I often get asked what type of exercise my patients should undertake, especially as most patients that I do see are fairly active, but become frustrated as they don't get to see proportionate results after putting in a decent amount of 'work' at the gym. The classical scenario is the PT instructing you to do endless sets of crunches to get rid of lower abs fat.
Doing crunches will certainly build your abs, but if you have a few kilos of fat hiding the abs then these will not be visible. It is thus imperative to get rid of this first and this means lowering your overall body fat percentage.
There have been many theories on what exercise provides the best 'fat-busting' results and there has been a significant shift in trains of thought.
Much of the scientific evidence now points to a combination of intermediate length aerobic exercise and high intensity interval training (HIIT).
Many personal trainers will promote doing 'cardio' to extremes to get rid of stubborn pockets of fat. This is largely a myth.
The long traditional aerobic workouts have less impact on fat metabolism and also on maximal oxygen consumption (VO2 max) compared to HIIT. High intensity interval training has been shown to burn fat more effectively. Partly this has to do with improving glucose tolerance and lowering insulin resistance. Compare endurance runners and 100m sprinters - the sprinters tend to have a better muscular physique.
HIIT increases the resting metabolic rate (RMR) for the following 24 hours due to excess post-exercise oxygen consumption (EPOC). After intense sessions of exercise the body goes into a state of oxygen 'deficit'. To replenish this lack and return the body back to a resting state there is an increased state of oxygen intake. Various processes take place: hormone balancing, replenishment of fuel stores, cellular repair (esp. muscle), innervation and anabolism (muscle buildup). This repair cycle is accompanied by an elevated consumption of energy. Fat stores are thus released and broken down to release fuel stores. One study result found a greater loss in subcutaneous fat.
Examples of HIIT:
- 2minutes of gentle pedaling followed by 20 seconds of intense rapid bursts at maximal effort for three sets
- 20 seconds of ultra-intense exercise followed by 10 seconds of rest, repeated continuously for 4 minutes (8 cycles)
There are numerous regimens around (Peter Coe regimen, Tabata regimen, Gibala regimen, Timmons regimen) and its best to choose one that incorporates the exercise you prefer.
So, extended sessions of cardio are useful, however, combined with HIIT one can achieve better results in a shorter space of time over fewer days a week, leaving you with more time to socialise and see family.
Tuesday 24 September 2013
VASER, Nutrition and the mummy tummy
Most women find it frustrating trying to lose stubborn pockets of fat. The odd crash-diet interspersed with motivated sessions of gym attendance and denying one-self the weekend night out with the girls. These are all realistic attempts at reducing lower body fat.
This is an all to frequent scenario of many women that cannot get rid of the mummy tummy. One of the main reasons is something called Oestrogen (Estrogen) dominance. One of the most prevalent hormones floating around women's bodies is Estrogen. It is a major player in fat storage.
The anatomical areas that are mostly affected are the hips, thighs and buttocks as they have high concentrations of Estrogen receptors. Hormonal imbalances are created by poor diet and lifestyle choices over a long period of time and hence result in disproportionate deposition of fat in those areas over time. Women thus have a propensity for storing fat in those areas. In addition, there is also a evolutionary reason (going back to the hunter gatherer days) for fat storage in those areas.
It goes without saying that stabilising the hormonal imbalance will help reduce those stubborn pockets.
A few tips to try regulate the Estrogen balance:
1. Refined carbohydrates and Sugars must be one of the first items to be eliminated from your diet. Sugars play an important part in a cycle that controls conversion of testosterone to estradiol, this increasing fat deposition in the lower body area.
2. Green, leafy vegetables - these all contain compounds that have high levels of estrogen detoxifying abilities and thus reduce the levels of the hormone. Examples include broccoli, asparagus, spinach, cabbage, cauliflower.
3. Vit B6, Vit B12, Folic acid, Zinc, Magnesium are all important elements in liver metabolism (Estrogen detox). Thus a good idea to take a high quality Vit B complex, zinc, magnesium supplement if you cannot attain this from your food intake.
Other hormones involved in lipid metabolism
Cortisol, Thyroid & Insulin and Growth Hormones also play an important role in fat metabolism. There is a fair amount of evidence that where people store their body fat is an indication of their hormonal profile. Insulin around the flanks (love-handles) and Cortisol around the mid-rif.
Insulin is probably the main player here as it is the fat storage powerhouse and fortunately we can control it. Insulin levels respond to levels of sugar in the bloodstream. It is an anabolic hormone which results in fat storage. It also results in low energy levels (hence the sleepy feeling after lunch).
High insulin levels prevent fat from being used as an energy source and rather result in fat being stored.......!!!!!
Cortisol is the stress hormone and results in deposition of fat around the belly button or mid-rif. If you eat too infrequently your body becomes stressed and thus releases Cortisol. Its thus important to eat regularly (approx. every 3 hours) and not only when your body desires. Human endocrinology cycles are an ongoing functional process and thus need to be 'fed' regularly. That feeling of starving in between meals results in cravings for sugars and carbs which then result in a wicked Insulin/Cortisol yo-yo effect. RESULT -> love handles and belly.........
It suffices to say that a combination of diet, exercise, a targeted supplementation program and lifestyle modifications can improve your hormone imbalances and thus effectively manage your body fat levels. Blast away that MUMMY TUMMY........and if you are really struggling and come to your wits end VASER is always an option
Other useful tips:
Drink green tea!- high in anti-oxidants
Omega 3 Fish oils (increase E2 decrease E16)
Avoid tap water (Britain’s water supply contains large amounts of estrogen)
Birth control pills (increase estrogen levels)
Don't overdo Spin classes or other aerobic exercises - high intensity interval training is more efficient for fat loss as it results in EPOC (Extended Post Exercise Oxygen Consumption)
This is an all to frequent scenario of many women that cannot get rid of the mummy tummy. One of the main reasons is something called Oestrogen (Estrogen) dominance. One of the most prevalent hormones floating around women's bodies is Estrogen. It is a major player in fat storage.
The anatomical areas that are mostly affected are the hips, thighs and buttocks as they have high concentrations of Estrogen receptors. Hormonal imbalances are created by poor diet and lifestyle choices over a long period of time and hence result in disproportionate deposition of fat in those areas over time. Women thus have a propensity for storing fat in those areas. In addition, there is also a evolutionary reason (going back to the hunter gatherer days) for fat storage in those areas.
It goes without saying that stabilising the hormonal imbalance will help reduce those stubborn pockets.
A few tips to try regulate the Estrogen balance:
1. Refined carbohydrates and Sugars must be one of the first items to be eliminated from your diet. Sugars play an important part in a cycle that controls conversion of testosterone to estradiol, this increasing fat deposition in the lower body area.
2. Green, leafy vegetables - these all contain compounds that have high levels of estrogen detoxifying abilities and thus reduce the levels of the hormone. Examples include broccoli, asparagus, spinach, cabbage, cauliflower.
3. Vit B6, Vit B12, Folic acid, Zinc, Magnesium are all important elements in liver metabolism (Estrogen detox). Thus a good idea to take a high quality Vit B complex, zinc, magnesium supplement if you cannot attain this from your food intake.
Other hormones involved in lipid metabolism
Cortisol, Thyroid & Insulin and Growth Hormones also play an important role in fat metabolism. There is a fair amount of evidence that where people store their body fat is an indication of their hormonal profile. Insulin around the flanks (love-handles) and Cortisol around the mid-rif.
Insulin is probably the main player here as it is the fat storage powerhouse and fortunately we can control it. Insulin levels respond to levels of sugar in the bloodstream. It is an anabolic hormone which results in fat storage. It also results in low energy levels (hence the sleepy feeling after lunch).
High insulin levels prevent fat from being used as an energy source and rather result in fat being stored.......!!!!!
Cortisol is the stress hormone and results in deposition of fat around the belly button or mid-rif. If you eat too infrequently your body becomes stressed and thus releases Cortisol. Its thus important to eat regularly (approx. every 3 hours) and not only when your body desires. Human endocrinology cycles are an ongoing functional process and thus need to be 'fed' regularly. That feeling of starving in between meals results in cravings for sugars and carbs which then result in a wicked Insulin/Cortisol yo-yo effect. RESULT -> love handles and belly.........
It suffices to say that a combination of diet, exercise, a targeted supplementation program and lifestyle modifications can improve your hormone imbalances and thus effectively manage your body fat levels. Blast away that MUMMY TUMMY........and if you are really struggling and come to your wits end VASER is always an option
Other useful tips:
Drink green tea!- high in anti-oxidants
Omega 3 Fish oils (increase E2 decrease E16)
Avoid tap water (Britain’s water supply contains large amounts of estrogen)
Birth control pills (increase estrogen levels)
Don't overdo Spin classes or other aerobic exercises - high intensity interval training is more efficient for fat loss as it results in EPOC (Extended Post Exercise Oxygen Consumption)
Tuesday 10 September 2013
Scar treatment post VASER (for incision points)
In most cases the tiny incision points will heal very well and remain pink for a couple of months post-procedure.
I try and place my VASER access points in fairly inconspicuous areas so they are not that obvious. Unfortunately some areas that I treat require incisions that are a little more visible. The placement of the incision points is something you need to discuss with your surgeon beforehand if this if going to be of concern to you.
Points to remember are that they may become:
1. Keloid- slightly raised and bulky (more common on the chest and back in individuals of darker skin colour)
2. Hypertrophied - slightly stretched.
3. Underlying fibrotic tissue - the underlying tissue feels a little lumpy - this usually resolves with time.
4. Hyperpigmentation - the scar becomes slightly darker compared to the surrounding skin
5. Scar retraction - the scar becomes a little indented
What can you do to prevent this?
Unfortunately genetics play an important role in this and if your skin has those specific qualities then there is not much one can do to prevent this. Make sure there is not too much tension on the scar (this prevents hypertrophy).
Keloids can be treated with low does steroid injection to flatten them out.
Use bio-oil or even better, a Silicon gel. There are various types available and they are non-prescription. Apply the gel 2-3 times a day for about 2-3 months and you will see a vast improvement of the scar.
I try and place my VASER access points in fairly inconspicuous areas so they are not that obvious. Unfortunately some areas that I treat require incisions that are a little more visible. The placement of the incision points is something you need to discuss with your surgeon beforehand if this if going to be of concern to you.
Points to remember are that they may become:
1. Keloid- slightly raised and bulky (more common on the chest and back in individuals of darker skin colour)
2. Hypertrophied - slightly stretched.
3. Underlying fibrotic tissue - the underlying tissue feels a little lumpy - this usually resolves with time.
4. Hyperpigmentation - the scar becomes slightly darker compared to the surrounding skin
5. Scar retraction - the scar becomes a little indented
What can you do to prevent this?
Unfortunately genetics play an important role in this and if your skin has those specific qualities then there is not much one can do to prevent this. Make sure there is not too much tension on the scar (this prevents hypertrophy).
Keloids can be treated with low does steroid injection to flatten them out.
Use bio-oil or even better, a Silicon gel. There are various types available and they are non-prescription. Apply the gel 2-3 times a day for about 2-3 months and you will see a vast improvement of the scar.
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