The Definition of Health

We have observed that there was a continuum of measures from sickness to wellness to fitness. If it was a measure we could quantify, something of interest to a physician or exercise physiologist, we find it would sit well ordered on this pattern.

Take body fat, for example.

If you are 40 percent body fat, that is considered morbidly obese. The numbers vary by community, but 15 percent is often considered well or normal. Five percent is typically what you would see in an elite athlete.

Bone density follows a similar pattern. There is a level of bone density that is pathological; it is osteoporosis or osteopenia in early stages. There is a value that is normal. We find gymnasts with three to five times normal bone density.

I can do this with a resting heart rate, flexibility (any of the 10 general physical skills), and even some subjective things to which we cannot put numbers through analytical methods (e.g., mood).

I do not know of a metric that runs counter to this pattern. This observation led us to believe that fitness and health were varying different measures of the same reality. This also means that if you are fit, you first have to become well to become pathologically sick. It tells me that fitness is a hedge against sickness, with wellness as an intermediate value.

If there is anything in your lifestyle, training regimen or recreational pursuits that has one of these metrics moving in a wrong direction, I want you to entertain the possibility you are doing something profoundly wrong. What we find is when you do constantly varied, high-intensity functional movements, eat meat and vegetables, nuts and seeds, some fruit, little starch, no sugar, and get plenty of sleep every night, we do not have this divergent side effect. It does not work such that everything is improving except one value. We knew this observation could be another test in assessing one’s fitness regimen.

Recall that we represent fitness as the area under the curve on a graph with power on the Y-axis and duration of effort on the X-axis. By adding a third dimension, age, on the Z-axis and extending the fitness across, it produces a three-dimensional solid (Figure 2).

That is health. And with this measure, I have the same relationship to things that seemingly matter: high-density lipoproteins (HDL), triglycerides, heart rate, anything that the doctor would tell you is important. With this understanding, health would be maximally held by maximizing your area under the curve and holding that work capacity for as long as you can.

In other words: Eat clean and exercise five to six times per week throughout your life. This will buy you more health than will trying to fix your cholesterol or bone density with a pharmaceutical intervention. That it is a failed approach.

Us vs. Them

I want you to understand how these definitions of fitness and health are different than those found in exercise-science literature.

First, understand that our definitions of these quantities are measurable. One of the problems with exercise science is that it would very rarely meet the rigors of any real science (chemistry, physics, engineering).

Secondly, it is also almost never about exercise. For example, maximal oxygen consumption (VO2 max) and lactate threshold are correlates, maybe components, but absolutely subordinate to what happens to work capacity. Who would take an increase in VO2max for a decrease in work capacity across broad time and modal domains? What that would look like is breathing more air than you ever had before on a treadmill test in a lab but losing the road race. Similarly, someone’s lactate threshold could increase, but he or she still gets choked out in the fight because of lack of work capacity.

I could make a list of hundreds of these metrics, and no one has ever produced a great athlete by advancing them one at a time. It does not happen. I can move them best by doing constantly varied, high-intensity functional movements; doing things that look like Fran, Diane, Helen; turning fitness into sport by working with fixed workloads and trying to minimize the time by making every workout a competitive effort among the cohort. And when I do that, what we find is that these metrics do spectacular things.

Suppose a man at 90 years old is living independently, running up and down the steps and playing with his grandchildren. We would not be concerned if his cholesterol numbers were “high.” There is a problem looking only at longevity. Imagine a curve that stretches to 90 or even 105 years but has very low work capacity for its duration. That is not what we are about: It is about vitality and capacity. What can you do?

It is imperative for making meaningful assertions about training that fitness and health are measurable. The area (or volume) under the curve gives me a scientifically accurate, precise and valid measure of an athlete’s fitness (or health). And we are the first to have ever done that.

When we showed this to physicists, chemists, engineers, they agreed there is no other way to assess the capacity of something, be it a rocket, motorcycle, truck or human. Tell me how much it weighs, how far it moves and how long it takes.

Everything else is entirely irrelevant.

Takeaway

For more detailed reading, click here and read pages 5-39.

Tyler