The South Beach Diet Supercharged: Faster Weight Loss and Better Health for Life (7 page)

The really exciting news is that with every additional interval, you burn an even higher proportion of fat. This is because with every subsequent interval, you require more and more oxygen for both the work and recovery portions. This means that you slide further and further toward the aerobic systems and use both fat and carbohydrates to rebuild the creatine phosphate and ATP needed for the next interval. However, you can still maintain higher levels of activity than would be possible during aerobic training at a constant pace, because the recovery periods allow replenishment of ATP and creatine phosphate and removal of waste products. The bottom line is that more energy is used, with more and more of it coming from the aerobic use of fat. And one last happy thought:
The more you train, the more fat you burn during recovery
.

As good as it is, intense interval training isn’t for everyone. It must be customized for people with certain orthopedic problems or serious heart conditions. Again, my advice is to check with your physician before starting this or any other exercise program.

And please, before you do any exercise, read the next chapter, “Boomeritis: The New Epidemic!” to make sure that you’re exercising safely.

From my discovery of baseball at the age of 5, I have always loved sports and have played just about all of them. Unfortunately, as I got older and spent more time in the office and at the hospital, pickup basketball, soft-ball, and touch football gradually faded into oblivion, except for occasional games with my two sons. My major athletic endeavor became tennis, which I played competitively in my youth and spent summers teaching. I also jogged on a regular basis (and had for years) and did short spurts of ice hockey (yes, ice hockey in Miami), karate, and Rollerblading. About 10 years ago, I gravitated to golf. I had to give up some of the more taxing sports because as I got older, I tended to get nagging injuries—particularly shoulder, low-back, and knee pain. I was not alone. Not surprisingly, the preponderance of such injuries among baby boomers like me has come to be known as boomeritis.

About 3 years ago, I began doing core training with Kris Belding, the Pilates teacher who designed the core functional fitness part of our exercise program, and I was amazed at how much better I felt. My overall strength and flexibility greatly improved, I felt younger, and I stopped experiencing the boomeritis aches, pains, and injuries that previously seemed to occur on a regular basis. And I finally fulfilled one of my mother’s longtime admonitions: “Stand up straight!”

While I was at home in Miami Beach, I had no trouble following my usual exercise and diet routine. But like so many people who travel a lot for business, I wasn’t always as diligent on the road and occasionally gained a few pounds during my travels. (I didn’t always follow my own advice about being prepared with healthy snacks.) Also, I found it difficult to put enough time into a cardio workout that was necessary to complement my core training.

Fortunately, about this time, I was lucky enough to meet my collaborator on this book, Joe Signorile, PhD, who teaches exercise physiology at the University of Miami. Joe told me about the benefits of interval training and convinced me that I could burn more calories and achieve a higher level of fitness in a shorter period of time than I was currently spending on my workout. While I had heard about interval training for competitive endurance athletes, I was unaware of its potential benefits for the rest of us. I reviewed the scientific literature he suggested and was convinced that interval training for nonathletes was an important advance.

The beauty of interval training—which, as I explained in the last chapter, involves doing short bursts of high-intensity exercise followed by an easier recovery period—is that you can do it wherever you are and adapt it to any activity.

As fate would have it, about the same time I met Joe, my friend and patient Mel was raving about his experience with boxing. I knew that Mel had boxed as a teenager, and I was surprised to hear that at age 72, he was back in the ring, albeit with a trainer. Mel’s wife, a former professional dancer, and I had been trying to get him to do regular exercise for years, but he was quickly bored by conventional workouts. I was delighted when I heard that he had kept up with his boxing lessons for more than a year—and it showed. His energy level had increased immensely and his blood chemistries, blood pressure, and weight all reflected the benefits of his time in the ring.

Those of you who are unfamiliar with boxing may not know that it’s one of the most demanding of all sports. In fact, boxing is possibly the ultimate in interval training, with 2- to 3-minute rounds of intense exercise followed by a rest period.

I had always heard that boxers are among the fittest of all athletes and was curious to give boxing a try as a way to work intervals into my own cardio program. I was referred to a fabulous boxing trainer, Luis, and began working with him. But before I go further, let me put in an important disclaimer. What I did with Luis was baby boomer boxing: Luis held up hand pads and directed me on when and how to punch them. He was not allowed to punch me back!

What I learned was a progressive choreography, where my skills and fitness improved at a fast pace. Within a few months, I was “floating like a butterfly” around the ring. I was also clearly burning more calories in less time than during my previous long jogs or walks at a steady pace.

I was thrilled with my progress and improved fitness. But then I made a big mistake that led to injury, pain, and an unfortunate break from exercising. In fact, it’s what inspired me to write this chapter of warning for my fellow boomers.

At the end of our sessions in the ring, Luis and I would do some classic boxing exercises using a medicine ball. This was fine until I did a repetitive move of lifting, throwing, and catching the heavy ball over my head. Almost instantly, I felt a sharp pain in my left shoulder. But instead of stopping at that point, I disobeyed the advice I always give to my own patients: I ignored the pain and continued with the over-the-head exercise. Over the next few days, the pain in my shoulder got worse.

When I went to the doctor, I didn’t even have to see him before my problem was identified. His wife, who was assisting him, was recording my medical history. When she heard about my medicine ball escapade, she immediately told me that she often heard her husband advising patients my age (and even those quite a bit younger) not to lift weights overhead—and especially not repetitively. It was now clear to me, even before it was confirmed by the doctor and an MRI, that I had joined the crowd of my peers who had sustained a rotator cuff injury.

The orthopedist explained that, with age, there is simply less room within the shoulder joint because of normal calcification that occurs as the result of general wear and tear, and this room is compromised even more when we lift weights overhead. The result is trauma within the joint that tears the rather delicate rotator cuff muscles. This injury at least temporarily ended my nascent but promising boxing career. It also put a major crimp in my golf swing and the quality of my Pilates training. Fortunately, I didn’t require surgery, and after about 6 months of regular visits to an outstanding physical therapist, I returned to pain-free exercising.

As I described my experience to many of my patients, it seemed that half of the men and a third of the women I saw had also experienced rotator cuff problems. Many had required surgery, and almost all had learned the “nothing heavy overhead” lesson. I was really sorry that I hadn’t had that important piece of information earlier, when it could have saved me from my own injury.

During the time that my exercising was severely limited, I noticed another ailment. My wrist was hurting. Was this arthritis? No. It was carpal tunnel syndrome, a problem many of us boomers and preboomers develop by spending long hours typing on computers. In an informal survey of my patients and friends, carpel tunnel syndrome, like rotator cuff injuries, seemed to be occurring in epidemic numbers. And a quick review of the medical literature confirmed how common carpal tunnel syndrome has become in our postindustrial society.

I’m not telling you these stories to discourage you from exercising. The alternative is far worse. Being sedentary increases your risk of developing many of the illnesses known to man and woman, including arthritis, cancer, heart disease, and Alzheimer’s. I’m telling you this so you don’t make the same mistake I made. If I had known not to lift heavy objects repetitively over my head, I’d still be boxing today. The problem wasn’t the sport; it was the way I trained for it.

It doesn’t matter what activity you’re doing. You could be playing tennis, lifting weights, jogging, or ballroom dancing. If you do foolish things like ignore pain (as I did), do too much before your body is ready, ignore previous injuries, or don’t train properly for your sport or activity, you will get into trouble.

An Injury-Prone Generation

As more and more baby boomers heed the advice of their doctors and engage in various modes of exercise to stay fit, there’s no question they are becoming increasingly vulnerable to injury. Boomeritis is going to get a lot worse before it gets better. According to a 2006 article published in the
New York Times
, sports injuries were the number two reason for visits to a doctor’s office in the United States; only the common cold accounted for more visits! And orthopedists are reporting a surge of injuries among middle-aged athletes, weekend warriors, and wannabes.

Why are we injuring ourselves in record numbers?

One reason is that many people who have not exercised for years, or who have never exercised before and who are poorly conditioned, have suddenly decided to make up for lost time. They join a gym and start running full-out on a treadmill or lifting too-heavy weights with a vengeance, or they go for long jogs outside on hard pavement.

On one hand, it’s wonderful that so many people are inspired to start or increase a fitness program. On the other hand, this enthusiasm needs to be tempered with appropriate caution: Whatever form of fitness you pursue, it’s a good idea to begin slowly so you don’t get injured. There’s a reason our fitness program, which you’ll learn about in Part II of this book, is a three-phase program. During Phase 1, which you do for 2 weeks (or longer, if need be), you gently ease into an exercise routine, making sure your body is ready before you move on to the next phase. Once you’re in Phase 2, you will become stronger and more flexible, ready for an even more challenging workout. And once you’ve mastered Phase 3, you will know how to work your body in a safe, healthy way, and you’ll be able to integrate the concepts of the program into your own fitness regimen, if you like.

Too Much, Too Late

I’m a cardiologist who sees people every day who have heart disease or who are at risk for it. But sometimes I feel more like an orthopedist. I always take an exercise history from my patients because it is such an important part of their cardiac status. What I invariably hear is a litany of complaints characteristic of boomeritis: Low-back pain; rotator cuff pain; hip, knee, wrist, ankle, and neck pain; tennis elbow; Achilles tendinitis; and shin splints are the most common ailments cited. The good news is that almost all of these are preventable.

The problem is that many people—even the very fit—are not doing the right exercise for their bodies, especially their midlife bodies. For example, I see far too many knee and hip injuries in my practice, often among runners. In fact, I have rarely seen a baby boomer who runs regularly on hard surfaces who has not experienced knee, hip, and/or low-back problems. Many of these people continue to run even though their joints are tender and painful. I tell them that they can keep their running shoes, but it’s time to do more joint-friendly exercise, at least part of the time.

I also see a fair number of people who simply overdo it when it comes to exercise. Instead of giving their bodies a needed break, they keep pushing themselves harder and harder, farther and farther, to the point of injury. You can get away with running for miles every day on a hard surface when you’re in your teens or twenties, but by the time you hit 40, I don’t recommend it. The human body was never meant to sustain that kind of beating. (If you do want to continue running, I urge you to do an interval training program and run fast for only short periods of time, with adequate recovery periods. And, if possible, avoid hard surfaces.)

And it’s not just runners and middle-aged athletes who are exposing themselves to overuse injuries. Let me share another of my personal boomeritis experiences. About 10 years ago, I attended the annual American College of Cardiology meeting in New Orleans. I stayed at a hotel about a mile away from the convention center where the meeting was held. I walked to and from the center and then walked for miles within the convention center. Great exercise! Two days into the meeting, as I hiked back to my hotel, I began to notice pain and tenderness in my shins, which seemed to get worse with every step. Just as I thought I couldn’t walk any farther, I spotted a shoe-shine stand and decided that I needed a shine and a rest. As I sat down, I complained to the shoe-shine man that my shins were really aching. He observed the thin-soled loafers I was wearing and quickly made the diagnosis of shin splints. (I was clearly not the first conventioneer who had sought refuge at his stand because of shin pain.)