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WARNING: this is going to be a doozy of a post.

The topic of calorie restriction to increase one’s lifespan has grown in popularity in recent years and to be honest, I am not falling for it. First: we don’t necessarily know for sure whether or not it works. Sorry weirdos, but just because there have been a bunch of studies performed on rats doesn’t mean it correlates to humans. Second: as the study below showcases, the later one starts restricting calories in life, the less impact it will have on life span. So unless we want to starve our children their entire lives, I don’t see this fad catching on. Third: is it really worth it to live your life in constant hunger, cold (decreased metabolism lowers body temperature), and with very low energy levels only to increase your life by a few years at best? Seems a bit harsh in my eyes. And who says those extra years are going to be “high quality” years. No one really knows the long term health risks of chronic caloric restriction, unless we want to count the Olsen twins as proof. Oh snap!

Below is a research review done by Lyle McDonald a few months ago concerning calorie restriction (CR) and life span. I thought it was very interesting and figured I would share it with the masses as well. Enjoy nerds…..(wink).

Research Review

Speakman JR and Hambly C. J Nutr. 2007 Apr;137(4):1078-86. Links

Starving for Life: What Animal Studies Can and Cannot Tell Us about the Use of Caloric Restriction to Prolong Human Lifespan.

Caloric restriction (CR) is the only experimental nongenetic paradigm known to increase lifespan. It has broad applicability and extends the life of most species through a retardation of aging. There is considerable interest in the use of CR in humans, and animal studies can potentially tell us about the impacts. In this article we highlight some of the things that animal studies can tell us about CR in humans. Rodent studies indicate that the benefits of CR on lifespan extension are related to the extent of restriction. The benefits of CR, however, decline as the age of onset of treatment is delayed. Modeling these impacts suggests that if a 48-y-old man engaged in 30% CR until his normal life expectancy of 78, he might increase his life expectancy by 2.8 y. Exercise and cold exposure induce similar energy deficits, but animals respond to these energy deficits in different ways that have a minor impact on lifespan. Measurements of animal responses when they cease restriction indicate that prolonged CR does not diminish hunger, even though the animals may have been in long-term energy balance. Neuroendocrine profiles support the idea that animals under CR are continuously hungry. The feasibility of restricting intake in humans for many decades without long-term support is questionable. However, what is unclear from animal studies is whether taking drugs that suppress appetite will generate the same impact on longevity or whether the neuroendocrine correlates of hunger play an integral role in mediating CRs effects.

My comments: Excuse me a bit of lofty prose here…

For literally centuries, man has looked for ways to extend life or achieve immortality. From drugs to anti-oxidants to various other approaches, escaping the breaths of death has been a common human goal. In recent years, one approach has come to the forefront as not only having the potential to increase lifespan but actually having been shown to do so in most models studied (apparently houseflies are an odd exception).

That approach is called caloric restriction (CR) and is sometimes differentiated from your basic calorie restricted diet by adding the rider of caloric restriction with optimal nutrition (CRON) with the idea of CRON being a reduction in total food intake while still ensuring sufficient/optimal intake of required nutrients.

Of course, by needs, most of the research on CR has been done in animal models since it’s not feasible to track humans over their lifespan to see what effect CR will have. However, CR has been studied in humans under more short-term conditions, looking primarily at various health parameters as an end result. For example, the Biosphere II experiment ended up being a 2 year CR model when the food supply failed and this allowed researchers to examine a number of effects of CR on human metabolism.

And before addressing this week’s study, I want to make that very clear distinction: there are two possible effects of CR. The first, and the one that the paper this week addresses is an actual increase in lifespan. As the paper points out, in some studies, an increase in 50% of average lifespan has been observed in some animal models. Applied to humans, CR might be expected to increase lifespan from an average of 78 to 116 years in men and 83 to 124.5 years in women.

However, an additional potential impact of CR is on overall health and even if CR fails to increase human lifespan, it could still have potential benefits on various health parameters (such as insulin levels and cancer risk). That second aspect of CR is not discussed in this paper but may be of as much importance.

One of the questions, and the one this paper addresses is what animal studies can and cannot tell us about the impact of CR on human metabolism.

The first issue addressed is what level of restriction is needed with 50% of normal intake generating the largest impact on lifespan. Because of the intakes of the control animals, this actually ends up being a 65% reduction from normal food intake. This level of restriction is required to get the maximum 50% increase in lifespan. Smaller reductions, such as 30% below normal, generate only a 20% increase in lifespan. Think about those numbers for a second. A male with a predicted maintenance of 2700 calories/day would be expected to consume 1350 cal/day for extended periods, a female with an 1800 cal/day maintenance would have to subsist on 900 calories per day for extended periods to gain benefits of CR.

The next topic discussed had to do with when restriction should begin for optimal results. The paper points out that almost all studies of CR in rodents and mammals occur very early in life, essentially after they are weaned (basically, child mice and rats). Basically, they are CR for their entire lives. Studies where CR is instituted later in life typically show much lesser impact with mortality rate frequently being identical to non CR animals.

Clearly, early onset CR has little relevance to humans who are unlikely to restrict their caloric intake for their entire lives. Rather, individuals (typically as they get older) become more interested in CR. An important question is then what benefits might occur if CR is started later.

Tangentially, and interestingly, the paper notes that elderly often begin eating less (often due to the onset of disease) and a loss of weight tends to be associated with higher mortality; nutritionists often focus on trying to keep bodyweight from dropping in these individuals.

In any case, plotting the relationship between the impact of CR on lifespan and when it is started, the researchers show a linear decline in impact as age goes up. putting this into table form, assuming that the animal research applies to humans, they show the following

Age at onset Time on restriction 15% restriction 30% restriction

15.6 years 62.4 years 5.6 years 11.2 years

23.4 years 54.6 years 4.7 years 9.4 years

31.2 years 46.8 years 3.3 years 6.5 years

39 years 39 years 2.4 years 4.8 years

46.8 years 31.2 years 1.4 years 2.8 years

54.6 years 23.4 years .25 years .3 years

62.4 years 15.6 years 0 years 0 years

Age of onset is when CR is begun, time on restriction refers to how many years the subject would have to restrict calories. The last two columns show the potential impact on lifespan of either 15% or 30% caloric restriction. For example, if someone began CR at 39 years old, and restricted their food intake by 15% for the next 39 years, they could expect an increase in lifespan of 2.4 years. If they could handle a 30% reduction in food intake, they might get 4.8 years extra lifespan. By the time folks are in their 50’s, CR has essentially zero impact on predicted lifespan. Again, assuming that the animal research holds. It’s possible that CR will be more effective in humans, just as its possible that it won’t even be as effective as in animals.

Another important question regarding CR has to do with hunger and whether or not it ever goes away with chronic CR (tangentially: this is also a question of importance to anyone trying to maintain an extremely reduced bodyfat level). To test this, the researchers placed mice on 20% CR for 50 days (equivalent to roughly 2.5 years in humans) and then allowed them to eat ad libitum to see if appetite had decreased. Quite simply, it hadn’t and the animals ate like crazy when given access to food. Unpublished data on their neuroendocrine profiles indicated that the animals remain physiologically hungry throughout the CR period.

The next point addressed by the researchers had to do with the mechanisms by which CR work which I’m not going to go into in detail. However, the researchers make an important note regarding the impact of CR on energy levels and exercise along with differences in the most common causes of death between rodents and humans. In rodents, the major cause of death is cancer whereas in humans it is cardiovascular disease. Additionally, while exercise regularly is shown to have benefits for humans (in terms of health), this is not the case for animals.

They mention that the reductions in activity that typically occur with CR (they anecdotal reports of humans involved in CR of low-energy, along with chronic cold) could be detrimental to humans (but not to rodents); reducing exercise due to low energy levels might predispose humans to higher risk for cardiovascular disease. At the same time, primate studies of CR suggest improvements in markers of cardiovascular function. Additionally, one study of CR groups suggest a much improved cardiovascular risk profile; however that group was also engaged in regular exercise and were much leaner. Whether the impact on risk was due to exercise/low bodyfat or CR per se is impossible to determine.

Finally, the paper addresses what the animal studies can’t tell us about CR. The first issue is whether or not the extent and duration of CR required to generate effects in humans is even feasible in humans. That is, in animal models it’s simple to institute CR, the animals eat what you give them. Outside of small groups, it seems unlikely for the average human to voluntarily reduce food intake by 20% or more for upwards of 40 years, especially if the benefit is a mere 4-5 years increase lifespan.

Another issue is whether drugs that generate weight loss (usually through blunting appetite) have the same impact as CR per se. Given that some of the effects of CR seem to be mediated through the same neuroendocrine effects that make the animals hungry, drugs that alter normal neuroendocrinology may not generate the same effects. Interestingly, the researchers mention surgical intervention as being a potential way of ensuring lifetime adherence to CR protocols.

Finally, they address whether it’s feasible (beyond issues of hunger) for humans to engage in CR when they have to live in the real world. That is, it’s one thing to have rodents confined to a cage who eat what they are given engage in prolonged CR. Even there, studies in rodents suggest a loss of lean body mass. While this isn’t detrimental to a caged animal, a loss of functional mass would be detrimental to humans who have to function to survive. An additional issue would be immune function as rodents are kept in a pathogen free environment; however studies of CR suggest an increase in immune function.

Summing up: assuming that the animal research can be applied to humans, it would appear that CR is unlikely to have a large impact on human lifespan per se (again, this is outside of potential health benefits) even if it is instituted quite early. Since this is unlikely, and most individuals engaging in CR are older in the first place, it’s interesting to note that the predicted impact on total lifespan is small approaching negligible. Thirty years of chronic hunger, cold and low energy levels might net a 40 year old an extra couple of years of life at best. This seems rather unreasonable to me.

Once again, an issue not addressed in this review is the impact of CR on various health parameters. However, at least some research suggests that other approaches (such as intermittent fasting or every other day fasting, or exercise to generate the caloric deficit) may generate the same effects as CR per se and may be much more reasonable for long-term application.

It’s been awhile since I had any nutritional content on the blog, so I figured I would let people know about an outstanding product. My friend and uber cool nutritionist Mike Roussell released his manual “Your Naked Nutrition Guide” a few months ago. Not only is it the most awesome name for a manual ever, but it’s made my job infinitely easier when dealing with my clients and their nutritional whoas.

TG: What was one of the main reasons why you wrote Your Naked Nutrition Guide?

MR: I created it because 1. I know it works and can help people and 2. There is so much bad nutrition information out there. Despite all the nutritional information available today there was a void when it comes to practical information that people can use to get results.

The manual has been unofficially in the works for years, probably ever since I got into nutrition. I found that every time I would start working with a new person I was reinventing the wheel so to speak in regards to answers the same questions, outlining the same strategies, etc. With this manual I just poured out all the practical, results driven nutrition principles that I use and have used with clients. In Your Naked Nutrition Guide you will find the exact steps that I use with people to improve their health and change their bodies. Basically by putting all this information into a manual I can impact many more people’s health and body composition than if I were do try to help as many people as possible though face to face interactions.

TG: What do you feel separates your manual from the rest?

MR: The amazing cover!

Okay seriously…Your Naked Nutrition Guide definitely isn’t like other manuals out there for several reasons. I dedicate a whole section to planning and goal setting. This isn’t theoretical stuff but how to practically map out your plan so that you reach your goals much faster than you would otherwise. In the manual there is also a supplement section. I created the “Supplement Pyramid” where I separated supplements into Basics, Performance Enhancers, and Experimental. I outline what supplements fall under what categories, when you should take them, what to look for when buying them, and how much you should take. Another area is the Naked Nutrition Serving System. Counting calories is a miserable thing to do and definitely a waste of your time. With this serving system, I have outlined when and how much food to eat. You just pick the foods you like. There are several chapters dedicated to creating your own meal plans and manipulating them depending on your goals. Those are probably the top three areas where Your Naked Nutrition Guide separates itself from the rest.

TG: What can people expect when they buy your manual?

MR: Results. Really, this manual is all about results. Or did you mean what else is included content wise? In regards to content you get everything I just talked about plus a section on the importance of using multiple units of measure to track progress, what measures to use, and how often to use them. There are also chapters on Nutrient Timing and an in-depth look at the 6 Pillars of Nutrition – my foundational nutritional strategies. There are meal plan templates, recommend food lists, goal setting templates, charts outlining how many servings of each type of food you should eat depending on your caloric intake and desired macronutrient ratios. You get the point…a lot of practical content.

Q: Tony, the fitness coordinator where I work just asked me to take another client, but she has a left knee injury (ACL). She wants to go on a fat loss program. I don’t want to risk injuring her just doing bodyweight squats and lunges because she has mentioned tome that both movements hurt her knee. My experience is still limited, and I have only dealt with clients with healthy joints. I would like to help this person, but I do not know exactly how to go at it. Any advice you could give me would be great.

A: It’s not surprising that it was/is an ACL injury. Research has shown that women are upwards of SIX times more likely to experience an ACL injury compared to their male counterparts. Research has also shown that for some reason, women kinda like Brad Pitt. Never heard of him. In any case, there are a multitude of reasons as to why women are more predisposed to ACL injuries. For one, most (not all) are weaker than a baby’s fart. Secondly, it comes down to simple biomechanics. Women have wider hips and narrow knees compared to men (also called the Q-angle) which places them at risk for injury.

That being said, you can still do TON of lower body work with her. Focus your attention on the posterior chain specifically (hamstrings and glutes). The ACL is the primary restraint of posterior translation of the tibia (conversely, the PCL restrains anterior translation), so anything “we” can do to strengthen the posterior chain will benefit women immensely in this regard.

Exercises to do:

1. Rack Pulls (or partial deadlifts). Start from knee height to groove the pattern. Once they master that, you can move on to other deadlift variations.

2. Pull-Throughs (the perfect cure for anyone who suffers from flat tush syndrome).

3. SHELC (Supine Hip Extension w/ Leg Curl) on a SWISS ball.

4. Glute Ham Raises

5. Reverse Lunges/Walking Lunges (long stride). Key Point: the longer the stride, the more emphasis you place on the hamstrings.

6. Work on squat technique. 99 out of 100 times, if someone says that squatting hurts them, they’re performing it wrong. If a doctor tells someone not to squat, 99 out of 100 times, I want to drop kick him or her across the head. Everyone uses a toilet with no pain……that’s squatting. Teach her to squat with her hips/hamstrings and NOT her quads. She should break with her hips on the descent and not her knees. Have her squat down to a 14-16 inch box and see what happens. The important thing is to have her do it in a pain free ROM. From there you can have her do bodyweight squats and gradually load her (goblet squats, front squats, etc.). Additionally, you may find some use with adding in some isometric holds. Something to think about.

7. As far as conditioning, if you have access to a sled that would be perfect since it’s pretty much ALL concentric action (no eccentric). So there should be no pain what-so-ever doing those. I wouldn’t have her do sprints quite yet (I am sure her running mechanics need work anyways), but maybe something along the lines of the ellipitcal would be a better option for the time being.

8. Buy “Bulletproof Knees” by Mike Robertson. As a trainer, any resource you can use to deal with acute or chronic knee issues with clients, the better of you’re going to be. Mike’s manual is one of the best. It’s simple, precise, and you won’t feel bogged down by a bunch of medical mumbo-jumbo. Mike gives you a solid plan of attack to deal with just about any knee issue you may come across. And lets be honest, being in this profession, it’s going to happen. Think of it as an investment (in yourself) and not an expense.

In a nutshell, you can still train her lower body. For the love of all that is holy, just steer clear of the usual suspects (leg press, leg extensions, leg curls, etc). Those are probably what got her in this mess in the first place.

Tony Gentilcore

I got an e-mail this morning that had a link to this article in the NY Times titled: Is the ‘Mom Job’ Really Necessary? In a nutshell the article describes how some plastic surgeons are charging upwards of $10,000-$30,000 for a procedure called “the mommy makeover.” Aimed at mothers, it usually involves a trifecta: a breast lift with or without breast implants, a tummy tuck and some liposuction. The procedures are intended to hoist slackened skin as well as reduce stretch marks and pregnancy fat.

One woman explains how after she gave birth, she ended up with really badly stretched skin and nothing was where it was supposed to be even after doing “crunches til the cows came home.” All of this despite hiring a personal trainer to work with her three times per week for eight months. As a last resort, she ended up getting the “mommy makeover” and life, seemingly,was back to normal. Except for the fact that you know, she is now half human and half mutant killing cyborg.

My thoughts on the matter:

1. Genius marketing by the plastic surgeons. I can’t blame them for wanting to make a ton of money. According to the article, plastic surgeons across the country performed roughly 325,000 “mommy makeovers” in 2005. (Draw drops to floor……..Ca-ching). Just wow.

Must stink for those women to know that for cost of what it would be to buy a power rack, barbell, a bench, and some dumbbells for their home ($1500), they could have saved themselves quite a bit of money. Additionally, an outdoor track is free. Gym membership is probably $50-$100 per month for those who can’t train at home. Heck a “good” personal trainer will cost some money, but it’s still significantly less than a VERY invasive surgery that you could potentially die from.

2. Through reading this blog, most of you should by now that “doing crunches till the cows come home” is a complete waste of time. Matter of fact, your time could be better spent watching grass grow while waiting for the paint to dry. No wonder this particular woman didn’t get any results after eight months of working with a personal trainer.

3. My friend Jen Heath has had FOUR kids and she never used that as an excuse to not get her body back. Matter of fact she went from 195 lbs when her twins were born to looking like this not too long after.

How? She worked her butt off in the gym performing deadlifts, squats, pull-ups, rows, and energy system work (intervals). Notice there is no mention of crunches, aerobics classes, or pink dumbbells for 20 reps? Not to mention she was dialed in with her nutrition (yes, it’s that important). She didn’t make excuses and WORKED for what she wanted. No quick fix surgeries (which lets be honest, aren’t guaranteed) . Matter of fact Jen developed a solid product called “Fat Loss Pros” where she interviews some of the top names in the industry concerning fat loss. You can actually learn how to do it the right way, for about $9,900 less than what it would cost you to get “the mommy makeover.” How you like dem apples?

Tony Gentilcore