No animal evolved to be sedentary.
Food for athletes should not be just an ethical choice. In primitive societies, food is fuel. Getting it is hard, involving running down large animals or back breaking work like agriculture or climbing trees. In a society of plenty, food becomes an item of conversation. If you are training, food must be fuel.
Being a vegetarian can work (though the few strict vegans I know had to abandon it with digestive issues and one even developed kwashiorkor), but generally nutritional debates have been taken over by people with an axe to grind. Vegetarianism is promoted as being intrinsically healthy. Rubbish. Can you eat healthy as a vegetarian? Sure. But just avoiding meat (and this means fish, poultry, and whatever has a chance at evading you) is morality masquerading as dietary management. One of the great benefits of doing a stint of serious training is that you will learn what your body needs and learn how to eat right. Putting an athlete on a low-fat, low sodium, low protein diet might well put him or her in the emergency room. One of my friends from India points out that while vegetarianism was promoted for lower castes and holy men, warriors were required to hunt animals then eat meat to get strong. Buddhists as well are far from uniformly vegetarian and Tibetan Buddhists are quite carnivorous.
Running and Cardio exercise
Running is not the best exercise. Another study indicated strongly that markers for metabolic syndrome did not turn into metabolic syndrome if the subjects had sufficiently high strength. More succinctly, there was no correlation between simple cardio-respiratory fitness and (lack of) metabolic syndrome but there is an inverse relationship between strength and metabolic syndrome. In plain English, simple physical strength is the best single indicator of health. Charles Poloquin, who is an excellent trainer, pointed out that one of his greatest gripes comes in confusing correlation with causation in regards to running. Lean, small-framed, light people tend to gravitate to running and excel at is because of their size. It has been foisted on the population and seems to be received wisdom that running therefore makes you skinny. He finds that he has to combat this idea constantly when trying to train athletes to get stronger. They are absolutely convinced that the only way to maintain weight is to run.
Cardiovascular exercise has its place, but will not make you necessarily healthier all around. Indeed, another study on marathon runners over 50 had the seemingly surprising result that there was no particular cariovascular advantage to running longer distances and all participants had markers for cardiac damage at the end of a marathon. Four (of over 100) of the subject died from cardiac events during races in the course of the study. Even Jim Fixx, who started the running craze in the 70’s and 80’s as Everyman’s Fitness dropped dead of a heart attack immediately after a run. Running did nothing to prevent his arteries being 95% clogged. Now, these were all very long distance runners (a marathon is 26+ miles) which is much more extreme than most people’s running. It is also clear from other studies that there is benefit in lowering blood pressure as well as stress management for moderate, i.e., less than 5 – 10 mile runs. Upshot: Running in moderation can be good (enjoy it immensely myself) if your body mechanics support it. I cannot recommend it as the primary exercise for weight control or as a basis for a conditioning program. It is merely a good tool for building certain types of endurance.
A study published in the Lancet on the relationship between BMI and cardiovasular disease showed that a lower BMI corresponds to greater risk of cardiovascular disease and that even fairly high BMI (up to 35) showed no correlation. Extremely high obesity did show a high risk. The most reasonable explanation is that lower BMI corresponds to sarcopenia, or the frailty that often accompanies aging. High obesity corresponds with inflammation caused by too much body fat. Without proper exercise, people tend to lose muscle mass at the rate of 1% per year from the age of 25 on. The take away point is that simply keeping your weight down as you age probably kills you faster than not. The popular image of a rail thin person who has switched to being a vegan in later life (which occurs in the process of getting some sort of holistic knowledge of the universe denied to the rest of us) is a frequently occurring one and powerfully reinforced in movies and television. Supposedly the more we all look like Gandhi as we age, the healthier we are.
Me and My Vitals
I am currently 51 years old. I weigh 187 lbs and have 9% fat. Now according to standard charts, at 5′ 11″ my BMI is 26.1 which means I am technically obese. According to the BMI, my maximum healthy weight is about 172. Let’s do the math. My lean weight — no fat at all — is 170 lbs. So my lean weight almost exceeds the max BMI value for total weight. Taking their figures, I would (at 15% bodyfat, anything less than 20% is considered excellent) need to weigh 172 = 146 + 26, i.e. I would need to lose nearly 24 lbs. of muscle and gain 9 lbs of fat to be healthy. A more normal suggested weight of 155 is even worse at 155 = 132 + 23, requring I lose close to 40 lbs of lean tissue.
Update: It is Dec. of 2012, coming up close to a year since I wrote the previous paragraph and now my weight is 197 still at about 9%, so my lean weight is up to 180 and my BMI is 27.9. Other vitals are unaltered. I stated later in this that my goal was to hit 180 lean weight by this time and have.
My blood pressure is 140/62 and my resting pulse is around 50. HDL (good) cholesterol is 88 (50 is excellent, higher is better) LDL (bad) cholesterol is 100 (150 is good, lower is better.) My doctor tells me that, hands down, I am the healthiest person of any age in her practice and that my vitals are just great — for someone in their mid to early 20’s…
My point is that healthy numbers are given for the population at large and do not apply in any specific case. At my last checkup the nurse asked
Her: “What medications are you taking?”
Her: (Long pause) “How did you manage that?”
My Bias:“Getting in shape” is a misnomer. It is very, very hard to do, especially if you have laid off of some (or most) forms of physical activity.
Never get out of shape in the first place.
Research indicates that exercise slows the aging process, probably because recovery from hard training happens to repair a lot of the damage from aging too. Training cannot reverse these changes, merely slow them from the starting point. If you start training at 20, this is your baseline. If you wait until you are 50, that is your baseline. Waiting until you are out of shape and have health problems to start getting healthy means it might be virtually impossible to catch up. It might literally take a couple of years of training 3 – 4 times a week until you can actually start a conditioning program and very few people can overcome that sort of inertia. Having been maimed for a bit, and come back, I can testify that the one deciding factor is the ability to move yourself. If you lose that, you are dependent upon others for your quality of life and all it takes is a somewhat inattentive caregiver to kill you. I have been successful so far and offer myself as an example of what hard work can do.
Quick note: My upper (systolic, or outgoing) BP number is a bit high, but this is normal for some top-notch athletes due to a condition called athletic heart. In this case, the left ventricle is larger than normal and coupled with a lowered pulse rate there is a corresponding rise in outgoing pressure to move a greater volume of blood (“elevated stroke volume”). A positive diagnosis is an ultra-sound which determines that the left ventricle is much larger and more powerful than normal. When I had it measured last, admittedly several years ago, my heart total heart size was roughly an extra one-third above normal, mostly in the left ventricle. My measured cardiac and respiratory capacity was roughly 50% above most trained athletes and I was estimated in the top 2% of all athletes (not the general population). This was done at an Olympic training center in Heidelberg Germany and their assessment was that I was in much better shape than the average Olympic quality athlete. The heart is a muscle like any other and undergoes hypertrophy in response to training. This is a sports-specific adaptation and has no epidemiologic evidence to show it affects longevity, positively or negatively. This means I am a big, powerful athlete inside and out. When athletes cease training, the heart (just like any other muscle, I reiterate) returns to a much more normal size with no ill effects.
An enlarged heart without an athletic reason is indeed a sign of cardiac distress and normally means that blood pressure is so high that the back pressure (lower BP number > 100) between beats is stretching the heart. If the heart enlarges past a certain point, it is too inefficient to pump blood and a condition knows as congestive heart failure ensues, which is eventually fatal (the only real cure is a heart transplant). Rather than a nice upside-down pear shape, the heart is nearly spherical. Think of stretching a muscle as far as you can then trying to flex it with force and you get the analogy. High blood pressure (also called hypertension) is called a silent killer for this reason: It is asymptomatic for years until irreversible damage is done.
Interestingly enough, most runners, even those that do long distance running, do not show the benign increase associated with athletic heart, though sprinters often do. The cardiovascular system is able to systemically adapt to increased, steady state activity (e.g. blood vessels to legs dialate, blood flow to upper body considerably restricted) so there is no need to augment heart capacity. Bodies are usually very efficient indeed when they adapt to stress. I suspect this is why older, high mileage runners do not fare so well in overall cardiac health, but I have zero proof of this last fact. Athletic heart deserves to be better known, since it is often misdiagnosed in the medical community and might even be confused with congestive heart failure. Athletes should generally always be prepared for such issues when going to general practitioners and quality health care for athletes is always an ongoing concern. It is very, very easy to get misdiagnosed, so finding a good doctor who knows your health history and is willing to discuss it at length with you is a must.