John F. Groom 64M

Central to making people healthy and fit is a simple question; how do you evaluate fitness? While developing Global Fast Fit, I noticed there were very few good benchmarks for fitness. This was a surprise to me, as there seems to be an obvious use for such benchmarks in evaluating fitness routines, as well as small or large scale health care programs, private and public.  How do you know what is working, or not, if you don’t have an effective measurement tool?  I’m referring to a benchmark that works for the academic and professional health care community.  Of course, there are many informal ways of assessing fitness on an individual or small-scale basis. Appearance is the most common way – of course that’s very subjective and not quantifiable.  In gyms, guys will use single rep max as a proxy for strength, most often with the bench press exercise.  Runners will use marathons or 10K times.  Weight, body mass index, and various biomarkers like cholesterol levels, blood pressure, and others are common as well.  There are many obvious problems with all of these; typically, they measure only one part of fitness or health, such as cardiovascular endurance or upper body strength.   Biomarkers are not good predictors of functional health.   As I found when Global Fast Fit started trying to develop reliable benchmarks, there is a lot of available data; most of it is of very poor quality, self-reported and subject to all sorts of inconsistencies. In most cases, websites and apps don’t indicate where they found the data they use for benchmarking.  Return to resting heart rate is a useful metric, and that data is collected on millions of wearable devices like watches, but standard protocols for academic use have never been developed.    In the academic community, VO2Max has long been considered the gold standard for cardiovascular fitness.  Unfortunately, it's really more of a bronze standard, if that. In addition to the basic fact that VO2Max is only designed to measure cardiovascular endurance; ignoring strength, balance, agility, speed, flexibility, it has many other problems.  Variability in Measurement Age and Gender Bias Insensitivity to Training Adaptations Overemphasis on Aerobic Fitness Expense and Accessibility Mismatch with Real-World Endurance Cardiorespiratory Fitness Beyond VO2max Non-Linear Decline with Aging Adaptation of left ventricular morphology to long-term training in sprint- and endurance-trained elite runners Enhancement of nitroglycerin induced blood vessel relaxation in chronic renal failure model rats   For a company like Global Fast Fit interested in providing fitness and health solutions to those in challenged parts of the world, the fact that VO2Max is very expensive, inconvenient, and requires expensive training and equipment to operate is important.    But this article is not so much about the particular issues with VO2Max as a standard; what’s more interesting from a big picture point of view is the fact that a system first developed in the 1960s is still being used today.     According to Wikipedia, the concept of VO2max — the maximal rate of oxygen consumption during exercise — was introduced in the early 1920s by Archibald Vivian Hill and his colleague Hartley Lupton. In the 1950s–1960s, Scandinavian scientists (notably Per-Olof Åstrand and Bengt Saltin) made important contributions to turn VO2Max into a protocol that could be used by the academic community.  By the late 1970s to early 1980s it was accepted as the leading standard of fitness by the academic community.  And little has changed in the following decades.   In 1968, Dr. Kenneth Cooper published a field test with participants running as far as possible in 12 minutes in the JAMA medical journal to estimate VO2Max.  This is often used as a benchmark field protocol correlating with VO2Max, even though in practical terms it has very little to do with the actual VO2Max test.   For better or worse, the Cooper Test was, and still is, widely known, taught, and used as an academic reference.  So, let’s say we pick 1968 as the starting point for widespread adoption of VO2Max, in part because the Cooper test was also widely used to measure fitness in US schools, the military and elsewhere.  (Like the VO2Max test, but for different reasons, the Cooper test is also very flawed; not only does it only measure cardiovascular fitness, but its application to wide population is also very limited for the simple reason that the vast majority of people can’t run for 12 minutes.  This has become markedly more true over time as populations around the world have become more sedentary.  And the Cooper test is really more a test of motivation than fitness – even for very fit people, running at a high level of intensity for 12 minutes is extremely challenging. Very, very few people are able and willing to endure 12 minutes of maximum stress.  So, let's use1968 as a starting point for VO2Max and related applications like the Cooper Test. Think about that; in the world at large how much has changed since 1968?   In the US, obesity has risen from 13% in 1968 to about 40% now.  In spite of this, or because of it, regular exercise, at least as a concept, is much more popular now.  Good statistics going back to 1968 are sketchy, but it appears that the number of Americans who claim to exercise regularly has more than doubled. Smoking has dramatically decreased among the US population, less than a third of those who smoked in the late 60s smoke now.    Interestingly enough, 1968 happened to be the year in which digital technology really took off. In March Hewlett Packard introduced the first programmable desktop computer. In June Robert Dennard received a patent for a new and important method of data storage, DRAM. In July Intel was founded. In December Douglas Engelbart presented his original versions of a mouse, a word processor, email, and hypertext. So 1968, 57 years ago, marks both the beginning of the digital revolution and the birth of VO2Max in fitness.   In the digital world, everything has changed. In the fitness world, almost nothing has changed. Computing and processing power has risen almost inconceivably; thousands to millions of times more power for many tasks. The Apollo 7 space mission in 1968 – the first successful crewed Apollo mission - used the Apollo Guidance Computer (AGC).  The modern smartphone has about 4 million times more ram than the Apollo system, and instructions per second are about a million times as fast on your smartphone than AGC.    So, things have changed quite a bit since VO2max and the Cooper test were developed. Yet, in the health and fitness community very little has changed.  Sure, lots of apps and wearables have been developed. But if I go into a gym in 2025 is it really any different from a gym I went into as a 13 year old in 1974? Very high end gyms like Equinox might appear superficially different, but for the vast majority of people using gyms the basic setup has changed very little; basic barbells and dumbbells, a room for group exercises, some simple exercise machines.    Treadmills gained widespread use in commercial gyms in the late 1970s in the US and haven’t changed much since then.  In fact, in my personal case, the very large LA Fitness gym that I use in Manassas, VA has not changed at all in basic functionality over the years. If anything, gym equipment has become less technologically advanced; the Fun n Fitness gym I used in 1974 had Nautilus equipment, which was the apex of equipment sophistication.  So, the world of exercise has changed very little, even in a world that has changed dramatically since 1968. More to the point, VO2max is still being used as a fitness benchmark.  Why?   Is it because VO2Max is such a good benchmark it doesn’t need to change? No, see above. The real reason is the inherent conservatism of the professional health community and the fact that there are no incentives for early adoption of other systems that might lead to the kind of protocols and widespread data availability that would make new systems more attractive.    One obvious reason things haven’t changed is that everyone in the healthcare community knows what VO2Max is, they accept it as the industry standard, and there is a formalized universal test protocol, as well as lots of reference data that has accumulated over time.  So, it is used simply because others have been using it for a long time.    Academics in the health field are expected to crank out a very high volume of papers; who has time or energy to fight the system or try to introduce better benchmarks? If you’re just using benchmarks to measure progress in some kind of health study, the type of benchmark you’re using is probably a very secondary consideration to the main point of your research.   A less attractive, but equally viable explanation – and one that applies across all of academia – is that academics see the fact that VO2Max is difficult and expensive to implement not as a negative, but a positive.  Since it requires sophisticated training and expensive equipment, those using VO2max, or anything equally complex, have a veneer of sophistication. A stationary bike is what I have used for VO2max test, but treadmills are also used (Incidentally, that’s another problem, non-comparable testing methods).  The equipment gives the testing environment a “lab like” air, and in fact many places where VO2Max is available are called “performance labs” or something similar. But looking like a lab doesn’t solve any of the inherent measurement problems; it just provides a veneer of the “scientific” process.    At Global Fast Fit, we created what we think is a better solution.  There are several benchmarking routines; Pro, Standard, and Shuttle, but they all provide the same basic ingredients; pushups, plank leg lifts, squats, and a run. For Standard, 15 pushups, 15 squats, 15 plank leg lifts, and a 250 meter run.     The focus of Global Fast Fit is balance; the biggest mistake most people make in exercise, other than simply not doing enough, is that they do the same exercises focusing on only part of their body. Big beefy guys in gyms do too much bench press and too little running; Lithe running types don’t do enough strength work. Almost no one outside of sports training does enough speed work.  Outside of very gentle elder training programs, very few people work on balance, almost none on agility.    The Global Fast Fit routine meets our inclusiveness goals because:    It is safe; we’ve done thousands of these routines all over the world without a serious injury.    Importantly, it tests upper body strength, core strength, leg strength, speed, and general cardio capacity, with a single elapsed time. In a minor way, it also tests agility as you quickly move from one exercise to another.  (This is the “global” part of global fast fit, meaning full body). We also believe the central nervous system demands of doing different exercises sequentially are greater than doing a single exercise for the same duration.    It's fast – we've had a couple people break a minute, but most people can do the standard routine in a few minutes.  So, motivation is less of an issue than in a test like Cooper.   It can be used as a fitness assessment as well as a benchmark. It’s a very simple and fast way to identify imbalances, both for individuals and across wide groups.  For example, we’ve found, even among fit women, a real deficiency in upper body strength.  This is simply because they’re typically not doing any upper body work.   Doing these movements at a relaxed pace, GFF routines become a good starting point for identifying structural issues by a therapist or doctor in a clinical setting.    Because we video participants, we’re able to judge form and make sure that datasets include truly comparable routines.  A certified routine from a 20-year-old Chinese man doing standard is going to be comparable to a 60-year-old woman in Kenya.  We currently manually review all entries for conformance to form standards; eventually we hope to use Ai to automate this process.   The routines require no equipment; just a space to do bodyweight exercises and a space to run. If desired, a treadmill can be used, but the vast majority of our routines have been performed outside.  We created the GFF Shuttle for those situations where a treadmill is not available, and running space is limited. The lack of required equipment is important in countries like Kenya, Uganda, and India, which are some of our main focus areas.      GFF routines can be done anywhere, unlike VO2Max testing; you don’t have to find a lab, which are typically only located in affluent urban areas. How hard and expensive it is to find a place to do VO2Max?  We had our trainers around the world investigate this.         Chennai, India  AIWO Wellness Center  5000 INR (56 USD)  ~3-4 hour Travel Time  Dongguan, China  Humen Hospital  200 USD  ~1 hour Travel Time  Bali, Indonesia  Wellnesslab Omni  Inti Saint Medis  3M IDR ($182) ~30 min Travel Time  Bangkok, Thailand  Greenbell Clinic  6500 THB (200 USD)  ~1+ hour Travel Time    Virginia, United States  George Mason Freedom Aquatic and Fitness Center  175 USD  ~45 min Travel Time  Nairobi, Kenya  Kenyetta Hospital  Aga Khan Hospital  None public at the moment    Kampala, Uganda  Makerere University  None public at the moment        Johns Experience USA Adhi’s Experience Bali Our trainers are, well, trained, to judge correct form but implementing a GFF benchmark routine is simple, which is helpful in environments where access to advanced fitness education is limited.    In summary, Global Fast Fit provides much better functional fitness benchmarks than those currently used by the professional and academic health communities.  But given the conservative nature of health research, we realize it will be years before our benchmarks replace VO2Max in the healthcare community.   

With a new year I thought it might be interesting to take a look at changes in American health over the last 50 years, so I asked chatgpt.com to tell me about those changes: Share 1. Obesity Rates 1975: Approximately 15% of U.S. adults were classified as obese. Today: Over 42% of U.S. adults are classified as obese (2020 CDC data). Implication: There has been a dramatic increase in obesity, linked to dietary changes, sedentary lifestyles, and larger portion sizes. 2. Life Expectancy 1975: Life expectancy in the U.S. was approximately 72.6 years. Today: Life expectancy is around 76.4 years (2023 CDC estimate), though it has fluctuated due to factors like the COVID-19 pandemic. Implication: While life expectancy improved for several decades, recent trends show a plateau or decline due to issues such as chronic diseases, drug overdoses, and other public health challenges. 3. Physical Activity 1975: A higher proportion of Americans were engaged in physically active occupations, and fewer had sedentary jobs. Today: Over 80% of jobs are considered sedentary or require low physical activity, contributing to lower daily energy expenditure. Implication: The shift to more sedentary lifestyles has significant health consequences, including increased risks for heart disease and diabetes. 4. Diet and Nutrition 1975: The average diet included fewer ultra-processed foods and sugary beverages, but higher rates of smoking were observed. Today: The typical American diet includes a higher percentage of calories from processed foods and added sugars, contributing to metabolic disorders. Implication: Diet quality has worsened in many respects, despite increased awareness of nutrition. 5. Smoking and Substance Use 1975: About 40% of U.S. adults smoked cigarettes. Today: Smoking rates have decreased to around 12.5% (2023 estimate), but issues like vaping, opioid use, and alcohol consumption have increased. Implication: Public health campaigns against smoking have been successful, but new challenges in substance abuse have emerged. 6. Chronic Diseases 1975: Rates of chronic diseases like diabetes and heart disease were lower. Today: Prevalence of type 2 diabetes has more than tripled, affecting over 11% of adults. Implication: Chronic disease rates are higher today, correlating with lifestyle and dietary changes. 7. Mental Health 1975: Mental health awareness was limited, with fewer diagnoses and less treatment. Today: Mental health conditions like anxiety and depression are more widely recognized, but rates of these conditions are higher, partially due to increased awareness and modern stressors. Implication: Mental health care access has improved, but challenges persist with rising rates of mental health issues. Now back to a human being: Overall, it seems like a mix: people are much fatter but still live a few years longer, probably thanks to more sophisticated medical interventions.  So lifespan is longer but that doesn't mean that health-span is longer.  We're much less active generally, and that's a huge problem.  We smoke much less, which is great, but deaths due to drug abuse, particularly opioids, have risen dramatically.  We write and talk much more about nutrition and what's in food, but still eat far more that is bad for us.  Type 2 diabetes has dramatically increased doe to the lack of physical activity and poor diets.   More people are diagnosed with mental health issues, but its very difficult to know if that's because those issues have actually increased or just because people are more willing to recognize them.