Exercise and Fitness Forum

Walking as a Primary Form of Exercise

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by Richard Betcher, M.D. The goal of going through surgery for weight loss is to become healthy and to lose the morbid problems caused by your obesity. This can only be reached by losing the excessive fat that you carry and improving the quantity and quality or your lean tissue, primarily muscle. The determination of your weight is a simple formula: Weight equals calories in (volume/ type) minus calories out (basal metabolic rate and activity). The surgical bariatric procedure is a means of input control only. Volume that you are able to take in is decreased and certain types of foods are not tolerated any further. The result is a forced reduction in total calorie intake if you utilize this tool appropriately. Just as much emphasis needs to be placed on the calorie output part of this equation. If you only do one or the other part of this equation, you will always fail. Therefore, emphasis needs to be placed in your ability to consistently perform activity that maintains adequate basal metabolic levels and overall activity. What does all this mean? When you decrease caloric intake for the body, it has to find other sources of calories to make the engine work. If this is not supplied externally by eating, then the body will respond in two ways to decrease its metabolic rate. First, it will decrease its muscle mass,primarily by converting much of that protein into glucose, which is then utilized as a fuel source by the body. The second thing is that the remaining muscle that you have will end up with less activity because there is no longer a fuel source to drive it. Think of your muscle mass as an engine. If it is only running on one or two cylinders, it will hardly move down the street and there will not be enough heat generated to keep the inside of the car warm. The same thing happens with your body. So, how do you make your body go after only your body fat? This is accomplished by the use of muscle in an adequate aerobic activity on a daily basis. Muscle is made up of muscle fibers that can be separated into slow, intermittent and fast twitch fibers. The slow-twitch fibers are the primary ones that we are concerned about. When adequate size and enzymes are present, the slow-twitch will very aggressively go after fat asa fuel source. The other muscle fibers are less likely to do that.The location you find these slow twitch fibers are primarily in your weight-bearing, walking muscles in your leg and gluteal areas. NASA, in an effort to determine how to maintain normal muscle mass for its astronauts in space,found that the single best exercise for the least amount of time was approximately a two mile nonstop walk, at earth?s gravity. No other exercise can come close to doing that. This is not a surprise when you consider that the act of walking is basically lifting a weight of 250or more pounds, depending on what you weigh and continuing the exercise for the time period it would take to cover two miles.No other muscle group in the body can maintain that level of activity. Try taking a bar bell of 200 pounds and doing a curl for a solid hour; most of us would not get through the first repetition. What we find happening with this two-mile walk is that the slow twitch muscle fibers of the biggest muscle groups we have, start to thicken, to develop more mitochondria.The mitochondria is the furnace that converts fat into something the muscle can use and develop the enzymes that make fat metabolism occur more easily. It is then just a matter of turning it on every day. Unfortunately, every morning you wake up, fat metabolism is again shut off. It requires a daily effort to get it turned back  on and that is accomplished again by a two-mile walk. Also, covering less distance does not get it started. Your body needs to sense enough continuous stress activity that the walk produces to finally turn on that part of the metabolism. In other words, if you only walk one mile, you are only burning glucose. By the time you get to two miles, your body starts to change its metabolism and it starts to consume fat. That fat metabolism continues on after the walk is finished for anywhere from four to eight hours. Much of the other activity you have during the day will continue to have fat metabolism tied with it and you will continue burning the one material you most desperately need to get rid of.In following the lead body mass of our patients over many, many years, we have found that many people present themselves with thirty to forty pounds of muscle deficiency from becoming very sedentary because of the obesity and other problems associated with it. The only way to get the muscle back is to do an adequate amount of exercise to replenish those thirty to forty pounds. Our bodies have a basal rate of metabolism that occurs daily. This is your muscle contracting in what we call fasciculations, which are minuscule contractions that produce body heat. Without these fasciculations, you could not maintain a body temperature of 98.6. The amount of calories consumed and the amount of body heat produced is directly proportional to the amount of muscle.      Are you a one-cylinder engine? If you are thirty to forty pounds of muscle deficient, you are obviously running on one cylinder. By getting all the cylinders working, you will be able to burn more calories, even at rest, than someone who refuses to do any activity and maintains a very low lean body mass. We have found that a daily two-mile leisurely, continuous walk will usually lead to between thirty and forty pounds of muscle gain and over 100 pounds of fat loss in one year. We use electrical impedance to determine the amount of lean body mass and find it very sensitive for this measurement. If we see muscle mass dropping in the later months and years of follow-up, it is a clear indication that this person has slowed down the frequency or even stopped his walking. Our patients have become accustomed to knowing that we already know if they are keeping up their exercise by looking at this body tissue analysis even before we come in the room and ask them if they are maintaining activity. It is also a great tool to visually show people what happens when they again become sedentary. What these patients find is that any drop of activity from walking two miles a day, seven days a week will lead to very quick loss of muscle mass and even stopping of the burning of any fat. Weight loss of your lean body mass tissue, is not what you want to see.     In summary, your final weight is not determined by just having the surgery but also combining it with a daily exercise program. Walking, when it is done at a two-mile distance at any pace you are comfortable with, accomplishes significant muscle gain, daily burning of just fat, preservation of other lean tissue and in the end, helps you accomplish the goal that you are really after. Richard Betcher, M.D., graduated from the University of Minnesota Medical School and is the founder of Tempus Surgical Weight Reduction. Website: www.tempuswls.com.