Scott Rollins, M.D.INTEGRATE YOUR HEALTHGrand Junction Free Press Health & Wellness Columnist

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February 28, 2013
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ROLLLINS: Don't settle for 'wellness'

Wellness is quite more than simply the absence of disease. Similarly, to be "well" does not automatically mean one is fit. Rather, there is a spectrum that improves from sickness, to wellness, to fitness. Fitness can be thought of as "super-wellness." Fitness keeps us at the top of our game whether in sport or in health. But what does fitness mean? What traits make one fit?Many things can be correlated to determine fitness. For example, a body fat of 40% is unhealthy, while 20% is healthy, and 10% is fit. Blood pressure of 160/90 is unhealthy, 120/70 is healthy, and 110/60 is found in the fit athlete. Similar comparisons can be made with many traits such as cholesterol, heart rate and so on.When I speak of fitness I'm referring to a collection of attributes that confer the ultimate service to healthy "fit" human living. There are three main areas of focus in determining overall fitness - cardiovascular, strength, and flexibility. Furthermore, there are three metabolic pathways that humans use for athletic motion. The truly fit use each metabolic pathway to achieve the three elements of overall fitness.The metabolic "engines" for movement are the phosphagen, glycolytic and oxidative pathways. The phosphagen pathway is used in high-powered explosive activities lasting from 10 to 30 seconds, the glycolytic pathway in moderate-powered activities lasting a few minutes, and the oxidative pathway takes over for low-powered activities that last beyond several minutes. The phosphagen and glycolytic pathways don't require oxygen and are "anaerobic" while the oxidative pathway relies on oxygen and is "aerobic."

Think of the marathon runner, thin and lean, and you have the extreme example of the cardiovascular, oxidative fitness. The price of oxidative-only training is loss of muscle mass, strength, speed and power (strength times speed). Activities such as cross-country skiing, long-distance running or swimming exemplify oxidative pathway activities of lower power but longer duration. Aerobic fitness alone is not total fitness.Weightlifting is the basis of strength training. Particularly using the core muscles involved in the deadlift, clean, squat and jerk, building strength, speed and power along with flexibility. These fundamental movements involving multiple joints simulate real-life demands on the human body and produce hormonal and neurological changes that encourage strength fitness far more than isolated single-joint weight routines involving curls, leg raises, etc.Gymnastics, including the familiar Olympic routines, and activities such as yoga, dance and rock climbing, are especially geared toward developing flexibility, balance and coordination of movement. These activities also encourage agile transition from one movement to another and the ability to control the speed and direction of movement, or accuracy.

Anaerobic activities can also help develop aerobic cardiovascular health but need be structured properly. An example is "high intensity interval training" which is basically intervals of work and rest, with work being an all out effort. Work in the 10-30 second time range would hit phosphagen pathways with a rest time of 30-90 seconds. Work in the 30-120 second time range would hit glycolytic pathways with a rest of 60-240 seconds.One can repeat cycles of work and rest 5, 10 or 20 times, depending on the overall intensity. My 22-minute morning bike routine has eight cycles of 30 seconds of work with 90 seconds of rest, framed with a 3-minute warm up and a 3-minute cool down.By utilizing interval training the body will develop both the strength and speed associated with anaerobic conditioning while developing aerobic capacity as well. It is best to use as many varied activities and interval patterns as possible, not only to avoid boredom and muscle accommodation, but to encourage a broad development of muscles and to use the different metabolic pathways.Examples of interval training include alternating between sprinting and walking, biking super fast then just easy spinning, doing fast intense weight repetitions or circuits followed slower resting repetitions or circuits. Variation is the key so use your imagination and have fun.

All sports use varying degrees of the different metabolic pathways, but most of them will hit one pathway to the exclusion of the other two. It is important to mix up the activities to keep a well rounded fitness program. Two great workout programs that exemplify the varied approach to fitness training are P90X and CrossFit. My wife and I have done the P90X routines for years and especially enjoy that we can do them together, quickly, with a little inexpensive equipment, in the comfort of our home.The most aerobic sports include long distance running (over 2 miles) or swimming and cross-country skiing. The strength and speed-building anaerobic sports include shorter distance sprints (100-880 yards) in running or swimming, baseball, basketball, volleyball and wrestling. Some of the best all-around activities that incorporate all three metabolic pathways are intermediate length running (1-2 miles) and swimming sets, downhill skiing and rowing.Whether a young athlete in training, a middle-aged doctor trying to stay fit, or elderly hoping to hang on to mobility and function, the concept of total fitness applies. The only change that needs to be made is that of intensity. Adjust the degree of difficulty but still follow the interval training and variation in workouts or activities.If you are just starting out with fitness training or wanting to increase your fitness, keep in mind that it may be best to work through a progression starting with sound nutrition, then moving first through stages of cardiovascular conditioning, flexibility and strength, then finally sports. While sports encourage building all of the fitness attributes, the targeted workouts will more quickly and completely develop total fitness.Done properly, total fitness will support overall health and is a critical part of aging well. It provides a reserve of protection against illness and frailty of aging. Work to develop the fitness of an 800-meter track athlete, weightlifter and gymnast and you'll be more than fit - you'll be super fit!Scott Rollins, M.D., is board certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call 970-245-6911 for appointments or more information.


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The Post Independent Updated Feb 28, 2013 02:43PM Published Feb 28, 2013 02:41PM Copyright 2013 The Post Independent. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.