingly small amounts of exercise can confer not minimal, but substantial, health benefits. Have a look at this previous post for some of that evidence.

In a previous post, I talked about the relationship between positive emotions and health. I made the point that too much research focuses on the consequences of so-called “negative” emotions. In the post, I cited a study that was considered landmark research because it studied positive emotions. Specifically, the study found a correlation between expressions of positive emotions and lower blood pressure.

I wish I could report to you that today’s study is a follow-up to that study or even explored the relationship between positive emotions and other important aspects of our health. However, all is not lost. Today’s study IS quite important. Rather than looking at emotions, the investigation correlated a specific personality trait, optimism-pessimism, with mortality.

Just so we are on the same page  . . . let me briefly describe the difference between a personality trait and an emotion. Personality traits are considered to be relatively enduring characteristics and generally formed in early adulthood, if not before. Such traits are generally present in any individual, regardless of the specific environmental context in which they occur. And all individuals have a number of these traits or characteristics. An example would be a person who is described by him or herself and others as optimistic. Thus, that person would be more likely to be happy, or at least not terribly upset, even when facing adverse circumstances. Of course, this does not mean that such an individual never gets sad or unhappy, but just that they are not likely to remain with a depressed mood and is more likely to quickly return to their baseline optimism.

Emotions are very specific states that can be described as a distinct and integrated psychophysiological response and generally has three components: expression, autonomic changes, and a distinct subjective feeling state. There are now considered to be only a small number of such basic emotional states, examples being sadness, happiness, anxiety, anger, fear, and surprise. In contrast to personality traits, emotions are generally of short duration with varying intensity. Most individuals will experience a broad spectrum of emotions during any given day. A person might respond to any situation with one or more basic emotions, but then face a similar situation the next day and generate completely different emotional reactions.

Today’s study is huge, both in terms of numbers of subjects and length of time. The researchers followed over 7,000 students who had enrolled at the University of North Carolina at Chapel Hill. These were incoming students during the mid-1960’s and who were followed over the next 40 years. The students were administered the MMPI, a personality test I talked about in this post. The results of the MMPI were correlated with overall mortality during the next 40 years. 476 of the original subjects died during this time frame. It turns out that the most pessimistic subjects had a 42% greater probability of dying, from any cause, than the most optimistic.

I could point out a number of problems with the study, as well as some significant limitations. Yet, the impressive length of the study and number of subjects gives this investigation what is commonly termed power in scientific research. Thus it is fair to say that another salvo has been launched, adding to the already impressive collection of evidence that is telling us that one powerful key to transforming health lies in our state of mind and emotions.

Looking for the stuff on exorcism? I wouldn’t get my hopes up too high, but if its exercise you want, you came to the right place. Here is a recent study that is notable because of the powerful effects it found. There has been a recent trend in exercise research to try and quantify the doses or the outcomes. That is, to specify how much of some type of exercise to produce how much of some type of result. The present study took a slightly different approach - the researchers compared the results of exercise to the results of using a narcolepsy drug, modafinil.Pretty clever idea. They also tested various groups of people such as healthy adults, cancer patients, and patients with chronic diseases such as diabetes. The results indicated that virtually every group tested showed greater improvement using exercise versus the drug. The improvement was measured as an increase in the feeling of energy and a decrease in fatigue. While it might seem counterintuitive that expending energy by doing exercise would result in an increase in felt energy, there are good reasons to think that it does, in fact, work this way.

There is a whole host of prior studies which have shown that regular exercise promotes an increase of neurotransmitters in the nervous system, such as dopamine, norepinehprine, and serotonin. These neurotransmitters are known to produce mood-enhancement and energy-promotion.

It seems as though when we are tired, we usually look for a pick-me-up effect from caffeine or perhaps from so called sports energy drinks. One of the great values of using natural methods to produce desired effects is that whatever non-pharmaceutical technique, it can not only replace some potentially more invasive device but probably replace something that we are currently using that is less healthy.

BTW, while this study does not come right out and explicitly say so, but one implication is that it may only take a small amount of exercise to produce some positive effect. After all, who wants to exercise when you are feeling tired or even fatigued. The current result certainly provides strong support for regular exercise as having a prophylactic effect in preventing such fatigue, but it also may be that much lower amounts of exercise than commonly believed are beneficial. See my recent blog post for more on this subject.

In a previous post, I discussed the important work of Dr. Brian Wansink. He is noted for providing ground-breaking information about why we eat the foods that we eat, particularly when it comes to portion size. His work is part common-sense and part “why didn’t I think of that” insight laced with fun and humor that is all too lacking in science. Yet none of that detracts in any way from the relevance of his findings.

Dr. Wansink has recently published a book, Mindless Eating. He also has a website with a blog, some great quotes, and other stuff well worth perusing. Be sure and click on the Mindless Eating Meter at the top of the page - it takes you to a “quiz” that you shouldn’t miss.

. . . . a few minutes a day?

The short answer: maybe. I just read an intriguing new piece of research in the Journal of Physioology, by Martin J. Gibala et al. One group of authors is from the Exercise Metabolism Research Group in the Department of Kinesiology at McMaster University in Hamilton, Ontario, Canada. The other group of authors is also from McMaster at the Department of Pediatrics and Medicine.

This research is a follow-up to the ground-breaking article that was published last year, also in the Journal of Physiology. In that report, the authors were able to demonstrate that sprint interval training (SIT) was able to significantly enhance aerobic endurance performance. The average gain was 100% for the 16 subjects, that is, at the end of the two-week trial, each participant was able to double, on average, their total endurance time on an aerobic cycling task.

This initial experiment challenged a long-held view that only aerobic endurance training is able to effect changes in aerobic endurance performance. While it may sound logical at first, on further analysis, there would appear to be some flaws with this assumption. While it is hard to argue against the view that aerobic endurance training enhances aerobic endurance performance, it does not necessarily follow that it is the ONLY technique that improves performance.

There are actually a number of observations that support the idea that SIT also positively impacts aerobic performance. Olympic and other elite middle-distance runners have been long known to incorporate SIT into their training routines. In fact, Woldemar Gerschler introduced SIT about 70 years ago and the result was a number of world records. Also, the study of muscle biochemistry has revealed that SIT results in an increase in muscular enzyme activity. This finding has been known for some time.

This most recent study extends the protocol and provides further support for SIT as an effective paradigm for enhancing aerobic endurance. The first study compared SIT to a control group that engaged in no structured physical training. There have been previous studies that have tried to compare SIT with continuous training but the results have been equivocal.

The Gibala experiment is the first to directly compare interval versus continuous training using a matched-groups research design. Thus, the experimenters matched exercise mode, cycling, exercise frequency, three times per week, and training duration, two weeks. But what was different between the two groups was total training volume and time commitment. In fact, when total training volume was measured, the SIT group was at about 10% the total for the continuous group. Further, while the continuous group time total was 10.5 hours during the two week experimental period, the SIT group time total was about 2.5, which is about 24% of the continuous group. generally, the previous studies tried to equalize the exercise and time requirements in their two groups.

I think the implications of this research are clear. It is beginning to appear that sprint interval training may be a very effective, time-efficient training strategy for improving aerobic endurance.

Yesterday’s post was primarily about the emergence of the Open Access movement. Fortunately for almost all of us, excepting of course, the grubmeisters that want to keep necessary science content to themselves for profit, Open Access has been picking up support while dispelling nasty rumors. This looks more and more like something that Victor Hugo once said:

Nothing is so powerful as an idea whose time has come.

As I advertised yesterday, I want to mention an article that was just published in PLOS Medicine. The research article discusses global mortality and the burden of disease. And since it is a PLOS Open Access article, it is available to anyone, in full, free of charge.

I don’t know if it is just me, but it seems like AIDS is slowly moving off the radar. Sure, there are still newspaper articles and media reports, but it just seems like they are buried a little - or perhaps done as one of those “specials” that nobody watches on a Sunday afternoon.

There continues to be a mountain of AIDS research being produced, but I wonder if the same money and forces are being directed to this cataclysmic occurrence as has been in past years. Well, the news is not good. There are actually many sources I could cite, but for now, I will just mention the PLOS article.

Right now, AIDS is listed by the WHO as the fourth leading cause of death worldwide. The authors of the study project three different scenarios in order to make comparisons. They calculate a baseline scenario, which essentially is a best-guess formulation based on currently identifiable trends. They also project an optimistic and a pessimistic scenario.

To give you a point of reference, the baseline scenario does not assume that things will stay the way they are now. For instance, baseline includes an assumption that antiretroviral drugs which can effectively treat HIV will reach 80% of the worldwide population who need them by 2012. Despite all the projected advances, AIDS is still projected to become at least the third leading cause of death by 2030. In 2002, 2.8 million deaths were attributable to AIDS. Using the baseline scenario, this would rise to 6.5 million. Under the optimistic scenario, which assumes much greater prevention, deaths would rise to 3.7 million. While under the pessimistic scenario, deaths could rise as high as 120 million per year.

Any way you look at it, AIDS has been and will continue to be a global pandemic. It is one of the worst, of not the actual worst, medical and human crises in recored history. It will continue to exert a shattering toll on humanity, both in terms of death and the burden it places on all levels of humanity, individual, family, community, country, and world.

The Open Access journal movement in science is growing and growing . . . thankfully. The basic idea is that all scientific journal should be barrier-free. In general, there are two kinds of relevant barriers: price and permissions. Open Access would retain important copyright protections and licensing. But all other barriers would be granted which would mean that the journals would be free to anyone and everyone on the public internet.

I think you might imagine who is trying to block this movement: corporate and business interests who want to remain in control of this extremely valuable content. To be fair, I should add that some scientists are also opposed to Open Access. However, more and more are joining the important cause of guaranteeing that the public has the access it needs. As you might also imagine, librarians are almost universally behind Open Access.

Ok - so now it’s time for a plug to all the librarians in the world: you are doing a heck of a job, against trying odds and vast forces arrayed against you, making sure that citizens’ First Amendment rights are upheld. I have no doubt you will continue to demand the free distribution of any content that is necessary for the public interest.

Maybe one could have argued in the past that scientific literature was not relevant to public interest. But with science having become increasingly politicized, it has become exceedingly clear that all scientific literature is not only relevant but vital to serve public interest. Everyone must have access to this information that is so often used to make governmental decisions, sometimes at the highest levels of office. A democracy can only sustain itself when all have such vital access. The citizenry of the US must be able to express support or rejection of laws, policies, and regulations informed directly by science. If people are deprived of such information, they can and have turned to other ways of expression.

I have not forgotten my promised plug for PLOS (Public Library of Science). They have vaulted to the forefront of the Open Access movement. Many said that Open Access would desanctify the peer-review process. I will talk about peer-review in a future post, so I will say for now that is that there are arguments for and against it. However, it has become quite evident that Open Access can peacefully cohabitate with peer-review.

I think almost all of the PLOS journals are peer-reviewed. It is very gratifying to see that one PLOS journal, PLOS Biology, has already achieved significant stature in the scientific world. It is now a journal where major scientists and researchers in the field of biology want to be published. I think that PLOS Medicine is not far behind. Here is a snippet from their masthead:

PLoS Medicine believes that medical research is an international public resource. The journal provides an open-access venue for important, peer-reviewed advances in all disciplines. With the ultimate aim of improving human health, we encourage research and comment that address the global burden of disease.

Tomorrow: I will post info from one just published article from PLOS Medicine.