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Reduce body fat for better performance with Dr. Fedewa and Dr. Esco

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In your effort to lose weight over 40, it is a good idea to capture more data than just your weight (easy). But up until now, getting an accurate fix on body fat percentage was either expensive and time-consuming, or inaccurate. Today we meet Dr. Mike Fedewa and Dr. Mike Esco to discuss body fat, body fat measurement, and their new app, Made Health.


Let's Say Hello

00:01:34.740] – Allan
Raz, how are you doing this week?

[00:01:36.960] – Rachel
Good, Allan. How are you today?

[00:01:39.150] – Allan
I'm tired.

[00:01:42.510] – Rachel

[00:01:44.020] – Allan
It's a busy week. We're on the verge of opening the gym. We have a health inspection coming on Thursday. So we went there today to meet with them at the hospital. And they gave us some general guidance of things they would expect to see when they get here. So I had to have a pest control guy come out and I've got to make a few phone calls, make sure everything's in order, print a bunch of signs so everybody knows two meters, wear your mask, clean your equipment, please.

[00:02:15.600] – Rachel

[00:02:17.080] – Allan
And my employees have their rules. And so they'll know exactly what to do and they'll be checklists. And so it changes pretty much everything on how we used to run a gym. We've got to kind of rewrite and redo the entire way everything works. So I've been on that since first thing this morning. And then it's all kind of problematic from perspective of over this weekend. I lost my phone.

[00:02:44.400] – Rachel
Oh, boy.

[00:02:45.510] – Allan
We were out having dinner with some friends and on the way back and I knew I was wearing swim trunks. And so I knew that that pocket was a little loose. And so if you think you can drop your phone riding in a golf cart in the jungle, you will.

[00:03:03.822] – Rachel
Oh no!

[00:03:04.470] – Allan
And then other cars and trucks will run over it and then we'll get a heavy rain because it's Panama.

[00:03:10.500] – Rachel

[00:03:10.990] – Allan
So you get the phone back two days later and it's toast.

[00:03:16.200] – Rachel
What a pain.

[00:03:18.180] – Allan
There's no way to really buy an iPhone here on the island. And I'm kind of Apple-centric with my skill sets these days. And I really don't want to learn anything new as far as equipment. So I'll have to wait a few days before someone can bring me an iPhone from the city.

[00:03:34.680] – Rachel
Wow. My goodness, that's such a hassle.

[00:03:39.180] – Allan
Yeah. So, things that could have just done on, we use WhatsApp down here, so could have gotten on WhatsApp and take care like five or six different things like, OK, now I've got to get on my wife's phone and try to make this phone call and then try to use her WhatsApp and message someone. It's been an interesting week, but we're hopeful. Thursday will get here, we'll have an opportunity to get that inspection. I intend to pass the inspection. I really only have one thing that's outside my control. And I'm hopeful that I can get the people that are responsible for that to play nice for at least a day.

[00:04:17.360] – Rachel
Oh, goodness.

[00:04:18.890] – Allan
And then we'll see what'll happen.

[00:04:21.110] – Rachel
Good. My fingers are crossed for you. And I'm sure all your clients are anxious to get back to the gym.

[00:04:27.110] – Allan
Tammy and I get asked and my employees get asked every single day, when are you open? When are you opening? When you opening? February 1st is my my go live day. That's the date I have in my heart that I want to reopen this because we closed March 14th of last year. I don't quite want to go the whole year but…

[00:04:48.660] – Rachel
Yeah. Well, fingers crossed everything goes smoothly.

[00:04:52.670] – Allan
Yeah. We're close. We're really, really close.

[00:04:55.220] – Rachel
Oh good.

[00:04:56.330] – Allan
How are things up there.

[00:04:57.920] – Rachel
Snowy. Snowy and cold.

[00:05:01.920] – Allan
Is that part of the song, “And the weather outside is frightful.”?

[00:05:07.580] – Rachel
Yes, it is! But it is pretty. I figure if it's going to be cold it might as well be snow and make it look all pretty. So, it's good getting still getting my runs and, and the treadmill when it's icy and sketchy but outside on the trails when I can so it's still good.

[00:05:25.670] – Allan

[00:05:26.600] – Rachel

[00:05:27.470] – Allan
All right. We're going to have an interesting conversation, I'll admit straight up. Yeah. We talk about iPhones and losing iPhones and realizing actually how much I use them because I didn't actually think I used them that much because the iPhone will send you a message each week to tell you your usage. And my daily usage on my phone is typically less than an hour. And I do most of the things I need to do for my work and everything else on a computer. I do very little on it on a phone. But that one hour is important stuff.

[00:06:03.320] – Rachel
Yeah, for sure.

[00:06:04.910] – Allan
And so I'll admit, I love getting a new gadget, a new iPhone app, and I'll play with it for a little period of time and then I kind of get bored with stuff like that. But this one is one that I could see myself using for myself. I could see myself using it with my clients because it's going to give us data that is a better health marker than we would get by stepping on the scale. I am a fan of data and this phone app will help collect that data. So, I think you're going to like this conversation.

[00:06:36.410] – Rachel
All right.


[00:06:53.880] – Allan
Dr. Fedewa, Dr. Esco, welcome to 40 +Fitness.

[00:06:57.540] – Dr. Fedewa
Thank you for having us. We're excited to be here.

[00:06:59.910] – Dr. Esco
Appreciate the opportunity.

[00:07:01.380] – Allan
Now, you reached out to me and you have an app. And I'm a big fan of tools that give us information, tools that help us be successful. There's a lot of fitness apps out there, there's a lot of health apps out there and some of them are really, really good and some of them are not so good. But I looked around at your app and did a lot of deep diving into how the app worked, what you guys are doing, some of the research that you've done. And I really like the Made Health and Fitness App and what it's able to do for people that are looking to lose body fat and get healthy.

[00:07:37.530] – Dr. Fedewa
Thanks. We like it, too. We've been in the tech world, I guess, for about a year and a half through development and beta testing in our launch in October. So it's been a wild ride and I think we're a little bit different than some of the other app companies. We really want to deliver a tool that has research grade accuracy. And I think that that puts us in a unique position where we're we're very concerned that the numbers that are coming from the app and from our system are as accurate or comparable to what you would get in a clinic or in a lab. So that's where we want to be. So that means a lot to us. Thank you.

[00:08:12.960] – Allan
Most of the time I'm sitting there and a client will either come into my gym here in Bocas or they'll contact me online. And the thing that will come up will be, I want to lose weight. And I'm like, OK, how much weight do you think you want to lose and why do you want to lose it? And we go we start getting into those types of things. And I really wish we had never used weight as a measurement because what they what they want is they want to be a particular size.

[00:08:44.780] – Allan
That's what they really want. They want to fit into a particular size dress or jeans. And I tell them, if you weighed seven hundred pounds, which would you really care, if you were in a size two and they say, no. I saw this meme the other day that said, you know, if you were two hundred pounds on Earth and you went to Mars, you'd weigh seventy-six pounds. So, you don't have a weight problem. You've got a planet problem.

[00:09:10.590] – Dr. Fedewa
Right there. You got to move.

[00:09:14.940] – Allan
Now, there's a very particular reason why human beings have body fat. Can we kind of go through some of the things that actually are good about body fat?

[00:09:24.480] – Dr. Fedewa
Yeah, absolutely. I mean, if you if you want to go all the way back to caveman to prehistoric days and in body fat as a very essential function. It's a storage site for extra calories. And so that is good. It's always good to have extra calories around when you don't know when your next meal is coming from. So where during times where food is readily available and we we can eat to our fullness and store some extra calories maybe during times when the next meal is inconsistent or you don't know where it's coming from, you have that extra reserve of calories that you can fall back on so that you don't starve and you don't die. Tthat's that's a really good function of fat.

[00:10:03.270] – Dr. Fedewa
The other really good function of fat, if you think from an evolutionary perspective is temperature regulation. That's really good, right? I mean, now we have houses and homes that are climate controlled and you have clothes that can keep us warm. And probably most of us hang out somewhere between sixty five and seventy five degreescin the house or in the car. And so, if we didn't have that luxury, we would need that extra layer of insulation to help keep us warm.

[00:10:28.170] – Dr. Fedewa
And so those are two really, really good, very essential functions to survival and it provides extra padding around all of our vital organs. That's really good. Fat adipose tissue physiologically has a number of functions that actually you create a ton of hormones and different cells signaling on a molecular level that have very important purposes physiologically. So fat is not just an inert, inactive storage site for extra calories. It actually does have a physiological purpose to keep us alive and keep us functioning the way we should.

[00:11:02.420] – Dr. Esco
Suffice it to say that without that, we wouldn't be here, we wouldn't be able to sustain life, multiple important physiological purposes for fat.

Now, as you mentioned, Dr. Fedewa, a lot of times we're in an environment where we're climate controlled. We have an abundant access to food. So I don't have to go hunting or I don't have to wait because I know where this goes live, it's February 8th. And I would dare say if you walked outside in most of North America, you're not going to find fruit or vegetables just lying around. Most of what's going to be around is animals and maybe some roots, if you can dig them off the ground, not frozen, which is not in Alabama at this point, probably.

[00:11:49.610] – Allan
But you still you're not going to find much veg out there today and you're going to have to go hunt for it. And sometimes that means traveling a long distance, having the energy to do that and then having the energy to actually take down a beast and then carry it back to wherever we're hanging out that night. But today, some day, we don't have those things. So we don't need to build up a huge amount of extra fuel and warmth and all of those types of things.

[00:12:15.350] – Allan
So from your perspective, what would be a good level of body fat and does that change based on how old we are, how active we are, or just other functions like how long we want to live?

[00:12:29.390] – Dr. Esco
The recommendations for what would be healthy body fat percentage anywhere within the range of 8 to mid 20% in men and upper teens, low 20s to mid 30s for women. But really and truly, what really good body fat or healthy body fat or appropriate body fat percentage would be is dependent upon the individual, right? We work with a lot of athletes and obviously when we think of athletes, athletes are typically lean and have a low percent body fat.

[00:13:05.360] – Dr. Esco
But even in the realm of athletics, the range of body fat is really should be to support optimal performance, because this drive for thinness that we've created in our society is really not the best approach, because too little body fat percentage can have a numerous negative consequences as too much body fat percentage. So there is a range and that range would really depend on where a person is, what their lifestyle is, how old they are. Yes, we tend to gain body fat as we age, but some of that increase is necessary.

[00:13:47.660] – Dr. Esco
That increase can actually be a good thing if it's too much. That's that's obviously not ideal because too much body fat is obviously linked to obesity related disorders like heart disease and some forms of cancer. But there's body fat. But what's really more important than that is fat free mass. Right? So a part of fat free mass is skeletal muscle and bone density. And those things can decrease as well with aging.

[00:14:15.590] – Dr. Esco
There's an age associated decrease in muscle mass and strength, and that's labeled as sarcopenia. And that's not ideal. Exercise is important for preventing that or decreasing the effects of it. Then there's osteoporosis. Those things are actually linked also to low body weight and also low body fat percentage. Physical activity obviously is going to impact the body composition of an individual and it will help to keep fat to fat free mass ratio at an appropriate healthy level.

[00:15:01.490] – Dr. Fedewa
So what if I just rocked your world? Check the check this out. What have we said that it's not actually body fat that's the issue. It's actually your fat free mass or your muscle mass. So when we say your body fat percentage is too high, what we're saying is that for for the amount of weight that you have, the percentage of that body weight that is fat is relatively too much or is relatively higher than probably what we would want. When we kind of put that in real terms, your body fat percentage will never be zero. The percentage of you that's fat will never be zero. You'll always have some. It will never be one hundred. And so most of us probably stick somewhere around the teens to 20s and 30s, maybe into the 40s or 50s, 50 percent fat.

[00:15:46.280] – Dr. Fedewa
But I think what Dr. Esco is kind of getting at is that the fat free mass is really important. Some people would argue in our field that if you compare collegiate elite level athletes, especially in women, the body fat level, the body fat amounts that they have in pounds or kilograms might not be different than non athletes. The biggest difference is the fat free mass is the muscle mass. And so that makes the percentage of their weight that is fat relatively lower. But the total amount of fat that they have might not be that might not actually be that different.

[00:16:19.250] – Dr. Fedewa
So if we shifted the perspective and said rather than focus on you losing fat because it'll never go down to zero percent fat, what if we just focused on building up that fat free mass and and preserving the bone health like Dr. Esco talked about and preserving or maintaining or increasing the muscle mass, which would, again, drive down the percentage of you that's adipose tissue or body fat. And so that's kind of a cool perspective that I think gets lost a lot of times we just focus on losing weight and losing fat. It's like this primary marker in health.

[00:16:53.400] – Dr. Esco
To add to that, another important point is. Performance, how body composition relates to performance. Let me give you an example, the largest individual that I've ever evaluated, body composition on weight. Six hundred and fifty pounds. So it's very large, 50 percent of his body was fat. So three hundred twenty five pounds of fat.

[00:17:15.060] – Dr. Esco
But he also had three hundred twenty five pounds of fat free mass as well. But it could not do one push up. So is that muscle quality aspect is very important, but on the other hand, the leanest individual. Way less than 10 percent, but barely over 100 pounds, right? So very little body fat percentage, but as a consequence of an unhealthy body composition, very little fat free mass, also muscle quality was very low.

[00:17:44.110] – Allan
Yeah, you answered one question that comes up so many times when I'm on the Facebook forums, or should I try to lose the weight first and then start exercising to gain muscle? And my answer is, well, if you're over 35, no! Absolutely not! Because you're missing an opportunity. And every year that you don't do something, sarcopenia is biting you in the butt. So start lifting straight away. And that again kind of takes them into that. Well, what if I gain weight, which you may if you're lifting weights and you're somewhat restricting what you're eating to a point where your body is trying to shed body fat, you could be doing both and either remain the same weight or maybe a little more.

[00:18:30.340] – Allan
But that ratio that you're talking about of lean mass to body fat is moving in the direction you want to you want to move, which is why, again, this Made Health and Fitness App is actually really cool because it's going to give us some of that data, particularly if we use it consistently and look for trends.

[00:18:48.130] – Allan
Now, one of the other things that comes up a lot and what happens if a woman goes into menopause, her hormones shift and then she starts shifting where she's storing body fat men almost always start to store the body fat on their belly before they gain it elsewhere. But people have genetic differences and it goes to different places for different reasons. Why is it important where we store fat and what that means for our health or performance?

[00:19:15.910] – Dr. Fedewa
We have to two primary distribution patterns so people usually store extra weight or extra fat in two regions. One of them is the Android region. And this pattern is usually more common in men. And we think of this as the apple shape. So if you store a lot of extra body fat around your midsection, around your belly of beer belly would kind of be what we just kind of jokingly call it. But we store more extra fat around the midsection that carries a little bit higher risk for high blood pressure than having more of a pear shaped distribution pattern. If we store relatively more body fat kind of in that area, it doesn't carry the same, some people would argue it doesn't carry the same increased risk that fat stores around our midsection does. So that's actually one of the cool things about the app, is that because we're marketing regionally where people store more adipose tissue or more body fat, we can tell when somebody is storing more of that fat around the midsection, which could potentially put them at a higher risk of certain diseases.

[00:20:14.890] – Dr. Fedewa
And we can tell if somebody's storing more of that body fat kind of around their their lower body, their legs, hips, and thighs. And to your point that you kind of just mentioned about losing weight or losing losing fat and whether I should exercise to lose the weight first or add the muscle, we jokingly said the other day that we would we would almost hope people start exercising as part of the New Year's resolution and not see any weight change. Like exercise lifting weights. And I hope, honestly, that you don't lose any weight because that would tell us know we're possibly adding more muscle, which you could track and we're possibly losing more relatively more fat, but independent of any weight or composition changes. Eating a healthy diet and exercising and being physically active and physically active carries so many health benefits outside of those composition changes.

[00:21:10.030] – Allan
Being that I'm 5′ 11″ and then my little brother, one of my brothers is 5′ 4″, it's not a cool thing when the two of us weigh the same. And so the term there is not so much just the weight, it's it's the BMI. So the BMI is a term that's basically meant to adjust for the height of the individual. But even with that, I could tell you that with my muscle mass, relative to what I'm supposed to weigh at 5′ 11″, I'm not a 170 pounds. I'm closer to about 205. But, you know, my BMI is as a function of that puts me right in the right into the obese category. And I stay there all year round. And because I keep muscle mass and I don't lose the body fat, I kind of look at BMI as is valuable, but not also valuable, that it would be the only thing that I would look at because it's a number, it's a piece of data. And quite frankly, it's not the best piece of data. Like you said, knowing what our body fat percentage is, knowing what our lean mass is, that those are better. There are a lot of tools out on the market, some better than others. Could you talk about the various ways that someone can get their numbers and the pros and cons of each?

[00:22:31.360] – Dr. Esco
Yeah, sure. Within body fat, like how to how to measure body fat percentage and all of that's important. Body fat is just a component of body composition. So body composition is the relative proportion of fat and fat free mass that make up one's body weight. So the body weight kind of gets a bad rap. We don't want to focus too much on the scale, but it is important. It's an important value. And you're right, if someone shorter than you typically if there's the same weight, well, that may not be ideal for the other person, because BMI is the most popular body composition assessment tool. It's one of the simplest before before our app. I think our app is even simpler. But what that is, is just a ratio of height to weight. So it gives us an idea of ideal weight to one's height. So BMI is used to classify obesity by major organizations like World Health Organization.

[00:23:40.300] – Dr. Esco
And typically obesity is considered with a BMI of 30 or greater. But what BMI does not do, it does not evaluate body fat percentage. So the BMI of 30 does not equate to 30 percent body fat like a lot of people may think. It's actually the units are kilograms of body weight over height in meters squared. So even though a BMI may be 30 or greater, doesn't necessarily mean that person has high body fat percentage. So if we have somebody that we assess BMI on and they're sedentary and their BMI is greater than 30, typically that person is highly likely that they're also obese.

[00:24:20.180] – Dr. Esco
However, if we take BMI of our competitive football team, you know, and the running back and running backs or whatnot, the athletes typically have higher BMI. That technically would be considered obese, but they're quite lean because they have a lot of muscle mass that makes their body their body weight greater. So to get more accurate, we would measure body fat percentage and fat free mass. We would actually evaluate those body composition parameters.

[00:24:49.220] – Dr. Esco
And the only way to do that is with techniques that we have available in our lab, which is typically like imaging DEXA. DEXA is a considered a gold standard as an X-ray device that will measure and scan the body and measure body fat percentage and muscle mass. It's the gold standard for measuring bone mineral density as well. There's underwater weighing technique where a person gets in a tank of water and how much water they displace is related to their body fat percentage. And those techniques are typically found in the laboratory and they're accurate and sophisticated. They're very expensive to have the equipment and they requires a technician to know how to use those and deliver those as well. So they're not easily accessible.

[00:25:38.300] – Dr. Esco
There are field methods like the pinch-an-inch. It's the skinful technique, which is a very popular technique to measure body fat in the fitness community. The problem with that is it requires a period of time to be trained to know how to do that appropriately. And there's not good agreement across technicians as well. There's the bioimpedance technique, which is there are many different bioimpedance devices. There's the old handheld, hand-to-hand by devices, and then there's the fancier scales that we can see in some retail stores where the foot to foot and then there's more sophisticated bioimpedance devices and is typically have a range of error that can get really accurate the more expensive and sophisticated they are, but usually the more common ones are not very accurate.

[00:26:28.280] – Dr. Esco
And then there's, of course, our tool that we that we have recently created that measures body fat percentage and body composition from a single the picture.

[00:26:39.440] – Dr. Fedewa
I'll actually follow up to just to say that I think it's a very valuable tool We measure body mass index on every research participant that comes in. It's just an it's a measure. It's a tool. It's a marker that we can use to identify people who may be at risk for additional obesity related, unfavorable health consequences. I don't think for population trends that it should just be completely thrown out. We've seen in the States, we've seen about a 25 to 30 pound increase in the average body weight since 1960. We've seen about a half a kilogram per meter squared increase in BMI at the population level since the 70s and 80s. And so, if you look back over the past 60 or some odd years, we are getting heavier. And I think that that data are so valuable to track population trends, to show us that as a as a global society worldwide, we're not going in a very favorable direction. And there are certain groups that are maybe disproportionately affected by obesity and a lot of the health related consequences.

[00:27:47.430] – Dr. Fedewa
So I don't think that it should just be completely thrown out. But to your point, measuring the individual progress and finding the differences between two people, that may be the same height and the same weight, but different genders, same height, same weight, but different races, same height, same weight, but different ages. I think BMI to measure and account for those individual differences, I think misses that.

[00:28:11.600] – Dr. Fedewa
And so I think our technique and the app, I think the individual just deserves better. I think that there's a more accurate way now with the advances in technology to measure and track changes in composition rather than relying solely on weight on a scale, because I think some of the improvements that we see are just missed.

[00:28:31.620] – Allan
Yeah. Next week, I'm going to have Dr. Ian Smith on to talk about his book, Mind Over Weight. And he has a pretty neat spin on goal setting. And one of the things that he talks about with goal setting is to focus on more than. One goal, you know, you may want weight to be one of your goals, you may want to be able to fit in a certain pair of jeans or a certain dress, and that's all good.

[00:28:58.360] – Allan
But I actually think knowing your body composition is another core measurement that would be really good for you to track if getting lighter, if losing some body fat is what you're after and making sure you're maintaining your muscle mass. There are a lot of tools out there. The Dexascan is going to run you at least $100, maybe $150, depending on where you go. There are little places popping up here and there where you can go pay for a plan and they'll do a Dexascan once a quarter, once every six months, whatever, whatever you choose.

[00:29:29.440] – Allan
And you can see that trend in the water. I've never actually done the water test, the submersion test before. And I can tell you, having worked with calipers and trying to do the seven skinful locations and do it the same every time and get the same result is it's not fun. Bioimpedance does have this huge error rate, depending on how hydrated you are or the time of day that you're doing it. So what I like about your tool is it's in my hand because it's on my phone and it adds just one more tool in there for me to have some data quickly and easily, as quickly and easily as is taking a picture of myself.

[00:30:14.620] – Allan
Now, someone's going to take a picture of me because it can't just be a selfie with the duck lips and all of that. But there's a certain way I have to pose. And so someone's going have to take the picture. I'm have to dress a certain way. But can you tell me a little bit about how the Made Health and Fitness App is used and what it does for us?

[00:30:34.900] – Dr. Fedewa
Yeah, absolutely. You you actually can take a selfie. It's just a different type of selfie. So the image is scanned and we analyze total body composition. So the image itself down the app, you set up your profile. We're going to ask you some basic information about your height and your weight and your your age and race and gender that allows us to create a measure of body composition that's tailored directly to you, that can account for the small kind of age related changes in composition that we usually see.

[00:31:07.780] – Dr. Fedewa
The small differences between different race and ethnic groups, small differences between men and women. It kind of allows us to create a really accurate number that's tailored specifically to you based on your image. Once your profile is set up, the image can be scanned and analyzed in about 15 or 20 seconds. We have a few checks when a person is taking a scan just to make sure that it has the best quality and the most accurate results.

[00:31:29.920] – Dr. Fedewa
So the image has to be from the top of your head to the bottom of your feet. If part of you is missing or cut off is the image is being scanned for the landmarks that we need. Some of them could potentially be missing. And so the numbers will get will be a little bit inaccurate. Feet together, arms out. A lot of the landmarks that we're scanning for on the image are on the trunk. And so some of them we need we need to pinpoint the narrowest part of your waist and the widest point of your hips. So potentially, if your arms are too close to your midsection, we might miss those landmarks and accidentally misclassify. Snugly fitting athletic clothing like a like an Under Armour shirt or compression shirt. If you feel comfortable in sports bra going shirtless, that's completely fine. Leggings, yoga pants, compression shorts, boxer briefs, those are completely fine. Also, what we really need to, again, since we want to find the most accurate kind of picture of you that shows your true body shape, anything with baggy clothing that might kind of misrepresent what your true figure looks like would potentially introduce some error.

[00:32:29.710] – Dr. Fedewa
Other than that, I mean, the image scanning itself is pretty straightforward. We I usually take my phone honestly and set it up on a coffee table and pop it up against a coffee cup and making sure that every image and every scan that I take is at the same height. It's in the same room. It's with the same lighting. If you don't have access to a research lab like most of us don't at home, you can you can just kind of use whatever you have around the house to take the image.

[00:32:55.300] – Dr. Fedewa
I set my phone for a ten second timer and take a selfie that way. So I have a record of the image saved on my phone. Once it's uploaded to the app, it takes about 10 to 15 seconds to scan and analyze and you get your results instantly. From there you can send them to a trainer. If you're working remotely, you can export them to an email or to a text message. The image goes completely away so it's not stored in the app. We don't keep the images in a database. We wanted to do that for privacy and confidentiality reasons. So you don't need to worry about any images of you in your underwear getting out on the Internet, they go completely away. The only place that they would ever exist would be on your own personal phone if you saved it to your camera roll or to your device. The only thing that we see in the database are your numbers.

[00:33:41.170] – Dr. Fedewa
We use that again, one of the reasons why we ask your age and your race, we want the app to be used to create the biggest database of normative values that has ever been created. And so we want somebody who's 45, female, and Hispanic. We want to have the most accurate, normed data to show them to say here, this is what you should be or this is what somebody your age. This is kind of where most of the people in the population are. This is kind of healthier. This is kind of not so healthy. This is where most people who look and act and behave just like you, that have all the same characteristics. And I think all of those data because we're not limited to the issues with transportation or cost or scheduling and access to the different techniques, I think that we definitely are positioned to do that. I think we can make a big difference on shaping and reshaping some of our norms and expectations of what healthy actually is. And then I'll actually let Esco jump in a little bit more and talk about kind of the functions of the app and how it works.

[00:34:44.680] – Dr. Esco
Yeah. So, like Dr. Fedewa said, it's the simplest device on the market now for measuring body composition. All this requires just a picture of a person standing, which is which is easy to do. We don't have to worry about being trained to do skin forward or trained to use a DECA or anything else. And a person can do it right in the privacy of their own home. And there's a lot of barriers associated with going into a fitness center or related facility and having your body composition measured and having to let a fit professional in on how much you weigh. And all very personal number as well. With this there's no need to even worry about any of that person can do it right themselves and again in their home.

[00:35:37.090] – Dr. Esco
But it's also very accurate. Dr. Fedewa and I, this is our area, we've been doing research and body composition for years. We have PhDs in physiology and this is what we decided to focus our career on is body composition and in discovering techniques that are accurate and user-friendly and this what we've we've created.

[00:35:57.940] – Dr. Esco
We've shown that it's in near perfect agreement with underwater weighing and DEXA and those other laboratory measures that we talked about. So even if somebody were to go and have routine Dexascans, they can still use our device for more routine or weekly or frequent scans for body composition. So they don't have to wait months and years down the road to see if there's actual changes in body composition. They can make decisions earlier by using our app, in addition to some of those more sophisticated measures is if they choose to do so. It's the most user-friendly technique and of the field of tools that are out there, it's one of the more accurate methods.

[00:36:47.420] – Dr. Fedewa
We wanted to have something to, Esco mentioned tracking trends. We wanted to have something that you can use on your phone that you had access to all the time, that you can do it for less than a cup of coffee. And so when every every time that you would normally weigh in to track progress, we would we say, hey, man, why don't you take a picture also, right? So you can put some context around those changes that are happening on the scale.

[00:37:09.770] – Dr. Fedewa
Over the holidays, we were as a group of of the co-founders, jokingly tracking all of our changes in composition. And we were seeing ups and downs and swings in body weight. We would be up five pounds one day. We would be down six pounds the next day. And most of that is just due to water weight. It's just a fluid retention. Alcohol, really salty foods, different types of foods will cause you to hold more water weight or less water weight. Menstrual cycle for female users. We have changes in body weight. Most of that is is fluid. And so the cool thing about the app is that with a single picture, if you weigh yourself, you say, oh, my gosh, I'm six pounds heavier than I was yesterday, what the heck is going on?

[00:37:50.710] – Dr. Fedewa
You can take a picture and do a scan and see that about ninety five percent of that is fluid. It's fat free mass. And so that puts context around the changes in the scale that you're seeing. You can go, oh man, I gained six pounds, but that's OK, because most of it is fluid. And we can account for some of those ups and downs from day to day when we're looking at the big trends over time where if you're just relying on two measurements with a DEXA every six months, those small changes and those small improvements, a lot of times are overlooked.

[00:38:19.870] – Dr. Fedewa
You can be up or down on a given day and scan with the DEXA and maybe not show any progress. But we can show this really small changes over time to get a better idea of what's working, maybe and maybe what's not. If you're working with a trainer.

[00:38:32.350] – Allan
Information is powerful. Data is powerful, especially if you act on it.

[00:38:38.569] – Dr. Fedewa
It is.

[00:38:39.730] – Dr. Esco
Especially from a distance, too. So for a professional like yourself, Allan, working with clients that live in different parts of the world. This device is useful for tracking changes and the clients that you're working with. We wanted it to be for individual use, but also for professionals like yourself, practitioners, as well as in the lab and research.

[00:39:03.330] – Dr. Fedewa
Yeah, we wanted it to be, we never wanted to replace the trainer. We don't want to replace the practitioner with the app. So we were very specific with the way that it was designed. So we don't give any dietary recommendations in the app. We don't provide any exercise programming or prescriptions within the app. We want this to be a tool like you mentioned and like you'll talk about next week on the program is that, the more data you have, the more accurately you can track progress.

[00:39:27.810] – Dr. Fedewa
And sometimes from week to week, you may not see any progress if you're just focusing on one specific metric. So what what can we look at if we're if we're not seeing weight loss? Did we see changes in fat free mass or do we see changes in fat mass? It may be did we see changes in Android or glenoid fat? Do we see an improvement there if our total body fat percentage didn't change? Did we did we hit our water goal that we had our steps goal that we had our sleep goal?

[00:39:51.060] – Dr. Fedewa
I mean, you guys is the practitioners and the experts who are kind of out there doing this in the field. The more information that you can get your hands on to coach and train and kind of guide your clients through through their fitness journey, I think the better. And so we we just want to be one of the assessment tools for you to kind of track your progress and your users and then your clients. And so I think we want to let the coaching be done by the coaches. We want to let the training be done by the trainers. And we just want to be there to kind of help.

[00:40:20.070] – Allan
Dr. Esco. I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well?

[00:40:28.980] – Dr. Esco
Well, one is to be intentional, living a healthy lifestyle, right? Eating an appropriate diet. You know, staying active and exercising. Working towards staying positive, all those things require work, they're not just given to somebody you all right? So it takes it takes work to establish those habits and the person has to be intentional making that happen.

[00:40:54.570] – Dr. Esco
You mention making goals. So the second point is to make goals very important, to have something to strive for, but not being so focused on on one specific goal related to like body composition. It's very important to have an appropriate goal for what's healthy in terms of fat, fat free mass and healthy body weight. But more but more important than that is his overall performance. Have another fitness related goals running a 5K or or having some sort of other fitness related feat. Those things are very important. So we have something that we can strive for.

[00:41:32.400] – Dr. Esco
And then and then the third thing I think is the most important of all is to be patient, especially in the world of body composition, where the scale is so easily accessible and our app is very accessible. We're tempted to make frequent assessments. We want to see changes immediately, which doesn't really work that way. We have to be patient. If we're doing the right things, we're eating appropriately. We're being physically active. The goals will be achieved, but it's going to take some time.

[00:42:02.610] – Allan
Thank you. Dr. Fedewa, I'll ask you the same question. I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay?

[00:42:13.140] – Dr. Fedewa
Well, yeah, I think those are the more advice that you can get and the better. Probably the most important one that Esco didn't mention and I guess as the team had put this in number four is to remember that you probably will fail and you will see setbacks. And it's okay to have those, especially if you are focusing on on starting a new exercise program or changing the way that you're eating or focusing on losing weight. There will be huge improvements and there will also be some some pretty big setbacks. And so to remember that it's a long journey if you focus on losing fat, it didn't all happen and come on overnight. So it won't disappear overnight either. There will be ups and downs and twists and turns and to just be patient. So remember that it's okay to have setbacks and you just get up the next day and and start all of them and knock it out.

[00:43:04.560] – Dr. Fedewa
I think the second most important thing that I used on my own journey was to think like a healthy person and act like a healthy person. I don't think starvation or completely cutting out food groups is is healthy. I don't think exercising seven hours a day is necessarily healthy. But if you you start asking yourself, is it okay to eat a cookie? Yes. It's OK to eat a cookie. A healthy person to eat a cookie. A cookie is fine. Probably not OK to eat an entire box of cookies. Cool. Right. Is it okay to have a beer or a glass of wine every now and then? Yeah, absolutely. Is it OK to have ten? No, probably not. A healthy person may not do that. And so I think that that allows you a little bit of flexibility and a little bit of wiggle room because healthy people are not perfect people. They just tend to make healthier decisions more often than not. And so I think that flexibility helps. And I think tracking is is one of the most important things that you can do. And we've seen with some of our research participants just just the act of tracking the number of steps per day that you take is enough to increase your physical activity level by about 10 percent just because you're monitoring it and you're constantly aware of the same thing with calories or or sugar or water intake. It's about a ten percent change. Just if you're watching it and you're thinking about it and you're tracking it, it's enough to restrict energy intake or calorie intake or increase your water intake. And it's about a 10 percent swing. So, if you're not tracking, you can't see change. So get a baseline, measure, monitor and then kind of see what happens over time. And the more data that you collect, the better you can gauge your progress and figure out what's working for you.

[00:44:44.490] – Allan
Thank you. If someone wanted to learn more about the Made Health and Fitness App or the things you guys are doing over there at the University of Alabama, where would you like for me to send them?

[00:44:55.530] – Dr. Esco
Our website for the app is mymadeapp.com. And then to find us in the Google Play and Apple app stores search the phrase “made health and fitness.” So in terms of our work with the University of Alabama, we would encourage anyone to check our personal websites out by searching our names, either Michael Esco or Michael Fedewa, the University of Alabama. And we work in the Department of Kinesiology.

[00:45:28.580] – Dr. Fedewa
We have all of our research papers are up on our on our faculty websites. We have links to our research papers on social media for the app. You guys want to check those out? It's Made Health and Fitness on Instagram and Facebook and Twitter, too. As more research comes out of the lab, as we have conference abstracts and presentations and new research papers are published and presented, we will post those. We also have links to all that research within the app. There's a button says, see the science behind the app. We want to we want the users to be completely confident that the numbers that they're getting are research grade. And so we want to get the research data out there. We want to get the accuracy out there so people can be confident with how they're tracking and what they're measuring.

[00:46:08.600] – Allan
You can go to 40plusfitnesspodcast.com/472, and I'll be sure to have those links there. So, Dr. Esco, Dr. Fedewa, thank you so much for being a part of 40+ Fitness.

[00:46:19.580] – Dr. Esco
Thank you.

[00:46:20.720] – Dr. Fedewa
Thanks for having us. I can't wait to come back.

[00:46:22.550] – Dr. Esco

Post Show/Recap

[00:46:28.000] – Allan
Welcome back, Raz.

[00:46:29.260] – Rachel
Hey, hold on one second while I download this app real quick.

[00:46:32.140] – Allan
The app's called Made Health App. And,there's a lot of benefits to this to this thing. I am a big fan of data, and I'm not I'm not a huge fan of apps, as I mentioned earlier. But data is a big thing. And the thing that they've come up with, they've got two studies that that I read and both of them showed improvements in performance when people lose body fat.

[00:46:55.570] – Allan
Now they're talking about athletes in college, female athletes in particular. But but still, the women lost somebody fat and they performed better. They had more power and they had more stamina. So if you're a runner or someone who wants to play better tennis, this is something if you lose a little bit of body fat, even if you don't have much to lose, there can be some performance improvement. And then, of course, for the vast majority of us that do want to just get rid of some body fat, this is a good way to track that you're being successful. And it's a lot cheaper than almost all of the other alternatives out there because it's free.

[00:47:38.050] – Rachel
Yeah, absolutely. And and there's other metrics. I mean, it sounds like they capture a lot of data in their app.

[00:47:44.660] – Allan
They do. I mean, you know, what they're doing basically is you're supposed to stand and allow them to take you take a full frontal picture. They call it the anatomically correct, although they don't have their thumbs pointing in the right direction. But that doesn't matter. I'm just the personal trainer. They just determine like, that's not well, Okay, but whatever. They just basically want your arm slightly away from your body. So it's not messing with measurements.

[00:48:11.830] – Allan
And then they're just looking at those those measurements as far as how wide we are going from top to bottom. And then the other data that they have is your height, your age and your ethnicity. And that gives them an opportunity then to put that all into an algorithm and calculate a number. And based on the data that they show, they're really close to the water water submersion test. So you know the bipod uses air. There's a water dunking, a version that basically looks at your body mass. And it's how much water you offset in both of those are reasonably good, particularly if you're looking at trends.

[00:48:48.790] – Allan
The lesser good ones are the caliper tests, which, you know, if you go into a personal trainer, a lot of them will do that to try to measure your some body fat. But those are subject to human error. Very subject to human error. And they're hard to do without a ton and ton of practice. And then there's the the bio impedance, like the scales or the handhelds, and they tend to flaw significantly. If you're dehydrated or the next day you are hydrated. That can swing things crazy. And if you're heavier than they think you should be, again, they they they error on the side of saying it's body fat because most people that are using them are trying to get rid of body fat. So, all these things are good. If you're looking at general trends, they get better. The gold standard is the Dexascan, because the Dexa scan is going to measure bone density. It's going to measure water. It's going to measure muscle mass. It's going to measure fat. It doesn't back into a calculation, you know. So it's not a calculation. It's it's literally it's basically calculus or cutting little swipes through you just then looking at the density and various parts of your body to give you an idea. And while it Dexascan can tell you exactly how much body fat you have in each part of your body, this is just going to give you a general idea of where you carry most of your body fat.

[00:50:10.930] – Rachel
That's helpful. That's very helpful information.

[00:50:13.420] – Allan
It is. It's good for trendss. Now, I'm not a fan of weight, but I know that everybody's going to be stepping on the scale because it's it's a cost effective way to know that at least if you're losing body fat, you're probably losing weight. So it gives you an indication that what you're doing is working, but it also also measures other things like water, muscle, bone, brain, you know, things like that that you kind of need and you don't want to just get rid of because, you know, the brain weighs a kilogram and a half, you know, just want to get rid of that just to weight less.

[00:50:51.550] – Rachel

[00:50:52.270] – Allan
There's my five pounds. So this app measures. But I actually did a little guide years ago, but I'll rerelease that. If you go to the show notes, I'll have a link. And it's called the 7 Health and Fitness Measures That Matter. Basically, there's just other things that if you're really concerned and doing for your health, you should also be paying attention to this data.

[00:51:17.710] – Allan
Okay, and I don't think I actually put body fat on that guide. And the only reason I probably didn't put body fat on there is because there is a cost up, kind of a more a bigger cost. Go down to a you know, get a Dexascan or maybe go to a university where they would have one of those submersion tanks or a pod pod which uses air. So, you know, there are these other ways that you can do it.

This is going to be a cheap and easy way for you to measure an approximation, your body fat where you're carrying it. And then, these other health and fitness measures that I'll put in this guide are just kind of other things for you to consider as you're monitoring your health and fitness, because one of the things that I found is, you know, maybe you have a week where your body weight didn't go down. But your A1C did or your blood sugar, your fasting blood sugar. In the morning, you wake up and it's finally below a 100. That kind of thing matters a lot more than a pound less on the scale. And so these are these are the kind of things that I think you really should be focused on as you're going through this. And, yes, you can also do weight because it's just easy.

[00:52:29.410] – Allan
But if you want that guide, just go to the show notes, 40plusfitnesspodcasts.com/472. And I'll be sure to have that link there. The Made Health App is free. It's supposed to be free. When I actually did the interview, it wasn't quite free back then, but it's supposed to be free now. And they're concerned about privacy. So they're very clear with you up front. They're not going to keep the pictures that you're taking to to do this measurement. They're going to take the data from the picture that they need. They're going to wipe the picture and they never even hits their database. And then they're just going to get the data and you're going to get the results.

[00:53:07.510] – Rachel
That sounds awesome.

[00:53:09.790] – Allan
I think the only other thing that I'll put out there is your probably reading a lot in the press lately because things come around and go around and we'll go through a cycle of fat shaming. People say, okay, you can't fat shame it's okay to be the size that you are. And I adamantly agree with that. There's no reason to feel shame for where you are. You can't recover if you don't forgive yourself. So everything that's good in your life, if you're going to move away from something bad, you have to forgive yourself for being in that situation so you can look hopeful into the future. And so I agree fat shaming is a problem, but the articles that are coming out now are scientific-based and they're clear if you're carrying extra body fat, it's not healthy.

[00:53:56.380] – Rachel
Mm hmm.

[00:53:57.490] – Allan
There is no healthy fat. There is no fit fat. If you're carrying extra body weight, it's not good for your health. And, in a lot of cases, it's also not good for you in general because it's you know, it's wearing on your joints. A lot of times that extra weight is also at a cost of inflammation.

[00:54:16.240] – Rachel

[00:54:16.720] – Allan
So there's other things going on in your body physically beyond just your heart health and your risk of stroke and risk of diabetes and those types of things. So if you are dealing with excess body fat, this is the tool, this Made Health App is a tool. You should check it out.

[00:54:36.640] – Rachel
That sounds great. Yeah, I as a former weight obsessed, or scale obsessed person, I like that there's other metrics to follow. The scale is not the most important measurement of health. And just like you said, and I'm sure in your guidebook that you'll share, I go to the doctor, I have my blood drawn cholesterol, A1C, there's a lot going on inside that doesn't reflect necessarily what my outside looks like. So there's a lot of other indicators of health.

[00:55:07.030] – Allan
Yes. Yes there are.

[00:55:08.200] – Rachel
That are much more important.

[00:55:10.000] – Allan
All right. Well, Rachel, it's been a good week. I hope to talk to you next week.

[00:55:14.540] – Rachel
Yes, take care.

[00:55:16.000] – Allan
You, too.

[00:55:16.990] – Rachel


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