"Man is so made that he can only find relaxation from one kind of labour
by taking up another."
- Anatole France
As a recovering chronic cardio queen, I often sacrificed sleep to get in another run in hopes of
"staying fit" during residency.
First up, I apologize for the lengthy gap between posts...I know people always say this when they haven't been posting, but in keeping with the theme of my blog, I wanted you to know that I have been prioritizing other things for my personal stress management. I just took the Anesthesiology board exam (the part-one "written" section, to be followed by an oral examination next spring). So glad that's over!
I'd like to put an idea out there that is contrary to what many people believe about exercise:
Running marathons isn't necessarily good for you.
While this may not seem to fit with our typical subject matter, I'm inspired to share my opinions with you on this topic because I am currently in the best shape of my life, let alone significantly fitter than my postop state (30 lbs heavier and WEAK) of one year ago! My life balance, from both a physical and mental standpoint, seems to really be in line lately. I know... the elephant in the room - the completion of my residency - is not lost on me as a major component of these changes. Exercise is definitely not the most significant variable in the fat loss equation. As trainer Skylar Tanner pointed out here, you must clean up your diet first, have a handle on your sleep/stress level, and then follow that with exercise in order to lose fat and reshape your body.
Caveats aside, exercise is of course a vital tool in our black bags for stress management and overall wellness. However, some types of exercise may be better than others for this purpose. The gist is this: there is a positive hormonal response (growth hormone release, increased insulin sensitivity) associated with lifting heavy things and trying hard for short bursts, whereas long, medium-intense cardio work may have a negative hormonal response (increased cortisol) over time that negates any benefits. Blogger and author of The Primal Blueprint Mark Sisson makes his case against chronic cardio, pointing out that the supposed stress-relieving benefits of endurance training can be offset by these deleterious hormonal responses. Dr. Doug McGuff, an ER physician and author of Body by Science, provides evidence in his book and this article for the advantages of high intensity training. Dr. Colin Champ looked at the issue from an evolutionary perspective here, with some study citations thrown in as well.
On top of all this convincing evidence, endrance training takes a long time! Short, high-intensity sessions can be relatively easy to implement for a busy medical trainee or any professional who wants to remain active. And as professionals are well aware, there is never truly an end to our training! We must constantly strive for balance in a demanding workplace! Spend the extra time with your family, meditating, or doing some other self-care activities that you've identified as effective for you.
What I'm Doing
Diet and stress/sleep (although very important to leanness) aside, I do not owe the recent changes in my body shape and composition to slogging through a race or logging miles on some piece of cardio equipment. I owe it to minimalist strength training and short interval workouts.
I used to be a Cardio Queen in my day. I dabbled in the weight room, but mainly lifted light weights in an effort to "get toned but not bulky". Having never been a true athlete, I've spent my life either being skinny-fat and (relatively) fat-fat but never lean or strong. Last December, I began a lifting program like this one from trainer Nia Shanks. (NOTE: There is a wealth of information just on the internet about whole-body weight training using compound movements. If you are more of a book person, I also recommend the New Rules of Lifting series). Without any particular strength objectives, I made it a goal to lift 3 days/week for approximately 30-40 minutes, doing only 5 compound movements per session. As for cardio, I did high intensity intervals on an elliptical machine once or twice on those three days. My interval spurts were only 10 minutes total of 30 seconds hard work with one minute recovery. Other than that, I took regular long walks around the neighborhood with my husband and dog. This is not speed walking mind you, but regular old people type walking! I took no spin classes, no aerobics, and until this summer hadn't even touched my bike since pre-surgery!
By mid-January, I had lost about 10 pounds and at least 5% fat (as measured by hand-held ultrasound)... by March, I had lost another 5 lbs and a few more fat %. I feel and look better than I did during my "healthiest period" at the end of medical school, before all this residency and brain tumor madness began! My strength, flexibility and balance in simple tasks are much better, and my rock climbing has improved. I recently climbed at my hardest difficulty level yet, and I have my sights set even higher!
Some of you may protest by professing your love for marathoning or long road rides or endurance competition of any kind, but I challenge you to think about why you really log those miles. On top of the conventional wisdom that endurance training is the bastien of physical fitness, it feeds into the cult of busy-ness that we perpetuate in our modern lifestyle. How many times have we heard that colleague complain about how busy or tired he is, with the veiled bragging about how he was able to do the Ragnar Relay last weekend? Do you want to relieve stress? Get stronger? Get leaner? In the long run, chronic cardio really does none of those things. Consider lifting heavy things and going hard for shorter time. Your body (and your joints) will thank you for it!