Exercise, diet and vitamins for survival
Exercise – keep moving
Biologically we are designed to be constantly active, to use the strength of our muscles, to flex our joints to keep them supple and push our heart beat up to maintain our cardiorespiratory reserve. We need to exercise to survive.
Exercise activates our brain, keeps our blood pressure down, and provides a stimulus to the flow of lymph and the evacuation of our bowels. When we are active we can keep our body fat percentage in a healthy zone and our metabolism stays in kilter. Weight bearing motion protects our bones from osteoporotic thinning and going for a walk elevates our mood if it is depressed. In nature our pre-historic ancestors would stand, walk, trot or run full out all day. To rest they might stroll or squat on their haunches [which exercises the pelvic floor] and they would lie down to sleep. Sitting inactive would not be in their repertoire.
For 21st century homo sapiens the issue is continuing function and independence in old age. This requires several different sorts of fitness. Not just cardiorespiratory fitness [CRF], but also muscle strength for getting up and down stairs or in and out of the bath ; neuromuscular coordination to be stable, avoid falls and regain our balance when we trip and flexibility to keep everything physical flowing without injury. Inactivity kills – every year many older folk with a hip fracture have it mended in hospital only to lose their independence or die because of the associated immobility. Go into hospital, be in bed and your muscles waste, joints stiffen, blood vessels clot and infection sets in. it can be near impossible to turn the clock back to active living.
Use it or lose it – a suitable regime
1. Cardiorespiratory training
High intensity interval training [HIT] is more effective than continuous moderate exercise [CME]. Several studies show that HIT appears to promote superior improvements in aerobic fitness and better improvements in some cardiometabolic risk factors in comparison to CME. So save time and make it less of a chore with a high intensity plan. For example here is a 25 minute HIT plan for cycling [gym or road] involving 4 sprints. The resistance should be ~7.5% body weight.
The plan is to be used 3 times weekly.
| Warm up | Sprint | Recover | Sprint | Recover | Sprint | Recover | Sprint | Recover |
| 2 min | 30 sec | 4 min | 30 sec | 4 min | 30 sec | 4 min | 30 sec | 4 min |
After the first couple of sessions aim to increase to 6 sprints. Recovery can be less if breath and heart rate settle eg 3 minutes.
Doing cycle sprints 3 x weekly increases the efficiency of muscle oxygen use and doubles endurance capacity after only 2 weeks. This approach also has very beneficial effects on metabolism [notably insulin resistance].
A similar approach in Edinburgh has recently shown that even less exercise is effective, ie 3 times each week plan a 10-min exercise session.
Start with low-intensity cycling for 5 minutes, then do two brief ‘all-out’ sprints of 20 s. with 2 minutes rest in between and 2 minutes to warm down.
This regime improved aerobic capacity and significantly increased insulin sensitivity by 28%.
2. Resistance training
The key is quality use of limited time not extended periods of training. A US study confirms that one set of good weights exercise taking 15 minutes is as effective metabolically as 3 sets taking 35 minutes.
The exercises target all the major muscle groups and include the leg press, leg curl, calf raise, bench press, lateral pull-down, shoulder press, biceps curl, triceps extension, abdominal crunch, and back extensions.
The ten exercises are divided into three circuit rotations.
- Leg press, bench press, and leg curl exercises.
- Lateral pull-down, calf raise, and shoulder press exercises.
- Biceps curl, triceps extension, abdominal crunch, and back extension exercises.
The schedule is ten repetitions of each exercise at 50% of the estimated ten repetition maximum (10 RM).
A 4-min rest is allotted between each rotation.
All lifts are timed conducted at 2-s concentric and 4-s eccentric movements to decrease the likelihood that momentum is being used to perform the lift and to ensure loading throughout the full range of motion.
3. Functional effectiveness
Balance coordination and flexibility. These attributes are best maintained by functional exercise. It doesn’t matter if it is badminton, tennis, line dancing or water polo it just needs to be something that you do regularly that moves you around makes you stretch and flex and shift the balance of your weight.
Diet – our bigness problem
The old cliché ‘You are what you eat’ is evermore true. Mostly we are overweight or obese. This is very different from our UK population of 20 years ago and it is dangerous. It happens because simply and unavoidably, what we eat is dangerous – too much of the wrong stuff and not enough of the right stuff.
Why does it matter? Being overweight alters our metabolism and increases the risk of life threatening conditions such as diabetes, hypertension and CHD and non life-threatening but personally important issues such as osteoarthritis of hip or knee and back problems. Sadly, once we become fat the little exercise we do has a diminishing benefit on our cardiorespiratory fitness. Bluntly, being fat increases our mortality rate dramatically.
So what shall we do? Here are some easy action points.
Easy action points
| Decide to make some simple changes today | Start with breakfast [most of us get this wrong] Porridge, or eggs, and spinach – not croissants or Coco-Pops. |
| Make an eating plan [not start a diet] You are going to do this permanently |
Find alternatives to obvious disasters The sausage roll, bag of crisps, Mars Bar – lunch |
| Stock some healthy staples that do not go off Sardines, tuna, lentils, frozen peas, eggs. |
Make your own lunch [see above] Remember Cottage cheese |
| Stop worrying about butter and get scared of processed food and bad carbohydrate Glucose syrup, hydrogenated fats, added salt |
Make 50% of every plate you eat non-potato vegetable Green is best but low GI roots are OK |
The eating plan
The best answer is that starvation is not the answer. Pretty much anything else that you can stick to will help.
The diet plans and experts are out in force this year. The DASH plan, Dukan, Slow carb diet, Wholegrain, Abs diet, Intermittent Fasting, Weightwatchers, Slimming World and Atkins just to name a few.
If you follow one of these then it must be so easy that you have no strain or pain. When you look at all of these they have some common elements.
- Eat breakfast – actually eat a big breakfast
- Eat more green vegetables – probably eat as much as you can get down of green vegetables
- Have some fibre to keep you regular
- Choose which fats you eat but do not stop eating fat [or you lose all sorts of critical nutrients]
- If you are eating the right sort of foods you should not be going hungry
- If you have to have snacks [some regimes recommend these] choose ones that are healthy and keep them by you [a few unprocessed, skin-on almonds for example.]
Other things that may help
Eat the same known good meals in rotation and vary the added flavour eg spicy or not, herby or not, with or without garlic and ginger, a different green vegetable. No mistakes then!
Why not the Atkins diet?
Although the Atkins diet helps people drop weight in the short term, it is dangerous in the long term. A study from Harvard in 2010 looked at around 2000 men and 2000 women from long term studies. They said in conclusion
A low-carbohydrate diet based on animal sources was associated with higher all cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates
Fatness theory – why we have a problem
The issues are
- Insulin resistance brought on by eating carbohydrates that instantly elevate blood sugar. This is what drives all the bad metabolic and cardiac effects. So low glycaemic foods are better than white carbs and sugar.
- Skipping meals especially breakfast, then bingeing sugary foods to survive.
- Too little veggie stuff.
- Allowing things to get progressively worse: just buying bigger clothes. The problem just accelerates and becomes resistant to solution.
Vitamins & supplements
Why the need for supplements?
Theoretically, it should be possible to get all the vitamins and trace elements that we need from our diet.
In practice many people are deficient in some essentials. Taking supplements is an insurance. We have done this for 50 years as a nation, adding iodine to salt, fluoride to water and encouraging women to take folic acid before conceiving to prevent spina bifida and vitamin D in pregnancy to deal with maternal deficiency and fetal needs.
Older men need some supplements but only a few have proven benefit.
What do we need?
| Vit D | Normally we make it in in our skin in response to sunlight. Thus it can be low in Winter and if we spend most of our time indoors. It pushes calcium into bones and contributes to immunity. It seems to be important in CHD, recovery from infection or cancer. Deficinecy is a real problem. There is no added benefit from overdose. Take 800 iu daily |
| A multivitamin | There is good data to show mortality benefit from this. Men should avoid any preparation with iron as too much iron increases the risk of CHD. 1 daily |
| Omega 3 oil | Fish oil is the main source. The ratio of Omega 3 to Omega 6 is important. We have plenty of Omega 6 but may get short of O3. Benefits for Colorectal cancer prevention and survival from cancer treatment suggest 2G of active DHA/ EHA. This might be 4 capsules of concentrated fish oil. There is no ‘overdosage’. |
| Omega 6 oil | Avoid this [see above] |
| Zinc | Many of us are zinc deficient. Zinc is important in wound healing and all immune functions. Take a course of zinc 40mg daily for 2 weeks then reduce to 20mg daily maintenance. Doses >50mg daily have adverse effects on cholesterol patterns. |
| Zinc | Many of us are zinc deficient. Zinc is important in wound healing and all immune functions. Take a course of zinc 40mg daily for 2 weeks then reduce to 20mg daily maintenance. Doses >50mg daily have adverse effects on cholesterol patterns. |
| Aspirin | See Cancer Prevention. Take 75mg of gastro resistant aspirin daily |
What we do not need
| Vitamin C | We need Vitamin C [we all know about sailors and scurvy] but the Linus Pauling theory that we need 1000’s of grams of the stuff to prevent colds is completely disproven. Fresh vegetables, fruit and a multivitamin tablet daily will cover this. |
| Vitamin E | Extra vitamin E actually increases mortality so no need to supplement with this. |
| Glucosamine | The randomised controlled trial data says that this has no greater effect on joints than placebo. |
