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"Evil Medicine" - A Book Review

A trusted colleague recently recommended that I read the book "Evil Medicine" by Richard Dennis. The book was originally published in 2005 and it covers a lot of ground in 109 pages, particularly about the pharmaceutical industry, prescription (and over the counter) medications, and the potentially negative effect they can have on your health. The author is a reporter and has written several other books besides this one, and he shares a few personal stories about the damage that prescription drugs can do. Mr. Dennis also takes a closer look at the bureaucracy of the Food and Drug Administration, and he details how political connections have exponentially increased the profits of the pharmaceutical companies.

The title of this book sounds alarmist, but it's important to understand the intended and unintended effects that medication has on your body. Any medication that you take is ostensibly ingested in order to combat a certain physical symptom that you experience. If you are diabetic and have high blood sugar, you will likely be prescribed metformin (or something similar) in order to reduce the amount of sugar your liver releases into your blood. The problem is that prescription drugs don't cure anything; they actually interfere with the body's normal processes and metabolism, which is why many people that are long term users of prescription medications are severely nutrient deficient. Modern medicine in the United States has largely devolved into a doctor seeing a patient for less than five minutes and writing a prescription. Physicians today generally treat symptoms rather than solve the underlying problem. Think about it: diabetic patients that simply take metformin do not cure their diabetes, they are merely managing the disease. It is far more lucrative to physician's practices and pharmaceutical companies to simply treat the symptoms rather than cure the patient. Have you encountered a physician who has counseled a diabetic patient to practice intermittent fasting, go on a low-carb diet, and regularly perform high-intensity strength training? That would go a lot further toward curing diabetes than by simply taking metformin every day.

Dennis says that when it comes to prescription medications, cause and effect are largely misunderstood. He states, "Every symptom comes from one cause: being out of homeostasis. If you don't address the problem nutritionally, you don't address the problem." Doctors usually think the answer to the problem is to prescribe medication, but they are thinking reactively rather than proactively. Rather than think about what caused the problem, they treat the symptoms. This is particularly the case when it comes to antibiotics. There are certain situations when an antibiotic must be prescribed, particularly in the case of a life-threatening infection. The problem is that doctors are now inclined to prescribe them when a person gets a minor sniffle; this leads to antibiotic resistance. Worse yet, according to the author, "Antibiotics also deplete B vitamins, necessary for hundreds of biological processes, including proper nervous system functioning." We often think of antibiotics as being very targeted, but as Dennis illustrates, "Antibiotics aren't a smart bomb, either. They kill the good guys, the bacteria necessary for proper digestion, the bacteria that eat up toxins in your system."

I think this book is especially pertinent to the world we currently live in, in which you can hardly go a single TV commercial break without seeing at least one advertisement for a prescription medication of some sort. It is especially topical considering the recent rollout of the Covid vaccines on the market. We need to understand the role that the Food and Drug Administration (FDA) has in dealing with the pharmaceutical companies. At the time of the writing of this book, "Researchers estimated that 106,000 Americans die from appropriately administered, FDA-approved prescription drugs. That's more deaths than the annual total for AIDS, suicide, and homicide combined." If the FDA is supposed to be a watchdog over the pharmaceutical industry, how can this happen? The FDA's safety budget is a small fraction of the marketing budget of the major pharmaceutical companies; there is simply no way they can effectively police the industry. In addition to that, the drug companies fund the vast majority of the clinical trials for medications waiting to be released to the market. Data can very easily be manipulated to make a drug seem far more safe and effective than it truly is (think Vioxx). These are some things to consider if you are debating whether to get the Covid vaccine.

If you don't want to be on a steady cocktail of prescription medications as you get older, what can you do? First of all, it's important to have the mindset that your health is your responsibility. The drug companies, government, and medical industry can't do it for you. Consume a diet that largely consists of single-ingredient, whole foods, and avoid sugar. Practice intermittent fasting for 14-18 hours a day, at least a few times per week. Hydrate well, and moderate consumption of alcohol. Sleep for 7-9 hours per night. I also recommend supplementing with Zinc, Vitamin D, Vitamin C, Magnesium, and possibly fish oil. If you have to take prescription medication, be sure to increase your nutrient intake while on the drug. Finally, lift heavy things once in a while! Perform one or two Total Results workouts per week to increase muscle and bone mass, improve your resistance to injury, and keep your metabolism and cardiovascular system running in top form. None of these are new ideas, but they have stood the test of time.

One last quote from the author: "The average number of prescriptions per person in the U.S. increased from 7.3 in 1992 to 10.4 in 2000." I suspect that number is even higher in 2021. Every drug that you take to deal with one ailment creates another problem. You don't have to be a slave to the pharmaceutical industry. Educate yourself and take charge of your health, starting today!

Posted April 06, 2021 by Matthew Romans

Is Fitness Testing Really Necessary?, by Matthew Romans

As a part of my efforts to further my education, I recently finished taking an exercise science course online at Maryville University. The course covered a wide variety of subjects, from athletic training to sports and exercise psychology, and while I disagreed with most of the other students as far as exercise philosophy and methodology are concerned, I got a lot out of the course. One unit that was covered during the semester had to do with fitness testing. After going through that unit and participating in assignments that had to do with the subject, I thought it valid to question whether fitness testing is really necessary. It was a good exercise for me to go through the testing, so that I could make up my own mind and share my thoughts with Total Results clients and regular readers of our blog articles.

I performed the following fitness tests over the course of one week: the Stork Balance Stand Test (https://www.topendsports.com/testing/tests/balance-stork.htm), the Cooper 1.5 mile Run Test (https://www.topendsports.com/testing/tests/2-4-km-run.htm), the Rockport Walk Test (https://exrx.net/Calculators/Rockport), a push-up test (maximum number of push-ups completed to muscular failure), BMI (body mass index), and a couple of different step tests. For the tests that are designed to measure aerobic fitness/endurance, we were required to calculate our VO2 Max (the maximum amount of oxygen the body is able to use during exercise) based on things like body weight, our scores on the tests, and mathematical formulas we were given. Based on age, we would reference our scores on a norms chart to see how we compared with our peer group.

I scored extremely well on a few of the tests (the run test, the walk test, push-ups, and the aerobic step test), did fair on the anaerobic step test, and scored poorly on the balance test and BMI. Some of the results were not surprising, but other results were; what could all this mean? The result of the balance test was unexpected. This requires you to place your non-dominant foot on your dominant knee, and stand on one foot with your heel raised for as long as you can. I had a difficult time performing this task for longer than ten seconds, even though I have no difficulties with balance in performing everyday activities or things that are sport-related. Balance skills tend to be specific in nature to the activity you are doing, and if you practice those specific skills, your balance will improve. People who perform this test as a means of evaluation don't get to practice the test ahead of time, but I suspect they would perform better if they practiced it before being evaluated again on their performance.

As for the tests in which I performed well, the run test and the push-up test stood out to me. I was not surprised that I did reasonably well in the push-up test, but I was surprised that I was able to complete as many as I did (over 50). I have not done regular push-ups in many years, so it's not as if my skills were particularly sharp. The run test really blew me away. I have not run (outside of participating in sports) specifically for distance in over twenty years, yet my mile time was 4:45, and I completed the entire run in 7:19. How can this be explained? My current exercise regimen consists of one Total Results strength training workout per week, and outside of occasional hikes and walks all I do in terms of physical activity is the active nature of my job as an instructor. I perform no specific "aerobic exercise", yet my VO2 Max numbers were extremely high. I believe that I am physically fit, but I am also of the opinion that VO2 Max as a measuring tool is completely worthless. It is a test that was originally designed to measure the minimum oxygen uptake in comatose patients, but has been twisted around to supposedly measure something completely different. Even the late Michael Pollock, PhD, who performed more research with VO2 Max than anyone before him, said that, "Maximum oxygen uptake testing is not a test of anything. Any variable data from this test is almost entirely a genetic aberration." If that is the case, why is VO2 Max still held in such high esteem in the exercise physiology community? My theory is that many in that industry use VO2 Max and many of the established fitness tests to make themselves feel more important and to justify the expense of their education. I believe that these results also underscore the fact that regular high-intensity weight training is the most effective means of keeping the cardiovascular system functioning at peak capacity, and that running is completely unnecessary in order to achieve this end. It is also worth noting that I scored poorly on the Body Mass Index test. Based on my height and weight (6 feet, 190 lbs), which are the only things measured, I am considered pre-obese. This test does not take into account lean muscle versus fat mass, so it is rather arbitrary. I am certainly not a ripped Adonis, but I'm nowhere close to being obese. I had long suspected that BMI was of dubious merit, but this confirms it.

Is fitness testing necessary? For the purposes of the Total Results exercise philosophy and our clients, I believe the answer is no. The exercise physiology community considers body composition to be a form of fitness testing; we perform body composition measurements on most of our clients within their first few sessions, but we don't look at it as testing. Rather, it's an opportunity to establish a baseline in order to get on the right path toward fat loss, and we use it as a measurement of progress. We can learn more about a prospective client by going through health history paperwork, asking questions, and putting them through a couple of exercises during their initial consultation than by having them do a series of tests that are very skill-specific. It is unnecessary for people to stand on one foot, run, or step up and down on a bench in order to gain insight as to their baseline level of conditioning. All of that may look impressive to the casual observer, but none of it means very much. Many of these fitness tests carry a high risk of injury, and that runs counter to the Total Results mission. We want to help you to achieve maximum physical improvements safely and efficiently.

Our exercise philosophy is the same today as it was when we opened nearly twenty years ago. We will continue to work every day to improve and give you the best exercise experience money can buy. Our mission is your amazing!

Posted March 22, 2021 by Matthew Romans

My Experience at DiLorenzo Chiropractic, by Matthew Romans

I am currently taking an exercise science course online, and one of the course requirements is to complete ten observation hours in an exercise science-related professional setting. I completed my hours at DiLorenzo Chiropractic, which is located just up the street from my house in Leesburg. Dr. Matt DiLorenzo and his wife Mandy own the practice; they are long-term clients of our exercise studio and have referred several of their patients to us over the years, so I was somewhat familiar with Dr. DiLorenzo's philosophy. Dr. DiLorenzo is the sole chiropractor in the practice, and Mandy runs the office, takes care of scheduling appointments, handles payments, and communicates with the insurance companies. Dr. DiLorenzo treats patients with a wide variety of injuries and ailments, and some of his patients have worked with him for many years.

One of the key components to Dr. DiLorenzo's chiropractic treatment protocol is to understand the nature of subluxations. These are changes to spinal and postural alignment which can irritate nerves and cause pain. As Dr. DiLorenzo says, "The structure of the spine dictates the function of the nervous system", so he performs adjustments on his patients in order to restore proper alignment and relieve pain. He believes in sticking to the basics, as his practice is not a rehabilitation or physical therapy clinic. The specific nature of treatment will depend on the individual patient he is working with, but with new patients he will perform an initial consultation in which he learns as much as he can about a patient's medical history. He takes a series of x-rays on new patients (which is done on the premises), and prepares an oral report to explain the nature of the patient's structural problem. Although this rarely occurs, Dr. DiLorenzo can also prepare a written report upon request. Treatment frequency can vary, depending on the patient. Dr. DiLorenzo generally recommends that patients receive treatment twice per week for six weeks to start; by this point they should start to feel some relief and get an indication that the treatment is working. Beyond that point, patients might come more or less frequently. Some of the patients I observed come once per week, every two weeks, or even once per month.

Education is a very important aspect of the treatment philosophy of DiLorenzo Chiropractic. Dr. DiLorenzo talks at length with patients about the importance of supplementation, diet, and exercise, in addition to regular movement. He makes book suggestions and usually gives educational handouts about chiropractic treatment to his patients each week. I am very impressed at the rapport and the connection that the DiLorenzos have with their patients; they are well-liked and well-respected, which is one reason why so many of them are long-term patients. Dr. DiLorenzo talks to his patients throughout their treatment sessions; this helps to keep the patients at ease and feeling comfortable, even when they are in discomfort. I was slightly surprised at how brief each treatment session typically is, but Dr. DiLorenzo is very efficient at diagnosing where the patient is misaligned, and he is able to restore function and relieve pain very quickly.

I learned quite a bit during the time I spent at DiLorenzo Chiropractic. As I said, they have both been clients at my studio for over a decade, but I confess that prior to this experience, my knowledge of their practice was quite superficial. I had an opportunity to take an x-ray of Dr. DiLorenzo's knee (he is scheduled to have a meniscal procedure shortly), and he showed me how to do it. That was a great experience for me. He also went over patient x-rays with me, as well as strategies that he would implement to help restore function and relieve pain. I was given much reading material, and even got a few excellent book suggestions. I have a better understanding of the nature of Dr. DiLorenzo's chiropractic treatment, and feel even more confident in referring clients to him. Mandy was very generous with her time and knowledge as well, especially in discussing with me all that is involved with running the office on a daily basis, challenges that they face, and the most rewarding aspects of owning this practice.

Working with the DiLorenzos helped to reinforce my belief in what I am doing. The DiLorenzos and I share a similar outlook on life, and believe many of the same things that I believe, and I think it's important to have allies in life as well as in business. We had many discussions about things going on in the world and the challenges that come from running a business in the current political climate.

I am grateful to Matt and Mandy for being so generous with their time and knowledge, and for making me feel welcome at their office. I hope to return for another visit in the future. If you suffer from joint pain, headaches, or other maladies, I highly recommend you check out DiLorenzo Chiropractic.

Posted March 05, 2021 by Matthew Romans

Lessons Learned From Twenty Years Owning A Gym

I have owned a small gym for 20 years. I estimate I have personally performed 50,000 one-on-one training sessions in that time, and my employees have performed tens of thousands more. I have talked with hundreds of clients, friends and family about diet. I have read thousands of articles and dozens of books on exercise and nutrition. I have written hundreds of newsletter articles and blog posts on health and fitness. This experience has not made me an expert but has allowed me to observe all manner of behaviors in the realm of diet and exercise and learn some lessons about what creates success in the quest for health and fitness.

What follows are some of the lessons I have learned over the last 20 years.

  • Lifelong commitment is required. Most people will not stick with it. We use a term called "Six Week Syndrome" to describe most participants in exercise or diet programs. They make a commitment to themselves, start a program with big goals and plans, follow their plan for a month or two and then life/work/family makes keeping that commitment challenging, and they end up bailing on the program and reverting to previous behaviors. This has happened to almost all of us, including myself, multiple times. My most successful clients have made a long-term commitment to their health. They find a way to work out every week, year after year, regardless of everything going on around them. They take individual responsibility. They do not rely on their doctor, their family members, or even their exercise instructors. They use these resources but rely on themselves. They do not make excuses. They work around injuries or other obstacles.
  • Daily habits equal success. Having big goals will not make you successful. You need to have a system in place. It doesn't matter if your goal is to lose 50 pounds, or to run a marathon, or fit in a certain size dress. The people with lasting success losing weight or getting fit created a system with the component habits that happen every day and every week and those consistent behaviors add up over time. (see our blog post from September 2020 about the book "Atomic Habits"). They work out every week. They walk every day. They golf or play tennis every week. They do Yoga or meditation every day. They do not overeat or overdrink (at least not very often). They try to get a consistent amount of sleep every day. It is the little habits done hourly, daily and weekly that make you fit and healthy.
  • A nutrient dense, non-dogmatic diet approach seems to be the most effective long-term solution for health and weight loss/maintenance. There are a thousand diets out there. Many people have had at least short-term success with many different diet plans. There are low fat diets, low carb diets, high fat diets, prepackaged food diets, points-based diets, 30 day cleanses, and many more. Most diets that eliminate whole categories of food are difficult to sustain for a lifetime. You will always be hungry or crave certain foods. Those most successful at long term weight maintenance tend to gravitate to a diet that focuses on nutrient dense foods from all food groups (animal and plant proteins, healthy animal and plant fats, healthy carbohydrates sources like fruits and vegetables) and moderate their intake through smaller servings or time restricted eating, etc. They also shun heavily processed food like partially hydrogenated oils, sugary snacks, highly refined and enriched products like cereals, flour, and commercial breads. Eating nutrient dense foods provide all the vitamins, minerals, amino acids, etc. needed and will satiate you with less overall volume.
  • You must put stress on your body, but not overdo it. Many exercise programs fail either because they are too low intensity to elicit gains (ex. Steady state jogging), or because they are too high force, too high volume, and/or too high duration to remain safe over time (ex. Sports as exercise, high speed/force exercise studios, etc.). Our bodies prefer homeostasis, so we must provide a fairly severe stimulus in order make improvements. However, overuse or improper form or high forces will cause injury, breakdown, and a weakened immune system. Much of what passes as exercise today actually does more harm than good. Over twenty plus years, I have not found a better fitness combination than occasional (1 or 2 times per week) high intensity, slow motion weight training sessions combined with daily constant low-level movement (Yoga, walking, biking, golfing, etc.).
  • The mental aspect of exercising is more important than the physical. Proper exercise is hard. I do not particularly look forward to my workouts because they are very uncomfortable. People have the best workouts when they can block out that discomfort, along with any other distractions and focus intently on perfect form and maximum effort. This does not mean breaking personal records. Rather, it means getting and staying in control, in a stoic state, until the exercise and the routine are finished. If you can get your head to that point, your workouts and hence your fitness levels will improve.
  • Sometimes things go wrong. Despite our best efforts at smart exercise, clean diet, and a healthy lifestyle, people get sick or injured. While lifestyle choices can contribute to many diseases such as heart disease, diabetes, and certain cancers, we still don't know how to prevent many cancers and other diseases. Also, even the most fit, healthy person, can have an accident and tear a ligament, herniate a disc, or worse. The fact is we don't know when our lives will end or change dramatically. However, being at the highest health and fitness levels we can be will allow us to better deal with any circumstance life throws our way.

The last twenty years of helping the community achieve health and fitness have been the honor of a lifetime for me. I have learned a lot. I hope we can all keep striving for maximum health and fitness in these challenging times.

Posted February 18, 2021 by Tim Rankin

Physical Conditioning versus Athletic Skill Training, by Matthew Romans

Programming is at the very heart of what we do as exercise professionals. An exercise program is a plan of action for helping the client to achieve their goal, and should be tailored to meet the needs of the individual, albeit while working within a guiding philosophy. This holds true whether we are talking about designing a strength training routine, or if we're working with an athlete in terms of specific skill conditioning for sport. If the exercises in the strength training routine do not properly track muscle and joint function, or place the client in unnecessary danger, you are doing that person a grave disservice. Further, skill conditioning needs to be as specific as possible to the nature of the sport in which the athlete participates.

The purpose of specificity is to ensure that the client/athlete works to build skill in the nature of the sport he or she is pursuing. There are three types of skill transfer: positive, negative, and indifferent. Positive transfer occurs when the activities of practice and performance are identical. Negative transfer occurs when the activities of practice and performance are close, but not the same. Indifferent transfer occurs when the activities of practice and performance are completely unrelated. Let's say that you were working with a basketball player that wanted to improve his free throw shooting. In order for positive skill transfer to occur, the player would need to shoot a regulation-sized ball at a basket that is regulation height, and at a distance of fifteen feet away, just as he would in a game. Negative skill transfer would occur if the basket were the same height and the free throw line was the same, but the player used a women's basketball rather than a men's ball. This creates skill confusion, as the closer two skills are to one another without being exact, the further away they are in your mind's perception. Indifferent skill transfer would occur if you had the basketball player toss a bean bag at a cornhole target. These two skills are completely unrelated, so it does nothing to help improve free throw percentage.

Many years ago I worked for a company that specialized in training high school, collegiate, and some professional athletes. Another trainer at the same facility had worked with Alonzo Mourning, at the time a member of the Miami Heat, a few years earlier. I learned that this trainer had Mourning shoot free throws with a weighted basketball, much heavier than a regulation ball. As it turned out, during this particular season Mourning shot the lowest free throw percentage of his career up to that point. The likely reason is that this activity resulted in negative skill transfer. Although shooting a weighted ball seems just like shooting a regulation ball, the increased weight of the weighted ball made it seem in his mind's perception that he was performing two different skills.

The principle of specificity gives exercise instructors a guide to work with in designing a program. When you are testing someone, or preparing an athlete to be tested, the training should be specific for that test. For example, if you are working with a prospective NFL football player to prepare for the Scouting Combine, you want to have him perform drills on which he will be tested. One such test is to perform the barbell bench press exercise for as many repetitions you can complete with 225 pounds. It would not make sense to have your athlete prepare for this test by performing with dumbbells, as that is a completely separate skill. You should strive to have the barbell, weights, and bench as close to, if not identical, to what he will use at the Combine. As mentioned in the article "Applications of Training Specificity for Coaches and Athletes", 2006, "The greatest degree of improvement in muscle function following training must be when modality closely matches training movement." While specificity certainly applies when it comes to weight training, I think it's important to understand that there are two types of conditioning: skill conditioning and general conditioning. Skill conditioning applies to a specific skill or sport at which you are trying to improve. Practicing scales on a piano or trying to master a certain passage would be an example of this. General conditioning occurs when you are trying to increase strength, flexibility, cardiovascular and metabolic endurance, and improve resistance to injury. These are the goals of properly-performed strength training, and important considerations include muscle and joint function, force, speed of movement, entry and exit of machines, volume, frequency, and intensity.

I think it is also important to distinguish weight training from weight lifting. Weight training should be safe, and its goal is to build strength by performing gross motor movements that track muscle and joint function. Weight lifting, on the other hand, is very much skill-based and involves more fine motor, and often explosive movements. A great deal of throwing and catching of weights is involved here, as you can witness by observing Olympic-style lifting. It also carries a high risk of injury, which one who participates in this sport assumes and understands, however, for the purposes of general conditioning and building strength, is a bad idea. I would also like to point out that the above-mentioned article had many points that I agree with, but one fallacy in particular. It made mention of "purely anaerobic training." This is bogus. There is no such thing, as you cannot completely shut off the aerobic or anaerobic pathways in any activity. Certain activities may involve a significant portion of one pathway over the other, but neither one is completely shut off. Slow-speed, high intensity weight training is the most effective way to train both the aerobic and anaerobic energy systems, as once the intensity of the exercise increases, the aerobic pathway realizes that the anaerobic system must be brought into play, and working to muscular failure ensures that the fast twitch muscle fibers will be sufficiently taxed.

So how would I approach the idea of working with an NBA basketball player? From a specific skill conditioning standpoint, I would work closely with the coaching staff to find out what exact drills they would do in training camp to test and/or build skill, and I would replicate them as closely as I could. As with anything, I would dutifully regulate the variables of frequency, intensity, and duration, but also make adjustments to any or all of those variables in the case of injury. Incorporating some measurement of vertical jump would be pertinent, as this is most relevant to basketball. I would supervise the player while he played pickup basketball, since pickup ball has the most similarity to playing in an official game, and also try to regulate the amount of minutes he plays. As far as weight training workouts are concerned, there isn't all that much that I would do differently with a basketball player than I would do with a lacrosse player. Muscle and joint function in all human beings is remarkably similar, so the key is to select exercises that will strengthen all the major muscle groups efficiently without overtaxing recovery ability. Strength training frequency will depend upon the additional workload that the player is experiencing, and less frequent weight training workouts may be in order. In my experience, less is often more. Strength training should be looked upon just like medication; we want the minimum dosage necessary to elicit the desired effect. Work intensely, but briefly, and move quickly from one exercise to the next after achieving muscular failure. One main difference that I might incorporate into a basketball player's routine would be regular performance of the calf raise exercise, in order to give extra attention to the ankle joint.

Overall, it's important to know your client/athlete, and to ask questions about their daily routines, nutrition, sleep habits, and other demands on their time and energy, as this input helps them to feel invested in what you're doing to help them, but also to give you material to work with in terms of crafting their exercise/conditioning program. Get to know them and their personality, and that will help you to get inside their heads and figure out how best to teach and motivate them.

Posted February 04, 2021 by Tim Rankin