Fit But Overweight Or Normal Weight But Unfit

Picture from Truenorthwellness

What if you were fit but overweight and even obese compared to being unfit but normal weight. Which do you think is better?

A new meta-analysis pooled results from 20 prospective cohorts thus investigating nearly 400,00 people (Weeldreyer et al, 2025). Participants were categorized by body mass index (BMI) as normal weight, overweight or obese. Their carodiorepiratory fitness (CRF) were measured by maximal exercise testing to determine if they were fit or unfit based on age adjusted VO2 max. This was to determine if BMI or CRF predicts mortality risk better.

This meta-analysis is different from earlier ones since it includes more women. It also has participants from a broader age range, geographic backgrounds and health status. Better statistics all round. Findings more generalizable and results more precise.

The reference group - normal weight and fit was compared to all other combinations. Compared to the reference group, those who were both overweight but fit and obese but fit, both groups had virtually the same risk of dying from any cause. About 4 percent lower and 11 percent higher respectively, which was not statistically significant. Being fit protected against being overweight and obese for all-cause mortality.

Not so good news for the unfit. Those who had normal weight but were unfit had a 92 percent higher all-cause mortality risk. The risk was similarly high for unfit and overweight (82 percent higher) and even higher for the unfit and obese (104 percent higher).

For cardiovascular disease mortality, the differences between weight categories were more pronounced. The fit but overweight had a 50 percent higher risk while those fit and obese had a 62 percent higher risk than fit individuals with normal weight. Note that neither was significant, although it meant that being fit protected one against the risk of dying from cardiovascular disease.

Now for those who were unfit for cardiovascular disease mortality, the numbers were not pretty, in fact they shyrocketed. 104 percent higher risk for normal weight, 158 percent for  overweight and 235 percent for the obese.

In short, being unfit more than doubled mortality risk for many cases, regardless of BMI, while being fit can netralize the impact of carrying extra weight.

These findings show that BMI alone is a weak predictor of health and improving cardiorespiratory fitness can cancel out much of the risks associated with a higher BMI.

Perhaps BMI is not a good indicator. One may have a high BMI and yet be muscular and fit - the Amercian football players in the NFL have high BMI values. They are classified as obese, but they are actually very fit and muscular.

Should we be more concerned with increasing fitness levels over weight loss during public health awareness? There seems to be more emphasis now on weight loss and eating less processed food rather than increasing physical activity. 

This study suggests boosting fitness levels should be at the top of the list, not just as a replacement for tackling obesity. Studies like this show that physical activity is definitely more important than diet for those who want to live to a ripe, old healthy age. Not to say that diet does not matter. But fitness is king. Perhaps our Ministry Of Health should angle some incentives?

Reference

Weeldreyer NR, De Guzman JC, Paterson C et al (2025). Cardiorespiratory Fitness, Body Mass Index And Mortality: A Systematic Review And Meta-Analysis. BJSM.59:339-346. DOI: 10.1136/bjsports-2024-108748

Take 12 Weeks Off And Come Back Stronger?

Consider the following scenario. You have trained well and have just taken part in the Swimrun World Championships. You then take 12 weeks off from training. You resume training again for 12 weeks and tests show your VO2 max levels exceeded those just before you took 12 weeks off. 

Too good to be true? Can a long break be that good for you? 

A French exercise physiologist and triathlete Romuald Lepers agreed to take 12 weeks off deliberately (for the sake of science) and allowed himself to be tested. With his colleagues' help, he underwent a whole bunch of tests straight after he competed in the World Swimrun Championships in 2022. After that he rested for 12 weeks and the tests were repeated. He then resumed training for 12 weeks and repeated the same tests. 

The results were published in 2 different journals last year showing what happened when you lose and then regain fitness, raising a possiblity that perhaps a long training break is actually good for you.

The first published article documents Leper's changing fitness. After 12 weeks of rest, his VO2 max measured in a treadmill running test dropped by 10.9 percent. In a similar test on an exercise bike, it dropped by 9.1 percent. That's a big drop equivalent to about 15 years of normal aging. For reference, Edward Coyle's famous paper from 1984 saw a 16 percent drop in VO2 max after 12 weeks of laying off training.

Here's the surprising good news. He gained 5.5 pounds of fat and lost 4.6 pounds of muscle during the 12 weeks rest. After retraining, he lost 9 pounds of fat and regained 2.4 pounds of muscle. His body fat levels  went from 10.1 percent to 13.3 percent then to 8.4 percent. A net loss of 5.7 percent at the end of the experiment. 

Cycling VO2 max levels

After 12 weeks of training again, his VO2 max did not just recover, it was better than before he stopped training (5 percent higher). The running test was 4 percent higher than before. In the cycling test it was 6 percent higher (pictured above). 

The fat loss will explain some of the improvement in his VO2 max as it is calculated relative to body weight, so losing weight can create the 'illusion' that you get fitter without changing your oxygen processing abilities. However, his overall oxygen processing capacity did improve, independent of his weight.

Another possibility documented in the second published journal is that something changed in his muscles making them more responsive to training. Lepers had muscle biopsies (ouch - they are very painful!) at each stage to measure the chemical changes occuring. Fast twitch muscle activity was ramped up during detraining while aerobic capacity and mitochondria function decreased. Retraining mostly reversed those changes and in his case resulted in better than baseline muscle properties.

Now, Lepers is an accomplished triathlete. In his younger days he placed in the top 150 at The Hawaii Ironman World Championships. At the time of the study, he was 53, training 10-12 hours a week and consistently placing near the front in his age category in Ironman 70.3 races. Lepers has trained consistently for more than 3 decades, and never missed more than 2 weeks of training at a time previously. 

Sounds good so far? Leper's results also seem to line up, declining with detraining and impoving to be even better with retraining.  If you're in your 20's, you can take 12 weeks off, train hard again and definitely regain your fitness and more. This case study suggest the same can be true in your 50's.

Note that this is just a case study, where n=1 where we may not get the same results as Lepers. This is different as missing 12 weeks through injury since you may not be able to start training full on especially if surgery was needed.

So here are the not so good bits if you read both articles in detail. Leper's cycling efficiency went down and his running economy worsened. He did not recover the muscle mass he lost and that is worrying (note to self : need to maintain strength training). Fortunately for him, his race results in the following season with similar with the previous season. Actually I thought that was remarkable given the fact that he took 12 weeks off.

I really liked Leper's experiment since I am in the same age group as him. Many of my older patients and friends take shorter and less frequent breaks from training because they are afraid they will lose their fitness from too long a break. I am definitely in the same boat. Now we can all be less paranoid about taking long breaks from training. Even if I do not get better than before, just the fact that one can get back to your previous level is reassuring enough.

Reference

Lepers R, Mater A, Assadi H et al (2024). Effect Of 12 Weeks Of Detraining And Retraining On The Cardiorespiratory Fitness In a Competitive Master Athlete: A Case Study. Front Physiol. DOI: 10.3389/fphys.2024.1508642.

Zanou N, Gremeaux V, Place N and Lepers R (02024). Cardiovascular And Muscular Plasticity In An Endurance-Master Athlete Following 12 Weeks Of Detraining And Retraining: A Case vStudy. JCSM Comm. 7:82-90. DOI: 10.1002/rco2.93.

Instead Of Complaining About Wearing Face Masks..

He wore a mask, I didn't - posed lah ;) 

Almost daily during the circuit breaker (CB) period last year, my older boy and I went out to ride our bikes since there were hardly any cars on the road.  Most of the time we had our cloth face masks on. Needless to say, we found riding uphill more difficult when having them on. 

Made it to the top of Mt. Faber

Newly published research backs this up. Researchers had 28 young (18 to 29 years) and healthy participants perform 2 maximal exercise tests on a treadmill. One with and one without a cloth face mask.

Each participant runs to complete exhaustion as the treadmill speed and incline is increased every 3 minutes and the time to exhaustion is recorded. This is used to estimate VO2 max levels. Heart rate, blood pressure, rate of perceived exertion and the participant's perceptions of wearing a face mask while running were also recorded.

Key findings were that cloth face masks reduced run time to exhaustion by 14 percent and VO2 max by 29 percent. With masks on, the participants felt more short of breath and claustrophobic at higher exercise intensities compared to not wearing masks. Blood oxygenation levels (Sp O2 levels) were also lower when cloth face masks were worn. The reduced levels of oxygen in the blood show a definite physiological effect. 

The more effective the mask in filtration capacity (the more protection for the wearer), the more it will affect exercise performance. Take home message is that using a mask during exercise does make it a lot harder. The researchers recommend that exercise time, frequency and especially intensity be modified when wearing a cloth face mask.

The researchers also cautioned that their findings of impaired performance with cloth face masks may be in part due to the perceived discomfort. Meaning, the participants were less motivated to keep running at higher treadmill speed and incline. 

My racing days are long gone, but if I were still training and competing, I'll probably don a cloth face mask while training (sometimes) to up the intensity a few notches so that when I race without a cloth face mask, I'll be hard to beat. That's just like respiratory muscle training. But that is just me. Please do not take this as training advice! 

Reference

Driver S, Reynolds M, Brown K et al (2021). Effects Of Wearing A Cloth Face Mask On Performance, Physiological And Perceptual Responses During a Graded Treadmill Running Exercise Test. BJSM. epub first 13 April 2021. DOI: 10.1136/bjsports-2020-103758.

Does Dynamic Stretches Help Running Performance?

Our new physios doing the dynamic stretches

Previously I had written that performing any static stretches before exercise or competition can be detrimental to your athletic performance. Studies have also shown that doing static stretches before competing or exercising is more likely to cause an injury. In fact, performing just one static stretch of 30 seconds can reduce your maximum strength.

Meanwhile, fitness professionals, coaches and other studies have suggested performing dynamic stretches as an alternative warm up to static stretches instead.

Well, this published study had runners do both. An initial assessment was done to get the runners VO2 max levels. The researchers had a group of well trained university runners do a general warm up (GWU) on one day versus doing a general warmup (GWU) plus dynamic stretching (DS) before getting them to run until exhaustion on a treadmill on another day.

The GWU consisted of running on the treadmill at a speed equivalent to 70 percent of each runner's VO2 max for 15 minutes. Each runner then did a standing rest for 5 minutes. This was followed by the run to exhaustion on the treadmill at a speed equivalent to 90 percent of their VO2 max. 

When doing the GWU plus DS, dynamic stretches were done for all the lower limb muscle groups (10 reps each), see picture below. That took 3 min 45 seconds in all. After resting for 1 min 15 seconds, the runners started their run to exhaustion on the treadmill at a speed equivalent to 90 percent of their VO2 max. 

Well, this published study had runners do both. An initial assessment was done to get the runners VO2 max levels. The researchers had a group of well trained university runners do a general warm up (GWU) on one day versus doing a general warmup (GWU) plus dynamic stretching (DS) before getting them to run until exhaustion on a treadmill on another day.

The GWU consisted of running on the treadmill at a speed equivalent to 70 percent of each runner's VO2 max for 15 minutes. Each runner then did a standing rest for 5 minutes. This was followed by the run to exhaustion on the treadmill at a speed equivalent to 90 percent of their VO2 max. 

When doing the GWU plus DS, dynamic stretches were done for all the lower limb muscle groups (10 reps each), see picture at the top. That took 3 min 45 seconds in all. After resting for 1 min 15 seconds, the runners started their run to exhaustion on the treadmill at a speed equivalent to 90 percent of their VO2 max. 

The results showed that the GWU plus DS group lasted significantly shorter (10:40 min)  than the group that just did the GWU (12:40 min). Distance covered was between 2.3 to 5.4 km.

The authors of this study were hypothesizing that performing GWU plus DS may help improve endurance running performance. Unfortunately the results indicated otherwise. 

Another study by the first 3 authors (Yamaguchi et al, 2015) showed that performing the same five DS (10 reps) followed by a rest period of 1 min 23 secs actually prolonged the run time to exhaustion (an extra 18.2 percent) compared to a sit down rest. Run to exhaustion on the treadmill was also done at a speed equivalent to 90 percent of their VO2 max.

What is good about this study was that there was real attention to detail. The testing was done during the off season for the runners so no prior vigorous training was done. The runners were also asked to avoid performing intense exercises or training on each test day and the day prior. 

The runners were also instructed to have similar meals and drinks on the test days and previous day and to finish any meal 2 hours before running. Runners were also asked to avoid alcohol the day before running and caffeine on the test day. Each runner wore the same attire for the test runs and performed the test at the same time of day in consideration to circadian rhythm. The laboratory temperature was kept constant at 20-24 degrees Celsius throughout. In short, the authors tried to keep everything else constant other than the warm up. 

What wasn't as good? Bear in mind that the study only had 8 runners. They are definitely fast runners (looking at their profile), but the sample size is small. The rest period after the dynamic warmup was also extremely short (150 seconds). Fatigue after the DS was attributed by the authors as the cause for worse performance.

When I was competing in events like 1500m - 5000m on the track, I'll do a rather languid jog of 2-3 km to warm up followed by some limbering movements to loosen up. This was followed by repeating some striding (or goal pace running) 5-8 times for 150-200 meters. Then it would be resting and waiting for our event to start. Definitely longer than 1 minute 15 seconds before racing. Definitely did not do any sort of stretching then.

My advice would be to try out dynamic stretches or whatever that is new (shoes, bike, run technique etc) in your off season, not before an important competition, to see if it would be something that might work for your body. Most importantly, do what works for you. Every body is different.

References

Yamaguchi T, Takizawab K, Keisuke S. (2015). Acute Effect Of Dynamic Stretching On Endurance Running Performance In Well-trained Male Runners. J Strg Cond Resc. 29: 3045-3052. DOI:10.1519/JSC.0000000000000969

Yamaguchi T, Takizawab K, Keisuke S et al (2019). Effect Of General Warm-up plus Dynamic Stretching On Endurance Performance In Well-trained Runners. Res Quart Ex and Sport. 90(4): 527-533. DOI: 10.1080/02701367.2019.1630700.

*thanks to Thiviyan and Rashid Aziz for getting me the articles

Can Exercise Give You Headaches Or Migraines?

My patient rings up complaining of having a terrible migraine after going out for a run. She suffers frequently from migraines and usually exercise and/or seeing us in the clinic would help. She was hoping to come and see us since Physiotherapy has been reclassified as "essential services".

Despite Physiotherapy being reclassified as an "essential service" recently on 29/4/20, the criteria to see patients in the clinic are very strict.

The Ministry of Health (MOH) have told us that face to face sessions are only for "patients whose condition would deteriorate significantly or rapidly if treatment is not provided or performed and would potentially threaten their health and well being".

We can only open once a week seeing a maximum of 6 patients and we're told to "leverage on tele-consult/ tele-rehab as far as possible".

Many of our patients have called or messaged us asking to be seen and we've explained that we can only treat them if they meet the above criteria.

My running patient did add that she ran a lot harder and that was when her migraine started. I told her that I just read an article on runners and their calcitonin gene-related peptide (CGRP) levels.

In that study, 46% of the enlisted running subjects reported suffering from headaches/ migraines while 54% did not.

CGRP helps with making your blood vessels larger (vasodilation), which then increases blood pressure and inflammation in your nervous system. Increased CGRP levels are known to be associated with headaches and migraines.

The researchers measured CGRP levels (by drawing blood) in  runners before and after running. They then got the runners to run 21 kilometres at 75-85 VO2 max.

 CGRP levels significantly increased by one and a half times in the entire group after the run. CGRP was significantly higher for those who had prior migraines before the run and those runners reported suffering from migraines after the run.

This led the researchers to conclude that medium to long distance endurance exercise boosted CGRP levels and that high intensity exercises can heighten the reaction further. This can potentially trigger both headaches and migraines brought on by exertion.

Previous research has shown that exercise can decrease frequency of migraines and improve symptoms and reduce migraine triggers (Aristeidou et al, 2018). With this new article I have to add that migraine sufferers need not stop exercising, but they do need to watch their exercise intensity.

Low to moderate exercise intensities does not seem to be a trigger. There are also medications that helps with blocking CGRP for those of you who don't mind ingesting medication in order to exercise hard. Check with your doctor for the prescription.

Good news for those who do not suffer from headaches or migraines as an increase in CGRP levels is good for you as it has a protective effect for cardiovascular function.


References

Aristeidou S, Baraldi C et al (2018). The Association Between Migraine And Physical Exercise. J Headache Pain. 19(1): 83. DOI: 10.1186/s10194-018-0902-y.

Tarperi C, Sanchis-Gomar F et al (2020). Effects Of Endurance Exercise On Serum Concentration Of Calcitonin Gene-related Peptide (CGRP): A Potential Link Between Exercise Intensity And Headache. Clin Chem Lab Med. DOI: 10.1515/cclm-2019-1337.

To all our patients reading this and asking to be treated. Yes the government has indeed allowed some businesses to open. As you can see from the MOH circular, clinics have very strict criteria regarding who we can see even though this is not published in the news. Rightfully so since we are still in the circuit breaker period.

Please bear with us, we will inform you as soon as we are given further instructions by MOH to allow us to see more patients.

Heat Acclimatization Can help Exercise Performance

Other than the heavy rain the last two days, it's been very hot recently. I used to love training and racing in the heat. Living in sunny and super humid Singapore meant that we're used to such conditions.

I'll often train in the hottest part of the day so that when race day came, whatever sweltering conditions encountered (on race morning) will seem like a breeze. There was a year (2001) when the Osim Singapore Triathlon was held in Sentosa and it was 38 degrees Celsius on race day and I used that advantage to finish 3rd overall behind Dimitry Gagg (former World Triathlon Champion in 1999).

On the podium with Dimitry Gagg in 2001

Turns out I may have been right in getting an edge over my competitors. And you can use that to your advantage too.

Heat is now hot! This shift towards heat training has been trending for the past few years. From running marathons to even climbing mountains, athletes around the world have been trying to get potential performance benefits of heat training.

Many of these heat studies started because of the 2008 Beijing Olympics. Many runners were preparing for the sweltering conditions and that lead to a whole lot more research done on heat acclimatization.

There are even studies of using heat therapy to fight heart disease and repair muscles.

Most heat acclimatization protocols help athletes perform better in the heat. This includes lowering core body temperatures, increasing perspiration rates and increasing volume of blood.

And what if after all that training in the heat race day wasn't hot? What if race day turns out to be as cold as the 2018 Boston marathon?

Fret not, results of a study (Lorenzo et al, 2010) on whether being well adapted to heat might affect your performance in cool conditions put that worry to rest. Scientists had cyclists train for ten days in 41 degrees Celsius (105.8 degrees Fahrenheit). Their VO2 max improved by 5 percent while their one-hour time trialing performance improved by 6 percent! This was when they were tested at 12.8 degrees Celsius (55 degrees Fahrenheit). Just in case you were wondering, they improved by 8 percent in hot conditions for both VO2 max and the one hour time-trial.

Control group cyclists had no improvements in V02 max, one-hour time trial performance, lactate threshold and other physiological parameters.

Suddenly, hot rooms, saunas and even non breathable training suits were the latest must haves and even suggested to be a cheaper and more convenient alternative to altitude training.

When it is too hot, it is a shock to our system. This is similar to what happens to our system when we exercise or train in altitude.

When we exercise in altitude, the decrease in oxygen triggers the body to produce more red blood cells. Heat training increases the volume of blood plasma in our bodies and this help send more oxygen to our muscles.

However, it is not totally certain that increasing blood plasma volume may lead to improved athletic performance. What may happen from the resulting dilution of blood is that it may trigger a natural response for the body to produce new red blood cells - just like altitude training.

Training in hot conditions does not only change blood plasma. Other benefits include psychological resilience (or the ability to endure) and altered perception of high temperature. Just like what I intended for by training in the hottest part of the day.

Before you head out and train yourself silly in the heat, make sure you gradually increase your intensity and heat exposure. Drink enough but do not overdrink.

Reference

Lorenzo S, Halliwill JR et al (2010). Heat Acclimation Improves Exercise Performance. J App Physiology. 109(4): 1140-1147. DOI: 10.1152/japplphysiol.00495.2010.

How Quickly Do You Lose Fitness When You Stop Training?

Picture of Singapore Stan Chart marathon by RunSociety from Flickr

Well, many of you've just done your last race of the season. Yes, after the Standard Chartered Singapore Marathon 2016 this morning it's off season time at last.

Now it's time to take some much needed rest, both physically and mentally and not worry about training for a while.

The most common question and worst fear among my patients who run (or race triathlons) is how quickly do they go out of shape if they stop running (or training).

Ever wondered how long before detraining kicks in? Well, just as you don't become a fast runner overnight, you don't lose your fitness that quickly too. Nothing goes up in a straight line, there'll be some peaks and valleys. Likewise you don't lose your fitness overnight too.

Okay, first the good news. Research on detraining or how quickly you go out of shape shows that those who are less well-trained have less to lose. This make sense considering the elite athletes have further to fall.

Elite athletes can lose up to half of their aerobic fitness within the first 12-21 days of not training. They can then lose half of their remaining fitness in the next 12-21 days and so on. The bad news, those who've trained for a few months have a slower decline, but lost all fitness within 4 weeks.

Most studies suggest that an elite athlete's VO2 max levels drop 7 percent if they stop training for 12-21 days. They can lose another 9 percent from days 21-84.

One major reason for the quick fitness decline is the loss of blood volume. In the first 12-21 days that you stop training, you can lose up to 500 milliliters of blood. It's a simple supply and demand situation. When you stop training, you take away the demand.

The body loses the ability to bring oxygen to the muscles and you also have less fluid available for sweating (which cools the body).

The good news is with retraining, you can regain blood volume in a week although it takes a while for your red blood cells to grow again.

Other than blood volume, your mitochondria cell density, lactate threshold and your ability to oxidize fat stores all deteriorate.

Researchers have found it difficult however to measure time to regain your fitness. A common suggestion is that for every week lost, it takes two weeks to regain that previous level. The reason for this all those functional capabilities mentioned above.

When I was still racing, I used to take two weeks off at the end of the season. Yes, two weeks of no swimming, running, cycling and weight training. This allowed me to recuperate both physically, recharge mentally and also to spend time with my family, loved ones and friends. And when its time to train again, I'd be raring to go.

Do bear in mind that not all systems in your body detrain or retrain equally. Do consider your age. Runners in their 20's can resume training as though they never took time off. Older runners will take longer. 

Strength gains (from weight training) are not lost as quickly as aerobic (or cardiovascular fitness) and it usually takes 4 weeks before you start to lose peak muscle strength and maybe that will be another article later on.

So congrats and well done to those of you who ran this morning and make sure you take that well deserved time off.

References

Coyle EF, Hemmert MK et al (1986). Effects Of Detraining On Cardiovascular Responses To Exercise: Role Of Blood Volume. JAP. 60(1): 95-99.

Joyner MJ and Coyle EF (2008). Endurance Exercise Performances: The Physiology Of Champions. J Physiol. 586(1): 35-44. DOI: 10.1113/j.physiol.2007.143834.

Can Watermelon Juice Make You A Better Athlete?

You've read from our blogs about drinking coconut water, green juices, lemon water etc. I am sure that  when it comes to our health or getting a competitive edge, we are always eager to try something new but evidence-based.

Guess what I read in a recent article? L-citrulline supplementation appears to help VO2 max levels and high intensity exercise performances. In real food form, watermelons are the best natural sources of L-citrulline.

In the published study, ten cyclists were given either L-citrulline, L-arginine or placebo tablets over a period of three seven-day cycles. On day six and seven, the subjects completed a moderate and intense cycling test.

Only the subjects taking the L-citrulline tablets had improved their VO2 max, time to exhaustion and maximum power during a 60 second all out sprint. There were no changes in performance in the L-arginine or placebo group.

Now, before you run out and eat/ drink all the watermelons you can, here are some of my personal thoughts.

The sample size (10 athletes) in the study was relatively small. Recreational cyclists were used in the study so the results may be different in elite athletes. So great news if you're a recreational athlete.

For elite athletes however, probably you may want to wait for more studies to be replicated to make sure the results are valid.

The subjects in the study were given L-citrulline tablets. You'll need to drink about 2.5 litres of watermelon juice to get the same dose of L-citrulline used in this study. And probably have to go the the toilet pretty soon after.


Reference

Bailey SJ, Blackwell JR et al (2015). L-citrulline Supplementation Improves O2 Uptake Kinetics And High -intensity Exercise Performance In Humans. J App Physiol. 119(4): 385-395. DOI: 10.1152/japplphysiol.00192.2014.

Want To Run As Fast As The Kenyans?

Want to run as fast as the Kenyans? You may need to lose some more weight. A new study suggests that Kenyan runners are fast because of their extreme thinness (and not just due to living / training from young at altitude).

For a long time it was thought that the success of Kenyan runners were due to their walking/ running long distances on their way to school while growing up. In comparison, our kids now get a ride in fancy cars from their parents or the school bus to school and play computer games after. And, of course struggle to keep up in major marathons and get their behinds kicked.

Renown scientists Yiannis Pitsiladis and Daniel Lieberman were among the group of researchers who tested the early training theory and to their (and mine) surprise found that there was not sufficient evidence supporting that. These mostly thirteen year old Kenyan kids were really active and they covered around 7.5km to and fro in their daily trips to school and back. They also did not eat any junk food. The kids who ran and walked the most to school did not actually have the highest Vo2 max scores.

Rather, what actually stood out in their research was that the kids had a really low BMI (body mass index), i.e. they were really thin. Being fit and skinny means you'll have a high Vo2 max. These "untrained" kids were found to have the potential to run a 2:18 marathon for the boys and 2:39 hrs for the girls! And these are just the groups' averages.

So bad news for the rest of the world as Kenyan runners will probably continue to dominate distance running for a while yet.

Reference

Gibson AR, Ojiambo R, Konstabel K, Lieberman DE et al (2013). Aerobic Capacity, Activity Levels and Daily Energy Expenditure in Male and Female Adolescents of the Kenyan Nandi Sub-Group. PLoS One. 8(6) : e66552. doi: 10.1371/journal.pone.0066552.

*Picture from Flick.com

Aqua Based Rehabilitation (Deep Water Running)

Recognize anyone?

If you've ever wondered how our injured national athletes still keep most of their hard gained fitness, read on.

Their pool based water work is often the key to a quick return. For those not injured, the swimming pool can also be used as a great training tool in addition to your other workouts. Look closer at the 2nd picture and you may recognize some of our badminton players who have been to the last 2 Olympics- Ronald Susilo, Kendrick Lee, Xing Aiying and Li li etc. Our Singapore badminton team went to the pool once a week at least during periods when they were training at their hardest so they can train in a setting with little or no impact to minimize injuries with yours truly leading the session in the water with them.

Now, this is not a typical swim training session like you might think. As most land based athletes are not good swimmers, I often use aqua running techniques (or deep water running) to produce a valuable training effect for them. It would take a far longer time to get them to be of a good swimming standard to get the same effect from swimming and since time is a precious commodity in sports rehabilitation hence the use of deep water running. Moreover, most of these athletes or patients are involved in some land based or running sports, so swimming offers less transferable benefits or movements that are similar to their land based activities.

Done right it is a full body workout involving the legs, arms, shoulders and core muscles.It is also a good alternative to pounding the streets day after day. A study comparing a group doing deep water running versus another group road running found both training programmes produced similiar improvements in V02 max levels.

Water is about 773 times more resistant than air, so it can strengthen all key running muscles. Water is also isokinetic, meaning the water resists you as much as you resist it. The harder you move your arms or legs through the water, the more drag force or resistance you encounter. What's more challenging? Doing the workout without a flotation device or belt. I often get my athletes to do the entire session without one to push them harder.

The pool is a very good and versatile environment for rehabilitation work and training for athletes and patients. By including this session, you can allow for injured athletes or patients to recover quicker and allow others to undertake higher intensity water based training. It will not do the aqua training technique justice for me to describe how you do it in just a few short sentences, please contact us know if you need more advice on this. Physio Solutions conducts deep water running classes, give us a ring to find out more.

References

Davidson, K (2000). Deep Water Running Training Improve V02 max in Untrained Women. Journal of Strength and Conditioning Research. 14 (2) 191-195

Dowzer, CN and Reilly, T (1998). Deep Water Running. Sports Exercise and Injury. 4: 56-61