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Some facts about exercise

Core strength: cardiologist Joe Yammine writes that If one's focus is on muscle building and strength development, starting out with anaerobic exercises, such as weightlifting and resistance training, can be more effective to getting fit, as opposed to cardiovascular fitness, endurance, or weight loss, with aerobic exercises (jogging, cycling, and swimming) which can help elevate heart rate, increase oxygen consumption, burn calories and improve endurance (Photograph submitted)

Should I start with “cardio” or weightlifting?

The optimal sequence of exercise, whether to start with aerobic or resistance training, depends on the specific goals and preferences of the individual, as well as the overarching principle of safety in a workout routine.

While there isn’t a universally “right” sequence, several considerations can guide the decision-making process:

Aerobic First: If the primary goal is cardiovascular fitness, endurance, or weight loss, beginning with aerobic exercises (eg, jogging, cycling, and swimming) can help elevate heart rate, increase oxygen consumption, burn calories and improve endurance.

Anaerobic First: If the focus is on muscle building and strength development, commencing with anaerobic exercises (eg, weightlifting, resistance training) can be more effective.

Injury Risk: There's some evidence to suggest that performing resistance training before aerobic exercise may increase the risk of injury.

This is because pre-fatigued muscles might be more prone to injury during activities that require endurance, coordination and balance, like running or cycling.

In addition, starting with a cardio workout could warm up the different muscle groups and ready them for weightlifting and resistance, decreasing trauma risk.

Warm-up and cooldown: Regardless of the chosen sequence, it is crucial to incorporate warm-up and cooldown routines before and after workouts. These activities help prepare the body for exercise and promote recovery.

To note here that the optimal duration of warm-up and cooldown is variable but ranges between five and ten minutes.

Which is better for bone health: Cardio or resistance training?

Both! Regular cardio activities, especially those with high-impact elements like running, can “stress” the lower body bones and stimulate the production of bone-forming cells, along with more calcium and collagen deposit in the bone matrix.

This can make the bones in the lower spine, hips, thighs and legs denser, and helps preventing osteoporosis.

On the other hand, resistance training, such as lifting weights, resistance bands, or body weight exercises, stimulates muscle mass and strength.

As muscles pull on bones during exercise, it creates tension, which can also activate the above physiologic pathway and enhance bone density.

Should I consume proteins around workout sessions? How about sugar?

There is a substantial scientific evidence supporting the role of protein intake in muscle building, especially in the context of exercise.

Protein is rich in amino acids, the building blocks of muscle tissue. Consuming adequate protein provides the body with the necessary “raw materials” for muscle growth and repair.

Increased protein intake has been shown to stimulate muscle protein synthesis, which is particularly important with resistance exercise (e.g., weightlifting).

The exact amount of protein needed varies based on factors like individual needs, exercise intensity, and training status.

As opposed to older and more limited data, newer evidence suggests a limited importance of protein intake timing on optimising muscle protein synthesis.

Pre-exercise protein intake may provide amino acids for immediate use during exercise, while post-exercise consumption can help initiating the repair and growth process, by replenishing amino acids stocks.

In particular, the “anabolic window”, or post-workout window, suggests that consuming protein within a certain time frame after exercise is particularly effective for muscle building.

This window is typically thought to be within 30 minutes to 2 hours after exercise. Recent research suggests that the anabolic window might be more extended than previously believed, with muscle protein synthesis remaining elevated for several hours post-effort.

Some studies doubt this concept altogether, except when people exercise after some period of fasting: in that case, immediate versus delayed post-exercise protein intake might make a difference in muscle build-up.

Regarding sugar, its role in muscle building is not as direct as that of protein.

Carbohydrates are the body's primary source of energy during exercise, and consuming them before exercise can be important for optimal training capacity, especially in lean athletes or children.

It is essential to focus on complex carbohydrates that provide sustained energy, rather than simple sugars that can cause rapid blood sugar spikes and crashes.

Should I take a hot or a cold shower after exercise?


Hot showers can promote muscle relaxation and relieve post-exercise muscle soreness.

The warmth helps to increase blood flow, which can aid in the removal of accumulated metabolic waste products like lactic acid, and reduce muscle tension.

Moreover, hot showers can be soothing and mentally relaxing, potentially reducing stress and promoting a sense of wellbeing.

On the other hand, cold showers are known to have a constriction effect on vessels, which can decrease blood flow to damaged tissues, potentially reducing the flux of inflammatory cells and molecules to them, mitigating inflammation.

Additionally, cold showers can increase alertness and boost one’s mood due to the release of endorphins, contributing to a feeling of invigoration.

What is exercise-related “VO2 max” that is displayed on fitness tracker?

VO2 max, often displayed on smartwatches and fitness trackers, is a measure of maximal oxygen consumption or “aerobic capacity”.

It is an important indicator of cardiovascular fitness and endurance. VO2 max represents the maximum volume of oxygen your body can utilise during intense exercise, typically measured in millilitres of oxygen per kilogram of body weight per minute (ml/kg/min).

Smart devices estimate VO2 max based on formulas driven from data such as heart rate, age, gender, weight, and the intensity and duration of your workouts.

Knowing your estimated VO2 max can help you tailor your exercise routines. VO2 max can also be used to track changes in your fitness over time.

Keep in mind that while smart wearables can estimate VO2 max, laboratory-based assessments, which involve more precise measurements, are considered the gold standard for determining your actual VO2 max.

• Joe Yammine, MD, is a consultant cardiologist at the Bermuda Hospitals Board. The information here is not intended as medical advice or as a substitute for professional medical opinion. Always seek the advice of your physician

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Published November 21, 2023 at 7:59 am (Updated November 21, 2023 at 8:34 am)

Some facts about exercise

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