However, exercise should not only be considered as a method to lose weight but also as an essential tool in remaining healthy through treating and preventing illness and diseases. This May’s Exercise is Medicine™ Month, is a time for everyone to recognize, emphasize and celebrate the valuable health benefits of exercise and to May-Kit Happen.

Exercise is Medicine is a program launched in 2007 by the American College of Sports Medicine (ACSM) and the American Medical Association (AMA) and is designed to encourage American’s patients to incorporate physical activity and exercise into their daily routine. Whilst this program is being promoted primarily in the US it is a program which is applicable globally. According to the World Health Organization, one of the major challenges in the prevention of non-communicable diseases and in the promotion of physical activity and other healthy lifestyle choices is communicating the importance of action now in return for future benefits.

Exercise should not just be advised to the overweight but promoted to everyone for overall, life-long health. The U.S Physical Activity Guidelines suggest participating in at least 150 minutes of moderate-intensity physical activity per week, whilst the Australian guidelines are to put together at least 30 minutes of moderate intensity physical activity on most, preferably all, days. The UK current physical activity guideline for children is to achieve 60 minutes or more activity on 7 days a week. But with modern transport, technology and labour saving devices how many of us actually achieve these guidelines?

Aside from weight loss, exercise also provides the added benefits of:

• better circulation, preventing heart disease, stroke and high blood pressure;
• increases strength by helping to build and maintain bones, muscles and joints to reduce the risk of injury or osteoporosis;
• improves agility and flexibility;
• reduces the risk of diabetes and certain cancers;
• promotes psychological well being and can reduce the risk of alzheimer’s disease.

Don’t forget to check with your doctor first that you are healthy enough to start exercising, they may also be able to provide you with a suitable exercise plan or classes in your area. Exercise is Medicine aims not only to promote exercise to the public but also to encourage doctors to prescribe it to their patients. Network members, including Strenua’s World, have committed to supporting the guiding principles of Exercise is Medicine:

• Exercise and physical activity are important to health and the prevention and treatment of many chronic diseases.
• More should be done to address physical activity and exercise in health care settings.
• Encourage ACSM’s efforts to bring a greater focus on physical activity and exercise in health care settings.

If you are interested in learning how you can become more active in your life then sign up for the one-month Exercise is Medicine™ email series for the public. You will receive helpful tips on how to create a life-long exercise plan and stick to it, regardless of your age or current fitness level, easy-to-use resources and plenty of motivation to keep you moving.

Robert E. Sallis, MD, the chair of Exercise is Medicine, says ‘We all know exercise is not a magic bullet. It doesn’t guarantee you won’t get cancer or have high blood pressure. But research clearly shows exercise helps treat and prevent many chronic diseases including diabetes, heart disease, cancer and hypertension. Of all the measures that can be taken to prevent illness and disease, exercise is, by far, the most worthwhile. Whether you’re sick or healthy, young or old, fit or not, exercise makes you feel better almost immediately!  The trick is to sustain a fitness regime. Help is out there. Support is available. Whatever it takes, just get moving!’

There are scientific trials that have shown low carb-high protein diets provides more weight loss than high carb-low fat diets, but equally there are a number of studies that don’t show that effect. One study has shown that a low fat diet is better than a moderate fat diet, whilst others have shown that a moderate fat, Mediterranean style diet is superior to a low fat diet.

Whatever the diet, there is short term research out there to both support and disprove it. Now research published in the New England Journal of Medicine has examined the advantages of high fat, protein or carbohydrate diets over 2 years. Unlike other diet studies this one had a large number of participants (811), involved a high number of men (40%), and had good adherence to the diet by the participants (80% completed the 2 years study compared to normal diet studies where 40% drop out).

The participants were aged 30-70 years old with a BMI of 25-40. They were randomly assigned to one of four diets, with the percentage of energy from each food source being:

• Diet 1: 20% Fat; 15% Protein; 65% Carbohydrate
• Diet 2: 20% Fat; 25% Protein; 55% Carbohydrate
• Diet 3: 40% Fat; 15% Protein; 45% Carbohydrate
• Diet 4: 40% Fat; 25% Protein; 35% Carbohydrate

Each person was given a diet with a deficit of 750 calories a day as calculated from their resting energy expenditure and activity levels. Also 90 minutes of moderate exercise a week was prescribed.

Other goals of the diets were they should have

• 8% or less saturated fat,
• at least 20% fibre,
• 150mg or less of cholesterol per 1000kcal,
• carbohydrate foods with low glycemic index.

Typically weight loss is greatest 6-12months after starting a diet followed by a subsequent steady regain of weight. In this study at 6 months participants in each diet had lost an average of 6kg (7% body weight). The participants in each diet reported a reduction in calories of around 400kcal, although a mean weight loss of 6.5kg at 6 months corresponds to a reduced daily intake of approx 225kcal.

Aerobic exercise is effective in improving our cardiorespiratory fitness whilst  improving the burning of fat and overall energy use. Weight training or resistance work acts as a stimulus to the muscularskeletal system to increase muscle size and strength. It is therefore recommended that a training routine combines both types of exercise as each has its own advantage. Normally aerobic or resistance exercises are performed in a single training session and if are combined aerobic exercise is often completed first as it is seen as a warm up of the muscle prior to resistance training.

A group of researchers from the College of New Jersey however wanted to examine the impact of resistance training prior to aerobic exercise. The study published in European Journal of Applied Physiology involved 11 males and 21 females who ate a moderate (50%) carbohydrate diet. Six static weight machines were chosen for the resistance exercises: Leg press, lat pull down, leg extension, seated row, shoulder press and chest press. For each subject their 8-RM was determined. This being the maximum amount of weight that could be lifted through a full range motion 8 times. Each subject completed each one of the following trials on different days

1. Aerobic exercise only (C) (cycle for 20mins at 50% maximum oxygen uptake (VO₂max))
2. High intensity resistance training (HI)  (3 sets of 8 reps at 90% of 8-RM) followed by aerobic exercise
3. Low  intensity resistance training (LO) (3 sets of 12 reps at 60% of 8-RM) followed by aerobic exercise

Throughout each aerobic activity the researchers looked at oxygen uptake and also the oxidisation of carbohydrate and fat. Oxidisation is when the fuel source ie, fat or carbohydrate, combines with oxygen to provide energy.  They found that fat oxidisation  and oxygen uptake was higher in the HI group than either LO or C in both males and females. Prof Kang, the paper’s author suggests that whilst fat oxidation following LO training was itself higher than aerobic exercise alone it is the intensity of the resistance exercise that is more important than the total volume of exercise completed.

Interestingly after the first five minutes of aerobic exercise they found no difference in carbohydrate oxidation rates. Prof Kang suggests that it appears in training that combines both aerobic and resistance exercises, performing a comparatively higher intensity resistance exercise first would boost the use of fat and energy during any subsequent aerobic activity.

He suggests that the metabolic effect of the resistance work is due to an increase in lipolytic hormones, which may have a short time before they revert back to their resting levels and that the aerobic exercise should ideally start within 5mins of resistance exercise, but after no more than 20mins.

So according to Prof Kang’s research if you really want to burn fat quicker get to the gym half an hour before your aerobics class or run and lift some weights.

I have lost ¼ inch on each bicep and half an inch across my chest, 1/2 inch at my waist and 3/4 inch across my navel. There were no changes around my hips, bum and lower legs although each thigh lost almost 1.5inches.

My knee still gives me some pain and I’m still doing exercise to strengthen the muscles in my legs with the high reps obviously helping to tone my thighs. I’ve started running a few times a week, so far only 3-4 miles and at marathon pace, so not too fast. My physio says that it is important I don’t tire my legs while they are weak as I may develop poor technique running over longer distances leading to more problems later on.

I’m quite satisfied with my results I have achieved with little effort and I haven’t noticed the missing sugar from my coffee, nor do I really need a second chocolate bar in the evening. Over the next few weeks I’m looking to increase my running and other cardiovascular exercise and hope fully lose some inches from my hips. I’ll let you know how I get on.

I chose 9 points to measure on my body which I’ve shown on my photos. Point A is at my biceps and point B across my chest. I’m never sure exactly where to measure for hips and waist so I’m going to measure at the thinnest part of my waist (D), level with my navel (C), across hip bone (E) and widest part of my bum (F). The final points are the widest part of my thighs (G), above my knees (H) and across my calves (J).

I’m also interested in measuring my improvement in fitness not just changes in weight and body inches, so I am also measuring my resting heart rate.

• A Bicep 11 1/4 inches (L) 11 1/4 inches (R)
• B Chest 36 1/2 inches
• C Navel 31 inches
• D Waist 28 3/4 inches
• E Hips 35 1/4 inches
• F Bum 39 inches
• G Thigh 23 3/4 inches (L) 23 3/4 inches (R)
• H Knee 19 inches (L) 19 inches (R)
• J Calf 15 inches (L) 15 1/4 inches (R)
• Weight 9 St 10lb (136lbs)
• Height 5 ft 2
• Body Mass Index (BMI) 24.9
• Resting Heart Rate 63 beats per minute (BPM)

Looking at these measurements I’m a bit concerned that my BMI is so close to being overweight and my waist and bum definitely could lose some inches. But my priority is to concentrate with strengthening my right leg so I can move on to more intensive cardiovascular and endurance training.

Hopefully we’ll see some changes in these numbers next  few weeks.