The AMA is Wrong When it Comes to Women's Health

The misinformation out there is becoming so frequent that I can barely keep up with it…

The American Medical Association just released a jaw-dropping recommendation that women should engage in medium-level intensity exercise for 60 minutes a day, 7 days a week for life in order to maintain their weight.

The AMA’s recommendations are “aimed at women of normal weight who don’t want to diet but do want to avoid gaining weight over time.” So essentially, the AMA is telling women that they can eat whatever they want as long as they’re willing to step up the cardio to an hour a day – forever.

This is astonishing in its short-sightedness, and there are several inherent flaws with this logic. But I’m going to focus on two key issues:

1. 80% of all unhealthy weight gain is due to poor consumption (read diet) habits – not a lack of exercise.

Or to put it more simply, if you eat too much of the wrong types of food, you are virtually guaranteed to gain weight – even if you a fairly physically active individual. This means that if you defer to high amounts of grain-based, high-sugar, and high trans-fat foods, you are going to abnormally spike your insulin levels and overload you body’s ability to process this garbage.

And stepping up the cardio or signing up for a year’s worth of heavy endurance training is not going to address this very fundamental issue.

2. The best long-term indicator of human health is having a high percentage of lean body tissue – especially muscle mass. And you get this primarily through resistance training – not through cardio or endurance training.

All the marathon training, treadmill workouts, and spinning classes in the world will not build higher levels of life-sustaining lean muscle mass. In fact, too much cardio will actually cannibalize it.

And higher levels of cardio with no period of recovery leads to increased cortisol levels and chronic systemic inflammation. If you combine this with the inflammation already generated by poor eating habits, you are setting yourself up for a downward spiral that will only lead to stress, burnout, and illness.

Remember, you are what you eat – and no amount of physical activity will make up for a bad diet.

5 Comments

  1. Beck
    March 27, 2010

    Thanks for your help. I’m with you about inflammation. I have to add that as a healthy woman, the expectations about the femail body are unrealistic in society. And it “rankles” me too (nice word). My doc who once told me I had to lose weight to get into a healthy BMI (despite good diet and exercise) is now insisting that I’m too thin. I lost 8 lbs since her “talk” with me 2 years ago. My BMI is 22. Can’t win with them.

    Love the primal breakfast eats! Best of luck and thanks again.

  2. Beck
    March 25, 2010

    BMI is inaccruate, for sure. Even my Internist flat out recognizes it’s inaccuracy.

    However, BMI is a formula based on height and weight so it is a good indicator of “weight”, not health (skinny fat).

    You mention inflammation. Since I have you here. How does inflammation cause someone to be “heavier”? I’ve heard that before and don’t understand it. Does it make you retain water? Why are you heavier after a long cardio workout when you’re most likely dehydrated? Inflammation. But what does inflammation actually do to make gravity haul you down?

    Thanks for bringing this article to my attention. It makes me so mad!!!

    I’m still not jumping into 35 degree Lake Michigan for a “swim”. Love the blog but ya’ll are nuts! The kind I like!

    • srhernan
      March 25, 2010

      Okay, let’s take a small step back. I personally think it’s a mistake to place too much emphasis on body weight when trying to quantify human health. But our current medical and fitness industries, unfortunately, tend to do exactly that.

      My position has always been to emphasize body weight less and focus more on inflammation as a determinant of optimal human health. So let’s look at your question in that context.

      Inflammation may or may not contribute to weight gain. It is possible to be rail thin but have very high levels of systemic inflammation (think marathon runners). It’s also possible to have a high body weight with relatively low inflammation levels (think people who eat a lot of healthy food but are not very physically active).

      I’m not sure what exactly causes immediate changes in body weight after long cardio workouts. My guess would be fluid retention – and that would be a temporary phenomenon.

      As far as real weight gain (i.e. fat accumulation), inflammation triggers a stress response that leads to UNHEALTHY fat accumulation:

      http://www.netbiosciencenews.com/NR/2000/Dec00/stress-fat.htm

      And that’s another area that rankles me about the medical/fitness communities. They don’t differentiate between healthy and unhealthy body fat accumulation. So you could have a very healthy mesomorph with a “worse” BMI than a “healthy” cardio fiend or chain smoker.

      The bottom line is that if you modify your consumption and activity patterns the right way, you will better modify your overall body composition (i.e. more lean muscle tissue, less unhealthy fat). This may or may not result in weight loss in the short or medium term. But in the long term, you’re building body tissue that burns energy more efficiently and insulates you from injury and disease – which is really all I care about!

  3. Beck
    March 25, 2010

    I agree with your post. I have personally tried this (and NOT eaten anything I wanted) and still hadn’t met my goals. It’s only been since engaging in HIT and primal nutrition that I have converted over to lean muscle.

    My question however is that the docs performed this study and got this specific outcome – factually. In the paleo community we base everything on studies too. How do we differentiate the facts? It’s hard to justify all the “science” when it contradicts itself. I for one surely don’t want to be on a treadmill 60 minutes a day 7 days a week to stay baseline, gain no muscle and cannibalize the muscle I worked so hard to earn. Whom do the masses believe? JAMA, of course! Advise.

    • srhernan
      March 25, 2010

      Hi Beck. Here’s how I look at all of this. The study demonstrated that daily hour-long cardio will lead to weight loss and weight maintenance as defined by BMI standards. This is the 800 lb gorilla. BMI doesn’t really measure body composition – specifically lean muscle %. Nor does it measure systemic inflammation levels or degrees of intramuscular fat accumulation.

      But unfortunately, BMI is still the default used by most health professionals when trying to measure and quantify a person’s level of overall health and fitness.

      The challenge to the paleo community, I believe, is to come up with a quantitative way of measuring human health which better captures body composition metrics. Then the medical community can begin conducting studies using that as the default measurement standard instead of BMI.

      So hopefully, scientists and researchers in the paleo/EF community can come up with a better alternative to BMI. The challenge, though, will be to sell it to the health/fitness/medical communities who currently accept BMI as “the rule of law.”.


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