We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
I am writing about the muscle atrophy of age more than its more severe form of sarcopenia (which we see all the time in its advanced form in frail elderly).
Use it or lose it? Not exactly, unfortunately. After age 40, men and women lose an average of 1% of their muscle power each year, and more rapidly after 50. Only heavy exercise can slow this deterioration and help maintain function and energy, but it can't stop it. Even high-performing master athletes are effected by it (which is obviously why that category exists).
All that is not to mention the various physical things that happen to people over 50.
For inspiration, take a visit to some independent-living old folks home, or some place in Florida. It can be frightening to see what happens to people who keep living past 70 but do nothing to maintain their bodies other than to visit doctors.
It was not long ago that being pudgy or having a bit of a gut signaled prosperity, and leanness signaled lower class. Now it's the opposite. With incredible food abundance, and with obesity always in the news, funding for nutrition-related studies has grown. So now we know a lot more about how insulin works and about how the three food categories (fats and oils, carbs, and protein) are handled by the body. We are also learning about how hunger and satiety work. It's quite interesting but complicated.
These are "First World issues." In our world of nutritional abundance, recreational, social, and emotional eating, and the constant temptation of food porn, "hunger" often does not denote a need for nutrition except for the skinny, and satiety is often over-ridden by habit, speed-eating, stomach-stretching, delicious foods, sugar-and-carb dosing, and insulin-resistance. That is what it means when overweight people, who have no pressing energy needs at all other than water, vitamins, and minerals, eat hungrily two or three times a day. We term that appetite "false hunger" not because the appetite is not subjectively experienced but because appetite has, for them, disconnected from nutritional need and satiety signals (which are very slow to go into effect). That luxury used to be only for the wealthy.
It's like the flip side of anorexia. Anorexia nervosa is famously difficult to ameliorate, but it is not too difficult for most pudgy or fat people to re-set their bio-psycho-social food-o-stat if they want to. For starters, that entails small portions, plenty of protein to satisfy the hormones, and very slow eating so as not to short-circuit the awareness of the moment at which "That's enough to sustain me, because I don't feel hunger anymore." That way, the "Eat 'til I'm filled or stuffed...now I'm stuffed" effect never has to happen.
In the Western world, "sufficient" can be the stopping point, not "filled." Except Thanksgiving, when feeling ill from getting stuffed with stuffing is expected.
Being too scrawny, with underdeveloped muscle and bone, is life-limiting and unhealthy, but not as life-limiting as carrying excess fat around with its lengthy list of associated ailments. There's no need to carry it on your body, because there's a pizza joint on every corner to prevent sudden death from starvation. Most people, fortunately, make themselves sensitive to satiety signals most of the time so most active adults are neither significantly under- or over-weight.
Obviously, little of this applies to most children and adolescents.
It's the time of year when you send your kids or grandkids on the coast of New England out to the salt marshes and mudflats to dig Steamers at low tide. They are the most delicious seafood in the world. AKA Soft-Shelled Clams.
Digging for Steamers takes a bit of skill and gentle use of the right tool (a clam rake or, better yet, a clam fork), because you don't want to crack their fragile shells. And you have to know where to look, because they cluster. The fun part is getting covered with black marsh mud without having to pay for a spa.
You steam up a giant pot of them, just long enough for them to open and cook a bit, but not so long that they get tough or fall apart. You want to steam them, so don't use too much water in the pot. It's acceptable to throw a slice of onion in the water.
Then you pour everybody a mug of the broth from the pot and a heaping pile of clams. That broth is the essence of the sea and the marshes. And you give everybody a bowl of melted butter. I prefer them without the butter so you get the pure clammy flavor. You pull them out of the shell using their long necks as a handle, and I toss the necks to the gulls.
These in the photo below are not Steamers. These are Littleneck Clams, which should never, ever be cooked for any reason - which they have been in the photo. It's a disgrace. Cooking them turns them into clam-flavored chewing gum. They should only be slurped down fresh and alive:
These are Steamers. These precious critters are only eaten steamed, and I am convinced that God made them for that purpose:
Running as "exercise" was a fad in the 70s. There are many ways to improve endurance short of running marathons, or even 3-mile morning runs.
Being able to hike 10 miles is a good thing in life. Makes life fun and interesting. But if your interest is in cardiac fitness, HIIT is the way to go.
Is it worth swimming laps, doing treadmill or elliptical lengths, etc? Certainly, but only as a minor component of fitness. That's my opinion.
"Diet and exercise." Those are the usual suggestions.
Fact is that, with exceptions for situations with hours of vigorous activity daily (eg military basic training), a daily routine of stressful exertion of every sort is for building or maintaining functionality for most people but not for fat loss. It doesn't work.
Building strength is another matter. As readers know, for general fitness we like a combination of heavy weight training, "Cardio" of the HIIT type plus some endurance cardio, and calisthenics. That covers all of the basics.
How Hard Should I Work Out? To lose weight? That's not a thing. For general fitness, a hard hour 5-6 days/week is good.
I have posted about the confusion engendered about human life expectancy data.
For one thing, the numbers mean nothing for us as individuals, because our life chances depend on weight, fitness (a tiny bit), genetics, luck, etc.
If you go back a few centuries, it is surprising to see that, at least in the Western world, life expectancy has not increased much if you discount infant and childhood mortality from infectious diseases. In 1700, if you made it to age 25, you had a goodchance to make your 80s barring farm accidents. There is also the factor of maternal mortality from Puerperal Fever. Many women died from that.
It is well-known that vigorous exercise does not "work up an appetite." On the contrary, it tends to reduce hunger and appetite.
That might not apply to 8 hours on the Appalachian Trail or a day job as a lumberjack, but it is certainly true for me with my 1-hr daily exercises. The more consistently I exercise, the less interest I have in food and the smaller the portions I can handle. This effect is most pronounced with demanding cardio and calisthenic exercise, not much with strength exercise or with sports. There is a theory that the effect has something to do with Peptide YY.
Nobody wants to eat anything after a hour of tough cardio exercise and that suppressive effect tends to last 24 hrs.
Maybe it makes some genetic sense. If you need to move yourself vigorously and frequently, the less fat you have on you the better you can avoid becoming part of a Tiger Dinner Party. Hunger is an interesting instinct and only recently has it been studied biochemically. One thing we know for certain is that subjective hunger or attraction to food is not a signal for a need for nourishment for most adults in a food-rich environment.
Overweight people seem to have the strongest subjective hunger, and sedentary people tend to have stronger appetites. Cause or effect? Chicken or egg?
We've written about this topic in the past, but it's worth reviewing the misconceptions about cardio fitness and cardio exercise. (Remember, in our view, "cardio" should be only 1/3 of your exercise program beacuse it does little for muscle and bone strength, and little for athleticism.)
Any exercise, from walking to weight-lifting, makes more demand on heart function than sitting or lying down. So cardio exercise has a spectrum from very light to maximum intensity. Simply put, the core purpose of "cardio" exercise is to maintain or upgrade heart function (cardiac condition is measured by things like a Cardiac Stress Test with Echo, Stroke Volume, Cardiac Output, cardiac vasculature, and left ventricle size to some extent). Like weight-lifting for skeletal muscle, it requires stress, relative to your conditioning and medical condition.
With lighter stresses (eg non-sprint, endurance-oriented swimming laps, jogging, rowing, stair machine, elliptical, etc) we are putting our hearts to some use, but we are working more on general time endurance than cardio. (Lots of people do those things thinking that they involve fat-burning, but don't count on that to work if you do 1 hour/day.) For people who are not training for specific goals, building endurance is great for life. Nobody wants to slow down or feel tired during ordinary recreational activities like sports or hiking. These non-sprint exercises aim for around 70% of one's max heart rate to make it worth your precious time.
The higher the physical demand - the intensity of an exertion for your level of fitness - the more you are training your heart rather than just using it. The highest levels of exertion (say, with sets of deadlifts near 80% of your max, or with 30-second sprints) are anaerobic and can push your heart rate to 90% of your max. That heart-pounding rest time or slow time is to catch up on oxygen.
For endurance, an hour of lap swimming, cycling, jogging, elliptical, stair machine, ski machine, rower, etc at around 70% of your max heart rate is where you ought to be, if in decent health. Over time, you will need to raise the speed to get to those heart rates. These exercises do nothing much to build muscle or bone strength.
For maximum cardiac fitness (with bonus endurance benefits as well), mixing in sprints which get your HR to 80-90% of your max should be included. Bursts of intensity. In the Maggie's Fitness for Life program, the other good sources of intense cardiac stress are the powerlifts and calisthenics. Ideally, some of all of those because there is more to fitness than cardiac fitness. Fitness is a package deal.
An interesting detail is that to up your game in any area of exertion, it's always a good idea to do what you do not usually do. Explosive linebackers get better with distance running, distance runners get better with weights and sprints, heavy lifters get better with calisthenics. Balance.
People have been asking me about Damar Hamlin. Cardiac arrest or, sometimes termed "Sudden Cardiac Arrest", occurs at all ages. It is only newsworthy when it occurs in young, otherwise healthy athletes. Still, it happens enough that many states have rules about medical check-ups for athletes. I suspect that it occurs more often than reported.
Sudden Cardiac Arrest is usually associated with a heart arrhythmia called ventricular fibrillation. The heart stops. These have a long list of possible underlying causes, but it seems possible, if rare, that even a blow to the chest can set it off. The risks are that you die, or survive with brain damage. First aid is CPR (all of our readers should know how to do that), then shock from a defibrillator. The brain begins to die after a handful of minutes without a functional heartbeat.
In youth, arrest is hardly ever related to a "heart attack," which refers to a Myocardial Infarction.
"Slate" is an old highly woke online magazine. Easy to dismiss. However, they have begun a series on fitness and health that might be good, or at least rational: Fitness goals for 2023.
For example, they make the point that exercise is, generally, useless for weight loss. Weight is nutritional - period. There surely are genetic effects on body architecture and maybe even on satiety-signalling.
Is exercise useful for cognitive functioning? Dubious.
Also, the point that the current thing about "lots of fruits and vegetables" is nonsense. Food is not medicine. Nothing wrong about those things though as long as you do not think of them as magic.
Fitness goals, I agree, are primarily about feeling good, maintaining functionality and vitality, and looking good for as long as possible. Those make life better. 6+ hours/week is good.
I stand by the Maggie's Fitness for Life program: Weights, calisthenics, and cardio. With a little luck, it might slow your fate in a wheelchair.
It has become a casual consensus that exercise, or at least daily vigorous movement, enhances one's immune response.
Anecdotally, it looks likely. But the catch is that it's the most fit people who do an hour or so most days, so is it causality? Statistically, fitter people are best prepared to deal with the attacks of nature: better disease-resistance, better healing, etc.
People with physical jobs do not need to think about it, but most of us do. In a way, daily exercise is an attempt to recreate a bit of what humans were built to do.
I feel that exercise (The Maggie's Fitness for Life program, especially) has the main goal of maintaining functionality and vigor for as long as possible. Sure, looking good matters too, in life. Nutrition for weight, exercise for strength.
The US government keeps telling people what a "healthy diet" is. For years, they wanted 11 servings of carbs daily. Now they want "fruits and vegetables." Why?
I understand that we live in an hyper-politicized world right now. It seems more so than in the past, but I can't say. It does seem to me that "the long march through the institutions" has been occuring. I especially hate to see it occur in my field of clinical medicine.
I do not mind debate about the role of government in medical care, and will even listen to arguments in favor of Medicare for all citizens. That is a different topic.
I have posted most of these concepts in the past, but it's time to revisit them.
First off, people use the term to refer to different things. Some use it to refer to anything that raises your heart rate at all, such as walking, hiking, or swimming aerobic laps. Anything we do to remain active, if not to reach for better levels of fitness, is worthwhile.
Why is low-intensity activity worthwhile? Because it helps maintain a current level of function. Keep walking 1-3 miles daily, and odds are you will keep doing it until something physical intervenes. That's all that most people want.
However, I think of "cardio" as heart-centered exertion. That means stressing the heart with the goal of improving fitness and conditioning. While my favorite forms of cardio (treadmill, stair machine, rower) keep many muscle groups busy if not stressed, the goal is cardiac muscle power. That is why cardio focus is almost 1/3rd of the Maggie's Fitness for Life program.
How do you stress your heart muscle, rather than just using it a little bit? By making high demands just as you can do with other muscles. That means sprints on your favorite "cardio" forms. That's assuming your doctor tells you that you are fit for intensity.
Regardless of the exercise, it's easy to know when you are sprinting because it's all-out for 30-60 seconds at intervals. That is HIIT. Sprints are anaerobic, not aerobic. People claim that heavy weight-lifting can have the same effect, and that is likely true. Still, I feel a couple of hours/week of HIIT cardio is a good supplement, plus endurance, plus mental health.
Why do people with any fat stores ever feel hungry, or eat anything at all, considering they may have 1-5 month's worth of energy stored as fat? (We term the hunger experienced by overweight people "False Hunger," because it is.) Except in the truly malnourished or extremely fit, low body-fat athletes, hunger is rarely a signal of an energy deficit or of any nutritional need.
Think about it. Even normal-weight (neither overweight nor underweight) people carry 8-10 weeks of energy stored in fat if they can only access it.
You can consider appetite in the pudgy or overweight, not to mention the obese, to be a design flaw based on the hunting and gathering, and, earlier, just plain gathering condition of human existence, same as the other great apes who only become overweight in captivity. Agriculture and food abundance, along with sedentary life, exposed the design flaw for people who overnourish themselves. Of course, physical inadequacy is another side effect.
There's nothing magical about that number, but it's a lot more active than 100 steps. On average, 10,000 steps is 5 miles. That's easy for New Yorkers and other city-dwellers, not so easy for suburbanites.
From a practical standpoint, body fat can only be gained, or lost, through nutrition. Exercise is minimal for fat loss. I'd make an exception for those hiking 15 miles/day on the Appalachian Trail while carrying 40-60 lbs of gear, food, and water. Or the kid.
I have seen people treated for cancer until the day they died with the poisons still dripping into their veins. I disapprove, although I am not an oncologist. There is a time to be born, and a time to die. Hospice care is a blessing with opioid meds as needed.
Part 1 
We've written about this topic in the past, but it's worth reviewing the misconceptions about cardio fitness and cardio exercise. (Remember, in our view, "cardio" should be only 1/3 of your exercise program beacuse it does little for muscle and bone strength, and little for athleticism.)
What is "flavor." and where does it come from?