Sunday, February 10, 2013

Fighting Fitness Myths

Last week, news circulated that an article had been published in the New England Journal of Medicine about myths in the world of obesity treatment. The article summarizes seven myths that, it says, haven't been proven. 

The journal article was reported in a number of places including ABC, NBC and others.  One of the many other places it was reported was the British site called Medical News Today.  MNT has slowly become one of my favorite places to get news like this, so I'll use that as my baseline in a moment.

But first, let's take a look at what we should all learn about myths -- particularly those in the fitness and health world:

  • Context is key:  We often want to boil things down to the bottom line, the take-home, the key point -- so much so that multiple buzzwords all mean exactly that.  It isn't at all unusual for us to boil things down to that key point and then extrapolate from that point to places that weren't in the original context.  
  • Myths kind of make sense:  We apply our own smell test to the things we're told.  If something doesn't pass that smell test, we're much more cynical.  If it does seem reasonable, it's much more likely to take hold even if it's unproven -- and the myth grows. 
  • Myths are things we want to hear:  We all have a desire to get the most value from the least effort.  This isn't being lazy -- it's being efficient.  And it's good thing.  But, in our effort to work smarter instead of working harder, we can buy in to ideas that wouldn't make as much sense if it didn't allow us to cut corners.  
  • Over-generalization:  We tend to find it easier to understand each other and the world around us when we categorize people and things into groups.  In many scenarios, it's a good thing.  It's efficient and we learn things in one instance that we can apply to another.  The problem we can't always be categorized into a group.  Like I often get a kick out of saying, you are unique..  just like everyone else. 
  • Someone stands to gain something:  Myths can be perpetuated by people who stand to gain from the myth being trusted.  This applies just as easily to the well-intentioned as it does to people who are looking to make a quick buck.  We see something that we can use in our efforts improve their health, so we take that nugget and spread it around. 
With those ideas in mind, let's dig into the meat of the article (credit given where credit is due, the "myth" and "fact" text below is straight from the MNT article):

Myth 1: Small, continued changes in our caloric intake or how many we burn will accumulate to create a larger weight change over the long term.
Fact: Little changes in caloric intake or burning do not build-up indefinitely. Body mass changes eventually cancel out any change in calorie burning or intake. 
I'm not entirely sure where this particular one comes from.  No one's really tried to sell me on this concept.  I will say that this sounds something like an exaggeration of something you will hear a lot of trainers (including me) say:  those little changes can add up to give you big results.  In fitness, it is often unintentionally implied that if you aren't doing everything right then you might as well not be doing anything at all.  In an effort to articulate the importance of being comprehensive, we in the fitness business can inadvertently imply that need to do all of them to get any kind of value at all.  In short:  You had an unhealthy dinner last night?  You might as well just skip that morning workout!

Well, that just plain isn't true.  If you took the stairs today instead of the elevator it helped you -- even if you had pizza for lunch.  If half of your dinner plate was fruits and veggies (just as we tell you it should be) it helps you -- even if you skipped your typical workout.  Sure, I'd rather you are perfect every day and you never misstep, but those little changes really do help.  
Myth 2: Realistic goal-setting in obesity treatment is essential. If no goals are met, patients can become frustrated and lose less weight.
Fact: Some data points out that people achieve more by setting more challenging goals. 
So, there apparently is a pervasive belief that people need to be given small, achievable goals.  This article claims that people need to be challenged more.  That claim says they'll respond better when the bar is set higher.  Here's a crazy idea:  They're both true.  Odd, right?  They're each true for different people!

Here's an area where the medical environment can have some drawbacks.  Medical studies and medical programs are so emboldened to scientific study -- and the scientific method -- that unique individuals can't be distinguished unless they can be categorized into defined groups.  Remember, I'm not just a fitness professional.  I come from a technical field and a degree in science (Physics, specifically), so I know a thing or two about the scientific model -- and I trust it.

When you come to a personal trainer, you expect an approach to your training that is, well, personal.  I (the personal trainer) start with your current fitness level, your goals, and your limitations do devise a training regimen that is specific to you. Over time, I also hope to learn a bit more about you to learn how to implement that regimen in a way that best fits you.  Other than trial and error to some extent, I don't have a fully tried and true scientific program at my finger tips that is proven to work best for you.  I need to rethink and adjust on the fly.  It's just as much art as it is science.  This is particularly true for goal setting.  One study says I should use small attainable goals -- and the other says we should reach for the stars.  Neither says anything about you.  That, we figure out on the fly.
Myth 3: Slowing losing weight is better than shedding the pounds quickly. Quick weight losses are likely to be gained back.
Fact: People who lose weight quickly are actually more likely to weigh less after many years. 
Whoa!  I perpetuated this myth just the other day when I told a client that "lose weight fast" programs weren't to be trusted.  Should I call him up and apologize?  Well, let's think about it first.  How about the context.  The context of the study is the treatment of obesity.  That context, I'm guessing, means we're assuming patients are involved in medically-driven weight-loss programs. 

When someone tells me about some "lose weight fast" scheme, I often see that as a red flag that something's wrong.  A red flag, not tell-tale proof.  I start to wonder if the scheme relies on the person losing lots of water weight, or worse, muscle mass.  If someone loses a lot of water weight or muscle mass, it's likely that they will put that weight right back on eventually.  If it's muscle mass they've lost, they'll end up even worse off than when they started.

If I dig deeper into a weight loss scheme that doesn't seem to fall prey to these kinds of programs, I often decide that the person following it should be followed closely by professionals to make sure weight loss is happening in a way that is healthy -- and sustainable over the long-term.  That's exactly what medically-driven weight loss programs do!
Myth 4: You will only lose weight when you are "ready" to do so. Health-care professionals should measure each patient's diet readiness.
Fact: Among people who seek weight loss treatment, research suggests that examining readiness does not predict weight loss or helps to make it happen. 
I purposely drew out my thinking a bit in "myth #2", the one about goal setting because this one is the same idea.  Some people need a few tries as this fitness thing.  Sometimes, we can look back and claim that the first few tries didn't work because they "weren't ready."  People are just too personal for these ideas to be generalized for everyone.  We can get statistics that tell us what most people respond best to, but that's all we get.  None of us come complete with an owner's manual.
Myth 5: Childhood gym classes in their current state, play an important role in the prevention of childhood obesity.
Fact: Physical education classes currently, do not appear to counteract obesity. 
I'd call this one "piling on."  Fitness professionals, teachers, and parents all see the benefits of childhood fitness -- particularly in a culture where childhood obesity is on the rise.  We see the direct benefits of children being active and we hope that including every kid in gym classes will help every single one of them.  Is that proven?  Maybe not. 

So, how do we see this one coming?  Well, it passes the smell test.  Kids participate in gym class, so they are less likely to be obese.  Makes sense!  And the potential myth gets perpetuated.  By whom?  Well, remember the fitness professionals, teachers, and parents who wanted to do what's best for the kids?  We could very well be the culprits. The lesson: when we fight for something that we see as so important, let's be sure we're actually getting the result we want.
Myth 6: Breastfeeding helps prevent future obesity for the breastfed baby.
Fact: Although breastfeeding has advantages for both mother and child, data does not confirm that it protects against obesity. 
This, potentially, could be more piling on.  There are a dozen benefits to breastfeeding.  Let's make sure every benefit being listed is backed up with actual facts.
Myth 7: One act of sex can burn up to 300 Kcals per person.
Fact: In reality, it is just about one-twentieth of that on average, and not much more than resting on the couch.
To avoid crossing the line here, I'll just say this:  not all acts of sex are the same.  To imply that all of them use the same number of calories -- whether it's 300 Kcals per person or one-twentieth of that -- is just a little silly. 

The fitness and health business always has been dominated by myths -- and it won't change any time soon.  It is our job as the consumer to try to dig through the junk to find was is not only true but also what applies to us.  That's never easy.  But, if you stick to the basics -- eating healthy and staying active -- you can never go wrong.  The rest requires a healthy dose of cynicism. 

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