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Healthy Weight: What Does That Mean, Exactly?

Despite what the headlines declare, it’s far too simplistic to conclude that being overweight is healthier than being underweight.

The study that garnered all the attention—a meta-analysis of 51 other studies—found that those with a Body Mass Index (BMI) of 18.5 or below had a 1.8 times higher risk of dying than people with a BMI in the normal range. Meanwhile, people classified as obese, with a BMI of 30-34.9, were 1.2 times as likely to die, while the severely obese—with a BMI of 35 or higher—were 1.3 times as likely to die.

What does that mean, exactly? Not what everyone seems to think it does. BMI is a simple formula, a calculation of height vs. weight that can be a useful indicator of health. But it’s not perfect. It can’t differentiate between muscle and fat, so two people might be the same height and weight—and thus the same BMI—but have a very different muscle to fat ratio, and different overall health. “Rather, a ‘robust body size’ is one where there is a good amount of muscle mass and a limited amount of abdominal fat,” Dr. Joel Ray of St. Michael’s Hospital in Toronto, who led the study, says. “BMI is not the best indicator of obesity-related mortality risk, but it is in underweight people.”

You also have to remember that being over- or underweight is not necessarily the thing that’s going to kill you. Low weight can be caused by factors like drug use, alcohol use, and poor self-care; a higher BMI can be accompanied by heart problems and diabetes.

But that doesn’t mean you should ignore BMI either. According to Dr. Steven Heymsfield, a professor at Pennington Biomedical Research Center at Louisiana State University, “BMI is only a first step in evaluating an individual’s health.” A high BMI is a good indicator that a patient needs other tests—for blood pressure, blood lipids and other risk factors.

If you want to be really careful, check both your BMI and and waist circumference. “That’s not a bad approach if you have the resources; the combined measure is a better index than either one alone in most studies,” Heymsfield says.

But no matter your BMI it’s a good idea to talk to your doctor about what that number actually means for you and to focus on what really counts: staying active.

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A Cup (or Two) of Excellent Health

The good news about your morning cup(s) of joe keeps pouring in. Drinking two or more cups of coffee daily reduces your risk of death from liver cirrhosis by 66 percent.

And the findings aren’t a fluke. A 2006 study that followed more than 125,000 Californians for about 20 years found that for each cup of coffee consumed per day, participants were 22 percent less likely to develop the liver disease at all. Participants who drank both coffee and alcohol also had lower liver enzymes—indicators of liver damage or disease—than those who drank alcohol but not coffee. So there's your excuse to spike your morning cup.

Beyond your liver, studies have long shown that coffee is beneficial to your workouts. Caffeine ups fatty acids in your blood, fueling your body with fat instead of carbohydrates (saving those supplies until the crucial final moments in a workout or race). And serious athletes have long bought in: caffeine is one of the few drugs allowed in sports competition.

After it was removed from the World Anti-Doping Agency list, researchers studied more than 20,000 urine samples from official national and international competitions and found that three out of four athletes had consumed caffeine either during or before competition—with endurance sports showing the highest caffeine excretions.

On top of that? Coffee provides the biggest source of antioxidants in the American diet, may both prevent Parkinson’s and help control its symptoms, may reduce risk of diabetes, and—unlike soda—may help prevent depression. So don’t feel guilty about picking up that second cup—you might be helping yourself in the long run.

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Row the Distance Without Carbs

If rowing across the Pacific Ocean with your significant other doesn’t sound tough enough, how about doing it without any energy gels, granola bars, or sports drinks?

Fueling a massive endurance effort with almost no sugar or carbs isn’t the most traditional route for athletes, but Sami Inkinen and Meredith Loring want to prove that it can work. This June, the married duo plans to go from San Francisco to Honolulu as part of the inaugural Great Pacific Rowing Race—and to see that through on a diet of fat and protein. (Inkinen and Loring believe sugar and processed carbohydrates only hinder athletes.)

This unconventional approach is reminiscent of the increasingly popular paleo and low-carb diets, which have been embraced by CrossFit addicts, dieters, and triathletes alike. Whether the low-carb craze is the best approach for active individuals (let alone endurance athletes) remains controversial. Some nutritionists have embraced the high-protein, high-fat approach, asserting that it reduces inflammation, stabilizes blood sugar, and eliminates the need to eat regularly during distance exercise. But other scientists say our bodies need carbohydrates during exercise to avoid muscle depletion, to keep metabolism functioning properly, and to achieve optimal performance.

“Carbs are like super-high octane fuel for athletes,” says Matt Fitzgerald, author of Racing Weight, as well as the upcoming book Diet Cults. “The best endurance athletes in the world—runners in East Africa—eat a very high carbohydrate diet.

The dissenting opinions carry over to Inkinen and Loring’s planned ocean crossing. Stephen Phinney, the pair’s nutritional advisor and a physician-scientist who wrote The New Atkins for a New You, has become an advocate for the low-carb approach for endurance athletes, explaining that the diet reduces inflammation and muscle soreness. Phinney believes Inkinen and Loring will have no trouble fueling their long-distance row with a diet that contains just 10 percent carbohydrates—and that they’ll be able to avoid energy swings and experience faster recovery rates.

“If Sami and Meredith were racing in a five-kilometer event, a well-formulated ketogenic diet might not be the best strategy,” Phinney says, referring to a high-fat, low-carb diet. “But they’re going to be rowing 12 to 14 hours a day, for 45 to 60 days, at relatively low intensity.”           

Other sports scientists, however, state they’d never recommend a low-carb approach during an endurance competition, even if the athletes are exerting at a steady rate. Michael Joyner, a physiologist at the Mayo Clinic, says most top distance athletes consume carbs when they’re racing because that’s what improves performance. Carbohydrates boost the central nervous system, keep metabolic pathways working, and provide energy, Joyner explains. Fitzgerald also advocates carb consumption for athletic competition, adding that such food offers a superior energy source during exercise stress.

Despite the controversy over the low-carb approach for exercise, Inkinen and Loring are certain the fat-and-protein diet they’re signing on for is the one that will best serve them for the 2,400-mile ocean crossing. They plan to race 14 other boats, singles, pairs, and fours among them. Along with safely completing the crossing, the couple hopes to set a record for the fastest Pacific Ocean crossing for a pair.           

The ocean menu will include nuts, coconut butter, salmon, dehydrated vegetables, lard, macadamia nuts, and, as a treat, unsweetened dark chocolate. They won’t consume any caffeine because they believe it will hinder sleep during the two-hour breaks. Per day, Inkinen will consume about 9,000 calories, and Loring will total about 5,000—so they’ll carry about a million calories’ worth of food in the boat.

“We see this adventure as a way to prove that you not don’t need sugar in real life, but you also don’t need it in exercise,” Loring says.

Loring first adopted a low-carb, low-sugar diet in 2004, with Inkinen following suit a year and a half ago. Inkinen believes the dietary change made him less prone to illness and improved his performance in distance triathlons. Both say they don’t need frequent snacks during exercise because they’ve trained their bodies to run on fat stores—and that, as a result, they feel better while racing.

“We don’t have sugar crashes, so we don’t have to eat as often,” says Inkinen. “We no longer have to rely on gels every 30 minutes.”

Read more about Sami Inkinen's and Meredith Loring's journey.

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The New Rules of Fitness

Decades ago, fitness consisted of two workouts: all-out, all the time; and “LSD”—long, slow distance training. Then fitness went high-tech. Personal-metrics devices from companies like Polar, Garmin, Nike, and others became a billion-dollar industry. Nutrition took wild turns, too. Rocky-style raw-egg shakes were replaced by beet juice smoothies as the (legal) performance-enhancing drug of choice. At last, science-based training had replaced superstition.

But along with the research came the meaningless buzzwords, pseudo-science peddlers, and gimmicks (Shake Weight, anyone?). What's more, every age-grouper suddenly seemed to be an expert in exercise physiology. We've been following this stuff for a long time (37 years, to be exact), and we know how challenging it is to ferret out rules that actually work. Here are the 12 you need to know—and apply—starting now. Welcome to the new rules of fitness.

#1: Stop Overdosing on Vitamins and Supplements

The multivitamin industry is widespread and lucrative—but it’s always been difficult to demonstrate that taking supplements offers a real benefit, says Thomas Sherman, an associate professor of pharmacology and physiology at Georgetown’s Medical Center. For years, multivitamins were considered a low-level insurance policy and performance upgrade. Pop one if you’re worried you’re not getting the right nutrients, and you’ll be healthier—perhaps even stronger and faster. The problem: “There is a lot of theory, but no real data,” Dr. Sherman says. To make matters worse, a string of recent studies suggests that antioxidants get in the way of training adaptations, making them detrimental to performance.

#2: Go the F*ck to Sleep

Somewhere along the way, Americans, with their Puritan work ethic, decided sleep was a bad thing. But if you're an athlete (or, hell, just a human), you need to take sleeping as seriously as you do training and eating. “In the past, many athletes would continue to train well past their body’s physical ability,” says Michael Breus, Ph.D., author of The Sleep Doctor’s Diet Plan: Lose Weight Through Better Sleep. Less sleep theoretically means more time for PRs, but your body doesn’t see it that way. Performance rests on a good night’s sleep, when your body chemistry shifts, and all kinds of beneficial bodily repair gets underway.

Need proof? In a recent study, 11 Stanford varsity basketball players maintained their sleep schedules for 2 to 4 weeks then slept as much as possible at night for 5 to 7 weeks—aiming for about 10 hours. Researchers measured timed sprints, shooting accuracy, and reaction times after every practice, and levels of daytime sleepiness, and mood throughout. The results: Athletes sprinted faster, shot more accurately, and felt better

#3: Get Away from Your Chair

You probably go above and beyond the American Heart Association’s guidelines for 30 minutes of moderate exercise five days a week, but that may not be enough if you’re planted in a seat all day. That’s according to a new study that found an hour of sedentary behavior increased people’s risk of being unable to perform basic functions—like doing household chores—by 46 percent even if they still met the exercise requirements. “We don’t like to be idle,” says Allen Lim, Ph.D., founder of Skratch Labs.

There are ways to lessen the blow, though—without having to actually train more. Research by James Levine, Ph.D., M.D. of the Mayo Clinic found small movements throughout the day—fidgeting, walks, or getting up to go talk to someone instead of hitting send on an email—can work toward counteracting the effects of sitting.

#4: Train Specific to Your Sport

Ten thousand hours of practice may not make you an expert—if you’re training at the wrong intensity. A recent study in the International Journal of Sports Physiology and Performance that studied Olympic medal-winning speed skaters and their fitness regimes reached an interesting conclusion: While performance increased throughout the years, there was no increase in training or skating hours. The shift, instead, was to polarize training—training at a very high intensity in this case.

“It’s important to ask yourself what you’re training for,” says Lim. “Speed skaters do short, high-intensity events, so it makes sense that they train specifically for that,” he adds. But if you’re training for a century—and need the fitness to survive six hours in the saddle—then you need to put in that time. After a disappointing showing at the 2010 Tour de France, Bradley Wiggins revamped his training to meet the exact demands of the 2012 Tour. Forgoing many of the early season races, Wiggins spent time on the island Tenerife, preparing for the races's high-altitude summits. And his approach paid off: In 2012, he became the first British cyclist to win the race.

#5: Quit Flexing in the Mirror

The media has driven home the same message for years: If you look good with your shirt off, you’re healthy. The truth? “You can be protected from disease if you exercise—even if you are over eating and gaining weight. Unfit and skinny may be worse than fit and fat,” says Lim.

The new mantra is simple: “Beat yourself up over whether or not you are getting enough daily physical activity not over how you look,” says Lim. “Thin man syndrome”—or being skinny, but lacking muscle and having a high percentage of body fat—can put you at an increased risk for cardiovascular disease, says Stacy Sims, MSc, Ph,D., co-founder of Osmo Nutrition. Carrying a little extra weight—so long as you have the muscle—won’t negatively impact your hormone profile or appetite like being scrawny, she says. Fit versus fat is an ongoing debate—and the jury’s still out on how much fat you can have without being “unhealthy.” The bottom line: Lean muscle is critical for overall health—even if the mirror isn’t reflecting those results yet.

#6: Be a Little Salty 

“Sweat sodium is much more variable than we thought with a stronger genetic link than previously known,” says Lim. What he means: When you sweat and lose salt, there’s huge variability between you and the guy next to you. “Someone can lose 200 milligrams (mg) of sodium per liter of sweat an hour and someone else could lose 2,000 mg per liter of sweat per hour,” he says. That’s like having a shoe store and needing to stock size 2 to 200 to accommodate everyone.

The practical application of this is listening to your body—and not assuming that salt is always so bad for you. “Our own mechanism for taste can be affected by how much you salt you lose,” he says. So if you’re athletic, you sweat, and you crave salt, eat salt,” Lim says. The "salt is unhealthy" mantra probably doesn’t apply if you workout frequently.

#7: Stop Playing the Age Card

There’s a common misconception about aging that needs to be laid to rest—and it’s that you get old, and you lose your ability to move. Some research suggests that you lose 8 percent of your muscle mass each decade after age 40 and muscle loss increases significantly after age 75. But in a recent University of Pittsburgh study of 40 competitive athletes ages 40 to 81 who worked out four to five days a week, researchers found that athletes in their 70s and 80s had similar thigh muscle mass as those in their 40s. The 40-somethings were also just about as strong as the athletes in their 60s.

Those results make sense when you look at people like Kelly Slater—the 42-year-old pro surfer, the oldest to ever win the Surfing World Championship—or American cyclist Chris Horner, who last fall became the oldest champion of one of cycling's three-week grand tours. Though a calendar would tell you their time has passed, a lifestyle of movement has kept them in the game. 

“As you get older, you simply have to take training in a different approach,” says Sims. Plyometric work and pure strength workouts help maintain neuromuscular connections and muscle mass and help generate speed and power.” 

#8: Minimize the Junk Miles

Give those long, slow jogs a break. According to a 2008 study in the American Journal of Physiology, one and a half hours a week of high-intensity intervals will improve arterial structure and function just as much as five hours a week of lower-intensity workouts. Even more: When highly trained recreational cyclists reduced their distance from 200km per week, swapping it with 12 x 30s sprints a few times a week and four minute intervals, their performance improved.

With intensity, your body learns to recognize stress, and overcome it without taking hours out of your day. Being more responsive to immediate stress increases your aerobic capacity, decreases bad cholesterol, works to build lean mass—much more than a long, slow fat-burning workout can offer, says Sims.

#9: Experiment on Yourself

"There’s a tendency to say, 'This is the average result, so this is the result,’” says Lim. But at the end of the day, we are our own experiment, Lim adds. Take research that looks at how different athletes respond to variables like altitude. In a recent Australian study of 16 highly trained runners with maximal aerobic power who simulated “live high, train low," researchers found that there was incredible individual variation in both physiological changes and performance. Some people have no response at all—others have a massive response.

Another noteworthy study that discovered great variability in results was the A to Z study, which tested people on four different kinds of diets. While statistically, all diets yielded similar weight loss after a year, a closer look at the data reveals incredible variation. “People who were outliers in one group did better on a different kind of a diet,” Lim explains. When it comes to diet performance, it’s—again—so particular. What works for you may not work for everyone else—and vice versa. 

#10: Embrace a New Era of Hydration

In 1965, when Gatorade was introduced to the sidelines of a University of Florida football game, a craze was born. “The typical mindset is to replace carbs and electrolytes,” says Sims. “But the bottom line is that anything’s that over a 4 percent carbohydrate solution can dehydrate.” Why? Water goes from a low concentration to a higher concentration, she explains. So drinks that are too sugary can force your body to move water out of your blood and muscles instead of into them, she says.

Hydration should be about just that: Hydration. And as research continues, low-concentration approaches to hydration like Nuun, SOS, and Sims’ own OSMO, have become popular.

#11: Workout Before Breakfast

Breakfast may be the most important meal of the day, but if you’re waking up to a fast sweat, it can wait. In a recent study, two groups performed a high-intensity workout before or after eating the same morning meal. The results? The group that sweat before eating lost more weight, says Lim.

One reason: When you wake up, you have plenty of fuel stored from the night for a short workout—your blood glucose levels are stable and your body is in fasting mode. “Your workout stimulates muscle sensitivity to insulin, so when you eat, most of the food goes back into muscle rather than fat,” Lim says.

#12: Train Your Brain 

Ten years ago, hardly anyone trained their minds like they trained their bodies. Now, just about every serious athlete practices visualization or specific relaxation techniques—arousal control or pre-performance routines. “Everyone on the world class stage is closely linked when it comes to physical capabilities and technical proficiencies,” says Michael Gervais, one of the best sports psychologist’s in the business who coaches the likes of Olympian Kerri Walsh and professional daredevil Felix Baumgartner.

That’s why the U.S. Olympic Committee staffs five full-time sports psychologists: In order to win a gold, you must have a mind-body connection that’s strong enough to stop worrying about the crowd, failure—or arguably worse, brimming success. Take Team USA Swimmer Eric Shanteau: After receiving a cancer diagnosis weeks before the Beijing Olympics, he spent days at a facility near his home undergoing brain training simulations for focus. While Shanteau didn't medal at Beijing, he set a personal best in the 200-meter breaststroke and went on to earn a gold medal four years later at the 2012 London Olympics.

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Can a Green Smoothie Change Your Life?

Can a green smoothie transform your life? After watching 56 minutes of Powered by Green Smoothies, I had to say yes. In the new documentary by Sergei Boutenko, ten ultrarunners and CrossFitters kept their typical training and racing regimen unchanged but added a quart of green smoothies—packed with leafy greens and fruit—to their diet every day for six weeks. The result: Those who could follow the program experienced quicker recovery and significantly less soreness.

And we’re not talking just one less day of feeling sore: One participant ran a 100-miler and was logging 15-20 miles after only ten days off, instead of his typical month of recovery. Another runner found that he could run farther than a marathon without ever hitting that wall most people have to grind past—and he felt so good the next day that he went for a 10 mile run.

So how is this possible? “When you do any endurance activity, your body releases free radicals which damage your cells and cause oxidative stress,” says Matt Ruscigno, MPH, RD, an endurance athlete and leading expert on vegetarian nutrition, co-author of No Meat Athlete: Run on Plants and Discover Your Fittest, Fastest, Happiest Self. Phytochemicals—which include all compounds abundant in plant-based foods, like antioxidants, beta-carotene, and vitamins—help fight these free radicals, lowering inflammation, which reduces soreness and recovery time.

Lower inflammation may account for some of the smoothie’s benefits: Many of the CrossFitters in the documentary had existing injuries like sore shoulders and elbows, but after adding the green drink to their diet, their trouble spots started to fade and they were even able to do workouts their injuries normally prevented them from doing. And, when they stopped drinking smoothies after the six weeks, most of their aches started up again.

Depending on the athlete’s pre-documentary diet, the benefit could also simply come from the extra calories smoothies provide, says Lona Sandon, RD and certified fitness instructor, assistant professor of Clinical Nutrition at the University of Texas Southwestern Medical Center at Dallas. “A lot of CrossFitters tend to follow a high-protein, low-carb diet so they’re often shorting themselves on adequate carbohydrates—undermining their energy stores—and on fruit—and all their beneficial nutrients,” she says. And while runners know to carbo-load, many are still restrictive with their energy intake, and an extra 200-400 calories could give them a surprising boost, she adds.

The extra carbs probably account for one of the most interesting results of the documentary: The CrossFitters saw more improvement from their baseline endurance test than the runners did. Almost all the runners added an extra 200 meters to their original 12 minute lap test—which could make or break first place in a race—but the CrossFitters significantly improved the number of kettle bell swings, pull-ups, and sprints they could get through compared to six weeks before. Extra energy would allow the CrossFitter’s muscles to work longer before fatiguing, Sandon explains.

And while athletes may benefit from the vitamins and antioxidants of smoothies, keep it to whole food: High-dose supplements can actually hinder some benefits of high-intensity training, says Sandon. In fact, a recent study from the Norwegian School of Sport Sciences in Oslo found that after a grueling 11-week training program, athletes who had taken a high dose of antioxidants—specifically vitamin C and E—every day saw fewer biomarkers of beneficial fitness gains than athletes who trained sans supplements. This supports past research showing that high doses of inflammation-fighters actually lowers your body’s ability to produce beneficial compounds on its own and lower inflammation naturally, Sandon explains.

But are smoothies the best way to go? “Smoothies are a great way to get a lot of nutrients at once, because you’re blending more whole foods than you could eat in one sitting,” says Ruscigno. And you don’t need to drink a whole quart—which is four cups—to gain the perks: “Everyone could benefit from more fruits and vegetables in their diet, so even a 10-ounce smoothie still provides more fruits and vegetables than most people eat in a day.” If you already packing enough carbs and calories to support your training regimen, you might not see as big of a boost though, he warns.

And you don’t have to drink pure kale to see results: “Most of my participants weren’t big smoothie drinkers, so I started with 60 percent fruit, 40 percent leafy greens,” says Boutenko. “But within 6 weeks, their taste buds adjusted and by the end they were requesting more vegetables in the mix.”

To see how else green smoothies affected the endurance athletes, check out the documentary at

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