Pursuing Health
Three-time Fittest American Woman Kari Pearce on Preparing for the 2020 CrossFit Games PH166

Three-time Fittest American Woman Kari Pearce on Preparing for the 2020 CrossFit Games PH166

October 20, 2020

I think that’s part of why I love competing, is being side-by-side with people, having the spectators cheer you on and scream you on, and just being in the environment- it’s just so much energy.  You push yourself and you don’t think as much about the pain as when you’re doing a workout by yourself. But I’m thankful that there was… because CrossFit ended up sending judges, it was nice that we had a judge, and the gym that we were at had some of their members come and spectate, and my coach- it was really cool also having my coach right there next to me, which is different than any other sort of competition.  So, it kind of felt like a competition but also didn’t. Like I said, just because of those factors, but I did my best to keep it the same as a competition setting because, I bet similar to you being an athlete and growing up in gymnastics, just that competition mentality- nothing is like it, and you just bring yourself a little bit higher up than in training. - Kari Pearce

In just 6 years, Kari Pearce has built one of the most impressive resumes in the sport of CrossFit.  A 6-time CrossFit Games competitor, she has been a consistent performer, never finishing outside the top 10 since her rookie season in 2015.  She has also earned the title of fittest American female three times and has represented Team USA at the CrossFit Invitational in 2016 in Canada and in 2017 in Australia.

Kari is among the top 5 Fittest Women on Earth who are about to take on Stage 2 of the 2020 CrossFit Games.

Kari has a background in gymnastics and competed for the University of Michigan where where her team won 4 Big Ten Championships. There she also earned her degree in Movement Science from the School of Kinesiology and was three time Academic All Big Ten.

In addition to being a full time athlete, Kari has used her experience with gymnastics, CrossFit, and coaching to develop PowerAbs, which is a core program done by thousands of people around the world.

In this episode we caught up just a couple weeks before Stage 2 of the 2020 CrossFit Games to talk about some of our shared experiences growing up doing gymnastics in Michigan, her collegiate gymnastics career, how she found CrossFit, some defining moments in her Games career thus far, and how she has approached all the twists and turns of this unprecedented season.

In this episode we discuss:

  • Kari’s background doing gymnastics in Michigan
  • Why she decided to pursue collegiate gymnastics instead of Olympic gymnastics
  • Her insights into how the culture of gymnastics can improve to protect young athletes
  • Lessons in nutrition and recovery that, in hindsight, Kari thinks would have benefitted her as a young gymnast
  • How Kari got into CrossFit
  • High points and struggles within her career so far
  • Kari’s approach to dealing with injuries and finding the right mindset to allow them to heal
  • Her experience and approach to the 2020 training season
  • Making the move to Las Vegas
  • Her reflections on Stage 1 of the 2020 CrossFit Games
  • Her approach to training as she prepares for Stage 2
  • Why Kari feels her coaches and training environment are important to her success as an athlete
  • Her daily routine
  • The Power Abs program
  • Three things Kari does on a regular basis that have the biggest positive impact on her health
  • One thing she thinks could have a big impact on her health, but she has a hard time implementing
  • What a healthy life looks like to Kari

You can follow Kari on her websiteInstagram, YouTube,  Facebook and Twitter.


Related episodes:

Ep 36a & 36b - Dominique Moceanu on Gymnastics, Healing and Health

Ep 130 - Kristi O'Connell on Training for Joy and Balance

Ep 145 - 2019 Third Fittest Woman Jamie (Greene) Simmonds

If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.

Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on October 17, 2020.

Thriving on the Unexpected: Cory Schmidgall PH165

Thriving on the Unexpected: Cory Schmidgall PH165

October 13, 2020

“I have learned how to adapt to the unknown and unknowable. I have learned to focus on what I CAN do. This led me to my main mantra to date which is, “What’s the next step?” which is what I focus on in any type of adversity or workout. - Cory Schmidgall

Cory Schmidgall tried just about every fitness program out there.  Nothing seemed to light the fire he remembered from his football days, or satisfied the competitive drive that motivated him to try out for the NFL.

It was while he was recovering from a major surgery, an anterior cervical discectomy and fusion of his spine, that he read about CrossFit. “I tried a few of the WODs at my local rec center. While everyone was looking at me as if I were crazy, I tried Elizabeth. 21 minutes later I was hooked.”

A few years passed, and Cory found that he was struggling with hip mobility and recovery due to inflammation, despite putting extra work in to improve in those areas. A consult with his orthopedist confirmed that he had a genetic degenerative hip disease. At only 37, he suddenly felt twice his age, and began to spiral into a blackhole of self-pity. But his CrossFit community wouldn’t let him. “One day, when I was kicking rocks at our box, one of the other members simply said, ‘Dude, why don’t you just focus on what you CAN do.’ Simple but effective.” From that day forward, Cory took on a new mindset.  He began to look at CrossFit as prehab to train for surgery.

In the span of 10 weeks, Cory had surgery on both hips.  The pain was brutal.  But he remembered his friend’s words of encouragement.  “I started slow and again focused on what I could do daily. I started over with all movements focusing on form and rehab. I used CrossFit methodology for rehab, on top of the hip movement rehab, and the CrossFit nutrition protocol to stay on top of inflammation and heal my gut from years of pain meds. I felt I was getting in the best shape of my life prior to surgery but even more so in the months that followed.”

Life wasn’t done dealing to surprises to Cory.  A year and a half after his hip surgeries, he was diagnosed with skin cancer, and went back under the knife to have it removed, adding a new scar to his thigh.  Just a year later, this was followed by a second cervical discectomy and fusion, adding another level to his previous procedure.

Just as he had before, Cory prepared for these new challenges by keeping his eyes on the horizon, using CrossFit, and by getting his nutrition on point.

Says Cory, “5 years in now, I have learned how to adapt to the unknown and unknowable. I have learned to focus on what I CAN do. This led me to my main mantra to date which is, “What’s the next step?” which is what I focus on in any type of adversity or workout.”

When I first read Cory's story, I was impressed not only by the remarkable mindset he's used to approach so many challenging surgeries, but also by how he's worked hard to develop skills to manage his own panic attacks and anxiety.  I was excited to catch up with him to learn more about how identifying his why has been so critical to growing through these obstacles, and how he's using his experiences to help others.

In this episode we discuss:

  • How sports and injuries played a role in Cory’s life growing up
  • Pursuing his goal of playing in the NFL
  • Struggling to find his identity as he retired from sports
  • The relief of finding an explanation for neurological symptoms he had been experiencing
  • Cory’s first CrossFit workout
  • The turning point for Cory’s mindset in approaching his injuries
  • How Cory is using his experiences to help others
  • What’s allowed him to grow through these obstacles
  • Strategies that have been helpful for Cory to manage his anxiety
  • Cory’s morning routine
  • Three things Cory does on a regular basis that have the biggest positive impact on his health
  • One thing he knows would have a positive impact on his health, but he struggles to implement
  • What a healthy life looks like to Cory

You can follow Cory on Instagram, Facebook, and Twitter, or you can listen to his podcast, Anxiety WOD.


Related episodes:

Ep 102 - Jason Khalipa and the AMRAP Mentality

Ep 108 - Training Smarter, Not Harder: Prevention and Recovery from Injury with Pure Physio

If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.

Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on October 10, 2020.

Boosting Immunity and Reducing COVID Risk with Dr. Aseem Malhotra PH164

Boosting Immunity and Reducing COVID Risk with Dr. Aseem Malhotra PH164

October 6, 2020

I think a lot of doctors kind of know this but don’t really… it’s never really been at the forefront of their minds until now. We know, for example, that people who have high blood glucose or type 2 diabetes have worse outcomes from any infection - specifically respiratory infections. So, when I started looking at the literature and also looking at how immune health links to excess body fat, obesity, and type 2 diabetes pre-COVID, the data was very clear that this was a big risk factor for a dysregulated immune system, an immune system that isn’t going to function properly. So, it wasn’t just about the associations that we were drawing from COVID-19 and worse outcomes.
- Aseem Malhotra

Dr. Aseem Malhotra is a cardiologist with the U.K.’s National Health Service and a world renowned expert in the prevention, diagnosis and management of heart disease.

He is a visiting Professor of Evidence Based Medicine at the Bahiana School of Medicine and Public Health in Salvador, Brazil, an honorary council member to the Metabolic Psychiatry Clinic at Stanford University School of Medicine California, and is Cardiology MSc examiner at the University of Hertfordshire, U.K.

Dr. Malhotra is a longtime health activist and a founding member and lead campaigner of Action on Sugar, an initiative which highlights the the harm caused by excess sugar consumption.

Most recently, he has been a vocal advocate for improving metabolic health to reduce vulnerability to disease, including COVID-19, and has authored the book The 21-Day Immunity Plan: How to Rapidly Improve Your Metabolic Health and Resilience to Fight Infection.

Dr. Aseem and I recently sat down to chat about the link between metabolic health and immune function, ways we can improve our own immunity, and why turning the tide in the fight against poor metabolic health will take more than just personal responsibility.

*Dr. Malhotra’s bio was adapted from his website.

In this episode we discuss:

  • Dr. Malhotra’s background in cardiology and how he became involved in health activism
  • Why personal responsibility is only a very small factor in the epidemic of chronic disease
  • How obesity and metabolic health have affected the COVID pandemic
  • The markers of metabolic health
  • The link between immunity and metabolic health
  • Lifestyle factors that optimize the response to vaccines
  • A broad overview of things we can do to improve our immunity
  • 10 key points for policy makers to address metabolic syndrome on a grand scale
  • Three things Dr. Malhotra does on a regular basis that have the biggest positive impact on his health
  • One thing he struggles to implement that could have a big impact on his health
  • What a healthy life looks like to Dr. Malhotra

You can follow Dr. Malhotra on Instagram, Facebook, and Twitter.


Related episodes:

Ep 144 - Pursuing Health Pearls: What COVID-19 is Teaching Us About Our Health

Ep 146 - Pursuing Health Pearls: Understanding and Assessing Metabolic Health

Ep 135 - Immune System Strength with Dr. Leonard Calabrese

If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.

Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on October 2, 2020.

Nutrition on a Budget PH163

Nutrition on a Budget PH163

September 29, 2020

After doing some deep dives on the basics of nutrition, exercise, sleep, stress, and metabolic health, we’re excited to now be able to start exploring some of the nuances of these topics and others in upcoming editions of Pursuing Health Pearls.

In this edition, we’re going to explore whether eating healthy really is more expensive, and share some resources for eating real food on a budget.

If you haven’t yet seen Episode 150 where we share our general approach to nutrition, we’d highly recommend going to check that one out because it will provide more context for why eating real food is so important for our health.


It's Complicated.

Back in Episode 150 we talked about the importance of consuming real, whole food for our health, yet our current food environment often makes it very difficult to do so, especially for those with limited financial resources.

We live in a world where ultra-processed foods are readily available and hard to escape. They are served in schools and hospitals, we have fast food restaurants on every corner, and the government subsidizes crops including corn, soy, wheat, and rice which make up the majority of ultra-processed foods allows them to be cheaper for the consumer.

38 million people in the US are on the Supplemental Nutrition Assistance Program (SNAP, also known as food stamps), which allows for the purchase of soda but not rotisserie chicken because it’s a prepared food. This is another example of the fact that it’s not easy to get access to real, whole food in our country.


Is Eating Healthy Really More Expensive?

We’ve all heard the argument that eating healthy is more expensive, and in general, research does back this up.

A study published in Frontiers of Nutrition in 2019 compared 3 different healthy eating patterns against the existing eating patterns of minority groups based on NHANES 2013-2014 data.

All diets were based on 2000kcal/day with national food prices adjusted for inflation.  The foods in the “healthy eating patterns” groups included foods in their nutrient rich forms, were low in sodium, and had no added sugar. The researchers found that existing eating patterns of minority groups cost around $5-$6 per day. In comparison, the healthy eating patterns cost $8.27/day for the US-Style, $5.90/day for the vegetarian pattern, and $8.73/day for Mediterranean eating pattern. Basically, the cost of the vegetarian eating pattern was about the same as the existing eating patterns of minority groups, but the cost was $2-$3 more per day for the eating patterns that included meat and seafood, which does add up over time.

It is important, however, to look at nutrition not only through the lens of cost and calories. While the healthy eating patterns in this study cost more than existing patterns for the same amount of calories, these healthy eating patterns were higher in protein, fiber, vitamins and minerals, and lower in solid fats, sugars, and sodium, and were overall healthier.

This highlights the fact that we have to look not just at the cost of food, but the total cost associated with eating a certain way over time. Eating ultra-processed foods which don’t contain much in the way of nutrients and are more likely to contribute to chronic disease later on may save $2-3/day now, but eating this way may be very costly down the road in the way of increased medical costs, medications, suffering, and poorer quality of life.

Again, this is backed by research! A 2015 Review of fast food patterns and cardiometabolic disorders found that eating away from home and consuming fast food were associated with having a poorer quality diet (with higher calorie and fat intake and lower micronutrient density), being overweight particularly with abdominal fat gain, poorer metabolic health, increased inflammation, diabetes, metabolic syndrome, and cardiovascular disease.

However, just knowing the importance of eating real foods is not enough, because there are so many social factors that influence our ability to implement healthy eating patterns. What is local available in our communities is a huge factor. Studies show that places with greater availability of fast food are associated with a higher mortality and hospital admission rates for heart disease, as well as a higher risk of obesity.1,2


A Disclaimer...

We recognize that we do come from a privileged place, and that we ourselves do not have first-hand experience of having to navigate eating on an extremely limited budget. As discussed above, we also recognize that there are a lot of systemic factors that need to be addressed in order to truly remedy this problem.

However, we also don’t think we should wait around for those systemic issues to be fixed because people are suffering as a result of these problems right now. So, in order to explore this issue further, we decided to undertake an experiment to determine the cost of fast food vs. whole food purchased at a grocery store. We also collected numerous resources that may be helpful when navigating eating real food on a limited budget.


A Comparison of Fast Food vs. Grocery Store, Real Food Meal Plans

In this experiment we decided to compare one week of meals from fast food restaurants vs. shopping at a grocery store and preparing the meals at home. We realize that there are plenty of problems with this comparison, because we are not exactly comparing apples to apples here. The fast food meals are already prepared and convenience is part of what you are paying for. Fast food meals generally cost less than eating a healthy meal out at a restaurant. We do have to take into consideration the additional cost in the form of time, energy, knowledge, and access to a kitchen that are required in order to shop, prepare, and cook the food at home, but we would argue that this up-front investment is worthwhile to avoid disease, suffering, and medical costs in the long run.

We also recognize that it is probably not realistic for someone to eat every single meal over the course of a week at a fast food restaurant. It’s probably more likely for someone to eat a few fast food meals intermixed with prepared or ultra-processed foods from a grocery store. We did think it would be informative to look at an entire week rather than just one meal though, so you can think about this as more of theoretical exercise.

So, here’s how we structured the comparison:

  • We created one week meal plans including breakfast, lunch, dinner, and snacks
  • We aimed for approximately ~ 2000kcal/day on both plans
  • We attempted to include realistic meals of what one might order or want to eat
  • For the fast food meal plan, we looked at the 5 largest fast food chains from across US which include McDonalds, Burger King, Taco Bell, Wendy’s, and Pizza Hut
  • For the grocery store, real food meal plan we looked at sourcing ingredients from Kroger and Aldi. Both of these stores are available across most of the US with Kroger being the 2nd largest retailer after Walmart in 42 states with ~3500 locations, and Aldi on track to become the 3rd largest grocery store with over 2000 stores across 37 states. We have also been impressed with Aldi’s more recent efforts to make healthier food (including organic options) more affordable and accessible.
  • Some examples of meals on the grocery store, real food meal plan include:
    • Three ingredient pancakes with peanut butter and berries
    • Overnight oats
    • Mediterranean pasta salad
    • Chicken salad
    • Zucchini noodles with marinara
    • Snacks of nuts and fruit

You can download a comparison of both meal plans, as well as our Budget-Friendly Real Food Meal Plan which includes shopping lists and recipes for free here.

To summarize some takeaways from this experiment, we’ll first compare just one day of meals from each plan. Below we look at the meals for Tuesday, but you can access the entire week here.


Fast Food Meal Plan:

Breakfast: Egg McMuffin (McDonalds) with hashbrowns, and a large coffee= $4.94

Lunch: 3 soft tacos (Taco Bell), chips and nacho cheese sauce, and a large drink = $6.36

Dinner: Avocado chicken salad (full order with dressing from Wendy's) and a large drink = $8.28

Total Calories: 1720

Total Cost: $21.08

Cost per Calorie: 1.2 cents


Grocery Store, Real Food Meal Plan:

Breakfast: Hard-boiled eggs with fruit and 1/2 avocado = $1.54

Lunch: Chicken salad with cucumbers and a peach = $3.55

Dinner: Zucchini noodles with marinara meat sauce = $1.65

Snacks: 2 handfuls of nuts ($0.92) and a piece of fresh fruit ($1.17) = $2.09

Total Calories: 1961

Total Cost: $8.83

Cost per Calorie: 0.45 cents


As we look at this comparison, a few observations stand out. First, it costs over twice as much for the fast food pattern, even with about 200 fewer calories. The cost per calorie was about ⅓ on the grocery store, real food pattern than with the fast food pattern. The cost of the grocery store, real food pattern is also consistent with the US-Healthy and Mediterranean health eating patterns from the research study we discussed above at $8.83/day. Additionally, the fast food meal plan includes far fewer micronutrients. Finally, drinks provided large sources of empty calories, added sugar, and excess cost in the fast food meal plan: a large soda added an additional 290 calories and 77g of added sugar, and costs $1.49. Similarly, a small caramel mocha adds an additional 310 calories, 40g of added sugar, and costs $2.39.

When we compared the entire week of meals, we found that the total cost of the fast food plan was $126.90, or $18.13/day average. The total cost of the grocery store, real food plan was $64.95, or $9.28/day average, about half as much as the fast food plan. Total calories per day averaged close to 2000 for both meal plans.

Again, we recognize that this isn't exactly an apples-to-apples comparison. We could have compared an ultra-processed grocery store meal plan to one composed of real food, or fast food to eating out at a healthy restaurant, but we hope this will still provide some insight and make all of us think twice before choosing to eat out at a fast food restaurant.

This exercise also highlights the importance of planning ahead to do grocery shopping and meal preparation. Having everything needed on hand to make a healthy meal decreases the chances of being influenced to stop by a fast food restaurant at the moment.

Tips + Resources for Eating on a Budget

We hope you’ll download and use our Budget-Friendly Real Food Meal Plan as inspiration, but there are also a plethora of tricks and resources available to make it easier to eat healthy on a budget. We’ve included some of our favorites below:

  1. Grow A Garden: This does require time, space, and attention, but it can save a lot of money over time while also providing access to much more nutrient-rich produce.
  2. Buy on Sale: Looking for sale or special items is a great way to save money at the grocery store.
  3. Buy in Season: Seasonal items are generally cheaper and more nutrient dense. SeasonalFoodGuide.org and the SNAP Seasonal Produce Guide are great resources for determining what is in season in your location.
  4. Use the Clean 15 and Dirty Dozen: Using the Environmental Working Group’s Dirty Dozen and Clean 15 guides can help to prioritize which foods are most important to purchase organic if you are interested in doing so. EatWellGuide.org is another great resources for finding local organic foods.
  5. Shop at Farmers’ Markets: LocalHarvest.org provides a list of all of the farmers markets in your area based on your city and zip code.
  6. Buy Produce with Blemishes: Purchasing produce has too many blemishes to be sold in grocery stores can save money and also helps to decrease food waste. Imperfect Foods delivers to most of the Midwest, Northeast and all along the West Coast, and Perfectly Imperfect Produce is another similar service we have used in the Cleveland, OH area.
  7. Produce Delivery: Farm Boxes deliver fruit and vegetables to your door which also saves another valuable resource, time.
  8. Buy in Bulk: Purchasing items in bulk from places such as Webstaurant Store, Vitacost, Nuts.com, or Thrive Market can reduce the cost per serving of grocery items.
  9. Use the Environmental Working Group’s Good Food on a Tight Budget: This is an extensive resource that lists the most nutritious, most economical, and least polluted fruits, vegetables, proteins, grains and dairy items. It also provides simple tips for eating well, quick lists of foods with the most nutrition for the lowest cost, tasty recipes, easy tools for tracking food prices and planning your weekly menu, and a blank shopping list to help you stay on budget.
  10. Calculate your Grocery Budget: Tools such as this calculator from Iowa State University can make it easy to plan ahead.
  11. Clip Coupons: Savings from grocery coupon sites such as Organic Food Coupons, Manbo Sprouts, Saving Naturally, Organic Deals, All Natural Savings, Health Savers, and Organic Deals and Steals can add up!
  12. Savings Apps: The use of smartphone savings apps such as Grocery Pal, Cartwheel, Coupon Sherpa, Apples2Oranges, and Key Ring can also reduce the cost of groceries.

In summary, we hope this was a helpful way to start a discussion about eating for our health even while on a limited budget. This is a deeply seeded and systemic problem that needs to be addressed on many levels from farm subsidies, to food deserts, to the availability of healthy food in schools and hospitals, and more. We hope this edition of Pursuing Health Pearls provided some insight and resources to help you or your loved ones get started with or continue healthy eating in a more affordable way.

As a reminder, you can download our Nutrition on a Budget Guide which includes:

  • Our Fast Food vs. Grocery Store, Real Food Meal Plan comparison
  • A One Week Budget-Friendly Real Food Meal Plan complete with shopping lists and recipes as well as cost, calorie and macronutrient breakdowns for each meal
  • Resources for eating real food on a budget


We have to give a HUGE shout out to Ariana Fiorita, functional and integrative registered dietitian who helped us with the research and resources included in this guide.

Finally, as always, we welcome your feedback. Please feel free to share ideas, your own favorite resources for eating healthy on a budget, or future podcast guest recommendations on this topic here.


Related episodes:

Ep 150 - Pursuing Health Pearls - Our Approach to Nutrition

Ep 95 - Optimizing Your Nutrition with EC Synkowki


If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.


Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on September 28, 2020.

Simple, Sustainable Nutrition with EC Synkowski PH162

Simple, Sustainable Nutrition with EC Synkowski PH162

September 22, 2020

There's no diet plan, there's no 30 day challenge that's going to stick with you forever.  You, ultimately at some point, are in the driver's seat.
- EC Synkowski

EC Synkowski is the founder of OptimizeMe Nutrition, a company dedicated to helping anyone improve their health and well being with simple, non-restrictive diet methods.

EC started CrossFit in 2006 and over time her enthusiasm and hard work led to seminar staff and flowmaster positions for the Level 1 and CrossFit Weightlifting courses, a CF-L4 certification, and a career as a Program Manager with CrossFit, Inc.  In 2017, EC stepped down from her position at CrossFit to focus on finishing her second master’s degree in Human Nutrition and Functional Medicine.

From there, she founded OptimizeMe Nutrition, where she focuses on helping individuals understand nutrition physiology and it’s day-to-day application.

She is the creator of the #800gChallenge, a straightforward eating plan that encourages participants to maximize their fruit and vegetable intake and encourages the consumption of whole, unprocessed foods, and it’s slightly more advanced partner, Lazy Macros.

I was excited to catch up with EC for her second appearance on the podcast.  We talked about the 10 Principles of Nutrition, the importance of making sustainable changes to our diet, and the nutrition takeaways she’s gleaned from the COVID-19 pandemic.

This conversation left me feeling inspired, and Dani and I have decided to run a four week challenge using EC's Lazy Macros approach starting on September 28, 2020 for all of our Pursuing Health subscribers!

Our focus will be on eating 800 grams of fruits and vegetables and meeting protein goals each day, with a leaderboard to track people who demonstrate the most consistency with the 800g, protein, workouts, and sleep.

This challenge will be open to all subscribers at no additional fee. We're hosting a live Q+A for our subscribers on the evening of September 24th to answer all your questions and then we'll get started together on the 28th, so if you're not a Pursuing Health subscriber yet, today would be a great time to join!

In this episode we discuss:

  • EC’s 10 Principles of Nutrition
  • Her thoughts on fasting
  • Why the #800gChallenge has such a positive ripple effect on our nutrition
  • Her thoughts on the carnivore diet
  • The Lazy Macro approach
  • The impacts of under and overeating protein
  • Why she started The Consistency Project, and why she keeps tracking so simple
  • EC’s new podcast, The Consistency Project
  • The nutrition takeaways that have been reinforced by the COVID pandemic

You can follow EC on Instagram and Facebook, or on The Consistency Project podcast.


Related episodes:

Ep 95 - Optimizing Your Nutrition with EC Synkowski

Ep 112 - Eating for Longevity with Dr. Valter Longo

Ep 150 - Pursuing Health Pearls: Our Approach to Nutrition

If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.

Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on September 19, 2020.

An Unlikely Antidote to Anorexia with Becky Fox PH161

An Unlikely Antidote to Anorexia with Becky Fox PH161

September 15, 2020

“My journey to finding myself and my will to live began with finding CrossFit.
- Becky Fox

The stress of everything was just too much. If she could just lose weight, Becky believed, she would be okay. She drastically cut her calories, restricted food intake and began exercising incessantly. A sophomore in high school, she succeeded only in losing athletic opportunities, a sudden drop in academic performance, and seclusion in her social life.

As her eating disorder consumed her, Becky would constantly think about how many calories she had eaten and how many hours she would need to spend in the gym to work them off. Friends and family became alarmed by her obsession with food and her sudden outbursts, and Becky sought help from a therapist, but it wasn’t enough.

Becky’s health continued to decline, and her bloodwork showed it. Her heart was not able to keep up with her physical state. Doctors stripped exercise from her, forbidding even recreational walks. Soon, depression, suicidal thoughts and self-harm replaced the physical activity Becky had once loved.

Becky’s sister had been by her side throughout her ordeal, and she knew just how important athletics were to Becky. Her sister had heard there was a CrossFit affiliate in their hometown, and hoped it might be a place Becky could go to work out safely and rebuild her self-esteem. “It sounded crazy at the time, putting an anorexic girl who had an addiction to exercise into a gym setting again. Little did I know that a box is very different than the typical gym.”

Becky came to an agreement with her family that if she met her calorie intake goal for the day, she would be permitted to attend a class. “I was hesitant. It was higher calories than I had in about a year, but I wanted fitness back in my life.”

Her first class was terrifying. Becky had developed extreme social anxiety and felt uncomfortable anytime she was away from home. But soon, she found she had a new home. “I could be myself and not worry about what anyone thought. The coaches were patient, everyone was kind, and no one treated me differently even though they could see every vein in my body. It gave me a reason to be OK eating again, fueling my body so I could work out later.”

As time passed, Becky developed close friendships with other members at her box, conquered her fear of food, and returned to a healthy weight. But her battle with eating disorders wasn’t over yet.

“I was always told in recovery that another eating disorder could hit me at any time and it would be something I would have to fight my whole life. Being as stubborn and strong-willed as I am, I never thought that would be me.”

2 years after she started CrossFit, Becky found the pendulum swinging the other way, this time towards binge eating. During the worst of her anorexia, Becky would have a small snack in the middle of the night to help calm her hunger pains and allow sleep. Although her body had returned to a healthy weight, her brain still turned to this old habit as a stress and anxiety reliever.

Becky’s midnight snacks grew to out-of-control binges, sometimes exceeding 2,000 calories a night. She feared her weight gain would be noticeable so she started restricting during the day, which only fed the cycle. Her depression returned with a vengeance, she lacked the motivation to work out, and found it embarrassing to be around her friends from her box.

Once again, Becky’s sister was at her side to help. They moved in together so that her sister could help her control the nighttime binges, even locking food up when it became necessary to break the habit. It was a long road back to a healthy weight as Becky sought to move at a slow pace that would be sustainable for the long term and not mirror her old anorexic ways. Once again, her commitment to fitness and her community helped her overcome her demons.

These days, Becky remains very active with her box, and even married one of the owners!  She recently graduated and is helping others as a school counselor. She is a firm advocate for the physical, mental, and social benefits of CrossFit.

“I have had to learn so much about balance through this process and just how important it is in our lives. I have also learned a lot about how important finding self-worth is and not tying it to my body. My body, my weight, my looks do not determine how good of a friend I am or how academically smart I am or how good of an athlete I am. My body is not just to be seen but to be used. CrossFit gave me new goals, and PR's helped me to see my progress and make the journey to recovery worth it. I was getting better, getting stronger, and finding myself, my confidence, and my worth. I cannot thank CrossFit enough because it literally saved my life.”

I first heard Becky's story some time ago, and I think it will resonate with so many women (and men!) who find a new respect and admiration for their bodies when they focus on what it can do, rather than what it looks like. I was excited to have a chance to catch up with her to learn more about how CrossFit helped her overcome her eating disorders, how we can support others who are struggling, and how she's using her experiences to help others in her new role as a counselor.

In this episode we discuss:

  • The factors that played into Becky developing an eating disorder
  • How she realized her relationship with food was unhealthy
  • Becky’s advice on the best ways to approach a family or friend with an eating disorder
  • How she was able to safely reintroduce exercise into her routine
  • The importance of trying multiple nutritionists and counselors to find the right fit for you
  • How Becky’s calorie restriction turned into binge eating at night
  • Why community support was so important for helping Becky to heal from her eating disorder
  • Using intuitive eating to establish a healthy relationship with food
  • Using self care to overcome the self-hatred she experienced with her disorder
  • What Becky’s life looks like today
  • How her own experiences help her as a school counselor and a CrossFit coach
  • Characteristics of CrossFit that led Becky to feel like CrossFit saved her life
  • How Becky found the right balance for working out at an appropriate volume
  • Three things Becky does on a regular basis that have the biggest positive impact on her health
  • One thing she knows would have a positive impact on her health, but she struggles to implement
  • What a healthy life looks like to Becky

You can follow Becky on Instagram, and you can follow her affiliate, SouthWind CrossFit on Instagram and Facebook.

Related episodes:

Ep 85 - Back on Track with Carleen Mathews

Ep 71 - The Sugar Free Revolution with Karen Thomson

Ep 30 - Nadia Johnston on How CrossFit Helped Her to Overcome Eating Disorders and Depression

If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.

Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on September 14, 2020.

Chandler Smith: Brotherhood, Heart, Attitude, Warrior PH160

Chandler Smith: Brotherhood, Heart, Attitude, Warrior PH160

September 8, 2020

I think if I just limited myself to being an athlete I’d be doing a disservice to the other demographics that I represent.  I’m a wrestler. I’m a former West Pointer. I’m an Army officer.  All these different intersectionalities that are composed within me, and everyone has their own group of intersectionalities that they represent. That’s how you - if you want to create understanding about something that you do that’s outside of the gym - the CrossFit box is a great space for it, because again, of what you said. It’s not a responsibility, but it’s an opportunity that I think should be recognized and capitalized upon.
- Chandler Smith

In 2012, Chandler Smith set a goal to qualify for the CrossFit Games by 2022.  In 2019, he smashed that goal when he placed 15th at his rookie CrossFit Games appearance, and now he's set his sights on climbing up the leaderboard.

The path to becoming an elite CrossFit athlete hasn't always been straight-forward. As a child, Chandler had aspirations of following in his father's footsteps and playing for the NFL. But as a smaller athlete, in high school he decided to focus on wrestling, a sport better suited for his stature.

A lifelong interest in the Army led Chandler to attend West Point, where he would continue to compete as a wrestler and received the Warrior Athlete of Excellence Award in recognition of his mental toughness, coachability, perseverance, and athletic skill.

Following graduation, Chandler was commissioned as an officer and began work as a tank platoon leader.  He had previously used CrossFit to help him train for wrestling, but now it became the primary focus for his athletic drive. In 2016, he made a splash onto the competitive scene when he qualified for the Atlantic Regional after finishing 7th in his region during his first complete CrossFit Open.

In 2017, an injury resulting in the loss of part of his ring finger cut his Open season short, and in 2018, a deployment to Bulgaria meant work took priority over training. When he returned to the States, Chandler resumed training with a single-minded focus, and a stellar performance at the 2019 Rogue Invitational earned him a ticket to the Games.

Today Chandler is a Captain in the United States Army as well as the officer in charge of the U.S. Army Warrior Fitness Team. In the lead up to the 2020 CrossFit Games, he's been training with athletes from all over the east coast in an effort to get out of his comfort zone and be as prepared as possible for whatever challenges lay in store.

When Chandler and I recently caught up, I was excited to hear what his 2020 training season has looked like, how his experiences in the Army have helped him grow as a competitor, and to hear his ideas on how CrossFit can improve it's diversity, equity, and inclusion.

In this episode we discuss:

  • What Chandler’s training has looked like leading into the 2020 CrossFit Games
  • His background and childhood, and how his parents and the Army have influenced him
  • Factors that influenced Chandler to attend West Point
  • How Chandler got into CrossFit
  • The power of writing down your goals
  • How Chandler’s success at the 2016 Regionals changed his approach to training
  • His experience at the 2019 CrossFit Games
  • Chandler’s role with the U.S. Army Warrior Fitness Team
  • How COVID has impacted his 2020
  • Chandler’s decision to sit out the 2020 CrossFit Games following Greg Glassman’s comments
  • His experience at the CrossFit Community Summit and first interactions with Eric Roza
  • Diversity, Equity and Inclusion within CrossFit
  • Chandler's experience with being in the racial minority of CrossFit athletes
  • The importance of being a good role model
  • His former political aspirations
  • #BHAW: Brotherhood, Heart, Attitude, Warrior
  • Three things Chandler does on a regular basis that have the biggest positive impact on his health
  • One thing he thinks could have a big impact on his health, but he has a hard time implementing
  • What a healthy life looks like to Chandler

You can follow Chandler on Instagram and Facebook.


Related episodes:

Ep 157 - Work Hard, Be Kind with Cole Sager

Ep 147 - Cancer, Racism, and Speaking Up with Deb Cordner Carson

Ep 130 - Kristi Eramo O'Connell on Training for Joy and Balance

Ep 52b - Tia-Clair Toomey on Realizing Her CrossFit and Olympic Dreams and Finding Confidence

If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.

Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on September 7, 2020.

Exercise + Why It’s So Good For Us PH159

Exercise + Why It’s So Good For Us PH159

September 1, 2020

In this edition of the Pursuing Health Pearls, we take a deep dive into one of the last big cornerstones of health - physical activity and exercise.

Generally physical activity refers to unplanned activity that you are doing throughout the day as part of your job or daily activities, while exercise is intentional, planned, or a structured form of physical activity, but you can expect us to use these terms interchangeably throught the rest of this post.

Here, we’ll look at current physical activity patterns in the US and the world, and break down the latest Physical Activity Guidelines for Americans which were created by the U.S. Department of Health and Human Services. Then we’ll provide an overview of the amazing benefits of physical activity, and dig into the mechanisms behind why it has such a positive impact on our physical and mental health. All of the information from this article comes directly from the guidelines unless otherwise noted.

This excerpt from the introduction of the guidelines sums up the health impacts of exercise well:

“Regular physical activity is one of the most important things people can do to improve their health. Moving more and sitting less have tremendous benefits for everyone, regardless of age, sex, race, ethnicity, OR current fitness level. Individuals with a chronic disease or a disability benefit from regular physical activity, as do women who are pregnant. The scientific evidence continues to build—physical activity is linked with even more positive health outcomes than we previously thought. And, even better, benefits can start accumulating with small amounts of, and immediately after doing, physical activity.”


Physical Activity Patterns in the US

Shockingly, only 26% of men, 19% of women, and 20% of adolescents report meeting current guidelines for physical activity (both aerobic and muscle strengthening).1  This means that close to 80% of Americans are not getting enough physical activity to support their health.

This physical inactivity is linked to $117 billion in annual health care costs and 10% of premature deaths. The therapeutic potential of exercise is far-reaching given that 7 of the 10 most common chronic diseases are improved by physical activity. So, along with nutrition, sleep, and stress management, physical activity is a crucial cornerstone for health.

This pattern of insufficient physical activity is also seen worldwide, although not to quite the same degree, where 1 in 5 people are insufficiently physically active according to a 2011 study of 300,000 individuals older than 15 years old form 76 different countries.2

Physical Activity Guidelines

Now that we know there is a lot of room for improvement, we’ll break down the latest Physical Activity Guidelines for Americans. This is the 2nd edition of these guidelines published by the Department of Health and Human Services, and it was published just two years ago in 2018.


We’ll begin with some definitions to give us context as we go through the guidelines:

Intensity of Physical Activity:

  • Light-intensity: Walking at slow/leisurely pace, cooking, light household chores
  • Moderate-intensity: Brisk walk, light biking, heavy house cleaning, mowing the lawn or raking the yard (can talk, but not sing)
  • Vigorous-intensity: Jogging, running, carrying heavy groceries upstairs, shoveling snow, fast biking, or a high-intensity fitness class (cannot say more than a few words)

Examples of different intensities of physical activity. Adapted from Harvard.edu.

Types of Physical Activity:

  • Aerobic: Endurance or “cardio” characterized by increased heart rate. eg) brisk walking, running, biking, jumping rope, swimming, or rowing.
  • Muscle-strengthening: Resistance training or weight lifting, exercises that cause the body’s muscles to work or hold against an applied force or weight. eg) external weights, resistance bands, or body weight exercises.
  • Bone-strengthening: Weight bearing or loading activity that puts a force on the bone to promotes bone growth and strength, commonly produced by impact with the ground. eg) jumping jacks, running, brisk walking, jump rope, weightlifting.
  • Balance: Improves our ability to resist forces outside the body that cause falls. eg) walking backward, standing on one leg, wobble board, or weightlifting with free weights.
  • Flexibility: Enhances the ability of a joint to move through full range of motion eg) stretching, yoga.

Next we’ll review the guidelines for children and adolescents, and adults, as well as some special considerations for older adults, those with chronic health conditions and disabilities, and pregnant and postpartum women.


Preschool Aged Children (3-5 years)

The previous version of the guidelines did not address children in this age group, but evidence for improved bone health and weight in children who are active between age 3-5 years has become clear. Our sedentary lifestyles are now affecting children and younger and younger ages, so that may be why it was important to specifically address this group.

The guidelines here are very general, basically saying that kids should be active throughout the day to enhance growth and development. They should be encouraged to engage in active play that includes a variety of activity types.


Children and Adolescents (6-17)

For children and adolescents, it’s important to provide opportunities and encouragement for movement that is age-appropriate, enjoyable, and offers variety. 60 minutes or more of moderate-vigorous physical activity daily is recommended, and this should include vigorous activity, muscle strengthening activity, and bone strengthening activity at least 3 days per week each.



General recommendations for adults include encouraging them to move more and sit less throughout the day, and these guidelines acknowledge that any amount of moderate-vigorous physical activity is beneficial. Previous guidelines had suggested activity had to come in at least 10 minute intervals, but the evidence is now clear that any amount of activity provides positive health benefits.

For substantial health benefits, adults should do at least 150-300 minutes of moderate-intensity, 75-150 minutes of vigorous-intensity (or some combination of the two) aerobic activity per week. Ideally, this should be spread throughout the week. To see what this would look like, that would be a minimum of 30 minutes of moderate activity (like brisk walking) or 15 minutes of vigorous activity (like biking or running) 5 days per week, or some combination of those. It’s important to note that additional health benefits have been associated with more than 300 minutes of moderate-intensity activity per week as well. In addition to this aerobic activity, muscle strengthening activities of moderate or greater intensity and that involve all major muscle groups are recommended two or more days per week.


Older Adults

The guidelines for older adults are the same as adults, but include a few extra points.

  • Part of weekly physical activity for older adults should include multicomponent activity that includes balance training as well as aerobic and muscle-strengthening activities.
  • The level of effort should be relative to their level of fitness.
  • When they can’t do 150 min of moderate intensity activity per week because of chronic conditions, they should do as much as they are able.

This sounds a lot like CrossFit, doesn’t it? Constantly varied, functional movements, done at intensity that is relative to the individual.


Pregnancy + Postpartum

For pregnant and postpartum women, at least 150 minutes of moderate-intensity aerobic activity per week spread throughout the week is recommended. If the woman engaged in vigorous intensity aerobic activity before pregnancy, she can safely continue during pregnancy and postpartum.

It is also important to note that the guidelines recommend pregnant and postpartum women should be under the care of a healthcare provider who can monitor the progress of the pregnancy, and they should consult their health care providers about whether or how to adjust physical activity during pregnancy and postpartum.


Adults with chronic health conditions and disabilities

The recommendations for this group are the same as adults, but if they are unable to meet those guidelines they should engage in regular physical activity according to their abilities and avoid inactivity. Basically, something is always better than nothing. Adults with chronic health conditions and disabilities should be under the care of a health care provider when engaging in exercise, and they should consult with a healthcare professional or physical activity specialist about the types and amounts of activity that are appropriate for their abilities and chronic conditions.

Physical Activity + Safety

One of the big deterrents for many considering starting an exercise program is a fear of injury or heart attack. The guidelines specifically address this issue, stating that studies in generally healthy people clearly show that there is low risk with moderate-intensity activity.

The risk of injury does increase with the total amount of physical activity, which makes sense. For example, someone who is running 40 miles per week has higher risk of injury than someone running 10 miles per week. Not surprisingly, there is also higher risk of injury in contact or collision sports such as soccer or football.

It is also important to note that those who are less fit are more likely to be injured than those who are more fit when doing the same activity. For example, cardiac events (heart attack or sudden death) are very rare during physical activity, but the risk does increase when a person suddenly becomes more active than they were previously. The greatest risk comes when an adult who is usually inactive engages in vigorous intensity activity (for example, shoveling heavy snow). People who are regularly physically active, however, have the lowest risk of cardiac events both during activity and overall. In order to minimize this risk, it’s important for someone who is deconditioned and starting to ramp up their activity to “start low and go slow.”

The bottom line is that the health benefits of physical activity far outweigh the risks of adverse events for almost everyone, and we also have to weigh the risks of being inactive, such as increased risk of chronic disease, decrepitude, and injury or heart attack when life does demand for us to suddenly exert ourselves.

Here are some ways that the guidelines suggest to minimize risk:

  • Choose types of physical activity that are appropriate for current fitness level and health goals
  • Increase physical activity gradually over time to meet key guidelines or health goals. “Start low and go slow” with lower intensity activities and gradually increase frequency, duration, and intensity over time. Consider one-on-one instruction when learning something new.
  • Use appropriate gear and sports equipment, choose safe environments, follow rules, and make sensible choices about when, where, and how to be active.
  • Consider air quality when planning to be active. Exposure to air pollution is associated with health problems including asthma attacks and cardiac events. If possible, modifying the location or timing of exercise outdoors to avoid heavy traffic and industrial sites especially during rush hour or high pollution times can improve safety. The Environmental Protection Agency Air Quality Index (AQI) provides information about when air conditions are unhealthy that can be accessed here.
  • And as a reminder, those who have a chronic health condition, symptoms, or are pregnant, should be under the care of a healthcare provider and consult with their health care provider or trainer about types and amounts of activity that are appropriate for them.


Physical Activity and Our Health 

Now that we know the guidelines and some parameters for implementing physical activity safely, we’ll review what we know about how physical activity impacts our health.

Most striking is the impact of physical activity on all-cause mortality, or death from any cause. To put some numbers to this, it’s estimated that people who are active 150 minutes/week have a 33% lower risk of death from all causes than those who are not physically active.

The graph below compares amount of physical activity per week and mortality. As you can see, the highest mortality (or risk of dying) is over on the top left, when someone is not physically active at all. From there, there is a pretty steep drop off - where going from no physical activity to just small amounts of physical activity results in a large reduction in risk of dying. Most of the benefit of physical activity on mortality risk is achieved by the time you get to 150-300 minutes/week, which is how the guidelines were derived. However, there does seem to be additional benefit and no increased risk of mortality even at very high levels of physical activity (3-5x the amount recommended in the guidelines).


Relationship of Moderate-to-Vigorous Physical Activity to All-Cause Mortality from the 2018 Physical Activity Guidelines for Americans.


Aside from decreased risk of death, regular physical activity has many other specific health benefits which are outlined in the table below:

Health Benefits of Regular Physical Activity from the 2018 Physical Activity Guidelines for Americans.



Cardiorespiratory + Metabolic Health


Cardiorespiratory and metabolic health are the areas that have been most heavily researched and where the benefits of regular physical activity are abundantly clear. Physical activity strongly reduces both the risk of developing and dying from cardiovascular disease including heart attack, stroke, and heart failure.

Exercise also reduces elevated blood pressure, an effect that can be observed immediately after just one bout of physical activity. Regular physical activity can also reduce the risk of developing high blood pressure in the future.

Regular physical activity also reduces the risk of developing type 2 diabetes. Insulin sensitivity can improve with just a single bout of physical activity. Physical activity also helps to control blood glucose in people who already have type 2 diabetes, and reduces the progression of the disease.

Lower triglycerides and higher HDL are also observed in those who exercise regularly. Physical activity can also help with weight gain, but it’s important to note that a lot of the benefits of exercise are independent of weight. So, even if someone is not losing weight while exercising, they are still experiencing a lot of health benefits.


Bone and Musculoskeletal Health

Exercise also plays a big role in the health of our muscles and bones. We know muscle strengthening exercises help to preserve or increase muscle mass, strength, and power and can also improve muscular strength in people with conditions where the musculature is affected such as stroke, MS, cerebral palsy, and spinal cord injury.

When it comes to bones, regular exercise helps us to build strong bones as we are growing up, and it also helps to reduce the decline in bone density that is often seen with aging. Improved symptoms of osteoarthritis and other bone conditions, pain management, function, and quality of life are also seen in those who are physically active. In particular, having arthritis can often be a deterrent to doing exercise, but regular physical activity is associated with decreased pain, improved physical function, and improved health-related quality of life in those with osteoarthritis, and being active does not seem to make the arthritis progress any more quickly than it would otherwise.


Functional Ability and Fall Prevention 

Physical activity is critical for functionality and the prevention of falls in older adults. Physical activity can prevent or delay the onset of functional limitations that necessitate the need for assisted living or 24/7 care in a nursing home.

Physical activity also reduces the risk of falling which can result in injuries that dramatically change one’s quality of life. Hip fractures are one example of this. An all-too-common story is an elder who falls and breaks their hip after which they never return to the same baseline, end up needing support for their activities of daily living, and continue to experience a decline in health until the end of life.

For those at risk for these kinds of injuries, multi-component physical activity programs including muscle strengthening, balance, gait and coordination, and moderate-intensity activities such as walking are most successful at reducing falls and injuries. This type of exercise is also beneficial for recovery of injuries such as hip fractures as well as neurological conditions such as Parkinson’s Disease and stroke.


Brain Health 

The positive benefits of physical activity are clear, and this is an exciting and continually emerging area of research.

Some of the benefits of exercise on the brain are immediate, after just one bout of exercise. These include: reduced anxiety, improved sleep, and improvements in some aspects of cognitive function such as performance on academic achievement tests, executive function, processing speed, and memory.

Regular physical activity over the course of days to weeks is also associated with the following improvements: long term anxiety, deep sleep, sleep quality, sleep efficiency, and daytime sleepiness, decreased use of medication to facilitate sleep, aspects of executive function such as the ability to plan and organize, monitor, inhibit or facilitate behaviors, initiate tasks, and control emotions, reduced risk of dementia, improved quality of life, and reduced depression.



Physically active adults have a significantly lower risk of developing several common types of cancer including:

  • Breast
  • Colon
  • lung
  • Bladder
  • Endometrial
  • Esophagus
  • Kidney
  • Stomach

Benefits are also seen in breast, colorectal, and prostate cancer cancer survivors with regard to quality of life, and the risk of dying from their cancer as well as all other causes.


Pregnancy + Postpartum

Finally, with regard to women during the pregnancy and postpartum periods, physical activity is generally safe and reduces risk of excessive weight gain and gestational diabetes during pregnancy. It increases cardiorespiratory fitness without increasing risk of negative birth outcomes such as low birth weight, preterm delivery, or early pregnancy loss. In the postpartum period, physical activity decreases symptoms of postpartum depression and can improve the return to pre-pregnancy weight.


Risks of Sedentary Behavior 

Now that we’ve reviewed all the wonderful positive impacts of exercise on our health, we’ll highlight the increased risk that comes from not being physically active, or from sedentary behavior.

We’ve all heard the phrase “sitting is the new smoking” by now, and it’s well deserved - sedentary behavior poses a tremendous health risk.

What does sedentary behavior actually mean? Sedentary behavior includes waking behavior with low energy expenditure, in a sitting, reclining or lying position, which may include TV or other screen time.

Relationship among moderate-to-vigorous physical activity, sitting time, and risk of all-cause mortality in adults from the 2018 Physical Activity Guidelines for Americans.


The National Health and Nutrition Examination Survey estimates that children and adults in the US spend 7.7 hours per day sedentary. According to the study, that’s more than half of the time they are awake! The prevalence of sedentary professions has increased by 20% in the United States between 1960 and 2008, with a simultaneous decline of more “physically active professions.”3 This may explain, in part, why we are now facing such an epidemic of sedentarism and chronic disease.

More time spent in sedentary behavior increases the risk of all-cause mortality, cardiovascular disease mortality, cardiovascular disease, type 2 diabetes, and cancer of the colon, endometrium, and lung.

A large 2016 meta-analysis study which pooled 16 studies looking at over 1 million people demonstrated that increased daily sitting time and decreased moderate-vigorous physical activity increased all-cause mortality risk.4 The heatmap above used data from this study to plot all-cause mortality risk based on both daily sitting time and the amount of moderate- to vigorous- physical activity.

From all of this data, it is clear that two different approaches are both necessary to decrease all-cause mortality risk: 1) increasing the amount of moderate- to vigorous- physical activity done per week and 2) reducing the time spent sitting (replace with light-intensity activity). Two ways we personally like to do the latter are using standing desks, and the Pomodoro Technique as a way to take regular breaks and move around.


Comparison of Exercise and Pharmaceuticals

Next, we’ll review the impact of exercise relative to pharmaceutical drug interventions we have for certain chronic diseases. When making such comparisons, it is important to note that exercise does not benefit just the specific condition the drug is treating and what is being studied. As we’ve reviewed above, exercise has a wide range of positive side effects from improved mood, to decreased cancer risk, to decreased frailty and fall risk. So even if exercise is equally or even slightly less effective than a pharmaceutical drug (that comes with its own unwanted side effects), many people may still opt to incorporate exercise if given the choice.

A 2015 study that looked at 16 meta-analyses including over 305 randomized controlled trials with over 300,000 participants found that physical activity was more effective than drug interventions among patients with stroke.5 The drug interventions they looked at included antiplatelet drugs such as aspirin or plavix and anticoagulants such as coumadin. Additionally, they found no difference in mortality outcomes between exercise and drug interventions for secondary prevention of heart disease  (i.e. trying to prevent cardiac death after already having been diagnosed with heart disease), or prediabetes.

Finally, a separate review of randomized controlled trials comparing exercise to antidepressants showed that exercise and antidepressants were equally effective for depression.6


The Mechanisms: How Physical Activity Impacts Our Health7

Here, we will review 3 main mechanisms by which exercise improves our health:

  1. Optimizing the stress response
  2. Reducing inflammation
  3. Enhancing brain health


A Review of the Stress Response

We’ve talked about the stress response in many previous episodes, but essentially it is composed of two different systems:

  • The Hypothalamic-Pituitary-Adrenal (HPA) Axis, which releases glucocorticoids including cortisol
  • The Autonomic Nervous System (ANS), which includes the sympathetic nervous system that releases chemicals like epinephrine (adrenaline) and norepinephrine

Activating these systems in response to an acute stressor (such as getting chased by a tiger, or slamming on your breaks at the last minute to nearly miss a car accident) then coordinates the response of other systems (cardiovascular, musculoskeletal, GI, immune, nervous) in a fight-or-flight response that includes mobilization of energy or glucose, increases in heart rate and blood pressure, enhanced cognitive processes such as alertness, arousal, vigilance, and attention, and a coordinated inflammatory response to prepare for potential injuries or infections.

However, chronic long-term activation of this fight or flight response results in persistent activation of these systems, which can lead to chronic systemic inflammation and a whole host of chronic health conditions.


Optimizing the Stress Response 

Acute exercise activates the stress response in a dose-dependent manner (that means higher intensity or longer duration exercise results in a more robust stress response). This may seem counterintuitive, however, over time this can be a good thing.

It turns out that although exercise acutely increases the stress response, repeated, intermittent exposures to exercise, with enough time to recover in between, can lead to physiological “stress training”, meaning we develop a more optimized response when we encounter exercise or other stressors in the future.

This is an example of the concept of hormesis, which is the notion that low levels of cellular stress (whether from exercise, toxins, temperature changes, or other factors) stimulate or upregulate existing cellular and molecular pathways that improve the ability of cells and organisms to withstand greater stresses.

An untrained person initially mounts a dramatic stress response to exercise, but after training, the stress response to the same physical stimulus is lower. Not only is the response to physical stress lower, but regular activity seems to provide protection against mental and/or psychological stressors as well. Regular physical activity results in greater control of the parasympathetic system (the “rest and digest” part of the ANS that counters the “fight or flight” effects of the sympathetic nervous system). This is why those who engage in regular activity are also found to have lower heart rate and blood pressure readings at rest. Additionally, higher physical fitness is also associated with a more optimized immune response.


Reducing Inflammation 

In addition to optimizing the stress response, exercise also plays a role in reducing the chronic systemic inflammation that is seen in states of metabolic dysfunction and chronic disease. For example, inflammatory biomarkers such as C-reactive protein (CRP) are lower in those who engage in regular physical activity compared to those who are inactive. Regular exercise has been shown to reduce brain inflammation in response to insults such as stroke or infection.

This reduction in inflammation could be at least in part due to a reduction in visceral fat mass, which we know releases many pro-inflammatory chemicals, but there also seems to be an anti-inflammatory effect separate from the reduction in fat mass that may come with regular activity.

Interestingly, we know that a specific chemical called IL-6, when released from contracting skeletal muscle promotes an anti-inflammatory environment. More IL-6 is released with increased intensity and duration of exercise. Although IL-6 has a proinflammatory effect when released from other tissues such as adipose tissue, when released from skeletal muscle it has been shown to have anti-inflammatory effects.


Enhancing Brain Health 

A final mechanism by which exercise improves our health is by enhancing brain health. Chronic stress with persistent cortisol exposure has detrimental effects on brain including: reduced volumes of certain brain regions such as the hippocampus and prefrontal cortex, decreased expression and signalling of neurotrophic factors (factors that improve cell growth, survival, and repair), reduced generation of new neurons and their supporting cells called glial cells, depression, and impaired cognitive function.

Regular exercise, on the other hand, has been shown to enhance positive mood, decrease depression and anxiety, and increase cognitive function. This occurs by two major mechanisms:

  • Structural: Regular exercise results in increased neurogenesis, synaptogenesis, gliogenesis, angiogenesis. This means increased production of brain cells, more connections between those cells, increased surrounding support cells, and more blood vessels to bring nutrients and take away waste from the brain cells as they do their job. Structural brain changes seen with regular exercise include: increased grey matter volume and white matter integrity (especially in the prefrontal cortex and hippocampus), and decreased age-related hippocampal volume loss.
  • Cellular and Molecular: Regular physical activity results in increased expression of growth factors and neurotransmitters, which results in improved function and communication between neurons.

Together both of these mechanisms help to enhance neuroplasticity, or the ability of the brain to learn and make new connections between neurons, and may be able to reduce or reverse some of the detrimental effects of chronic stress on the brain.

Brain-derived neurotrophic factor (BDNF) is one of the most important and widely studied growth factors when it comes to the impact of exercise. BDNF supports the survival of existing neurons and promotes the growth of new neurons and connections. Low levels of BDNF are found in many chronic disease states and metabolic conditions associated with insulin resistance including neurodegenerative diseases like Alzheimers, major depression, impaired cognitive function, cardiovascular disease, type 2 diabetes, and obesity. Enhanced BDNF levels are associated with improved metabolism and cardiovascular function, and decreased risk of Alzheimer’s. BDNF levels are downregulated by chronic stress and inflammation, but exercise has been shown to significantly increase BDNF production in the brain, which then circulates to the rest of the body.8


In summary, a great majority of our US population is not getting enough physical activity to substantially benefit their health. The ways that increasing physical activity and decreasing sedentary time can improve our health are numerous, and we reviewed the most recent guidelines for Americans to reap these benefits. Regular exercise can have similar effects to pharmaceutical drugs for some common conditions like stroke, heart disease, prediabetes, and depression. Exercise exerts its health benefits through three major mechanisms: optimizing the stress response, reducing inflammation, and enhancing brain health.

When it comes to helping a friend or family member get started with exercise, interventions that are based in behavior change theory are usually most successful. Some that we have found most useful are the stages of behavior change, motivational interviewing, and solution focused therapy. Generally, community or peer support is helpful for creating sustained change. Technology can provide feedback or remote coaching and guidance to someone starting a new program. Most importantly, we find that helping someone to tie their physical activity goals to their values and what’s most important to them in life is the key to finding long term success.

We also recognize that we have a lot of work to do to improve the ability of our population to be more active on a community level. Working with our communities to make doing physical activity a safe and easy choice is something we can all strive to do.


Related episodes:

Ep 132 - Healing Through Functional Movement with Dr. Amy West

Ep 139 - Stress: The Elephant in the Room with Dr. George Slavich


If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.


Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on August 31, 2020.

Eric Roza: CrossFit’s new CEO on Health, Happiness, and Performance PH158

Eric Roza: CrossFit’s new CEO on Health, Happiness, and Performance PH158

August 25, 2020

So, you have this term sheet, and the term sheet is non-binding, either party can walk away.  The most important part of it is that you’re agreed on some basics for the transaction, and there’s what’s called a no-shop or exclusivity period. Usually lawyers write that, and that says that the seller can’t talk to anybody else. You can do a lot of work, spend a lot of time, spend a lot of money figuring out how this is going to happen.  So, instead of talking to any lawyers, I just said I’m going to write this myself right from the heart. So, I wrote - I basically said, “Greg, please don’t shop this deal or try to negotiate it in anyway. I’m not commodity money. I’m a passionate [person] who wants to spend the rest of his life building on your legacy.” And, it was my first version of this notion of being the world’s leading platform for health, happiness, and performance.
- Eric Roza

When CrossFit, Inc. announced that Eric Roza would be taking over as the new owner and CEO, the news was met with excitement and enthusiasm from the CrossFit community. As a longtime CrossFit athlete and affiliate owner, he has experienced first-hand the power of CrossFit to forge bonds and bring people together, as well as the challenges facing affiliate owners.

Eric brings much more than just a passion for CrossFit to the table.  He has a wealth of experience as an entrepreneur, business owner, executive, and consultant.

Eric studied Economics at the University of Michigan, and completed his Masters of Business Administration at Stanford University Graduate School of Business.  In 2007 he founded Datalogix and served as CEO until the company was acquired by Oracle in 2015.  From there he led Oracle's Data Cloud.  Most recently he's served as an executive in residence for a venture capital firm and taught entrepreneur leadership as an adjunct professor at the University of Colorado Boulder.

Eric is also an active board member for several organizations and supports charitable efforts focused on mental healthcare, education, and entrepreneurship.  In his downtime, he enjoys working out with friends, skiing, mountain biking, running, singing, and playing guitar with his band, The House Cats.

I first met Eric about a month ago, and we immediately connected over his vision to make CrossFit “The world’s leading platform for health, happiness, and performance." I was excited to catch up with him to learn more about the behind-the-scenes process for taking over as CrossFit CEO, the key elements that have played a role in the transition, and his vision for the future of CrossFit.

In this episode we discuss:

  • Eric’s fitness background and how he found CrossFit
  • How CrossFit has impacted his mental health
  • Eric's dream of owning CrossFit, and how that dream materialized
  • How he assessed what needed to be done to transition CrossFit to new leadership
  • The importance of identifying and communicating with stakeholders
  • The inception and evolution of the CrossFit Community Summit
  • The biggest priorities for CrossFit at the moment
  • CrossFit's new mission to become, "The world's leading platform for health, happiness and performance."
  • Why CrossFit for health and CrossFit for performance are not separate entities
  • The notion of thinking “in the box” vs “out of the box:” expanding the idea of what a CrossFit box is, and bringing CrossFit to different audiences
  • Who will be driving the decision-making process of CrossFit moving forward
  • Three things Eric does on a regular basis that have the biggest positive impact on his health
  • One thing he thinks could have a big impact on his health, but he has a hard time implementing
  • What a healthy life looks like to Eric

You can follow Eric on Instagram, Facebook and Twitter.


Related episodes:

Ep 58 - Nicole Carroll On the Early Days and Preserving the Culture of CrossFit

Ep 118 - The State of CrossFit with Coach Greg Glassman

Ep 131 - Dave Castro on Changes in Life and the CrossFit Games

If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.

Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on August 24, 2020.

Be Kind, Work Hard with Cole Sager PH157

Be Kind, Work Hard with Cole Sager PH157

August 18, 2020

When you think of the CrossFit community, you think of people who are going to the gym to challenge themselves, to be better than they were the day before, and that is such a cool part of the community, and it’s what I fell in love with.
- Cole Sager


6-time CrossFit Games athlete Cole Sager wants to be known as the kindest person you'll ever meet, and in doing so, he hopes to motivate others to be the kindest, hardest-working version of themselves.

Growing up in a small town in Washington, Cole played sports throughout his youth and aspired to be an NFL player.  In 2009 he joined the Washington University Huskies as an invited walk-on, and was one of only a handful of true freshmen to play.  At the end of his freshman year, he was awarded the Scout Special Teams Player of The Year award, an honor that would change the trajectory of his life.  The honor was awarded based on hard work, and receiving it ignited Cole's drive to always be the hardest worker on the field.

As Cole neared graduation, his goals shifted from playing professional football to becoming a professional CrossFit athlete. Within months of his first CrossFit workout he qualified for Regionals, and just one year after that he established himself a serious contender when he placed first at the 2014 North West Regional and 17th in his rookie appearance at the CrossFit Games.

Eventually, Cole took a leap of faith, resigned from his job as a loan originator, and began training full-time in his home garage gym.  With the support of his wife, Genasee, and his coach, Ben Bergeron, he has built a reputation as one of CrossFit's most consistent athletes.  Career highlights so far include placing 5th at the 2016 CrossFit Games, 2nd at the 2019 Fittest in Cape Town sanctional, and 3rd at the 2019 Rogue Invitational, but according to Cole, one of his biggest achievements was winning the Spirit of the Games award in 2017, an honor that recognized all the hard work he puts into developing his character.

I was excited to catch up with Cole to learn more about what drives the intensity behind his training, the qualities he values in himself and others, and why he believes developing character leads to athletic excellence.

In this episode we discuss:

  • How Cole is approaching the 2020 CrossFit Games
  • How he stays focused on his goals in the face of doubt
  • Cole’s collegiate football career
  • Letting go of NFL aspirations and falling in love with CrossFit
  • Cole’s experience of getting to his first CrossFit Games
  • How he started working with Ben Bergeron as a coach
  • The qualities of a good coach
  • How Cole has developed as a person over the course of his CrossFit career
  • How he stays driven to train even on days he doesn’t feel like it
  • The importance of accepting help from others to hold yourself accountable
  • How Cole’s wife, Genasee, is a vital part of his team
  • A typical day for Cole and Genasee
  • Three things Cole does on a regular basis that have the biggest positive impact on his health
  • One thing he thinks could have a big impact on his health, but he has a hard time implementing
  • What a healthy life looks like to Cole

You can follow Cole on his website and on Instagram, YouTube, Facebook and Twitter.


Related episodes:

Ep 54 - Neal Maddox: From Football to Forty

Ep 56 – Katrín Davíðsdóttir and Ben Bergeron on the Process of Creating a Champion

Ep 76 - Working Against Gravity with Adee Cazayoux

Ep 84 - Chasing Excellence with Ben Bergeron

If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating. I’d love to hear your feedback in the comments below and on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health every other Tuesday.

Disclaimer: This podcast is for general information only, and does not provide medical advice. We recommend that you seek assistance from your personal physician for any health conditions or concerns.

This post was originally published on August 17, 2020.

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