Maximum Wellness Mackie Shilstone

Understanding a person’s metabolism – the process in which the body converts food consumed into fuel to expend during all of its functions – is a key component to any successful weight/fat loss program. Resting metabolic rate (RMR) represents roughly 65% of all the calories a person expends during a day - keeping the heart beating, temperature control, breathing, and circulation activities. 
Some people have a fast metabolism – one that effectively processes and converts the food you eat into energy, versus a slow metabolism that stores more of the energy from daily food intake.
RMR, also referred to as basal metabolic rate (BMR) - is the total amount of calories that a human body requires to maintain itself.  
Other metabolic components include the thermal effect of eating – the energy cost of chewing, digesting, and absorbing nutrients, which increases the RMR by 5 to 15%; physical activity expenditure – daily exercise - that adds another 15 to 30% to RMR; and non-exercise activity thermogenesis (NEAT), that represents walking, sitting down, getting up, and any restless-type activity.
During my thirty years of multiple hospital-affiliated sports performance, fitness, and wellness programs, we measured a person’s RMR using a metabolic cart, which was also used to determine their ventilatory threshold and maximum endurance capacity – all factored into a client’s macro-nutrient intake and exercise guidelines to reduce excess weight and body fat, while preserving or increasing lean muscle. 
There are equations that have been used to compare against the RMR measurements.
Harris-Benedict (HB):
Men: (13.75 x W) + (5 x H) – (6.76 x A) + 66Women: (9.56 x W) + (1.85 x H) – (4.68 x A) + 655Weight (W) is in kilograms Take your weight in pounds / 2.2 = weight in kilogramsHeight (H) is in centimetersTake your height in inches x 2.54 = height in centimetersA = ageThe main issue with the HB calculation is that it does not take into consideration your increase or decrease in lean body mass (muscle).
A more accurate formula is the Cunningham equation: 
RMR = 500 + (22 x LBM in kilograms). This formula requires obtaining a body composition from a DXA scan or the use of body composition devices, like bio-impedance, and skin calipers (less accurate with obese individuals). You divide your LMB in pounds by 2.2 to get kilograms.
If you would like to learn more about metabolic rate, check out maxwellnutrition.com. You can also find information on other RMR formulas at 
https://www.lizino.net/facts-about-resting-metabolic-rate/
 

The Journal of the American College of Cardiology reported on the results of a modeling study in August 2022 that concluded, “the association of CRF (cardiorespiratory fitness) and mortality risk across the age spectrum (including septuagenarians and octogenarians), men, women, and all races was inverse, independent, and graded. No increased risk was observed with extreme fitness.”
The study – "Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex" – further concluded that, “being unfit carried a greater risk than any of the cardiac risk factors examined.”
The study group included a diverse group – age, gender, and race – of 750,302 U.S. veterans aged 30 to 95, who were followed for a median of 10.2 years. Age and gender-specific CFR categories were created based on peak MET (metabolic equivalent) achieved on a standardized treadmill test – one MET equal to 3.5 ml/kg/min. 
According to the study investigators, “the lowest mortality risk was observed at approximately 14.0 METs for men and women, with no evidence of an increase in risk with extremely high CRF. The risk for least fit individuals (20th percentile) was 4-fold higher compared with extremely fit individuals.”
In a related editorial, my friend, Cardiologist, Carl (Chip) J. Lavie, MD, whom I worked closely with during my tenure as Director of Health and Fitness for the Ochsner Heart and Vascular Institute, commented, “indeed, "improving CRF should be considered a target in CVD prevention, similar to improving lipids, blood sugar, blood pressure, and weight.”
If you would like to read the abstract from this study, here’s the link.
https://www.jacc.org/doi/abs/10.1016/j.jacc.2022.05.031
For more detailed information on similar studies, go to maxwellnutrition.com.

Sarcopenia is the aging loss of lean muscle, resulting from a loss of strength – dynapenia – and a related anabolic resistance – the inability to regenerate lean muscle at the same rate, as a younger individual. This degenerative process can begin without interventions, such as increased protein intake and resistance training, in the fourth decade and accelerate after the age of sixty.
New research – Dietary Protein Intake Is Positively Associated with Appendicular Lean Mass (ALM) and Handgrip Strength Among Middle-Aged US Adults - published in the December issue of the Journal of Nutrition, comments that, “protein intake predicts skeletal muscle mass and strength among older adults, but knowledge of similar associations among middle-aged adults is lacking.”
In order to determine the effect of protein intake on lean mass maintenance in middle-aged adults, researchers from Purdue University in Indiana, assessed appendicular lean mass, adjusted for BMI (body mass index), and handgrip strength data from 1209 men and women from 2011 to 2014 aged 40 to 59 years of age. ALM is the sum of lean tissue in the arms and legs.
Daily protein intake per kilogram of body weight was determined by two- 24-hour recalls. The participants protein intake was broken into three categories: less than the recommended daily allotment of 0.8 grams per kilogram (2.2 pounds) of body weight; moderate protein intake of between 0.8 to 1.2 g/kg/; and high at greater than 1.2 g/kg.
The ALM - the sum of lean tissue in the arms and legs - was assessed by DXA Scans and handgrip strength. The investigators used the National Institutes of Health criteria for the ALM to define the categories of “low lean mass and “weakness.”
The results reflected, “among middle-aged adults, 15.6% of men and 13.4% of women had low lean mass and 3.5% of men and 2.3% of women exhibited weakness.” 
It was further determined that, compared with the moderate protein group, the high protein group had a higher handgrip strength and the low protein group had lower grip strength among men and women. 
The researchers concluded that higher protein intakes were associated with greater ALM and handgrip strength relative to BMI. The take-away is that a protein intake above the recommended daily intake of 0.8 g/kg/day, may need to be increased after the age of 40. 

Dementia, which globally effected over 50 million people in 2019, is characterized by a progressive and unrelenting deterioration of mental capacity – compromising everyday activities.  
Dementia is a symptom of underlying brain degeneration caused by vascular disease or traumatic brain injury, such as from accidents or contact sports like American football, brain tumors, and the list goes on.
Dementia is classified into two distinct areas: Alzheimer disease and vascular dementia. Since a stroke doubles the risk of developing dementia, it’s estimated that more than a third of the dementia cases could be prevented by reducing the risk to a stroke.
According to research – Consumption of Coffee and Tea and the Risk of developing Stroke, Dementia, and Post-Stroke Dementia: A Cohort Study, which appeared in December 2021, in the open access, peer-reviewed journal Plos Medicine, “epidemiological and clinical studies have shown the benefits of coffee and tea separately in preventing dementia. However, little is known about the association between the combination of coffee and tea and the risk of dementia.” 
Chinese researchers sought to investigate the associations of coffee and tea separately and in combination with the risk of developing stroke, dementia, and poststroke dementia, based on data from a large population-based cohort – the UK, a population-based cohort study that recruited more than 500,000 participants (39 to 74 years old), who attended 1 of the 22 assessment centers across the UK between 2006 and 2010.
365, 682 participants reported their coffee and tea consumption. The researchers determined that, “coffee intake of 2 to 3 cups/day or tea intake of 3 to 5 cups/day, or their combination intake of 4 to 6 cups/day were linked with the lowest hazard ratio (HR) of incident stroke and dementia.”
It was also determined that consuming 2 to 3 cups of coffee with 2 to 3 cups of tea daily were associated with a 32% lower risk of stroke and a 28% lower risk of dementia – with the intake of coffee alone or in combination with tea being associated with lower risk of poststroke dementia. 
The Chinese investigators concluded that, “our findings support an association between moderate coffee and tea consumption and risk of stroke and dementia. However, whether the provision of such information can improve stroke and dementia outcomes remains to be determined.”

In August of 1985, I designed and implemented the performance nutrition and conditioning plan that transformed the former undisputed World Light Heavyweight Champion Michael Spinks from his light heavyweight weigh-in weight of 175 pounds to 200 pounds. 
On September 21st, Spinks won a 15-round historic victory over the reining, undisputed World Heavyweight Champion Larry Holmes. Previously, no light heavyweight boxer had ever successfully moved up and beaten the world heavyweight champion. Both Spinks and I made history on that night. 
Losing scale weight, while preserving or increasing fat free mass (FFM), can be quite challenging, as any bodybuilder can attest to. 
Researchers from the University of Alicante in Spain and California State University in Northridge, California published research – Achieving an Optimal Fat Loss Phase in Resistance-Trained Athletes: A Narrative Review – in the September 2021 issue of the journal Nutrients. 
The researchers used a literature review to develop an evidence-based overview of dietary-nutritional strategies for the loss of fat mass (FM) and maintenance of FFM in resistance-trained athletes.
The first area of concern is caloric intake, which for resistance athletes, “should be set based on a target BW (body weight) loss of 0.5–1.0%/week, in order to maximize retention of FFM.” The researchers point out that athletes with an initial lower percentage of body fat should take a more conservative approach to caloric restriction (CR).
As for protein intake, 2.2–3.0 grams/kilogram of body weight per day (g/kg BW/day) should be distributed throughout the day in three–six meals and ensuring in each of them an adequate amount of protein (0.40–0.55 g/kg BW/intake), note the investigators.
Relative to integrating protein intake around resistance training, “an intake 2-3 hours before training and another 2-3 hours post-training is preferable.”
Carbohydrate consumptions needs to be adapted to the athlete’s activity level, in order to support the energy demands of the training (2–5 g/kg BW/day). “Individuals, who wish to engage in more severe CHO restriction (e.g., ketogenic conditions),” comment the researchers, “may increase the risk of FFM loss, despite a similar capacity to preserve strength.”
The fat macro-nutrient intake should ensure a minimum of greater than or equal to 0.5 grams per kilogram of BW per day.
From a micronutrient standpoint, the researchers point out that there is a need to overcome any potential deficiencies in vitamin B1, B3, B6, vitamin D, and the minerals magnesium, calcium, zinc, and iron. 
A good starting point is to use a multivitamin/mineral formula containing, note the researchers, 10 or more vitamins and minerals at recommended daily intake levels in healthy people.
Creatine - produced naturally in the body from the amino acids glycine, methionine and arginine - is used in the phosphocreatine energy system in explosive activities lasting 0–10 seconds. 
The researchers comment that, “athletes may benefit from creatine supplementation indirectly, since it has been observed that creatine supplementation in combination with strength training could increase the training-induced proliferation of satellite cells and myonuclei in skeletal muscle, resulting in increased muscle fiber growth.”
For more information about developing a creatine muscle gain protocol in conjunction with your physician, I refer you to my book, Lean & Hard, the body you’ve always wanted in 24 workouts (John Wiley & Sons).
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Researchers from multiple departments of Boston University report in October 2021 in JAMA Network Open that a higher midlife estimated cardiorespiratory fitness level was associated with a lower burden of subclinical atherosclerosis and vascular stiffness, along with a lower risk of hypertension, diabetes, chronic kidney disease, cardiovascular disease, and mortality. 
Vascular stiffness refers to left ventricular afterload and the resulting coronary perfusion – leading to cardiovascular disease (CVD). It’s measured by pulse wave velocity (PWV), which can slow with aging – leading to systolic (top blood pressure number) hypertension. 
Prior research has shown that a higher CRF level lowers the risk to CVD and all-cause mortality by itself and/or in conjunction with other CVD risk-reduction measures, such as with the Mediterranean eating strategy and weight control. 
The American Heart Association recommends that primary care physicians assess CRF in their clinical practices. 
As referenced in the Boston University research – Association of Estimated Cardiorespiratory Fitness in Midlife with Cardiometabolic Outcomes and Mortality – “CRF is measured via cardiopulmonary exercise testing; however, this method requires in-person assessment with specialized equipment and trained personnel, rendering it expensive and less accessible.”
 Luckily, non-exercise estimated CRF (eCRF) algorithms have been developed using readily available clinical information, such as age, sex, waist circumference, resting heart rate, and physical activity. 
In my former hospital-affiliated sports performance, fitness, and wellness programs, we used 12-lead EKG cardiopulmonary VO2 max testing – with a cardiologist interpretation of the data to determine the appropriate heart rate training intensity zones for both athlete and non-athlete.
As for the eCRF, I have successfully used the Polar algorithms and heart rate monitoring devices (polar.com) to provide guidance to members of the US Army Special Operations Command.

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