Doing P90X: My Variations

Giant Rubber Bands

I bought P90X almost three years ago but didn’t try the whole program right away.  At the time I was doing a mixed workout of strength ball training, using stability balls and weights in strength and balance exercises, plus some stretching and cardio.  I used P90X to vary the regular routine, doing one or two workouts a week.  Over many months I went through all of P90X Lean, the more cardio-oriented version of the program.  During this period of gradually working into P90X I received two important benefits:  learning Ab Ripper X and deciding that I needed to be doing at least some plyo.

This summer I decided to do P90X Classic, the basic version of the program.  The strength workout I had been doing had gotten too easy and the three sessions of intense cardio seemed to be too much.  I had already done each of the P90X workouts before so I knew what to expect.  I had also read many of the reviews of P90X on amazon.com, which can give you valuable pointers about how to fine-tune the workouts to suit your needs, as well as advice about whether you should be doing it at all.  If you haven’t exercised in years or were never in very good shape P90X is not the place to start.  But for people who want to take it to the next level it’s a truly great program.

When I first did P90X I couldn’t even finish all of the warm-up.  It had been years since I had done jumping jacks and some of the workouts include seventy or eighty of those before you even start the real exercise!  So I struggled through as many as I could and, over several months, got to the point where I could keep up with Tony Horton and the rest of the group, for that part at least.  With the five strength workouts, which are really the heart of the program, I could do most of the moves, somewhat.  One that I still can’t do is pull-ups and a couple of these routines have lots of them.  My trainer Greg Simmons introduced me to giant rubber bands which can offset part of your weight so you can do an assisted pull-up.  You hang the band from a bar, use a chair or short ladder to step into it, and voilà – pull-ups!  The strength workouts also include many variations of push-ups so I’m getting better at those.  When I was younger I couldn’t even do one push-up except the on-your-knees kind.  In the yoga routine I can’t really do the sequences with Warrior 3 and Half Moon because my balance is poor, but I keep trying anyway.  Plyo is the toughest part of P90X for me because jumping and hopping take a lot of explosive energy, but they're hard for the people in the class too.

Ab Ripper X is the shortest of the routines – 16 minutes and you can get it down to 12 if you do it on your own­ ­– and the only one you do three times a week.  Less than that doesn’t get you good enough results, as I found out by trying it.  At first I couldn’t do some of the moves; Crunchy Frog was pretty tough, as was Roll Up/V Up, and Oblique V-Ups were almost impossible.  I did 25 reps of the ones I could do and at least tried the others.  Eventually I got to the point where the whole thing was too easy so, following a tip I found online, I used ankle weights and small dumbbells for some of the exercises.  I also use knee and ankle weight for Kenpo X, the martial arts workout.

I feel that these workouts have improved my strength, especially in the shoulders, arms, and back, totally reshaped my midsection, and helped my flexibility and balance somewhat.  I haven’t lost much weight, only a couple of pounds over eight weeks.  I also find that I’m not getting enough of a cardio workout, even in Plyometrics and Kenpo X.  My metabolism is very slow, about 1100 RMR, and I’m in good shape so my heart rate gets up to around 120 and then goes right back down to below 100.  This is true even when I keep up with the group on the DVD.  After about six weeks of this, I added back a couple of half-hour sessions of cardio at the Y in order to keep up my condition in that area.

The exercises in these workouts are varied and challenging but what keeps me coming back is the ambience.  These sessions combine playfulness and hard work.  Tony Horton clowns around but also gives plenty of direction and serious advice.  I also like the fact that Beachbody didn't over-edit the tapes to remove some unintentionally funny moments, like when the handles of Sophia's bands hit Tony in the face.   It’s a comfortable atmosphere, perhaps partly because what we’re seeing is Tony working out with his friends.  Dreya Weber is the wife of P90X’s Creative Director Ned Farr; Joe Bovino and Tony are longtime friends; some of the other guys work out with Tony at the beach on Sundays.  The often-repeated motto “Do your best and forget the rest.” epitomizes the combination of effort and self-acceptance that are at the heart of this program.

Related Posts: "Room for Improvement:  the Wisdom of Tony Horton,"
                        "Ab Ripper X - Argh!,"

Statins - Whoops!

In the late 1990’s my cholesterol was high and my doctor wanted me to take a statin to lower it with the idea of reducing my risk of a heart attack.  I was uneasy about this suggestion - in the past I had been put on drugs that were later un-recommended or taken off the market entirely.  (See “Statistics and the Twenty Year Rule” and “Stilbestrol and Me.”) – so I said, “Let me try diet and exercise instead.”  That is how I got started on a long-term health and fitness project and the creation of this blog.  My cholesterol is now low enough that no doctor would recommend a statin anymore.  In the meantime, the thinking about statins is changing: for people with high cholesterol but no heart disease statins have no benefit and some worrisome risks.

Late Sunday’s “Sound Medicine” featured an interview with science writer Sharon Begley in which she reviewed the latest research in this area. There was so much good information in that short segment that I went back and located the article on which Begley’s remarks were based, “The Cholesterol Conundrum.”  Statins are one of the most widely prescribed – and most profitable – groups of drugs sold in this country.  One-quarter of American adults over 45 take a statin and sales in 2009 were $14.3 billion.  In the case of patients who already have heart disease or have had a first heart attack there is no question that these medications reduce the risk of dying, having a second heart attack, or needing heart surgery.   

But medical practice made a logical leap from this situation, called “secondary prevention,” to the notion that, in healthy people with high cholesterol, statins could prevent a first heart attack.  Unfortunately, this turns out not to be true.  Begley cites recent research indicating that 60 healthy people would have to take a statin for five years to prevent one heart attack and 268 would have to take a statin for five years to prevent one stroke, not much of a return on the financial investment.  But it gets worse.  Statins may increase blood sugar levels and raise the risk of type 2 diabetes.  This group of medications can also cause muscle weakness and a recent animal study indicates that it may make it more difficult to exercise.  In addition, statins can cause cognitive changes, such as confusion and memory loss.  Some patients believe they are getting Alzheimer’s, when it is actually the statins that have caused the symptoms.  Fortunately, these normally go away when the drug is discontinued.

Given the new information, I feel fortunate that I stayed away from statins.  If I ever do get heart disease, that will be another story.

Brain Games

In the fall of 2007 WTIU, our local television station was running a fund drive and offered as a premium the Brain Fitness Program, a brain training program based on a series of games.  Created by Posit Science, the BFB, grew out of the research of neuroscientist Michael Merzenich and others exploring neuroplasticity, the idea that the brain is constantly changing, adapting, and reinventing itself throughout life.  Before the 1970’s it was generally thought that each individual was born with a particular brain which changed only as it declined as part of the process of aging.  Merzenich and others demonstrated that the brain, even that of an older person, is capable of renewing itself and learning new skills.  (It also used to be thought that after childhood we could no longer make new brain cells, just lose them.  That turns out to be wrong too! Some research indicates that exercise helps the brain produce new cells.)

My copy of the BFP shipped with a CD of the public television show on the research and a copy of The Brain That Changes Itself, a terrific book by Norman Doidge,MD, which recounts some of the main events in the development of this new idea.  The training program itself consisted of six games and emphasized auditory processing.  You would move through a series of activities in which you distinguished first individual sounds, then syllables, followed by short sentences and finally narratives.  There were evaluation components so you could see how you were progressing in each area.  According to these, I made lots of progress though I wasn’t much aware of a difference in my everyday thinking.  Oddly, my sense of smell improved, not necessarily a good thing!

Posit Science now has a new auditory processing program which I haven’t tried.  I did purchase and complete Cortex With InSight, which I liked better than the BFP:  less time per training session, sleeker graphics and functionality.  I also thought the program improved my useful field of view (helpful for driving) and my divided attention.  It did not do much to help either my visual precision or speed of visual processing.  Also, a point not mentioned by the accompanying materials, if your acuity is affected by cataracts or some other condition that will limit how far you can go with these games.  After I had cataract surgery my performance in the program improved dramatically.

The Posit Science training programs have a sterling scientific pedigree but they are expensive and somewhat time-consuming.  A practical alternative for people who don’t want to spend the money or time is Lumosity, a brain training website with a variety of short games covering different types of mental processing, such as memory, spatial sense, and problem solving.  You can try the games free but with an annual subscription you can track your results and compare them with those of people in your age group.  I tend to dip into these for fifteen or twenty minutes at a time.  Lumosity is in the process of bringing out some new games with good graphics and more variety so I’m using them more lately.  I like to work on speed and arithmetic calculations, which are two of my weaker areas.

Heartbreaking Choices

Today’s Wall Street Journal included an important article, “The Crushing Cost of Care,”

by Janet Adamy and Tom McGinty that should be required reading for anyone concerned about the cost of health care in this country.  It tells the story of Scott Crawford, who developed heart disease in his twenties and had a heart transplant at 41.  The heart transplant was a success but a series of medical crises ensued, resulting in an extended hospital stay, increasing physical suffering, and his death less than a year later.  The article is primarily about choices, mostly by people other than Scott himself:  his parents, his surgeon Dr. Ashish Shah, and critical care specialist Peter Pronovost. 

Why I'm Still Stretching

Stretching has gone out of fashion in recent years.  Formerly touted as a way of improving your workout and preventing injuries, the practice, particularly static stretching, has been shown in some studies to decrease power in activities such as running and jumping and to have no benefit in preventing injuries.  The new thinking is that workouts should be preceded by a warm-up, such as jogging in place, and ballistic stretches like goose-stepping.  Some recommend avoiding static stretching altogether on the grounds that it tends to tighten muscles, while others would give it a role in a post-workout routine.  The current situation was discussed in a New York Times blog post by Gretchen Reynolds.

For a few months I tried ballistic stretching before working out on the elliptical and I was not impressed.  It did not raise my heart rate high enough to prepare me for the workout nor did it improve my flexibility by extending my range of motion.  These days I do a warm-up consisting of jumping jacks and jogging in place; I don’t do any stretching at before a workout.  In the evenings, especially on days when my muscles are sore from resistance training, I use a foam roller, then do a series of resistance stretches.  These exercises, which I learned from Anne Tierney and Steve Sierra, involve pulling against the stretch which is supposed to avoid tightening the muscle.  Stretching makes me more comfortable, more relaxed, and probably lets me sleep better.  

The stretches I learned in years of yoga classes helped me to recover full range of motion after having a frozen shoulder.  I am now applying the same type of technique to my hands, which have scar tissue at the knuckles because of arthritis.  I’ve been in enough yoga classes to believe that what happens to the body happens to the mind as well.  A calm, relaxed body is probably conducive to an open, percipient mind.  New research also shows that a flexible body can mean flexible arteries, lower blood pressure, and a reduced risk of cardiac problems, findings that are of great interest to me because of my family history of heart disease. 

When Emotion Trumps Science: the Latest on Hormone Therapy

Let’s imagine that there is a new medication available for post-menopausal women.  It is an effective remedy for hot flashes and osteoporosis and lowers the risk of diabetes and colon cancer.  In younger women, it may protect against heart disease.  One version of this drug can also diminish a woman’s risk of dying of breast cancer.  Potential downsides include a small increased risk of having a stroke (12 more per 10,000) or of dying of breast cancer (about 1 more death per 10,000 with the drug). 

This blog has a feature called “Should I Be Taking This?” in which the potential side effects of a particular medication are listed first, followed by ostensible benefits.  Often the first list is quite long and the second rather short and tentative.  Some of the medications have only been on the market for a short time so the full extent of the risks and benefits may not yet be apparent, a situation I discussed in “Statistics and the Twenty Year Rule.”  

Against this background hormone therapy seemed like a pretty good deal:  substantial and proven benefits associated with risks that amount to tenths or hundredths of a percent.  And some hormone medications had been around for decades.  I started taking Premarin, an estrogen-only version of hormone therapy, in 1979 after a complete hysterectomy at age 32.  The initial dosage of 1.25mg was too high and was later reduced by half.  I tried taking even less but started getting hot flashes.  Then in 2002 the Women’s Health Initiative study of estrogen-plus-progestin therapy was halted because of higher-than-expected rates of breast cancer and heart attack in women using the medication; the risks of the therapy were deemed to outweigh the benefits.  When this news was released, widespread panic ensued among women using hormone therapy.  Many abandoned it altogether.  WHI was taken as a blanket rejection of hormone therapy by the medical community, whether researchers intended it or not.

The women who discontinued taking these medications avoided risks but they also lost substantial benefits.  Many undoubtedly experienced hot flashes which disturbed their sleep and interfered with their ability to concentrate.  People tend to joke about hot flashes but insomnia is a big deal.  Sleep is right up there with air, water, and food among the essentials for survival.  That’s why sleep deprivation is used as a form of torture.  These women were also more likely to get osteoporosis.  Sometimes their doctors prescribed bisphosphonates to protect from bone loss but these have been related to a rare type of femur fracture and, in a few cases, with osteonecrosis of the jaw (disintegration of the jaw bone), although the nature of the association is not yet clear.   

Women with a higher risk of breast cancer or stroke may not want any additional risk, however small.  My situation is different.  The Cleveland Clinic’s online calculator of stroke risk puts mine at 3.6% over 10 years, about half the average for women my age.  Taking estrogen may increase that risk to 3.60432%, an increment too tiny to worry about.  Decisions about medical treatment should be made on an individual basis: one size does not fit all.  The hormone therapy saga is a good illustration of this point.  

For those of us on hormone therapy, the medical discussion of this issue has been like an extended good news/bad news joke.  In a recent issue of the Wall Street Journal the invaluable Melinda Beck brings us up to date on the most recent findings.  The current notion is that for younger women the benefits may outweigh the risks.  Did doctors overseeing WHI anticipate the extreme reaction to their study? Did they consider what the consequences would be for women who stopped taking hormones?  Some of them, when quoted, sound a bit defensive.  In the WSJ article Rowan Chlebowski, a WHI investigator, asks:  “Why would anyone want to double their risk of dying from breast cancer?”  If the additional risk is tiny and the benefits include protection from hot flashes, osteoporosis, colon cancer,and diabetes, I’d say it was worth it.   

Women are still being advised to take these medications for the shortest time possible because of the risks, but how much is known about longer term use of these medications? I’ve met or read about many women like me who have taken them for decades and are doing fine.  When is someone going to study us?

Fat Gain Versus Weight Gain: All Calories Are Not Created Equal

In January of this year I read about a new study on how calories from different types of food affect fat gain and weight gain, but until I heard Dr. David Crabb’s discussion of the study on WFIU’s medical program “Sound Medicine” I didn’t appreciate how counter-intuitive and downright strange the results were.  Dr. George Bray of the Pennington Biomedical Research Center in Baton Rouge began by determining the daily caloric needs of 25 healthy men and women.  Then, over an eight-week period, he fed them 1000 calories more.  

The participants were divided into three groups according to the type of diet they were fed during the study.  Some received a diet low in protein - about 5% - and high in fat; others ate a normal protein diet of roughly 15%, an average of 139 grams per day; while the third group consumed a high protein diet of 26%, about 228 grams per day, and very little fat.  Carbohydrate levels for all three groups were the held constant.
   

At the end of the eight weeks all the groups had put on the same amount of fat but weight gains varied among the groups in an unexpected fashion.  The low protein/high fat group put on the least amount of weight and those on the high protein/low fat diet put on the most but the normal and high protein groups gained lean body mass in addition to fat and increased their energy output, while the low protein group actually lost lean body mass.  In his commentary Dr. Crabb notes that it is surprising that the protein in the diet alone produced an increase in lean body mass without any sort of physical training.  (The study did not involve any exercise for any of the participants.)  Presumably the loss of lean body mass would make it harder for the high fat group to lose the weight they had gained once they started to do this, though the study did not address that point.

Some commenters on the research see the study as further evidence of the unreliability of BMI as an index of good health.  At the end of the study the low protein group weighed less but were also less fit.  One aspect of the study seems to confirm a point made by nutrition researcher Douglas Paddon-Jones, that the body does not absorb more than a certain amount of protein, about 30 grams per meal maximum for most people.  Those on the high protein diet did not gain much more lean body mass than those on the normal protein diet.  

Related post:  “Get Older, Stay Strong:  Exciting New Research" 3/08/2012