OBESITY PANACEA

The above video shows a short clip from the Rachel Ray show (If you received this post via email, please click the title to see the video). In it, Rachel's guest describes the magical Acai berry, which she claims is both the "supergenius smart food of all smart foods" AND "The healthiest drink you can get". Why is it such an amazing health food? It has a lot of antioxidants in it. That's it.

She goes on to claim that one small glass of Acai berry juice is the equivalent to 3 servings of fruits and vegetables. Is it because the juice has the equivalent nutrients and minerals as 3 servings of fruits and veggies? Nope. Is it because one glass has the equivalent fiber of three servings of fruits and veggies? Definitely not! It is because acai berry juice has more antioxidants than three servings of fruits and veggies. That's it!

Antioxidants are a good thing, but as I have argued before, these Superfoods distract people from the issues that actually are important - like moving to a diet that is higher in plant-based foods and increasing physical activity levels. It makes me sad when people buy into these types of products, and while I have enjoyed making several of Rachel Ray's 30-minute meals, I wish she would stop hosting products that are at best of little use, and at worst make it harder for people to live healthier lifestyles.

Travis

UPDATE: Acai Berry Scam Exposed: We Called It!

Related posts:

1. Accelis: The Panacea for Obesity?
2. Human Chorionic Gonadotropin for Fat Loss: "Fallacy and Hazard"
3. Metabolic Syndrome Fighter "May" Cure All Diseases*


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So suggests a new study by Babraj et al. published yesterday in the online journal BioMed Central Endocrine Disorders.

Specifically, the authors found that 2 weeks of very short-duration but high intensity aerobic exercise improved glucose tolerance by 12% - an effect that persisted for a few days after the last exercise session.

Photo by: jcheng

The study had 16 young (age: 21 years) and lean (BMI: 23.7 kg/m2) males perform two weeks of high-intensity training on a cycle ergometer. Over the two weeks they performed a total of 15 minutes of actual exercise, with 3 sessions per week, each consisting of 4-6 30-second sprints on the ergometer.

Post training, both the glucose and insulin area under the curve during an oral glucose-tolerance test improved, by 12 and 37%, respectively.

What makes this finding even more interesting is the notion that these metabolic improvements were achieved after an expenditure of only 250 kcal/week.

The authors suggest that the increased glucose tolerance can at least be partly explained by an increase in the levels of the glucose transporter, GLUT-4, in skeletal muscle, as a prior study of similar training brought about a 20% increase in GLUT-4 levels.

While the title of today’s post may be provocative, there are a few caveats to the practical implications of this study.

For one, 250kcal energy expenditure per week is unlikely to lead to any significant change in body composition (loss in fat and/or increase in muscle) – the mechanisms by which many health benefits of exercise are at least partially mediated. The implication for weight-loss is even more laughable.

Additionally, for most sedentary individuals, going from couch to high-intensity short-duration training may be a recipe for disaster. I’m sure we are all aware of the significant spike in heart attacks that often occur after the 1st big snowfall of the year. Every year I see the same story on the news: sedentary man goes to shovel his driveway – this becomes the most intense activity he has done since last winter, and he ends up at the hospital. Thus, while this type of training may be well tolerated by lean 20-year olds, I doubt it will be very applicable to the majority of the general population.

Knowing how much people like quick fixes for all ailments, I almost fear advertising the results of this study. Nevertheless, while the general applicability of this study is poor, the results are certainly interesting.

Peter
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I came across a very thought provoking article by Dr David Ashton in the Guardian online yesterday. In it, he describes how obesity surgery candidates are often required to have a psychological exam in order to be cleared for surgery - something which is not required for most other types of surgery. He denounces this as a form of prejudice against obese individuals, resulting from the popular misconception that obesity is caused by an underlying psychological illness, rather than a complex interaction of biology and environment.

Neither Peter nor I have any experience with obesity surgery ourselves, which may be one reason why I was so surprised when I came across this article. Although I was aware that obesity surgery candidates are subjected to psychological screening, I was under the impression that it was to ensure that candidates were ready for the consequences of the surgery itself, as well as the adaptation to life post-surgery. In essence, I thought that these psychological exams were meant to screen-out patients if they were unlikely to benefit from the surgery in the long-term. Some people may argue that is weight bias (or even paternalistic) but it seems to make sense. Why subject someone to the physical, emotional and financial costs of surgery if they are unlikely to benefit from it?

I know that several of our readers work in the field of obesity surgery, and we would really appreciate your input on this topic - what do you think of Dr Ashton's arguments? Do psychological exams for obesity surgery candidates makes sense, and if so, should similar psychological exams be given to candidates for other surgeries? Whether you work in this area or not, let us know what you think.

For more on Dr Ashton's work, visit his website here.

And finally, I would like to wish a very happy birthday to one of our most committed readers, "Aunt" Irene.

Travis
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I am confident that most people (and especially parents) would agree that childhood nutrition is important. After all, children who develop obesity are likely to maintain that obesity into adulthood, and we are seeing a disturbing increase in the prevalence of "adult" diseases like atherosclerosis and type 2 diabetes in children and adolescents. However, a recent study from my alma mater (the University of Calgary) suggests that a poor diet in early childhood can have long-lasting effects even in those who do not develop obesity at a young age.

In this recent study which is available ahead of print on the Journal of Physiology website, Maurer and colleagues fed rat pups a diet that was either high in protein, high in fiber, or a control diet. Once the rats had reached adulthood, they were switched to a diet that was high in fat and sugar (not unlike the typical North American diet) for a period of 28 days. Surprisingly, in response to this high calorie diet, the rats that had grown up consuming a diet that was high in fiber gained less weight and body fat than those who grew up consuming a diet high in protein. Further, rats that grew up on the high fiber diet also had significantly better glucose tolerance, suggesting that their metabolic risk was also lower than those who grew up on a diet high in protein.

How could early childhood diet influence an individual's response to a high calorie diet in adulthood? Maurer and colleagues report that the high fiber diet in childhood influenced the levels of glucagon-like-peptide 1 and leptin, two hormones which are known to affect satiety (the feeling of fullness) as well as insulin sensitivity and energy balance. The authors speculate that diet in early childhood may affect gene expression and hormone levels in ways that influence the body's response to caloric surplus well into adulthood.

So, what's the take-home message? Obviously if you are reading this blog post, it is too late to change your own early childhood nutrition. However, this study provides yet another reason to promote healthy lifestyles (including diet and physical activity) to people of all ages, in the hopes that they will pass them along to their children and grandchildren, and reduce their susceptibility to obesity and metabolic risk later in life.

For a full interview with Dr Raylene Reimer, the senior author of today's paper, please click here.

Travis
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In line with all the talk about childhood obesity and possible interventions we've had this week on Obesity Panacea, here is another potential intervention for childhood obesity courtesy of Saturday Night Live: Happy Fun Ball!

But be careful: Happy Fun Ball may stick to certain types of skin!

Enjoy and have a great weekend.




Peter
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Before we get any emails, the answer is an emphatic no. A few weeks ago our colleague Sam Hetz sent me a link to the George Foreman Lean Mean Fryer, which is pictured below. The Lean Mean Fryer is a deep-fryer which has a patented spinner which uses centripetal force to remove some of the fat introduced while cooking. Think of it like the machine that spins the water out of your swimsuit.

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During the summer I read the book In Defense of Food, and absolutely loved it. In Defense of Food lays out a very clear argument for why we should "Eat food. Not too much. Mostly plants."A full review of the book can be found on Dr Arya Sharma's blog here. In Defense of Food appealed to me not only because it was so well written, but also because of the shift in my own own eating patterns over the past few years to a diet higher in fresh veggies and unrefined grains, and lower in meat and refined grains and sugars (mostly due to the positive influence of my girlfriend, rather than any conscious action on my part).

Given my experience with In Defense of Food, you can understand my excitement when a new book on the same topic came out this month. Titled Food Matters, this new book by Mark Bittman describes his personal journey to a diet very high in plants, and relatively low in meat and animal products. While In Defense of Food really laid out the argument for eating more whole foods, this book is more of a how-to manual, describing what has worked for the author, and what he thinks may work for others. Although his personal health story is impressive, the best part of the book for me was the appendix with over 75 recipes covering everything from how to cook beans to complex dishes that can feed several people. Although the only recipe we have followed so far is how long to cook a pot of lentils (they turned out perfectly!) the recipes sound delicious, and I am looking forward to trying them in the coming weeks. My only concern is that some of the meals seem very low in protein, and I worry that I would not stay full as long as I would like, which is often a problem for me if I am not careful when eating plant-based dishes.

Although I enjoyed the recipes, in comparison to In Defense of Food I found this book a bit of a disappointment. The arguments at times seemed rushed and haphazard. Further, it seemed like some of the main points were just rehashing In Defense of Food, but with less detail. Now I will say that my personal preference is for a book that lays out the evidence and makes very clear, sober arguments. On the other hand, if what you are looking for is an author filled with passion and emotion (not to say that those are lacking in In Defense of Food) then you will probably enjoy Food Matters more than I did. And if you are looking for a quick primer on the main arguments for switching to a diet high(er) in plants (but not necessarily devoid of meat or animal products), as well as some good recipe ideas to get you started, this book is for you. If you are looking for a more detailed discussion however, then In Defense of Food is the way to go.

-Travis
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This weekend I read a study just published in the January 2009 edition of the American Journal of Public Health, regarding the effects of a community based intervention program in Brazil aiming to increase the physical activity levels of the population. The Academia de Cidade program (ACP), which was started by the local government in Recife, Brazil offers free exercise classes in 21 public spaces throughout the city such as parks, beaches and recreation centers for all the local residents each day from 5 - 9 a.m. and from 5 - 9 p.m. The recently published study, which evaluated the program, found that such programs provide an “effective public health strategy to increase population-level physical activity in urban developing settings.”

This study also reminded me to discuss something interesting I saw in Israel on a past trip. While touring the city of Eliat, at the southernmost tip of Israel, on the red sea, I came across what can only be described as Muscle Beach for kids. For those who missed that prior reference – Muscle Beach is an outdoor weight-lifting facility in Venice Beach, California, where Arnold Schwarzenegger trained back in his steroid-fuelled prime. As I found out first-hand on a trip to California, at Gold’s Gym, you can hoist dumbbells, get a great tan (with a little bit of heat stroke), and even get your picture taken by the passing tourist (who obviously can’t recognize a fellow tourist).

So you can imagine my excitement when I saw what can only be described as Muscle Beach for kids on the main waterfront boardwalk in Eliat. As you can see in the following pictures, this gym houses basically every major piece of exercise equipment, but in miniature. All of the machines use your body weight as resistance, so no need for dumbbells or weights – a likely hazard for kids. Having individually tried every one of the machines (with pictures to prove it), I have to admit they provided a fairly significant resistance.


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First off, I'd like to wish my friend, colleague and fellow Obesity Panacea contributor, Mr. Travis Saunders a happy 25th birthday!

Also, I have finally been able to find a video (that is viewable in Canada as well as the US) that we have wanted to post on our blog for a long time. It is a video from the show Saturday Night Live, which nicely addresses all things ridiculous with exercise videos - especially those circa 1980's. [If you subscribe via email to Obesity Panacea, you will have to go to the actual site to view the video].

Enjoy the chuckle and have a great weekend.

PJ


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Are diet soft drinks bad for you? I received this question from Perry Romanowski after it came up on his blog, Just Your Average Joggler (which I highly recommend) and I thought it would make an excellent topic for today. More specifically, I would like to discuss the relationship between diet soft drinks and obesity.

At first, I did not expect there to be any relationship between diet soft-drinks and obesity - if they contain no calories, they can't possibly contribute to a positive energy balance, right? (e.g. energy in > energy out). Early studies of calorie-free sweeteners like aspartame seem to support that position. For example, a review article from 1991 suggests that "aspartame-sweetened foods or drinks is [sic] associated with either no change or a reduction
in food intake". However, more recent studies suggest that the issue is not quite so simple.

An article published last summer by Sharon Fowler in the journal Obesity suggests that individuals who consume diet soft drinks are at dramatically increased risk of overweight and obesity than those who do not consume diet soft drinks. For example, over an 8-year period, individuals who consumed just 3 diet soft drinks a week were 40% more likely to be overweight or obese than those who consumed none. The risk of overweight and obesity continued to increase dramatically with increased diet soft drink intake, and was independent of other factors like exercise, smoking, and socioeconomic status.

The Fowler study doesn't prove that diet soft drinks cause obesity (people who drink more diet soft drinks may also have other behaviors that put them at increased risk for weight gain), but they are still pretty surprising. While diet soft drinks may themselves be free of calories, recent evidence suggests that they may increase caloric intake at future meals. For example, when rats are given access to unlimited amounts of food, those who are used to consuming calorie-free drinks eat dramatically more than those who are used to consuming drinks flavoured with sucrose. It may be that calorie-free drinks impair the body's ability to anticipate the caloric content of a given meal, eventually resulting in increased caloric intake and weight gain. Others have suggested that calorie-free sweeteners like aspartame may also increase appetite at future meals.

So, while it is not yet completely clear if diet soft drinks cause obesity, there are some good reasons to limit their intake. Plain water is always a great choice, and if you find that too boring, consider adding a few slices of lemon or cucumber to add some fresh flavour (an idea I had never heard of until I came across it on the Thought for Food blog). And as always, a little physical activity is always a good decision :)

Thanks again to Perry Romanowski for the interesting question.

TJS
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If you live in southeastern Ontario, like Travis and I do, you awoke today to piles of snow everywhere and a bone-chilling – 24 degrees Celsius (without the wind chill). On such days it is a struggle to get yourself out the front door, let alone to head to the gym. In addition to poor weather, sometimes the gym may be closed, or as I have recently noted – the gym may be packed on account of all the New Year’s resolutions – all reasons which may deter you from getting a work-out. Indeed, it is well established that the more hurdles (weather, schedule, etc.) you have to overcome, the less likely you are to perform the hopeful behavior (being active). It is important, however, to recognize that the gym is only one way to obtain your physical activity for the day.

Much like Travis discussed yesterday with diet and caloric intake – every little bit helps, and the same is true of physical activity. Not only can you accumulate your minutes of exercise in small bouts throughout the day, but the activities you perform need not be the regular treadmill, stationary bike, or elliptical at your local fitness facility. For example, cleaning up your home can burn quite a few calories and has the added bonus of producing a tangible result (i.e. clean house). Vacuuming, in particular, when performed with a certain intensity can really work up a sweat. Also, on a day like today, shoveling the snow on your driveway (depending on the size) could be the most exhausting exercise of the week, and you didn’t have to step foot in a gym. It is important to always seek out opportunities to be active throughout your day, with a wide variety of activities – helping to reduce monotony of daily treadmill running, and reducing the absolute reliance on a gym for maintaining your activity level.

As a personal anecdote, I will briefly go over my random workout on Sunday. I had planned on heading to the gym all day long, but was occupied with other things, and by the time I finally decided to go, it was dark, snowing, and generally unpleasant. So instead I devised my own workout for that day. The first part of my routine consisted of running up and down the stairs of my 7 floor apartment building – much to the annoyance of my neighbours, I’m sure. To make it more interesting, here was my routine: start on the bottom level and run up to the 7th floor, then cross the 7th floor to enter the opposite stairwell, then run back down to ground level. Next, I ran up only to the 6th floor, crossed to the opposite stairwell, and run down – and so on and so forth with descending levels. I did two sets of this routine – the second time I took 2 stairs with each step to up the intensity a bit (total time to completion: ~22 min). Following this, I really spiced things up by playing some boxing on my Nintendo Wii (total time: ~22 min) – a fairly intense workout for anyone, especially if you are competing at the PRO level, like me (Yes, I am a huge nerd). Further proof of the concept in the previous parentheses, I also wore a heart rate monitor throughout the workout (for scientific purposes) – for the total duration of approximately 44 minutes, my average heart rate was about 135 – just about 70% or my age-predicted maximal heart rate – not bad! And, I never left the building…

Feel free to post comments about some random workouts you have had in the past – I am very interested to hear your stories.

PJ
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Over the holidays I had a very interesting talk with an uncle of mine who has recently cut sweets out of his diet. He told me that a little over a year ago he had seen his physician and while all of his blood work was good, it wasn't perfect. He is very physically active, but has always enjoyed sweets (not just as a dessert, but also as a snack), and decided that maybe this was a good time to cut them out of his diet. And with few exceptions (a slice of cake at a special occasion, etc) he has managed to largely cut sugary sweets out of his diet for well over 1 year.

While the fact that he made a positive health decision may be admirable in and of itself, I was more impressed by the physical changes that have resulted from this relatively minor change in his diet. His waist circumference has dropped several inches, and just as importantly, his blood sugar and lipid profile have improved substantially, to the point where his physician said that it literally could not be any better for a man his age. It was fun to see how excited he was about the changes, and that he has no plans to revert to his old diet anytime soon.

While anecdotal, I think there is a very important lesson that we can take from my uncle's experience: He made a reasonable lifestyle change that he knew he could maintain over the long term. He likes sweets, but he knew that for him personally, reducing the number of sugary snacks was a change he could live with for years to come. And he still has a piece of cake from time to time, but he realizes that that's ok too. This is in contrast to many other people that I know that attempt to make changes that do not suit their lifestyle, or their preferences. Or the people that make a lifestyle change that is so strict that they can only hope to follow it for a few months. For a change to make a real difference, it has to be something you can maintain as a part of your lifestyle for years, and hopefully for the rest of your life.

So instead of looking at quick fixes, or "miracle" foods like the acai berry, why not think about the small, attainable changes that can make a real difference to your health. It could be walking to work, skating on your lunch hour (a very real possibility in many northern cities like Kingston which is literally peppered with public outdoor rinks), or cutting down on your consumption of sugary drinks or red meat (changes that I have personally made over the past few years). But if it's something that you can maintain for the years to come, it is likely to have a very positive impact on your health.
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When many people set out to exercise, they do so with the primary goal of losing fat mass. There is much advice floating around about how to optimize or maximize fat loss during exercise; one of the most commonly touted is that of the fat burning zone. Essentially, it is suggested that when performing aerobic exercise (walking, jogging, swimming, etc.) one should work at a fairly low intensity – the fat burning zone – to augment fat oxidation and thus fat loss (pictured above). The fat burning zone target exercise intensity varies from source to source but is approximately 50-60% of your maximal heart rate (maximal heart rate calculated simply as 220 – your age [with plenty room for error]).

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Travis Saunders is a PhD student in Exercise Physiology in Ottawa, Canada. Travis completed his BSc (Hon) in Kinesiology at the University of Calgary, where he was awarded the Gold Medal for the highest academic proficiency in his class. He recently completed his Master’s degre in Health Physiology at Queen’s University, which focused on the relationship between body composition, metabolic health, and inflammatory hormones in elderly men and women. His PhD research is supported by Doctoral Research Awards from the Canadian Institutes of Health Research and the Canadian Diabetes Association, and is focused on developing exercise interventions for obese youth. Travis is a Certified Exercise Physiologist, and a member of The Obesity Society, the Canadian Obesity Network, and the Canadian Society for Exercise Physiology.  He is also a Content Editor at ResearchBlogging.org. In his spare time Travis is a competitive distance runner. He has medaled in both the Calgary and Manitoba International Marathons, and completed his first Boston Marathon in 2009.


Publications

Changes in Weight but not Physical Activity or Cardiorespiratory Fitness Are Associated with Change in C-Reactive Protein: Results From the INFLAME Study. Church, T., Conrad, E., Priest, E., Rodarte, R., Saunders, T.J., Ross, R. and Blair, S.N. Medicine and Science in Sports and Exercise. Epub ahead of print. DOI: 10.1249/MSS.0b013e3181c03a43

Breast Volume is an Independent Predictor of Visceral and Ectopic Fat in Premenopausal Women. Janiszewski, P.M., Saunders, T.J. and R. Ross. Obesity. 2009 Oct 22. Epub ahead of print. DOI: 10.1038/oby.2009.336

Age-related changes in total and regional fat distribution.  Kuk, J.L., Saunders, T.J., Davidson, L.E., and R Ross.  Ageing Research Reviews. 2009; 8 (4): 339-348.  DOI:10.1016/j.arr.2009.06.001

Associations of the Limb Fat to Trunk Fat Ratio With Markers of Cardiometabolic Risk in Elderly Men and Women. Saunders, T.J., L. E. Davidson, Peter M. Janiszewski, J-P. Despres, R. Hudson, and R. Ross. Journal of Gerontology: Medical Sciences. 2009; 64A (10): 1066-1070. DOI:10.1093/gerona/glp079

Lifestyle treatment of the metabolic syndrome. Peter M. Janiszewski, T. J. Saunders, R. Ross. American Journal of Lifestyle Medicine. 2008; 2: 99-108
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Ok, I know the holidays are done and gone, but today's topic was too good to pass up. Several of our colleagues attend a fitness chain which had a poster of a chubby gingerbread man on the wall throughout the holidays. Under the gingerbread man was a caption that read "The average person gains 8-10 lbs over the holidays". 8 to 10 pounds?? This poster immediately raises a few questions:

1. Where does this information come from? Who is the "average" person they are speaking of? Aged 18-80? Does it include kids? Seniors? Different ethnicities?

2. If the average person gains 8-10 pounds, that means that some people are gaining much more. Is that even physically possible over a 1 or 2 week period (the definition of 'holiday season' varies pretty widely from person to person)? Canada has a population of roughly 33 million - if we gained an average of 9 lbs over the holidays, as a nation we put on 297 million lbs this year alone!

This 8-10 lb weight gain statistic seems a bit strange, so I decided to look it up on google scholar. Fortunately, I came across an excellent article from the New England Journal of Medicine which examines this very issue. Back in 2000, Yanovsky and colleagues examined the amount of weight gain during the American holiday season (from American Thanksgiving until New Year's). Then, as now, this claim of 8-10 lbs holiday weight gain was quite common - Yanovsky reports that organizations ranging from CNN to the Texas Medical Association used the information in press releases during the holiday season of that year. In addition, self-report studies tell us that people believe that they gain 5 lbs or more over the holidays, but that does not necessarily mean that they do.

Fortunately, Yanovsky and colleagues objectively measured the body weight of 195 men and women over the course of the year. They report that the average weight gain from mid-November to mid-January was less than 1 lb! Less than 10% of the participants gained 5lbs or more. The weight gain during the holiday season was, however, significantly greater than that during the pre- or post-holiday period, and the holiday weight-gain was not lost over the course of the year.

So, what does this study tell us? First of all, it tells us that the statement on the gingerbread poster is completely bunk. While it might be appealing to rip on the gym chain for using such false information, the same information has been peddled by medical associations, so it's hard to say they are completely to blame. Still, the article by Yanovsky and colleages was published 8 years ago (and was the first study to pop up on google scholar), so it wouldn't have been too tough to realize that they were spreading false information.

And on a somewhat more serious note, it also tells us that on average, people do gain a small, but significant amount of weight over the holidays which is maintained throughout the course of the year. Not enough to warrant fear mongering, but enough to cause some concern - a pound or two a year can add up over time. And some people do experience significant weight gain, a phenomonen which was sigificantly more common in overweight and obese individuals. It is an issue which is worth following, but one that I hope people aren't losing sleep over.

So remember, as the holidays approach next year, don't let the gingerbread men (whether on your plate or a poster) get you down.

Big thanks to our friend Wendy for letting us know about the poster and for her helpful comments.

TJS
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From Ross and Janiszewski, 2008. Benefits of increasing physical activity levels in obese individuals: 3 possible scenarios. Note the benefits in scenarios 2 and 3 where BMI or weight does not change. BMI – body mass index, WC – waist circumference, CRF – cardiorespiratory fitness.

In all, these observations bring to question whether weight loss is the optimal outcome for determining the efficacy of treatment strategies designed to reduce obesity related co-morbidities. We suggest that overweight/obese individuals and clinicians alike look beyond weight loss as the only indicator of treatment success when targeting obesity-related health risk. Remember that increasing physical activity levels will lead to substantial health benefits – even if the scale doesn’t budge.

PJ

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Regular readers of the blog will know that I am quite a fan of ParticiPACTION. As part of their new campaign, they have introduced a "stories" section on their website which I think will be of interest to many of our readers. Individuals are encouraged to visit the website, and describe their favourite personal physical activity story. The idea is that people will be able to visit the site and get ideas and inspiration from the way that others have incorporated physical activity into their lives. Some of the stories are pretty inspirational, and the best ones will be used in future ParticiPACTION commercials.

There are already about 700 stories online so far (in French and English), and the numbers are growing rapidly. In addition, all stories are searchable by category, which is very handy when you want to find stories that are relevant to you. I've even put one up myself, although it is far less inspirational than most others that I've seen! I've put a thumbnail of my story below (for some reason I can't embed it), and clicking the thumbnail will take you to the actual story on the ParticiPACTION site. Although ParticiPACTION definitely has a Canadian focus, I encourage our readers from outside of Canada to check it out as well. And please consider sharing your physical activity story, through the site or otherwise, with others.



TJS
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Taken from Paffenbarger et al. 2001

Hopefully this little historical note, along with some of our prior fitness tips (i.e. benefits of a single exercise session, taking the stairs) will aid in motivating some towards realizing their goal to get a bit more active in the new year.

PJ

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