Permanent Fat Loss Principles: The “Secret” is No Secret

Permanent Fat Loss Principles: The “Secret” is No Secret

Though you trudge away on the treadmill and scrape by on seeds and sprouts, the bathroom scale refuses to budge. But actually, the formula for fat loss is quite simple.

Self-proclaimed health “experts” and hokey fitness gimmick infomercial hosts promise you can cull the kilos (or pare away the pounds) by exercising only three minutes a day.

Then there’s the fine print: Losing “weight” is easy.   LOSING FAT and keeping it off can be downright difficult.  But don’t despair; there is hope! Arm yourself with these fat trimming lifestyle tips and keep it off for life!

Fat Loss Principles For Life

1) Banish Your Bathroom Scale

First things first: banish your bathroom scale and only take it out once every other week.  It is your fat loss foe! It is a traitor that will deceive you (unless you know how to keep it in line).

The media, food companies, and woo-pushing quacks have brainwashed everyone to focus on “weight loss” instead of FAT LOSS with little to no consideration for body composition. This sells products, but it’s the wrong message.

Anyone can “lose weight” by starving themselves on a fad diet but, while you might seemingly “lose weight” on the scale in the beginning, this is not fat loss. It’s mostly glycogen (stored carbohydrate in the muscle), water, muscle, and maybe a little fat.

And guzzling a so-called “skinny teatox” or “fit tea” loaded with laxatives and diuretics might fool you into thinking you’ve lost fat, but you’ll quickly regain the water and fecal weight as soon as you stop using it.

2) Buy Into Body Composition, Not Just Body Weight

Exercise. Focus on building and maintaining valuable muscle. Muscle is very metabolically active and pays a higher caloric “rent” to sustain itself (even at rest). Fat tissue, on the other hand, is something of a metabolic freeloader which burns comparatively fewer calories.

If after a few months your scale weight hasn’t changed much, you might notice that your clothes fit better.  This is usually a result of an increase in muscle and decrease in fat.

Have a look and compare these two cross sectional thigh scans.

thigh_with_fatthigh_with_fat2The first image shows a strong dense muscle with minimal fat penetrating into the muscle.  The second image shows a weak, wasting muscle which is infiltrated with fat.  The overall surface area is similar, but you can see the drastic difference in composition.

3) Don’t Trust Fibbing Exercise Machines 

Ever seen those “fat burning” or “cardio” buttons on treadmills and stationary bikes?  The irony is the so-called “fat burning” button can keep you fat and the cardio button will help trim your gut and butt.  This is where it gets confusing so pay attention.

In the image below, you can see that a lower intensity (lower VO2) burns proportionally more fat as a fuel source during exercise (fat burn button). The trade off is that you also burn less overall calories per unit of time compared to higher intensities.

At higher exercise intensities (cardio button), you burn more carbohydrate (sugar) as a fuel source (blue dots in the image), but you burn more calories per unit of time.


Comparing apples to apples, if you did 10 minutes on the treadmill on the low-intensity fat loss setting versus 10 minutes on the the higher-intensity cardio setting, you’d actually be better served by the cardio setting.

Independent of the fuel source during exercise, your overall energy (calorie) expenditure is higher. The energy deficit created by exercise is later justified by the body pulling fat out of storage (even when not exercising).

In the long-term, you are served much better by exercising at higher intensities per unit of time and maximizing the energy burn than focusing on which fuel source you’re using during exercise.   The overall CUMULATIVE calorie deficit is what matters and that’s what’s going to have you looking good for the long haul!

If you’re new to exercise and out of shape, then you may need to start off at a slow pace in order to allow your body to adapt.  Progress slowly and work up to higher intensities over time to maximise intensity to enhance energy expenditure.

4) Build Your Fitness Foundation

Following on from above, if you’re completely new to exercise, develop your fitness foundation slowly and gradually progress to higher intensities. Doing too much too soon may leave you sore and discourage you from continuing. Check out my 10 quick tips to get off the exercise rollercoaster and set your fitness foundation in stone.

Start off at a leisurely pace on the bike or treadmill for no more than 20 minutes and do this 3 to 4 days per week.

Depending on how you feel, increase your duration by 5-10 minutes per session each week until you can do 45-60 minutes of non-stop cardio exercise.

5) Integrate Intense Intervals

With your fitness foundation in place, start cranking up the intensity by integrating intervals into your routine (this is key for fat loss). Intervals are higher intensity bursts interspersed within your cardio routine designed to raise your heart rate and crank up the calorie burning control knob.

During your cardio exercise, start off with 1 to 2-minute high intensity bursts and then give yourself 3-4 minutes of active recovery at a lower intensity (keep walking or pedaling).

Perform your intervals at an intensity high enough that you can barely speak to the person next to you, preferably an exercise partner who shares your same fat loss goals.

6) Work Up to High Intensity For Longer

Once you’ve established your fitness foundation and incorporated intervals into your regimen, try to maintain higher intensities for longer durations.  The longer you maintain the higher intensities, the more energy you burn, the more fat you pull out of storage, and the greater your overall fat loss.

7) Lift Weights (or Body Weight). Muscle = Metabolism

Muscle is the machinery that drives your metabolism.  Resistance training is known to enhance muscle size, structure, and function all of which cause a cascade of health benefits.  It doesn’t mean that you need to grunt and groan amongst bespandexed gym gorillas.

Many of the fitness boot camps leverage on calisthenic style exercises which mostly use body weight for resistance.  Muscles don’t have eyes.  As long as you’re stressing your muscles at a level above and beyond that which they’re normally accustomed, you can expect improvements in your appearance and, of course, your metabolic health.

8) Focus on Small Changes For Big Improvements

Avoid radical changes in your diet, as this only sets you up for failure.  Focus instead on making tiny nutrition changes you can live with.  For example, try cutting down on soda, chips, and sweets.

If you drink a liter per day, wean your way down to 500 milliliters, then to 250, and eventually to water.  One little change can translate to big changes in both scale weight and appearance over the long haul.

If you consume 250 calories less and expend 250 calories more with exercise each day, over one calendar year you’d could plausibly strip off about 23 kilograms (50 pounds) of body fat.

Obviously the actual amount of fat loss will vary due to inter-individual differences in genes, habits, and behavioral considerations (see my article: Obesity Genes: Does your DNA predict Body Fat and Weight?).  Small changes are important because they minimise the “famine response” and keep you off the exercise rollercoaster (and then some). As a general rule, healthy FAT LOSS is approximately 1 – 2 pounds (0.5 to 1 kg) per week.

9) “Incidentally Speaking,” Waste Energy with Incidental Activity

The emerging science of inactivity physiology shows that we need to be as inefficient as humanly possible as often as possible.

  • Waste energy at all times of the day outside of your structured exercise sessions.
  • Avoid life’s shortcuts.
  • Nix the elevators. Opt for the stairs.
  • Walk up those steep hills.
  • Take public transit and weigh yourself down with a laptop case or backpack.
  • Use a handbasket at the supermarket instead of a trolley (shopping cart).
  • Use a standing workstation instead of a sit-down desk.

The more energy you blow throughout the day, the greater your overall fat loss.  Every little bit counts and it all contributes to the “bottom line.”

10) Buddy Up

Sure, misery loves company, but so does exercise!  Identify your supporters and saboteurs.   Avoid the saboteurs who will attempt to undermine and derail your efforts out of jealousy.   Surround yourself with positive, supportive people who will either exercise with you on your journey or play the role of cheerleader!  It may also be helpful to join online support networks which will allow you to share your experience with other like-minded people who may be going through the same thing.

11) Make it Fun

It’s the age-old question: What’s the best exercise in the world?  The one you LIKE and the one you’ll do on a regular basis!  I see lots of trainers and exercisers alike debating over which exercise is best, but when it comes right down to it, you just need to find something that will make you more active.   If you like to walk, then walk.  If you like to ride your bike around the neighborhood, then ride your bike.  As mentioned above, intersperse some intervals to crank up the calorie burning control knob!

12) Unfriend the Media

The media is NOT your friend.  Cancel your cable TV subscription or at least stop watching it 20 hours per week. Nix the fluffy celebrity gossip magazines. These types of publications are loaded with unrealistic body images that are merely airbrushed photos meant to provide false hope and sell copies.

13) Fire Your Health Guru

The popularity of social media has led to rampant proliferation of self-styled “health gurus” like the so-called Food Babe and David “Avocado” Wolfe, both of whom have gone down in flames for making outlandish claims with no health science training.

While we all want to believe claims that health nirvana is just one miracle diet, supplement, or infomercial gadget away, the grim reality is that none of this works.

Guru promises of simple solutions to complex problems will likely leave you with complex problems without simple solutions. While not always a guarantee, checking for university qualifications in a health science can increase your chances of getting reliable information that will help you adopt a healthy lifestyle for life.


In all my years as a diet and exercise professional, I can tell you one thing with absolute unequivocal certainty: the secret to permanent fat loss is that THERE IS NO SECRET.

Every client I’ve worked with who has lost weight and kept it off did not rely on slimming wraps (i.e., It Works body wraps). They simply committed themselves to a healthy lifestyle and then stuck with it for the long term. Thing is, we’ve known it all along.

Even the ancient Greeks knew it.  Hippocrates is quoted as saying, “If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.”

More recent evidence of this can be found on Dr. Rena Wing’s National Weight Control Registry at the University of Rhode Island.

As much as we’d all like to believe in “wishful shrinking,” miracle diets, pills, powders, and infomercial gadgets do not work.  If they did we’d all be thin by now!

Bottom line:  consistency in doing the right thing will always win out over quick-fix fad diets and gimmicks.  Stay the course!  

CrossFit: An Independent Unbiased Review

CrossFit: An Independent Unbiased Review

CrossFit exploded onto the scene about a decade ago and since then has amassed a huge following – and a lot of criticism. But is this criticism fair and warranted? CrossFit helps a lot of people, so how can it be bad?

In this guest post by professional strength and conditioning coach Dan Jolley, MSc, he takes a step back and provides a level-headed and balanced rundown on CrossFit, the pros and cons, and those who might benefit most from it.

Over to you Dan!  -Bill

There has been a massive change in gyms and group exercise over the last few years. At the forefront of this has been one of the most polarising exercise modalities of recent years – CrossFit.

While nothing in a CrossFit workout is actually new (they use bars, weights, and equipment that has been around for decades), their workouts are put together in a novel – and in some circles, controversial – way.

Plenty has been written about CrossFit, most of it very polarising. Therefore, the aim of this article is to take the view of an impartial observer. I’ll assess the pros and cons of this form of exercise and examine what the evidence says about its claims.

Principles of CrossFit

To define CrossFit, it is useful to go to the source. According to the CrossFit website:

CrossFit is constantly varied functional movements performed at high intensity. All CrossFit workouts are based on functional movements, and these movements reflect the best aspects of gymnastics, weightlifting, running, rowing and more.

While this isn’t necessarily a novel approach, there are a couple of things worth noting. One is the use of the word “functional.”

What Does “Functional” Actually Mean?

“Functional” is a buzzword bandied about by the fitness industry in recent years and tends to be attached to the use of free weights, body weight exercises, and exercises that challenge stability. None of these are bad things.

In fact, as a strength & conditioning coach, these are all options I use daily. You will always see plenty of free weights in a CrossFit gym, and this has influenced the broader fitness industry to provide this equipment too.

But when deciding whether or not a movement is functional, it’s worth considering whether that “function” is relevant to the person doing the training.

Personal trainers are generally taught to select exercises (and other variables) to suit the needs of the client. This is good practice regardless of whether or not you consider your exercise “functional”.

There isn’t necessarily an agreed-upon industry standard definition of this term as it relates to exercise. The key phrase from the Wikipedia definition, “movements based on real-world situational biomechanics” is a good place to start.

CrossFit has a slightly different take:

We scale load and intensity; we don’t change the program. The needs of Olympic athletes and our grandparents differ by degree, not kind.

What this suggests is that everyone walking into a CrossFit gym will do the same workout, in the same order, though the resistance applied will vary.

Exercise selection is generally seen as a fundamental part of exercise prescription that can be varied to suit the individual (a good summary of the research on resistance training prescription can be found here).

CrossFit suggests that everyone can benefit from the same program.

To a point this is true: beginners, especially, will benefit from any increase in exercise levels, regardless of the choice of movement. This becomes less true with more training experience since the athlete is closer to his/her own physiological ceiling, but more on that later.

CrossFit and Exercise Intensity

The other variable that may be manipulated in a CrossFit workout is intensity:

The more work you do in less time, or the higher the power output, the more intense the effort. By employing a constantly varied approach to training, functional movements and intensity lead to dramatic gains in fitness.

In this case, the concept of power (i.e. a faster workout) is used synonymously with intensity. But in other modes of exercise, intensity can be changed in other ways.

In resistance training, for example, intensity is often measured as a proportion of the maximal weight a person can lift (i.e. their one repetition maximum, or 1RM) that is used for an exercise.

When running, intensity could be the proportion of maximal speed or heart rate, depending on what can be measured at the time.

Further, if we look at intensity subjectively, a more intense effort could be anything that the exerciser thinks is harder (the concept of RPE – rate of perceived exertion). This can be influenced not only by the difficulty of the workout, but other social and psychological factors, and their recovery from their previous workout.

We can also vary difficulty of a workout by using methods such as repetitions which are slower, or over a longer range of motion, or more repetitions at a lighter weight. The speed of the movement is just one variable that a good trainer can manipulate.

In CrossFit however, the emphasis is on completing workouts faster. Speed is characteristic of these workouts, rather than a variable to adjust.

How Can You Tell Which is a CrossFit Gym?

This can be harder than you think. CrossFit gyms are independently owned, not franchised. As such, there is no common image or corporate branding. And while there are similarities in the types of equipment you will find, the size and layout of gyms will vary significantly.

Similarly, they tend to be operated by the owners, and there can be significant differences in the approach of the owners and the instructors they employ.

They have a few things in common though. The word “CrossFit” will probably be in the title. When you go into a CrossFit gym you know what you are going to get in terms of exercise. You will lift weights. The exercises will generally be big, compound (multiple joint, multiple muscle group) lifts. You will be challenged to lift heavy. There will be an element of cardiovascular fitness in the workout. And you will race against a clock, with your time being written up on a board.

Each gym will have their “workout of the day” or WOD. In keeping with the principles of CrossFit, most people who attend the gym that day will complete this session. Depending on the gym they may have other classes or sessions for different levels of ability. The workout may take around 45 minutes, so fits pretty comfortably into a working day.

One of the major characteristics of CrossFit is the atmosphere of the gym. Though (as mentioned earlier) there is significant variation in gyms, there is an element of teamwork and camaraderie that is missing from most commercial gyms.

You don’t see many people training on their own in a corner wearing headphones. This is either a positive or a negative – depending on how you like to train – but it is obvious! There is a genuine social element to attending one of these gyms.

Who Are CrossFit Coaches?

Again, this is a tough one to answer, as the coaches I’ve met come from a variety of backgrounds. Some have come from a traditional gym or personal training background, some have sport science degrees, and others have come from sporting or Olympic weightlifting backgrounds. And some have known nothing but CrossFit in their fitness careers.


CrossFit qualifications have been a point of discussion in the fitness industry for some time. The basic qualification for a new instructor is a two-day course, which includes theory, practical components, and an assessment. There are other courses an instructor can do to update their knowledge after that but these are not compulsory.

While this is better than nothing, it compares poorly to the rest of the industry. In Australia, the Certificate III and IV qualifications for personal trainers, for example, have recently become much more demanding and can take up to 12 months to complete full time.

University qualified personal trainers and accredited exercise physiologists have 3 to 4 years of education. And to work in sport in a professional or semi-professional capacity as a strength and conditioning coach, it’s pretty hard to even get a foot in the door without a Master’s degree or PhD, as well as practical coaching qualifications.

While not everyone needs such a highly qualified coach, it is clear that, in terms of education and depth of scientific understanding, basic CrossFit certifications compare poorly to the industry at large. It’s always useful for the client to know what qualifications their trainer holds and whether they are up to date with ongoing education.

Is CrossFit Effective?

The short answer is: it depends on the individual and level of exercise experience.

One of the key tenets of CrossFit – the high effort the workouts consistently call for – means that even someone with a decent exercise history can stand to benefit from the increased effort. All of us have been guilty of coasting in our workouts from time to time, so getting pushed harder can lead to real improvement.

The workouts are also conducted in group settings, against the clock, with the encouragement of trainers. The psychological benefits of this environment are huge; most of us will work harder in these conditions. If you have fairly general fitness needs, this could be a great environment for you.

For those with more specific needs, CrossFit might not be their best option. Earlier in this article, I discussed the need for specificity when designing training programs. For those with a long training history, or those who compete at higher levels of sport, generic programs are comparatively less effective.

For example, in my time as a strength and conditioning coach, I have worked at high levels within Australian Football and American Football (gridiron). Both groups of athletes need a degree of aerobic fitness and repeat sprint ability. CrossFit would improve both groups of athletes if they were relatively untrained.

But the Australian Football players may need to run hard over relatively long distances with short rest between efforts. The American Football athletes, on the other hand, need to be able to perform high intensity sprints, but get much longer recovery between efforts and cover much shorter distances.

I spend much more time developing the aerobic capacity of Australian Football players, whereas the gridiron guys have much more of a repeat sprint focus. With CrossFit’s focus on generic programming and timed workouts, and speed as their major marker of intensity, the specific requirements of each sport may not be met.

Additionally, differences in the distances covered, types of change of direction and physical contact, and the different body positions in the sports mean the training programs of these players end up looking quite different.

And lastly, the needs of an individual may change over the course of a season. Meeting these needs often involves an element of foresight and planning (called “periodisation”). The WOD on any given day may not match these needs.

How Safe Is CrossFit

The answer to this is, it depends who you are (do you sense a trend here?). It is hard to label CrossFit as “safe” or “unsafe” due to the massive variation in gyms and clientele. But regardless of the gym you are joining or the exercise program you are beginning, there are a few things that should be standard:

  • Did the gym you joined ask you to complete a form outlining your medical and injury history?
  • Did they ask follow up questions based on the answers you provided?
  • If they identified you as a high risk client, did they request a medical clearance?

If they didn’t do any of these things, they are breaching their duty of care. There is now an industry standard form and process endorsed by both Fitness Australia (which regulates personal trainers), and Exercise & Sports Science Australia (which regulates exercise physiologists). This level of detail is a good start and clearly a step in the right direction.

  • Did the trainers at this gym assess your ability to perform the exercises required? A movement screening of some sort (for example, the Functional Movement Screening), a fitness test, or a strength test, would provide relevant information here. If everyone is doing the same program, it’s worth making sure everyone is capable!
  • Do they offer introductory courses? Despite the marketing, I know from firsthand experience that not everyone can do the same movements. In particular, CrossFit WODs may involves parts of (or even full) Olympic lifts, which are technically quite challenging. If they run beginner’s classes, sessions where they teach these lifts, or individually adjust the exercises to suit the individual participant’s ability, you can have some confidence that they are looking after their members.

There is an inherent risk to performing any exercise under high levels of fatigue, such as CrossFit may encourage. As a general rule, injury rates in CrossFit are comparable to other sports. A 2014 study of CrossFit participants found the injury rate to be 20%, though those with more trainer supervision had lower injury rates. This may be a level of risk that someone wishing to compete in CrossFit may be willing to take on, but the recreational exerciser with general goals should make an informed decision about whether this exercise intensity (and risk) is appropriate for them.

CrossFit-induced Rhabdomyolysis?

One of the most well-publicised risks of participating in CrossFit is rhabdomyolysis (or “rhabdo”). While this condition is not unique to CrossFit, there has been an upsurge in rhabdo cases with the increasing popularity of this type of exercise. The CrossFit brand is also not helped by the casual way that rhabdo is treated by some of its proponents.

CrossFit Rhabdomyolysis clown

“Uncle Rhabdo,” one of the unofficial mascots of CrossFit. From

In an exercise setting, rhabdomyolysis occurs when skeletal muscle breaks down rapidly. While some muscle damage is an essential part of our adaptation to exercise, a very high volume of demanding resistance exercise using large muscle groups (i.e. squats), can cause an extreme amount of muscle damage. As a result, byproducts of muscle breakdown enter the bloodstream. Very dark urine, and unusual swelling in the muscles are obvious signs.

Previously this was seen in athlete populations such as triathletes and ultramarathon runners, but those who are relatively untrained and doing CrossFit workouts have a higher risk than other modes of exercise. The incidence of rhabdo in CrossFit is not well documented and the scientific literature to date mostly deals in case studies, so it’s hard to draw conclusion from such a small sample of cases. On top of that, a competent and well-qualified trainer should be able to manage the progression of the client at a safe rate (as discussed above), rather than throwing them off the deep end straight into the full workout.

My Experience?

The aim of this article was to remain impartial and present the risks and benefits of CrossFit to someone without a pre-existing opinion, or a lot of exercise knowledge. My own personal experience with CrossFit has been fairly limited, but unusual for someone writing an article about this mode of exercise, I am neither an advocate or a hater.

I have used CrossFit gyms for testing and training sessions when coaching teams which didn’t have access to gym facilities. This is because they have the weights, lifting platforms, and other equipment we need that not all gyms have. The trainers I’ve met as a result and been welcoming and helpful.

When holidaying in the US a couple of years ago, I was staying with some friends in Denver who train at a CrossFit gym. I went along for a workout with them one morning and found it to be a reasonably enjoyable experience.

While it was not a session I would normally select for myself, I was happy to join in. The instructors were degree qualified, did a movement screening with me before the session, and made sure I warmed up properly. And I got a decent workout (I didn’t perform at my best though – I blame the altitude!). Overall, it was a professionally run operation.

I’m aware of other CrossFit trainers who are highly experienced and possess good qualifications beyond their CrossFit certifications. Unfortunately, I am also aware of trainers who cut a lot of corners and operate outside their scope of practice (by purporting to be able to treat injuries or prescribe diet plans).

I’m also personally aware of one case of exercise-induced rhabdomyolysis from a CrossFit workout here in Perth. This person was the typical higher risk candidate for the condition (having a poor training history to that point), but was put straight into the main workout by her trainer and ended up hospitalised.

Take Home Message on CrossFit

Like all exercise modalities, this CrossFit is not for everyone. If you want a challenge, have a moderate level of fitness, and have lifted weights in the past, go for it. If you want to compete in the sport of CrossFit, by all means go for it.

If you have a history of injuries or medical conditions that may affect your ability to exercise, then a group setting, or high intensity exercise, may not be the best choice for you. CrossFit is both of these!

If you have very specific needs (such as sports performance), then CrossFit may give you a bit of a boost to your training in the short term, but a more structured long term approach will provide a better benefit.

Retirement is Bad For Your Health (So Don’t Retire!)

Retirement is Bad For Your Health (So Don’t Retire!)

I subscribe to a number of research digest emails, many highlighting molecular research which, for the most part, I find profusely boring and impractical.  But one headline from Medscape caught my eye: “When It Comes to Work, How Old is Too Old?

The intro made reference to the author’s grandfather and, in many ways, immediately reminded me of my own grandfather (which I’ll address later).

The passage read:

My 92-year-old grandfather cuts hay atop a 5-ton tractor each summer, baling winter feed for more than 800 head of cattle. The rest of the year he herds, corrals, immunizes, and cares for the cattle.

But digging further into the implications of this question, it spurred a number of thoughts on what will no doubt become a growing issue – particularly in places like the United States still recovering years later from the global financial crisis.

I just read a related article today on the

Questions remain about how the US national debt may affect federal pension funds. Connecting the dots, I seriously question whether those reaching retirement age will actually be able to retire at all if there’s nothing left in the coffers to pay retirees.

While continuing to work well past age 70 might seem like a fate worse than death for most, I’d argue that, from a health perspective, this might even be a good thing.

Retirement is Bad For Your Health

In this day and age of better medicine and longer life spans, the idea of retiring at 65 is antiquated and only contributes to age-associated declines in physical and mental health.  I’m sure you can think of someone you know who retired and then sat back in their easy chair waiting for the grim reaper to come knocking on the door.  You may have noticed a loss of muscle tone and a steadily encroaching waistline.

On the other hand, I’m sure you can also think of people who’ve retired from their careers but continued to lead physically active lives, kept involved in social events, and perhaps even went back to work a part-time job just to have something to do.

As a health professional, I believe the latter is a much more productive way to live in so-called retirement.

The article references a publication by Rohwedder and colleagues in the Journal of Economic Perspectives (2010; 24:119-138) and states:

Many workers benefit significantly from continuing to work into old age. Work is “medicine” – even better than medicine for many. In addition to providing economic security and often wider access to healthcare options, work enhances well-being, promotes social interaction, increases the variety and quality of life, and provides many people with a sense of accomplishment and achievement.  Although some older individuals work out of necessity, many report that they continue to work to contribute, or to “make a difference.” Almost all jobs help older people sustain and extend their physical activity level and support increased social engagement and larger support networks. Work provides accountability for many; an absence from work may serve as the first sign to warn distant family that something is wrong with a loved one. Emerging evidence also suggests that work may improve brain health, sustain healthy cognition, and protect memory.

The overarching theme here seems to be that NOT working is hazardous to your health. In my experience working in a hospital-based cardiac rehab program, I’ve seen many older adults come into the clinic after a massive heart attack and open-heart surgery and, after pushing through the first couple weeks of exercise sessions, they begin to feel better physically (as expected).

More importantly, they develop a sense of social connectedness by relating their personal stories with other patients sharing similar medical histories. I found this effect to be even more pronounced in widowers who, after having lost a spouse, given up their careers (evil retirement!), and feathering an empty nest, were basically sitting around doing nothing up until their hospitalization. In a twisted version of irony, it may very well be that a small heart attack was just what they needed to shake off the retirement blues and rediscover the joy of living again.

The Body Only Knows Neglect, Not Age

In my lectures, I like to use a quote I once heard regarding age and health: “The body does not know age….the body only knows neglect!” And in my line of work, I can confirm wholeheartedly the unequivocal truth in this statement.

Stories of Resilience and the Human Spirit

I recall the story of a former patient named Norma. She was a dainty grandmotherly lady in her late 70s who’d never set foot in a gym in her life. Upon arrival to cardiac rehab, she was a bit intimidated by all the treadmills and bikes. After familiarization with the equipment, she developed a comfort level with exercise and, dare I say, even became an exercise junkie! She was there religiously three days a week, on time, all the time, every time.  She even showed up by accident on a public holiday when the clinic was closed!  All of us at the clinic developed a fondness for her and even gave her the moniker “Stormin’ Norma!”

Bonnie was another patient of ours who was in her early to mid 90s.  Despite some limitations in her eyesight, she was quite resilient and always willing to try any exercise we put in front of her. By the time I left the clinic to pursue other professional goals, she was doing a pretty solid pace on the treadmill, tolerating a fair workload on the stationary bike, rowing on the rowing ergometer, lifting weights, and taking yoga classes.

The two words you frequently heard out of her mouth were, “I’ll try.” Whenever we asked her to try a new exercise, her response was always the same: “I’ll try.” And as I took a step back and looked at her, I realized she was so functional and spry simply because she refused to roll over and take frailty as a given!

Exercise is Hard, No Exercise is Even More Difficult

Some older people think that exercise is “too hard” but the reality is, life WITHOUT physical activity is exponentially harder. Sure, if you exercise, you’re probably going to have some sore muscles and pinched nerves once in a while, but the penalty for doing nothing is far worse than a few transient aches and pains.

I’ve led a very physically active life over the years and, in spite of knee injuries, broken ribs, a tweaked back, and pulled muscles (and the list goes on), I still think it was all worth it. Again, the penalty for a physically inactive life is a slow, insidious onset of degenerative orthopaedic and metabolic dysfunction, not to mention the decrement in cognitive function – yes, exercise is good for the brain, too!

Ode to an Active Family

On a more personal note, I love it when I speak to my mother and she tells me about all the gardening work she’s doing around the house (especially now that it’s springtime in the US). Ok, so it’s not quite like going to the gym and giving the body a good flogging, but it does constitute physical activity, it’s functional and relevant to her life, and she enjoys it – ticks all the boxes as far as I can tell!

In closing, I’d like to pay homage to my own grandfather and his personal brand of “exercise,” even before it was the trendy thing to do.  My memories of him would have reflected his so-called retirement years, but seeing how he moved about, you’d never have known he was “retired.”

John Sukala

Before I go on, you have to understand, he lived in a rural area in central-western Pennsylvania which means open space…and lots of it.

I fondly remember him going out into the field next to the house and using a scythe to chop down large areas of tall grass.  Being a farmer, he was out there with a hoe and preparing the soil for laying down crops.  He kept some animals so he built his own sheds to house them.  Even when he wasn’t “working” he always seemed to be doing something physical.

In the summers, we’d go fishing which would entail hiking around the lake to find a good spot to cast out our lines. In the winter, he’d spend all day out in the woods hunting with my dad, uncles, and older cousins.

But one lasting memory I have of him that still remains strong to this day was when he would kick my sister and me out of the house and refused to let us watch television!

He’d slap a hammer and nails in our hands and say something along the lines of “get out there and wack some nails into 2 x 4s!”  Pop-Pop walked on water in my eyes so whatever he said must have been the right thing to do!

While he may not have had all the science background on child obesity and inactivity physiology, he certainly had enough common sense and intuitiveness to know what was good for us.

Despite all the doomsday headlines telling soon-to-be retirees to fear for the worst, I think it’s all for naught.  We’re already living longer due to modern medical technology, so why not help it along by beginning a second career at 65!

How to Choose a Personal Trainer in 2017 – Using Science!

How to Choose a Personal Trainer in 2017 – Using Science!

Choosing a personal trainer in 2017 can be a daunting experience. Who is best qualified to help you? Who will deliver excellent service in the most safe and effective way possible?

In this post-truth age of social media-driven misinformation like “alternative facts” and “fake news,” lots of maverick trainers out there literally make up whatever training or nutrition theories they want, with no research evidence to back it up, wrap a marketing campaign around it, and then demand critics “prove them wrong.”

To be clear up front, this is not a hit job or a scathing indictment against personal trainers. Quite the contrary, there are excellent trainers out there who stick within their scope of practice and transform peoples’ lives. And it’s sad that their good reputation is being sullied by the presence of maverick trainers who are in way over their heads in professing knowledge they don’t have.

In this guest post by professional strength and conditioning coach Dan Jolley, MSc, he discusses the research around personal trainers’ knowledge and skills against the backdrop of their perceived level of knowledge and skills. He’ll then provide practical tips you can use to find a qualified trainer best suited to help you meet your goals. Over to you Dan! –Bill

Hiring a personal trainer: hasn’t this been covered before?

There are plenty of articles giving you good advice on how to find a personal trainer. Some of the advice is excellent (check out these articles here and here if you want to read further), but it’s an evolving landscape out there and it’s not just a simple case anymore of “find someone who is registered or certified.”

There are about 20,000 registered personal trainers in Australia (and, unfortunately, plenty more that aren’t registered), so there’s plenty of choice.

But we’re going to take a slightly different angle on choosing a trainer.

Not just what the trainer knows, but what they think about what they know. In fact, this could be the most important thing you find out about your personal trainer.

But firstly, what recommendations are already out there?

Choosing your personal trainer

Here is a quick 7-point tick list for choosing a good trainer:

  • Are they qualified? A Certificate IV in Fitness is the minimum standard for a personal trainer in Australia, though some have university exercise science degrees.
  • Are they a Registered Exercise Professional? If the trainer turns up in Fitness Australia’s register, you can at least be sure they have the minimum qualifications. You can also see what professional development they have done (though this is self-reported).
  • Do they have the appropriate insurance? A minimum standard is professional indemnity and public liability insurance.
  • Do they outline fees & charges up front? Standard advice in any industry. Make sure you know how much you are spending. Also ask about any refund or cancellation policy.
  • Are they capable to delivering the type of training you are after? If you have specific requirements due to injury, age, or unusual needs (i.e., uncommon diseases), can the trainer meet these needs? Some people may need a trainer with more advanced qualifications and specialty knowledge.
  • Do they perform a pre-exercise screening? This is a limitation for many trainers. This is not just a bit of paperwork, or a coffee and chat about what you want to achieve. This should be an in-depth, documented discussion of your exercise, medical, and injury history. Standard screening tests should be performed, as well as a movement screening, strength, or fitness testing as appropriate. You should be referred to a general practitioner or allied health professional if necessary before you begin training.
  • Do they operate within their scope of practice? If a trainer encourages the use of fat blaster nutritional supplements, plans highly restrictive diets, offers professional sports coaching, or claims to be able to diagnose or treat injury or illness, they are practising outside their scope of practice. I address this issue in my previous article on spot reduction in which I tackle exercise misconceptions that refuse to die.

What else should you know about your trainer?

Something I would like to add to this list of recommendations, however, is “make sure your trainer is aware of his/her own limitations, and is not overly (arrogantly) confident.” There is no shortage of personal trainers out there willing to tell you they are an “expert” in their field.

They may tell you they are up to date with the latest science of exercise and nutrition and are absolutely cutting edge. But are they? It’s unlikely unless they have a postgraduate research qualification (i.e., honours, masters, or doctoral degree in a health science discipline) and are able to read/comprehend complex biochemistry and physiology, interpret statistics, and then put the results into practical context.

The information presented to students as part of a personal training qualification is often a distilled and simplified interpretation of large and complex bodies of evidence across multiple health science disciplines.

Personal trainers may pick up a lot of additional knowledge by attending professional development courses, but they are still relying on experts in their respective fields (such as physiotherapists, dietitians, exercise physiologists, psychologists, etc.) to interpret the information and provide the context and perspective relative to the personal training field.

How much does your personal trainer know?

There’s surprisingly little research about the knowledge of practicing personal trainers, so to answer this question we must rely on international studies.

Results from a small qualitative study in Switzerland (which does not require personal trainers to be registered) found 85% of personal trainers possessed the required qualifications (with 12% having a university degree), but many used poor practices, or operated outside their scope of practice (such as prescribing supplements when providing nutritional advice). Furthermore, 73% of trainers did no follow up on the nutrition advice, which is unfortunate considering how unsuccessful the majority of weight loss attempts are.

While 62% did some ongoing reading or self-directed education, fewer than 20% attended a conference or course. However, this doesn’t tell us about the quality of the information to which they are exposed.

survey of 115 trainers in the US found that personal trainers with a bachelor’s degree in exercise science and certification by American College of Sports Medicine or the National Strength and Conditioning Association as opposed to other certifications were strong predictors of a personal trainer’s knowledge, whereas years of experience was not related to knowledge.

Personal Trainer Knowledge

From Malek et al. 2002. Importance of Health Science Education for Personal Fitness Trainers. Journal of Strength and Conditioning Research. 16 (1), 19-24.

Another US study from 2015 found similar results, with personal trainers demonstrating poor knowledge of exercise prescription guidelines.

Neither study found that the length of practice of a personal trainer improved their knowledge. This is important, as experience is often seen as a substitute for formal education in the fitness industry and is sometimes more highly regarded than education by many personal trainers I have met.

What has been shown to improve knowledge is the level of qualification the trainer possesses. So maybe we can consider this when choosing our trainer. Do they have, or are they in the process of completing, a university exercise science degree?

Following on from above, it’s worth mentioning that in the United States, no university degree or formal training is required by law to become a personal trainer. For some certifications, you can read a book, memorise as much as you can, and then take the exam. If you pass, then you’re a personal trainer.

An alarming finding of the 2015 study was the unfounded confidence that most of the trainers surveyed possessed. When asked to rate their knowledge after completing the test, only 7% of the trainers thought they knew less than half the answers. This is despite an average score of 43% in this case! More than half the trainers surveyed thought they knew “most of the answers”, though more confidence didn’t relate to better test scores!

The Dunning-Kruger Effect: the less you know, the more you think you know

In 1995, McArthur Wheeler robbed a Pittsburgh bank in broad daylight, in full view of security cameras, without an apparent disguise. But when arrested later that day, he was shocked that he had been caught. After all, he had rubbed lemon juice on his face. For some reason, Mr Wheeler thought that this would make his face invisible to security cameras!

While most of us would shake our heads at his stupidity, two Cornell University researchers were intrigued at how confident he had been in his (obviously flawed) knowledge. They wrote a paper entitled Unskilled and Unaware of It: How Difficulties in Recognizing One’s Own Incompetence Lead to Inflated Self-Assessments.

The phenomenon they described became known as the Dunning-Kruger Effect, which suggests that a certain amount of knowledge is required for someone to be aware of their lack of knowledge.

For a personal trainer, a small amount of education could make someone confident that they are ready to go into the industry and represent themselves as a fitness expert.

But someone with more education may also develop an awareness of how much more there is to know, and how incredibly complex a system like the human body is. And though they are more educated and informed, they often do not express as much confidence in their knowledge.

Personal trainer Dunning Kruger Effect

Figure 1 – Visual representation of the Dunning-Kruger Effect.  Image credit: refusetobeboring. com

Where does this overconfidence come from?

If you have a trainer already, you may be thinking “surely you’re talking about those other trainers? My trainer is on the ball!” You may be right, but all of us – you and I included – are affected by errors in thinking that influence our confidence.

One of the major ones is confirmation bias. This is when we interpret information in a way that supports our pre-existing opinion. There may be no problem here if our pre-existing opinion is correct, but this isn’t always the case.

When our knowledge of a topic is limited, it’s probably wrong, or incomplete at best. We then receive new information in a way that confirms our opinion and we become more convinced we are right. This is how misconceptions form and strengthen over time, so you end up with people believing vaccines cause autism (they don’t), the earth is flat (it isn’t), or homeopathy works (it doesn’t).

Even armed with this knowledge of confirmation bias and how it affects your thinking, you are still prone to it. Researchers have tried interventions to eliminate confirmation bias and none have been reliably successful to date. The best we can hope for is to be aware of it, and examine our own thinking and attitudes for bias on a regular basis. This also requires a willingness to admit our mistakes and be open to correction, which can be a challenge for many of us.

The attitude of your trainer is crucial

A study of personal trainers in the United Kingdom found that trainers would often behave in the fitness industry differently to how they were taught during their course. They would do what their instructor required during the course then operate in whatever way they thought best once in the workplace.

While it is possible that these trainers were making better decisions than their instructors were, and interpreting information more accurately, this seems unlikely.

Admittedly, I’m relying on anecdotal evidence here – my 8 years of lecturing in personal training courses makes me doubt the ability of these graduates. More likely, they were overly confident in their knowledge and abilities for the reasons discussed above.

The same trainers saw on-the-job training and industry experience as important, but said cost would discourage them from attending formal professional development opportunities. So the trainers prone to confirmation bias are not exposed to information that could lead them to correct their opinions. And as has been shown in previous research studies here and here, industry experience is not always a reliable indication of the quality of your trainer. But even this finding may be rejected by trainers with a contrary opinion.

While years of experience may tell you how dedicated to their craft a trainer is, and qualifications may tell you how intelligent or well-read they are, it isn’t the whole story. If your trainer is unwilling to accept that their opinions may be wrong, then it’s your health they may be putting at risk.

How to tell if your personal trainer is aware of their knowledge limits

A perfect opportunity to find out about your new trainer’s openness to evidence and change is the pre-exercise screening. If you have a medical or injury issue that will affect your training, what type of questions do they ask?

If your trainer wants to know which allied health professionals you have received treatment from, what remedial exercise, treatment, or medication was been prescribed, and what recommendations for ongoing management you have received, then you may have a good one. If they ask you detailed questions about how you have managed your exercise until now, even better. If they also want to discuss things further with other professionals, or do some extra reading, excellent! They get a gold star, and you have a trainer you can trust!

If, on the other hand, they don’t ask these questions, and are highly confident in their ability to treat or manage this issue, or are dismissive of the opinions of these qualified professionals, be sceptical. Unless one of these professionals was a homeopath – their opinion can be dismissed immediately.

In closing, the moral of the story is make sure your trainer is well-qualified, aware of their own limitations, and not proudly standing on top of “Mount Stupid.”

Are Antioxidant Supplements Necessary?

Are Antioxidant Supplements Necessary?

Free radicals? Disease? Here, take these antioxidant supplements…just in case!

We’ve been hearing about it for years. Free radicals are molecular villains responsible for everything from aging to heart disease to cancer, and that’s not even the tip of the iceberg.

Open up any popular health or fitness magazine at the supermarket check-out line and you’ll see glossy advertisements touting the clinically-proven “cure” – antioxidant supplements.

Then you go home, turn on the television, and there’s the news reporter citing some prestigious university’s study about how antioxidant supplements actually CAUSE cancer.

What’s going on here? Who’s right? Who’s wrong? Well, it all depends on whom you ask and which studies you believe. And even then, it’s still a very tangled web.

By textbook definition, free radicals are atoms or molecules that have one or more unpaired electrons in their outer orbit. In this state, they are highly reactive – and destructive – to everything in their paths.

That sounds understandable if you’re a biochemist, but what does it mean in practical terms? Before we move on, let’s break the whole process down from largest to smallest.

Bioenergetics 101

In the big picture, your body survives by breaking down and assimilating the food you eat.

Carbohydrates are converted to glucose, protein to amino acids, and fat to fatty acids and glycerol.

In these elemental states, they are combustible fuels readily oxidised (burned) by an assembly line of cellular reactions.

The released energy drives the formation of adenosine triphosphate (ATP), your body’s internal chemical currency.

Fanning the Flames: Cellular Respiration

Just like wood in a campfire, food must also have adequate oxygen so it can be completely oxidized.

In our cells, the mitochondria are metabolic firepits that must have oxygen to stoke the furnace.

However, sometimes too much oxygen gets sent down the “conveyor belt” forcing it to fall off the assembly line.

When this happens, the “mishandled” oxygen becomes highly volatile, highly reactive, creating what are called free radicals.

They bounce around inside the cell, wreaking havoc on cellular structures, particularly the cell wall.

Sounds nasty, but we have to be careful not to throw out the baby with the bathwater.

The truth is, free radicals are a normal part of our body chemistry. In fact, they even have beneficial functions that help keep us healthy.

For example, white blood cells give off free radicals, which attack viruses, bacteria, fungi, and other foreign invaders in order to weaken them enough to be destroyed by our immune system.

You’re probably breathing a sigh of relief.  But before you get too comfortable, remember that too much of a good thing is not always a good thing.  Free radicals must be kept in check by their big brothers: the antioxidants.

Antioxidants to the rescue

Antioxidants encompass a wide range of muscle enzymes and nutrients that “quench” free radicals.

They work by chemically stabilizing the free radicals, effectively stopping their destructive course.

Enzyme antioxidants can be synthesized in the body.

On the other hand, nutritional antioxidants like vitamins A, C, and E must be supplied by the diet.

While most people get adequate quantities in their diets (deficiencies are rare in developed nations), it has been observed that even athletes with suboptimal intakes of dietary antioxidants still get enough to adequately protect against free radical damage.

In the sports science arena, considerable research has been conducted to evaluate the effects of antioxidant supplements, over and above our normal dietary intake, on sports performance and muscle damage.

Exercise, Free Radicals, and Antioxidants

We’ve established that free radicals are a normal part of human metabolism. Now take it one step further.

During exercise, oxygen demands can increase 10-15 times resting levels.  This increases oxygen flux through the mitochondria, which also increases free radical production.

Maybe now you’re wondering if exercise has an “evil side.”

The good news is that regular exercise causes an increase in some antioxidant enzymes.

This means the physically conditioned person is more efficient at trapping free radicals and minimizing their damage.

Conversely, the untrained “weekend warrior” has lower antioxidant enzymes and is subject to more damage due to lower radical quenching capacity.

Are antioxidant supplements necessary?

You want to know the bottom line: Will antioxidant supplements stave off free radicals and reduce muscle damage?

There’s plenty of research out there on aerobic endurance athletes, but how does that apply to you if weight lifting is your preferred exercise?

Not much.  As of this writing, few studies have investigated antioxidants and resistance training.

Antioxidant research

High intensity interval training: study 1

In a study by Ortenblad and colleagues at Odense University in Denmark, 16 subjects (8 jump-trained, 8 untrained) performed six bouts of 30 second continuous jumping separated by two-minute rest intervals.

They found that trained exercisers had higher protective muscle antioxidant enzymes and lower levels of creatine kinase (a marker of muscle damage).

Interestingly, there were no significant differences between groups in malondialdehyde levels (a marker of free radical damage on cell membranes).

These results suggest that mechanisms other than free radical generation are responsible for exercise-induced muscle damage.

It also underscores the importance of regular exercise and the body’s ability to adapt and compensate for free radical stressors, independent of taking antioxidant supplements.

This study’s protocol is particularly relevant to exercisers. The metabolic demands of repetitive, high-intensity jumping make it anaerobic (like plyometrics training), thus circumventing oxygen and its cellular assembly line through the mitochondria.

According to Priscilla Clarkson, Ph.D., Professor of Exercise Science at the University of Massachussetts in Amherst, “There are other ways to generate free radicals than just through oxidative metabolism. They can also be generated by lactic acid.”

But this doesn’t mean you need to ease up in the weight room.

“For both resistance and aerobic exercise, I think that the body can naturally take care of what is produced, given that the diet is adequate in antioxidants,” she adds.

High intensity interval training: study 2

In a study by McBride and colleagues at Penn State University’s Noll Physiological Research Center, recreationally weight trained men received 1200 IU of vitamin E followed by three circuits of eight resistance exercises with 2, 1.5, and 1 minute rest periods between each successive circuit.

Creatine kinase levels went up in both groups, but lower amounts were observed in the supplemented group compared to those on the placebo.

Malondialdehyde levels significantly increased in both groups, with no between group differences.

These results also suggest that resistance exercise produces free radicals, and that vitamin E supplementation may help moderate muscle tissue damage.

On the surface, it seems possible that vitamin E supplementation effectively quenches free radicals, which could reduce muscle damage, and hasten your recovery time.   However, there may be more to this than meets the eye.

According to Allan Goldfarb, Ph.D, Professor of Exercise and Sports Science at the University of North Carolina in Greensboro, “If you pre-treat athletes with vitamin E (which acts as a membrane stabilizer and antioxidant) and measure creatine kinase in the blood after eccentric exercise, this protein level decreases.

Thus, people have indicated that vitamin E prevents muscle damage and protein leakage. However, these are two separate processes. They have been shown to be independent and, at times, can be separated. So it’s possible to stabilise the membrane to prevent creatine kinase levels from increasing, but still have muscle damage.”

The fly in the ointment

You can selectively quote studies arguing for or against the efficacy of antioxidant supplements. But remember that the results are only as good as the experimental methods employed.

Subjects’ age, training level, exercise modality, intensity, and duration, type of antioxidant administered, and nutritional status are just some examples of factors that can confound research results.

On top of all this, you should know that it is very difficult to accurately measure free radicals or indicators of their damage.

There are a variety of fancy biochemical tests that can be done, some more accurate than others. The caveat is that most of these are indirect measures that force scientists to extrapolate and hypothesize what’s actually happening at the cellular level.

If It Ain’t Broke, Don’t Fix It

All this confusion makes you wonder if we should just wipe the slate clean and start over. But there’s no need to be so hasty in our judgment.

We know that exercise induces free radicals and that they must be kept in check.

Regular exercise, coupled with a healthy diet, appears to offer protection against the deleterious effects of free radicals.

Sometimes strenuous exercise produces more free radicals than our bodies can handle. Thus, antioxidant supplements may be warranted in appropriate circumstances.

However, this issue is clouded by considerable variability and limitations in experimental methods and chemical analyses, which leaves us wondering how much merit there is to these recommendations.

Dr. Clarkson sums it up best, “Taking a multivitamin/mineral supplement with no more than the recommended dietary allowance seems a conservative yet prudent approach.  Taking too much may cause more harm than good.”


Clarkson, P.M.  (1995) Antioxidants and physical performance.  Critical Review of Food Science and Nutrition.  35(1-2): 131-141. (view article)

Dekkers, J.C., L.J. van Doornen, and H.C. Kemper.  (1996) The role of antioxidant vitamins and enzymes in the prevention of exercise-induced muscle damage.  Sports Medicine.  21(3):  213-238. (view abstract)

Drews, G., A. Wozniak, G. Chesy, A. Rakowski, and B. Wozniak. (1998) Effect of exercise on the activities of selected antioxidant enzymes in the erythrocytes of weightlifters.  Biology of Sport.  15(2):  75-79. (view abstract)

Groff, J.L., S.S. Gropper, and S.M. Hunt.  (1995) Advanced Nutrition and Human Metabolism.  2nd ed.  Minneapolis, MN:  West Publishing.  pp. 308. (view reference)

Kanter, M.M.  (1994) Free radicals, exercise, and antioxidant supplementation.  International Journal of Sports Nutrition 4: 205-220. (view abstract)

Kanter, M.M. (1998)  Free radicals, exercise, and antioxidant supplementation.  Proceedings of the Nutrition Society.  57(1):  9-13. (view abstract)

Karlsson, J.  (1997) Antioxidants and Exercise.  Champaign, IL:  Human Kinetics.  pp. 31-32. (view reference)

McBride, J.M., W.J. Kraemer, T.Triplett-McBride, and W. Sebastianelli.  (1998) Effect of resistance exercise on free radical production.  Medicine and Science in Sports and Exercise.  30(1):  67-72. (view reference)

Ørtenblad, N., K. Madsen, and M.S. Djurhuus.  (1997) Antioxidant status and lipid peroxidation after short-term maximal exercise in trained and untrained humans.  American Journal of Physiology.  272:  R1258-R1263. (view abstract)

Sacheck, J.M. and J.B. Blumberg.  (2001) The role of vitamin E and oxidative stress in exercise.  Nutrition.  (17):  809-814. (view abstract)

Sacheck, J.M., E.A. Decker, and P.M. Clarkson. (2000)  The effect of diet on vitamin E intake and oxidative stress in response to acute exercise in female athletes.  European Journal of Applied Physiology.  83(1):  40-46. (view abstract)

Personal Interviews
Priscilla Clarkson, Ph.D., Professor of Exercise Science at the University of Massachussetts, Amherst

Allan Goldfarb, Ph.D, Professor of Exercise and Sports Science at the University of
North Carolina