Finally Some Research on Crossfit!

High intensity, short duration exercise programs are growing in popularity. Evidence shows that such exercise programs lead to significant improvements in cardiorespiratory fitness (aka  aerobic fitness), body composition, muscular strength, and of course, health. Crossfit is a company that believes in this fitness principle and emphasizes programming focused on functional fitness. It has had much success and is continuing to grow in popularity. Unfortunately, there is no peer-reviewed research available on the effectiveness of Crossfit training. I am certain that anyone involved with Crossfit would happily provide anecdotal evidence that it has led to significant improvements in their fitness, health and quality of life. But for a program to be endorsed by professionals in the field, evidence is required.

As such, I was delighted to see a paper recently published in the Journal of Strength and Conditioning Research entitled “Crossfit-based high intensity power training improves maximal aerobic fitness and body composition” (doi: 10.1519/JSC.0b013e318289e59f); In Press).  I was particularly delighted to see that they used cardiorespiratory fitness as an outcome since the program consists primarily of strength and power based exercises. The study was a 10 week intervention with a total of 23 males and 20 females. The average age of this sample was approximately 32 years. Participants completed a maximal treadmill exercise test to determine VO2max; a measure of cardiorespiratory fitness that is considered to be the gold standard. The second main outcome assessed in the study was body composition as measured by the Bod Pod (air-displacement plethysmography). Unfortunately, this is not considered to be a highly reliable or valid method for assessing changes in body composition. The researchers would have been better off taking measures such as waist circumference, flexed bicep circumference or skinfolds at specific sites. These would have been more accurate in describing changes over the 10 week training period. Nonetheless, significant improvements in VO2max, body fat% and lean mass (i.e. muscle mass) were found. Another significant shortcoming of the present study is the lack of a control or comparison group. We know that exercise leads to improvements in fitness and body composition, but does Crossfit training provide additional benefit over other forms of exercise? We can’t answer that question with this data. More importantly, given the unreliable measure of body composition, the only take away from this study is that Crossfit training may lead to significant improvements in VO2max. Just in case I’m starting to sound cynical, I would like to emphasize that cardiorespiratory fitness or VO2max is the strongest predictor of health and mortality, so this is a very important finding.

TAKE HOME MESSAGE: There is no doubt that exercise is good for you and that high intensity exercise is better. For those of you interested in improving your health and cardiorespiratory fitness, Crossfit may be a great option. It provides a social support system, motivating coaches and a positive environment for exercise; all things that will really help you adhere to a Healthy, Active Lifestyle Forever!

NOTE: High intensity requires that you have a certain baseline level of fitness, so be sure to ease yourself into such a program; this will minimize your risk for injury and make for a much more enjoyable experience.


Reasons we should be cautious of the new finding that being overweight reduces the risk of death

A recent article published in the Journal of the American Medical Association entitled “Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories concluded that “Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality.” In other words, based on body mass index, these authors found that being overweight was a good thing and that being obese is not a problem.

Well, here is the problem: the authors used body mass index (BMI). This is a ratio of one’s height and weight. It can be calculated by dividing your weight in kilograms by your height in meters-squared. A BMI of 18.5-24.9kg/m2 is considered to be normal where as a BMI of 25-29.9 is considered overweight and a BMI of 30-34.9 is considered grade 1 obese. The problem with this measure is that it does not take into account the distribution of fat. For example, let’s say I had a BMI of 28, but the majority of my fat was located in my thighs and arms. This may not be desirable, but it isn’t necessarily a health risk. It is when fat is located in the mid-section that we should be concerned. Specifically, fat located in the mid-section underneath the muscle i.e. visceral fat is of great concern. Waist circumference is therefore a better predictor of disease and mortality risk than BMI as it tells a more complete story. Let’s go back to my original example. If my BMI were 28 and I had a waist circumference of more than 88cm (102cm for males) then I would be at HIGH risk for death and diseases.

So, my quick take on this paper is that it should be ignored by the media and the general population. There is unequivocal data to show that being over-fat is a health risk. Granted, having a BMI that categorizes one as overweight or obese doesn’t necessarily mean the person is over-fat. It is because of these limitations that the Edmonton Obesity Staging System was created. Please read my previous post on this comprehensive approach here: and please stay committed to your Healthy Active Lifestyle Forever!



Five Tips to Stay Healthy this Holiday Season

Christmas is a special time of year.

It’s filled with presents, food, family and lots of holiday cheer.

But when it’s all over and there is nothing left to do,

We are often left unhealthier and feeling somewhat blue.

So here is a list of 5 things that you can do,

To make sure this season doesn’t leave too many New Year’s Resolutions for you!

  1. Get lots of sleep: If you want to ensure you don’t munch on goodies all day, stay cheery, have lots of energy and stick with an active lifestyle, it is ESSENTIAL that you get all the zzzz’s you can. There is a strong and growing field of research to indicate a significant relationship between lack of sleep and obesity. So schedule in your 8 hours for every night this holiday!!!
  2. Liquid Calories and Portion Size: ‘Tis the season of food and drink. And we shouldn’t deprive ourselves of our favourites, but remember, one or two bites should be good enough to satisfy your cravings! Keep portion sizes in mind and be aware of how many snacks you’re eating while waiting for the big turkey or ham. Try to avoid loading up on mashed potatoes, dinner rolls and gravy. More importantly, keep track of how many glasses of wine, beer and hot chocolate you’re drinking. Those liquid calories add up fast!!!
  3. 30 minutes to move:  Time is a big barrier to maintaining physical activity levels over the break, but all you need is 30 minutes, and  no one said they had to be a solitary 30 minutes! Go for a walk with your siblings or parents or cousins or in-laws or nieces and nephews. It’s a great way to keep moving and a great way to have meaningful conversations with your loved ones! Here is a little inspiration for those 30 minutes a day:
  4. Laugh Lots!: Laughter really is the best medicine. It’s a great stress reliever, and boy do we ever need one at this time of year. So either rent a good comedy or bring up old embarrassing stories of one another and get laughing. You might even get a good ab workout from it J
  5. Relax and Enjoy: Many of us work our buns off so that we can enjoy time off with the families this time of year. Some of us have worked really hard to ensure that our families have a great holiday meal, presents and the like. Overall, we lead stressful lives, and this time of year is no exception. Be kind to your mind and body by taking some time to rest, relax and enjoy the season. Do some yoga, take a nap or listen to soothing music. Whatever works for you!

If you’re happy, rested and relaxed, you’ll be able to stick with your healthy, active lifestyle forever!


Pole Dancing…I mean Pole Walking is good for your health!

Well, pole dancing is probably good for your health too, but in this article I will be focusing on the health benefits of pole walking a.k.a Nordic walking or Nordic pole walking. If you’ve ever seen someone out for a walk with ski poles in their hands, you’ve witnessed Nordic walking. You might wonder why they have these poles in their hands. The short answer is that Nordic walking is a much more effective way to improve health than standard walking. Adding poles to a standard walk allows you to walk faster and also allows you to engage the muscles of the upper body; muscles often neglected in a standard walk. This form of walking has been shown to be especially beneficial to those with type 2 diabetes, people who have arthritis and of course to those hoping to lose weight.

A recently published intervention among overweight adults with varying levels of blood glucose control (normal, impaired and type 2 diabetes) assessed the benefit of unsupervised Nordic Walking among middle-aged and older adults. The researchers randomly assigned participants to either a control group (i.e. no exercise changes) or a Nordic walking group. The Nordic walking group was instructed to increase their weekly physical activity levels by 5 hours per week for 4 months using the Nordic poles. They attended an instructional class and were explained what intensity range they should walk within. At the end of the 4 months the Nordic walking had differing effects in the three groups. In the group with normal blood glucose levels body weight and waist size (waist circumference) both improved significantly. In the groups with impaired blood glucose levels, exercise capacity and physical fitness levels improved significantly. Finally, in the diabetes group, blood glucose levels and exercise capacity improved significantly. Another noteworthy finding was that those in the Nordic walking groups increased their weekly physical activity levels by 4-5 hours per week in each of the three groups. This is great news as it seems that Nordic walking is an activity that overweight individuals enjoyed and therefore were able to stick with!

It appears that one simple addition or change to your walking routine can have a fairly significant influence on your health and fitness levels. While it wasn’t assessed in the study described above, and research certainly is limited in this area, I can say from personal experience that Nordic walking can lead to improvements in muscular endurance of the upper and lower body as well as increase the speed with which you can walk. All in all, it is a great way to increase the intensity of your walking and a great way to derive greater health benefits while spending the same amount of time being active. If you are interested in learning how to walk with Nordic poles please check the following website for instructors and groups in your area:

TAKE HOME MESSAGE: Adding some Nordic poles to your walk can lead to significant improvements in your health and fitness levels. Be sure to give it a try, but make sure you learn the proper form before purchasing a pair of poles. This will ensure you prevent injuries and that you maximize the benefits derived from the activity. This activity is particularly beneficial if you are trying to lose weight, have diabetes or cardiovascular disease or arthritis. So be sure to give it a try and see if a simple pair of poles can help you get closer to your HALF!


Being sedentary influences your chances of aging successfully, regardless of whether you are active!

Successful aging is a term used to define the success or health of an individual as they age. It specifically refers to success in aging within the area of physical health, psychological health and social health. Physical health refers to whether one has a chronic condition such as heart disease, high blood pressure or diabetes and whether one has functional impairments such that they require assistance in basic activities (eg. a cane or a walker). Psychological health refers to depression, cognitive function (mental sharpness) and emotional vitality (happy and interested in life). Finally, social health refers to items such as engagement with life, social support and spirituality.

Research has shown that people who are physically active are more likely to age successfully. But the influence of sedentary behaviour i.e. the amount of time one spends in sitting activities, on successful aging is not known. In a recent paper entitled “Sedentary Behavior and Physical Activity are Independent Predictors of Successful Aging in Middle-Aged and Older Adults” published in the Journal of Aging Research (link), a colleague and I set out to understand the influence of sedentary behaviour in this relationship. Using a large sample of middle-aged and older adults from Canada we determined that sedentary behaviour influenced the chances of aging successfully (overall, physically, psychologically and socially) regardless of how physically active one was. Specifically, compared to sedentary older adults, moderately sedentary and least sedentary older adults were 38% and 43% more likely to be aging successfully overall, respectively. In other words, despite being physically active, someone who spends a great deal of time sedentary (for example, sitting at a desk or on a couch) is less likely age successfully in all three domains!

I must acknowledge, as with any research, this paper comes with some limitations. But, it is the first in what will hopefully be a growing field of research to indicate that being active isn’t enough, we must cut down on the amount of time we spend in sedentary activities in order improve our health or to maintain good health. Some people may say that this is impossible, that it is difficult enough to find 30 minutes to exercise. But there are simple strategies one can use to decrease sedentary time or to break up sedentary time. For great information and tips on this, please visit: or

TAKE HOME MESSAGE: Regardless of your age, you should make an effort to decrease the amount of time you spend in sedentary activities. This may be of particular importance to middle-aged and older adults, as these ages are considered “high risk” for the development of chronic diseases such as heart disease or cancer and are generally associated with higher rates of depression and loneliness. To ensure that you or your parents and loved ones age successfully, be sure to incorporate as much activity into your day, whether it be walking or gardening or cooking/cleaning or simply standing at your desk or sitting on a stability ball to watch TV. Anything you can do to break up sedentary time will help, so get moving and keep up with your HALF!


Ever see an overweight environmentalist?

When I was in grad school, I made my way over to the environmental studies building a couple of times so that I could recruit potential participants. Each time I was there, I noticed something strange. Everyone there was in the “normal” category for body mass index. Moreover, all the participants I screened from that program were ineligible because they were already physically active. It made me wonder, is there something about being an environmentalist, or an environmentally friendly person, that makes one healthier?

As far as I can tell, the answer is YES. I should mention that this article is completely opinion based (and somewhat observational). I’m sure there are overweight enviro-friendly people; I’ve just never met one! So what is it about being green that makes one healthy? My guess is two things; active transportation and local fresh food.

Active transportation means that instead of sitting in a pollution spewing car, enviro-friendly people opt to walk or cycle to work or school. If the distance is too great, they are more likely to take public transit, which also requires a bit of walking (to and from the bus-stop). There are several studies to indicate that those who engage in active transportation are more likely to be in the normal body mass index category. There is also emerging evidence that these individuals are overall healthier.

Eating locally grown food is known to reduce one’s carbon footprint, but it may also mean committing to eating fewer processed foods. Eating produce, breads and meat from local farms means more home cooking and consumption of fewer foods with added sugar and preservatives. Thus by eating local foods, one might be committing to a healthier diet as well as a greener planet.

Surely there are other behaviours that contribute to this “phenomenon”. But as a health and exercise scientist, these two are the most obvious ones to me. What is also obvious from writing this article is that a commitment to a green lifestyle might also be an important step in committing to a HALF!


Is your diabetes related to air pollution?

We’ve all heard that air pollution is bad for our health. But most people, myself included, assume that we are talking about respiratory health i.e. asthma or emphysema. The truth is, air pollution can be detrimental to cardiovascular and metabolic health too. In fact, a growing amount of research is finding that there may be an association between air pollution and type 2 diabetes.

Type 2 diabetes is on the rise in western countries and is slowly becoming one of the greatest health concerns worldwide. It is primarily a result of poor lifestyle and is considered a preventable disease. However, there are some risk factors (such as genetics and age) that are not in our control. A recent study published in Diabetes Care (Andersen et al. 2012) and conducted by a group of scientists in Denmark found that air pollution may be another one of those factors. The authors used data from the Danish Diet, Cancer and Health database and from national health registries to determine whether traffic-related air pollution levels and the risk for diabetes in the elderly are related. They found a weak and positive association between diabetes and air pollution. This means that higher levels of air pollution were associated with a higher risk of diabetes, particularly among those who were non-smokers or who were physically active. While the association in this study was weak, there is other evidence to suggest that this association indeed exists. For example, a recent study found that traffic-related air pollution is associated with death from diabetes (Raaschou-Nielsen O et al. Diabetologia 2012), while others have found that those with diabetes have worse outcomes when exposed to higher levels of air pollution (O’Neill et al. Circulation 2005).

It seems then that air pollution may be another risk factor for type 2 diabetes. The question is, is it a risk factor we can control or a risk factor that is out of our control?  Well, I would like to think it is one we can control, not just at the individual level, but one that our governments can do a great deal about as well. If air pollution is leading to an increase in the prevalence of chronic conditions, then it is a public health issue. The government should opt for clean and green energy solutions and make green choices more affordable for the general population. This could lead to significant savings in health care expenditure as well as a significant improvement in our quality of life.

TAKE HOME MESSAGE: Type 2 diabetes is preventable and in some cases, reversible; particularly if you have a HALF. However, there are some factors that may be out of our our control and require action from our government. If you live in an area with high levels of air pollution, write to your local officials and let them know that your health is on the line! While we can all do our part at being green, we need significant changes in air pollution levels to ensure we can all maintain our HALF!


What determines whether a person becomes an exerciser?

You often hear people say they don’t have time or they don’t have access to the appropriate facilities to start an exercise program. Yet, there are many people who are regularly active despite such barriers. So, what allows one person to overcome such barriers while another cannot? The answer is simple yet quite complex. The fact of the matter is, research has identified hundreds of factors that influence regular physical activity.

So the real question then becomes, which of these identified factors truly matters? Which ones are important when trying to make a lifestyle change and trying to engage in regular physical activity? A recent review entitled “Correlates of physical activity: why are some people physically active and others not?” published in the highly reputable journal The Lancet (link) set out to answer these questions. The authors undertook a massive task and reviewed hundreds of articles to determine which correlates/determinants of physical activity show the strongest association with physical activity among children/adolescents and adults. They identified 5 main areas of determinants: demographical, psychological/cognitive, behavioural, social and environmental. Among children/adolescents biological sex (male), ethnic origin (white), self-efficacy (confidence to exercise), family support, perceived behavioural control (whether one thinks they can be active) and environmental  variables such as walkability, traffic speed, access to recreation facilities were all strong determinants of physical activity. For adults health status (i.e. whether one has a chronic disease/limitation or not) and self-efficacy were the strongest determinants of physical activity. Others included personal history of physical activity, intention to exercise and environmental factors such as transportation environment (safety of crossing, side-walks etc), neighbourhood aesthetics (eg. greenery) and access to recreational facilities. The authors also looked at determinants specifically among low-middle income countries and noted that demographic variables such as biological sex, age and socioeconomic status were the strongest determinants. Further, cultural differences in the value of physical activity and social support were noted as being important. Finally, the authors pointed out that genetics MAY play a role in determining whether one is active or not because of the enjoyment or pleasure that physical activity brings for some versus the pain and exertion it brings to others.

It seems then that those who are regular exercisers have the right combination of factors in place. But, the real question is, what can we do for those who do not? Or what can those who do not have the right combination of factors do for themselves? First, as the authors suggest, this data can inform new policies that help overcome barriers. For example, governments can invest in creation of cycling lanes or work to improve neighbourhood sidewalks. Second, individuals who have many barriers but are interested in becoming active can seek out social support to assist them with overcoming the barriers. For example, they can find groups in their geographical area that are interested in similar activities through social media outlets or local facilities. Finally, it is important to find the right type of physical activity/exercise i.e. the type that brings you pleasure. Enjoyment is a great predictor of whether one maintains an active lifestyle, so be sure to search for the right activity/activities, and you’ll be sure to stick with your new HALF!

TAKE HOME MESSAGE: This article was meant to inform people in the field of health promotion and policy development on what can be done to increase physical activity levels among the global population. But we can all learn a little from it. If you work with or have children/adolescents, it seems working on self-efficacy and providing family support will help greatly with their HALF. If you are an adult who hasn’t quite made the habit, or know of someone who needs to create their HALF, then motivate them to become active regardless of their health status and help them boost their self-confidence. Some of the strongest determinants of a HALF are belief in ones’ ability that they can do it. So get out there and tell everyone you know that they can do it, there is no barrier that can’t be overcome when you truly believe in a HALF!


Can you be healthy if you are obese?

It seems like a paradox. The notion that obese people can be healthy is completely contrary to any public health message we have ever seen, yet, there is increasing evidence that SOME obese individuals may be just as healthy as their normal weight peers.  The question that arises then is: what is it about being obese that makes a person “unhealthy”?

The simple answer to this question is that obesity is associated with a higher risk of cardiovascular disease, type II diabetes, cancer and early death. This is primarily because people who are obese generally have a poor diet and low physical activity levels; they might also consume more alcohol. In other words, the lifestyle that is leading to their obesity is also leading to higher cholesterol, blood pressure, blood glucose levels etc. These of course are primary risk factors for the above mentioned diseases.

Recent research indicates however, that just because someone is obese it does not necessarily mean that they have these risk factors. In a study published in the Canadian peer-reviewed journal, Applied Physiology, Nutrition and Metabolism, Dr. Kuk and her colleagues used a large database (Aerobics Centre Longitudinal Study) to establish just this. They used the Edmonton Obesity Staging System (EOSS), a risk-stratification system that classifies obese individuals using health indicators on a scale of 0-4 with 0 being low risk and 4 being high risk. Using over 20 such indicators, Kuk and colleagues found that only obese individuals in stage 2 or 3 (they were unable to assess stage 4 because of limitations in the dataset) were at an increased risk of death, cardiovascular disease and a variety of other conditions. In other words, there were some obese people (those in stage 1) who were not at a higher risk when compared to normal weighted people. Interestingly, this was not the case for cancer. Regardless of which stage the obese individual was in, they had a higher risk of cancer when compared to their normal weighted peers. In addition, they found that even when they took into account the diet and fitness levels of their obese participants, the risk remained high for people in stage 3.

So, how is this possible? How are SOME obese people able to maintain normal or near optimal health levels?  The present study does indicate that the obese individuals in stage 1 were more fit than the others. It is also entirely possible that the healthy obese individuals were consuming more fruits and vegetables, were getting 8 hours of sleep, drinking their 8 glasses of water and coping better with life stress. It is possible that these individuals had “healthier” lifestyles than their obese peers and therefore successfully reduced their risk for many chronic conditions.

TAKE HOME MESSAGE: If you are obese make sure you understand what your risk is before setting off on a stressful weight loss program. It is important to realize that weight loss does not necessarily mean improved health. Stop focusing on the scale and re-focus on your overall lifestyle. This will reduce your risk for several chronic diseases and in time (perhaps more time than you hoped) you will lose weight!

And remember, you have control of your HALF!