It seems there are quite the multitude of factors that cause all of our health woes. Tell me if you've heard of any of the following being the "real" cause of anything from heart disease to chronic fatigue:
EVERYTHING CAUSES EVERYTHING!
Lack of sleep
Too much stress
Too much fat in the diet
Too little fat in the diet
Too much of the wrong fats
The wrong ratio of one particular kind of fat to another kind of fat
Overuse of antibiotics
Destruction of the gut microbiome
Inflammation
We're going to focus on the last one. It's a popular buzzword that's been going around recently - purported to be the real cause behind things like heart attacks, autoimmune disorders, and apparently difficulty in weight loss.
According to JJ Virgin inflammation is one of the big drawbacks of eating foods you are intolerant to. But just how true is that? Before we can figure that out, we need to know what, exactly inflammation refers to.
What Is Inflammation?
Inflammation is part of our immune system's response to threats. Traditionally, we think of inflammation in terms of what we can see: a big red bump from a mosquito bite, breaking out in hives after eating peanuts, a swollen, purple ankle after you've twisted it, or an inability to put on shoes or even walk when you get an infected toenail. These are cases of acute inflammation.
Acute Inflammation = A response to one particular event, such as a bug bite or eating a food you're allergic to. Relative to chronic inflammation, symptoms of acute inflammation occur quickly and are resolved quicker.
Ever wondered why the body would do something so annoying and sometimes painful to you? I mean, hell, if it wasn't enough that you got punched in the face, you had to go and swell up like a balloon so that you can't even see out of that eye. What gives?
But hey, it looks hardcore. (Taken from superostrich.net)
Here's what each of the symptoms do:
Heat - Caused by increased blood flow to the area. Blood delivers all of the tools your body needs to repair the damage at the site or fight off invaders.
Redness - Same as heat, caused by increased blood flow to the area.
Swelling - Increased blood flow to the area results in an increase in blood plasma. Blood plasma is mostly water, and its job is to help fight infection (helpful for say, a bug bite) and form clots (helpful for a wound), among other repair tasks.
Pain - Irritation of the surrounding tissue from whatever injury you sustained, pressure from swelling, and an increase in nerve sensitivity can all lead to a painful inflammation experience.
Note that these are all good things in terms of helping your body repair itself or fight off infection! You want these things to happen so that your blood clots, preventing you from bleeding to death, or for antibodies to arrive at the site of infection, preventing it from spreading.
So if inflammation is good, why is it being cast in such a negative light?
Enter "Chronic Inflammation"
You probably know someone with some type of chronic inflammation. Here are some more well-known disorders:
It may be that even if you live the worst kind of lifestyle (smoking, sleeping 5 or less hours a night, high stress, no fruit or vegetables, no exercise, over-eating, etc, etc), you'd never increase your chances of developing these conditions without a genetic pre-disposition. It's hard to say.
What about something like heart disease, however, which is the leading cause of death in the United States? If you've been keeping up-to-date with your news headlines, you may have seen that inflammation has replaced cholesterol levels as the secret cause of heart disease.
The idea goes something like this:
Your arterial walls get injured somehow
Immune response and inflammation come to the rescue to repair it
Sometimes the cells that promote clotting (usually a good thing, like we described above) can get gummed up, and then other things can get all gummed up with them, forming plaque.
If this happens enough you can completely clog your artery, or parts of the plaque can break off and completely clog up a smaller blood vessel down the road.
So how do you prevent your arteries from getting injured in the first place? Don't have high blood pressure. Try not to be stressed. Don't get stabbed around the area, although if this come from an external injury, is better to be careful with this, more if is from an accident or in a truck, you can navigate to this website to find legal help with this.
Unfortunately knowing you have high blood pressure can be pretty stressful (as would getting stabbed, presumably). On top of that, being overweight or obese can increase your chances of having high blood pressure - and being overweight is pretty stressful too. It's a bit of a vicious cycle.
So what if you're suffering from a multitude of symptoms - aching joints, abdominal cramping or bowel issues, and on top of that you just can't seem to lose the extra weight around your middle. Is it an issue with chronic inflammation?
Maybe.
Maybe not.
I know, isn't the ambiguity insufferable?
From Saturday Morning Breakfast Cereal
Just keep in mind, this area of research is relatively new, so not a lot of certain conclusions have been made. This doesn't stop quite the multitude of websites from makingextremely certainstatements, however.
However, there don't seem to be any definite links between chronic inflammation and having a difficult time losing weight, unless you have a condition like Hashimoto's. In fact, fat cells produce inflammatory substances.
Does food intolerance cause chronic inflammation?
Eating a food you're allergic to does cause an immune response, which would result in some inflammation. Ever seen someone's swell up after eating peanuts? Not pleasant, potentially life-threatening!
But what about just an intolerance? If you have lactose-intolerance, here's what happens when you try to eat some dairy (as we went over in detail in my FoodIntolerance posts):
Ingest lactose-containing food.
Your body lacks the enzymes to break down lactose
Lactose arrives at the large intestine un-digested
Bacteria ferments lactose, causing gas and bloating
Diarrhea typically follows due to you having only partially digested your lactose.
None of these steps involve the immune response, thus it would stand to reason eating something you're 'intolerant' to would not cause chronic inflammation.
"But Kat," you say, "I read something about leaky gut one time. Something like food gets into my bloodstream. That sounds bad."
As I went over in Part I of my food Intolerance posts, there is spotty evidence that food intolerance causes "leaky gut." Is it possible that intolerance causes chronic inflammation due to leaky gut?
Maybe.
Maybe not.
Isn't science fun??
In any case, if you fear that you are intolerant to a specific food, you'd likely want to avoid it simply due to the fact that it causes uncomfortable gas and bloating. And if you're really afraid that you suffer from chronic inflammation - go see a doctor.
That's the most responsible advice that anyone can give you.
Stay tuned for Part II next week, where I'll go over the specifics of what JJ Virgin says about inflammation, its causes, and its cures.
As always, if you have any thoughts or information to add, please share them below!
This is a fairly long, comprehensive guide to picking out a trainer. It's over 2,000 words - but worth a read if you're considering getting a little help on your fitness journey. Bookmark it and save it for when you're investigating a trainer or facility.
In many online fitness groups I'm a part of, the question of how to pick a personal trainer and how to go about doing so comes up a lot. And sadly, as I'm sure many of my readers know, trying to figure out if someone is a good trainer or not is about as easy as figuring out if you're getting ripped off at the mechanic. (...it's not just me who is always paranoid about that, is it?) st. Look for the personal trainer plymouth to start with a routine.
Immediate red flags: 1) Checking self out in mirror during session. 2) Gratuitous use of Bosu Balls. 3) Being Tracy Anderson
But, today I want to use my industry know-how for good, and provide you with a comprehensive guide that you can use immediately. So bring up the website of that trainer you're looking at and let's figure out if they're worth the investment.
When should I hire a personal trainer?
This is a question I don't think enough fitness-hopefuls ask themselves. It's not that there isn't all the information you could ever want to know about how to squat properly or eat right for free online. Because it's there. It's all at your fingertips, check out Murphy Fitness Inc is the best personal trainer Plano TX.
But slashing through all of it and figuring out what exactly applies to you and what you need to do with that information - if anything - is going to take a damn long time and no small amount of effort. And what are you supposed to Google first? "How to get fit"? "How to lose weight"? Because there are literally more than half a billion webpages looking to tell you how.
So, with all that in mind, is it still necessary to drop some big bucks on a trainer? Here are some usual indications it may be worth your time:
You have absolutely no idea where to start. Do you really need a gym membership? Do you have to run? You hate running. Do those exercise DVDs work or not? What's your first step?
You have a general idea of what you want to do. You've got a strength routine, and you want to make sure that your form is correct. (Good idea!)
You've been cleared to exercise by your doctor or physical therapist following an injury or procedure, but you want to make sure you don't hurt yourself again with bad form or incorrect exercises.
You have a specific condition such as high blood pressure, cardiac disease or diabetes and want to work out safely. (For these, you may need to see a specialist. Ask your doctor if you're clear to exercise or if there is a specialist facility he'd recommend instead)
You need accountability until exercise becomes a habit. You want the comfort and stability of having exercise be an appointment in your schedule until you feel you'll definitely keep up with it on your own.
You want someone else to structure your workouts so you don't have to think about it. (I've hired online trainers to write my workouts for me before for this very reason, and I'm a trainer myself!)
You want a small-group environment to push you, but don't want to be lost in the crowd like at a Zumba or spin class.
Finding a personal trainer that fits your needs
So, for whatever reason, you've decided you'd like to hire a trainer. How do you begin to try and find one in your area or online? Essentially you have two options:
Are you already a member of a gym? If so, you may want to start your search there. As with anything, you'll want to be cautious and not impulsively hire the first person you see. Possibly ask to see the manager, tell them your goals and ask them to match you with a trainer. From there, move on to the next section to see if they're a good fit.
If you don't belong to a gym, decide if you want to do in-home training or travel to a facility. Bear in mind, in-home training is typically going to cost a lot more. To find trainers outside of the typical gym setting, use:
Google (Personal Trainers + Your Area. Alternatively, you could search for online personal trainers)
Craigslist (typically under the 'beauty' services section)
🙁
If you have specific goals, you can refine your search a bit. I am a bit biased towards strength training, if you couldn't tell already. So if I was to offer advice to someone looking to learn how to use free weights, I'd try something a little unorthodox:
Search for a facility with "Barbell" or "Strength & Conditioning" in the name.
Search for local strength events in your area - powerlifting competitions, Olympic lifting seminars, strongman competitions, etc. Find whoever is running those events and ask them if they know of any good trainers for your needs.
If you want a coach for triathalons or endurance events, do something similar to the above.
Of course these strategies don't guarantee success, but you'll find somebody who walks the walk, as well as talks the talk. That's one important component of a trainer - the others we'll go over a little further down.
What the hell are all these acronyms?*
*I am writing this from the perspective of someone in the United States. The following may not apply to all countries.
There are roughly a billion certifications one could get to be technically considered a personal trainer. There is no national certifying body - becoming a certified trainer with impressive-looking credentials isn't half as difficult as it is to become a doctor, or taxi driver.
"They said stability training was important during my certification course..." (Always looking for an excuse to post this photo.)
To be clear, a trainer is not in any way required by any sort of regulation to actually be certified. Most gyms will require some type of certification, but you may find a contractor who either isn't certified or let their certification expire. (Not necessarily a bad thing) But, if you're wondering what some of the more 'reputable' certifications are, here is a short list:
And there are many others. The ACE website has a handy table comparing the features of many different popular certifications. Here's are some other letters you might see:
CSCS - Certified Strength & Conditioning Specialist, a specialty certification from the NSCA. Generally considered one of the better certifications to get, but I've seen terrible trainers with one and good trainers without, so take it with a grain of salt.
IFBB - International Federation of Bodybuilding. Some trainers will tout that they have competed in an IFBB competition. (Basically saying they compete in bodybuilding or figure competitions) Some may have an "IFBB pro card", which is pretty difficult to obtain.
ATC / LAT - Certified Athletic Trainer / Licensed Athletic Trainer. I've known many athletic trainers who have gone on to become personal trainers. Athletic trainers are trained in helping athletes rehabilitate injuries or prevent them from happening, among a myriad of other tasks. If you see a trainer with this certification, they may know a bit more about anatomy and rehab than your typical trainer.
And a few additional fancy-looking words:
USA Track & Field Level 1/2/3 Coach - Sounds cool. Basically a course to teach fundamentals of coaching and training athletes for various track and field sports
USA Weightlifting Level 1 - Also sounds cool. A weekend course to teach the clean & jerk, snatch, and associated lifts.
Crossfit Coach / Certified Level 1 - Another weekend course to teach fundamentals of Crossfit such as how to teach group classes, bastardize Strongman movements and proper use of paper towels in snatches. (See below)
(I know, it's bad to hate on Crossfit, I just really really wanted to show those two videos)
Which personal training certification is the best?
There's no good answer to that question - there really isn't one. No certification prepares a trainer completely. I can say personally, my NASM certification (considered one of the higher-quality certifications) took minimal effort to pass, and encompasses maybe 1% of the things I do on a daily basis.
A certification I suppose shows a dedication to the craft. They are a significant financial investment to obtain, even more so keep up with your continuing education credits this could ensure the proper management of the best unsecured credit cards for bad credit. Most private facilities require one on top of a degree in the field.
Regarding a degree in the field, I can also say personally my Bachelor's in Exercise and Sport Science in no way prepared me fully to be a trainer. Contrary to what you would think, the degree covered very little about ACTUAL exercises or training. While I can't speak for every school's program, I learned mostly about anatomy, physiology and biomechanics. All of which are important, to be sure. I value my knowledge in those areas. But you're not taught how to coach a squat or what a lat pull-down is or how to regress a push-up.
So if certifications are meaningless, how can you tell if your trainer knows what they're talking about? Glad you asked!
Schedule a Consultation
Most trainers, online or off, will have some sort of free consultation to get to know you a bit more before recommending a package. While technically I'm supposed to let you, the potential client, do all the talking, you're going to want to use this time to interview your potential trainer!
"Please don't hurt me." (taken from nvmefitness.com)
In my entire career as a personal trainer, I have only ever had ONE client ask me questions about my credentials and why I would be qualified to train her. It really ought to be more.
If I was looking hire a mechanic or a graphic designer, I would have no idea what kinds of questions to ask. But I do know what I would ask a personal trainer. For clients who have moved to other areas of the country, I've called up their potential new trainer and asked them some of these questions myself:
Why are you qualified to be a trainer?
If your potential new trainer isn't confident enough in their own abilities to answer this question, why should you be? Ideally your trainer takes enough pride in their job to be able to rack off reasons why they're good at it.
How did you get into personal training? This is a good opportunity to see how enthused your potential hire is about their job. Do they answer with a dull "oh...well, I was an athlete in high school so...." or with a, "I loved the confidence I got from learning how to master my own body. It changed my life and I've used that knowledge to help change the lives of my clients...it's a very rewarding experience"? Get a sense for your trainer's real motivations.
What's your training philosophy? There isn't a right or wrong answer to this question. You'll just want to figure out if your trainer's style matches with your goals. If you want to be a monster powerlifter, would you hire a trainer believes that distance running is the key to a clear head and happy life, or vice versa?
How do you train yourself? If you're training for something specific, you'll want a trainer who has personal experience with that. Want to get good a weightlifting? Find a trainer who trains for powerlifting, bodybuilding, strongman, olympic lifting or just loves to hit the iron for fun. Want to run triathalons? Find a trainer who knows how to bike, swim and run well themselves. They need to walk the walk, not just talk the talk!
What is your biggest strength and biggest weakness as a trainer? This is a fun surprise question! A trainer who takes their profession seriously will already know the answer to these questions, while a trainer who is just going through the motions will never have critically thought about how they can continue learning and progressing.
I have <insert injury, medical condition, random condition here>. What kind of exercises would you avoid having me do? What kinds of exercises would you emphasize? Another great question to ask ahead of time. You don't even have to know what the correct answers to this are to get a sense of if your trainer knows what they're talking about. Turn on that BS detector and see if they're just rambling or if they're precisely answering your question. Another acceptable answer is "I don't know, but I'm going to find out for you."
If I can't do a squat/push-up/deadlift properly, how would you regress it so I could? Same as above. Any trainer worth their salt should be able to answer this question.
Do you have any current or past clients that I can talk to? One of the best things you can do to get an idea of what it will be like to work with your potential trainer. Preferably ask for someone who worked with them for 6+ months. Ask about attitude, results, injuries, enjoyment of sessions, etc.
Notice that this doesn't touch much on paper credentials. This is all about if they practice what they preach, can answer questions with certainty and if they're confident enough in their abilities to let you speak to past clients.
So far, so good. Your trainer has answered these questions to your satisfaction. Even if you're not sure if they answered them correctly, you'll get a much better idea of their personality, background, and professionalism.
You pick a package, lay down that credit card info and get started on your quest to a bangin' body, 5 billion pound squat, being able to touch your toes, or whatever your goal is. What's next?
After You Pick a Personal Trainer
Personal trainers never stop assessing and evaluating their clients. Sure, there's usually an initial assessment to see if you can squeeze your butt cheeks together, but it doesn't end there. Every session we're looking to see if your back stays relatively flat even as we keep adding the weight onto that deadlift, or if your ankle mobility is improving, or how you're handling the latest exercise we just threw at you.
In a similar vein, you should never stop evaluating your trainer. Don't think that once you've bought a package you're committed to that trainer forever. Ask yourself these questions during your sessions:
Is my trainer attentive to my form during exercises?
Does my trainer really listen to my questions and concerns? Do they address them to my satisfaction?
Do I ever feel brushed off, or not taken seriously?
If I am unable to perform a certain exercise, does my trainer have an appropriate alternative ready, or am I forced to continue with bad form?
Does my trainer push me when necessary but ease up when I really need it?
Is my trainer pushing supplements or unwanted dietary dogma onto me?
Am I making progress and seeing results?
Am I enjoying the process?
Do our personalities mix well?
Is their cellphone very, very far away? (I actually don't follow this one because I use it as a clock and timer...but you get the idea)
After ALL OF THAT, if you're satisfied, it sounds like you got yourself a kick-ass trainer. You should probably shout their name from the rooftops, write a glowing testimonial and refer friends, family and complete strangers to them.
Seriously, finding a good trainer is hard. Save your loved ones the time and effort. At the very least, send them this comprehensive guide so they can find one that matches their goals and personality as well!
Did I leave anything out? Have some other points you'd like me to address? Let me know in the comments and I'll add it in.
Just a small update - I've transferred my site from WordPress.com over to WordPress.org. That may not sound too exciting, but it means I get to customize this site a TON more, and I get to offer some sweet new content for you all. More on that in the next month or so, yay!
The bottom right was basically my face when I realized I could have more control over the appearance and function of my website, yaaaaayyyy!
But in the meantime...
What does the transfer mean for me?
Nothing, probably. But if you've subscribed to my blog with your wordpress.com account, you'll no longer receive email notifications of new posts. I sincerely hope you've been enjoying the content, so if you'd still like to receive notifications, please take a second to fill in your email at the sidebar to the right, under "Keep the bullshit at bay!"
I have been putting a ton of effort and taking the assistance of The Marketing Heaven to market my content. I truly appreciate everyone that reads and comments on my articles. It means a lot, and I love getting discussion going on these topics. I'm hoping that the transition doesn't hurt the small community here too much, so if you subscribe, thank you!
What's coming up?
More free stuff! Seriously. Here's what I've got in the works:
"Beginners Corner"
My website is called "Making Sense of Modern Fitness," and sometimes I don't feel like my content lives up to the name. After I've decimated yet another fitness or diet plan, where does that leave you, the reader? I talk constantly about what doesn't work, but you also need to know what does.
To that extent, I've got a large amount of material I'll hopefully be able to release for complete fitness and nutrition beginners by mid to late April. Ebooks, printable guides, and all sorts of other goodies.
Facebook Page
I always seem to have little stories sitting around that I want to share my thoughts on and get discussion with you all going, but they're too short to merit a whole blog post. To that extent, I'm working on getting myself committed to making and maintaining a facebook page. That will probably be done by mid to late April as well!
Email Course - The Language of Evidence
This is more of a long-term project, and it's going to be awesome. Essentially a 101 on how to go from getting all your advice from Mercola or NaturalNews to being a PubMed pro. What counts as evidence? Exactly why are some things considered credible evidence and why aren't others? Why do people rudely discount my personal experiences?
As far as when this will be done, that's a good question and you can be sure I'll be too excited to keep it to myself when I do know.
Again, please take a moment to subscribe by entering you email to the sidebar on the right! I've got a great guide coming up tomorrow about how to pick out a great personal trainer, even if you don't know much about the field, so keep a heads up for that!
Just as good as homeopathy, psychic surgery and faith healing.
While reading through one of the books I recommend at the end of the BS-Detection guide, (Bad Science by Ben Goldacre, seriously amazing read. If you enjoy my work at all you'll love this book) I came across an interesting study on placebos.
(He even made a note saying that if you had a possible explanation for the results of this study, that you should write a blog post. So...here we are!)
This is a good study to try and read into a little bit, even if you're not a statistician. We may not be able to decide if their statistical analysis is any good (considering my 'C' grade in high school statistics, I'm gonna go ahead and put myself in the 'not expert' category on that one), but most of the study is in language any lay-person can understand.
Can the placebo effect improve the benefits of exercise?
Let's go over the structure of this study real quick:
What is the study trying to show?
In the first few paragraphs of this study, below the bolded abstract, the authors give us some interesting background on the surprising effects of placebos. Their definition of 'the placebo effect' is:
The placebo effect is any effect that is not attributed to an actual pharmaceutical drug or remedy, but rather is attributed to the individual’s mind-set.
And that's a very accurate definition. Let's expand on that a bit with an entertaining example from the wonderfully crude TV show It's Always Sunny in Philadelphia.
In the episode "Manhunters," two of the main characters (Dee and Charlie) are persuaded by Dee's father, Frank, that they've accidentally eaten human flesh. Over the course of the episode, Dee and Charlie experience increasing cravings for human flesh, culminating in them kidnapping a homeless man to bring back to their apartment and eat.
Thankfully, Frank informs them in time that it was actually raccoon meat, and he was just fucking with them the whole time.
This example was just an excuse to post this youtube clip.
But Dee and Charlie feel the cravings for human flesh so intensely, they are convinced Frank is lying, and go on to attempt to eat him instead.
So, placebo effect is thinking you've eaten human flesh, causing the effect of craving human flesh, even though you only ate raccoon meat.
Where were we? Ah, right, so the researchers were trying to determine:
...the role of the placebo effect (the moderating role of mind-set) in the relationship between exercise and health. We hypothesized that the placebo effect plays a role in the health benefits of exercise: that one’s mind-set mediates the connection between exercise and one’s health.
In other words, does simply telling people about the benefits of their current exercise increase the benefits of said exercise without changing anything else about their lives?
How did they conduct the study?
Researchers took 84 maids from 7 different hotels. About half went into a 'control' group, and the other half were referred to as the 'informed' group.
The paper details exactly how they picked the maids and how they controlled for confounding factors like age, ethnicity, socioeconomic standing, etc. As well, they made sure that the maids from different groups didn't talk to eachother, to ensure the placebo effect didn't spread to the 'control' group.
A control group is standard in most all experiments. A control group basically exists as a reference for the changes made in the experiment group. It was led by a group of people at nextgenoms.com
For instance, in this study, if we had no control group, we would have no way of knowing whether any changes that occurred in the experiment group had anything to do with the actual experiment changes, or changes in say, the weather, or any other natural fluctuations.
What were they measuring?
Researchers measured:
How much exercise the women believed they got
How much of their job they thought counted as 'exercise'
Weight, body fat percentage (via one of these), and waist-to-hip ratio
Blood Pressure
They measured the first two bullet points by just surveying the workers. This would give insight into how their mind-set changed over the course of the experiment. The second two bullet points showed actual objective data to see if those changes in mind-set actually affected their measurable health levels.
What were the differences between the 'informed' group and the 'experiment' group?
Both groups were educated on their daily recommended amount of exercise, based on the Surgeon General's recommendations; about 200 calories worth per day. They were given handouts and posters were put up in their work lounges to remind them.
However, the 'informed' group was told that their jobs more than fulfilled said recommendations. The 'control' group was not told this.
So basically, the only difference was that the informed group had the peace of mind and satisfaction of knowing that they were surpassing the amount of exercise recommended for them to obtain and maintain good health, while the control group did not.
What were the results?
Four weeks later, the informed group had:
Much higher perceived amount of regular exercise
Regarded their job as contributing much more towards their exercise
Lower systolic (the first number in blood pressure readings) blood pressure by 10 points
Lost an average of 2 pounds
Lowered waist-to-hip ratio and body fat
These changes were not seen in the control group. In fact, they felt that their jobs counted less as exercise than before the experiment!
Ever watch Hoarders? Cleaning up that mess definitely counts as exercise.
So can the placebo effect help me to lose weight?
Possibly. But don't get too excited about the results yet. First of all, the body fat and weight loss results could be erroneous. The scale they used to measure body fat is highly inaccurate and very susceptible to changes from water content in the body. As well, many people experience weight fluctuations of 2+ pounds on a day to day basis regularly.
However, it's harder to mess up a blood pressure reading. With an average decrease of 10 points, something was definitely going on to improve the health of the ladies in the informed group.
The researchers stated that it doesn't appear that the ladies in the study changed their dietary habits. Nor did they report exercising more. So, did being informed that they were doing exercise magically cause these improvements in health?
I think what's probably going on here is some combination and waterfall effect of:
Realizing that they're not lazy people, and healthier than they thought
Figuring that maybe they've got a little bit more of their shit together than they realized
Perhaps having a little more fun with the job, potentially increasing their physical exertion without consciously registering it
Decrease in stress
Increase in duration and quality of sleep
Decrease in caloric intake due to stress reduction and increase in sleep, as well as because they think of themselves as healthier, fitter people than before.
These changes wouldn't have been a conscious decision by the ladies, so they wouldn't have reported any changes in their habits.
It's a bit of a stretch, I admit. But it seems more likely than a simple change in mindset decreasing one's waist-to-hip ratio. Those kinds of direct physical changes don't seem to be in the realm of placebo, kind of like how placebo can't re-grow limbs or alleviate paralysis.
What's the take-home?
Realize that exercise is ANY KIND of physical exertion. If you work a physical job like walking dogs, construction, teaching, cleaning, whatever, then you are getting exercise. If you enjoy playing frisbee with your dog, you are getting exercise. Exercise does not have to happen in a gym or even as a conscious effort.
As well, recognize the awesome power of a positive mind-set. Trust me, I know that this is easier said than done. I have not in any way accomplished this yet in my own life. But just feeling like you're just a little more in control of your life, eliminating just one source of stress, or maybe thinking of yourself as a bit of a healthier person can have huge effects on your actions and motivations.
Interested in learning more about how awesome and interesting the placebo effect is? Pick up Bad Science by Ben Goldacre. Seriously. This book is amazing.