RadioMD Presents: Train Your Body | Original Air Date: May 12, 2015
Host: Melanie Cole, MS
Guest: John P. Higgins, MD
Train your body. Here's exercise physiologist Melanie Cole, MS.
MELANIE: People ask me every single day, what type of exercise is best for losing weight? Which is more important, diet or exercise? I get these questions every day and all the time, and, of course, they are going to be answered definitively today by me expert guest Dr. John Higgins. He is a sports cardiologist at the UT Health Science Center in Houston.
Dr. Higgins, welcome to the show.
DR HIGGINS: Hey, Melanie.
MELANIE: So, which is more important in your personal opinion. All the research you've done all these years. Diet or exercise, does one matter more?
DR HIGGINS: Yes, Melanie. The answer is exercise, and the second best is diet, but the penultimate best is a combination of exercise and diet.
MELANIE: Well, absolutely true and I agree with you because when I eat horribly, and sometimes I'll just have a big ol' burger for dinner and just -- you and I know, I love my food. I'm a big foodie, so are you, but if I don't exercise, then that food goes right to my thighs, right to my hips. If I keep my exercise up, I can usually maintain, maybe not necessarily lose if I'm going to eat like crap. So, let's talk about the exercises that you feel will help us the most when we're talking about weight training, aerobics, walking, swimming, running. What do you put in your top thing for losing weight?
DR HIGGINS: Well if I -- starting off Melanie, and this is more of a philosophical thing, but if I've got someone who's just not doing anything, I'll want -- whatever they will do, I'll take that as a first step. So whatever exercise they say they're going to do, I’ll say, "Great, get into it!" Then, after they've been doing -- so some of them might say they like going to the gym and doing some resistance machines or weight machines. Others might say they like doing walking, but after a while, I will have the discussion with them of the facts of exercise, and that is, what exercises do you want to be doing if you want to burn off the most calories. Those exercises are the aerobic exercises. So, just to give your listeners an idea of how many calories per hour we're talking about here, Melanie. Doing something like weight training, you know, going and lifting free weights or machine weights, you're not burning up much calories, unfortunately. You're only burning on average about 200 calories an hour. Also yoga and other stretching exercises, they are great and we do recommend them for people, but if your goal is to lose weight, they don't do a lot either. Yoga will burn about 150-200 calories an hour as well. Once you start getting into the aerobic exercises, like walking for example. Just walking at a relatively slow pace around three to four miles an hour, you're already at 250 calories an hour. If you go to more aerobically challenging exercises like swimming, jogging, or step aerobics, you're talking about 400-500+ calories an hour, and cycling as well. So, if you want to look at the actual numbers, we need to think about those aerobic exercises, and I will give them priority. I'm not saying the other things are not important and, in fact, as part of a comprehensive exercise program for most of my patients. I will have the foundation being the aerobic exercise at least three to five days a week, and then I'll add to that some resistance training, some stretching, some strengthening, and/or yoga as well.
MELANIE: So, let's just quickly start with walking. How fast do you have to walk to burn that many calories? Is a casual stroll enough or does it have to be a pretty brisk walk?
DR HIGGINS: Well, the more brisk you walk, the more calories you'll burn. So for example, Melanie, if you are walking really slowly, for example, you're only covering a couple of miles in an hour, which is a fairly slow walk. You're only going to be burning about 100-150 calories per hour. Whereas, if you are going to be walking at about four miles per hour, and that's about a mile every fifteen minutes, which is not a fast walk, but it's a reasonably brisk walk, but you can still have a nice conversation. You're going to be burning about 250 calories per hour and then if you take it up a notch like those power walkers that you see out there who are walking five, six miles per hour. They are going to be burning closer to 300-350 calories an hour. That's still short of somebody who's jogging or running, which is around about 500 calories an hour, but if people can't do that and they prefer the walking, because they have issues with knees or hips or other things, I am all for the walking.
MELANIE: Do you like something like the elliptical better than if someone were to say to you, "I want to take up running" or "I want to use the elliptical". You know, putting that kind of a piece of equipment up against some of the other just body weight, do-on-your-own kind of things. What do you think of those?
DR HIGGINS: Oh, yeah, the elliptical machine is good. Melanie, that's a good way to burn calories, because you're exercising both your lower and your upper limbs, and the nice thing, is you can do it in air-conditioned comfort or a controlled temperature environment. You're also not getting as much of the pounding. It's more of a smoother motion of the joints, so in particular, patients of mine who have various joint problems like rheumatoid arthritis or osteoarthritis, or patients who are trying to lose weight and they're quite overweight, and they're just not down to a weight where they feel comfortable with the pounding from running, either outside or on a treadmill, I definitely go with the elliptical machines as well as things like the stationary bikes, and also, water aerobics. In fact, water aerobics is a tremendous burn. It burns more than step aerobics. In fact, a well-done water aerobics program will burn up to 800 calories an hour.
MELANIE: Wow, so that's -- and you don't always think of swimming. People don't think of swimming or water aerobics as being that really tough of a workout, but really you just don't feel it as tough, because the impact is so low and because your body is cooling itself externally from that water, so you don't feel that heat value that you get from these other excursuses.
DR HIGGINS: Exactly, Melanie. That's a great thing, I think, about water aerobics. I see, at our gym, more and more people doing that of all ages as well. It initially start as very popular with the elderly folks, because they're not getting the pounding and they have a little bit of the gravity effect, but now all ages are getting into that, and they are even doing things like putting bicycles in the water now at various gyms. They are doing what's called aqua cycling, because that burns more calories than just regular cycling. There's a whole lot of different things. The bottom line is, Melanie, there are so many different things that people can do. I am certain that someone can find something that they like to do, which is going to give them a good calorie burn, and, hopefully, that will help them either maintain their weight -- and to maintain their weight, I would probably tell them that they need to do at least around 150 minutes a week, but if they want to bring it up to the next level and lose weight, they are probably going to have to increase that amount of time closer to four hours a week, rather than two and a half hours. It can be done and the other nice thing is, Melanie, I tell my patients to mix it up and spread it out. You don't have to go and do a whole one-hour or one and a half hours in one session. You can do thirty minutes, maybe in the morning, at lunch time go for a fast walk, and if you've got your Fitbit on, or your device, you can measure all of the steps you're doing, and then in the evening, maybe go for a swim or a stationary cycle. So, you can kind of add it up to achieve your goal.
MELANIE: That's what you need to do is to mix it up, and you heard it here from Dr. John Higgins. If you had to choose exercise or diet, exercise is number one, diet being number two, and the combination being the best of all worlds. Exercise to lose weight is aerobic type exercise. You can do water aerobics, you can walk, you can jump, you can bike, you can cycle, you can elliptical, you can do anything that you want that burns calories. So, as long as you're doing it that's your best bet and your best fight against weight loss.
This is Melanie Cole for Radio MD. Stay Well!