In his groundbreaking book, “Outlive: The Science and Art of Longevity”, Dr. Peter Attia takes a deep dive into the science and art behind living a longer, healthier life. Drawing from a wide range of sources, Attia discusses the importance of not only living longer but living better, with a focus on overall health and well-being. This comprehensive guide covers various aspects of longevity, including diet, exercise, mental health, and cutting-edge medical screenings such as DEXA scans and VO2 Max testing – services that we offer here at My Vital Metrics.

The Importance of Longevity and Healthspan

Outlive by Peter Attia emphasizes the significance of not only extending our lifespan but also improving our healthspan – the period during which we maintain optimal health and vitality. Dr Attia argues that the key to achieving this lies in addressing the most common causes of death and chronic illness in the developed world, such as cardiovascular disease, type 2 diabetes, neurodegenerative diseases, and cancer.

By focusing on preventative measures and making informed lifestyle choices, we can reduce our risk of developing these conditions and improve our overall health and well-being. In doing so, we can potentially extend our lives and enjoy a higher quality of life well into our later years.

The Role of DEXA Scans in Longevity

One of the critical health screenings recommended by Dr. Attia is the DEXA scan. DEXA (Dual-Energy X-ray Absorptiometry) is a state-of-the-art imaging technology that accurately measures bone density, body composition, and muscle mass. By providing detailed insights into an individual’s body composition, a DEXA scan can help identify potential health risks and inform personalized health and fitness plans.

Regular DEXA scans can track changes in body composition over time, allowing individuals to monitor their progress and make necessary adjustments to their exercise and nutrition plans. By incorporating DEXA scans into a comprehensive health assessment, individuals can take control of their health and make informed decisions to improve their overall well-being.

Obviously, the DEXA is the cornerstone of the services we offer to clients and is the first go-to measure to get a sense of their metabolic health.

Exercise: A Pillar of Longevity

Dr. Attia highlights the critical role of exercise in promoting longevity and overall health. He advocates for a well-rounded fitness regimen that includes strength training, cardiovascular workouts, and functional movement exercises. By engaging in regular physical activity, individuals can reduce their risk of developing chronic illnesses, maintain a healthy body weight, and improve their overall quality of life.

Our take on this is that it is clearly the correct position, and like Attia, we always recommend a multi-part fitness regime for our clients. For those of us who need to lose fat though, we would go one further and suggest that people have very clear in their minds the role of each part of exercise. Cardiovascular exercise is not there to ‘burn fat’ as most people think of it, but rather to ensure that everything remains working at optimum. Strength training is not there for its calorie-burning effects, but rather to build strength and muscle mass, and so on. By being clear about the role of each we can ensure that all exercise is targeted.

VO2 Max Testing: Measuring Cardiovascular Fitness

Another essential component of a comprehensive health assessment is VO2 max testing. VO2 max represents an individual’s maximum rate of oxygen consumption during intense exercise, providing a measure of cardiovascular fitness. By understanding their VO2 max, individuals can tailor their exercise programs to improve their cardiovascular health and overall fitness. Attia notes that as a single measure, the VO2 max is a better predictor of all-cause mortality than any other. This means that it should not be only athletes who take these intense tests, but all of us. Please note that for certain health conditions, you might need to get clearance from your doctor before you can complete the VO2 max test.

Nutrition: The Foundation of Health and Longevity

Dr. Attia underscores the importance of proper nutrition in promoting longevity and overall health. He emphasizes the need for a high-quality diet that provides adequate protein, healthy fats, and nutrient-dense carbohydrates while avoiding excessive sugar and processed foods. By making informed dietary choices and focusing on food quality, individuals can optimize their health and reduce their risk of developing chronic illnesses.

Sleep: A Critical Factor in Health and Longevity

A good night’s sleep is essential for overall health and well-being, and Dr. Attia highlights its significance in promoting longevity. Poor sleep quality and insufficient sleep duration have been linked to various health problems, including obesity, cardiovascular disease, and cognitive decline. By prioritizing sleep and adopting healthy sleep habits, individuals can improve their overall health and well-being.

Mental and Emotional Health: The Missing Piece

Dr. Attia discusses an often-overlooked aspect of promoting longevity: mental and emotional health. He emphasizes the need for individuals to address underlying mental health issues, develop healthy coping mechanisms, and prioritize self-care. By focusing on mental and emotional well-being, individuals can improve their overall quality of life and increase their chances of living a longer, healthier life.

Comprehensive Health Screenings: Taking Control of Your Health

Dr. Attia advocates for a proactive approach to healthcare, emphasizing the importance of comprehensive health screenings to identify potential health risks and inform personalized health plans. In addition to DEXA scans and VO2 Max testing, these screenings may include cholesterol testing, functional movement assessments, and other specialized tests.

Conclusion: Taking Control of Your Health and Longevity

In summary, Dr. Peter Attia’s “Outlive” offers a comprehensive guide to promoting longevity and overall health. By addressing the most common causes of death and chronic illness, adopting a well-rounded exercise regimen, focusing on proper nutrition, prioritizing sleep, and addressing mental and emotional well-being, individuals can take control of their health and increase their chances of living a long, healthy life.

It should be clear by now that we would absolutely stand behind him on all his suggestions for a path to being a centenarian, but we would say that of course.

For those in the UK seeking to take control of their health and optimize their chances of living to 100 and beyond, there are very few companies that offer many of the services recommended by Dr. Attia, but we are fortunate and proud to be one of them.

Here at My Vital Metrics, the tests we offer include DEXA scans, VO2Max testing, cholesterol testing, functional movement assessments, and more. By taking advantage of these cutting-edge health screenings and implementing the strategies outlined in “Outlive,” individuals can make informed decisions about their health and work towards a longer, healthier life.

We do think that Dr Attia’s book is so important, we are going to do a bit of a series of blog articles to cover different aspects of the testing we do and how it relates to his suggestions.

The HbA1c blood test is a measure used to diagnose diabetes. However, even at pre-diabetic levels and below, there’s a lot that the HbA1c can tell us about our body’s ability to use carbohydrates and sugars.

In this article, we’ll take a look at what the HbA1c blood test shows, how to interpret the results, how you can use your HbA1c levels as a guide to your ideal macronutrient ratio, and how other lifestyle factors can influence the HbA1c.

What is the HbA1c blood test?

The HbA1c test is a simple blood test that measures your average blood glucose level over the last 90 days. An HbA1c finger prick blood test is a quick and non-invasive test that can be quickly processed to deliver the results. The results of an HbA1c test can be used to:

• Diagnose diabetes
• Assess diabetes risk
• Check how well your existing diabetes medications are working
• Track how diabetes might affect your long-term health
• Offer insights into optimal macronutrient ratios in your diet

Unlike a straightforward glucose test (which is often done after fasting for 12-16 hours), you don’t need to fast prior to having an HbA1c blood test. Since the HbA1c shows an average of the amount of glucose present in your blood over the last 90 days, eating prior to the test is unlikely to have a significant impact on the result.

What does an HbA1c test show?

HbA1c is looking at markers on the Haemoglobin in our blood. When our blood sugars are raised, that leaves an imprint on the blood. When blood sugar is raised repeatedly, it leaves multiple imprints. These are like high-water marks on a pier. We can look at the blood record and effectively determine how often the blood sugar has been high, and how high it’s been. Half our blood cells die and are replaced with new ones over the course of 30 days, so over 3 months, we have a totally different set of blood cells than we did at the start, and this is why we don’t recommend frequent HbA1c tests, or at least not before a good percentage of the blood has changed over in this natural process of replenishment.

It’s important to understand what it can and can’t tell us about our health. First, it can’t tell us the precise amounts of glucose, insulin, and other hormones present in the blood. To do that, you’d need a blood draw and insulin pump test, and that’s not what HbA1c is designed to do. Second, if it were to show a high reading, in the diabetic range for example, it can’t tell us the precise cause of that diabetes, only that there are markers on the Haemoglobin which indicate prolonged or repeated elevated blood sugar over the last 90 days. Even though it’s possible to use an HbA1c test to diagnose diabetes, it’s not an exact science, and should not be the sole test done to come to a diagnosis. Third, HbA1c testing is most useful for assessing diabetes risk and what might happen if you were to develop diabetes.

How to interpret the results

Broadly speaking, the closer a reading is to 0, the better, though no-one can ever really expect a reading of 0. It’s important to note that HbA1c is only a numerical representation of average blood glucose levels. It does not tell us how high or low glucose was at any given time. It is also important to take into account any factors that could affect your reading, such as if you’re pregnant, if you’re eating a large amount of sugar, if you’ve taken certain medications, etc. If your HbA1c is between 39mmol/l (5.7%) and 48mmol/l (6.5%), you have an elevated risk of developing diabetes.

How to use the results to make lifestyle changes

If your HbA1c is above trace but normal or below 48mmol/l (6.5%), there’s no need to stress out. You do not have diabetes. However if you are looking to optimise your diet for fat loss and general health, we categorise the ‘normal’ range into a number of ranges, and apply some lifestyle changes which will help you do that.

If you have a level of 48mmol/l (6.5%) or above, this is an elevated risk level and we will advise you to talk to your GP if this is new information to you. One of the first things to do is to get your HbA1c under control.

If you don’t have diabetes, but your HbA1c is below but approaching 48mmol/l (6.5%), we will send you away with some dietary considerations. In general, the higher your HbA1c level is, the more we would advise limiting first simple sugars, then limiting carbohydrates overall, and as we approach the limit we might suggest things like consolidating meals into fewer instances of eating, or implementing time-restricted-feeding. all these measures are aimed at giving your body a break from blood sugars and allowing insulin levels to come to baseline for longer periods of the day.

Interestingly, other interventions like stopping smoking or swapping out processed foods for whole foods all have a positive impact on HbA1c. Overall, having a greater amount of muscle mass also helps.

Final thoughts

HbA1c testing is a useful tool that can help to assess your diabetes risk and report on your average blood glucose levels over the past 90 days. It can’t tell us the precise amounts of glucose, insulin, and other hormones present in the blood. It also can’t tell us the precise cause of diabetes. With it, and combined with our dexa scan, we can give a more accurate blueprint of the kind of diet which may work for you to address any fat loss or recomposition goals, or indeed how to better eat for health and longevity.

Want to read more?

The following articles and studies were used to write this article, and so you might gain further insight by reading some in full:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933534/

https://www.ncbi.nlm.nih.gov/books/NBK304271/

https://www.who.int/health-topics/diabetes#tab=tab_1

https://journals.lww.com/jfmpc/Fulltext/2022/06000/Reduction_in_HbA1c_through_lifestyle_modification.171.aspx

https://www.researchgate.net/publication/6223951_Glycaemic_Control_in_Athletes#:~:text=Athletes%20showed%20a%20consistent%20trend,0.2%25%3B%20p%20%3D%200.017).

The benefits of exercise are hardly a secret. From losing weight to lowering blood pressure and reducing stress, the positive effects of working out are well-known. 

However, what many people don’t realise is just how significant of an impact exercise can have on our lives. With just 20-30 minutes of exercise each day, you can improve your mental health, increase physical strength, and boost your energy. Not only will exercise positively affect almost every aspect of your life, but it’ll also help you feel great! 

If you’re looking to start exercising more or would like to get back into it after a break, keep reading for some great tips on how to reap the benefits of exercise. These incredible short-term and long-term benefits of exercise are sure to provide some workout motivation!

‍The science behind the benefits of exercise

A comprehensive meta-analysis evaluated the benefits of exercise on energy levels, fatigue, and vitality. The analysis included 81 separate trials involving over 7,000 participants. Each trial consisted of at least two exercise sessions per week, with control groups either remaining sedentary or participating in low-level activities like stretching.

Here’s what they found:

• Increased energy: Regular exercise leads to small but meaningful improvements in energy levels.
• Reduced fatigue: Exercise significantly decreases feelings of fatigue.
• Boosted vitality: Participants reported moderate increases in their overall sense of vitality – better than results achieved through medications or cognitive behavioural therapy.

These exercise benefits were enhanced by:

• Higher-intensity exercise (this improved all outcomes).
• Combining resistance and aerobic exercises (this optimised energy and vitality).
• Longer exercise sessions and sustained programmes (these reduced fatigue).

Although it may seem counter-intuitive, exercise helps reduce fatigue by improving hormonal regulation and enhancing sleep quality. This combination ensures you feel more energised during the day.

Physical health benefits of exercise

Regular exercise offers a wealth of physical benefits. Let’s take a look at a few.

Lower your risk of heart attack and stroke

Heart disease and stroke are two of the most dangerous health conditions, but the benefits of exercise can significantly lower your risk. According to the CDC exercise recommendations, adults should aim for:

• 150 minutes of moderate aerobic exercise per week, or
• 75 minutes of vigorous aerobic exercise per week.

Regular exercise can reduce the risk of heart attack by up to 40% and stroke by 50%. Additionally, it lowers blood pressure, improves cholesterol levels, and reduces your resting heart rate, all of which promote cardiovascular health.

Reduce chronic pain and stiffness

If you experience chronic pain or stiffness, exercise can be an effective remedy. By increasing blood flow to your joints and releasing endorphins, exercise can alleviate discomfort from conditions like arthritis, back pain, or muscle strains. Improved range of motion and flexibility are additional short-term benefits of exercise for those suffering from stiffness.

Help you breathe easier

For those with asthma or other respiratory issues, regular exercise offers significant advantages. By improving lung function, increasing endurance, and reducing stress, exercise can help prevent asthma attacks and enhance breathing. Long-term commitment to exercise can make breathing more effortless and enhance overall quality of life.

Mental health benefits of exercise

Provide a sense of well-being and happiness

The mental benefits of exercise are profound. Regular workouts release endorphins, which create feelings of happiness and reduce stress. Exercise also boosts serotonin levels in the brain, enhancing mood and alleviating symptoms of depression and anxiety.

Additionally, exercise can:

• Improve self-confidence.
• Enhance cognitive function.
• Promote better sleep quality.
• Foster social connections through group activities or sports.

With these benefits, it’s no surprise that mental health professionals often recommend regular exercise for emotional well-being.

Short-term and long-term benefits of exercise

Short-term benefits of exercise

• Boosted mood and reduced stress.
• Immediate improvements in energy levels.
• Enhanced focus and mental clarity.
• Reduced stiffness and improved flexibility.

Long-term benefits of exercise

• Lower risk of chronic diseases, including heart disease, diabetes, and some cancers.
• Improved muscle tone and joint health.
• Sustained weight management.
• Enhanced longevity and quality of life.

By focusing on both the immediate and lasting exercise benefits, you can create a healthier and more fulfilling lifestyle.

What about exercise and weight loss?

Exercise is often associated with weight loss, but science shows that it’s only one piece of the puzzle. At our lab, we focus on ensuring clients achieve an overall active lifestyle, complemented by weight training to preserve and build muscle mass. However, significant weight loss primarily relies on caloric restriction rather than counting the calories burned during exercise.

That said, exercise offers numerous benefits beyond weight loss, making it a key part of a healthy lifestyle. By focusing on the benefits of exercise, you’ll find motivation to stay active, even beyond achieving weight goals.

Conclusion

The benefits of exercise are undeniable. Whether you’re aiming to improve mental health, reduce the risk of disease, or simply feel better day-to-day, regular physical activity offers unparalleled advantages. From the short-term benefits of exercise, such as boosting mood and energy, to the long-term benefits, like enhanced vitality and reduced chronic disease risk, there’s no reason not to incorporate movement into your daily routine.

Ready to experience the life-changing benefits of exercise? Start small—20 to 30 minutes a day—and build from there. Whether it’s a brisk walk, weight training, or yoga, every step you take brings you closer to a healthier, happier you. To find out more about how My Vital Metrics can bring you closer to achieving your exercise goals, reach out for a free fitness and nutrition consultation at MVM today.

The T-Score doesn’t compare you to your own age group, but rather compares your bone density to what is considered ‘peak’ bone density – which is usually a healthy 30 year old, or thereabouts. Once again it is expressed in standard deviations, so a positive value means you have more dense bones than average, and a negative value means your bones are less dense than average.

DEXA Scan Results: Understanding Your Body Composition

Choosing the Right Body Composition Goal for You

It’s the age-old fitness question: can you build muscle and lose fat at the same time?

Here at My Vital Metrics, one of the first things we will do when you come in for a fitness assessment depending on your results, will be to help you set a primary goal. For body composition clients this will often mean choosing between fat loss and muscle gain.

So, does that actually mean you can’t build muscle and lose weight simultaneously? Classic body-building would say so, claiming that you need to ‘eat big to get big’. Overall, it’s technically true that you need to be in a caloric surplus to gain muscle, and you most definitely need to be in a caloric deficit to lose fat – so that makes these two goals incompatible, right?

As always, body recomposition is a little more complex than that, so let’s break it down and see whether this Holy Grail of body recomposition is possible.

Before we dive into the topic of fat loss vs. muscle gain, we should point out that there are many other worthwhile health and fitness goals: movement quality; injury prevention; posture; sporting performance, and many more. With that in mind, let’s start with the phenomenon that causes the most confusion on the issue of whether you can gain muscle and lose fat at the same time: “newbie gains”.

Building Muscle and Losing Fat: “Newbie Gains”

There’s plenty of good evidence in the literature that for new lifters, gaining muscle and losing fat at the same time is absolutely possible. There is some debate however over the specific mechanism of action by which this is achieved. One theory is that because they are not yet efficient at converting food into muscle, the metabolic adaptations happening for the first time require a lot of extra energy from the body, and so someone burns extra fat.

However, most newbie lifter plans (if taking a newbie in an untrained state, and assuming they want to burn fat also) would usually put them into a caloric deficit, and so really the question is ‘how does a newbie gain muscle so well, when in a deficit?’ We’ll hold this question for a moment while we go through the science.

The Science of Losing Fat: A Calorie Deficit

The most important thing to remember is that you need to be in a caloric deficit to lose fat. This means you need to be eating less than your body burns to keep itself alive and you moving around. Everything you do, from breathing, or your heart beating, to brain function, even to the act of eating and processing food will expend calories. And, of course, your activity: moving around, and exercise is all part of that. How much less you need to be eating depends on a lot of factors.

The best way to establish an accurate sense of your caloric needs is through an RMR test. This will tell you how many calories you need each day to keep yourself alive (this is your Resting Metabolic Rate or Basal Metabolic Rate), and how many calories your Total Daily Energy Expenditure (TDEE) is. This is the number of calories you could eat to be in perfect energy balance – neither gaining nor losing weight. From there, we can work out how many calories you need to eat to lose fat. This will be somewhere between your TDEE and your RMR.

We have to remember, however, that being in a caloric deficit isn’t a magical switch to start burning fat alone – the body will make economies to try to balance its energy from all its systems and all its tissues. Without other stimuli to the body, the body is just as likely (more likely actually) to rid you of muscle which you aren’t using, because muscle is costly tissue to maintain. It may also leach from bones, and temporarily reduce expenditure in many other ways to balance its energy needs. This whole process: the process of removing tissue to use for energy is called ‘catabolism’, and someone in this state can be referred to as ‘catabolic’. So a deficit will (without other stimuli) lose us muscle – that’s the key thing to remember as we move to talk about how a caloric surplus works.

The Science of Gaining Muscle: A Calorie Surplus

Contrary to the above, to gain muscle you need to be in a caloric surplus. This means you need to be eating more calories than your TDEE. Of course, just eating more than you need is not sufficient to gain muscle. You need to send stimuli to the body to tell it where to put those extra calories. Left to its own devices, and without this stimulus, the body will add to systems as it sees fit. This might mean it upregulates (turns up the dial on) the immune system, hair and nail growth, mental energy, dopamine responses, and of course, there’s inevitably going to be some of those calories which go to fat stores, energy stored for future use. To predispose you to gaining muscle you have to have a good-quality hypertrophy or strength training plan. This creates the stimuli to the body to divert some of these excess calories over to muscle growth. It is a signal to say to the body ‘Hey, I am lifting big, so you’d better make these muscles stronger and bigger or I might injure myself or be unable to do what I need to do to get food and keep myself alive’. Of course, we know that your lifting is not directly connected to your survival, but from an evolutionary point of view, that’s how the body sees it. Likewise with the deficit though, a surplus will add to all tissues. If you weight-train, then some of that excess will go to muscle, and bone, as well as strengthening tendons and ligaments. Inevitably, however, some fat will also be gained, so sizing up the amount of the surplus is important. In classic bodybuilding methods, a surplus is the ‘bulking’ phase of the diet, and they accept that fat will be gained during the process, but they value muscle more so they take this hit, with the expectation that they’ll lose the fat later down the line. This whole process – the adding of energy to muscles, bones and other tissues is called ‘anabolism’ – so someone in this state is referred to as ‘anabolic’. You may recognise the term from ‘anabolic steroid’ – which are basically hormones which increase the body’s anabolism.

Energy Balance Throughout the Day

We haven’t discussed so far the important role of protein in the above processes. Suffice it to say that protein is critical as it contains all the building blocks that allow us to put on or keep muscle. The protein content of a diet is incredibly important in that it facilitates greater anabolism, and prevents excess muscle catabolism.

So from the above, it seems pretty clear – you are either anabolic or catabolic at any given point in time. Case closed, you can only pursue one goal at a time – right? Not quite.

So, the premise is correct: you can only be in either an anabolic state or a catabolic state at any one time, however, which state you are in will vary throughout the day. Just woke up and started moving about, before breakfast? You’re catabolic. Had a nice big breakfast, you’re now anabolic for a while. Just finished your workout? You’re very catabolic. Downed a protein shake? You’re anabolic again.

So you aren’t permanently in one state or another, but rather it varies throughout the day, and by playing with this, and timing your meals (and protein especially) appropriately, we might be able to get to this goal.

How to Fuel your Body to Build Muscle and Lose Fat

If you want to gain muscle and lose fat concurrently, you need to make sure that you’re in a surplus (eating more than you need) for some of your day, but also be in a deficit (eating less than you need) for the other parts.

When you are in each state will need to depend on your workouts. Remember, the major stimulus you can put into the system is a solid weight-training workout. So it is immediately after this, and for a few hours that you’ll want to be in a surplus so that the body diverts all those excess resources over to refilling muscle glycogen, and repairing muscle tissue. For the rest of the time you’ll want to be in a deficit.

Overall, the energy balance does need to be a deficit. If the balance at the end of the day or week is positive calories, then you will not be able to lose any fat.

Have we found the Holy Grail of body recomposition?

In short, both of these can happen at the same time, but it’s not the easiest balance to maintain for many people. Remember also that by aiming for both, you are compromising on maximal progress on each. We are all for this approach, however. It gets people eating a good amount of calories that is sustainable and should feel pretty filling, and good, and it allows people to pursue an overall better physique and get healthier on multiple measures of fitness simultaneously. We’d overall rather see this approach which may take a year or maybe even two, rather than the dramatic bulk-cut cycles we sometimes see.

That said, this approach may have diminishing returns the further up the bell curve you are in terms of existing muscle mass. In other words, if you are a person who is already carrying a lot of muscle from many years of training, managing to grow more muscle while in a deficit is increasingly unlikely the more muscle you already have. Going back to our ‘newbie gains’ discussion, this is probably why new lifters are so much better able to add muscle when in a deficit. If they are carrying much less muscle than we are evolutionarily capable of, the body is far more likely to add muscle as a priority given the right stimulus.

To find out more about how you can meet your body recomposition goals, book a free fitness consultation at My Vital Metrics today!

One of the most common questions we get is what kind of diet our customers should follow. Of the various diet plans and options out there, the one that comes up the most is the keto diet, or very low carbohydrate diet. Below we look at what the keto diet is; what a keto diet looks like on a day to day basis, and whether someone should consider it as a way to lose fat or recompose. We will also cover issues of performance and health.

What is the keto diet?

The keto diet is a low-carb, high-fat eating plan that has first gained some notoriety in the 1970s with ‘Dr Atkins’ Diet Revolution’ book. It caused such a stir at the time because Dr Atkins claimed that a person could eat any amount of food and still lose fat on the keto diet. These claims were later retracted, and keto hit the news again in the 1990s with the reissue of ‘Dr Atkins’ NEW Diet Revolution. The diet is based on the premise that carbohydrates (including sugars and grains) stimulate the secretion of insulin, a key hormone that helps the body store fat amongst other things. When your body runs out of carbs storage, you are forced to use body fat as the primary fuel source. When burning fat, in the absence of any stored carbohydrate, the body produces by-products of the fat-burning process called ‘ketone bodies’. Therefore, because this style of eating is intended to create ketones, it is referred to a keto-genic (genic is just Greek for ‘giving birth to’ – thus ‘gene’, ‘genesis’ etc). The key thing with keto is that you try to eliminate carbohydrates altogether. In reality this isn’t possible, but many keto advocates will attempt to keep carbs below 20g.

Is Keto the same as Low-Carb?

Keto is the very extreme form of low carb diet, but the two forms of diet are not the same. Low carbohydrate diets range all the way from around 40% of your daily calories coming from carbohydrates, right down to as little as possible – which is theoretically ‘keto’. In most low carbohydrate diets the focus is on measurement and control of carbs. On keto the key measurement that’s performed is daily (or more frequent) urinalysis or blood test or (more recently) breath testing to see if the body is producing ketones. It works on the assumption that carbs have been all but eliminated from the diet, so they don’t need to be measured per se.

What does a keto diet look like on a day to day basis?

On a day-to-day level, keto adherents will be eating a lot of meat, and (hopefully) green leafy vegetables and broccoli. They may be adding oil to all their food and may be having nut butters and other high-fat snacks (but without the bread). The food will be heavy and high on protein and fats (being the other two macronutrients). Breakfasts may be hot. Eggs, bacon, sausages are all fine – but hold the toast and beans. In restaurants they may steer away from Asian foods which tend to have a lot of hidden sugars and will likely go for the plainest meatiest dish on the menu. They’ll be asking their waiter to remove chips, potato (sweet or otherwise), bread, rice, noodles. With the availability of very low carb food substitutes, at home they may be having noodles or rice made of Konjac flour, or heart of palm but for some even this may be too many carbs. Desserts may just not exist at all, or some adherents may have one small square of 90% cark chocolate. I once knew someone who would prepare a dessert of 0-calorie jelly and double cream. All in all, it’s pretty restrictive.

In what circumstances might the keto diet be helpful?

A keto diet may help to reduce insulin resistance and increase insulin sensitivity. With the aim being to keep insulin low, this may have some beneficial effects on this and blood sugars in general. I may also be helpful for adherence in the specific case that all the foods that a person really likes are these heavy fatty, carb-less foods. There are of course some key medical areas in which a keto diet may be helpful. The diet was originally developed as a treatment for some forms of epilepsy. Ketones are a unique energy source in that they can cross the blood-brain barrier, and so can be used to fuel the brain. There is an evolutionary theory that the body developed ketones in order to serve this very purpose in circumstances of low availability of plant foods. In general people who are well adapted to the keto diet, often praise it for the smooth even mental energy and focus it gives them. By not being subject to the vagaries of high and low blood sugar, ketone advocates will say that they work and think better on keto. The nature of the food will also keep you fuller for longer, so if you find yourself feeling hungry every couple of hours, maybe keto could show you what long-term satiety feels like.

The cons of the keto diet

The first and most obvious downside of the keto diet is how restrictive it is. In a restaurant it will be near impossible to find a meal that doesn’t need to be modified in order to be somewhat compliant. And even with modifications, the threat of hidden sugars is ever present.

The second is the the days referred to as ‘keto flu’. In the first few days of adopting the diet, the body is having to adapt to an energy source it is not accustomed to. It may not be efficient at this and may in effect be ‘waiting around’ for more carbohydrates to enter the system. During this time the person feels especially lethargic, low motivation, low energy, and often headaches and other symptoms may emerge. Once the person starts to keto-adapt these symptoms will usually subside.

Lastly, keto is a huge problem because it is a bit ‘all or nothing’. If you have a single big carb meal, this will certainly be sufficient to kick you out of ketogenesis and may even refill some lost glycogen. If this happens that means that it may even mean you’ve lost ‘keto’ status for another 5 days, and another period of keto-flu is ahead of you to get back into it. The fact that the diet can’t really withstand even small lapses in adherence is a big problem, psychologically. If someone has a carb meal, they often will throw the diet to the wind and carb up while they can, and ‘restart on Monday’. This approach is hugely problematic and ultimately defeating for any consistent or concerted fat loss effort.

Is the keto diet good for fat loss?

The ketogenic diet has been proven to be an effective weight loss tool in clinical trials, but the diet must be properly followed to result in weight loss. The key thing to note however is that, as anyone who has followed keto can tell you, in the first week after the keto flu, you lose sometimes 2-3kg straight off the bat. This can be very encouraging, but we also know that this weight loss is pure water. Every molecule of glycogen (stored carbohydrate) in the muscles and in your liver, attaches to two molecules of water. When you deplete your glycogen, the water is released, leading to the 2-3kg of weight loss. In DEXA terms, this will mean an instant loss of 2-3kg of lean mass. So, it’s important to keep consistent between scans. If you take your baseline scan already in keto, you will need to take your update scans also in keto to get a like-for-like comparison.

In longer term studies however, the results of keto dieters did not exceed that of other forms of diet when equated for calorie deficit. Keto is therefore not a magic bullet of any kind for fat loss. Furthermore, the extreme restriction of lifestyle that accompanies keto may make adherence to and consistency on the diet plan very difficult.

The final verdict: Should you follow the keto diet?

There may be a limited number of circumstances in which the keto diet may have some uses, but in general we don’t like how all-encompassing it needs to be to be effective. Ultimately it will be the number of calories you consume on the plan that is the determinant of the amount of fat you can lose. If we ever choose to deploy a keto plan (and it is unlikely we would prescribe something so restrictive) it would be for a very particular purpose, and probably be for a short amount of time.

As we are all about sustainable ways of eating and long-term eating for health rather than diets, we don’t really like how many adjustments people have to make to their lives in order to follow this plan.

That said, if someone is keen to go on keto, we will of course support them, but we will still come back to the fundamentals of a sustainable calorie deficit while eating a wide-ranging nutrient dense and interesting diet. And time and time again, we have the DEXA results to show that this approach works. Every time.

Weights vs. Cardio: Which should I be doing if my aim is to ‘recompose’?

The most common question I get when talking about exercises for recomposition is whether weights or cardio will be better for the client’s goals. The answer to this is going to depend very much on each client’s needs and goals, but there are a couple of universals. Some weight training as part of any general recomposition plan is a non-negotiable part of the plan. Cardio is a bit more particular, and I would only recommend it in certain circumstances. Lets take a look at the two forms of training, what they do and how they should be used.

What do we mean by body recomposition?

Recomposition is a process of changing your body’s composition – what it is made of. 80kg at 25% body fat for a man, is a very different picture to the same 80kg at 12%. Generally speaking, composition goals tend to be about getting more muscle and less fat into the same or similar weight footprint.

A comprehensive fitness program should consist of a combination of different types of training to maximize results, and build an overall level of ability in each area. This usually incorporates a combination of strength and conditioning, metabolic training, stretching, and functional training. This is to build an overall fitness program and optimize the body for all aspects of life. Of these though, functional training and stretching are more enablers in a recomposition programme, while the strength and conditioning and the metabolic training do all the heavy lifting (pun intended) with the actual recomposition.

When to use weights in recomposition

Weight training is often not the first thing most people think of when they think of exercising for a fat loss programme. Think of the countless images in ads and movies of people running or skipping or rowing. Weight training is more commonly associated with a goal to build strength and muscle mass. However, when considering the value of weights vs cardio for a recomposition programme, lifting weights has an essential function: to preserve the muscle mass we already have.

We will talk diet in more detail below, but in general terms, a recomposition diet will involve a calorie deficit of some form. That means eating fewer calories than your body is expending. In this context, we must limit out expectations of how much new muscle the body is going to be able to build. With the exception of people completely new to weight training, most people will not be able to gain a lot of mass while in a deficit.

So why do it? Well, muscle is incredibly expensive for the body to maintain. In other words it takes a relatively large number of calories to maintain your muscle mass when compared to maintaining fat or bone. The outcome of this, is that when your body is in a caloric deficit, the body will need to make cuts, and as a metabolically expensive tissue, the body will, if left to its own devices cut muscle first. It will do this unless there is some reason not to. The body is smart, in that it will not cut tissues which are actively being used. If you are sending signals to the body (by lifting weights) telling the body that you are using the muscles, the body will preserve those muscles which are being used. If you don’t send those signals, then the body will reduce tissue size in all tissues, but it will start with those tissues which will spare it the most calories, and that’s your muscles.

But I didn’t want all that muscle anyway!

Actually, you really do. Unless you are a professional sportsperson in some very specific sports, more muscle is almost always a good thing. We will all undergo some muscle loss eventually in our lives. The process accelerates in our 40s and 50s, and so I always advise clients to pack on as much muscle as they can before these ages, and then just work to preserve it after this time. With a good level of muscle mass, preserved through regular weight training, we can have full, productive, and quality lives into our 70s and beyond. Planned for well, we may never reach a time when we can’t get out of a chair by ourselves. But coming back to recomposition, more muscle mass, means a higher metabolic rate, which means we can eat more, while still losing weight. If you lose a lot of muscle, it will affect your metabolic rate, and you will have to eat an ever decreasing number of calories to maintain losing weight (to a point).

The upshot of all of this, is that weight training is an absolute essential parto f any recomposition programme, and separate to that, I would say is an absolute essential part of anyone’s fitness routine.

When to use cardio in body recomposition

Cardio is a type of training that involves working at a moderate-to-high intensity for a period of time. It is a form of training that can be used to help increase the body’s ability to use oxygen while improving overall health and fitness. A well trained cardiovascular system will mean you are able to climb stairs, run for the bus, or just generally go about your day without getting out of breath. Cardiovascular health is an absolute must for everyone. A healthy cardiovascular system is a huge mitigating factor in a host of health risks. To train the cardiovascular system well you need to do a couple of different types of training: long slow distance type at a low level heart rate (zone 2) will improve your aerobic base, while HIIT training will improve your anaerobic threshold. These types of training do take time, and are worth doing for their own sake. When it comes to recomposition however, the story is not as clear as all that.

We used to think that if you spent 1 hour on a given day running, and burned 800kcal in that run, that this would automatically put you into an 800kcal deficit, and that the body would take the excess from your fat stores. Cardio was therefore all about creating a deficit through greater activity. Unfortunately the most recent science on the matter indicates that this is not what happens. Instead, the body seems to want to stick within its own limited number of calories that it likes to consume, and, instead of burning new calories, will make cuts to other parts of expenditure in order to accommodate the extra calories required for the exercise. An 800kcal run, which is not replenished with food, may for example cause the body to cut the budget of the immune system by 300kcal, brain function 200kcal, and dopamine production of 100kcal, new calories burned then would be only 200kcal, and the rest would be calories redirected from other systems.

So when it comes to burning through calories, cardio is not anywhere near as efficient as we used to think. The body is too smart a manager of resources to always dip into storage when energy is low. So the real question of the article is really not a toss-up between cardio and weights, but actually a toss-up between creating a calroie deficit through cardio, or creating it through food.

I have limited time – what should I focus on?

It seems pretty clear from above, that as far as time-efficient ways to engage in a recomposition programme goes, weights is a non-negotiable, while cardio seems optional. The creation of a calorie deficit through cardio is incredibly inefficient, and most especially is time-inefficient. If we choose to instead take a calorie controlled way of eating, and create out calorie deficit through that, then cardio ‘exercise’ becomes an optional, and for some people I would not even suggest that they do any dedicated cardio ‘exercise’. I’m using ‘exercise’ here to indicate cardiovascular work which is just going through the motions in order to burn more calories. This is separate from cardiovascular ‘training’ which is specific and targeted work to train and get the cardiovascular system stronger.

Conclusion

If you thought I would end this article with an on-the-fence result saying that “Weight training and cardio are both important parts of any recomposition program” you’re about to be disappointed. In my mind weight training to preserve muscle whilst eating to a calorie deficit is the best and most sure-fire way to achieve success in a recomposition programme. If you want to simultaneously throw in a HIIT session to keep your heart in tip-top shape, then that’s great, and I’d recommend it, but don’t do it thinking you’re burning through new calories. One final thing I haven’t mentioned is NEAT – Non-Exercise Activity Thermogenesis. This is the general level of activity you have during the day outside of your workouts. It is getting up and moving around between zoom calls, walking to the shops or the station and so on. This type of activity is really important to keep high for general health and will be a great plus to your recomposition programme. As ever if you’d like to discuss this and more, and get specific in how to recomp yourself, get in touch and book a DEXA.

Returning to work in the office: How does it impact your health and fitness?

After covid, the return the office may be a relief for some but a necessary evil for others. Either way, any return to the office is going to have a number of potential impacts on your health and fitness, from a higher level of daily activity, through to greater stress owing to the commute. Many will also find it more difficult to fit in their time for the gym or fitness goals. Here’s our guide on how to maximise the good things that returning to the office will bring, while working around or minimising the negative effects.

The pros of returning to work in the office

More daily energy expenditure

The first and most obvious positive aspect of returning to work after the covid is that you’ll have a greater level of daily activity. If you are in a sedentary desk job, then it’s likely that working from home has been the same, and that you’ve had a couple of years of very low levels of incidental activity. Your job may not have changed, but the very act of having to go into the office, with the commute and walking to meetings, walking to get a coffee, and similar will mean that overall you may find it a lot easier to get a good number of steps in each day. Of course, in addition to this you could increase activity further by taking the stairs instead of the elevator, parking further away from your destination if you drive, or getting off the bus/tube one stop early and walking the rest of the way.

Workmates can be supportive to your fitness goals

One of the most positive things about returning to work is being able to spend time with your colleagues. Sometimes, they might be people you see every day, sometimes they might not. Either way, it’s always nice to have someone at work who can understand what you’re going through and what a challenge juggling a demanding workload and a fitness goal can be. It can also be helpful for your fitness goal if there are other people in the office who are trying to keep fit too. They may have new training tips or food ideas for when you’re struggling with healthy eating.

The cons of returning to work in the office

The commute

There are some cons to consider when returning to the office. Firstly, the commute itself could have a more detrimental effect on your health and fitness, as you give up time each day that could be used for exercise or work out sessions. Mixing on tight-packed public transport is going to make it more likely that you may pick up coughs and colds again, and of course we aren’t totally through Covid yet either. Alternatively, if you’re travelling by car, your commute is likely to involve sitting in traffic for greater lengths of time – something that is far from good for your health.

Less time for the gym

The most obvious negative effect of returning to the office is that you are more likely to have less time to go to the gym. The morning commute, from home to work, will take up a significant chunk of your day. There’s also a possibility you’ll also be working longer hours at the office which may mean less time for exercise once again.

Convenience lunches

Being in the office means that you’ll often have the opportunity to nip out to one of the many chain or individual eating spots for lunch. If controlling your calories is part of your plan, it can be quite difficult to keep a close eye on what you are consuming. Further even when calories are listed, you may notice just how much higher calorie these foods are than the same food prepared at home.

How to make returning to work in the office work for your fitness

The following measures can counteract or help with the issues listed above.

– If you’re lucky enough to have a desk job, take some time out during the day for a walk around the office or building. Try taking a lunch break away from your desk as well, and find a colleague to go with. In fact, studies have shown that people who dine with colleagues are more likely to feel energised after lunch than those who eat alone. Little things like planning meetings in rooms which require you to walk a little further, or take the stairs can all add up your overall activity.

-If it’s an option, try cycling to work. Your workplace may even have a cycle-to-work scheme to help with this. If you are too far away, you could even split your journey: train into one of the major terminals and then grab a bike from one of the cycle share-schemes to complete your journey.

– If you find that your commute creates a time issue for your gym programme, you may need to mitigate this with shorter, more intensive gym sessions, or switching some of your sessions to the weekend. You may also choose to switch your gym to one near the office, so you can use your lunchtime for a session, or go straight from work to the gym, and avoid the peak of the commute time.

-Higher levels of general activity might mean that you wish to focus your gym time on activities you can train and improve at – weight training or high intensity cardio which go by principles of progressive overload. Leaving out general long-slow-distance type cardio and relying on your increased level of incidental activity to keep your daily calorie burn high can save you time also.

-While meal preparation may seem like a time-consuming activity, it actually can be a considerable time-saver. Finding recipes that you can batch cook, pack individually, and freeze means that with just 30 minutes of cooking can get you a full 6-8 meals. A couple of hours of meal prep on a weekend can get you all your meals across 3-4 recipes for your entire week. Then a few minutes of microwaving is all that’s needed during the week.

Conclusion

Returning to work in the office can be tough. You need to shlep in with thousands of others, and work to a schedule that may not be as flexible as you would like. But there are ways to make your return to the office easier and get off on the right foot when it comes to your health and fitness.

We recommend setting a plan in advance with your boss or line manager to ensure that you still have some flexibility with your hours and work commitments. Along with the points discussed above, a little bit of planning can go a long way towards helping you stay on track with your fitness goals.

If you’d like to talk to us about how to structure your goals and habits, by all means please get in touch on the form below.

How to start preparing for your spring fitness routine

Spring is a time when people start thinking about their summer body and what they’d like to achieve. However, many people leave planning and starting this till too late to be successful. It’s important to start to prepare as early as possible to give you the best chance of success. There are a few key steps that we think are important in planning your spring fitness routine. Where are you at?

Before starting your fitness routine – Baseline!

Well, you don’t need to wait for anything to start, but one of the first things to do is to take a baseline. This will help you know where you’re at. You need to know what is possible and what you are capable of. Once you have this information, it will be easier to plan for success.

A good baseline will help to guide your goals, but be careful, because picking the wrong measurement may lead to disappointment. Of course, we would always suggest that for composition goals, the DEXA is the best measurement there is. It’s detailed, consistent and absolutely reliable on ensuring that you are measuring the right things, and this will allow you to set your goals accordingly. Additionally you’ll be able to see what changes are making the most impact. If controlling your eating is going to feature (and there should be some eating control to most regimes), then a Resting Metabolic Rate Test can also help to accurately set your calories.

Formulate some goals

Once we’ve baselined, next we need to formulate some goals that are realistic and achievable. Remember, even when on a good fitness journey, it might take twice as long as you expect. One thing that’s really important when doing this though is not to set yourself up for so big a challenge at the start that you’re unlikely to achieve it. This is where the next part comes in.

Plan your daily actions of what you need to do to achieve your goals

So now you have the baseline and you have your goal. You’ll need to break it into achievable daily actions. Consider these three questions: 1) What time of day are you most likely to be successful in doing what you need? 2) What are some things that don’t take too much time and can be done on autopilot as you go about your day? 3) What is doable even if life has been a little crazy lately?

These daily actions will form habits, and it’s our habits that will achieve our goals for us. The habits will directly link to the goals. If your goal is to lose 5kg of fat in 3 months, but your daily habit is to eat only 100 calories under your maintenance, then your goal and your habit are out of line, as that deficit will not achieve the goal. However, if your goal is to lose 15kg in 3 months, and you work out (correctly) that this would require a daily caloric deficit of 1166kcal, then your goal and habit is in line, but your habit is completely unsustainable. The likelihood of you achieving your daily habit is very small, and would be counter productive if you tried, as this is too deep a deficit for most people to safely achieve.

Plan for slip-ups and breaks

It’s also important to consider how any social and other plans can affect your fitness routine. You need to plan around these accordingly so that there aren’t any major breaks in the routine: breaking momentum which could result in lack of motivation or support. Don’t forget about the slip ups either! They’re going happen (we all slip-up from time to time) but don’t let them become an excuse not to keep pushing forward with your goal – use them as an opportunity for learning and getting back on track sooner rather than later. Don’t let the slip-up of one meal turn into a slip-up for 1 day without reason, and this is where the planning comes in. Take occasional check-ins along the way to measure progress and ensure that things are staying on track – but be careful because checking in too frequently can cause fluctuations which might make you lose motivation or enthusiasm for the process altogether. Lastly, try not to underestimate the importance of scheduling in days or events which you can let go. We all need a social life, and don’t want to feel like we are counting and measuring every day.

Remember to take occasional check-ins and keep a daily log of adherence

It’s important to take regular check ins, but be careful not to measure too often as it may cause you to lose motivation. Daily weighing in or similar is usually counterproductive. check in monthly at most, and more likely every 6 weeks or so. The best form of daily tracking and logging is simply to mark down whether you kept to your habits for that day. Seeing the number of days on which you kept all your daily practices gives you a pretty good picture of your room for improvement also. This allows you to forget other measurement for the day-to-day, and trust the process.

What to do if you’re losing motivation?

You’ve set a goal for yourself and you’re doing your best to stick to it, but now you’re feeling like you’re losing motivation. Don’t worry! We all go through this. This is where the importance of a solid plan comes in. The daily actions and habits discussed above are what will get you through when motivation fails. (Yes, I said *when* motivation fails – because inevitably it always does). The trick here is to create a plan that’s sustainable, but not perfect. When you feel like quitting, just return to your daily actions, your habits and your plan, and trust the process.

Conclusion

If you’ve started to think about a spring/summer fitness journey, you need to be taking action today! Take a few minutes today to think about what you want to achieve this year and how you want to feel come summertime—whether it’s more energy, less stress, or just feeling more in shape.

Now it’s time to get started! Of course come and get tested with DEXA or our other tests, to get your baselines. But start small, and rely on the plan and the daily habits to get you through. For example, if more activity is the daily target, start by adding another 10 minutes to walking time, or another 2000 steps each day this week. Build up from there.

If you’d like to talk to us about how to structure your goals and habits, by all means please get in touch on the form below.