Book Review: Fight The Fat

Omastase shimashita! This is the Japanese phrase for "sorry to keep you waiting". I had problems creating post on the blog on my laptop that I resorted to use my wife's laptop. Well here's the book review as promised.

This is my first attempt at a book review. Please feel free to give me your comments or share it with your friends if you like it.

Book Review : Fight the Fat – What You Must Know and Do to Lose Weight
Author: Dr Ben Tan
Price: S$25.20
Available at all major book stores

Brutally honest! This is my first impression of Dr Ben Tan’s book on weight management. After going through the book, I find that this book is not only relevant for all people concerned about weight, but is also an excellent reference for exercise trainers.

The book advocates 3 pillars of dietary restriction, discretionary exercise and incidental daily activities as essential means to the end of weight loss. One would have to work towards a target of incurring an energy deficit of about 1,000 kcal per day. This works out to about a loss of 1.0 kg of body fat (7,700 kcal) per week, which is in line with the guidelines of the American College of Sports Medicine (ACSM).

1000 kcal per day means that you have to run 1 hour 25 minutes daily or brisk walk 2 hours 30 minutes. Wow! This is near impossible for someone who does not exercise regularly and he/she would have given up without even trying. Hence, the person trying to lose weight would not only have to exercise but also to reduce his / her food intake, and to increase his/her daily activities (which mean less lying on the couch or driving the car). Thus, the 3 pillars of diet, exercise and daily activities as mentioned above. There is no short cut, which is what I have been telling my clients.

The part I like most about this book is the chapter on separating facts from myths. The book rebutted many promotional gimmicks for slimming products and services used to trick consumers. One common trick is that the slimming product or service would claim that someone lost weight after taking the product or service. However, this claim would be given little weight in the scientific community as there is no mention of sample size and percentage of success, etc. One person could have lose weight after taking the product, 9 other persons may not! Similarly, slimming centres do not publish the number of clients who do not lose weight or gained weight after engaging their services.

The “Before and After” gimmick usually employed to capture consumer’s attention was also shot down in the book. A question was asked on how much fat this person (see picture) lost? The answer is of course “None”.
Why? Read the book for yourself, else I’ll be sued for copyright infringement.

Of course, it is not easy for a person trying to lose weight just by doing all the action plans written in the book by himself / herself. However, this book provides him/her a good understanding of the foundations, methods, reasons and obstacles regarding weight loss, and it addresses the motivational factor too. There are also some good templates and action plans provided by the book.

For the exercise trainer, these templates and action plans are very useful. The book also provides tables on the caloric values of selected local food items which would come as a handy reference. There is a section on exercise-related injuries which I think would interest trainers, since many obese individuals have weight-related musculoskeletal injuries.

On another note, Dr Tan advises that one would be better off focusing on cardiovascular exercise to lose fat as it is difficult to significantly increase resting metabolic rate by gaining enough muscle mass through weight training. Thus, the book does not have examples of weight training techniques or methods.

From a weight loss point of view, I would agree with him. But from a motivational point of view, I think it may be good to incorporate some weight training exercises such as wall push up or core work. Gain in strength is usually faster than weight loss (due to neuromuscular adaptation) and I think this could encourage the person to work harder or carry on the program since he/she can see some improvements of his/her fitness.

All-in-all, I have more positive comments for this book and I would recommend it for people who are trying to lose weight to get one. Wish you all the success in managing your weight!


Book Review Written by:



Koh Mui Tee
Diploma in Sport & Exercise Sciences
American College of Sports Medicine Certified Personal Trainer
Singapore Sports Council Certified Fitness Instructor


P.S. If you are keen to lose weight or gain fitness or have any enquiries on exercise-related matters, please call Mui Tee at 9477 3180 or email at muitee@singnet.com.sg. Thank you.

Fight the Fat

Bought the book "Fight the Fat" written by our famous Dr Ben Tan, Asian Games gold medallist today.

Glanced a few pages and find that it is quite interesting, well written and relevant for all people concerned about weight and all exercise trainers.

I will finish the book fast and give you a book review by this weekend.

The Monk's Teachings

Someone taught me this. I think it is very interesting:

A teaching by a monk whereby he says; "If someone tells you your nose is crooked, why should you get angry? If it is the truth, why get angry with the truth? And if it is not true, why is there the need to be angry?"

Anger management, not that I need one.

5 away defeats!

The whole Liverpool team played crap football in tonight's loss to the Arse-nal. Bloooooddy pissed off! I am still up at 2.50 am! Can't believe they played so poorly away from home.

losses to bluenoses, bolton, chelski, manure and arse-nal. wah piang!

Title contenders, my foot!



P.S. I make no apologies for any offensive comments here, it is the Liverpool team that should apologise.

Fitness Improvements

Quite busy this week. Just a quick update to say that my NKF patients showed great improvements after 12 sessions of training.

Most of the patients walked about 500 metres in the 6-min walk tests in July but most of them managed more than 550 metres with some clipping 600 metres last weekend. Not only physically, they have also feedback to me that they benefitted psychologically and socially.

Very happy for them. Share my joy.

Know what you are doing

I had the last of my 12 sessions with the NKF patients last weekend. I will conduct a fitness assessment this weekend before getting in new patients for the next programme.

In the last session, I went through the safety aspects of exercise for the patients again as I did in my first session. For example, as many of the patients are hypertensive, I reminded them not to do strenuous exercise and not to hold their breath (valsalva maneuver) while exercising. It is imperative that patients with chronic diseases know what they are doing and what they cannot / should not do. For instance, hypertensive patients would have their blood pressure shot up if they hold their breath for sometime. This may lead to a stroke!

I always feel that educating my clients/patients is a very important part of my profession. This does not apply only to patients but also to the general public / athletes. I have come across athletes who do not stretch properly or do not know what muscles they are stretching. Also many of them have neglected stretching due to time constraints. This may have led to many tight hamstrings, calf muscles, ITB which could be the causes of injuries. Improved flexibility may also lead to better performance, although this is not guaranteed. But it would reduce the risk of injuries.

Similarly, for the general public, education about sports / fitness is very important. Many people have done crunches in order to reduce the abdominal fat. They do not recognise that crunches is a strength training exercise, not a cardiovascular exercise. Strength training exercises work primarily the muscles, not the fat. So crunches build your ab muscles. If your ab muscles are covered by a layer (or many layers) of fat, how could you show your ab muscles? You have to watch your diet, jog/swim/cycle/walk more to reduce this fat so you can get rid of your tummy. The formula is easy, take in less calories, expend more calories.

Many friends have also asked me about the various diet. The truth is that all diets work! This is because diet works on reducing calories. In the short term, you created a calorie deficit and lost weight. However, dieting is normally not sustainable as diets usually meant a shortage in certain food content, such as vitamins/minerals. This may lead to other problems as the diet is not balanced. ACSM (American College of Sports Medicine) recommends a combination of both diet and exercise for effective weight management.

Thus, if you want to achieve your objective, you must know what you are doing and what you should not be doing. This concept is frequently applied in working life, but this applies to exercise too!

Sick

Have been sick this couple of days due to running nose and sore throat. I think I passed the flu to my wife too who is having a bad throat today.

Hope to get well soon and back to my training again.

I will come back with further updates a couple of days later.

Pounding on Pavement

Running season, many running questions and comments.

One common comment that I heard is that the runner should not run too much on the pavement so that he / she can have less leg injuries such as knee pain or shin splint due to the pounding on the pavement.

This is quite true. Remember your physics lessons? Newton's 3rd law (bet you might have prayed for durians to drop on Newton rather than apples when you were studying physics) states that for every force, there is an equal and opposite reaction force. Thus, for every stride you take on the pavement, there is a reaction force back to your foot. So imagine the impact on your leg.

So how do you reduce the impact? There are a few ways -

(1) Run on treadmill
(2) Run on grass
(3) Run on sand

Although running on treadmill can be boring for some runners, it offers quite a lot of benefits for training. For example, you can monitor your pace closely with the speed control or increase intensity by increasing the gradient. You can also practice 2 training methods on the treadmill - LSD (long slow distance) and interval training.

In LSD training, the exercise continues as long as you are able to maintain your heart rate within the prescribed zone and energy is available. LSD is performed at an intensity less than that normally used so that the duration of the workout can be longer. The goals of LSD training include development of endurance in supporting musculature, and fat utilization within corresponding glycogen (carbo) sparing. Typical training sessions last between 30 minutes and 2 hours. To prevent overtraining, LSD should not take place more than twice a week. LSD is suitable for beginners, athletes recovering from injury and special population such as the elderly. LSD is also suitable for long distance runners or swimmers.

I have talked about interval training or sprint training in an earlier blog. Interval training can be quite tough and I would recommend that you build up a certain level of fitness before you try this form of training, either on the treadmill or outdoors. Interval training is suitable not only for runners, but also other sports such as football, rugby, tennis, etc.

If you still find running on treadmill boring, you can try to run on grass or sand or hilly places. This is a form of training called the Fartlek training. If I did not remember wrongly, it is invented by the Swedish? Swiss? Can't recall, anyway not important for you, right?

Unfortunately, Singapore do not have much lush greens for us to run on grass. Probably you can try Bishan Park or find any football fields and run around it. MacRitchie's ground is actually rather hard. Another place to do Fartlek training in Singapore may be Sentosa Island where you can run on sand or hills. East coast may also be a place for you to run on sand. The sand would absorb much of your impact when you run, thus, you would need more leg power (quadriceps / hamstring / calves) to run.

Don't just run and run, remember to rest and recover properly too.

The Most Expensive Parking Lot in Singapore?

I brought my mum to Fort Canning Park for a Friday morning walk yesterday. While we were passing by car park B, we saw this parking sign depicting S$100 for 1/2 hourly parking! So funny.

Fort Canning Park is a lovely place to walk. You could get up from the steps beside MICA building; or from the steps opposite Liang Court or if you are not keen with steps, the slope is slightly less challenging from the Registry of Marriages. You may see some historical sites and cannon.

The top of the hill is about 7 or 8 stories high. If my mum, 68, can get up there without any problems, you can too! There is a fort which you can climb up to as well at the top of the hill. Find it for yourself if you go there.

The Importance of Stretching

The Stanchart Marathon is on 3 Dec 06 (Sun) and is about 8 weeks away. I met a few runners who have come to me for post training recovery massage and to release tight muscles such as hamstrings and ITB (Iliotibial Band).

I realised that some of them are not aware that proper stretching is a necessary part of the training. One of the benefits of stretching, as many are aware, is to increase flexibility as muscles may be tight after a whole day of sedentary work or after some exercise.

Stretching can also help recovery as to reducing muscle soreness (DOMS or delay onset of muscle soreness), which occurs one or 2 days after a heavy bout of exercise. To verify this, I skipped stretching after my 30 minute run a couple of months ago. For the next few days, I experienced muscle tightness in my legs that I have not had before. I kept stretching and stretching to relieve the tightness. After this verification, stretching reaffirmed as a compulsory part of my routine after exercise.

It is also claimed that stretching may help to prevent injuries. This is not true, stretching cannot prevent injuries, but it may help to reduce the risk of injury. How does stretching do so?

As I have mentioned above, stretching helps to relieve muscle tightness. One less known fact for laypeople is that muscles usually work in pairs. For example, the biceps and the triceps; the quadriceps and hamstrings. In technical terms, we call this the agonist (prime mover, eg, biceps in a biceps curl) and the antagonist (triceps in a biceps curl). This is a wonder of the human body creation that made sure our body movements are controlled. However, I am not talking about movement kinetics in this article. So, back to stretching.

One of the common causes of sports injuries is muscle imbalance. If the quadriceps are heavily worked on but the hamstring are weak(as in the case of many runners), there is an increased risk of hamstring pull or strain. Thus, stretching and strengthening exercises must be done on both the quadriceps and hamstring muscles to prevent muscle imbalances.

Another common injury is the ankle injury which I have talked about in an earlier article. The key pair of muscles for the ankle movements (such as tip toe or plantar flexion) are the calf muscles (gastrocnemius and soleus) and anterior tibialis (located on the shin). Many people do not work on the calf muscles, not to say the anterior tib which is less known. This unawareness may also lead to another injury called the shin splint, which is pain along any part of the shin.

So if you are running for leisure or for marathon training, what are the muscles in the lower limb you should stretch? These are the more important muscle groups I think you should stretch:

(1) Quadriceps
(2) Hamstring
(3) Outer calf (gastrocnemius)
(4) Inner calf (soleus)
(5) Anterior Tibialis (major muscle on the shin)
(6) Outer Thigh (Iliotibial Band and abductors)
(7) Inner Thigh (adductors)
(8) Hip Flexors (Iliopsoas)
(9) Hip Extensors (Gluteus group or butt)
(10) Piriformis (deeper glute muscles)

Don't know how to stretch? Call me, email me or drop me a comment here...

If you need a rub down (massage) after your training or strength and conditioning advice for your training, contact me too.

Chester

Liverpool FC announced today that they have opened a merchandise store in Chester, an hour's drive from Liverpool. It brings back memories of my trip to Liverpool in Nov 2003. As part of the trip, we went to Chester to watch a reserve game and toured Chester before the game. I attach some lovely pictures here for your pleasure viewing.

The lovely ladies in the picture are my wife, Regina and my mum.

Fit the Bill

As a fitness professional, I was looking forward to see the program when I found out about this Channel U Fitness Reality Program - Fit the Bill 人健人爱 hosted by Mr Vincent Ng 翁清海, our national wushu champion and Ms Belinda Lee, 李心钰.

After watching the program, I was sort of disappointed and decided to write to the Straits Times forum on the following areas about the fitness tests at the end of the program that could be better addressed:

(1) Fitness Tests do not reflect the gains in the training - During the 2 weeks of training which the participants undertook, they were put through strength training in gym, aerobics classes, etc. However, the tests which eliminate a participant include more performance-related fitness components such as balance (walking on a balance beam), speed and anaerobic fitness (such as jumping over a series of hurdles). I do not see in the program such training were provided.

Moreover, the ladies in the program seemed to me that they are more concerned about weight management. Thus their training would have been centred on cardiovascular training to burn more calories and strength training to build lean body mass. Test on balance, speed, jumping ability and anaerobic fitness are more appropriate for athletes and not general public like the participants. Thus, gains in strength and cardiovascular fitness from training may not be appropriately reflected in the tests.

(2) Fitness Tests centred on lower body strength and ability - the 5 tests (walking on balance beam, step ups, leg lifts, leg raise and jumping over hurdles) all worked on the leg and abdominal strength. Participants would fatigue quickly and this may not reflect their true ability. A better rounded approach would be to include upper body exercises such as push-up or shoulder presses which can be done in the park.

(3) Safety - Since all the tests centred on the lower extremities, participants would fatigue easily and thus the risk of injury would increase. My concerns came true when the last participant, Catherine, fell over the hurdles. Hurdle jumping is a form of plyometric training and is normally done by athletes. The participants should not be put through this test and serious injury may occur if they fall.

I hoped that my 2 cents worth would help to provide improvements for future programs. If they don't publish my letter, you can read it here.

Just another note, one of the fitness trainers commented that he eats less carbohydrates at night. So what does he eat? Fats? proteins? fruits? vegetables? Do you know that fruits and vegetables contain a high proportion of carbohydrates?

Pizza Fergie

Saw this picture on the net as a build up to this weekend's match. Thought it was damn funny!

Ashley Cole (according to Straits Times) insinuated that it was Fabregas who threw the pizza as he said the person wasn't French nor English. I thought there were also Dutch, German, Ivory Coast and Swedish on the team.

Anyway, who cares who threw the pizza!

Ha ha ha!

Walk! Instead of Taking Public Transport

Bus fares, MRT fares are going to increase; taxi fares have already gone up. What do you do? Take it in your chin and swallow the bitter pill? "Swallow"? that's a word made sexy by a superstar in Singapore......

Okay, jokes aside. If you are pissed with the increase in fares, why don't you boycott public transport and start walking? Walking is free, it is a form of exercise, it helps you to burn calories (and thus weight loss??), and most importantly, it keeps your money in your pocket instead of those money suckers in the transport companies.

There are many ways to walk and many routes in Singapore for you to walk. For example, if your house is one or 2 bus stops away from the MRT, walk home instead of taking the bus. This would save you 39 cents x 2 (to and fro).

If you used to take bus/mrt from Tanjong Pagar to Raffles Place, why don't you walk? It is not too far, just about 10-15 minutes walk. To and fr0 would make it a 20 minute exercise, your daily requirement..... see, it is not difficult to chalk up your quota for exercise.

I shall not touch too much on the benefits of walking. I think almost everyone knows the benefits of exercising but not many people make the effort. In fact, if you want to exercise or walk, you do not need to make too much effort.

There are many parks in Singapore for you to walk - Botanic Gardens, Bishan Park, Labrador Park, etc. If you thinks these places are too far away, there may be a park connector near your door step.

Do you know that the park connector starting from Bishan Park connects you all the way to Kallang River Park and Marina? Do you know that it is possible to walk from Tampines MRT station to Pasir Ris Beach using the connector? or walk all the way from Boat Quay to Great World City? You may also get nice riverside sceneries along the way, while doing your walks.

Oh, Singapore is too hot for walking! Yeah, I agree with you. You may either walk in the evening or if you don't like to sweat, there are a lot of shopping centres for you to walk. One favourite walk which I like is the Citylink Mall. From City Hall, you can walk a minimum of 10 minutes to Marina or you may extend your walk to Suntec City or Millenia Walk for 30 minutes or more while doing your window shopping. You may also walk from Raffles Place to One Raffles Quay, a new office building for about 10 minutes. All these are within the comfort of the aircon.

So what are you waiting for? Come On!

NKF Walk in Sentosa

I went to Sentosa to help out in a Sunday morning (27 Aug) 2km walk for 700 NKF patients and staff. The initial target for the walk was 500 people but the actual turnout was 700 people due to overwhelming response. Luckily, Sentosa agreed to accommodate the increase of 200 people.

NKF held regular Sunday morning walks for its patients for about 2 years in parks around Singapore such as Labrador Park and Bedok Reservoir. This is the first time NKF is visiting Sentosa and the turnout is one of the largest in 2 years.

I think the turnout speaks volume for Sentosa of its progress over the last 5 years, which was the number of years I had been its account manager in DBS until 3 months ago.

5 years ago, the reputation of Sentosa was one of boring, expensive and out-of-date attractions. I think this reputation is so deep-rooted in the minds of Singaporeans and many foreign visitors even until now. Some of my friends still think lowly of Sentosa.

I would agree with my friends that Sentosa “was” what they thought of. However, the new management of Sentosa has made many conscious efforts and initiatives to not only bring new attractions but also to project its image positively.

Sentosa has recovered from its failed attractions of Fantasy Island, Volcano Land and created new fun rides such as the Luge and Sky Tower. I remember that the old hawker centre was expensive and both the quality and quantity, yes, quantity, were bad. It now has many new food outlets ranging from Delifrance, Subway, Coffee Bean, Sakae Sushi to Nogawa in the Sentosa Golf Club. My favourite is the American/Mexican Food at the Steword's Riverboat where you can get really fresh caesar salads

Sentosa is also now a hip place for beach goers and you can see a lot of bikini babes (wolf whistle please) there. I remember my ex-boss’s boss always visit Sentosa with his family. Sometimes, I joked, which family?

The island now offers a lot more than its past and the future is going to be more exciting with Sentosa Cove and the Casino (I hate the word IR). Go find out for yourself.

NKF is now like the old Sentosa, which was a PR disaster. I have many friends who have negative thoughts about NKF. People were pissed off by its over-aggressive campaign such as the TV shows, donation letters, and donation cards for school students. I was one of the angry donors who cancelled my monthly donation. In fact I cancelled the GIRO one year before the scandal! I have foresight!

I started the exercise classes for about 15 NKF patients after the saga and began to learn a lot about the organization and the disease. Firstly, kidney failure is a serious chronic disease and patients need to go for dialysis 3 times a week for about 4 hours each (with some patients up to 5 hours). I visited some of my patients during their dialysis and I can’t imagine myself sitting on the chair for 4 hours receiving dialysis. This is not to mention complications such as leg cramps and unstable blood pressure after each dialysis. I think I am blessed to be healthy.

I am also lucky to meet those patients training under me. These patients are positive and energetic despite their sickness. I have seen other patients in the dialysis centre who have almost given up and I think this is very sad. It is not easy to stay positive after you have been diagnosed with kidney failure.

These patients training under me are actually part of an advocate group setup by the “old” NKF. Despite the misgivings of the management of the “old” NKF, I think this is a very good scheme. These advocates serve as mentors to other patients and help solve their individual problems. Patients who are suffering would often rebut that caretakers do not understand their pain, but they would be speechless against the advocates who are fellow patients.

The “old” NKF also setup a Centre for Exercise Medicine and Nutrition for its patients. It encourages its patients to exercise regularly as exercise is beneficial for them, physically and more importantly, the mental aspects. It is not easy to run such an exercise centre with 3 staff (in the old NKF) to service 23 dialysis centres around Singapore.

One of the Centre’s initiatives was the Sunday morning walks in parks including this walk in Sentosa. I hope the new NKF can continue this good work and beef up the staff strength. 3 staff is definitely not enough manpower to handle 2 thousand patients and run around 23 centres.

I also hope the new NKF management would be able to follow the current Sentosa management in turning around its image. While it is now taking in more and more patients, it should also not forget about the hardwork of its staff and take care of the mental well-being of the patients.

My patients have been telling me that the nurses are so busy taking care of the increase load in patients now that the patients’ rapport with the nurses was not as good as before. This is sad but I think this may be typical of the Singapore healthcare system, which takes care of quantity and not quality. I am a firm believer that patients must be treated not only with the physical aspects but more importantly, be able to improve their mental well-being. You can be treated with the best doctor or medicines but if you have given up on life, what is there to fight on?

Sorry for my readers that this has been a long blog but it is something that I have thought about seriously. I am in no way related to NKF / Sentosa nor receive any ‘goodies’ from them. While it is in our human nature to criticize (as in the case of the "old" Sentosa and "old" NKF), we must also always remember to give credit when it’s due.

EPL Is Back!

It must be me talking about ankle sprain in my last blog. Both Carra and JAR twisted their ankle in the 1-1 draw against Shitty United.

A draw is a bad result for Liverpool but I thought it serves as a wake-up call for all the players. The media has been building the team up due to the strength which Rafa has built with new signings such as Bellamy, Pennant and Kuyt. But the Reds have not won the Premiership yet. So we should just let our talking be done on the field.

Hopefully we will do better against Maccabi Haifa and West Ham in the next games.

Ankle Sprain

Yesterday was a funny day. I saw 4 students with ankle sprain!

The funnier thing was that all 4 students play different sport - middle distance runner, basketball, rugby and ballet!

The ankle is important in that it helps to support the whole weight of the body. If you sprain your ankle, it is not likely you can stand properly and you would definitely walk with a limb or may need the help of a crutch.

The ankle joint has 4 ranges of motion, plantar flexion (foot pointing downwards), dorsi flexion (foot pointing upwards), inversion (foot pointing inwards) and eversion (footing pointing outwards). The most common ankle sprain is a plantar flexed inverted sprain, which happens commonly among basketball players when they land on someone's foot.

To strengthen the ankle joint, there are a few exercises that can be done. One common one is the calf raise. You may do single leg or double leg calf raise. Of course the single leg calf raise is tougher as the whole body weight bears on one leg. Another common exercise is the towel gathering exercise (using your toes). Step ups are also good exercises to improve your ankle stability.

If you have any friends who have ankle problems. Email me or call me.

Kidney Transplant

I usually spend Sunday mornings conducting exercise classes for my patients in NKF on a volunteer basis.

As part of the exercise routine, these patients would have to have their blood pressure measured before and during exercise. I usually take the chance to chit chat with them when they are having their measurements. What we have discussed today certainly gave me a new perspective in life.

One of the patients, 38 years old, had a kidney transplanted 20 years ago in China when he was 18. It was a shock to him when he found that he had kidney failure. During that period, NKF, the old NKF, was not even setup. Thus, a lot of Singaporeans went to China and India for kidney transplant.

My patient went to a military hospital in China. He has certainly changed his life perspective from this episode. At the age of 18, one would have lofty ambitions for the future. But to be diagnosed with kidney problems is certainly a traumatic experience. Further, when he was at that Chinese hospital, 7 persons, all Singaporeans, died due to complications arising from kidney transplant. My patient was horrified, of course. But he also noted that this might not be the hospital's fault as he thought that some of these Singaporeans, who died, may have pushed the hospital too quickly for a transplant when their bodies were not ready to take in a new organ.

Nevertheless, my patient decided to stay on with the transplant while other Singaporean patients went home or went to India for transplant. Eventually, he got his new kidney from a 29 year-old man. All-in-all, my patient stayed in China for about a year.

The transplanted kidney lasted about 19 years. This is long as most transplanted kidneys last less than 10 years apparently. My patient was having nightmare about kidney dialysis before the kidney broke down. The premonition came true.

Luckily, my patient was mentally strong enough to accept that the transplant kidney may fail one day and he would have to go back to dialysis again. He has seen many examples of people who failed to accept their fate and gave up surviving. I am glad for him too.

Sometimes we do not know how lucky we are........

Sprint Training

I put my student, Matthew, on sprint training yesterday. He broke his right tibia and fibula (shin bones) 7 months ago in a rugby game. Since recovery, he has been doing strengthening exercise under my care.

He received a piece of good news last Wednesday when his doctor cleared him for running. Immediately he went for a jog in Bishan Park despite me telling him not to do so before Karen and I saw him. Typical of 14 years old boy! We wanted to look at his running gait so that he would not develop bad running style and come back to us with ankle pain or knee pain.

Luckily his running style was alright except that his right leg has a slightly smaller stride than the left. This is not unusual since the right leg was the injured leg. We told him to consciously take a bigger stride for the right leg and the anomaly was thus corrected.

As his rugby team was short of players, the coaches were eager to get him back. I conducted 3 shorts sprints of 50 metres and 2 long sprints of 80 metres for him. I can see that he was knackered after the sprints, with his heart rate going up to 195 bpm. This is expected as his cardiovascular fitness has dropped after a period of 7 months without running. In any case, we need to build this up quickly although he has been doing step-ups and cycling regularly before he was cleared to run.

Sprint training or interval training is a quick and exhausting way to build up cardiovascular and anaerobic fitness. It involves sprinting for a distance followed by a period of rest or slow jog (which is an interval before the next sprint). If your stamina is low, you will tire after only 3 sprints. Thus, Matthew did all right with 5 sprints.

You can also do interval training on a stationary bike. Try sprinting on the bike for 5 intervals and you would look like you have just showered, with your sweat of course. I did that regularly when I am still not confident of running due to my slipped disc. It did my cardiovascular fitness a hell lot of improvement!

World Cup 2006

Good Riddance to WC 2006! This must be one of the most boring world cups that I have seen. The only memory I have of this world cup is that I slept during all 3 England games! Their performance were diabolical!

Many friends and Singaporeans are England supporters. I am not. I only support Liverpool. I think the Liverpool lads were treated badly by Eriksson during the WC. Stevie G was played out of position but still got 2 goals; what can you say when Hargreaves replace Carragher at right back? Crouch did alright but have to give way when the naive Looney came back. How can Looney play alone upfront? Crouchy would do a better job.

I had high hopes for the African teams but once again, they let me down. I had the impression that they had shored up the defence from what I saw in the Cup of African Nations. With so many players playing in Europe and some in Germany, some African teams, in particular Tunisia and Ghana would stand a chance. They were a huge disappointment

This might surprise all my friends - I did not watch the finals. Italy and France? can't be bothered. Zizou's headbutt was discussed all over the media. My friends think that this could be kelong, as what most Singaporeans think when a favourite loses a match or a star loses his "head"! By the way, Materrazi was a bluenose (Everton).

Anyway, the WC is over. Bring on the EPL!

For my fellow Liverpool fans, there will be a friendly against Wrexham this Saturday. Hopefully Channel 22 would screen the game.



Not a Liverpool Fan but a Liverpool Fanatic

Fitness Assessment

The past week was a week of fitness testing for me. Fitness Testing is an important tool for my trade (exercise training) as it establishes a baseline fitness level for my client and we can work together to improve that fitness level and ultimately to achieve my client's objectives, such as losing weight, managing medical conditions or winning championships!

I started out with a fitness assessment for a personal training client on Sunday who is concerned about weight management. She isn't exactly overweight but just needs to start exercising to achieve her ideal weight of 60 kg. She is 1.71 metres tall.

On Tuesday, Jamo brought me to his football team for a fitness assessment. He wants his team to be fit so that they can challenge at least for the regional title for secondary school in 2007. Fitness assessment for footballer are different from the general population.

For the general pop, you do the 2.4 km run or 12 minute cooper run for cardiovascular fitness, and usually a 1 minute sit-up test for muscular endurance. While for footballers, the standard test for aerobic fitness is beep test (or 20 metres multi-stage shuttle run test). They would run 20 metres from one end to the other end on the sound of a 'beep'. On the second 'beep' they would run back. The intervals between the beeps would become shorter and shorter and thus the footballers would have to start sprinting at higher levels.

The minimum mark for S-League players is 12-8 for 2006 (12-6 for 2005). It is claimed that David Beckham achieved level 15 while Ronaldhinho level 16. Jamo's team, aged between 13-15, achieved an average for 8-6. I think there is much room for improvement as I conducted the beep test for a under 16 team of a S-League club in 2005 and the boys ran above level 11.

Other tests that I conducted for the boys are 1-minute push-up test and vertical jump. Upper body strength is usually neglected by footballers as they concentrated on their ball skills. It should be emphasised to them that upper body strength is important in fending off challenges by the opponent. A good example would be Ronaldinho's upper body strength to fend off John Terry's challenge to score his goal in a Champion's League game in 2006.

Vertical Jump is a test I like. Probably, because I used to play basketball until I discovered that I have slipped disc. It tests how high a footballer can jump as this is useful when he jumps for headers. The boys jumped an average of 48 cm. Not bad, but I would have like them to achieve 55 cm if they come under my training.

I conducted a 3rd fitness assessment for my NKF patients yesterday (Sunday). Fitness assessment for special population is entirely different from footballers or general population. For a start, you cannot get them to run. But it is important to get them to improve their cardiovascular fitness as it may reduce their high blood pressure condition.

Luckily sports scientists invented this test called 6-minute walk test. The test measures how far the patient can walk in 6 minutes. My patients are relatively healthier and cheerful and I am glad they did very well for the walk.

Also, you cannot ask the patient to do sit-ups or push-ups for muscular fitness. Again, scientists invented the 30s chair stand test and 30s arm curl tests for their lower and upper body strengths. The patients are tested how many times they can stand up from a chair without using hand support within 30 seconds or how many times they can do a biceps curl for 30 second using 5lbs dumbbell for ladies and 8 lbs dumbbell for men.

Oh, didn't realise I wrote so much.... my readers must be bored to death about my fitness testing week.

I will come back with more interesting stuff about exercise and fitness later this week.