Research Review

Kruger J et. al. Dietary and physical activity behaviors among adults successful at weight loss maintenance. International Journal of Behavioral Nutrition and Physical Activity 2006, 3:17

ABSTRACT: BACKGROUND: There is limited population-based data on behavioral factors found to be important for successful weight loss maintenance among adults. METHODS: Data from the 2004 Styles surveys, mailed to U.S. adults aged >=18 years were used to examine the difference in selected weight loss strategies and attitudes among persons who reported successful weight loss attempts (lost weight and able to keep it off) and persons who were not successful (previous attempts to lose weight were unsuccessful or they could not keep the lost weight off). Behaviors examined included modification of diet, leisure-time and sports activities, and self-monitoring, and barriers to weight management. RESULTS: Among adults who reported losing weight or trying to lose weight, 31.0% had been successful at both losing weight and maintenance after weight loss. Successful weight loss status differed by sex, age, and current weight status. Assessment of reported weight loss strategies, found that exercising >=30 minutes/day and adding physical activity to daily life were significantly higher among successful versus unsuccessful weight losers. Individuals who were successful at weight loss and maintenance were less likely to use over-the-counter diet products than those who were unsuccessful at weight loss. Significantly more successful versus unsuccessful weight losers reported that on most days of the week they planned meals (35.9% vs. 24.9%), tracked calories (17.7% vs. 8.8%), tracked fat (16.4% vs. 6.6%), and measured food on plate (15.9% vs. 6.7%). Successful losers were also more likely to weigh themselves daily (20.3% vs. 11.0%). There were a significantly higher proportion of successful losers who reported lifting weights (19.0%) versus unsuccessful (10.9%). The odds of being a successful weight loser were 48%-76% lower for those reporting exercise weight control barriers were influencing factors (e.g., no time, too tired to exercise, no one to exercise with, too hard to maintain exercise routine) compared to those who reported little or no influence of exercise; similarly, the odds were 48-64% lower for those who found certain dietary barriers to be influential (e.g., eat away from home too often, diet/health food costs too much). CONCLUSION: Self-monitoring strategies such as weighing oneself, planning meals, tracking fat and calories, exercising 30 or more minutes daily, and/or adding physical activity to daily routine may be important in successful weight loss maintenance. Leisure-time activities such as lifting weights or cooking/baking for fun are common strategies reported by those who were successful weight losers.

My comments: Although some might disagree with me, losing weight is generally not that difficult. People do it all the time. The problem is with keeping it off. In my mind, weight/fat loss maintenance is equally as important, if not moreso, than losing it in the first place. I mean, let's face it, we know how to get people to lose weight/fat. Yes, fine, researchers will continue to find an optimal 'fat loss diet' and argue about protein, carbs and fat until the cows come home but, no matter what you do, losing/fat weight means changing something about eating habits.

But once the fat/weight is off, how do you go about keeping it off. Previous work looking at the National Weight Control Registry (NWCR, a database of individuals who have successfully lost a certain amount of weight and, more importantly kept it off for several years) has examined this issue and several papers (for example Phelan et. al. 2006) have reported on it and found many common behaviors among successful losers.

The above paper follows up on that work with a survey sent out to determine if there were any common behaviors between individuals who successfully lost weight and kept it off versus those who either didn't lose weight or had no success in keeping it off.

And, basically, replicated what the NCWR (and to a great degree, common sense) had already determined

Frankly, there's not a whole lot more for me to add to what's already in the abstract. 31% of people reported successfully losing weight of the people polled.

Among both successful and unsuccessful dieters, there were 5 common behaviors which included: reduced amounts of food consumed, eating more fruits and vegetables, eating smaller portions, eating fewer fatty foods and consuming no sweetened beverages. This is kind of interesting as it suggests that simply modifying eating habits isn't a guarantee of success in weight loss or maintenance.

The biggest differences between successful and unsuccessful dieters started to show up when self-monitoring behaviors were examined. A much higher percentage of successful individuals reported planning meals, tracking calories, and tracking fat compared to the unsuccessful people. They also measured the food on their plate and weighed daily. While this seems to contradict the paragraph above, the researchers commented that:

This apparent contradiction is explained in the following way: the first set of behaviors were questions about anything that had been tried at least once in the past year; the second set of behaviors referred to ongoing behaviors. So folks who had tried to reduce food intake or portions or fatty foods at least once in the past year could answer yes to the first set of behaviors, only dieters engaging in long-term (i.e. daily) tracking could report positively on the secon

Given how badly most people estimate their true food intake (unless they have spent a lot of time measuring stuff to where they can get a decent eyeball), this isn't surprising; people who track their actual food intake on a more consistent basis would be expected to do better at both weight loss and maintenanc

Another common behavior with successful weight losers was weighing daily. This ties in with previous work from the NWCR database showing that people who monitor their weight (bodyfat percentage would also work here) more regularly are more likely to keep weight off. This is probably because regular monitoring prevents people from letting things slip too far, when the weight starts creeping up again, you can get more attentive to your diet and exercise habit

As to exercise, a larger percentage of successful losers reported exercise with walking as the primary behavior. Weight training was also more common in successful losers. Along with this the researchers mention th

Men were more likely to weight train

Men were more likely to be successful at losing weight

As a random tangent, cooking/baking for fun was more likely to be done in the successful group; the researchers suggest that perhaps individuals who like to cook are more likely to eat at home.

Finally, individuals reporting more barriers to exercise (no time, too tired after work, no workout partner, too hard to maintain a program) or barriers to changing diet (eat out too often, like junk food, don't pay attention to diet, diet/health foods not satisfying or costs too much) were more likely to fail. No surprises there, people who come up with reasons why they can't change their diet or exercise habits (or both) generally don't do very well at weight loss or maintenance.

Overall, this paper doesn't really tell us much that we didn't know. Self-monitoring both of bodyweight (or body composition) along with actual tracking of food intake, portions and such is associated with not only successful weight loss but also longer-term weight maintenance. Exercise is clearly important (although, somewhat surprisingly, exercise seems to be more important for weight maintenance than weight loss per se; I discuss this issue in both the Rapid Fat Loss Handbook and A Guide to Flexible Dieting) with weight training appearing to be especially beneficial.

Which is just a long way of saying that successful weight loss will ultimately hinge on changing one's exercise and eating habits and, more importantly (via self-monitoring), keeping them changed in the long-term.

Feature Article

Body Composition Numbers Part 1

Two weeks ago, I ran a piece on muscle and fat; this week (and 2 weeks from now in part 2), I'm going to continue with that vein and discuss some more details about bodyfat percentages.

When you know the amounts of fat and lean mass present in the body, you can calculate overall body composition (lets get a little bit more specific and refer to it as bodyfat percentage) which is the percentage of your total weight which is fat. The rest will be lumped into the lean body mass (LBM) category. This includes muscle mass, organs, water, glycogen, minerals and other stuff; basically everything that's not fat mass

So let's say I wave my magic wand and find out that you weigh 200 pounds with 20 pounds of bodyfat. Your bodyfat percentage would then be 20 pounds fat / 200 pounds total = 10% bodyfat. That is, 10% of you is bodyfat, the other 90% or 180 pounds is lean body mass (LBM)

Now, if you lost 5 pounds of fat with no change in LBM, you'd have 15 pounds fat / 195 pounds total or 7.7% bodyfat. If you gained 5 pounds of LBM with no change in bodyfat, you'd have 20 pounds fat / 205 pounds total = 9.7% bodyfat. If you somehow managed to gain 5 pounds of LBM while losing 5 pounds of fat, you'd have 15 pounds of fat / 200 lbs weight = 7.5% bodyfat. With starting numbers, you can also determine how much weight you'd have to lose (assuming 100% fat loss) to reach a certain body fat percentage. I'll show you how to do it.

Let's say that you're 200 lbs and 15% bodyfat, this gives you 30 lbs of fat mass and 170 lbs LBM. Say you want to get to 10% bodyfat. How much fat do you have to lose?

To determine this, we will divide your current LBM (170 lbs) by 1 minus your goal bodyfat percentage as a decimal (20% becomes .20, 10% becomes .10, 15% becomes .15, 8% becomes .08, etc). So 10% bodyfat means we calculate

1 - 0.10 = 0.90

Now divide LBM by that value so

170 lbs / 0.90 = 188 lbs

That's your goal weight to hit 10% bodyfat assuming 100% fat loss.

So our 200 lb/15% bodyfat individual has to lose 12 lbs of fat to get to 10%.

In this vein, I should note that losing fat has a much larger impact on bodyfat percentage than gaining the same amount of muscle. That is, losing 5 lbs of fat dropped bodyfat percentage by 2.3%; gaining 5 lbs of muscle only dropped it by 0.3%. So if your goal is to get your actual bodyfat percentage number down, losing fat is the better overall strategy. Actually, losing fat while gaining muscle is the best overall strategy but since it's so difficult to accomplish under most circumstances, it's not worth considering for the most part.

Related to this, people tend to lose muscle and gain fat as they get older. It's not uncommon to hear people who are 30 comment that they weigh the same as they did in college but none of their clothes fit. Even if their weight is no different, their body composition is heading south: they are losing muscle and gaining fat at the same time. Whether this is related to age per se or just decreasing activity levels is still being debated but it looks like keeping up activity and watching food intake can prevent most of the normal deterioration associated with age.

So what's a good bodyfat percentage?

This is a question where the answer depends on what you're talking about. Depending on whether your goal is reducing health risks or achieving optimal health, competing in a bodybuilding contest, competing in some other sport, just looking good, or what have you, the percentage bodyfat that is 'ideal' varies. So let's look at some different numbers and categories.

For health or at least reducing health risks there is some debate regarding optimal bodyfat percentages. Some groups don't even use bodyfat percentage, preferring the Body Mass Index (BMI) method (which is a relationship between weight and height), which correlates roughly with health risk, instead. While BMI shows a reasonable relationship with such things as health (and even bodyfat percentage) in inactive individuals, it's inappropriate to use with active individuals. Two individuals who are 5'7" and 200 lbs will have an identical BMI even if one is 30% bodyfat and the other is 10% bodyfat, BMI tells us nothing in this case.

Both too much and too little bodyfat can carry health risks. Some groups still use the archaic concept of 'overweight' and 'underweight' but bodyfat percentage is more indicative which is why I'm spending so much time discussing it. The terms 'overfat' and 'underfat' would be a lot more accurate. A 200 pound athlete at 7% bodyfat isn't at the same risk level as a 200 pound sedentary individual at 25% bodyfat, although they weigh the same amount. Saying that 200 lbs is 'overweight' misses the point.

The current 'average' recommendations for healthy bodyfat are 10-15% for men, and 18-25% for women and these numbers increase slightly as you get older. By comparison, average bodyfat percentages are 11-18% for men and 21-28% for women although I suspect these averages are going up in recent years as the population fattens. By extension, excess bodyfat, far in excess of recommended levels (10-15% for men, 18-25% for women) correlate with increased health risk. However, even if the above values are not attainable (and they frequently aren't), most credible research shows that even small fat/weight losses (10% of your current bodyweight) increases overall health and decreases the risk of such diseases. So don't let the above numbers depress you, that's not the goal. If you are a female at 35% bodyfat, reducing that to 30% will improve health even if you're still outside of the recommended range.

Research is also showing that individuals who carry extra fat (weight) but are active are healthier than if they are inactive. They may even be healthier than thin individuals who are inactive. That is, assuming one is active, even if they don't lose a lot of fat/weight, they may still be healthy. Focusing solely on body composition, to the exclusion of all else can ignore this fact and it would be remiss of me not to mention it.

At the low end, you run into other sorts of health and hormonal problems for males in the 4-5% range, females the 10-12% range

Bodybuilders and athletes don't have as much choice and have to work within what is required by their sports whether it is necessarily healthy or not. It's part of the price of playing. For athletes not required to have a certain bodyfat level for aesthetic reasons, performance has to be balanced against bodyfat levels and lower is not always better

Generally, male contest bodybuilders will be 3-5% bodyfat on the day of the contest. Females may be anywhere from 6-8%. If you're wondering how female bodybuilders achieve bodyfat percentages that are theoretically impossible (based on estimates of essential fat), just accept that it is probably due to problems with the equations more than anything else

Most bodybuilders don't maintain that level of leanness year round, at least not if they want to gain size or feel particularly energetic . The exception is those genetic rarities who maintain 5% bodyfat year round without effort who appear healthy. They're the ones who can eat freely and maintain a low bodyfat without effort. It's ok to hate those people, by the way. I'd suggest you do so just on principle.

From a health standpoint, females really shouldn't maintain a bodyfat much below 12% year round, for various reasons, the biggest one being that most will not maintain appropriate estrogen levels which can cause bone loss down the road. Yes, a lot of female athletes do maintain those levels of bodyfat, but it's generally not healthy in any way shape or form

By comparison, elite male runners clock in around 6% bodyfat, cyclists around 8-10% and swimmers at 10-12%. Female are, on average, a little bit fatter because of the difference in essential fat. A male at 6% total bodyfat is carrying 3% fat on top of the 3% essential fat, which is equivalent to a woman carrying 15% total bodyfat (3% on top of 12% essential fat). This is part of the reason males outperform females in most sports: less dead fat weight to carry around. More muscle mass, for any given bodyweight, is another part of the reason. To be fair, there is some indication that women might be superior in very long distance events, and have more endurance in those types of sports, because they appear to use fat for fuel more effectively

Speaking of swimmers, now you know why some people think swimmers are 'fat' ; it's because they carry more fat than other elite athletes (a whopping 10-12% compared to 6-8%). Obviously they are still leaner than the majority of people. The fat helps them float and improves performance which is why they maintain a higher level bodyfat. Being leaner would actually make them slower in the water because more energy would go into keeping them on top of the water, instead of moving them forward. Those crazy cold-water swimmers, who do stuff like swim the English channel have to carry more bodyfat to keep themselves warm and prevent hypothermia. They're still nuts, in my opinion, but at least they stay warm

Those interested in appearance may want to know what levels they need to get to achieve the look that is currently in vogue (i.e. what's presented in the mass media such as the fitness magazines): visible abs for men, lean thighs and a flat tummy for women. While there is some variance, on average a male will have to have a bodyfat percentage below 10% to have visible abdominals (i.e. the much coveted 6-pack) and get rid of their love handles. Unless a woman is genetically blessed, her legs may carry a lot of fat until she hits the 15% range (or so), although she'll usually have abdominals showing at that level

Some men have more 'female' type bodyfat patterning and have visible abs at high percentage bodyfat levels but fat legs. Post-menopausal females who don't go on hormones may develop a 'male' bodyfat patterning with a lot of fat around their midsection. There are also a lucky few who carry their bodyfat very evenly on their bodies and won't look 'fat' even while carrying quite a high percentage bodyfat. We'll see why these patterns exist in a bit.

To be continued in 2 weeks.

Questions and Answers

Q: I was wondering if, for hypertrophy purposes, there is any real advantage using bar bell squats instead of leg presses. Looking at things from perhaps an oversimplified perspective, the leg press seems to have the same joint movements and muscle lengthening/stretching as the squat - plus it's a lot safer for the lower back. I'm guessing it may come down to maximum load that can be moved. But can people squat more than they can leg press? Also, I'd be surprised if it were practical to use loads >1RM (negatives) for a squat, whereas on a leg press machine with a partner or two it is quite easily done.

I'm thinking the squat just 'feels' harder because of all the stabilizers that are used and there is more need for proper technique to make it safe. I know a lot of power lifting purists will scream that the squat is the king of exercises, yada yada yada, but for leg/glute hypertrophy, what is the advantage? Some people also seem to think squatting causes more testosterone and or GH release but is there any solid evidence of this? I would doubt it.

A: I'm sure my answer will offend the hardcore/hardhead lifters but I think there may be advantages to leg press versus squats under some conditions. Yes, I know it's taken as an article of faith that you must squat to build big legs but let's took a look at reality:

Go find a squatter who isn't adding weight to the bar. His legs are not growing.

Go find me a guy who is adding weight to the bar on the leg press. His legs are growing.

What's more important? The exercise or the progression.

Note: I'm assuming some things about volume, frequency , eating, etc. But assume everything else is equal in the above examples.

Point being this: muscles grow in response to progressive tension overload. Exercise selection is almost secondary to this except inasmuch as some movement are easier/more safe to add weight to and/or some movements may allow you to generate more muscular tension. You can build big biceps with concentrations curl as well as barbell curls assuming your loading parameters are correctly.

As far as comparing loads between the two movements, this isn't really accurate. The leverages on the leg press will allow almost anyone to move more weight (in absolute terms) than squatting. What we are concerned with is not the weight on the bar but the tension that the muscles have to generate to move that load.

The simple fact is that the leg press is a compound movement working a large number of muscles through a decent range of motion. You can apply progressive overload just as readily as on anything else. Other potential benefits are that it takes the low back out of the equation. (Note: at the same time, done improperly, letting the low back round off the pad can make the leg press a deathtrap for the low-back. Doing the leg press one legged makes it nearly impossible to round the low back, and hits many of the hip stabilizing muscles as well.) Often times it is the upper body or low back which fatigues/fails (especially on high rep sets); why let ancillary muscle groups limit the training effect to the LEGS?

On which note: leg presses can often be used as a secondary leg exercise after back squats; to get a greater leg stimulus after the low/upper back is fatigued from squats. Again, hardhead lifters/coaches will shit on this approach but enough athletes (including some very strong powerlifters) do this to make me think that the hardheads are full of it.

Additionally, some people with poor levers for squatting may be able to leg press more safely or effectively and get a better training response.

I'm unaware of research comparing hormonal response of squat to leg press; in all likelihood the small hormonal spikes that occur during weight training are irrelevant to growth anyhow. It's more about the interplay of tension, fatigue (maybe) and stuff like that.

Oh yeah, as a final comment, I don't want anyone to think that I'm anti-squat. I love squatting, I miss squatting (it doesn't fit into my current training goals with the skating) but I think that a properly performed leg press can be an extremely effective exercise for the lower body in terms of growth. Personally, I don't see the fascination with training the stabilizers if your goal is hypertrophy although I've seen that argument given for why free weights are superior.

Q: The newsletter is a great source of information! Thanks for the taking the time to put it together.

I would like to piggyback on the muscle loss question (my note: this is referring to the question from the cyclist last week):

As you reduce muscle mass through dieting-how would you maintain muscle strength or power? I learned how to reduce muscle mass while on UD2 by reducing protein but, how would you maintain strength and/or power?

A: There's the rub: you probably won't. I discussed this issue with Alwyn Cosgrove and he mentioned having had to do something similar (overtraining + low-protein) with one of his MMA guys to bring him down a weight class. The problem is that his absolute performance cratered and it took him months to recover. However, the athlete still performed better at the lighter weight and was stronger than his competitors, which was the goal all along.

Strength/power is related to (at the very least) both muscular size and neural factors. Lose size and potential strength/power output will be compromised. Of course, for some sports, relative strength/power (strength/power relative to bodyweight) is often more important. As long as you lose more mass than you lose strength, you may still come out ahead relative to bodyweight and perform better.

An example, mathematically. Say that at 200 lbs you can back squat 400 lbs. Your strength/weigh ratio is 2:1 (400 lbs strength/200 lbs weight) Now you do what we're talking about and drop to 180 lbs, losing some muscle along the way. As long as your squat stays above 360, you will be stronger pound for pound (360/180 = 2). So if you end up squatting 380, you're relative strength will be 2.1 (380/180). If you end up squatting 350, it will be 1.94.

Neural factors are probably going to be a little better maintained during such an approach, or at least a little more likely to be retained. A lot of that will depend on how you train. If your able to maintain at least some heavy work in a more neural zone (1-5 reps), you can probably maintain those factors a lot more easily than if you work in high repetition ranges.

I would probably tend to have someone train with a relatively low volume (maintenance loads) of high intensity work in an attempt to maintain as much maximum strength as possible. I doubt they'd maintain it without loss, the goal would be to do the best they could. So warmups to 1-2 heavy sets of 3-5 of 2-3 key movements (think one pushing movement, one pulling movement, one lower body movement).

Also, I would probably have someone diet down in stages as I suggested originally. So diet for 4-6 weeks and then take a couple of weeks eating at the new maintenance (but with adequate protein/calories/carbs) to regain some lost strength. Then diet down again.

Q: Are there differences between sarcoplasmic or sarcomere (myofibrillar) hypertrophy?

Are they two totally separate types of muscle growth?

Is Gironda style training only good for Sarcoplasmic?

Do you know of any sites or articles on this topic?

A: Ok, first let's define some terms.

Sarcoplasmic hypertrophy generally refers to growth of non-contractile elements. This includes mitochondria, water, glycogen, minerals and the blood supply. Basically, it's all the stuff that contributes to muscle size that isn't actual muscle fibers.

Myofibrillar growth, as you might imagine, is growth of the actual contractile fibers themselves.

European texts (cf: Supertraining, Science and Practice of Strength Training, Fitness and Training for All Sports by Siff/Verkoshanksy, Zatsiorsky, and Hartmann/Tunemann respectively) refer to the two as if there was no question of their existence.

American researchers tend not to be quite as agreed on the concept. Some research done in the 80's on elite powerlifters and bodybuilders seems to support the idea (I address the issue in my first book, The Ketogenic Diet) but not all agree.

Practically, some have referred to this as pump growth (sarcoplasmic) vs. 'real' growth (myofibrillar). In the UD2, I mentioned that powerlifters and bodybuilders often have a different muscle quality or look to them. Powerlifters (or bodybuilders who use power style training) tend to have a density to them that bodybuilders who only use moderate loads often lack. Of course, this could also be a drug issue.

Generally, higher reps and short rest intervals (which stress the energetic components of the muscle) is thought to develop primarily sarcoplasmic growth while lower reps and longer rest intervals (with higher tension, which tends to stress the muscle fibers more directly) tend to primarily develop myofibrillar growth.

Many bodybuilding systems use a combination of heavy tension work (sets in the 5-8 rep range) and fatigue oriented work (sets in the 12-15 range or higher). You might consider a system like Doggcrapp training which starts the set with a heavy set to failure (usually in the 6-12 repetition range using a heavy weight) and then adds fatigue with rest-pause.

It's unlikely that any type of training would develop one or the other (I would always expect some contribution of the two) and, again, not all agree that the phenomenon exists in the first place.

Gironda style training seemed to revolve around moderate loads with short rests (for example, the 8X8 system) but he used a lot of different methods so I'm not sure you can say that his system falls on a specific continuum.

As far as sites or articles, I know that a lot of discussion of this issue has occurred at the Hypertrophy-Specific board. You might also check Dan Moore's Hypertrophy-research board. If anybody has examined this in insane detail, Dan has.