February 5, 2025 • 48 mins
Unlock the secrets to treating exercise as a potent medicine for women’s health with our insightful guest, Dr. Matthew Kampert. Learn how you can harness resistance training and load-bearing activities to bolster bone density and combat age-related bone and muscle loss.
Dr. Kampert highlights the need for integrating adequate protein intake and exercise to preserve muscle mass while managing weight. Listen in for a comprehensive discussion that promises to enrich your understanding of exercise as a transformative tool in women’s health.
To learn more about Dr. Kampert, visit clevelandclinic.org and youtube.com.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to the Speaking of Women's Health
podcast.
I'm your guest host, LeighKlecker, the producer of the
podcast, and I'm happy to beback in the Sunflower House for
a new podcast episode with DrMatthew Kampert.
I'm talking with Dr Kampert inthis new episode about exercise
as medicine for women.
(00:22):
First I'd like to share alittle bit about his
professional background and thenwe'll dive into the episode.
So Dr Kamper received hisundergraduate degree from West
Virginia University.
He went on to earn a graduatedegree in exercise physiology at
West Virginia and he thenattended Lake Erie College of
(00:44):
Medicine for his medical degreeand went to Cleveland Clinic,
South Point Hospital for hisresidency in family medicine.
Then he decided to do afellowship in sports medicine at
Cleveland Clinic and wasappointed to Cleveland Clinic
shortly after, in 2020, in thesports medicine department.
So welcome, Dr Kampert.
Speaker 2 (01:06):
Thanks for having me.
Speaker 1 (01:08):
Of course.
So, as I mentioned, we're goingto be talking about exercise as
medicine for women in thisepisode, and we've done several
previous podcast episodes aboutfood as medicine, so I think
this is a great topic.
As we're, all you know, in thisnew year hope, maybe setting
some resolutions and thinkingabout maybe some ways we can
(01:29):
live healthier, or maybe a newexercise regime and, as we know
from several other podcasts withour guests and Dr Thacker,
women who exercise theyregularly have a lower risk of
death from all causes, includingcardiovascular disease, and
we've also discussed many timeson this podcast how exercise can
(01:51):
help with mood, as it releasesendorphins and helps you to feel
happier, maybe more relaxed,and so these are just a few
examples of how exercise isbeneficial to our health, but I
think we're going to start withbone density and osteopenia and
osteoporosis.
So, dr Kampert, how can regularexercise help strengthen our
(02:16):
bones or prevent bone loss, anddo you want to talk a little bit
about bone density and how thatall kind of works together?
Speaker 2 (02:24):
Yeah.
So exercise plays a huge roleand really across the lifespan.
So you only have so many yearsto really lay down bone density.
Usually around age 26 is peakbone density for females, and
(02:45):
then your hormones and thingschange and then really the goal
is to minimize bone density loss.
You can always try to add alittle bit and there's
medications that help with that.
I won't go into much of that.
But really the type of exerciseis resistance training or things
(03:07):
that load the bone.
So not all exercise is createdequal and with the approach that
exercise is medicine, you haveto have the right dose and the
right prescription.
So you need to load the bones.
Aerobic exercise you get alittle bit of loading of the
bones with running, but cyclingyou really don't load the spine.
(03:30):
You can stress the long bonesand then swimming's great
exercise, but you're really notloading the joints or the bones
or the spine.
So you could actually lose somebone density in the spine from
cycling and lose bone densityfrom swimming.
If you think about space travel,one of the things they worry
(03:52):
about is muscle loss and bonedensity loss because you don't
have the effects of gravity.
So your body really does likethe bones to be stressed
appropriately and then theyrespond.
So by doing things likeresistance training or
load-bearing exercises, evenproper squatting mechanics and
loading that spine or rucking,you can increase the bone
(04:13):
density in the spine andthroughout the whole body and
you want to make sure that youhave adequate calcium and
vitamin D also with that processthat you have adequate calcium
and vitamin D also with thatprocess, right?
Speaker 1 (04:29):
So you said that running could be considered a
resistant exercise.
What other examples can youprovide?
Anything?
Speaker 2 (04:37):
that where the body's being loaded.
So why running does?
It is because you have theeffects of gravity and then when
you're running you have theimpact forces, so all that
jarring of the joints andeverything.
But really resistance trainingwhere you're really loading the
muscles, so where you're liftingheavier loads, so more than
(04:58):
your activities of daily living,so you could carry bags around
throughout the day.
But if you're lifting weightsweights you can only do a
certain number of repetitions,so it's a heavier load, it's a
larger stress on the bones, butnot the type of stress you will
want all day.
So any type of resistancetraining will help the bones and
the joints that you're loading.
But if you're only doing thingsfor the lower body, like leg
(05:23):
extensions and leg presses, youhave to remember you're not
loading through that spine andyou're only doing things for the
lower body, like leg extensionsand leg presses, you have to
remember you're not loadingthrough that spine and you're
not loading the bones of theupper extremities.
Speaker 1 (05:31):
So yoga, would that be a good one, Because you kind
of seem to be using your wholebody.
Speaker 2 (05:38):
Yoga has a lot of health benefits, but I wouldn't
identify that as one of the keyways to build muscle or to load
the bones.
I mean because you're reallynot increasing the forces much
more than the force of gravity.
Speaker 1 (05:54):
So weights and then, but making sure, like you said,
just don't stick to.
You know legs all day, or legsevery day, whatever the saying
is, but you know arms, shouldersall day or legs every day,
whatever the saying is.
Speaker 2 (06:06):
but you know arms, shoulders, you want to load all
the bones of the bodyappropriately, without
overloading them, because thenyou can get stress, injuries or
stress reactions or even stress,fractures?
Speaker 1 (06:15):
Sure, okay, and then how often do you recommend these
exercises be performed to?
You know, keep that bone lossfrom happening.
Speaker 2 (06:23):
Be performed to keep that bone loss from happening.
You really want to doresistance training at least two
to three times a week.
But different activities.
You want to be active.
So just being active helpsprotect against bone and muscle
loss.
If you're ever bedridden oryou're not up and about, that's
(06:45):
going to be detrimental in andof itself.
But from a standpoint of tryingto actually add some bone
density, you would want to do atleast two to three times a week
of structured resistancetraining.
Speaker 1 (06:58):
Okay, great.
And then of course, probably,like you're saying, just move as
much as possible.
You know if you maybe have ajob where you're at the desk all
day trying to get up and justyou know, move that.
So you're not sitting all day.
Speaker 2 (07:12):
Break up the sedentary periods.
Speaker 1 (07:14):
Yeah, I know I struggle with that.
You know a lot of my job iswriting, so I'm sitting at that
laptop and you know you kind ofget in a groove sometimes and
then you realize, wow, I haven'tgotten up in a couple hours.
It's achy and it doesn't feelso good.
So if a woman is new toweight-bearing or they've never
(07:36):
done any sort of resistanceexercise, maybe they've always
just either walked or swam ordid something a little bit more
low-impact.
You know, walked or swam or didsomething a little bit more low
impact how could they getstarted on adding that into
their you know, exercise andtheir lifestyle.
Speaker 2 (07:57):
Yeah, that's a good question.
So I think the easiest way todo it is with machines.
So with free weights you haveto develop that muscle, mind,
muscle control to reallystabilize them.
Develop that muscle, mind,muscle control to really
stabilize them.
But with the machines they'repretty simple to where, if you
set the seat height and the armsettings to the the right height
, it's really just pushingthrough the movement and you
don't have a whole lot ofstability issues.
(08:18):
And that's a nice way to startbecause that then you can load
appropriately with less risk ofinjury and then you can kind of
progress from there.
If you don't have access tomachines, you could always pick
up some bands, elastic bands,and that's a good way to get
started.
Body weight movements arealways an option, but sometimes,
(08:41):
if weight's an issue, you wantto be careful of how you load
the joints because you can'treally modify your body weight,
whereas if you're doingsomething with a machine you can
lighten the load.
Body weight stuff you have whatyou have, and if it's too much
(09:02):
of a load you could get aninjury.
So I would suggest reallyinvesting in a membership to
somewhere that is convenientgeographically.
Speaker 1 (09:14):
Yeah, I know my mom.
She was always a walker and aspinner, or more like riding the
stationary bike, but after sheretired she was able to, at a
certain age age to get and Ican't remember what it's called
and I apologize to our listeners, but when?
Speaker 2 (09:28):
I find out.
Speaker 1 (09:29):
Yes, that's it, yeah, and it's several dollars a
month, maybe five, and she getsaccess to the local Y here as
well as like a community seniorcenter they have where they also
have, so that's a good optionfor those looking for that and
they have a lot of the machines.
Speaker 2 (09:47):
Yeah.
Speaker 1 (09:47):
Yeah, great, so say someone is already diagnosed
with osteopenia Now.
So that is the like, apre-osteoporosis, correct?
Speaker 2 (09:59):
Correct, it's based on the bone density and there's
different levels.
Once you reach certain rangesof decreased bone density, then
you get into the osteopeniarange and then the osteoporosis.
Speaker 1 (10:14):
Okay, so if they've already been diagnosed with
osteopenia not quiteosteoporosis, what can they do
to maybe help prevent gettingosteoporosis in regards to
exercise or lifestyle?
Speaker 2 (10:29):
Yeah, the same things you would do to build it.
You just want to be morecautious and not overly
aggressive, because if you haveosteopenia or osteoporosis, it
does mean that your bones arethinner, they're not as dense.
So if you're too aggressiveyou're more at risk for a
(10:50):
frailty fracture, Not so muchwith the osteopenia but
osteoporosis, depending on howsevere it is.
So you just you want togradually increase and if you do
it gradually and you allowadequate rest, it's very safe to
do but really loading the bonesand making sure that you're
optimizing from a dietarystandpoint with your calcium and
(11:13):
vitamin D, and it's best to getthat from foods.
Speaker 1 (11:16):
Right, yes.
And for our listeners out there, you know if you've been
listening to us for the lastyour calcium and vitamin D and
it's best to get that from foodsRight, yes, and for our
listeners out there, you know ifyou've been listening to us for
the last two seasons, we have,you know, calcium calculator and
lots and lots of informationabout vitamin D on our website.
So that'sspeakingofwomenshealthcom.
So I guess the same would gothen for osteoporosis if you're
already diagnosed with it, youknow, start off slow.
(11:37):
Talk with your you knowphysician about.
You know how you can build upand then get to.
Speaker 2 (11:43):
Maybe you know correct and then when you get to
the like actual osteopenia andosteoporosis, you want to talk
with your physician aboutmedications that might be
appropriate for you.
They can actually slow downbone loss or actually they're
anabolic agents that canactually build some bone density
(12:04):
.
But that's really a discussionthat you want to have with your
provider.
Depending on other medicationsyou might be on comorbidities
everything's risk versus benefitand you want to have an
informed discussion.
Speaker 1 (12:16):
Everything's risk versus benefit and you want to
have an informed discussion.
Can you sort of reverseosteopenia or osteoporosis with
exercise, Sort of aside frommaybe?
Speaker 2 (12:28):
the medication part.
But Depending on your age andthe degree and the underlying
reasons, you can increase bonedensity, though it's much more
effective to do in early age.
But regardless, you definitelywant to incorporate because of
the health benefits but also thebone density benefits.
Speaker 1 (12:53):
Right.
And then you know, as we getolder, you know the amount of
fractures falls and that youknow.
So if you can stop that beforeit becomes a problem and having
to do surgery, so well, this isgreat.
So the next subject I think wewant to explore is sarcopenia,
which is sort of the muscles.
(13:14):
Right, am I correct?
You're losing muscle as you getolder, or can you explain a
little bit more about what thatis?
Speaker 2 (13:21):
Yeah, so age-induced muscle wasting.
As you get older you start tolose muscle mass also.
So your cells are older, yourhormones change and you don't
have that anabolic effect tomaintain muscle mass.
One thing that really helpswith slowing that rate of muscle
(13:43):
loss is resistance training,because you load the muscles,
the muscles are an endocrineorgan of their self where
they'll actually releasemyokines and they'll activate
growth pathways.
And that's a big thing to thinkabout when you're thinking
about body composition.
(14:04):
If you're not exercising andyou're eating calories, what do
you think you're telling yourbody to do with those calories?
To store those calories in yourfat cells.
But if you're doing resistancetraining and you're loading the
muscle and you're eatingcalories and specifically
adequate protein, you're sendingcellular signals to build
muscle, to take those nutrientsand actually build and repair
(14:28):
and make larger muscles.
So it really kind ofcommunicates with the rest of
your body to try to build musclerather than letting the muscle
kind of deteriorate as you age.
And it's not just the musclemass.
So you do lose muscle mass asyou age, it's really the
(14:49):
strength.
You actually lose strength at ahigher rate than you lose
muscle size and that's theimportant factor to look at and
it's overlooked a lot becauseit's not often assessed.
So bone density you can getDEXA scans and then you can get
(15:12):
scans with bioelectricalimpedance where they measure
body composition.
They'll give you muscle mass.
But not too often are peoplegetting strength assessments.
That's something that we offerat the Cleveland Clinic, where
we do one rep max strengthtesting for all the major muscle
groups before we put togetheran exercise prescription, and
(15:32):
your exercise prescription isbased off of those strength
measurements and then we'llreassess you at three months,
six months, nine months, 12months and then to actually see
the improvements in strength andfunction.
Speaker 1 (15:48):
So what kind of tests are those?
I mean, I've heard gripstrength before.
Is it sort of something likethat how you test the muscle
strength.
Speaker 2 (15:55):
Well, we actually take it quite a bit further than
that.
So grip strength is there's alot of association with grip
strength and the rest of thebody whole body strength.
More so that as you lose it, soas you lose overall muscle mass
and strength, you lose gripstrength.
But we actually do anassessment.
(16:18):
We have programs and equipmentwhere we can measure one rep max
strength for each piece ofequipment, so similar to the
types of machines that we weretalking about where you would do
a chest press or a bicep curlor a seated row you would do a
chest press or a bicep curl or aseated row.
(16:42):
We have equipment that uses amode called isokinetic testing
Iso meaning same, kineticmeaning speed.
So no matter how hard you pushor press, the machine moves at
the same speed so it cancalculate how much force you
generate.
I don't know about promotingbrands or anything, so I don't
necessarily want to say thecompany's name that makes the
(17:05):
equipment, but that'sinformation we can share
afterwards on the website.
But we have a pretty elaborateexercise assessment and
prescription program and allthat data gets tracked and it
goes to a cloud and what we'redoing is integrating that cloud
with our electronic medicalrecords so all your exercise
(17:27):
assessments and training getspulled into your, your patient
charts so that we can reallykind of connect the exercise and
medicine and really deliverexercise as medicine is a real
prescription.
Speaker 1 (17:41):
Right, right, sort of like.
What like, do three reps ofthis on Monday?
Speaker 2 (17:46):
Yeah, that's great, yeah, so the equipment's so
advanced that once you do theassessment and we make the
prescription, it gets sent toyour account and when you walk
into the gym you scan with yourphone and it tells you which
machine to go to.
It adjusts the seat height.
On the prescription, it getssent to your account and when
you walk into the gym you scanwith your phone and it tells you
which machine to go to.
It adjusts the seat height onthe machines, the arm settings
on the machine, loads yourworkout arm and it guides you
(18:06):
through the rep.
So the concentric phase and theeccentric phase, so as the
joint angle shortens and as itlengthens.
So it teaches you to doresistance training, not just
weightlifting.
You have to control the loadand it's a safer, more
controlled way to train.
Speaker 1 (18:25):
Absolutely.
I mean, I feel like I hear alot, you know, at least from my
friends and family.
They're going on Instagram orTikTok or whatever social media
and they're like, oh, that lookslike.
Oh, look at her, she's gotgreat abs.
I'm going to do that workoutfrom this woman and this, you
know, these women are girls, youknow they're very young and my
mom is in her 60s.
(18:45):
So I'm like, well, that'sprobably not the workout you
should be doing.
So, you know, I feel likesometimes we're doing the wrong
things for our body and our ageand our muscle strength and our
bone density.
So it's pretty imperative toalways, you know, anytime,
before you start anything new,you should, you know, talk to
your physician about it andmaybe you need to see a
specialist like yourself.
Speaker 2 (19:07):
Yeah, and you make a great point.
You really don't want tocompare yourself to others and
you don't want to exerciseprescription that was made for
someone else or by someone else.
It needs to be individualizedfor you, and the only way to do
that is with an assessment, sothat you know where you're
starting and then it's based offof where you're at and then you
(19:28):
can monitor the progression.
And that's really the biggestthing is consistency over time,
and that's what you hear a lotof comments about.
Well, we know exercises work,but it works.
But how do you get people tostick with it?
It's easy you show them results.
That's why people becomemarathon runners and lifelong
runners or weightlifters becausethey saw the results.
(19:52):
So, by getting patients abaseline assessment at three
months, they may not realizejust how much stronger they got
until you reassess them and youshow them that and when they see
that it's so motivating andrewarding to them.
Speaker 1 (20:07):
Yeah, you know, and I know I've noticed as I've
gotten older.
I was a runner, you know,through high school and until
now, and I'm just, you know, I'mkind of plateauing.
You know I'm saying I'm not mybody's not even staying at the
same weight or muscle mass.
I can see it getting worse, butI'm not exercising any less.
So, you know, the last, I wouldsay five years, I've started,
(20:28):
you know, doing this bar Pilateswhere we use resistance bands
and weights, and I do yoga.
But I do that just because Ilike it, for the calmness and my
mental health.
But I do see a difference.
If I'm not going and doing thatresistance training, after you
know, if it's been two weeks,three weeks, I can totally tell
the difference.
I plateaued again.
So I think you know, likeyou're saying, keeping up with
(20:50):
it and then, as you hit acertain age, you may have to,
you know, change up that routineand as people, they can still
build muscle and get stronger.
Speaker 2 (21:01):
The thing is and they can train hard too the
difference is they need a littlebit more recovery time.
So where if for a hard workoutwhen they were younger, they may
have been able to train thatsame muscle group two days later
?
Sometimes it may take anotherday as you get older, but if you
gradually increase and you'reconsistent, you can train hard.
(21:22):
You just have to make sure thatyou're also recovering before
you train hard again.
Speaker 1 (21:28):
Yeah, that's a good point.
That's a good point, so sort ofgoing back.
I mean, we've been talkingabout sarcopenia, but who does
it affect?
Females, males, certain ages,certain anybody, everyone.
Speaker 2 (21:42):
Okay, so it comes down to age.
So really after your mid-30syou start to see a decline in
muscle mass and strength, unlessyou're actively doing
resistance training.
For women they see asignificant decline after
menopause and then when you getto like your 60s it kind of
(22:05):
accelerates more and more.
Men as they age, they kind ofhave a more gradual loss of
testosterone, which is reallytheir anabolic hormone that
signals muscle growth, and forwomen it's the estrogen that's
their anabolic component.
So postmenopausal, if they'renot doing resistance training,
they will see a rapid, veryrapid decline of muscle mass.
(22:29):
And it's actually impressivejust how much resistance
training can offset that decline.
If you would look at twoindividuals as they go through
menopause, if one is doing awell-structured resistance
stranding program versus afemale who isn't, it really
changes how they age.
Because the thing about musclemass is there's 2,500 calories
(22:53):
in a pound of muscle, there's3,500 calories in a pound of fat
.
The more muscle you have, themore calories you burn, because
muscle is very metabolicallyactive where fat is not.
So if you have a certain amountof muscle and a certain amount
of fat and your hormones changeand you're no longer maintaining
that muscle mass and you're notdoing resistance training to
(23:14):
maintain it.
Now I've been counting thecalories you burn through the
resistance training.
You're going to notice that youfeel softer or like you're more
fat, because what's going tohappen is your body's going to
be burning that muscle mass forenergy instead of the fat.
And for every pound of musclethat the body burns or doesn't
maintain, there's 2,500 calorieswith that.
(23:37):
So instead of burning that2,500 calories worth of fat,
it's coming from your muscles.
So even if you're not eatingmore and not exercising less,
your body composition can changebecause you're not supporting
previous muscle mass that youdid have.
Speaker 1 (23:54):
Got it, so can you.
So now you're making me want tolike, re, really re up my
resistance training.
But can you do too much of it?
You know, if I decided to do itsix days a week, is that too
much?
Speaker 2 (24:07):
So that's a loaded question so we have to approach
that in steps.
So I think the biggest concernthat females have is they don't
want to get too bulky.
You won't.
It's hard to build muscle,especially if you're in a
caloric deficit.
If you're trying to lean outand you're in a caloric deficit,
(24:35):
it's hard to build muscle.
And then for females, you don'thave the genetics of a male, so
you don't have the testosterone.
That's why women they can getcomparable leg strength if they
really train well, but there'salways going to be a deficiency
in upper body strength becauseyou have a lot of your androgen
(24:58):
receptors in your deltoids andyour upper arms and your traps.
So if you look at athletes whoabuse steroids, they have very
large traps and very bigdeltoids.
And if you look at females, theykind of have slender arms.
That's where the androgenreceptors are.
So don't be afraid to liftweights.
(25:19):
You're not just going to swellup overnight and you may feel
that you're bulky.
A lot of that is because you'reincreasing the muscle glycogen
stores.
Okay, so the more you use theglycogen which is stored
carbohydrates in your muscle,your body adapts and it stores
more glycogen in the muscle andone gram of glycogen holds three
(25:43):
grams of water.
So your muscles can swell upand that's kind of the pump that
you feel when you're liftingthat increased blood flow in
that pump all up.
And that's kind of the pumpthat you feel when you're
lifting that increased bloodflow in that pump.
So your muscles may become morefuller and you may feel that
you're kind of blocky and bulky.
But as you continue to improveyour diet and lean out, you lose
that layer of fat or adiposetissue over the muscle and you
(26:08):
realize that you're not bulkyand you really want that muscle
mass, because as you lean outyou don't want to be left with
kind of a low level muscle mass.
And that kind of gets into awhole discussion about weight
loss and some of those GLP-1medications that we could go
(26:29):
into now or later on, dependingon how you want to proceed.
Speaker 1 (26:34):
I mean that's really interesting.
That's actually a whole podcastepisode I do want to have.
So I mean I wouldn't minddiving into that, because I know
we're getting a lot ofquestions on our website about
women asking about these.
Speaker 2 (26:47):
So with the GLP-P ones, they're great at what they
do.
It's an appetite suppressant.
So when you eat, your, yourstomach and small intestines you
release these hormones thatmake you feel full, called
incretins, tells your brain thatyou're full.
Now some people they'll eat andthey'll always be hungry.
(27:08):
It could be because they don'tmake enough.
So when they eat they don'trelease these hormones and they
never feel full.
Some people could be resistant.
So they eat, they release anadequate amount, but they don't
respond to it, kind of like indiabetes, people who need
insulin because they don't makeenough, or people who don't
(27:30):
respond to the insulin that theydo make.
So that's why you have to startat a very low dose, because if
you're someone that just doesn'tmake this hormone when they eat
, you're very sensitive to it.
So the smallest dose can have aprofound effect.
And then some people they couldbe on the highest dose and they
really don't notice an effectbecause they already make a lot.
(27:52):
They just don't respond to itand giving someone more of
something they respond to is notgoing to have as much of a
profound effect.
And the thing is they're mostof them are once weekly
injections so you can'tun-inject it.
So if you're overzealous and youthink, oh, I'm always full, I
mean I'm never full, I'm alwayshungry.
I I don't want to start withthe low dose.
(28:12):
Always start with the low dose,because if you're just someone
that doesn't make it, evensometimes a fraction of that
starting dose is enough.
I mean can Go ahead.
No, I was just going to ask.
Speaker 1 (28:23):
So then when they're starting on this and they're not
eating as much, not eating asmuch, so then I mean I would
imagine that has to somehowaffect, you know, like their
bone density or and or theirmuscle mass, because then, like
you were saying, you have tohave to intake so many calories
to keep up with building thatmuscle, right?
Speaker 2 (28:43):
So, and that that's kind of the next thing I was
going to say um, people say thatthey don't want to take it
because you lose muscle mass.
Speaker 1 (28:54):
Yeah.
Speaker 2 (28:55):
The studies show that the way those studies were all
designed by the pharmaceuticalcompanies, there was no
resistance component.
They told the patients to eat500 calories less a day and be
active 150 minutes.
Nothing about resistancetraining.
Be active 150 minutes, nothingabout resistance training.
(29:15):
So the thing is they lost a lotof weight, but about up to 30%.
A third of the weight was leanmass.
Now it's not the medication'sfault.
The medication did its job.
It suppressed your appetite.
It doesn't matter if you're,when you're in a caloric
deficit're going to lose weight.
Whether it's willpower,bariatric surgery, poverty pills
(29:36):
, injections, stranded on adesert island, your body doesn't
care.
It just knows it's not gettingenough calories to sustain life.
And your body's smart.
What it learned was that itwants to make you as efficient
as possible so that you livelong enough to find your next
meal.
So the more muscle you have,the more calories you have to
(29:58):
consume to maintain that musclemass.
And, like we talked about,there's 2,500 calories in a
pound of muscle, 3,500 caloriesin a pound of fat, and it
doesn't take anything tomaintain fat mass and a pound of
fat.
And it doesn't take anything tomaintain fat mass.
So your body knows that I canget energy from burning this
muscle, but not only that.
I can decrease the amount ofenergy that it requires for me
(30:21):
to remain alive.
So your muscle, your body, willstart burning that muscle.
Unless you're using the musclea lot, you release myokines and
basically what your muscles say.
Hey, I understand I'm starvingto death, but I'm using these
muscles a lot, probably to tryto find food.
Leave the muscle alone and burnthe fat okay, and it's.
(30:43):
You have to remember all themuscles.
So if you only train your legs,you're not going to protect
your upper body.
You have to train the wholebody because you can maintain
the muscle mass in the legs, butif you're not training the
upper body, you're going to losemuscle mass and bone density
that way.
So that's where the problem is.
These medications should neverbe prescribed unless somebody's
(31:07):
in a structured resistancetraining program.
The cardiovascular exercise hasits benefits from health
benefits and a whole bunch ofother stuff.
But if you're just doing cardioand you're taking these
medications and limiting yourdiet, those are just increasing
that caloric deficit.
You're not protecting yourmuscle mass.
So that's the important thingthat inadequate protein and what
(31:35):
we see with the patients wehave in the data, we have in the
exercise environment we createdwith or without these
medications.
If patients can create acaloric deficit, they'll lose
weight.
If they follow our structuredexercise program or any
structured resistance trainingprogram, they'll improve
strength while losing weight.
Speaker 1 (31:56):
That's great, Thank you, it's really I mean it's
really interesting and we shoulddo like a part two about side
effects right, who arecandidates?
Because you know we see on a lotof these TV shows and you know
celebrities on.
You know in the media they'resaying they're going on these
pills.
Well, they sure didn.
Tv shows and you knowcelebrities on.
You know in the media they'resaying they're going on these
pills, but they sure didn't.
Or you know the medicine.
They sure didn't look like theyneeded to to begin with.
(32:16):
Maybe just a little extraexercise.
Speaker 2 (32:18):
So and the important thing to point out is these
medications.
Just like I explained, somepeople don't make enough of this
hormone and some peopleresistant.
Like any medication, when themedication binds their receptor
that your receptors downregulate, it's called
tachyphylaxis.
So you get a decreased responseto that medication over time
(32:43):
and there's some people.
That's why you continuallyincrease the dose.
You develop a tolerance.
Yeah, and you've got to thinkabout this long term.
If that's the only tool in yourtoolbox that you're using,
what's going to happen whenyou're at the highest dose and
you're still hungry?
And worse yet, what's going tohappen if you didn't do
resistance training?
(33:03):
Now you lost fat and muscle.
You didn't increase yourexercise capacity to protect
against that weight regain bybeing more fit and being able to
burn more calories.
So now when the appetite comesback, you're going to gain fat
back.
So you lost fat and muscle andnow you're a year older and
fat's going to come back.
(33:23):
Versus if you maintained yourmuscle mass and you improved
your fitness.
And you improved your fitness.
So when you first start, youmay exercise hard for 30 minutes
and may only be able to burn200 calories as you get more fit
if you exercise hard for 30minutes.
It's the same duration, the sameintensity 30 minutes hard.
(33:45):
But hard's relative.
You're more fit now.
You have different metabolicmachinery.
You have more mitochondria inyour muscle.
The reason you can run fasteris because you can burn calories
faster.
So now for that same hardeffort, for that same duration
instead of 200 calories you canburn 400 calories.
(34:06):
And now you don't hate exerciseand you have the endurance so
you could exercise for an hour.
So now you're talking 500, 600calories.
So that's more of a meaningfulcaloric expenditure to protect
against the weight regain thatoccurs when the appetite returns
.
Plus you preserve your musclemass.
So again, in no situationshould these medications be
(34:28):
prescribed.
No situation should thesemedications be prescribed?
Because if you do take them andyou lose muscle mass and it's
years later and the appetitecomes back, the patient's worse
off than if they never wouldhave met that physician, because
at least then they would havehad the muscle mass they lost in
the process.
Speaker 1 (34:46):
Yeah, oh, it's really , really interesting.
So I want to switch gears alittle bit and talk about cardio
respiratory fitness.
I had actually not ever heardthat word before, so I'm sure
many of our listeners are in thesame boat as me.
So how does this play animportant role in exercise?
(35:08):
What is that role?
Why is it important?
Speaker 2 (35:17):
It's huge.
The American Heart Associationreleased a position statement in
2016 that identifiedcardiorespiratory fitness as
important of a risk factor assmoking, high cholesterol, blood
pressure and diabetes.
So the other four we put a lotof effort and energy in to
addressing, but rarely do we doassessments for
cardiorespiratory fitness.
(35:38):
But again in our program at theclinic we do that a baseline
cardiorespiratory fitnessassessment and there's so much
that we can talk about from thatstandpoint, with fuel substrate
utilization and everything else.
But essentially,cardiorespiratory fitness is a
measurement of your aerobiccapacity, how efficiently your
(35:59):
heart can circulate blood from agood stroke volume, a
contraction, how well your lungscan remove carbon dioxide and
oxygenate the blood, and howefficient your muscles can
extract oxygen out of the bloodand utilize it.
So it's a whole bodyrepresentation and what it is is
.
It's a measurement of how muchoxygen you convert to carbon
(36:21):
dioxide, and you can get atremendous amount of information
by measuring that.
So, um, I can go into moredetail or we could do a whole
podcast just on that.
Speaker 1 (36:34):
Yeah, so is it like people who are in better shape,
or maybe people who do morecardiovascular exercise?
Okay, yeah.
Speaker 2 (36:42):
It's a relative term relative to your weight.
So you can improve yourcardiorespiratory fitness by
improving your body composition.
So if you lose weight byimproving your body composition.
So if you lose weight, your VO2max will go up.
So your VO2 max is the maximalamount of oxygen that you
consume and convert to carbondioxide at peak exercise and
(37:03):
it's relative to your bodyweight.
So at rest you consume about,on average, 3.5 milliliters per
kilogram of body weight ofoxygen per minute to sustain
life.
So the heavier you are, themore oxygen you consume.
So if you're more metabolicallyfit, if you lost 20 pounds of
(37:27):
fat and maintained your fitness,didn't change your fitness,
your VO2 max would go up.
Your cardiorespiratory fitnesswould go up because your body
weight's the denominator.
So if you look at simplemathematics, if you decrease
that denominator, your overallvalue goes up.
So it's relative to body weight.
So you can improve yourcardiorespiratory fitness by
(37:49):
decreasing your body weight.
And that's things that peoplenotice as they lose weight.
They can do more and it doesn'tfeel as overwhelming, but you
can get a lot of information.
So if you do a resting metabolictest which measures how much
oxygen you convert to carbondioxide, different fuel
(38:09):
substrates require differentamount of oxygen to fully
oxidize it.
So fat versus carbohydrates.
So if you fully oxidized oneglucose molecule, it has six
carbons in it.
That requires six moles ofoxygen, okay, and you produce
(38:32):
six moles of carbon dioxide.
So essentially, when you do themath, the chemical
stoichiometry, you divide thecarbon dioxide that you produce
by the oxygen you consume and itcomes out to a value of one.
So fat, it's a little bitdifferent.
(38:53):
You don't need as much oxygento burn carbohydrates as you do
fat, okay.
So the denominator is bigger.
So the value is lower.
It gets down to 0.7.
That's called a respiratoryexchange ratio.
It gets down to 0.7.
That's called a respiratoryexchange ratio.
So at rest you can actuallydetermine what fuel substrate
(39:14):
someone's utilizing.
If you're burning fat, like youshould be when you're fasted,
or if you have metabolicdysfunction and you're relying
more on glucose when you shouldbe burning fat.
And as you fix people'smetabolic dysfunction or
diabetes, you can see that valueimprove.
And then you also.
That's how you figure out howmany calories someone actually
(39:35):
burns.
You measure how much oxygenthey consume.
For every liter of oxygen youconvert to carbon dioxide, you
burn five calories.
That's where all thoseestimations come from.
There's actual measurementsthat we do, so you get that at
rest.
So if I measured how much oxygenyou convert to carbon dioxide
over a 10-minute period and Iextrapolate that out over a
(39:58):
24-hour period, I could tell youexactly how many calories you
need to sustain your weightwithout activity.
So now it's way more accurate.
Now if I did that same type oftest on a graded exercise test
where I gradually increased theworkload, I can watch your fuel
substrate shift to where, at lowintensity, you're burning fat
(40:19):
and as your intensity increases,you start burning carbohydrate
more and more.
And I could tell you where youstart to produce a lot of lactic
acid and all these differenttraining zones.
So that's where you get thesedifferent zone 1, zone 2, zone 3
, zone 4, zone 5.
And I could find exactly whatheart rate and what workload you
burn the highest percentage offat.
(40:42):
So it's not about exercising ashard as you can, it's really
about staying in kind of thisfat burn zone, the zone 2.
And that's going to stimulate alot of mitochondrial biogenesis
.
You make more mitochondria andthat's how you would stimulate
increasing your aerobic capacity, your VO2 max, your
cardiorespiratory fitness.
(41:03):
That's why these enduranceathletes do these low, slow runs
.
They don't just walk out thedoor.
Take off running as fast asthey can, for as how?
As long?
as they can yeah, it's differentathletes, different metabolic
pathways, aerobic versusanaerobic.
That's why you have elitesprinters and you have
bodybuilders and you have ultraendurance athletes.
(41:26):
That's why marathon runnersdon't look like bodybuilders and
bodybuilders can't runmarathons.
Speaker 1 (41:32):
Right, I mean, I noticed on my Fitbit when I'm
running.
Speaker 2 (41:37):
I will, it'll, it'll say sort of what you're saying,
some of these terms, um, butit'll very inaccurate, okay, and
they keep running equationsbased off of the workload that
you're doing and what yourcorresponding heart rate is and
your age and all these things,and it just makes guesses yeah,
the real way if you wantedaccurate data would to be um, to
(42:00):
have a metabolic assessmentdone with a metabolic cart where
we actually measure that.
So we would measure with a maskhow much oxygen you convert to
carbon dioxide and be real data.
And during the test, if you'dhave a heart rate monitor on, so
then we would have a heart rateto correlate with all those
values so we could tell you totrain at these heart rates.
Speaker 1 (42:23):
Yeah, I mean, I mean, goodness gracious, if we're all
exercising and putting all thistime and effort and I'm not
even doing it to the most bestway I possibly can to either
lose fat, then I mean that'sreally frustrating.
Speaker 2 (42:35):
You know, it's making me really mad right now that
that I don't know that becausesome people could could be
training too hard and outoutside the zone and that's
really fatiguing yeah, I meanthere's certain benefits that
you get from that, but it maynot be what you want.
You may want to stay in thatlow zone too, where you can do
it for a prolonged period oftime and you're not as fatigued
(42:57):
yeah but when you increase theintensity it puts a much larger
stress on the body.
That's why you can't sprintindefinitely.
It's a big stress on the bodybut you could walk for prolonged
periods of time, but walkingmay be too low intensity.
You want to find at what heartrate, at what workload the
percentage of fat is oxidizedand that's your fat max zone.
Speaker 1 (43:21):
And the only way to really get that, as you said, is
through this metabolic test.
Speaker 2 (43:25):
The only accurate way .
Otherwise you're just makingguesses and estimates.
Even your heart rate max basedoff your age, those huge
standard deviation variations towhere, for 95% of the
population, there could besomeone that could be.
The number you're telling themis off by 24 beats, either too
(43:46):
high or too low.
For someone it's going to bejust right.
But you have to look.
It's a bell-shaped curve.
Speaker 1 (43:52):
Yeah, so it depends, how lucky you are.
Yeah, wow, great.
Well, I know we wanted to talkabout female athlete triad, but
we're getting.
I know I'm going over my timelimit with you, so we'll have to
have you back on the podcast totalk.
You know even more about thisand we'll talk about you know
more.
You know on these weight losstips using you know various
(44:14):
other methods.
But before we wrap up, arethere?
Is there anything else or anyother words of wisdom for our
listeners that you would like toshare, dr Kampert?
Speaker 2 (44:27):
I think consistency is the key.
A lot of times people will getreal motivated and they just
want to make up for lost timeand you put too much of a stress
on your body so you can't burnthe candle at both ends.
You don't get stronger or morefit while you're working out.
It's actually the opposite.
It's when you recover.
(44:47):
So you have to make sure youhave structured recovery so
otherwise you're going to get anoveruse injury and you lose
that fitness quickly.
So you can lose a month's worthof work by being injured for a
week.
So if you get injured and youcan't work out for months, not
(45:09):
only do you miss out on thatprogress, you lose a lot of the
gains that you have.
So the key is to stay injuryfree and to be consistent.
And from a dietary standpoint,if you have a bad meal, don't
turn it into a bad day.
You can undo a month's worth ofhard work with one bad week of
(45:31):
eating.
So I mean, you just see it forwhat it is that you did
something you didn't want to doand then get refocused.
And sleep plays a big role inyour ability to regulate your
appetite, your mood, everything.
So you really want toprioritize sleep and stay
hydrated.
Speaker 1 (45:52):
That's great.
Yes, very true.
And if our listeners wereinterested in making an
appointment with you or learningmore about you, how can they
find you online, or is there aphone number that they can?
Reach you at.
Speaker 2 (46:06):
So the clinic does a great job of promoting us.
So they have, if you Googlelike Cleveland Clinic and then
my name, matthew Campert sportsmedicine, you'll get a video
come up eventually on googlethat has like our profile and,
um, even a video um of us kindof talking a little bit about
(46:28):
ourselves and our practice.
As far as social media, I don'tget too involved with that.
I do have something on linkedinwhere I'll post like articles
and things that we publish, um,but yeah, from an appointment
with I, the best thing wouldjust be to look online and I,
the the local news has done acouple new stories on the gym
(46:51):
and the equipment, so I canprovide those links to you If
that's something you would wantto share.
It'd be really informative andyou can see some of the patients
that they interview and theoutcomes.
Speaker 1 (47:00):
Yeah, that's great and yeah, and I'll put uh for
our listeners in our show notes.
I'll put the link that DrCampert is referring to on the
Cleveland Clinic website whereyou can find his video and his
information and phone number.
So well.
Thank you so much, dr Campert,for joining me on the Speaking
of Women's Health podcast and itwas a very enlightening episode
(47:22):
and we'd love to have you backand we do appreciate your time
and your tips.
And thank you to our listenersfor tuning in to another episode
and be sure to subscribe to ourpodcast if you already don't,
and it's free and you cansubscribe wherever you listen to
podcasts.
Thank you and we'll see younext time in the Sunflower House
.
Be strong, be healthy and be incharge.
Welcome to the Speaking of Women's Health
podcast.
I'm your guest host, LeighKlecker, the producer of the
podcast, and I'm happy to beback in the Sunflower House for
a new podcast episode with DrMatthew Kampert.
I'm talking with Dr Kampert inthis new episode about exercise
as medicine for women.
(00:22):
First I'd like to share alittle bit about his
professional background and thenwe'll dive into the episode.
So Dr Kamper received hisundergraduate degree from West
Virginia University.
He went on to earn a graduatedegree in exercise physiology at
West Virginia and he thenattended Lake Erie College of
(00:44):
Medicine for his medical degreeand went to Cleveland Clinic,
South Point Hospital for hisresidency in family medicine.
Then he decided to do afellowship in sports medicine at
Cleveland Clinic and wasappointed to Cleveland Clinic
shortly after, in 2020, in thesports medicine department.
So welcome, Dr Kampert.
Speaker 2 (01:06):
Thanks for having me.
Speaker 1 (01:08):
Of course.
So, as I mentioned, we're goingto be talking about exercise as
medicine for women in thisepisode, and we've done several
previous podcast episodes aboutfood as medicine, so I think
this is a great topic.
As we're, all you know, in thisnew year hope, maybe setting
some resolutions and thinkingabout maybe some ways we can
(01:29):
live healthier, or maybe a newexercise regime and, as we know
from several other podcasts withour guests and Dr Thacker,
women who exercise theyregularly have a lower risk of
death from all causes, includingcardiovascular disease, and
we've also discussed many timeson this podcast how exercise can
(01:51):
help with mood, as it releasesendorphins and helps you to feel
happier, maybe more relaxed,and so these are just a few
examples of how exercise isbeneficial to our health, but I
think we're going to start withbone density and osteopenia and
osteoporosis.
So, dr Kampert, how can regularexercise help strengthen our
(02:16):
bones or prevent bone loss, anddo you want to talk a little bit
about bone density and how thatall kind of works together?
Speaker 2 (02:24):
Yeah.
So exercise plays a huge roleand really across the lifespan.
So you only have so many yearsto really lay down bone density.
Usually around age 26 is peakbone density for females, and
(02:45):
then your hormones and thingschange and then really the goal
is to minimize bone density loss.
You can always try to add alittle bit and there's
medications that help with that.
I won't go into much of that.
But really the type of exerciseis resistance training or things
(03:07):
that load the bone.
So not all exercise is createdequal and with the approach that
exercise is medicine, you haveto have the right dose and the
right prescription.
So you need to load the bones.
Aerobic exercise you get alittle bit of loading of the
bones with running, but cyclingyou really don't load the spine.
(03:30):
You can stress the long bonesand then swimming's great
exercise, but you're really notloading the joints or the bones
or the spine.
So you could actually lose somebone density in the spine from
cycling and lose bone densityfrom swimming.
If you think about space travel,one of the things they worry
(03:52):
about is muscle loss and bonedensity loss because you don't
have the effects of gravity.
So your body really does likethe bones to be stressed
appropriately and then theyrespond.
So by doing things likeresistance training or
load-bearing exercises, evenproper squatting mechanics and
loading that spine or rucking,you can increase the bone
(04:13):
density in the spine andthroughout the whole body and
you want to make sure that youhave adequate calcium and
vitamin D also with that processthat you have adequate calcium
and vitamin D also with thatprocess, right?
Speaker 1 (04:29):
So you said that running could be considered a
resistant exercise.
What other examples can youprovide?
Anything?
Speaker 2 (04:37):
that where the body's being loaded.
So why running does?
It is because you have theeffects of gravity and then when
you're running you have theimpact forces, so all that
jarring of the joints andeverything.
But really resistance trainingwhere you're really loading the
muscles, so where you're liftingheavier loads, so more than
(04:58):
your activities of daily living,so you could carry bags around
throughout the day.
But if you're lifting weightsweights you can only do a
certain number of repetitions,so it's a heavier load, it's a
larger stress on the bones, butnot the type of stress you will
want all day.
So any type of resistancetraining will help the bones and
the joints that you're loading.
But if you're only doing thingsfor the lower body, like leg
(05:23):
extensions and leg presses, youhave to remember you're not
loading through that spine andyou're only doing things for the
lower body, like leg extensionsand leg presses, you have to
remember you're not loadingthrough that spine and you're
not loading the bones of theupper extremities.
Speaker 1 (05:31):
So yoga, would that be a good one, Because you kind
of seem to be using your wholebody.
Speaker 2 (05:38):
Yoga has a lot of health benefits, but I wouldn't
identify that as one of the keyways to build muscle or to load
the bones.
I mean because you're reallynot increasing the forces much
more than the force of gravity.
Speaker 1 (05:54):
So weights and then, but making sure, like you said,
just don't stick to.
You know legs all day, or legsevery day, whatever the saying
is, but you know arms, shouldersall day or legs every day,
whatever the saying is.
Speaker 2 (06:06):
but you know arms, shoulders, you want to load all
the bones of the bodyappropriately, without
overloading them, because thenyou can get stress, injuries or
stress reactions or even stress,fractures?
Speaker 1 (06:15):
Sure, okay, and then how often do you recommend these
exercises be performed to?
You know, keep that bone lossfrom happening.
Speaker 2 (06:23):
Be performed to keep that bone loss from happening.
You really want to doresistance training at least two
to three times a week.
But different activities.
You want to be active.
So just being active helpsprotect against bone and muscle
loss.
If you're ever bedridden oryou're not up and about, that's
(06:45):
going to be detrimental in andof itself.
But from a standpoint of tryingto actually add some bone
density, you would want to do atleast two to three times a week
of structured resistancetraining.
Speaker 1 (06:58):
Okay, great.
And then of course, probably,like you're saying, just move as
much as possible.
You know if you maybe have ajob where you're at the desk all
day trying to get up and justyou know, move that.
So you're not sitting all day.
Speaker 2 (07:12):
Break up the sedentary periods.
Speaker 1 (07:14):
Yeah, I know I struggle with that.
You know a lot of my job iswriting, so I'm sitting at that
laptop and you know you kind ofget in a groove sometimes and
then you realize, wow, I haven'tgotten up in a couple hours.
It's achy and it doesn't feelso good.
So if a woman is new toweight-bearing or they've never
(07:36):
done any sort of resistanceexercise, maybe they've always
just either walked or swam ordid something a little bit more
low-impact.
You know, walked or swam or didsomething a little bit more low
impact how could they getstarted on adding that into
their you know, exercise andtheir lifestyle.
Speaker 2 (07:57):
Yeah, that's a good question.
So I think the easiest way todo it is with machines.
So with free weights you haveto develop that muscle, mind,
muscle control to reallystabilize them.
Develop that muscle, mind,muscle control to really
stabilize them.
But with the machines they'repretty simple to where, if you
set the seat height and the armsettings to the the right height
, it's really just pushingthrough the movement and you
don't have a whole lot ofstability issues.
(08:18):
And that's a nice way to startbecause that then you can load
appropriately with less risk ofinjury and then you can kind of
progress from there.
If you don't have access tomachines, you could always pick
up some bands, elastic bands,and that's a good way to get
started.
Body weight movements arealways an option, but sometimes,
(08:41):
if weight's an issue, you wantto be careful of how you load
the joints because you can'treally modify your body weight,
whereas if you're doingsomething with a machine you can
lighten the load.
Body weight stuff you have whatyou have, and if it's too much
(09:02):
of a load you could get aninjury.
So I would suggest reallyinvesting in a membership to
somewhere that is convenientgeographically.
Speaker 1 (09:14):
Yeah, I know my mom.
She was always a walker and aspinner, or more like riding the
stationary bike, but after sheretired she was able to, at a
certain age age to get and Ican't remember what it's called
and I apologize to our listeners, but when?
Speaker 2 (09:28):
I find out.
Speaker 1 (09:29):
Yes, that's it, yeah, and it's several dollars a
month, maybe five, and she getsaccess to the local Y here as
well as like a community seniorcenter they have where they also
have, so that's a good optionfor those looking for that and
they have a lot of the machines.
Speaker 2 (09:47):
Yeah.
Speaker 1 (09:47):
Yeah, great, so say someone is already diagnosed
with osteopenia Now.
So that is the like, apre-osteoporosis, correct?
Speaker 2 (09:59):
Correct, it's based on the bone density and there's
different levels.
Once you reach certain rangesof decreased bone density, then
you get into the osteopeniarange and then the osteoporosis.
Speaker 1 (10:14):
Okay, so if they've already been diagnosed with
osteopenia not quiteosteoporosis, what can they do
to maybe help prevent gettingosteoporosis in regards to
exercise or lifestyle?
Speaker 2 (10:29):
Yeah, the same things you would do to build it.
You just want to be morecautious and not overly
aggressive, because if you haveosteopenia or osteoporosis, it
does mean that your bones arethinner, they're not as dense.
So if you're too aggressiveyou're more at risk for a
(10:50):
frailty fracture, Not so muchwith the osteopenia but
osteoporosis, depending on howsevere it is.
So you just you want togradually increase and if you do
it gradually and you allowadequate rest, it's very safe to
do but really loading the bonesand making sure that you're
optimizing from a dietarystandpoint with your calcium and
(11:13):
vitamin D, and it's best to getthat from foods.
Speaker 1 (11:16):
Right, yes.
And for our listeners out there, you know if you've been
listening to us for the lastyour calcium and vitamin D and
it's best to get that from foodsRight, yes, and for our
listeners out there, you know ifyou've been listening to us for
the last two seasons, we have,you know, calcium calculator and
lots and lots of informationabout vitamin D on our website.
So that'sspeakingofwomenshealthcom.
So I guess the same would gothen for osteoporosis if you're
already diagnosed with it, youknow, start off slow.
(11:37):
Talk with your you knowphysician about.
You know how you can build upand then get to.
Speaker 2 (11:43):
Maybe you know correct and then when you get to
the like actual osteopenia andosteoporosis, you want to talk
with your physician aboutmedications that might be
appropriate for you.
They can actually slow downbone loss or actually they're
anabolic agents that canactually build some bone density
(12:04):
.
But that's really a discussionthat you want to have with your
provider.
Depending on other medicationsyou might be on comorbidities
everything's risk versus benefitand you want to have an
informed discussion.
Speaker 1 (12:16):
Everything's risk versus benefit and you want to
have an informed discussion.
Can you sort of reverseosteopenia or osteoporosis with
exercise, Sort of aside frommaybe?
Speaker 2 (12:28):
the medication part.
But Depending on your age andthe degree and the underlying
reasons, you can increase bonedensity, though it's much more
effective to do in early age.
But regardless, you definitelywant to incorporate because of
the health benefits but also thebone density benefits.
Speaker 1 (12:53):
Right.
And then you know, as we getolder, you know the amount of
fractures falls and that youknow.
So if you can stop that beforeit becomes a problem and having
to do surgery, so well, this isgreat.
So the next subject I think wewant to explore is sarcopenia,
which is sort of the muscles.
(13:14):
Right, am I correct?
You're losing muscle as you getolder, or can you explain a
little bit more about what thatis?
Speaker 2 (13:21):
Yeah, so age-induced muscle wasting.
As you get older you start tolose muscle mass also.
So your cells are older, yourhormones change and you don't
have that anabolic effect tomaintain muscle mass.
One thing that really helpswith slowing that rate of muscle
(13:43):
loss is resistance training,because you load the muscles,
the muscles are an endocrineorgan of their self where
they'll actually releasemyokines and they'll activate
growth pathways.
And that's a big thing to thinkabout when you're thinking
about body composition.
(14:04):
If you're not exercising andyou're eating calories, what do
you think you're telling yourbody to do with those calories?
To store those calories in yourfat cells.
But if you're doing resistancetraining and you're loading the
muscle and you're eatingcalories and specifically
adequate protein, you're sendingcellular signals to build
muscle, to take those nutrientsand actually build and repair
(14:28):
and make larger muscles.
So it really kind ofcommunicates with the rest of
your body to try to build musclerather than letting the muscle
kind of deteriorate as you age.
And it's not just the musclemass.
So you do lose muscle mass asyou age, it's really the
(14:49):
strength.
You actually lose strength at ahigher rate than you lose
muscle size and that's theimportant factor to look at and
it's overlooked a lot becauseit's not often assessed.
So bone density you can getDEXA scans and then you can get
(15:12):
scans with bioelectricalimpedance where they measure
body composition.
They'll give you muscle mass.
But not too often are peoplegetting strength assessments.
That's something that we offerat the Cleveland Clinic, where
we do one rep max strengthtesting for all the major muscle
groups before we put togetheran exercise prescription, and
(15:32):
your exercise prescription isbased off of those strength
measurements and then we'llreassess you at three months,
six months, nine months, 12months and then to actually see
the improvements in strength andfunction.
Speaker 1 (15:48):
So what kind of tests are those?
I mean, I've heard gripstrength before.
Is it sort of something likethat how you test the muscle
strength.
Speaker 2 (15:55):
Well, we actually take it quite a bit further than
that.
So grip strength is there's alot of association with grip
strength and the rest of thebody whole body strength.
More so that as you lose it, soas you lose overall muscle mass
and strength, you lose gripstrength.
But we actually do anassessment.
(16:18):
We have programs and equipmentwhere we can measure one rep max
strength for each piece ofequipment, so similar to the
types of machines that we weretalking about where you would do
a chest press or a bicep curlor a seated row you would do a
chest press or a bicep curl or aseated row.
(16:42):
We have equipment that uses amode called isokinetic testing
Iso meaning same, kineticmeaning speed.
So no matter how hard you pushor press, the machine moves at
the same speed so it cancalculate how much force you
generate.
I don't know about promotingbrands or anything, so I don't
necessarily want to say thecompany's name that makes the
(17:05):
equipment, but that'sinformation we can share
afterwards on the website.
But we have a pretty elaborateexercise assessment and
prescription program and allthat data gets tracked and it
goes to a cloud and what we'redoing is integrating that cloud
with our electronic medicalrecords so all your exercise
(17:27):
assessments and training getspulled into your, your patient
charts so that we can reallykind of connect the exercise and
medicine and really deliverexercise as medicine is a real
prescription.
Speaker 1 (17:41):
Right, right, sort of like.
What like, do three reps ofthis on Monday?
Speaker 2 (17:46):
Yeah, that's great, yeah, so the equipment's so
advanced that once you do theassessment and we make the
prescription, it gets sent toyour account and when you walk
into the gym you scan with yourphone and it tells you which
machine to go to.
It adjusts the seat height.
On the prescription, it getssent to your account and when
you walk into the gym you scanwith your phone and it tells you
which machine to go to.
It adjusts the seat height onthe machines, the arm settings
on the machine, loads yourworkout arm and it guides you
(18:06):
through the rep.
So the concentric phase and theeccentric phase, so as the
joint angle shortens and as itlengthens.
So it teaches you to doresistance training, not just
weightlifting.
You have to control the loadand it's a safer, more
controlled way to train.
Speaker 1 (18:25):
Absolutely.
I mean, I feel like I hear alot, you know, at least from my
friends and family.
They're going on Instagram orTikTok or whatever social media
and they're like, oh, that lookslike.
Oh, look at her, she's gotgreat abs.
I'm going to do that workoutfrom this woman and this, you
know, these women are girls, youknow they're very young and my
mom is in her 60s.
(18:45):
So I'm like, well, that'sprobably not the workout you
should be doing.
So, you know, I feel likesometimes we're doing the wrong
things for our body and our ageand our muscle strength and our
bone density.
So it's pretty imperative toalways, you know, anytime,
before you start anything new,you should, you know, talk to
your physician about it andmaybe you need to see a
specialist like yourself.
Speaker 2 (19:07):
Yeah, and you make a great point.
You really don't want tocompare yourself to others and
you don't want to exerciseprescription that was made for
someone else or by someone else.
It needs to be individualizedfor you, and the only way to do
that is with an assessment, sothat you know where you're
starting and then it's based offof where you're at and then you
(19:28):
can monitor the progression.
And that's really the biggestthing is consistency over time,
and that's what you hear a lotof comments about.
Well, we know exercises work,but it works.
But how do you get people tostick with it?
It's easy you show them results.
That's why people becomemarathon runners and lifelong
runners or weightlifters becausethey saw the results.
(19:52):
So, by getting patients abaseline assessment at three
months, they may not realizejust how much stronger they got
until you reassess them and youshow them that and when they see
that it's so motivating andrewarding to them.
Speaker 1 (20:07):
Yeah, you know, and I know I've noticed as I've
gotten older.
I was a runner, you know,through high school and until
now, and I'm just, you know, I'mkind of plateauing.
You know I'm saying I'm not mybody's not even staying at the
same weight or muscle mass.
I can see it getting worse, butI'm not exercising any less.
So, you know, the last, I wouldsay five years, I've started,
(20:28):
you know, doing this bar Pilateswhere we use resistance bands
and weights, and I do yoga.
But I do that just because Ilike it, for the calmness and my
mental health.
But I do see a difference.
If I'm not going and doing thatresistance training, after you
know, if it's been two weeks,three weeks, I can totally tell
the difference.
I plateaued again.
So I think you know, likeyou're saying, keeping up with
(20:50):
it and then, as you hit acertain age, you may have to,
you know, change up that routineand as people, they can still
build muscle and get stronger.
Speaker 2 (21:01):
The thing is and they can train hard too the
difference is they need a littlebit more recovery time.
So where if for a hard workoutwhen they were younger, they may
have been able to train thatsame muscle group two days later
?
Sometimes it may take anotherday as you get older, but if you
gradually increase and you'reconsistent, you can train hard.
(21:22):
You just have to make sure thatyou're also recovering before
you train hard again.
Speaker 1 (21:28):
Yeah, that's a good point.
That's a good point, so sort ofgoing back.
I mean, we've been talkingabout sarcopenia, but who does
it affect?
Females, males, certain ages,certain anybody, everyone.
Speaker 2 (21:42):
Okay, so it comes down to age.
So really after your mid-30syou start to see a decline in
muscle mass and strength, unlessyou're actively doing
resistance training.
For women they see asignificant decline after
menopause and then when you getto like your 60s it kind of
(22:05):
accelerates more and more.
Men as they age, they kind ofhave a more gradual loss of
testosterone, which is reallytheir anabolic hormone that
signals muscle growth, and forwomen it's the estrogen that's
their anabolic component.
So postmenopausal, if they'renot doing resistance training,
they will see a rapid, veryrapid decline of muscle mass.
(22:29):
And it's actually impressivejust how much resistance
training can offset that decline.
If you would look at twoindividuals as they go through
menopause, if one is doing awell-structured resistance
stranding program versus afemale who isn't, it really
changes how they age.
Because the thing about musclemass is there's 2,500 calories
(22:53):
in a pound of muscle, there's3,500 calories in a pound of fat
.
The more muscle you have, themore calories you burn, because
muscle is very metabolicallyactive where fat is not.
So if you have a certain amountof muscle and a certain amount
of fat and your hormones changeand you're no longer maintaining
that muscle mass and you're notdoing resistance training to
(23:14):
maintain it.
Now I've been counting thecalories you burn through the
resistance training.
You're going to notice that youfeel softer or like you're more
fat, because what's going tohappen is your body's going to
be burning that muscle mass forenergy instead of the fat.
And for every pound of musclethat the body burns or doesn't
maintain, there's 2,500 calorieswith that.
(23:37):
So instead of burning that2,500 calories worth of fat,
it's coming from your muscles.
So even if you're not eatingmore and not exercising less,
your body composition can changebecause you're not supporting
previous muscle mass that youdid have.
Speaker 1 (23:54):
Got it, so can you.
So now you're making me want tolike, re, really re up my
resistance training.
But can you do too much of it?
You know, if I decided to do itsix days a week, is that too
much?
Speaker 2 (24:07):
So that's a loaded question so we have to approach
that in steps.
So I think the biggest concernthat females have is they don't
want to get too bulky.
You won't.
It's hard to build muscle,especially if you're in a
caloric deficit.
If you're trying to lean outand you're in a caloric deficit,
(24:35):
it's hard to build muscle.
And then for females, you don'thave the genetics of a male, so
you don't have the testosterone.
That's why women they can getcomparable leg strength if they
really train well, but there'salways going to be a deficiency
in upper body strength becauseyou have a lot of your androgen
(24:58):
receptors in your deltoids andyour upper arms and your traps.
So if you look at athletes whoabuse steroids, they have very
large traps and very bigdeltoids.
And if you look at females, theykind of have slender arms.
That's where the androgenreceptors are.
So don't be afraid to liftweights.
(25:19):
You're not just going to swellup overnight and you may feel
that you're bulky.
A lot of that is because you'reincreasing the muscle glycogen
stores.
Okay, so the more you use theglycogen which is stored
carbohydrates in your muscle,your body adapts and it stores
more glycogen in the muscle andone gram of glycogen holds three
(25:43):
grams of water.
So your muscles can swell upand that's kind of the pump that
you feel when you're liftingthat increased blood flow in
that pump all up.
And that's kind of the pumpthat you feel when you're
lifting that increased bloodflow in that pump.
So your muscles may become morefuller and you may feel that
you're kind of blocky and bulky.
But as you continue to improveyour diet and lean out, you lose
that layer of fat or adiposetissue over the muscle and you
(26:08):
realize that you're not bulkyand you really want that muscle
mass, because as you lean outyou don't want to be left with
kind of a low level muscle mass.
And that kind of gets into awhole discussion about weight
loss and some of those GLP-1medications that we could go
(26:29):
into now or later on, dependingon how you want to proceed.
Speaker 1 (26:34):
I mean that's really interesting.
That's actually a whole podcastepisode I do want to have.
So I mean I wouldn't minddiving into that, because I know
we're getting a lot ofquestions on our website about
women asking about these.
Speaker 2 (26:47):
So with the GLP-P ones, they're great at what they
do.
It's an appetite suppressant.
So when you eat, your, yourstomach and small intestines you
release these hormones thatmake you feel full, called
incretins, tells your brain thatyou're full.
Now some people they'll eat andthey'll always be hungry.
(27:08):
It could be because they don'tmake enough.
So when they eat they don'trelease these hormones and they
never feel full.
Some people could be resistant.
So they eat, they release anadequate amount, but they don't
respond to it, kind of like indiabetes, people who need
insulin because they don't makeenough, or people who don't
(27:30):
respond to the insulin that theydo make.
So that's why you have to startat a very low dose, because if
you're someone that just doesn'tmake this hormone when they eat
, you're very sensitive to it.
So the smallest dose can have aprofound effect.
And then some people they couldbe on the highest dose and they
really don't notice an effectbecause they already make a lot.
(27:52):
They just don't respond to itand giving someone more of
something they respond to is notgoing to have as much of a
profound effect.
And the thing is they're mostof them are once weekly
injections so you can'tun-inject it.
So if you're overzealous and youthink, oh, I'm always full, I
mean I'm never full, I'm alwayshungry.
I I don't want to start withthe low dose.
(28:12):
Always start with the low dose,because if you're just someone
that doesn't make it, evensometimes a fraction of that
starting dose is enough.
I mean can Go ahead.
No, I was just going to ask.
Speaker 1 (28:23):
So then when they're starting on this and they're not
eating as much, not eating asmuch, so then I mean I would
imagine that has to somehowaffect, you know, like their
bone density or and or theirmuscle mass, because then, like
you were saying, you have tohave to intake so many calories
to keep up with building thatmuscle, right?
Speaker 2 (28:43):
So, and that that's kind of the next thing I was
going to say um, people say thatthey don't want to take it
because you lose muscle mass.
Speaker 1 (28:54):
Yeah.
Speaker 2 (28:55):
The studies show that the way those studies were all
designed by the pharmaceuticalcompanies, there was no
resistance component.
They told the patients to eat500 calories less a day and be
active 150 minutes.
Nothing about resistancetraining.
Be active 150 minutes, nothingabout resistance training.
(29:15):
So the thing is they lost a lotof weight, but about up to 30%.
A third of the weight was leanmass.
Now it's not the medication'sfault.
The medication did its job.
It suppressed your appetite.
It doesn't matter if you're,when you're in a caloric
deficit're going to lose weight.
Whether it's willpower,bariatric surgery, poverty pills
(29:36):
, injections, stranded on adesert island, your body doesn't
care.
It just knows it's not gettingenough calories to sustain life.
And your body's smart.
What it learned was that itwants to make you as efficient
as possible so that you livelong enough to find your next
meal.
So the more muscle you have,the more calories you have to
(29:58):
consume to maintain that musclemass.
And, like we talked about,there's 2,500 calories in a
pound of muscle, 3,500 caloriesin a pound of fat, and it
doesn't take anything tomaintain fat mass and a pound of
fat.
And it doesn't take anything tomaintain fat mass.
So your body knows that I canget energy from burning this
muscle, but not only that.
I can decrease the amount ofenergy that it requires for me
(30:21):
to remain alive.
So your muscle, your body, willstart burning that muscle.
Unless you're using the musclea lot, you release myokines and
basically what your muscles say.
Hey, I understand I'm starvingto death, but I'm using these
muscles a lot, probably to tryto find food.
Leave the muscle alone and burnthe fat okay, and it's.
(30:43):
You have to remember all themuscles.
So if you only train your legs,you're not going to protect
your upper body.
You have to train the wholebody because you can maintain
the muscle mass in the legs, butif you're not training the
upper body, you're going to losemuscle mass and bone density
that way.
So that's where the problem is.
These medications should neverbe prescribed unless somebody's
(31:07):
in a structured resistancetraining program.
The cardiovascular exercise hasits benefits from health
benefits and a whole bunch ofother stuff.
But if you're just doing cardioand you're taking these
medications and limiting yourdiet, those are just increasing
that caloric deficit.
You're not protecting yourmuscle mass.
So that's the important thingthat inadequate protein and what
(31:35):
we see with the patients wehave in the data, we have in the
exercise environment we createdwith or without these
medications.
If patients can create acaloric deficit, they'll lose
weight.
If they follow our structuredexercise program or any
structured resistance trainingprogram, they'll improve
strength while losing weight.
Speaker 1 (31:56):
That's great, Thank you, it's really I mean it's
really interesting and we shoulddo like a part two about side
effects right, who arecandidates?
Because you know we see on a lotof these TV shows and you know
celebrities on.
You know in the media they'resaying they're going on these
pills.
Well, they sure didn.
Tv shows and you knowcelebrities on.
You know in the media they'resaying they're going on these
pills, but they sure didn't.
Or you know the medicine.
They sure didn't look like theyneeded to to begin with.
(32:16):
Maybe just a little extraexercise.
Speaker 2 (32:18):
So and the important thing to point out is these
medications.
Just like I explained, somepeople don't make enough of this
hormone and some peopleresistant.
Like any medication, when themedication binds their receptor
that your receptors downregulate, it's called
tachyphylaxis.
So you get a decreased responseto that medication over time
(32:43):
and there's some people.
That's why you continuallyincrease the dose.
You develop a tolerance.
Yeah, and you've got to thinkabout this long term.
If that's the only tool in yourtoolbox that you're using,
what's going to happen whenyou're at the highest dose and
you're still hungry?
And worse yet, what's going tohappen if you didn't do
resistance training?
(33:03):
Now you lost fat and muscle.
You didn't increase yourexercise capacity to protect
against that weight regain bybeing more fit and being able to
burn more calories.
So now when the appetite comesback, you're going to gain fat
back.
So you lost fat and muscle andnow you're a year older and
fat's going to come back.
(33:23):
Versus if you maintained yourmuscle mass and you improved
your fitness.
And you improved your fitness.
So when you first start, youmay exercise hard for 30 minutes
and may only be able to burn200 calories as you get more fit
if you exercise hard for 30minutes.
It's the same duration, the sameintensity 30 minutes hard.
(33:45):
But hard's relative.
You're more fit now.
You have different metabolicmachinery.
You have more mitochondria inyour muscle.
The reason you can run fasteris because you can burn calories
faster.
So now for that same hardeffort, for that same duration
instead of 200 calories you canburn 400 calories.
(34:06):
And now you don't hate exerciseand you have the endurance so
you could exercise for an hour.
So now you're talking 500, 600calories.
So that's more of a meaningfulcaloric expenditure to protect
against the weight regain thatoccurs when the appetite returns
.
Plus you preserve your musclemass.
So again, in no situationshould these medications be
(34:28):
prescribed.
No situation should thesemedications be prescribed?
Because if you do take them andyou lose muscle mass and it's
years later and the appetitecomes back, the patient's worse
off than if they never wouldhave met that physician, because
at least then they would havehad the muscle mass they lost in
the process.
Speaker 1 (34:46):
Yeah, oh, it's really , really interesting.
So I want to switch gears alittle bit and talk about cardio
respiratory fitness.
I had actually not ever heardthat word before, so I'm sure
many of our listeners are in thesame boat as me.
So how does this play animportant role in exercise?
(35:08):
What is that role?
Why is it important?
Speaker 2 (35:17):
It's huge.
The American Heart Associationreleased a position statement in
2016 that identifiedcardiorespiratory fitness as
important of a risk factor assmoking, high cholesterol, blood
pressure and diabetes.
So the other four we put a lotof effort and energy in to
addressing, but rarely do we doassessments for
cardiorespiratory fitness.
(35:38):
But again in our program at theclinic we do that a baseline
cardiorespiratory fitnessassessment and there's so much
that we can talk about from thatstandpoint, with fuel substrate
utilization and everything else.
But essentially,cardiorespiratory fitness is a
measurement of your aerobiccapacity, how efficiently your
(35:59):
heart can circulate blood from agood stroke volume, a
contraction, how well your lungscan remove carbon dioxide and
oxygenate the blood, and howefficient your muscles can
extract oxygen out of the bloodand utilize it.
So it's a whole bodyrepresentation and what it is is
.
It's a measurement of how muchoxygen you convert to carbon
(36:21):
dioxide, and you can get atremendous amount of information
by measuring that.
So, um, I can go into moredetail or we could do a whole
podcast just on that.
Speaker 1 (36:34):
Yeah, so is it like people who are in better shape,
or maybe people who do morecardiovascular exercise?
Okay, yeah.
Speaker 2 (36:42):
It's a relative term relative to your weight.
So you can improve yourcardiorespiratory fitness by
improving your body composition.
So if you lose weight byimproving your body composition.
So if you lose weight, your VO2max will go up.
So your VO2 max is the maximalamount of oxygen that you
consume and convert to carbondioxide at peak exercise and
(37:03):
it's relative to your bodyweight.
So at rest you consume about,on average, 3.5 milliliters per
kilogram of body weight ofoxygen per minute to sustain
life.
So the heavier you are, themore oxygen you consume.
So if you're more metabolicallyfit, if you lost 20 pounds of
(37:27):
fat and maintained your fitness,didn't change your fitness,
your VO2 max would go up.
Your cardiorespiratory fitnesswould go up because your body
weight's the denominator.
So if you look at simplemathematics, if you decrease
that denominator, your overallvalue goes up.
So it's relative to body weight.
So you can improve yourcardiorespiratory fitness by
(37:49):
decreasing your body weight.
And that's things that peoplenotice as they lose weight.
They can do more and it doesn'tfeel as overwhelming, but you
can get a lot of information.
So if you do a resting metabolictest which measures how much
oxygen you convert to carbondioxide, different fuel
(38:09):
substrates require differentamount of oxygen to fully
oxidize it.
So fat versus carbohydrates.
So if you fully oxidized oneglucose molecule, it has six
carbons in it.
That requires six moles ofoxygen, okay, and you produce
(38:32):
six moles of carbon dioxide.
So essentially, when you do themath, the chemical
stoichiometry, you divide thecarbon dioxide that you produce
by the oxygen you consume and itcomes out to a value of one.
So fat, it's a little bitdifferent.
(38:53):
You don't need as much oxygento burn carbohydrates as you do
fat, okay.
So the denominator is bigger.
So the value is lower.
It gets down to 0.7.
That's called a respiratoryexchange ratio.
It gets down to 0.7.
That's called a respiratoryexchange ratio.
So at rest you can actuallydetermine what fuel substrate
(39:14):
someone's utilizing.
If you're burning fat, like youshould be when you're fasted,
or if you have metabolicdysfunction and you're relying
more on glucose when you shouldbe burning fat.
And as you fix people'smetabolic dysfunction or
diabetes, you can see that valueimprove.
And then you also.
That's how you figure out howmany calories someone actually
(39:35):
burns.
You measure how much oxygenthey consume.
For every liter of oxygen youconvert to carbon dioxide, you
burn five calories.
That's where all thoseestimations come from.
There's actual measurementsthat we do, so you get that at
rest.
So if I measured how much oxygenyou convert to carbon dioxide
over a 10-minute period and Iextrapolate that out over a
(39:58):
24-hour period, I could tell youexactly how many calories you
need to sustain your weightwithout activity.
So now it's way more accurate.
Now if I did that same type oftest on a graded exercise test
where I gradually increased theworkload, I can watch your fuel
substrate shift to where, at lowintensity, you're burning fat
(40:19):
and as your intensity increases,you start burning carbohydrate
more and more.
And I could tell you where youstart to produce a lot of lactic
acid and all these differenttraining zones.
So that's where you get thesedifferent zone 1, zone 2, zone 3
, zone 4, zone 5.
And I could find exactly whatheart rate and what workload you
burn the highest percentage offat.
(40:42):
So it's not about exercising ashard as you can, it's really
about staying in kind of thisfat burn zone, the zone 2.
And that's going to stimulate alot of mitochondrial biogenesis
.
You make more mitochondria andthat's how you would stimulate
increasing your aerobic capacity, your VO2 max, your
cardiorespiratory fitness.
(41:03):
That's why these enduranceathletes do these low, slow runs
.
They don't just walk out thedoor.
Take off running as fast asthey can, for as how?
As long?
as they can yeah, it's differentathletes, different metabolic
pathways, aerobic versusanaerobic.
That's why you have elitesprinters and you have
bodybuilders and you have ultraendurance athletes.
(41:26):
That's why marathon runnersdon't look like bodybuilders and
bodybuilders can't runmarathons.
Speaker 1 (41:32):
Right, I mean, I noticed on my Fitbit when I'm
running.
Speaker 2 (41:37):
I will, it'll, it'll say sort of what you're saying,
some of these terms, um, butit'll very inaccurate, okay, and
they keep running equationsbased off of the workload that
you're doing and what yourcorresponding heart rate is and
your age and all these things,and it just makes guesses yeah,
the real way if you wantedaccurate data would to be um, to
(42:00):
have a metabolic assessmentdone with a metabolic cart where
we actually measure that.
So we would measure with a maskhow much oxygen you convert to
carbon dioxide and be real data.
And during the test, if you'dhave a heart rate monitor on, so
then we would have a heart rateto correlate with all those
values so we could tell you totrain at these heart rates.
Speaker 1 (42:23):
Yeah, I mean, I mean, goodness gracious, if we're all
exercising and putting all thistime and effort and I'm not
even doing it to the most bestway I possibly can to either
lose fat, then I mean that'sreally frustrating.
Speaker 2 (42:35):
You know, it's making me really mad right now that
that I don't know that becausesome people could could be
training too hard and outoutside the zone and that's
really fatiguing yeah, I meanthere's certain benefits that
you get from that, but it maynot be what you want.
You may want to stay in thatlow zone too, where you can do
it for a prolonged period oftime and you're not as fatigued
(42:57):
yeah but when you increase theintensity it puts a much larger
stress on the body.
That's why you can't sprintindefinitely.
It's a big stress on the bodybut you could walk for prolonged
periods of time, but walkingmay be too low intensity.
You want to find at what heartrate, at what workload the
percentage of fat is oxidizedand that's your fat max zone.
Speaker 1 (43:21):
And the only way to really get that, as you said, is
through this metabolic test.
Speaker 2 (43:25):
The only accurate way .
Otherwise you're just makingguesses and estimates.
Even your heart rate max basedoff your age, those huge
standard deviation variations towhere, for 95% of the
population, there could besomeone that could be.
The number you're telling themis off by 24 beats, either too
(43:46):
high or too low.
For someone it's going to bejust right.
But you have to look.
It's a bell-shaped curve.
Speaker 1 (43:52):
Yeah, so it depends, how lucky you are.
Yeah, wow, great.
Well, I know we wanted to talkabout female athlete triad, but
we're getting.
I know I'm going over my timelimit with you, so we'll have to
have you back on the podcast totalk.
You know even more about thisand we'll talk about you know
more.
You know on these weight losstips using you know various
(44:14):
other methods.
But before we wrap up, arethere?
Is there anything else or anyother words of wisdom for our
listeners that you would like toshare, dr Kampert?
Speaker 2 (44:27):
I think consistency is the key.
A lot of times people will getreal motivated and they just
want to make up for lost timeand you put too much of a stress
on your body so you can't burnthe candle at both ends.
You don't get stronger or morefit while you're working out.
It's actually the opposite.
It's when you recover.
(44:47):
So you have to make sure youhave structured recovery so
otherwise you're going to get anoveruse injury and you lose
that fitness quickly.
So you can lose a month's worthof work by being injured for a
week.
So if you get injured and youcan't work out for months, not
(45:09):
only do you miss out on thatprogress, you lose a lot of the
gains that you have.
So the key is to stay injuryfree and to be consistent.
And from a dietary standpoint,if you have a bad meal, don't
turn it into a bad day.
You can undo a month's worth ofhard work with one bad week of
(45:31):
eating.
So I mean, you just see it forwhat it is that you did
something you didn't want to doand then get refocused.
And sleep plays a big role inyour ability to regulate your
appetite, your mood, everything.
So you really want toprioritize sleep and stay
hydrated.
Speaker 1 (45:52):
That's great.
Yes, very true.
And if our listeners wereinterested in making an
appointment with you or learningmore about you, how can they
find you online, or is there aphone number that they can?
Reach you at.
Speaker 2 (46:06):
So the clinic does a great job of promoting us.
So they have, if you Googlelike Cleveland Clinic and then
my name, matthew Campert sportsmedicine, you'll get a video
come up eventually on googlethat has like our profile and,
um, even a video um of us kindof talking a little bit about
(46:28):
ourselves and our practice.
As far as social media, I don'tget too involved with that.
I do have something on linkedinwhere I'll post like articles
and things that we publish, um,but yeah, from an appointment
with I, the best thing wouldjust be to look online and I,
the the local news has done acouple new stories on the gym
(46:51):
and the equipment, so I canprovide those links to you If
that's something you would wantto share.
It'd be really informative andyou can see some of the patients
that they interview and theoutcomes.
Speaker 1 (47:00):
Yeah, that's great and yeah, and I'll put uh for
our listeners in our show notes.
I'll put the link that DrCampert is referring to on the
Cleveland Clinic website whereyou can find his video and his
information and phone number.
So well.
Thank you so much, dr Campert,for joining me on the Speaking
of Women's Health podcast and itwas a very enlightening episode
(47:22):
and we'd love to have you backand we do appreciate your time
and your tips.
And thank you to our listenersfor tuning in to another episode
and be sure to subscribe to ourpodcast if you already don't,
and it's free and you cansubscribe wherever you listen to
podcasts.
Thank you and we'll see younext time in the Sunflower House
.
Be strong, be healthy and be incharge.
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