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May 08, 2009

Video Article

FilFest 09 was CrossFit’s annual affiliate gathering, which took place on February 7th and 8th, 2009 in Austin, TX. In a question and answer session on Sunday the 8th, Coach Greg Glassman gives the crowd of a few hundred affiliates a brief on CrossFit’s new definition of health.

This material has been covered already in a thorough explanation of the volume of work capacity sustained throughout life, and in his presentation to the American Society of Exercise Physiologists. But, this short clip summarizes the essence of the definition extremely well. And, it specifically addresses some of the discussion happening in the comments of those two clips.

Fitness is defined as work capacity measured across broad time and modal domains. Health is the ability to sustain that fitness. It takes into consideration all-cause disruption in that any disease, illness, or injury will manifest itself as reduced work capacity (if it doesn’t, how sick or hurt can you be?). Therefore, the only way to sustain the highest levels of fitness is to avoid, or at least minimize, disease, illness, and injury.

This is a metric for defining and measuring health. Arguably, the first of its kind.

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31 Comments on “FilFest 09: Health and Fitness”

1

wrote …

Awesome presentation! This is great stuff with a huge impact. It seems so simple, yet so important to understand. Great stuff for a coach to share with clients who may care more about health than elite fitness. The concept of accelerated demise sounds good to me. I'll take a long life with high work capacity across broad time and modal domains, then an accelerated demise. I'll pass on living in a nursing home for many years or even decades. I've been thinking a lot about this stuff lately.

2

wrote …

Tony thanks for posting this...

You guys are putting up so many things on a daily basis now that if you skip a couple days it's becoming increasingly difficult to keep up with the knowledge being dished out on a regular basis.

3

wrote …

Coach, Can not express enough gratitude to you for all you do. This presentation at the Fil Fest was F'n awesome. Documenting it for "All" to see is A-1 Coach Glassman style as always. Thank You from me, my Clients and all those who see but
don't get to post. My life has been charged up since I found CrossFit and now at 60 I may be in the best shape of my life. Thanks to you and the superb HQ staff. All the best always.

4

wrote …

I love this idea, and have been contemplating it since it was first mentioned on the site. What keeps coming back to my thoughts is: how can this be a solid definition of health since there seems to be gaping holes?

I bring this up to stimulate some thought (I will elaborate in a second) or for someone to clear it up for me. Maybe I've totally missed something. Maybe this is a good metric of health, but not the only one. (The same way that Coach has discussed three models of fitness.)

This, to me, would be the most illustrative example for refuting this metric of health. What happens when a person who is 'fit' and 'healthy' - as defined by Coach's definitions - dies? Is it just bad luck? After all everyone is going to die. Or were they not actually healthy? I'm not considering random examples (eg getting struck by lightning, plane accident, whatever), I'm referring to medical problems, such as a 25 year old fit athlete dying on a basketball court from hypertrophic cardiomyopathy. How does being Crossfit 'fit' protect you from getting malignant melanoma or mesothelioma? It may prevent broken bones, CVD, certain cancers, but it is not all inclusive.

5

wrote …

Does anyone know where I may be able to find a copy of the Wall Street Journal article that Coach is talking about?? I searched "theodore dalrymple" along with "fitness" and "accelerated demise" and still could not find the actual article. Thanks.

6

wrote …

I totally agree that the new paradigm by which well-being is measured is fitness, and I further agree that Crossfit is THE BEST method to use to become and stay fit over a lifetime. A big chink in the armor is the high rate of injury that happens within the Crossfit model. Many people jump in, heedless of the scaling advice, and proceed to incur an injury they never experienced before - shoulders especially. These injuries go on to become chronic things - bursitis is probably the most common. I don't want to advocate putting up even more warnings and red lights for the dummies who jump right in, but clearly, some kind of entry test of fitness should be employed so these kinds of people can start off more slowly and fundamentally. I'm talking specifically about people who don't have access to an affiliate or personal coaching - just website lurkers. The risk of injuring these people is higher than taking them to the uber fitness that Crossfit is designed to do. What to do about this?

7

replied to comment from Matt Solomon

This doesn't represent a metric of health, it represents a definition of health. What's so cool about it is that it's giving a definition of health that isn't just based on risk factors for when you'll die, but describing how healthy you are during the course of your life. It is not saying that fitness will necessarily determine how long you live, it is saying that your health is defined as a factor of the length of your life and your average fitness throughout your life.


If somebody who is fit suddenly dies, that will cut of the "age" axis. This will limit their "health", since age is one dimension, so the model is not claiming that a fit person who suddenly dies is necessarily healthy. However, they had a healthier life than they would have if they hadn't been fit, and they may have had more health than somebody who lived very long buy could barely move.


This is saying that lack of fitness is more than just another risk factor that determines how long you might live, but that fitness across the span of your life is your health, and other risk factors (like heart problems, cancer, etc.) predict your health to the degree that they predict your fitness over the future years of your life.

8

replied to comment from Andrew Carnahan

Andrew, the description of the video states "This is a metric for defining and measuring health." ....?

Are you saying it's better to be more fit, thus more healthy and then die at a young age?! 25? 50? Why do people associate longevity with guaranteed total dysfunction? This is clearly not a black and white issue. Fitness and function/work capacity are continuums, and not a matter of having it or not.

Is someone who keeps a sub 2:00 minute Fran (and other awesome times/scores across various workouts) from ages 18 to 50 and then dies better off than someone who keeps moderate work capacity until they are 80? How does this metric compare that? Would you justify calling that 50 year old 'healthier'?

Furthermore, health goes beyond physical factors. There are many intangibles, like happiness. Being sad, depressed or angry your whole life might not limit your work capacity - in fact, anger might ramp your SNS drive, thus increasing your work capacity - but it won't be good or mentally healthy.

9

wrote …

Interesting video. Many people are thinking about health and fitness. Here is another video, another viewpoint, http://www.youtube.com/watch?v=0NxnywlDOb0 presented by Doug McGuff, co-author (with John Little) of Body by Science.

Justin

10

William Adams wrote …

What we are witnessing currently in Crossfit is the advancement of several elemental concepts that may just become the foundation of a new understanding of health. This is a very exciting time for Crossfit.

Have Fun, Train Hard,

Billy

11

replied to comment from Matt Solomon

Hi Matt,
I believe that the point is well made that at present we do not have an adequate metric for health. As coach points out VO2 max and such are not enough. It is easy to jump on longevity as an outcome i.e if you are fit even crossfit fit you will live for a long time, but the truth is we are all born with a genetic program that when exposed to our environment will result in some insult that will lead eventually to our demise.eg a 25 year old with a family history of melanoma who lives in sunny Barbados and does not wear sun screen will most likely get a melanoma and die.
What excites me about this fitness metric is the ability to withstand a physiologic insult, as an anesthesiologist I have been looking for this measure to tailor my perioperative management and risk profile patients. So if this same 25 year old comes for surgery bleeds his haemoglobin down to 3g/dl and suffers a wound infection and ends up on the ICU, it gonna be easier to manage the 25 year old with a sub 2min Fran as opposed to the 25 year old xbox potato. And its because the crossfitter has an increased work capacity, his body has an increased work capacity and the fitter he is the more he is able to withstand the insult.
"Is someone who keeps a sub 2:00 minute Fran (and other awesome times/scores across various workouts) from ages 18 to 50 and then dies better off than someone who keeps moderate work capacity until they are 80?"- I think the 50 year old is better off only from the point of view that he can bounce back from any insult better/faster than the 80 year old moderately fit. But it all depends on the genes and the environment/insult to be endured. I prefer to prepare for the worse and assume I need to be supremely fit, just in case.
Still trying to get my brain around these novelle ideas, thanks for the tickling my neurones.


12

wrote …

Just a thought. Coach used the example of a hypothetical 90 year old Greg Armundson who had 70% of his current work capacity but also high cholesterol. Now correct me if I misunderstood, but Coach seemed to imply the high cholesterol was irrelevant, since work capacity was still high. My issue with this model as a measure for health is that if someone had high cholesterol (or high blood pressure, etc.) which resulted in a heart attack which killed or debilitated them, we could agree that that person was in poorer health than a person with an exactly equal age and work capacity who did not have high cholesterol and continued living as they were. Of course the person who continued living would have a greater volume under the 3 axis model, but this would only be apparent after the hypothetical heart attack. This would seem to limit this models usefulness in defining health while the subject is still alive. I do agree that measured work capacity over broad time and modal demands is a great definition of fitness, I'm not sure health is as quantifiable. Also, this is my first post. Thank you for all this, it is changing my life.

13

wrote …

I love watching these videos; Coach is charasmatic and an accomplished speaker. But I'd REALLY like to see these presentations put into article form for more complete explanation and easy reference. Not to mention the written format is much easier on the visual learner.

14

Russell Berger wrote …

I think it is important to remember that the revised definition of fitness coach is presenting is as much a human construct as any other field of science. The idea of "Health" must be clearly defined before it can be measured... From what I can tell however, no one has ever effectively defined health as anything other than "not sick" until Coach came along. This definition of health encompasses far more than the absence of disease or a person's longevity. Using a little bioevolutionary logic, we can assume that the individuals nature selected for reproduction would be chosen almost entirely based on work capacity - the ability to fight, hunt, build, survive, and of course, impress a member of the opposite sex with this work capacity well enough to mate. Even our understanding of physical beauty shows a preference for figures that imply high-work capacity(and who doesn't love strong women doing Overhead squats?). To put the Greg Amundson example into the same analogy, nature doesn't care what your LDL levels are if you can club a tiger to death and build strong shelters. You will mate, your children will be protected long enough to mature, and your genetic imprint will be passed on. Longevity, blood lipids,and VO2 max do not fit into this equation. high cholesterol levels and high blood pressure aren't even good predictors of the diseases they are linked with. I've read in a number of studies indicating that somewhere near 50% of Heart attacks occur in people with average or "healthy" cholesterol levels. It's pretty clear why these metrics are described by coach as "subordinate"

T.S. Wiley's "Lights Out" (Robb Wolf recommends this one strongly) does a very good job illustrating the ways in which nature, by means of Cancer,Diabetes, Heart disease, and the other big derangement of the human body are just extensions of normal selection- "taking you out" when you become useless. She doesn't mention work capacity by our definition but I believe she would be in agreement with this model.

Does this mean increased work capacity will make us all live longer? Who knows, but then again, Nature rewards the species that lives better, not longer. I'd trade dying at 60 with a 4:00 Fran for living to 75 and barely being able to walk any day. I think we will find that most of the people doing CrossFit are of a personality type that would agree with this statement anyway.

15

replied to comment from James Biggs

Well, it comes down to the point - do we know, like for sure, that high cholesterol is bad (is it little bad, very bad, super bad, not bad at all and we just believe it is linked to heart diseases )? Or is it some kind of average stuff (of the same kind like recommended amount of fat/protein/carbs/vitamins for average person ) ? "Average" does't work here IMHO...
As Coach pointed out - being very functional at 90 (and let's say no one ever took you cholesterol measurement) and suddenly someone told you that your cholesterol is over the limit - would you at that point in time consider yourself ill ?

16

replied to comment from Russell Berger

Cool reply Russell !

17

wrote …

Using the volume under the 3-D curve as a measure of health seems of limited use to medicine because it is retrospective (it looks back). If I'm not mistaken health, when defined as an absence of disease, is gauged by taking several measurements (blood tests, etc), and comparing them to "normal" averages or charts to come up with risk factors. If Crossfit is going to develop a replacement for this method then we'll need more of an instantaneous or short-duration assessment technique that looks ahead.

I've been wondering if bringing down (for example) a Fran time from pretty fast to really damn fast would really make me healthier. Something tells me that slow and steady may ultimately be the best, especially if joints and internal organs don't get too taxed during the years of peak performance.

18

replied to comment from Russell Berger

I agree that no one has effectively defined health as anything other than not sick. I also see your point about survival of the fittest and work capacity linked to reproduction. And I agree that dying at age 60 in good health beats the hell out of dying in a nursing home. The point I attempted to make in my last post was that while work capacity measured over broad time and modal domains is an excellent definition of fitness, I don't believe that, measured over time, it is a useful tool for measuring or defining "health", since it cannot measure risk factors for diseases or conditions which have not yet affected work capacity.

I used the cholesterol example simply because coach used it, and this was an error on my part. I am not particularly knowledgeable regarding heart disease, my degree is in cj and sociology. Instead imagine we have 2 90 year old crossfitters, with near identical work capacity. If they had similar work capacity throughout their lives, by this 3 axis model they would be at the same level of health. If one of them is free from cancer, and the other has the early stages of some kind of cancer which will kill him in 3 months, but has not yet affected his work capacity, I would say that he is less "healthy" than his cancer free buddy. After the 3 months goes by, we can look at each crossfitters model and say, "Oh, this one's performance dramatically decreased here and then suddenly stopped, he was less healthy." However that information is not particularly useful after the fact. Health is a hard concept to measure and define. Perhaps if we combined Coach's model with "an absence of disease" it would work?

Put more simply, if I go to the doctor for a checkup and he tells me I'm in perfect health because I have excellent work capacity and can reproduce, and does not perform any of the standard screening tests for cancers, I'm probably going to switch doctors.

19

wrote …

Christopher,
you wrote "So if this same 25 year old comes for surgery bleeds his haemoglobin down to 3g/dl and suffers a wound infection and ends up on the ICU, it gonna be easier to manage the 25 year old with a sub 2min Fran as opposed to the 25 year old xbox potato. And its because the crossfitter has an increased work capacity," Interestingly, couldn't you argue that the benefits are because functions of VO2 Max and cardiac output and not work capacity? These three components are definitely related, but in this case, I think work capacity over broad time and modal domains is NOT ideal. Being able to pump oxygen around your body is - a marathoner would be better suited than a crossfitter. Coach mentions he could increase VO2 but it would be to the detriment of the other 10 aspects of fitness. In this case, flexibility, agility, accuracy, coordination, power and speed don't matter.

Russell,
there are definitions of health that go beyond just 'not sick', but it seems that CF (this is from other discussions) takes issue with the fact that they are vague and not measureable. They aren't really good working definitions. But is this one? Does increasing my volume under the curve make me more healthy? Does me going from 'xbox couch potato' to regular crossfitter help? Most likely. Does me going from above average crossfitter to Khalipa/Everett/Opt/Dutch good really make me more healthy? Are there still 'health' benefits or do they max out?

20

replied to comment from Matt Solomon

Matt – as regards the marathoner – there’s no evidence they are more likely to live longer or better than someone who walks 30 minutes a day. There are factors of their health that will be measurably worse than someone who walks 30 minutes a day. That’s another part of coach’s point – as regards improvements in the crude measurements of health that we have today, they all go up with CF, and none get worse. I’m not even convinced a marathoner will have a significantly higher VO2 max than an equivalent CFer, nor that their CV system would be better able to handle the emergency you address above. Your entire premise – that there is another methodology that prepares one better than CF for health/fitness - is speculation. To advance the discussion, please bring more evidence for us to consider. Paul

21

replied to comment from Matt Solomon

But as to your last question - that is an interesting one. My own guess is that that diminishing returns will be proven beyond a basic level of WCABTAMD. Paul

22

replied to comment from Michael Sawley

Michael, instead of the 90 year olds dropping dead from cancer in three months after a life of high WCABTAMD (an outcome so close to ideal that I think it must be viewed as a positive not a negative), think of the 45 year old with the classic profile of a guy at risk for early death of heart disease - lots of belly fat, high blood sugar, low HDL and high VLDL, high triglycerides, a family history of heart disease, male pattern baldness and years of minimal exercise. Throw in a high stress job, minimal positive relationships (divorced and strained relationships with children, parents and siblings), no significant spiritual practice, not well connected to any friends or social groups, and no effort to moderate the stressors in his life. We could predict his WCABTAMD – it will likely be very low.

FWIW, this guy’s also building a pretty good profile for high risk of other diseases of the West – cancer, stroke, diabetes … if he lives long enough.

A doctor can only offer this guy advice, which he probably won't take, and statins - perhaps something for the depression or chronic anger (unless it has not set in yet). Now if this guy wants to live, he should take little comfort in the statin Rx because the side effects are nothing to sneeze at, and for some might not outweigh the benefits. His WCABTAMD will still be the same, as will all the other nasty qualities of his life.

If on the other hand the guy pursued the CF Rx - randomized functional movements at (relatively) high intensity while eating meat, vegetables, nuts and seeds, some fruit little starch and no sugar - every measure of health we know to measure would go up, and none would go down. There would be no adverse side effect. This is a speculation, but it is supported by evidence.

The drugs have yet to be invented that would deal as effectively with this guy's problem - and if they did, can you imagine how much more they would cost?

IOW - what is the revolutionary medical intervention? It's CF. I would imagine most doctors would agree with that premise, because most see their patients’ problems (of this sort) as lifestyle driven. I know I’ve completely avoided the problem of how to get this miserable person to engage in CF – that’s another discussion.

I hope that’s really Coach’s point.

23

replied to comment from Apollo Swabbie

Paul, to advance your rebuttal, please don't be hypocritical.

"there’s no evidence they are more likely to live longer or better than someone who walks 30 minutes a day." I don't understand how you can claim the same feat about crossfitters but discard it for people who do endurance sports. Is there evidence for that about crossfit?

"There are factors of their health that will be measurably worse than someone who walks 30 minutes a day." And you're arguing that I'm speculating?! Really?! What factors?

Here are some VO2 max's (from running for fitness - no idea whether legit, just a quick google search, values in ml/kg/min) for some athletes: Lance Armstrong 84.0, Steve Prefontaine 84.4, Bjorn Daehlie (x-country skier) 90.0. You really want to claim that someone who walks 30 minutes a day is more healthy than these guys? Laughable.

My point was clear: VO2 max and cardiac output will help you if your blood/hemoglobin is low. Crossfiters will be better off than 'Average Joe', but how can you say that crossfitting is any better than simply improving those components? Sure, a CF guy might have better flexibility or max vertical jump than runners/cyclists but why does that matter? You further speculated that you know something about how crossfitters will have high a VO2 max? Do you have any evidence as to why I should believe you? Have you tested anyone?

I did not claim that other programs are better for fitness. I agree it's the best. I argued it's claim as being best for health. You put words in my mouth. Your response is classic on this site. Brush off the dissent and quickly claim the greatness of crossfit.

24

wrote …

Paul, I entirely agree with your most recent post (number 22). I wrote my last one while you were apparently typing. I agree the prescribed diet and exercise regime posted on Crossfit will help with all the medical problems you mentioned/alluded to. Health is much more broad than that.

25

wrote …

Love the debate... questioning is great, ask the same question doubting something though and you'll discover a doubtful answer.

Ask a question that brings greater meaning to you and you'll expand your understanding of the CF definition of health.

Not to say its the final definition of health but...

Perhaps one could ask "How can I test whether the CF definition of health can work for me?"

Crossfit for me has been an experiential learning process. Theorizing is awesome - it excites those neurons in the brain, but until I test it, how is it useful?

26

Russell Berger wrote …

Matt,

I would also take issue with any definition of fitness that wasn't measurable. If it isn't, it isn't scientific, and might as well be sociology (couldn't help that one, sorry)

you wrote:
"Does increasing my volume under the curve make me more healthy?" if your definition of health is increased volume under the curve, then yes- and as Paul has described, the Measure of work capacity is directly linked to lifestyle factors that tie into current "acceptable" if not inadequate definitions of health- blood pressure, lipids, body fat, etc.


James,

I have to disagree completely with your assertion that this Health-as-Work-capacity model can only be viewed in retrospect. The WOD itself is a daily assessment of health. This is purely anecdotal, but I've even noticed that poor lifestyle choices effect daily fitness measurements with a severity that mimics the order in which they would kill you- ie. Lack of sleep, dehydration, starvation, poor diet.


I think what this model may be showing us is that a fast Fran time isn't necessarily preventing disease, but the lifestyle choices that allow an athlete to produce a fast Fran time- our prescribed methods of diet, sleep, and exercise - might be just as influential. Which is it? Who cares. CrossFit just happens to be the most effective measurement by which you can test the validity of those lifestyle choices.

What we can't say yet (but I would be willing to put money on) is that successful CrossFitters won't experience the same auto-immune derangement and diseases that have become epidemics for the rest of society. Cancer, Heart Disease, alzheimer's,Diabetes...the whole gamut, are strongly linked with lack of sleep and high-carb diets.

27

Matt,

Regarding your comments about health including "intangibles, like happiness. Being sad, depressed or angry..."

After this presentation at FilFest, I mentioned this same thing to Coach, asking him how these intangibles fit into a definition of health that is starting to look like a quantification of "quality of life."

He agreed with me that these factors (having a job, a shitty marriage, being angry, depression etc.) are not measured by the fitness volume under the curve, but are also likely inextricably intertwined with them.

For example, is depression a cause of, or result of, people not exercising, eat well, or sleeping enough? I'd imagine that if your CrossFit numbers are getting better, many of the "intangibles" in your life are also getting worked on or worked out. In my experience, when a CrossFitter hits a plateau in training, it is equally likely to be an intangible as matter of form, nutrition, or whatever -- all these are completely intertwined and difficult to separate out as individual cause-effect factors.

I think the power of Coach's model is that it gives us a good starting point for further discussion toward a new understanding of fitness and it's relationship to health an to quality of life. At a minimum, it positions fitness front-and-center as the primary factor. That's in opposition to the current drugs-and-consumerism model that our society promotes for achieving health and good quality of life.

28

wrote …

So I've been thinking about this for about a week now, and I don't like that you start at zero as a baby. Your "health" at least conceptually certainly isn't zero, the potential inherent in every baby is tremendous and should be part of the definition in my opinion.

So your ability to adapt maybe should be included, not just a snap-shot of where you are currently. I mean just learning to stand up is an incredible increase in work capacity to me. Learning to walk like-wise...this is really counter-intuitive to label every baby as "health-less". And I'm not sure it's what a working definition of health should do.

29

wrote …

Well I had another thought right after I posted that. Maybe the shift in thinking is that babies don't start at zero, just because they would inevitably lose any fitness challenge or CF games, doesn't mean their work capacity is minimal. Babies don't have less energy than the elderly from my observation. Not only do they require more energy in, I believe they use more too. I am very ignorant on what the avg caloric intake needs are for any age group population, but it would seem you need more to grow than to maintain.

How do you account for all that energy use prior to the coordination, balance, agility is learned. Shouldn't that be in all of our Health volumes?

30

I searched as well and came up empty handed. I'd like to read the actual article but don't see it anywhere. Has anybody been able to locate it?

31

replied to comment from Stuart Brauer

I'm not sure, but this Theodore Dalrymple article looks like it may be the one Coach is referencing (it's interesting nonetheless):

http://www.oralchelation.net/data/HistoricalDiets/data10a.htm

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