Chapter 21: Case Studies of Athletic Development

Level 1 - The Health & Fitness Athlete: Metabolic Melvin

The final chapter of the book will include case studies from rank beginners to world-class professionals, based on specific athletes that I’ve worked with over the years (with names changed to protect the innocent 😊).

First up, we have our prototypical Health and Fitness athlete - Metabolic Melvin…

We began Chapter 1 with the quote

“If you do not find time to become and remain healthy, you will be obliged to find time to be ill”
- George Hackenschmidt.

And, unfortunately, that’s where our good friend, Melvin currently finds himself. After an active youth of playing various team sports and even dabbling a little in Triathlon through his 20s and 30s, the pressures of work and life got to Melvin and he let the physical side of life go.

As a busy professional, Melvin found himself taking on the typically low movement patterns of our prototypical Western Businessman…

…with a PAL of ~1.2 and typical daily expenditure under 400kcal of movement (total) per day - amounting to typical step counts under 3,000 steps per day. This very low activity coupled with a diet of convenience led to a steady gain in weight over the years, to the point that Melvin now finds himself obese, with a BMI of 32.

After some progressively declining medical visits, Melvin found himself pre-diabetic with fasting glucose levels in the high 6 mmol/L and an HbA1c of greater than 6% and with worrying cholesterol numbers of LDL’s in the 160s and triglycerides in the 300’s -- all of this in his late 40’s.

Concerned for the welfare of his family, Melvin reached the point where “enough is enough” and resolved to return to a good state of fitness and health. But, after all this time, he just didn’t know where to begin.

The foundations of fitness: Restoring Melvin’s Metabolic Base

When in doubt, it’s always best to begin at the beginning and, in health and fitness terms, that beginning is a strong movement/metabolic base.

But, before we get to that, Melvin’s Doctor smartly recommended a full medical and some metabolic/exercise testing before clearing for exercise.

On the positive, Melvin’s medical revealed borderline-high but not prohibitive blood pressure, normal cardiovascular and respiratory function and no limiting orthopedic conditions, so he was cleared for a progressive exercise test.

Melvin’s Initial Testing

Before the progressive exercise test, we did a Resting Metabolic test for Melvin to assess his resting metabolic rate and resting fat-burn. His Resting Metabolic Rate (RMR) was an impressive 2067 kcal/d…

However, even at rest, his RER was 0.9, indicating that only ~33% of this energy requirement, i.e. a paltry 680 kcal/d was coming from fat. The rest of his energy needs, a whopping ~1400kcal/day required a steady stream of carbohydrates to maintain! And it was this general lack of metabolic health and fitness that led to sugar cravings and a compulsion to eat high-glycemic carbs throughout the day, further reinforcing the problem.

The same trends of very poor metabolic fitness were shown in his exercise test…