Are You Confused By All the Conflicting Advice about Exercise and Nutrition?

If you want to strip away the fat from your belly to reveal a flat and attractive stomach, or build bigger biceps and broader shoulders, you can't afford to stumble along on the fitness myths of the past.

The good news is that you and I have easy access to more information about how to lose fat and build muscle than at any other time in history. This gives you the power to become your very own health and fitness expert.

One of the best places to get your hands on a goldmine of fat-burning secrets and natural muscle-building techniques that can save you years of wasted time and effort is in research journals. There's a mass of desirable information out there that few people get to read about in books or magazines.

Unfortunately, it's easy to feel so confused by all the conflicting advice about exercise and nutrition that your brain feels like it's going to burst. Let's face it — the sheer volume of information is literally overwhelming. And many of the "experts" disagree.

Most people become lost in this sea of information, and end up doing nothing. Like a rabbit caught in the headlights of an oncoming juggernaut, they know they should do something, but they're not quite sure what it is.

It's a fact that more people are out of shape than ever before. Currently, at least 6 out of 10 adults in the United States (with the United Kingdom close behind) are considered overweight or obese. And the problem is getting worse. Clearly, knowing more is not enough. Instead of actually using the information that's out there, we're simply drowning in it.

So, what can you do to avoid the confusion?

Here are three simple tips you can use to filter out all the rubbish and get clear on exactly what it takes to build a leaner, stronger, healthier body.

Tip #1: Adopt an attitude of curiosity.

Much of what we believe is shaped by what we see, read, and hear. Let's take supplements for example. The media's message about supplements — those pills and powders we take to look better and live longer — is usually mixed.

We often see a story about the benefits of taking a certain supplement. Often, this story refers to a published study. A week later, we read or hear a report about the dangers of the very same substance, with warnings by an expert to stay away from it.

Most people I know are fed up with all the conflicting information in newspapers and magazines. On Monday, vitamin C is being touted as the cure for cancer. By Friday, it actually causes cancer. It's easy to become so frustrated and confused that you simply ignore it all.

One common belief is that the science used to make decisions affecting all of our lives is pure — unfortunately, that is increasingly not the case. Special-interest groups influence policies related from needle exchange programs for the prevention of HIV to mammograms for breast cancer screening [1].

They accomplish this in part by sending an endless stream of press releases announcing "breakthrough" research to every radio station and newspaper in the country. Press releases are written purposely in a news format. They save journalists the time and trouble of researching the subjects on their own. Entire sections of a press release can be simply "cut and pasted" with little or no editing.

Sometimes as many as half the stories appearing in your favorite newspaper are based solely on press releases. Usually, they're mixed right in with other stories. Unless you've done the research yourself, you won't be able to tell the difference. When you see "breakthrough" research being cited, remember that the source could be another industry-backed group trying to sell you on a product or idea.

"We have a serious credibility problem," says Meredith Minkler, chairwoman of the health and social behavior program at the University of California-Berkeley School of Public Health. "The public doesn't trust science anymore."

Press releases

Even press releases put out by some medical journals exaggerate the importance of findings. Most professional journals are peer reviewed, which means that articles submitted for publication are scrutinized by one or more other scientists to see if the information they provide is accurate. Press releases, however, don't always reflect these efforts.

In a study of 127 press releases produced by nine highly respected journals, many failed to give full statistical information with which to put the findings of the study into full context [3]. Industry funding was acknowledged in only 22% of the studies that had received it.

In many cases, journalists report on research that's still at an early stage, but present it as though firm conclusions have been drawn. In a review of 252 news stories written about presentations from five scientific conferences taking place in 1998, one in four of the studies failed to get published in a scientific journal [2]. However, press coverage often gives the false impression that the findings are widely accepted.

Scientific conferences are intended to provide a forum for researchers to present new work to colleagues. The presentations represent work in progress, and many projects fail to live up to their early promise.

The search for answers isn't made easy by magazines and websites that rely heavily on advertising revenue from companies selling food supplements and various exercise devices. Because they float on advertising dollars, most popular magazines are reluctant to print anything that will discourage potential advertisers.

What's more, many magazines and websites are owned by the same people trying to sell you the supplements. Their content is often little more than adverts disguised as articles designed to convey an impartial image.

Remember that one of the main goals of a newspaper or magazine is to sell more copies. They'll achieve this with a sensational headline that reads something like "vitamin C causes cancer" rather than one that accurately reflects the findings of a study. True scientific breakthroughs are very rare, and progress is often painstakingly slow.

Take a deep breath, step back and ask how the findings measure up to previous research on the topic. One study is not really news. Think of it as a single piece of a jigsaw puzzle. It's only when you put the pieces together by comparing many studies in a given field that you get an accurate picture of what's really going on.

Press releases are also used to create "hype" about a product while making it appear as news. A good example of this is a supplement called Cellasene, which was promoted as a miracle cure for cellulite a few years back.

Despite the fact it doesn't work, Cellasene was a huge commercial success. There was a big public relations campaign heralding the introduction of Cellasene as a major news event. Rexall Sundown hired an agency to distribute a "video news release" describing the Cellasene clinical studies as "impressive." News stories on Cellasene appeared throughout the country... and people bought it.

Although Rexall have been ordered to pay up to $12 million to resolve Federal Trade Commission charges regarding its marketing of Cellasene, I'm guessing that will still leave them with a tidy profit.

Tip # 2: Read the research carefully.

The last 20 years have seen exercise and nutrition scientists produce reams of research. At the same time as advancing our knowledge, this information provides constant fodder for a growing number of health-related magazines, newsletters and product advertisements.

Most studies are available in the public domain — you can read them for yourself if you dig hard enough. Though sifting through the research may seem a daunting task, it doesn't have to be. Here are several important questions to ask.

Was the study published in a peer-reviewed journal? Not all studies are published in peer-reviewed journals. Those that are carry more credibility because they undergo scrutiny from a panel of experts.

The review process can last many months. During this time, the author may have to revise their article based on feedback from the reviewer. Some studies are rejected altogether.

However, the fact that a study is published in a peer-reviewed journal doesn't mean you should accept the findings without question. Rather than being peer reviewed, some papers are simply "pal reviewed" by a buddy of one of the study authors.

And some of the trials I've seen in peer-reviewed journals are so poorly done that I wonder if anyone ever bothered to actually read them in detail. Some journals seem so desperate for new material that they'd probably publish your shopping list.

In the area of exercise science, popular journals include Medicine and Science in Sports and Exercise, the Journal of Applied Physiology, the European Journal of Applied Physiology and Acta Physiologica Scandinavica. The Journal of Strength and Conditioning Research also publishes some useful research, though the quality is not always as high as the other journals mentioned.

Was the research funded by a company with a financial interest in the outcome? Every study has to be paid for by somebody. Just because a trial has been funded by a company with a vested interest in the outcome doesn't mean you should ignore it. However, be very cautious if the research is sponsored, especially if drugs or supplements are involved.

A five-year investigation into the inner workings of the National Institutes of Health by David Willman, a Pulitzer Prize winning reporter for the Los Angeles Times, reveals that more than $2.5 million of drug company consulting fees has been paid to top officials and scientists who oversee the clinical trials of drugs.

And that's just the tip of the iceberg. There are reports that supposedly "independent" consultations into how much sugar we should be eating are secretly funded by the sugar industry. And in the worst case of scientific fakery to come to light in two decades, a researcher who worked at the University of Vermont admitted that he fabricated data in 17 applications for federal grants to make his work seem more promising. This helped him win nearly $3 million in government funding. Read the full article from The Boston Globe in a pop-up window.

And according to an article in The Observer, pharmaceutical giants hire ghostwriters to produce articles — then put doctors' names on them! Many articles written by so-called independent academics may have been penned by writers working for agencies that receive huge sums from drug companies to plug their products. You can read the full article from The Observer in a pop-up window.

“The pharmaceutical industry relies on ghost-written publications in peer-reviewed journals as part of their marketing plans,” says Dr. Fugh-Berman, a general practitioner and author of The 5-Minute Herb and Dietary Supplement Consult.

Dr. Fugh-Berman was approached by a medical education company working for a well-known pharmaceutical manufacturer. The company asked her to lend her name as “author” to a completed manuscript that reviewed herb-warfarin interactions. The pharmaceutical manufacturer was developing a competitor to warfarin and had apparently commissioned the article to highlight problems with warfarin.

Fugh-Berman declined, and penned a commentary about her experience for the Journal of General Internal Medicine instead. "The arrangements made between drug companies or [medical education companys] and physicians are often discreet; negotiations are done over the phone, or in telegraphic e-mails," she writes. "Paper trails are minimized; there are no invoices, no contracts, and no written scope of work."

What was the group of the test subjects? Were they old or young, trained or untrained?

Some strength-training studies involving sedentary or elderly groups show large gains in strength — several hundred percent in some cases. This may sound impressive. But it may have been experienced by individuals whose strength in the leg press improved from 10 pounds to 30 pounds. At 30 pounds, they're still very weak when compared with younger people.

In a recent class-action lawsuit involving Cytodyne (manufacturers of the ephedra-free diet product Xenadrine®-EFX™), judge Ronald Styn of San Diego Superior Court concluded that the advertising for Xenadrine® RFA-1 — the now discontinued ephedra-based diet supplement sold by Cytodyne — excluded, misstated and overstated scientific findings.

A typical claim, that Xenadrine users had a more than 3,000 percent greater fat loss, was based on a small company-financed study showing that users lost 1.93 percent of their body fat, while those who did not use it lost 0.05 percent. According to Styn, such claims are a "distortion" intended to mislead consumers. Cytodyne argue that its claims were supported by the research, and that its advertising hyperbole was simply the "puffery" commonly indulged in by other manufacturers.

What type of study was it? Studies involving food supplements, sports drinks, energy bars and other performance aids should be double-blind and placebo-controlled. A placebo is a "fake" supplement used to reduce the influence of faith and belief in a treatment on the results of a study.

Double-blinded means that neither the researcher nor the test subject knows which supplement or drug they are getting. If either person knows, it can have a big influence on the results.

There are three types of experiments that are usually done to evaluate the potential link between diet and health.

The first of these are metabolic studies where researchers have complete control over a subject's diet for days or week at a time. These can be used to determine if a certain nutrient, food or diet affects certain biomarkers, such as cholesterol levels. The problem here is that these trials rarely mimic real life and usually aren't long enough to tell us how diet is affecting health on a long term basis.

At the other end of the experimental spectrum are observational studies, where large numbers of healthy subjects are recruited and what they eat for months or years is recorded. Unfortunately this sort of study usually has a myriad of confounding factors, which aren't always measured. Put simply, these are hidden factors that vary between groups and which scientists may attribute to other variables being measured.

The link between diet and heart disease, for example, is always a controversial one. Large studies may show an association or link between various nutrients in the diet and an increase or decrease in the risk of heart disease. But association does not mean causation.

There is research, for example, to show that people who eat breakfast are less likely to suffer from obesity or diabetes. But is it eating breakfast that's solely responsible for this? People who eat breakfast may be more likely to engage in other healthy behaviors, such as eating more fruit and vegetables. Maybe people who don't eat breakfast are less likely to exercise, or more likely to consume a diet high in sugar or trans-fatty acids.

Some studies show that people watching TV for more than four hours each day are more likely to be obese than those watching TV for less than one hour [6].

Does this mean that the TV is making you fat? Are broadcasters secretly implanting subliminal messages in their programs compelling you to eat more? Does your TV emit a "secret" form of radiation developed in a top-secret government laboratory designed to create more compliant and docile citizens by turning them into couch potatoes?

If I were a conspiracy theorist, the answer would probably be yes.

But it's far more likely that watching TV replaces physical activity. And it's this drop in physical activity, rather than the TV itself, which is responsible for the weight gain. There are statistical adjustments you can apply to a study if a confounder is measured. However, not all confounding variables are measured, or even identified.

Finally, we have the "gold standard" randomised intervention trial. In these studies, which are usually extremely expensive and, as a consequence, very rare, one group of subjects is asked to change some aspect of their diet, such as eating less fat, or more fruit (intervention group). The other group is told to carry on as normal (control group).

At the end of the trial, the results are analyzed to see if there is any difference in the number of cases of a certain disease in the intervention group compared to the control group.

In this case the trouble is compliance. At the beginning of the study, subjects in the intervention group are usually very conscientious about their diet. But as the study progresses they tend to slip. Control subjects, meanwhile, may change their diets voluntarily in response to health messages and over a period of time there is convergence between the two groups. To get meaningful data about the long-term effect of the diet, the study needs to last as long as possible. But the longer the study goes on the less difference there is between the two groups.

Does it pass the reality check? When you look at the claims in detail, there are some studies that completely fail any kind of reality check.

One controversial aspect of low-carbohydrate diets, for example, is the so-called metabolic advantage — the idea that more weight is lost calorie for calorie compared with diets higher in carbohydrate.

One study, for example, appeared to show a metabolic advantage of more than 1200 calories [7]. To me, this just didn't seem possible.

When I looked at the results of the study in detail, I saw what had gone wrong.

Firstly, the results of 3 of the 16 subjects in the low-carbohydrate group were not typical and skewed the results of the entire group. They're called "outliers" because their results lie outside the normal range.

What's more, although the subjects were told to record what they ate, there's no way of knowing how accurate these records were. Self reporting is a notoriously inaccurate way to estimate calorie intake. In some studies, people have been shown to underestimate their calorie intake by up to 50% [8]. In other words, someone who says they are eating 1500 calories per day may really be eating 3000 calories.

It's only when you look at the research in detail that you're able to spot these kinds of problems with the way the study was done.

Tip # 3: Look for evidence rather than proof.

Finding answers to these questions does not guarantee an end to the confusion. The "right" and "wrong" way to train with weights, for example, is still a subject that continues to confound consumers.

In January 2000, a study conducted at the University of Florida at Gainesville raised eyebrows when it suggested that one set of an exercise results in as much improvement as doing three sets [4]. In October of the same year, a Ball State University study found that multiple sets work better [5]!

This kind of conflicting evidence prompts many frustrated people to throw up their arms in frustration at the fact that "even the experts can't agree."

Of course, important variations in the way the trials were conducted explain the different results. However, by the time reports of the study reach your favorite newspaper or magazine, these subtle differences are often left out or ignored.

One hot topic is whether overweight people can lead a healthy life. Several prominent health experts suggest that it's possible to be fit and fat.

Possible? Yes. Likely? Researchers can't agree.

People who are obese tend to be at greater risk of diabetes and heart disease. Proponents of the fit-and-fat theory believe that exercise reduces the risk, regardless of whether you lose weight. After all, people who don't exercise, whether they're overweight, thin or someone in between, are often vulnerable to the same diseases.

Keep in mind that knowledge changes and evolves. Science is a process, and there are always holes in what we know. A study should be taken as evidence, not proof, and no single set of guidelines should be followed blindly.

About The Author Christian Finn holds a masters degree in exercise science, is a certified personal trainer and a regular contributor to Men's Health, Men's Fitness and other popular fitness magazines. If you're stuck in a rut with your current exercise and diet plan... fed up with only losing a pound here and there... or still skinny after months (or even years) of trying to build muscle and gain weight... click here now for instant access to his step-by-step muscle-building and fat-burning workout routines.

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References
1. Rosenstock, L., & Lee, L.J. (2002). Attacks on science: the risks to evidence-based policy. American Journal of Public Health, 92, 14-18
2. Schwartz, L.M., Woloshin, S., & Baczek, L. (2002). Media coverage of scientific meetings: too much, too soon? Journal of the American Medical Association, 287, 2859-2863
3. Woloshin, S., & Schwartz, L.M. (2002). Press releases: translating research into news. Journal of the American Medical Association, 287, 2856-2858
4. Hass, C.J., Garzarella, L., Hoyos, D.H., & Pollock, M.L. (2000). Single versus multiple sets in long-term recreational weightlifters. Medicine and Science in Sports and Exercise, 32, 235-242
5. Kraemer, W.J., Ratamess, N., Fry, A.C., Triplett-McBride, T., Koziris, L.P., Bauer, J.A., Lynch, J.M., & Fleck, S.J. (2000). Influence of resistance training volume and periodization on physiological and performance adaptations in collegiate women tennis players. American Journal of Sports Medicine, 28, 626-633
6. Vioque, J., Torres, A., & Quiles, J. (2000). Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain. International Journal of Obesity and Related Metabolic Disorders, 24, 1683-1688
7. Sondike, S.B., Copperman, N., & Jacobson, M.S. (2003). Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. Journal of Pediatrics, 142 , 253-258
8. Lichtman, S.W., Pisarska, K., Berman, E.R., Pestone, M., Dowling, H., Offenbacher, E., Weisel, H., Heshka, S., Matthews, D.E., & Heymsfield, S.B. (1992). Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. New England Journal of Medicine, 327 , 1893-1898