Tuesday, June 07, 2005

Gibala Claims Media 'Misinterpreted' Study On Interval-Based Training

Dr. Martin J. Gibala

Of the thousands of people who read my blog post from Monday entitled "Researcher Sending Wrong Message About Fitness," one of them just so happened to be the author of the study that newspapers reported people can be just as productive with six minutes of vigorous exercise per week compared with hours of moderate exercise.

Dr. Martin J. Gibala from McMaster University was kind enough to respond to my blog entry to defend his work. You can tell from the language he uses in his response that he was not pleased with my analysis. Nevertheless, I am happy to oblige his request to print his response in this forum. However, I reserve the right to add my own comments where appropriate.

Here's what Dr. Gibala wrote:

Dear Mr. Moore,

I was interested to read your comments regarding our study that was published in the June issue of the Journal of Applied Physiology. While I am not in the habit of blogging, your misinformed rant about the implications of our work compelled me to reply.

While I am honored that you made "Livin' La Vida Low-Carb" your first official act of blogging, I would not describe what I wrote on Monday as a "misinformed rant." Rather, I was simply expressing my concerns that the wrong message was being sent to the countless millions of people who are looking for professional advice about how much exercise is enough. If I was misinformed, then so was the entire published media.

"My initial response is, please READ our study. Obviously you have not; rather, you appear to be relying on second hand sources that have misinterpreted and/or overstated our findings. In fact, at no point in the article do we suggest that people should only perform 6 minutes of exercise per week."

So are you calling the media liars, Dr. Gibala? Every published news source I found on Monday was reporting that your research concluded that six minutes of "vigorous exercise" per week was equal to hours of moderate exercise. Is that wrong? While I admit I did not look at the actual research study myself, I'd be interested in knowing why all the media analysts got it wrong.

I referenced a WebMD story in my blog entry. Are you questioning the credibility of that reputable organization or its medical correspondent Daniel Denoon? Or perhaps you are questioning the Senior Medical Editor Dr. Michael W. Smith who reviewed the content of that story for its veracity? Are these men lying about your research, Dr. Gibala?

"You state, 'Combined with a healthy eating lifestyle, exercise can be a tremendous tool.' I completely agree, and recommend that everyone should heed the advice of leading public health agencies and perform 30-60 min of physical activity each day. However, the sad fact is that more than 50% of North Americans choose to ignore the recommended physical activity guidelines, despite extensive public health awareness campaigns. This fact has enormous social and economic consequences; for example, Booth et al. (2000) estimated that the health care burden of inactivity-related disorders in the U.S. is almost $1 trillion.

EXCELLENT! We've found some common ground at last. At least for the moment.

"It is fine to label people 'lazy' and bemoan their 'pitiful excuse(s)' for not exercising, but ranting from the soapbox about your own lifestyle conversion does little to address the problem of inactivity-related disorders."

Yeah, but maybe it can wake up people to the fact that they need to finally do something about their weight problem. That's what it took for me to finally realize it for myself. We are in a crisis in this country and around the world because of obesity and we need to start acting like it. If that means a few people like me become so passionate in our eagerness to help people overcome this awful condition that we seem to be "ranting," then so be it. Recommending people only exercise six minutes a week does nothing to help people start healthy fitness habits either.

Instead, perhaps we should consider other approaches, or at least offer credible alternatives that are based on sound science. There is an extensive body of scientific evidence that indicates interval-type training, or alternating bouts of high- and low-intensity exercise within a single training session, is effective for improving health and fitness."

I don't disagree that we need to look at other alternatives to get people to exercise. But my point is the rigors associated with "interval-type training" are not necessarily appropriate for people who weigh more than 300 pounds. As someone who used to weight 410, I shudder to think about even TRYING this method of exercise as a way to lose weight. It's a much better approach to get people to start exercising at their own pace and work their way up.

"Just because you 'disagree' with this approach and 'would have likely quit' is hardly reason for interval-based training to be dismissed outright. Indeed, I am utterly astounded by your arrogance, and the myopic manner in which you assume that your view is all-knowing."

Okay, now we're getting to the heart of the issue as Dr. Gibala's blood pressure begins to rise. I don't say that your approach should be "dismissed outright." I only said it would not be a good idea for someone who is not used to exercising to implement your strategy until he can better handle it. In fact, I even said that I could probably do your recommendation now that I am used to doing daily exercise.

As for my "arrogance" and "myopic" writing style that declares me as "all-knowing" (hey, that's God's job, buddy! LOL!), I think you have severely misinterpreted what I have written. I am merely someone who is confident about what livin' la vida low-carb has done for me and share my opinions on how my life has been transformed by this experience.

I don't even pretend to call myself an expert (nor do I play one on television) on the subject of health and weight loss. Instead, I can be described an enthusiastic layman ready and willing to share my anectodal experiences to help people relate to the information that is being distributed in the media about weight loss. My heartfelt desire is to help people better understand the information that is being spoon-fed to them by the media and to cut through the outright dishonesty that too often permeates from so-called stories on health.

In fact, you are claiming that the media "misinterpreted" your research in its reporting. That's my point entirely. They do it all the time to the low-carb lifestyle and yet nobody raises a stink about that. If it seems I'm attempting to make myself an "expert" on health and weight loss, then I cannot help that. All I can do is continue to share what I believe based on my own experience. That's what this blog is about from start to finish. If science backs up my opinion with facts, then I'll share those with you as well.

I do not have the time or space to review all of the evidence in support of interval-based training, but here are a few facts (backed by data from scientific studies published in highly-regarded journals):

1. Interval based training has been successfully applied to numerous populations including the elderly (Makrides et al., 1990) and even patients with heart disease (Rognmo et al., 2004). The latter study showed that high-intensity interval exercise training was superior to moderate exercise for improving cardiorespiratory fitness in patients with coronary artery disease.

2. Over the long term, people appear more willing to adhere or 'stick with' a higher-intensity, less frequent training program than a more frequent, less intense program. King et al. (1995) showed that, in previously sedentary 50 to 65 year old men and women, exercise adherences rates were significantly higher after two years of training in the higher intensity, less frequent exercise group.

3. Researchers are increasingly recognizing the important role of high intensity exercise for energy balance and weight control (Hunter et al., 1998). The reasons are numerous, but include the fact that higher-intensity exercise rapidly improves fitness, thus making low-intensity exercise less difficult and more easily tolerated.

4. It is possible to be 'overweight but fit' and active obese individuals can actually have lower morbidity and mortality rates than normal weight individuals who are sedentary (Blair and Brodney, 1999). Hence, strategies to improve fitness, such as interval-based training, can be effective regardless of weight loss.

5. Finally, one of the best predictors of insulin sensitivity and risk for Type 2 diabetes (an increasing epidemic in North American society) is the 'oxidative capacity' of the muscle (Bruce et al., 2003). Our study showed that interval-based training rapidly increased muscle oxidative capacity to an extent normally associated with traditional endurance training. Our data are consistent with other high-intensity, short-duration exercise training studies (MacDougall et al., 1998) and indicate that this type of training is effective for rapidly improving muscle health."

Okay, so you've presented your evidence for your exercise approach. Does that change what I wrote about it? Not one bit. I still think we are sending the wrong message to people that they can get away with doing considerably less exercise and expect to make that a regular habit in their lives. And I still haven't seen the part of your research where the media got it all wrong yet? Where did they get the notion of six minutes per week, Dr. Gibala? Did they make it up?

In closing, I reiterate that I wholeheartedly endorse the current physical activity (and dietary) guidelines put forth by leading public health agencies. However, your accusation that we are sending the wrong message in unfounded (again, please READ our study). The message from our study is not that 'you should only perform 6 minutes of exercise per week'; rather, our findings are a reminder of the potency of interval-based training for health and fitness. This form of training represents an option, or an alternative to the type of traditional endurance training that over half of the North American population appears unable or unwilling to adopt. Interval-based training is highly effective and can be adopted by a wide range of individuals (not just young healthy athletes, as you imply). It may represent a palatable alternative to those who cite 'lack of time' as a major impediment to exercise, and should hardly be dismissed outright based on the 'firsthand' knowledge of single individual.

Sigh. I just think it's funny that a medical researcher thinks people who are doing absolutely ZERO exercise right now are all of a sudden going to want to go out for even six minutes in a week's time and workout. That's laughable! When I was an obese man, exercise was at the bottom of my list of priorities. Just getting around in life was exercise enough for me. While Dr. Gibala trumpets his research as the answer to the obesity problem in the world, in reality he is merely offering an unrealistic solution to a very real crisis.

Thanks for responding, Dr. Gibala. I appreciate healthy debate on the subject of obesity and weight management. While I may not have the medical degrees that you hold, I am certainly entitled to express my opinions and challenge your research with some common sense.

I think we both want the same end result, but we come at it from different perspectives. That's why we need more open discussion of methods for dealing with obesity rather than simply relying on the "experts" to tell us what we need to be doing. Obviously, that has not been working.

Comments anyone?


Blogger Levi said...

Jimmy, I must admit that I do feel like you are being a little harsh on Dr. Gibala. As you point out, the media is often dead wrong. They often publish things without doing any kind of in-depth reaseach, or they take things out of context and hype something to make it look extra controversial. While you plainly state that you are giving your opinions, I think it's only fair if the author tells you that his paper doesn't convey the same message that you were initially attacking it for, that you shouldn't then continue to attack it again without reading his research and confirming this. It seems a bit silly to make a big deal about whether this should be done by those who are severly obese or not. It's somewhat common sense that those who can't walk across a parking lot without getting winded will not be able to jump into an intense interval training. These are details that may in fact be mentioned in the paper, who knows. Even if no mention is made about those who aren't used to exercise, a simple note that those people should use caution would certainly be enough. The point is that when you use charged and passionate language, you will often get similar in response from those who you may even agree with in a lot of ways if you take the time to look more closely. Having a calm dialogue about a subject, which perhaps is not as exciting as a passionate entreaty, can often be a lot more productive in educating both sides of a debate to the point where they might actually come to a mutual agreement...

6/07/2005 4:53 PM  
Blogger Jimmy Moore said...

Hey Levi,

Thanks for writing. That's fair criticism of my concerns with Dr. Gibala. But I would still like for him to articulate what led every single journalist in America to report that six minutes of intense exercise is equal to hours of moderate exercise. They had to get that from somewhere.

But, to be fair, I will read the study for myself. I agree that a happy medium needs to be reached so we are not discouraging people from doing ANY exercise because it's just too hard for them to do it rigorous or long.

Let's get our bodies moving and the weight will come off. Period. :)

THANKS for your comments, Levi!

6/07/2005 5:06 PM  
Blogger Julia Havey said...

What are your thoughts on 8 minutes in the morning and the 3 hour diet Jimmy? to me it sort of falls into the same misleading tag?!

6/07/2005 7:30 PM  
Blogger Regina Wilshire said...

Dr. Gibala asked that you review the actual study data/abstract rather than rely on second hand accounts of the published research.

Here is the abstract on PubMed:

He made a good point - the abstract has more information about the trial, the participants and the results than what was reported in the media.

Even the WebMD article you cite includes "Is there a catch? Of course. Those six minutes come from four 30-second bursts of all-out effort with four-minute rests in between each sprint. This "sprint interval training" adds up to three 20-minute sessions a week, says Martin J. Gibala, PhD, associate professor of kinesiology at McMaster University in Hamilton, Ontario."

Three 20-minute sessions each week isn't just 6-minutes as many in the media works out to an hour a week. But, ya know the headline got attention, even if it was inaccurate! And we're all well aware of the media's headlining to catch attention - just think of how often you've seen the headline that Atkin's is "Just eggs, bacon and steak" =)

6/07/2005 8:50 PM  
Blogger Jimmy Moore said...

Hey Julia! Look in my Popular Posts list and click on my review of The 3-Hour Diet. I'm not real fond of it as you will soon find out! :-)

6/07/2005 8:58 PM  
Blogger Jimmy Moore said...

THANKS for the link, Julia! I agree that the media distorted Dr. Gibala's research to make a snappy headline, but I still stand by my assertion that expecting an overweight or obese person to follow such a workout schedule as he is promoting is unrealistic physically. Take it from someone who used to weigh 410 pounds, it took everything within me just to do 3.0 mph on the treadmill for 15 minutes when I first started exercising. Let people work themselves up in their conditioning to do interval training rather than offering it as the starting point for people who have never exercise before in their life. Doesn't that sound more reasonable than the all-or-nothing approach Dr. Gibala wants people to do?

6/07/2005 9:02 PM  

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