How to Measure Your Fitness Level

Last week I attended the first ever Quantified Self Expo in San Francisco – which had a ton of interesting products and sessions on various topics covering areas of self-measurement. I was there demoing Revvo and also gave a talk titled “How to Measure Your Fitness Level”, which I thought would be useful for a wider group to review. Below are my slides :

How I Ignored Conventional Wisdom To Achieve My Fitness Goals

Yes its the time of the year when a remarkably large number of people resolve to do something they will predictably give up within a few weeks of starting i.e. trying to get fit. And until recently I was part of this pattern — resolving countless times to get fit yet giving up within a few weeks of starting an exercise program. Something however changed the year before & for the last ~2 years I’ve actually managed to stay at it for long enough to now genuinely claim that I am indeed fit.

The biggest challenge with getting fit – as we all know – is to actually stick with it through thick & thin – rain, snow and heat – long days & sleepless nights (thanks to my 2-year old!). And to achieve this I had to completely ignore conventional wisdom on the subject (as reflected in countless articles – for example, see here & here).

1/ Find Something You Like Doing

Conventional wisdom suggests you should find an activity you like doing and do just that if you want to get fit. I LOVE cycling along the Erie Canal (which is a few minutes walk from where I live) — I can cycle for hours. Yet I managed to do this just twice in the whole of last year!

It’s not difficult to explain why — I need to dedicate a significant chunk of time for the activity, the weather needs to be decent and my kids cannot ask to join me (which they inevitably do & I find difficult to refuse and in which case all we end up doing is a short & gentle trip where my heart rate goes up only because my 8-yr old keeps trying his best to jump into the canal).

Also the reason why I like the long canal biking trips so much is their rarity .. if I was doing this daily (say this was my commute), I’m pretty sure I’m not going to like it quite that much.

So forget trying to do the thing you like … instead focus on finding something that you can actually do on a daily basis.

2/  Find a Friend 

When I was 27 (that feels like a looong time ago!), I had a friend living in the apartment below who would wake me up at 5.30 so both of us could go for a run. And on days that he was being lazy I would pay him back! Even after nights of partying until 2 am I still managed to get out for a run early the next morning, thanks to him.

Things change when you have kids — your friends don’t control your schedule, your kids do. And that’s true for your friends too. Its still possible occasionally to co-ordinate our schedules so we can all get together for activity. However its incredibly rare to be able to do this on a daily basis.

So ignore conventional wisdom & find an activity you are happy to do on your own. Think of this as your time, free of work, kids, family & social commitments.

3/ Set a Weight Loss Goal

This is the conventional wisdom that in my opinion is the most dangerous & counter-productive. Yet how could you argue against setting a weight loss goal ? The reason – weight loss does not really happen via exercise alone. Many studies have shown that the average person loses very little weight solely through exercise. And some of course even gain weight (because we want to reward ourselves for that long ‘hard’ run we just finished!).

And so if you do set a weight loss goal, you’ll probably end up giving up on exercise because you won’t see results.

The real reason why you should exercise is so that you can stay fit. Fitness, as I pointed out in an earlier post, is not about your weight. Its about how effective your body is in providing & utilizing oxygen to fuel your physical activity. And is perhaps the single best indicator of your overall health.

Ideally you should measure and track your fitness (which until now has required a visit to an exercise science lab). Or track a proxy – such as your average heart rate for the same activity level, or your average pace / finish time for a fixed distance you run or bike. And particularly if you’ve been sedentary for a while, you’ll see improvement within a few days / weeks of starting an exercise program.

So what are my personal suggestions to help you meet your fitness goals?

1/ Set a Fitness Goal

2/ Find a Short Workout Effective at Improving Fitness

3/ Integrate that into your Daily Life

My workout is indoor cycling (at home), at high intensity, for 10 minutes daily — I can do this rain or shine, sleepy or otherwise. It may not be quite as much fun as cycling on the canal but it does not require that I change my lifestyle, plus I can watch music on youtube as I bike. I track changes in my fitness each time I workout so I know how much meaningful progress I’m making. I am change the intensity as I make progress so I don’t plateau. (Full Disclosure : I’m building a smart exercise bike called Revvo that does all this).

I do this pretty much the same time everyday — its now literally like brushing my teeth or taking a shower so it doesn’t require an enormous amount of willpower to get me going. It’s just a habit and that’s how it should be.

Happy 2015!


Disclaimer: The content on this blog (and linked websites) is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog or linked websites. Reliance on any information provided on this blog is solely at your own risk

Could 10 Minutes of Exercise Make You Fit ?

Study after study shows that we are in denial about a number of things – our weight and our calorie intake both of which we generally tend to under-estimate. But nothing comes close to the amount by which we over-estimate how active we are.

In a 2011 study published in the American Journal of Preventative Medicine, US adults self-reported close to 60 minutes of daily activity everyday (this includes exercise and also other casual activity such as gardening, household chores or walking to the pantry to pick up a chocolate!). However when activity levels were actually measured using an accelerometer turns out we are active for an average of just 9 minutes daily!

Guidelines provided by the American Council of Sports Medicine and endorsed by other leading health organizations suggest 150 minutes / week of moderate intensity activity (i.e. brisk walking or jogging) – which only 9% of US adults actually achieved. This level of activity is considered necessary to maintain / improve fitness.

So how do we resolve this problem ? A team of exercise physiologists from McMaster University, led by Gillen JB looked to see if we could improve our fitness by exercising for just 10 minutes, 3 times a week (Martin Gibala, a co-author to the study is a pioneer in interval training). After completing a 2-minute warm-up, study participants cycled all out for 20 seconds, followed by 2 minutes of recovery where they cycled at a gentle place. This was repeated 2 more times during that session and then finished off with a 3 minute cool down for a total time commitment of 10 minutes per session.

The results were astonishing – within 6 weeks both men & women saw a significant increase in their cardio-respiratory fitness by ~12%.

journal.pone.0111489.g005

Gillen JB, Percival ME, Skelly LE, Martin BJ, Tan RB, et al. (2014) Three Minutes of All-Out Intermittent Exercise per Week Increases Skeletal Muscle Oxidative Capacity and Improves Cardiometabolic Health. PLoS ONE 9(11): e111489. doi:10.1371/journal.pone.0111489

In addition, they also saw important health benefits – mean arterial pressure (which correlates with blood pressure) decreased by 7%. Insulin sensitivity (important for those with pre-diabetes & diabetes) also improved amongst both groups. 24-hour glucose levels however only dropped amongst men (& not amongst women, which warrants further study).

journal.pone.0111489.t002

This is not the first study to show significant benefits for interval training over continuous exercise – a meta-analysis published in the British Journal of Sports Medicine by Weston et al showed 2x improvement in fitness through interval training compared to moderate intensity continuous exercise. Another review by W Kent in the same publication indicated a 15% increase in fitness within 6 weeks of interval training.

What’s unique in this study is the relatively low time commitment required to achieve this remarkable improvement in fitness and health – a level of commitment that almost everyone should be able to make (with of course brief moments of intense effort). In other words there are no more excuses for not getting fit!


Disclaimer: The content on this blog (and linked websites) is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog or linked websites. Reliance on any information provided on this blog is solely at your own risk

How Fit Should You Be ?

Most of us would say being fit is a good thing – but exactly how fit do we need to be ? The answer – like most things in life – tends to be ‘it depends’. If your goal is to improve your athletic performance then definitely more is better (well trained world class athletes tend to have 2-3x higher fitness than the average untrained person).

However if you’re someone like me who does not want to compete in the Olympics (!) but does want to stay healthy, then is there a fitness level you could target? What is a healthy fitness level … lets see if science can give us an answer.

Fitness = Maximum Oxygen Uptake

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As I had defined in an earlier post, fitness or more precisely cardio-respiratory fitness is the ability of the body to supply oxygen to muscles during times of increased physical activity. Fitness is typically expressed as VO2Max, i.e. the maximum oxygen your body can uptake during structured exercise. And usually estimated by measuring oxygen uptake while progressively increasing running or biking speed until the person reaches maximum oxygen uptake (commonly called a “stress test” or maximal test). Athletes typically have higher VO2Max numbers (Norwegian cyclist & junior world champion Oskar Svendson has one of the highest reported fitness numbers / VO2Max of 97.5 ml/kg/min). VO2Max is typically expressed in units of ml/kg/min which basically translates to the maximum ml of oxygen per kg of body weight the body can utilize in a minute. Of course higher VO2Max by itself doesn’t guarantee a better race outcome – motivation, training status, efficiency and a host of other factors matter. But having lower fitness certainly makes it more important to work on the rest.

11 METs = Healthy Fitness Level 

METs-chart-(intensity)_03

From a health perspective, fitness is usually expressed as METs (Metabolic Equivalents) – a more clinically meaningful metric – both to understand how healthy the person is as well as to determine how much exercise intensity the person can cope with.  Essentially 1 MET =~3.5 VO2 units, which basically is the amount of oxygen you need to sit & watch TV! METs also provide an easy way to compare the relative intensity of different activities (the chart on the left is adapted from lists created by the CDC & ACSM).  The intensities are directly comparable – so sex is therefore almost 5 times as intense as watching TV. And your fitness needs to be at least 6 METs for you to be able to have sex, safely!

This gets even more relevant when you look at people with different fitness levels and their health outcomes. One of the seminal studies that looked at the relationship between fitness, cardio-vascular health & all-cause mortality was conducted by a group led by Saturo Kodama. They combined data from 33 different studies that covered 100,000+ subjects and segmented people into different levels of fitness.

METs-chart-(fitness)_03

In categorical analyses, individuals with low CRF (<7.9 METs in MAC) had a substantially higher risk of all-cause mortality and CHD/CVD compared with those with intermediate and high CRF (7.9-10.8 and ≥10.9 METs in MAC, respectively) … These analyses suggest that a minimal CRF of 7.9 METs may be important for significant prevention of all-cause mortality and CHD/CVD

Those with fitness of less than 7.9 METs had a 40% higher risk of mortality than those with intermediate fitness (7.9 – 10.8 METs) and 70% higher risk than those with high fitness (10.9+ METs).  And every 1 MET increase in fitness tends to result in ~15% improvement in cardiovascular health. Based on the Kodama findings & other studies, I would categorize fitness into five zones (chart on the right). So increasing fitness beyond 7.9 METs yields dramatic improvement in health outcomes. And a fitness level of 11 METs or higher would be considered healthy.


Disclaimer: The content on this blog (and linked websites) is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog or linked websites. Reliance on any information provided on this blog is solely at your own risk.

How to Measure Your Age!

How long you’ve lived is clearly one way to measure age — but if aging is about the gradual decline of body function and eventual mortality then perhaps there is another contender for the best way to measure age – your  fitness. And unlike your calendar age, you can actually change your fitness. In my last two posts I talked about my personal experience reducing blood pressure by improving fitness and the massive published data validating the link between fitness and aging induced blood pressure.

Now a group of Norwegian researchers from HUNT University have published a study looking at ~38K men & women who they followed-up for a mean duration of 24 years to demonstrate that fitness was a very good predictor of mortality at all age levels and perhaps the best predictor for those less than 60 years of age. Every 1 MET increase in fitness resulted in 15% lower risk of all-cause mortality amongst men and 8% lower risk amongst women.  In this particular example fitness was estimated using demographic + activity data (which gives a rough indicator but is not that accurate).  The accompanying NYT article has more detail on the study and related research.

The group also created a really cool online calculator — you can plug in your data and get an estimate of your fitness, compare it to age cohorts. Worth trying out!

From the study, here’s what your fitness should look like on average, if you’re aging well:

Fitness-Benchmarks

Study of ~14K Men Shows Higher Fitness Delays Aging Related BP

Its great when you discover stuff that is personally meaningful — but its even more gratifying when those discoveries have broader relevance.

A few days ago I ran across this study that was published (Sep 2014) in the Journal of the American College of Cardiology, essentially validating the point I was making through my own personal observations – that higher fitness can improve your blood pressure.

The study (lead author – Junxiu Liu, MD from the University of South Carolina) looked at data collected on ~14,000 men between 20-60 years who did not have hypertension, cardiovascular disease or cancer. Their baseline fitness was assessed and the study tracked them subsequently over multiple visits / years.

The results on blood pressure (hypertension) were striking – on average systolic blood pressure starting rising into pre-hypertensive level (>120 mmHg) at around 50 years of age. Higher baseline fitness had the effect of delaying the onset of systolic and diastolic blood pressure by literally 10 years.

The study authors are planning a follow-on analysis of data for women.

JACC

J Am Coll Cardiol. 2014;64(12):1245-1253. doi:10.1016/j.jacc.2014.06.1184


Disclaimer: The content on this blog (and linked websites) is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog or linked websites. Reliance on any information provided on this blog or linked websites is solely at your own risk.

How I Normalized my Blood Pressure via Anaerobic Interval Training

Reproducing the talk that I gave at the Quantified Show & Tell in Boston on how I was able to eventually improve my fitness and blood pressure when I shifted to anaerobic interval training.

SivaRaj_BPFitness

Siva Raj was interested in lowering his blood pressure. With a family history of cardiovascular disease and heart attacks he was worried about slightly elevated blood pressure (pre-hypertension). As someone engaged with understanding and building fitness applications he thought he would be able to lower his blood pressure by staying on track with a regular exercise program that focused on cycling. Interestingly his blood pressure measurement didn’t respond to his constant exercise or weight loss. After reading more research literature about the link between fitness and cardiovascular health Siva decided to change his training to improve his fitness. He decided to incorporate a increased intensity into his routine. After a short period of time he had increases in this fitness and was able to observe the reduction in blood pressure he was looking for. In the video below, filmed at the Boston QS meetup group, Siva explains his methods and talks about how he was able to track his body’s response to different fitness routines.


Disclaimer: The content on this blog (and linked websites) is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog or linked websites. Reliance on any information provided on this blog is solely at your own risk.