53 Studies Later: The Best Way to Improve VO2 Max
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VO2 max measures maximum oxygen usage during intense exercise and reflects overall health and performance. To have a high VO2 max, efficient functioning of lungs, heart, red blood cells, muscles, and mitochondria is crucial. So, how to get those?
Let’s HIIT it!
High-Intensity Interval Training (HIIT) outperforms moderate-intensity exercise, by a long way. Further, based on the data from the 53 studies mentioned in the title, we can know which of the protocols tested work best, and they are:
- 15×15 Interval Training: 15 seconds sprint (90–95% max heart rate) + 15 seconds active rest (70% max heart rate), repeated 47 times.
- 4×4 Interval Training: 4 minutes sprint (90–95% max heart rate) + 3 minutes active rest (70% max heart rate), repeated 4 times.
Whichever you choose, it is best to then do that 3x per week.
Note that “sprint” can mean any maximum-effort cardio exercise; it doesn’t have to be running specifically. Cycling or swimming, for example, are fine options too, as is jumping rope.
For more on each of these, plus how the science got there, enjoy:
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Want to learn more?
You might also like to read:
How To Do HIIT (Without Wrecking Your Body)
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Soy Allergy? No Problem! Turn Any Legume Into Tofu (Here’s How)
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Legumes have similar chemical composition, which means they can generally be used in the same ways as each other:
Variety is the spice of life
In the video, he demonstrates this with green peas, red lentils, and green lentils, and mentions that it is the same for chickpeas too. The process is:
- Soak 100g dried legumes overnight in plenty of water.
- Drain and blend with 250ml fresh water until smooth.
- Pour into a nonstick frying pan, add ½ tsp salt, and stir.
- Cook until it thickens into a paste, then cook for another 2–3 minutes on low heat.
- Transfer to a 500ml mold, smooth the top, and set in the fridge for 1 hour.
- If properly set, it can be eaten as-is or fried into crispy cubes.
- Stir-fry tofu with: ginger, spring onions, garlic, and chili.
- Sauce: suggestions include soy sauce, rice wine vinegar, mirin, sesame oil.
- Garnish with: sesame and coriander seeds
Science behind it: heating alters protein bonds and starches, forming a thick paste that sets.
Note: legumes contain natural toxins that are destroyed by cooking. For some, like those mentioned above, frying for a few minutes is sufficient. However, kidney beans are high in phytohemagglutinin, which requires at least 20 minutes of cooking to be safe, making them unsuitable for this process.
For more on all of this, plus visual demonstrations, enjoy:
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You might also like to read:
Six Ways To Eat For Healthier Skin
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Next-Level Metabolism – by Dr. Jade Teta
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This book starts with the preface that “this is not a diet book”, but all the diet books nowadays say that, even when the title is “The Such-And-Such Diet”. So, is this one a diet book?
No, it isn’t. It’s rather an informational explanation of how metabolism works, and the very many things that can affect it, ranging from genes and epigenetics to diet and exercise to stress and sleep, and more.
Where this book most excels is in the personalization aspect; it describes how to assess your own system inputs and outputs (which are a lot more things than just calories in, calories out), and read your own body’s cues in terms of what’s going on with you metabolically.
Because the truth is, we’re all a bit different (aside from, perhaps, identical twins etc living identical lifestyles in all respects, down to having the same meals and the same schedule), and while there definitely are some universal truths of metabolism (e.g. whole fruit is always going to be better than high-fructose corn syrup), when it comes to the finer details on the other hand, what goes for one person genuinely may not go for another, and there can be a multitude of reasons why. This book helps identify those, and go with what actually works for you.
The style is half pop-science, half pep-talk. The book could have been a lot shorter without all the pep talk, but for those who like that sort of thing, that is the sort of thing they like.
Bottom line: if you’d like to understand your metabolism (as opposed to some clinically standardized average of metabolism), then this book can help you do that.
Click here to check out Next-Level Metabolism, and level-up your understanding of it!
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Treat Your Own Back – by Robin McKenzie
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A quick note about the author first: he’s a physiotherapist and not a doctor, but with over 40 years of practice to his name and 33 letters after his name (CNZM OBE FCSP (Hon) FNZSP (Hon) Dip MDT Dip MT), he seems to know his stuff. And certainly, if you visit any physiotherapist, they will probably have some of his books on their own shelves.
This book is intended for the layperson, and as such, explains everything that you need to know, in order to diagnose and treat your back. To this end, he includes assorted tests to perform, a lot of details about various possible back conditions, and then exercises to fix it, i.e. fix whatever you have now learned that the problem is, in your case (if indeed you didn’t know for sure already).
Of course, not everything can be treated by exercises, and he does point to what other things may be necessary in those cases, but for the majority, a significant improvement (if not outright symptom-free status) can be enjoyed by applying the techniques described in this book.
Bottom line: for most people, this book gives you the tools required to do exactly what the title says.
Click here to check out Treat Your Own Back, and treat your own back!
PS: if your issue is not with your back, we recommend you check out his other books in the series (neck, shoulder, hip, knee, ankle) 😎
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How can I stop using food to cope with negative emotions?
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Have you ever noticed changes in your eating habits when you are sad, bored or anxious?
Many people report eating either more, or less, as a way of helping them to cope when they experience difficult emotions.
Although this is a very normal response, it can take the pleasure out of eating, and can become distressing and bring about other feelings of shame and self-criticism.
Adding to the complexity of it all, we live in a world where diet culture is unavoidable, and our relationship to eating, food and body image can become complicated and confusing.
Drazen Zigic/Shutterstock Emotional eating is common
“Emotional eating” refers to the eating behaviours (typically eating more) that occur in response to difficult emotions.
Research shows around 20% of people regularly engage in emotional eating, with a higher prevalence among adolescents and women. In a study of more than 1,500 adolescents, 34% engaged in emotional eating while sad and 40% did so while anxious.
Foods consumed are often fast-foods and other energy-dense, nutrient-poor convenience foods.
Stress, strong emotions and depression
For some people, emotional eating was simply a habit formed earlier in life that has persisted over time.
But other factors might also contribute to the likelihood of emotional eating. The physiological effects of stress and strong emotions, for example, can influence hormones such as cortisol, insulin and glucose, which can also increase appetite.
Increased impulsivity (behaving before thinking things through), vulnerability to depression, a tendency to ruminate and difficulties regulating emotions also increase the likelihood of emotional eating.
Depression increases the likelihood of emotional eating. TommyStockProject/Shutterstock So what do you do?
First, know that fluctuations in eating are normal. However, if you find that the way you eat in response to difficult emotions is not working for you, there are a few things you can do.
Starting with small things that are achievable but can have a huge impact, such as prioritising getting enough sleep and eating regularly.
Then, you can start to think about how you handle your emotions and hunger cues.
Expand your emotional awareness
Often we label emotions as good or bad, and this can result in fear, avoidance, and unhelpful coping strategies such as emotional eating.
But it’s also important to differentiate the exact emotion. This might be feeling isolated, powerless or victimised, rather than something as broad as sad.
By noticing what the emotion is, we can bring curiosity to what it means, how we feel in our minds and bodies, and how we think and behave in response.
Tap into your feelings of hunger and fullness
Developing an intuitive way of eating is another helpful strategy to promote healthy eating behaviours.
Intuitive eating means recognising, understanding and responding to internal signals of hunger and fullness. This might mean tuning in to and acknowledging physical hunger cues, responding by eating food that is nourishing and enjoyable, and identifying sensations of fullness.
Intuitive eating encourages flexibility and thinking about the pleasure we get from food and eating. This style of eating also allows us to enjoy eating out with friends, and sample local delicacies when travelling.
It can also reduce the psychological distress from feeling out of control with your eating habits and the associated negative body image.
Try to be flexible in thinking about the pleasure of food and eating with friends. La Famiglia/Shutterstock When is it time to seek help?
For some people, the thoughts and behaviours relating to food, eating and body image can negatively impact their life.
Having the support of friends and family, accessing online resources and, in some instances, seeing a trained professional, can be very helpful.
There are many therapeutic interventions that work to improve aspects associated with emotional eating. These will depend on your situation, needs, stage of life and other factors, such as whether you are neurodivergent.
The best approach is to engage with someone who can bring compassion and understanding to your personal situation, and work with you collaboratively. This work might include:
- unpacking some of the patterns that could be underlying these emotions, thoughts and behaviours
- helping you to discover your emotions
- supporting you to process other experiences, such as trauma exposure
- developing a more flexible and intuitive way of eating.
One of the dangers that can occur in response to emotional eating is the temptation to diet, which can lead to disordered eating, and eating disorder behaviours. Indicators of a potential eating disorder can include:
- recent rapid weight loss
- preoccupation with weight and shape (which is usually in contrast to other people’s perceptions)
- eating large amounts of food within a short space of time (two hours or less) and feeling a sense of loss of control
- eating in secret
- compensating for food eaten (with vomiting, exercise or laxatives).
Evidence-based approaches can support people experiencing eating disorders. To find a health professional who is informed and specialises in this area, search the Butterfly Foundation’s expert database.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14, or the Butterfly Foundation on 1800 ED HOPE (1800 33 4673).
Inge Gnatt, PhD Candidate, Lecturer in Psychology, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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New research suggests intermittent fasting increases the risk of dying from heart disease. But the evidence is mixed
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Kaitlin Day, RMIT University and Sharayah Carter, RMIT University
Intermittent fasting has gained popularity in recent years as a dietary approach with potential health benefits. So you might have been surprised to see headlines last week suggesting the practice could increase a person’s risk of death from heart disease.
The news stories were based on recent research which found a link between time-restricted eating, a form of intermittent fasting, and an increased risk of death from cardiovascular disease, or heart disease.
So what can we make of these findings? And how do they measure up with what else we know about intermittent fasting and heart disease?
The study in question
The research was presented as a scientific poster at an American Heart Association conference last week. The full study hasn’t yet been published in a peer-reviewed journal.
The researchers used data from the National Health and Nutrition Examination Survey (NHANES), a long-running survey that collects information from a large number of people in the United States.
This type of research, known as observational research, involves analysing large groups of people to identify relationships between lifestyle factors and disease. The study covered a 15-year period.
It showed people who ate their meals within an eight-hour window faced a 91% increased risk of dying from heart disease compared to those spreading their meals over 12 to 16 hours. When we look more closely at the data, it suggests 7.5% of those who ate within eight hours died from heart disease during the study, compared to 3.6% of those who ate across 12 to 16 hours.
We don’t know if the authors controlled for other factors that can influence health, such as body weight, medication use or diet quality. It’s likely some of these questions will be answered once the full details of the study are published.
It’s also worth noting that participants may have eaten during a shorter window for a range of reasons – not necessarily because they were intentionally following a time-restricted diet. For example, they may have had a poor appetite due to illness, which could have also influenced the results.
Other research
Although this research may have a number of limitations, its findings aren’t entirely unique. They align with several other published studies using the NHANES data set.
For example, one study showed eating over a longer period of time reduced the risk of death from heart disease by 64% in people with heart failure.
Another study in people with diabetes showed those who ate more frequently had a lower risk of death from heart disease.
A recent study found an overnight fast shorter than ten hours and longer than 14 hours increased the risk dying from of heart disease. This suggests too short a fast could also be a problem.
But I thought intermittent fasting was healthy?
There are conflicting results about intermittent fasting in the scientific literature, partly due to the different types of intermittent fasting.
There’s time restricted eating, which limits eating to a period of time each day, and which the current study looks at. There are also different patterns of fast and feed days, such as the well-known 5:2 diet, where on fast days people generally consume about 25% of their energy needs, while on feed days there is no restriction on food intake.
Despite these different fasting patterns, systematic reviews of randomised controlled trials (RCTs) consistently demonstrate benefits for intermittent fasting in terms of weight loss and heart disease risk factors (for example, blood pressure and cholesterol levels).
RCTs indicate intermittent fasting yields comparable improvements in these areas to other dietary interventions, such as daily moderate energy restriction.
There are a variety of intermittent fasting diets. Fauxels/Pexels So why do we see such different results?
RCTs directly compare two conditions, such as intermittent fasting versus daily energy restriction, and control for a range of factors that could affect outcomes. So they offer insights into causal relationships we can’t get through observational studies alone.
However, they often focus on specific groups and short-term outcomes. On average, these studies follow participants for around 12 months, leaving long-term effects unknown.
While observational research provides valuable insights into population-level trends over longer periods, it relies on self-reporting and cannot demonstrate cause and effect.
Relying on people to accurately report their own eating habits is tricky, as they may have difficulty remembering what and when they ate. This is a long-standing issue in observational studies and makes relying only on these types of studies to help us understand the relationship between diet and disease challenging.
It’s likely the relationship between eating timing and health is more complex than simply eating more or less regularly. Our bodies are controlled by a group of internal clocks (our circadian rhythm), and when our behaviour doesn’t align with these clocks, such as when we eat at unusual times, our bodies can have trouble managing this.
So, is intermittent fasting safe?
There’s no simple answer to this question. RCTs have shown it appears a safe option for weight loss in the short term.
However, people in the NHANES dataset who eat within a limited period of the day appear to be at higher risk of dying from heart disease. Of course, many other factors could be causing them to eat in this way, and influence the results.
When faced with conflicting data, it’s generally agreed among scientists that RCTs provide a higher level of evidence. There are too many unknowns to accept the conclusions of an epidemiological study like this one without asking questions. Unsurprisingly, it has been subject to criticism.
That said, to gain a better understanding of the long-term safety of intermittent fasting, we need to be able follow up individuals in these RCTs over five or ten years.
In the meantime, if you’re interested in trying intermittent fasting, you should speak to a health professional first.
Kaitlin Day, Lecturer in Human Nutrition, RMIT University and Sharayah Carter, Lecturer Nutrition and Dietetics, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Forget Ringing the Button for the Nurse. Patients Now Stay Connected by Wearing One.
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HOUSTON — Patients admitted to Houston Methodist Hospital get a monitoring device about the size of a half-dollar affixed to their chest — and an unwitting role in the expanding use of artificial intelligence in health care.
The slender, battery-powered gadget, called a BioButton, records vital signs including heart and breathing rates, then wirelessly sends the readings to nurses sitting in a 24-hour control room elsewhere in the hospital or in their homes. The device’s software uses AI to analyze the voluminous data and detect signs a patient’s condition is deteriorating.
Hospital officials say the BioButton has improved care and reduced the workload of bedside nurses since its rollout last year.
“Because we catch things earlier, patients are doing better, as we don’t have to wait for the bedside team to notice if something is going wrong,” said Sarah Pletcher, system vice president at Houston Methodist.
But some nurses fear the technology could wind up replacing them rather than supporting them — and harming patients. Houston Methodist, one of dozens of U.S. hospitals to employ the device, is the first to use the BioButton to monitor all patients except those in intensive care, Pletcher said.
“The hype around a lot of these devices is they provide care at scale for less labor costs,” said Michelle Mahon, a registered nurse and an assistant director of National Nurses United, the profession’s largest U.S. union. “This is a trend that we find disturbing,” she said.
The rollout of BioButton is among the latest examples of hospitals deploying technology to improve efficiency and address a decades-old nursing shortage. But that transition has raised its own concerns, including about the device’s use of AI; polls show the public is wary of health providers relying on it for patient care.
In December 2022 the FDA cleared the BioButton for use in adult patients who are not in critical care. It is one of many AI tools now used by hospitals for tasks like reading diagnostic imaging results.
In 2023, President Joe Biden directed the Department of Health and Human Services to develop a plan to regulate AI in hospitals, including by collecting reports of patients harmed by its use.
The leader of BioIntelliSense, which developed the BioButton, said its device is a huge advance compared with nurses walking into a room every few hours to measure vital signs. “With AI, you now move from ‘I wonder why this patient crashed’ to ‘I can see this crash coming before it happens and intervene appropriately,’” said James Mault, CEO of the Golden, Colorado-based company.
The BioButton stays on the skin with an adhesive, is waterproof, and has up to a 30-day battery life. The company says the device — which allows providers to quickly notice deteriorating health by recording more than 1,000 measurements a day per patient — has been used on more than 80,000 hospital patients nationwide in the past year.
Hospitals pay BioIntelliSense an annual subscription fee for the devices and software.
Houston Methodist officials would not reveal how much the hospital pays for the technology, though Pletcher said it equates to less than a cup of coffee a day per patient.
For a hospital system that treats thousands of patients at a time — Houston Methodist has 2,653 non-ICU beds at its eight Houston-area hospitals — such an investment could still translate to millions of dollars a year.
Hospital officials say they have not made any changes in nurse staffing and have no plans to because of implementing the BioButton.
Inside the hospital’s control center for virtual monitoring on a recent morning, about 15 nurses and technicians dressed in scrubs sat in front of large monitors showing the health status of hundreds of patients they were assigned to monitor.
A red checkmark next to a patient’s name signaled the AI software had found readings trending outside normal. Staff members could click into a patient’s medical record, showing patients’ vital signs over time and other medical history. These virtual nurses, if you will, could contact nurses on the floor by phone or email, or even dial directly into the patient’s room via video call.
Nutanben Gandhi, a technician who was watching 446 patients on her monitor that morning, said that when she gets an alert, she looks at the patient’s health record to see if the anomaly can be easily explained by something in the patient’s condition or if she needs to contact nurses on the patient’s floor.
Oftentimes an alert can be easily dismissed. But identifying signs of deteriorating health can be tough, said Steve Klahn, Houston Methodist’s clinical director of virtual medicine.
“We are looking for a needle in a haystack,” he said.
Donald Eustes, 65, was admitted to Houston Methodist in March for prostate cancer treatment and has since been treated for a stroke. He is happy to wear the BioButton.
“You never know what can happen here, and having an extra set of eyes looking at you is a good thing,” he said from his hospital bed. After being told the device uses AI, the Montgomery, Texas, man said he has no problem with its helping his clinical team. “This sounds like a good use of artificial intelligence.”
Patients and nurses alike benefit from remote monitoring like the BioButton, said Pletcher of Houston Methodist.
The hospital has placed small cameras and microphones inside all patient rooms enabling nurses outside to communicate with patients and perform tasks such as helping with patient admissions and discharge instructions. Patients can include family members on the remote calls with nurses or a doctor, she said.
Virtual technology frees up on-duty nurses to provide more hands-on help, such as starting an intravenous line, Pletcher said. With the BioButton, nurses can wait to take routine vital signs every eight hours instead of every four, she said.
Pletcher said the device reduces nurses’ stress in monitoring patients and allows some to work more flexible hours because virtual care can be done from home rather than coming to the hospital. Ultimately it helps retain nurses, not drive them away, she said.
Sheeba Roy, a nurse manager at Houston Methodist, said some members of the nursing staff were nervous about relying on the device and not checking patients’ vital signs as often themselves. But testing has shown the device provides accurate information.
“After we implemented it, the staff loves it,” Roy said.
Serena Bumpus, chief executive officer of the Texas Nurses Association, said her concern with any technology is that it can be more burdensome on nurses and take away time with patients.
“We have to be hypervigilant in ensuring that we are not leaning on this to replace the ability of nurses to critically think and assess patients and validate what this device is telling us is true,” Bumpus said.
Houston Methodist this year plans to send the BioButton home with patients so the hospital can better track their progress in the weeks after discharge, measuring the quality of their sleep and checking their gait.
“We are not going to need less nurses in health care, but we have limited resources and we have to use those as thoughtfully as we can,” Pletcher said. “Looking at projected demand and seeing the supply we have coming, we will not have enough to meet demand, so anything we can do to give time back to nurses is a good thing.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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