Is Exercise As Effective For Relieving Depression As Therapy and Medication?

Depression affects over 340 million people across the globe and here in the United States it is estimated that about 16% percent of the population will suffer from a major depressive disorder (MDD) during the course of their lives,  with women being almost twice as likely than their male counterparts to develop a disorder. ^1,2 With all the emphasis with regards to health care on obesity related illnesses it is often overlooked that depression is on track to become the second largest contributor to the global burden of disease by the year 2020.³ We know that physical inactivity increases the likelihood and duration of depression and that physical activity, whether it be work related, exercise or recreation significantly reduces the risk of developing a depressive disorder. This holds true across the board for people of all races and socio-ecomomic levels, but for those adverse to conventional therapeutic interventions, the question remains, can exercise be as effective as conventional therapy and medication in relieving depression?

Studies Find That Exercise Is A Strong Preventative Against Depression

In 2001 the British Medical Journal did a review of the antidepressant effects of exercise treatments. After looking at a total of fourteen randomized controlled trials they found that the positive effects of exercise treatment for depression when compared to no treatment at all was statistically significant. There were major reductions in depression ratings among those engaged in exercise programs as opposed to those who were inactive. There was some debate over the validity of this review as some of the participants in the studies may have had subclinical mood problems rather than fully diagnosed major depressive disorders. That being said the idea that exercise treatment is more effective than no treatment at all is supported by at least two other systematic reviews^{4, 5,6} and most of the systematic reviews find as well that ‘the antidepressant effect size of exercise can be comparable to that of psychotherapy and to that of pharmacotherapy.’ ^{7, 6, 8, 9}

The Anti-Depressant Effects Of Exercise May Be Comparable To Drug & Therapy Interventions

Does this mean that you should focus solely on exercise as a way to relieving depressive symptoms? Not at all, as there is a saying that in a battle one should always go down fighting with all swords drawn from their scabbards and the same applies to clinical depression. Given the effects of exercise on mood elevation, the combined use of therapy and drug interventions might result in faster onset of antidepressant action, so drug and therapy should not be instantly ruled out.10 More trials are needed before exercise can be recommended clinically as a prescription for dealing with depression, but if exercise could act as an immediate salve to the symptoms of depression given that antidepressant medications and therapy all take weeks to months before clinical improvements can be seen whereas the positive effects of exercise occur much faster. Most importantly, the use of exercise protocols are safe and do not interact negatively in any way with other drugs or therapeutic treatments.

Some experts argue that adherence to a standardized exercise program is the number one reason for failure among the general population and that it would be far more difficult for a severely depressed individual to find the motivation to exercise on a regular basis, but given the promising fairly recent results of brief high intensity weight training programs on relieving depressive symptoms¹¹ it might indeed be viable if the duration is considerably short especially as adherence to regularly taking anti-depressant drugs is equally a problem among individuals with depression. At the end of the day what these findings really highlight is that exercise and physical activity have a major role to play in our overall mental health and that more research should be done into its potential use as a clinical anti-depression prescription. In coming articles we will explore the relevance of short high intensity training on depression and how it might make getting the anti-depressive benefits of exercise far more attainable to those that find it hard to stick with an exercise program to being with.

References:

1.         Greden JF. The burden of recurrent depression: causes, consequences and future prospects
2.         Kessler RC, Berglund P, Demier O, et al. The epidemiology of major depressive disorder; results from the National Comorbidity Survey Replication- JAMA 2003
3.         Lopez AD, Murray CC. The global burden of disease, 1990-2020. Nat Med 1988
4.         Craft LL, Landers DM. The effect of exercise on clinical depression and depression resulting from mental illness: a meta analysis. J Sport Exerc Psychol 1998.
5.         Stathopoulou G, Powers MB, Berry AC, et al. Exercise interventions for mental health; a quantitative and qualitative review. Clin Psychol Sci Pract 2006.
6.         North TC, McCullagh P, Tran ZV. Effect of exercise on depression. Exerc Sport Sci Rev 1990.
7.         Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention in the management of depression; systematic review and meta-regression analysis of randomized controlled trials. Br Med J 2001.
8.        Martinsen EW. Physical activity and depression: clinical experience. ACTA Psychiatr Scand Suppl 1994.
9.         Blumenthal JA, Babyak MA, Moore KA, et al. Effects of exercise training on older patients with major depression. Arch Intern Med 1999
10.      Marije R, Collins K, Fitterling H. Physical exercise and depression. Mount Sinai School Of Medicine NY
11.      Singh, N, Stavrinos, TM, Scarbek Y, et al. A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. Journal of Gerontology 2005

Kevin Richardson is the creator of Naturally Intense High Intensity Training 10 Minute Workouts™ and one of the most sought after personal trainers in New York City. Get a copy of his free weight loss ebook here.

Nuts Will Not Make You Gain Weight 

You can’t have your cake and eat it as the expression goes, but you can have nuts and not worry too much about weight gain even thought they are high in calories and fats! One of the most interesting observations that I have made over the years is that people are able to eat peanuts and tree nuts in significant quantities and still lose weight in spite of the significant amount of calories that come with every handful. Nuts of all kind (what we categorize as nuts are not actually nuts at all- almonds, walnuts and pecans are technically fruits, cashews are seeds as are candlenuts, pistachios and pine nuts, macadamias are kernels and peanuts are actually legumes) are high in many valuable nutrients and have tremendous health benefits. Many nuts are rich sources of vitamins E and vitamin B2, and are rich in high in protein, making them quite popular among those who choose to avoid or limit their meat intake. Nuts are also high in folate, fiber, and vital minerals such as magnesium, phosphorus, potassium, copper, and selenium. Nuts are also very high in fats namely essential fatty acids linoleic and linolenic and most of the fats found in nuts are unsaturated and include monounsaturated fats which are extremely beneficial. Studies have found that people who consume nuts on a regular basis are less likely to suffer from cardiovascular disease¹ and that certain nuts such as almonds and walnuts can lower LDL cholesterol levels (the bad cholesterol)^2,3. In addition to their heart friendly benefits, nuts are also recommended foods for individuals with Type 2 diabetes thanks to their very low glycemic index. The problem is that because of their high caloric nature, many are afraid to add them to their diet for fear of gaining weight. Interestingly enough there are several studies that have validated what I have seen for several years now, namely that you can ingest a significant number of calories from nuts and not gain weight.

Studies On Nuts And Weight Gain

During a thirty week study of fifteen healthy normal weight adults at Perdue University participants added approximately 2000 kJ worth of peanuts to their regular diet for eight weeks and then for the next eight weeks peanuts replaced an equal amount of other fats in their diet. Researchers found that the subjects compensated for 66% of the energy provided by the nuts and body weight gain was far lower than expected with an average gain of only 3.6 kg. However when customary dietary fats were replaced with calories from peanuts body weight was maintained perfectly. Resting energy expenditure was increased by 11% after regular peanut consumption for 19 weeks and more importantly the high consumption of peanuts did not turn them off to its taste or lead them to consume other snack foods during the study. The study concluded that despite being high in calories, peanuts have a high satiety value and chronic ingestion evokes strong dietary compensation and little change in energy balance.⁴ Another study found similar findings with almonds. This study’s aim was to determine if adding 1440kJ (about 343 calories) of almonds in a daily diet would elicit positive energy balance and body composition change. For the duration of the 23 week study with twenty women there were no changes in bodyweight from daily almond consumption, but an inefficiency in absorption of energy from almonds was noted. The study concluded that a daily 340 calorie serving of almonds enough to brig about positive cardiovascular effects could be added to the diet with a limited risk of weight gain.⁵

Why Nuts Don’t Make Us Gain Weight

Why is it that nuts seem to defy the laws of thermodynamics that do not apply to other foods? We don’t exactly know why you can ingest more calories than the body needs to maintain an energy balance from nuts and still not gain weight but some data points to the fact that eating nuts increases the amount of energy our body expends and there seems to be evidence that our bodies do not absorb calories from nuts very efficiently. In either case these mechanisms seem to offset most of the calories ingested or the weight loss studies conducted all found that dietary compliance was improved when nuts were permitted. I personally include in all weight loss dietary recommendations for my clients for the health benefits and the fact that it does provide a welcome guilt free treat that actually helps you stay on your diet as well. Just be sure to get the unsalted variety!

Kevin Richardson is the creator of Naturally Intense High Intensity Training 10 Minute Workouts™ and one of the most sought after personal trainers in New York City. Get a copy of his free weight loss ebook here.

Being Skinny Doesn’t Mean Being Healthy

In today’s society, especially for women, being skinny is the ultimate goal of most people interested in weight loss.  The media not only bombards us with a constant barrage of ultra thin models to advertise everything from clothing to cars while medical experts continuously tout the reduction of risk of metabolic related disease by being thin. But the question remains, can you be on the larger side and still be in good health? The reality, outside of selling fat burning supplements diet pills, tummy tucks and liposuction is that getting fit is far more effective at reducing the markers for type 2 diabetes, hypertension and heart disease than by just being thin. 

You Can Be Overweight And In Better Health Than Someone That Is In A Healthy Weight Range

According to a study conducted at the University of Exeter in the U.K., longevity and good health comes far more from your activity levels than by simply being thin. The study observed the health of four groups of adult males, those who were thin and in good physical condition, those who were thin and in poor physical condition, those who were overweight but in good physical condition and those who were overweight and in poor physical condition. What was important for the relevance of this study in the real world is that everyone in the fit groups were long term exercisers and not just a group of people put on an exercise program for the purpose of the study. Blood sampling revealed an interesting fact: that both groups that were in good physical condition had significantly higher hdl (good cholesterol) levels than the unfit groups. 

Visceral Abdominal Fat Levels Are Lower In Overweight People Who Exercise Regularly

What was also significant is that the visceral abdominal fat and liver fat, which have been shown to increase the risk of cardiovascular disease (see my article on the dangers of visceral abdominal fat) was far lower in the overweight group of men in good shape than the overweight group of inactive men even though their body fat percentages were the about the same.  So although someone might be classified as being overweight because their Body Mass Index (BMI) is on the higher side and they have a higher body fat percentage as long as they consistently engage in intensive regular exercise it appears that they will not have a dangerous visceral fat distribution around their internal organs. At the end of the day a low fitness level is a far greater threat to your health even though you might be thin and svelte. 

The Biggest Predictor Of Mortality Is Fitness Levels Not BMI

Overweight but fit people are often healthier than their slimmer counterparts!

The study at Exeter University isn’t the only one that has come to these conclusions, a study here in the U.S. of 5,400 adults found that half of those classified as overweight and one third of those classified as obese according to BMI standards were found to be metabolically healthy. That means that they did not have any indicators that might suggest a predisposition to health problems. The study also found that a quarter of those that fell into the ‘healthy’ weight range had at least two risk factors for cardiovascular disease. A 12 year study published in the Journal of the American Medical Association that looked at mortality rates among 2,600 adults aged 60 and over found that while death rates were highest among the very obese (those with a BMI of 35 or higher), fitness level was always the strongest predictor of mortality risk, not BMI. Those who scored the lowest on treadmill tests were four times more likely to die in the next 12 years than those who had high fitness levels. 

Regular Exercise Is Far More Important Than Simply Being Thin

The message is simple- looking good is great but the key to longevity and good health is regular exercise. Keep that in mind the next time you look in the mirror and don’t quite see the six pack you might want to see- by exercising regularly and watching what you eat you’ll live longer and be in better shape that someone who may be skinny but is inactive. Keep training! 

Kevin Richardson is the creator of Naturally Intense High Intensity Training 10 Minute Workouts™ and one of the most sought after personal trainers in New York City. Get a copy of his free weight loss ebook here.

10 Foods You Should Never Have For Breakfast-

If you are serious about losing weight and getting into great shape you have to stay away from the common trend today of eating dessert instead of breakfast or skipping it altogether. In today’s fast paced world everyone is in a rush and the bad eating habits that come with such a lifestyle is largely to blame for our current problems with obesity, type 2 diabetes, cardiovascular disease and hypertension. Most will either skip breakfast or grab high sugar foods like donuts, pastries and highly processed boxed cereals all of which can wreak havoc on your blood sugar levels and really sabotage your efforts at getting into better shape. By skipping breakfast altogether you set the stage for overeating later in the day as your body tries its best to compensate for the lack of nutrition that it was supposed to get first thing in the morning. A lot of the guilt that people feel for the perceived loss of willpower when they overeat later in the day is simply a manifestation of  bad breakfast choices or from skipping breakfast entirely. Taking that into consideration, a change in eating habits need not be difficult as it is less a matter of willpower, but more a matter of making better selections earlier in the day. A good start with healthy breakfast choices makes it easier to keep on making good food choices as the day goes on. Remember also that:

SKIPPING BREAKFAST OR ANY MEAL FOR THAT MATTER CAN BE JUST AS BAD AS EATING THE WRONG FOODS!

That being said, here are some certain no-no’s for breakfast, foods that you probably should never eat under any circumstances for that matter:

1. Bagels

 Bagels have a high glycemic index, due to the low fiber content and are among the highest calorie breads. You are not much better off with whole wheat or whole grain versions as they are still high in calories and not that high in fiber (you would be better off with oatmeal any day). Adding cream cheese or other spreads, can also increase the calorie count to over 500 calories each!

2. Granola

 Touted as a health food but essentially far too high in sugar- and for the record, honey is not an acceptable source of sugar for anyone serious about getting into great shape.

3. Pancakes Most commercial products consist of wheat are high in calories and have a high glycemic index. Many also have corn syrup and trans fats as ingredients as well and forget about adding maple syrup if you don’t want your blood sugar levels to go through the roof! The only pancakes that you can count on are ones you make yourself with stone ground flours and without added sugars or honey.

4. Pastries

Why desserts have become a popular choice for breakfast is beyond comprehension but croissants, éclairs, donuts, jelly filled pastries and such- high in simple sugars, wheat, all have high glycemic indices and are just about as bad a choice as you could make for the first meal of the day. Instead choose high fiber natural foods like fruit and oatmeal but not the instant kind!

5. Juices

 Juices sound like a good idea, since they come from a natural source, but are not at all natural to the human body. Whole fruits have fiber, which in turn reduces their glycemic index, by slowing it’s the rate of absorption in our body. Juices, however do not have significant fiber levels and the since there is not much fiber present, it elevates blood sugar levels above acceptable levels. You can easily over consume juices, but you would never eat 12 apples at one sitting. However an average person’s realistic serving of apple juice gives your body just about that amount. Some argue that juices are high in micronutrients, such as Vitamin C and other antioxidants but such an argument is ridiculous. You get the same micronutrients in whole fruit, without the insulin rush. So if you want fruit, eat fruit, don’t drink juices. You’ll feel better and look better as well! Besides, the breakfast standard of a glass of orange juice is so processed that all the naturally occurring nutrients (Vitamin C included) are destroyed and manufacturers have to put the vitamins back in so what you are drinking is really dead orange juice product with a vitamin tablet dissolved in it. Not exactly the best first choice for the health conscious. Eat fruit!

6. Sausages & Cold Cuts

 All are highly processed meats and also very high in sodium. You would be much better off eating freshly cooked meat, chicken or fish. I would also add to this category the ubiquitous American breakfast food- bacon.  High in fat, high in calories, high in sodium, not that high in protein, and also high in potentially cancer causing nitrites. It should be noted as well that recent studies have found that processed meats are responsible for increased risk of heart disease so it should certainly be on your stay away list- (read more here.)

7. Muffins

 Another so called health food, but even the bran muffins are far too high in sugars and have too high a glycemic index to be considered as a breakfast food. Skip it!

8. Protein Shakes

Another bad idea that sounds good; you drink a shake and get all the minerals and macronutrients you need for the day, case closed. However our bodies simply are not made for liquid foods, and you find that blood sugar levels still plummet later in the day as well. Which is a great thing if you happen to be in the protein shake manufacturing business- but isn’t that great for the rest of us). At the end of the day a protein shake is really nothing more than a glorified milkshake, and should not be in your diet if you are interested in getting into optimal shape. And forget the magazine ads and articles. Supplement advertising is the main source of income for the magazines in the first place, so it makes sense for them to herald them as the greatest invention since the wheel. Read more on my post on protein shakes here.

9. Cold cereal

All cold boxed cereal, from Kellogs to the whole grain varieties sold by the so called organic companies is junk food with no exceptions (and adding milk only adds to the problems!) The obvious ones like Frosted Flakes are easily spotted as being a bad choice, but popular brands like Wheaties, Healthy Choice and others are also bad examples, as are breakfast bars. It can say ‘all natural ingredients’, ‘organic’ or what not, but there is nothing in our food supply more alien than boxed cold cereals. You will never find a Wheatie or corn flake in nature and in order for any cereal of this nature to survive for prolonged periods they have to be highly processed which not only takes a ways the naturally occurring nutrients, but also creates a food product that our body is not designed to consume. Many of these cereals also have corn syrup and large numbers of unpronounceable preservatives added to them but thanks to extensive marketing boxed cereal is accepted as a staple for many, especially kids and college students, but keep in mind that they are filled with preservatives and all of the vitamins and minerals you see listed are added by machines after the refinement process and will never be absorbed the way your body would from a fruit or naturally occurring food. Moreover they all have a high glycemic index which will go a long way in increasing your insulin levels and increasing your visceral abdominal fat stores. Do not be fooled as well if you see a breakfast cereal in a health food store and assume that it is healthy. Health food stores are about making profit and selling products, not about providing you exclusively with foods that are wholesome, and it would be naive to think otherwise.

10. Instant Oatmeal

 Since instant oatmeal is refined, even the plain variants are not as good as old fashioned oatmeal. The refining process removes a lot of the fiber, to make it cook faster, and so its glycemic index goes up. The flavored varieties are even worse and are loaded with sugar. Convenient as those instant containers may be, convenience should never be more important than making the best food choices for your body so get the non instant varieties- it is much better for you and is an excellent start to your day!

For more information on healthy eating for weight loss, download a free copy of my Naturally Intense Breakfast Guide below.

Kevin Richardson is one of the most sought after personal trainers in New York City and the creator of Naturally Intense High Intensity Training 10 Minute Workouts™. Visit Kevin’s official website at www.naturallyintense.net

Ultra Low Body Fat Isn’t Healthy

In today’s world being ‘ripped’ and ‘cut’ with an ultra low body fat percentage is often considered the Holy Grail of most people’s fitness aspirations. Images of fitness models, bodybuilders and other athletes with abdominals rippling and every muscle beautifully defined with ultra low body fat percentages adorn the pages of so many magazines and advertisements for health related products and services that many are led to believe that being under 5% percent body fat ( for men) and under 10% (for women) is the be-all-and-end all to their fitness dreams and aspirations. For many it also represents the quality of being super fit, and sadly few are aware that models and athletes they look up to don’t stay at such ultra low body fat levels for more than a few weeks out of the year and that in that state they are often very far from being fit and healthy.

Bodybuilders & Cyclists Aren’t Healthy At Extremely Low Body Fat Levels

As a natural bodybuilder I regularly competed at an insanely low body fat percentage of 3%. It was a grueling experience every time and in that world anyone over five percent was considered fat! Keep in mind that the average healthy young male has a body fat percentage of 10-20%!  This type of skewered perspective doesn’t only exist in the bodybuilding world, as the same rigorous standard applies for many other athletes as well. Long distance cyclists are a prime example. All the major contenders for the biggest cycling event in the world, the Tour De France, compete at just about 5% body fat or lower. Take a look at Lance Armstrong’s pictures right before a race and you’ll see that he has a bit of a gaunt look to him as opposed to what he looks like when he isn’t competing. In the cycling world the formula for winning an event like the Tour De France requires a sustainable energy output of 6.7 watts per kilogram of body weight. Increasing power is difficult however reducing body weight is a bit easier so cyclists do their best to be as light as possible by losing as much body fat as humanly possible.

Our Bodies Need Body Fat To Function

The problem is that our bodies need fat to function correctly and it might surprise you that the same athletes that look like the epitome of health don’t feel that energetic at such low body fat levels and suffer from suppressed immune systems and are extremely susceptible to colds and other viruses. Females usually experience a cessation in their menstrual cycle as a consequence of going too low as the body perceives itself to be in the throes of starvation and does its best to not get pregnant as it no longer has the capacity to carry a baby to full term with such low energy reserves. It is truly not a state that the human body wants to maintain and it explains to a large degree why it is inherently so difficult to reduce your body fat levels and why we have to go to unhealthy extremes to get ourselves at an ultra low body fat level.

What does it feel like to be under five percent body fat? I can tell from my experience that it isn’t pleasant at all. When I was competing the second my fat levels dropped below 5% the lethargy set in. I hardly had the energy or desire to do very much and my face had the sunken look of someone that hadn’t eaten in several months. It seemed as if someone so much as sneezed in my direction I would get a cold and I felt cold all the time (your body uses a layer of fat as a form of insulation to keep in your body heat- take that layer away and you lose heat very quickly and will have trouble staying warm in a cold environment.)  Above all I would have difficulty staying asleep- the body perceives such low fat levels as a famine response and forces you to stay awake longer in the hopes of finding food. When I filmed my workout DVD I had already made the decision that I would never again follow any type of extreme diet nor would I ever let myself drop under 5% body fat. Not only is an ultra low body fat level unnatural but we know now that fluctuations in weight can result in an increased risk of cardiovascular disease  and at the end of the day being healthy is more important than trying to achieve a low body fat percentage. The key is to find your own level and not use the calipers as part of a race to see how low you can go. Interestingly enough I can naturally maintain a level of 6 to 7 percent just by eating well and feel fantastic. But that relatively small dip of only two or more percentage points to under 5% makes a huge difference in terms of energy levels and overall health.  It just goes to show that there is a fine line between being superfit and super unhealthy.

Kevin Richardson is the creator of Naturally Intense High Intensity Training 10 Minute Workouts™ and one of the most sought after personal trainers in New York City. Get a copy of his free weight loss ebook here.