Theory Thursday

“Hiit it!”

H.I.I.T. – High intensity interval training.  It’s all the rage.  We’ve suggested your exercise regime could be much less boring, less slogging away at one medium speed on the treadmill or the exercise bike for an hour in your “fat burning” zone (and more of that in a theory thursday one week!) but what do you replace traditional “cardio” with, and why?

sample of a balanced weekly activity schedule

You heard last week that adding strength training +/- weights is an essential part of a healthy long life.  Two of your weekly workouts for 30 minutes should be strength, not on consecutive days.  Then you’ll add in a rest day to your week – on which you DO NOT sit on the couch of sloth but walk, do yoga, foam roll, play in a sandpit (or something).  You may then still want one day of a run or a bike ride that’s longer, especially if you’re planning a race.

So, you’ve got 3 days left to schedule in some activity and you want to be targeted.  If you’re training for an event you’ll be using those days for interval/hill training but if you’re just remodelling your lifestyle to add healthy things into the gaps you could try “H.I.I.T.” for 2 days.

Don’t forget to save one day for a recovery workout which could be power yoga, ballet or try this one from livestrong

What is H.I.I.T.?

No surprises, it does what it says on the tin.  The idea is “high intensity“.  No messing, this is massive, hard, fast efforts that leave you dripping with sweat and absolutely exhausted.  During a high intensity interval you should reach your “anaerobic zone” – that’s the heart rate at which your body cannot keep up the oxygen supply to the muscles.

How do you know you’re working hard enough?  You can use a heart rate monitor and work it out, but if you’ve got enough energy left to check your HR monitor I reckon you’re not going hard enough.  I find “RPE” or “rate of perceived exertion” to be a better guide (plus, I don’t have a heart rate monitor!)  In the rest periods you should be gently moving at a level that you could carry on a conversation, in the high intensity periods you cannot talk – it’s a “full sprint” “Usain Bolt” feeling.  You’ve done it right if you feel slightly nauseated 😉


The upside is, it’s intervals.  i.e. you’re not expected to go “full out” for any significant length of time.  The intervals range in length but the Tabata regime  is well established. It’s 20 seconds flat out then a 10 second rest period between intervals.

And the really good news?  If you want to be a purist, you do this for 4 minutes only (8 cycles).

How does that work?

Only 4 minutes of exercise?  Really?  Yes, really.  Here’s the science.  In essence, you’re creating an “oxygen debt” by working so hard that your body pays off for the next 24 hours, so you’re still burning calories long after you finish.

The important thing is to absolutely wring every last drop and ounce of effort out in each interval of activity.  Of course you will want to warm up and cool down and stretch, so plan on 20 minutes in the pain cave (I am adding a “faff factor”, too) and 10 minutes to shower afterwards!  So its still a 30 minute aliquot of time to find in the day – but you’ve been looking for that already.


Theory Thursday

Why weights?

Weights are great.  I can see you’re sceptical.  Weight training has all sorts of negative connotations and associations, especially with anabolic steroids and fake tan.  

But we could all benefit from strength training.  You saw in “tech Tuesday” this week that you don’t have to lift anything other than yourself to get strength benefits, so why and how should you do it?

Health not vanity

Muscle is good.  Strength and weight training can help you build muscle.  Muscle is metabolically active (burns calories) and the more muscle mass you have and use (exercising) the more fat you burn.  So, muscle can help with weight optimisation.  

Muscle is good.  If you have weight to lose, and you just diet, you could end up losing both fat and muscle – which will make it harder to lose weight.  So strength and weight training can help you hold on to muscle whilst losing fat and achieving your goal weight.

strong is the new sexy. apparently.

Muscle is good.  We all want to look forward to a healthy old age.  Unfortunately, our bodies inevitably lose muscle as we age, a process called “sarcopenia”.  Sarcopenia is the start of the road leading to osteopenia and osteoporosis (thin bones) a risk factor for fractures at low impact and shrinking.  Building muscle as you age could prevent that – and save your life!

Muscle is good.  At any age, we want to get about in our daily lives pain-free and without falling over, able to open jars, hang pictures, dig the garden.  Building muscle helps you in all areas of your daily life and creating a strong muscular core relieves back pain.

Muscle is good.  In later life, to keep your quality of life, you want muscle.  You want to be able to get up out of the chair, not fall over, take a wander round the garden on that uneven path and survive to “skype” the grandkids.  If you don’t take some strength training steps to reverse sarcopenia you could be “A over T” just standing up.

Mo Farah

Muscle is good.  Mo Farah started winning gold medals with the Oregon project.  What did he do differently?  Weights and strength training with Alberto Salazar.  If you’re a runner and you can’t go faster, despite all your best tempo runs, hill sprints and interval training, you need more muscle.  Afraid you’ll “bulk up”?  Unlikely – people trying to “bulk up” (look like Arnie) take up a lot of internet space out there discussing how tricky that is.

How to strength train?

Functional bodyweight training

There are many exercises that you can do do strengthen the muscles you utilise in your daily life.  Squats are getting up from a chair, sit-ups are getting up in the morning, push-ups help you lift and carry, “planks” help your core strength for simple balance.  Half an hour of mixed bodyweight exercises twice a week to repetitively perform these movements will improve and condition the muscles executing them.

Good for – weight maintenance and delaying the aging process!

the perfect squat

Light weights high reps vs. Heavy weights low reps

There is a whole world of research about whether it’s best to lift light weights lots of times or heavy weights only a few times to build muscle (metabolic below) and gain strength (neural below).

The bottom line seems to be, simply, surprise your muscles.  Your body is great at adapting.  If you do the same workout every time your “neuromuscular” connections will wise up and stop adapting by building new muscle fibres – they know how to use the ones you’ve already got.  So variation in your workouts is key, if you find yourself stagnating.  They call this “periodized” training, but we call it “not getting bored”…..

Good for – improving athletic speed, (getting ripped – but that’s not a valid superhero motivation*)

*although it makes the close-fitting superhero outfit look better…….


Theory Thursday

Eating Smart

We’ve talked about working out your BMR and tracking calories in and out as ways to achieve your goal weight, and we’ve talked about “snake eating” or intermittent fasting.  But you could interpret that as a license to eat only jelly to keep your calorie intake down and you’d then get hungry and malnourished if you didn’t


photo credit – Dr Ted Naiman MD


We fully believe, in the wise words of Garfield (remember him!) that

“diet is ‘die’ with a ‘t’.”



That means, no foods are off limits, there is no strict plan to follow, you are free to intermittent fast as it suits you and to make up your calorie count however you like and burn off as much as you like, how you like.  BUT, it’s so much easier if you “eat smart”.  What does eating smart look like?

1 – nutrient dense – don’t waste your calories on sugar and alcohol – you’ll regret it because you’ll be hungry and hungover!  Have lean protein which helps you feel full with plenty of veggies to give you your 5-a-day.

2 – Low Carb High Fat (LCHF) – minimise carbohydrate and don’t be afraid to replace carbs with good fat .

3 – (optional, if it suits you, but sensible) calorie or portion controlled – use my fitness pal, know your numbers to BE IN control, do not be controlled.

“That sounds like a diet” I hear you say……!?  Well, maybe, but the key is,

it’s up to you how you play it

The evil of sugar  


You’ve heard about it all over the news, but you’ve got a sweet tooth.  Or, you find you need a “sugar-fix” to keep you awake or to stop you getting shaky and faint (and you think you might be diabetic).  

Well, you’re not diabetic.  You do not need sugar.  You are an addict and you need to quit.  It’s really hard because “sugar” is not just the granular white stuff you put in your coffee, a lot of sugar is added and a lot of foods you eat just turn quickly into sugar in your bloodstream – and that gives you the energy spike and then the crashing low, described above.

How to fix it?

5% rule – OK, sorry, we made a rule.  Nowadays food is labelled.  LOOK and don’t pick up things with more than 5% sugar in them.  Labels usually tell you sugar in grams per 100 gram of product, so just stick to less than 5g of sugar per 100g of “foodstuff” and that is dead easy, dead simple and if you just did that and nothing else you might be the “you” you always dreamed of.

Low GI – Low glycaemic index or “complex carbs”.  These are the unprocessed carbohydrates with lots of fibre that your gut has to work much harder to extract the sugar out of.  Eat them and you won’t then get the “sugar rush” and the sugar drop then craving.  What are they?  wholemeal bread & pasta, quinoa, pulses, brown rice.  If that sounds a little bit “hairshirt” you might be as well to cut carbs altogether.

The overriding reason why we want you to do this is NOT because we are mean sadists but because you will NOT BE HUNGRY!  Try it & let us know!

Nutrient Dense 

So, you’re now convinced  that sugar is the “white death” and you are resolved to quit and never be insatiably hungry again.  You will regain your normal hunger signals.  What on earth are you going to eat?  There are plenty of resources on the internet and books to help you (& the photo at teh top of this page) – we’ve already banged on about livestrong and the blood sugar diet.  You need protein as a basic nutritional building block (myfitnesspal calls these “macros” as in “macronutrients”) and lean means chicken and fish, so start there.  Then you need “micronutrients” or vitamins and minerals and your “5-a-day” – veggies mostly, some fruit is fine especially berries.  Then you may or may not want to add a small amount of low GI less than 5% sugar carbohydrates and finally you definitely want “good fat”.

Good fat

For years we’ve been avoiding fat, yet now we’re avoiding sugar, but what fat is OK? We think it’s pretty easy – if it’s fat from a plant (except maybe coconuts) or an oily fish eat it merrily,

olive oil and oily fish

if it’s fat from an animal (or a coconut) be cautious if you continue to eat carbs (but not as cautious as you used to be: just don’t forget how calorie -dense fat is!)  If you are absolutely carb-free then you can have your saturated fat & eat it!


The bottom line on this one is

avocados are good 😉 and you can only afford to up the fat if you ditch those carbs!


(and by the way, eggs are OK now!)

And finally

No–one can be this disciplined 100% of the time.  We said at the start, nothing is off-limits, we just want to encourage you to eat smart i.e. make smart food choices that fill you up with life-prolonging nutrients and stop that insatiable hunger.  So we make no apologies for this excellent rule:

80:20 rule

80% of the time stick with the programme, 20% of the time allow yourself some wriggle room.

Now, go forth and eat smart 🙂 



Theory Thursday

When to exercise?

When is the best time to exercise? The short answer is – whenever you will actually, realistically, consistently do it! If it means the difference between no exercise at all and some exercise then 10pm is OK.

pair of trainers waiting to be taken for a run

Afternoon delight?

However, this is all about science. There is some evidence that afternoon workouts might be helpful on a number of levels:

1 – cortisol levels are even, testosterone is high -> less fat deposition, best muscular growth
2 – body temperature is up – > less risk of injury
3 – it’s not too late to interfere with your sleep pattern

clock showing 5pm

So if you do a 9-5 and can find 30 mins at the end of it that you can carve out for yourself (run home? Cycle home? Nordic walk home? Swimming pool on the way home? Get home and quickly do a YouTube workout before anyone notices…) then that could really work – as it’s fairly easy to fit into your schedule and works with meal patterns.

cycling home
commuting hobbit

Up and at ’em?

But there is a school of thought (and some evidence) that mornings are good, too. On the downside, your muscles are cool after sleep, also – omg it’s early! And your stress hormone cortisol is jacking up to store fat. BUT if you do it before you do anything else then it’s done. You can’t undo it – you have achieved for the day. Psychologically very satisfying. And maybe you’ll sleep better. Also, some recent research found that fasted exercise for men (but not women)is extraordinarily beneficial. So if you’ve got a y-chromosome get up and go before breakfast.

y chromosome

Shift work

But what if you just are not a morning person or you work weird shifts or long days? For me, exercise really wakes me up and I sleep poorly if I exercise after 7pm when I finish work, but for others it helps them sleep – so try it out! We’ll learn later that good sleep is one of the pillars of weight loss (it’s not all eat less move more!) so that would be a double benefit.

bike computer

Shift workers are really in trouble here. We keep hearing doom laden research about the poor health of shift workers – bad eating patterns, rubbish sleep, no exercise, risk of diabetes. And not only that but no vitamin D either. If you’re a shift worker please take some vitamin d and ask in the comments if you want a full theory Thursday about vitamin d – it’s my pet subject and I know an expert who’d be happy to guest blog! But also, think about what you can do to get some activity into your life. I’d be tempted to look at Michael Mosley – 3 minutes of exercise a week (in conjunction with the blood sugar diet).  There’s no evidence (yet) that it specifically  helps those doing shifts but maybe he would do some research on you?……it definitely reduces diabetes risk, at any rate.

In summary – exercise is great whenever and however you do it so don’t overthink it. Exercise is great when it works for you and seamlessly fits into your life and schedule as a habit and doesn’t have to be shoehorned in as a troublesome extra. But if it suits you, do it in the afternoon! It’ll avoid the temptation of afternoon snacking, too!

Theory Thursday

Eating like a snake



intermittent fasting, 


eat stop eat. 

clock and cutlery

That crazy Italian who will sell you expensive five day fasts.

dr valter longo

Yes, there’s a lot of it about. But try reading ‘the obesity code’ by Jason Fung, or ‘the eight week blood sugar diet‘ by the lovely Dr. Mosley. Both very sensible doctors, the first a nephrologist/diabetologist, the second a delightful doctor-cum-journalist/media star married to a sensible GP.

Lots of different names for a similar concept, so I’ve come up with my own which, for me, boils down to:

eating like a snake

You have seen the picture. Long slender snake, big animal shaped snake tummy in middle of snake. Then snake goes back to being long and slender.

fat snake

Am I long and slender?  Well, relative to the hobbit I am quite long when lying down. And my BMI is around 24.5.

My story

So, the cyclothymic back story is that since the age of 15 when my mother suggested I was getting fat (5’6″ and nine and a half stone – a healthy weight) I started binge eating and dieting erratically.  Whilst my siblings dabbled with bulimia and intermittent anorexia I just starved and binged and berated myself for my lack of self control; whilst never being thin. I’d have scored highly on the bulimic scoring tool, but being moderately fat isn’t often noticed as being a medical problem.

At my fattest: just after qualifying as a doctor; a large latte and almond croissant for breakfast, baguette with mozzarella for lunch and ten hours in the library each day.  I went to the gym every day without fail, but it didn’t stop me being thirteen stone for my (8 stone) sister’s wedding two weeks after my graduation. And I didn’t even get a bloody distinction, despite two distinction vivas.

When was I skinniest? 6 months after qualifying when I lived on the heady cocktail of quality street, trotting endlessly down the long long corridors of some dingy DGH whilst being mildly bullied by my consultant.

quality street
step away!

And the subsequent years when I joined the army and did a bit of running about.

But whenever I was happy I’d live on bread, pasta, rice and potatoes and get fat.

Motivation for change

So why, in 2015, was it important to be slimmer and what was going to make it more likely?

Firstly, I was forty. A year after the time when you are most likely to die from suicide or exercise craziness (39, 49, 59 year olds etc. etc. get a fear of mortality and do acts of sporting craziness or kill themselves more commonly in the year before ‘significant’ birthdays).

And secondly I’d decided to learn to ride side saddle.

This is a stupid sport. It’s only done because it looks good. It’s lopsided so doesn’t help you train for ANYTHING, although it’s good if you want to ride but have hip problems. It’s technically difficult, expensive, requires teachers from far flung places (who are generally terrifying women) and the purchasing of ancient leatherwork which will fall apart shortly after you’ve bought it. But hell, it looks really elegant. But only if you are slim.

side saddle victorian

So I decided to stop being a bit fat. ‘Cause I wanted to look better on a horse whilst sat sideways. Great reason. And partly because I wanted to buy a side saddle habit, and didn’t want to buy a size sixteen. I wanted to look like someone who could wear a corset under my habit and gallop across a field without passing out.

Very Low Calorie Diets?

And Michael Mosley published his book about v. low cal diets, and discussed why VLCD were not dangerous (as had been stated repeatedly) and then I read lots of stuff about fasting. So I tried it out on a friend, and she lost LOADS of weight on the Luton and Dunstable milk diet and then thought “….why not have a go?…..”


So then I started eat stop eat/intermittent fasting/milk diets/horrifying my hobbit buddy/snake eating.

And lo and behold, once I gave myself permission to be a bit hungry for a short time and got rid of the guilt about eating a reasonable amount but not excessively, and every now and again did a slightly longer fast I found my weight was where I wanted it to be. And has stayed that way. But it flies in the face of the breakfast eating three square meals a day brigade.

The Milk Diet

So, Luton and Dunstable milk diet: designed to shrink your liver pre-op before bariatric surgery. But if you did it for five days a month you would (probably!!) get the same benefits as the expensive five day diets the Italian sells in little packets (Professor Longo, looks twenty but actually mid forties).

Brace yourself, it’s not easy.

Daily allowance:

4 pints semi skimmed milk, one oxo cube, a vitamin and mineral tablet.

And that’s it. Oh, unless you count tea or coffee (you can have milk out of your allowance).

Try it. What’s the worst that can happen?

(constipation, headaches, nausea, loss of concentration, low mood.)

Don’t say you weren’t warned.






Theory Thursday

Are you a scientist?  A realist? Do you not believe the hype? Do you shiver at the Internet claims of the cabbage soup diet, the egg and grapefruit diet and the meal replacement diets?

picture of a golden egg

Do you long for some real evidence which you find relevant to your health aims?  Well, we’ll try to bring it to you here.  Even if you normally hate science, keep reading.  We’ll also try to translate it into plain English that makes the penny drop.  Then you can understand the best current health science.  Some of it is quite surprising and counter intuitive!  But it works – we know, we tried it.

Basal metabolic rate – BMR

Our bodies are amazing 24 hour machines, they burn calories just doing nothing.  Your basal metabolic rate or BMR is the number of calories you burn per 24 hours if at rest.  What is doing the burning when you’re just resting?  Well, your gut is quietly working pretty hard – extracting nutrients from your food, peristalsing (moving poo downstream).  Your brain is buzzing, repairs are being microscopically carried out all over the place, your eyelids are blinking.  Your bone is remodelling, your muscles are using some energy – amongst a host of other calorie burning functions. 


Modify the burn

You can imagine, then, that a number of things affect the number of calories you burn at rest:

1 – current weight – if there is more of you, there are more cells burning calories hence your BMR will be higher.

2 – current age – the younger you are the higher your BMR.  There are various reasons for this, but one is higher muscle mass.  Peak bone and muscle mass occurs aged 34 so if you’re young and you’re reading this – get building up to your peak now!  If you’re old – don’t despair, you can build some back up again!

3 – sex – men have a higher BMR to women, usually due to their higher percentage of muscle.


Calorie deficit

What does this mean?  Well, in order to lose 1lb of fat per week you need to be in a calorie deficit of 3500kCals, or 500kCals per day.  Very simply, if you have a BMR of 1500kCal and you currently consume 2000kCal a day then a 1500kCal nutrition plan alone might achieve your weight loss aims.  But that isn’t very satisfactory, as you will find if you have tried to do it.  Because as you lose weight (and get older) your BMR will drop and your muscle mass will probably drop and you will end up chasing your tail.  And it is VERY IMPORTANT to stick to no less than 1200kCal/day (unless on a short term very low calorie diet) to avoid malnutrition.

You can’t do anything to stop yourself aging or change your sex (****) but you can modify 3 factors to achieve your weight goal much more healthily and sustainably and create a calorie deficit:

1 – Take in less calories – nutrition plan


2 – Burn more calories – activity plan


3 – build muscle – strength training plan

If you exercise and strength train as well as eating right, not only can you eat more, you will gain muscle.  Although your BMR will drop with weight loss you will find it much easier to maintain.

Lessons learned

I had a very painful lesson to learn about my own BMR.  I had never looked at what it really meant to be so short in terms of my BMR.  I just ate what everyone else ate.  Working out my basal metabolic rate was absolutely sobering.  At 143.2 cm tall I will gain weight if I eat more than 1150 kCal/day (if inactive).  Putting that into context, look at a typically modest English diet:


cup of tea, 2 slices of toast with butter and marmite = 214 kCal,


ploughmans sandwich, pack of crisps, orange juice  = 685 kCal. 


shepherds pie and vegetables, glass of red wine – 528 kCal

total =1427 kCal

(and imagine I might not stop at one glass of wine, I might have pudding, I might have a “snack” – all adding to the calorie count)

As above, if every 3500kCal over your metabolic usage is a pound of weight gained, finally I understood that I would gain 1/2 lb per week and be 133kg (wider than tall!) by the age of 50 if I didn’t do something.  I couldn’t just diet and eat 1150kCal a day – anything less than 1200kCal can lead to malnutrition.  I had to exercise.  Not only that, but I had to build muscle – later on a “theory Thursday” we’ll talk about sarcopenia, but every year past the age of 30 we lose muscle mass (which is metabolically active) and hence our BMR drops and drops every year, so if I didn’t improve my BMR I would be eating less and less each year until I figured my daily caloric intake to avoid weight gain would probably amount to a single peanut!



I like peanuts, but that was not a future I relished. 

“Eat smart, move more, build muscle”

So, now you know why you’ve been getting fatter as you age even though you may not have been eating more.  Be honest and acknowledge the degree to which your sedentary lifestyle is making you lose muscle and raising the risk of weight gain.  Have a look at total lifestyle change – a nutrition and activity plan with strength training that puts you into 500kCal deficit per day (or 3500kCal deficit averaged over a week) until you reach your goal weight:


****artistic licence – in fact you can change your sex