The Fitness and Strength Experiment: Overview

The Fitness and Strength experiment will be one of the most important and challenging experiments in your entire journey. Important, because exercise of all kinds is the best medicine known to mankind. Challenging because doing it, and doing it at the right level requires effort and consistency. We probably spend about half of our time with patients discussing this topic.

As with all of your experiments in the lifestyle experiment, the key here will be to create a measurable improvement through exercise and then check to see if that improvement has had an impact on internal and external measures of metabolism and insulin resistance. This experiment has 2 parts, Fitness and Strength, they are described below:

1. Fitness: Measured cardiorespiratory fitness (CRF) has an extremely strong association with insulin sensitivity. Patients in the top decile for fitness are about 40% as likely to have insulin resistance as patients in the lowest decile. In our fitness experiment, we will estimate the top level of performance that we are capable of (something called V02 max) and then we will try and improve it through progressive cardiovascular (aerobic) exercise. Once it has been improved, we will repeat measurements of body composition and insulin resistance.
   

2. Strength: Equally important to CRF are muscle mass and strength. Patients in the top quartile for age-adjusted strength are nearly 30% as likely as patients in the lowest quartile to have insulin resistance. In our strength experiment, we will measure muscle mass and strength using various methods. Then we will start a resistance (weight lifting) program and improve both strength and ideally mass. Once they have been improved, we will repeat measurements of body composition and insulin resistance.