We held a Q&A with Dr. Noah Akala, a medical practitioner who also is a football and fitness enthusiast, to answer some common questions and clear up some misconceptions that arise when people engage in physical training from a medical perspective, as well as to look at ways in which this translates to home-based training.

In this series of Q&A, we do a deep dive with Dr. Akala to clear the air and get advice on a wide variety of issues.

How did you choose to start physical training and how has being a doctor affected your approach to physical fitness?

Health&fitness was always a passion from a very early age. Growing up as the youngest of four siblings meant there was always running around and I was always the slowest. That helped me develop a competitive spirit and drive that found expression in sports and exercise.

Prior to medical school, I was competing with the whole world! To be faster, stronger… Now, with a deeper knowledge and appreciation of what it truly means to be healthy, I compete against myself.

A doctor’s life is quite demanding, especially under the current circumstances. How do you find time to train? How are you yourself adjusting your routine these days, now that you can no longer play football?

My personal perspective on this has always been that time is a matter of priorities. Sports was never a leisure activity done when I had time. It was always built into my daily routine in the same way as meal times and sleep.

My day feels incomplete without the endorphin rush that comes from a sprint and throwing some weights around. In normal times, I get about three to four days of football in with extra training on the side. With the lifestyle changes necessitated by the coronavirus pandemic, I now follow a domestic training routine that I get to do with my kids. It keeps everybody engaged, entertained and active.

As a medical professional who actively engages in physical training, what would you say are the biggest benefits that you’ve seen as a result of training?

In my experience as a medical doctor and as an amateur athlete, the biggest benefits of a healthy lifestyle supported by training is primarily in your quality of movement and in your sleep. By quality of movement, I mean the ability to perform routine daily tasks efficiently and pain free regardless of age. An active lifestyle keeps inflammation at bay and allows you to live a fulfilled and happy life. Furthermore, an active lifestyle enhances your ability to get deep and restful sleep that promotes focus and productivity during the day.

How big an impact does physical training have on mental health? 

It is now common knowledge that an increased heart rate arising from intense physical activity facilitates the release of endorphins. Endorphins are nature’s “feel good hormones.” A daily dose of endorphins reduces dependence on artificial alternatives that can create addiction. Moreover, it allows individuals to focus on a progressive journey that is within their control giving anyone and everyone willing to work on themselves a deep sense of purpose. 

It’s been reported that physical training results in the release of certain hormones in our bodies. What does this do for us and how long-lasting is the impact after training?

As mentioned above, an increase in heart rate can stimulate the release of endorphins that can give the individual a brief and fleeting sense of euphoria. For example, avid endurance runners are always chasing what they call the “runner’s high” caused by the release of these hormones at peak activity.

Many of us are now working on beds, sofas, kitchen tables and the like with resulting back and joint pains. What does physical training/exercise do for one’s posture and how is this important?

The human body is a machine built for use. Just like your car or bike, if you leave it parked and you don’t grease those bearings with regular exercise, it’ll begin to show signs of wear and tear prematurely. If you do have to work from home, skip the lounge furniture and consider a standing desk; this will do wonders for your upper back and indeed your basal metabolic rate. 

Under what circumstances is physical exercise actually advised/prescribed in relation to injury, illness or while on medication?

Depending on injury or illness, exercise may expedite recovery or improvement. A diabetic may find great improvement in his or her blood sugar levels with regular exercise, however, “training through the pain” is NEVER recommended. Exercise is meant to be challenging but not debilitatingly painful. If you ever feel this way, please consult your doctor for further advice. If you have pre-existing conditions such as heart disease or lung disease, the responsible thing to do is to get your doctor to clear you before engaging in any kind of exercise. This can be determined on a case by case basis.

How much exercise is sufficient to maintain a healthy lifestyle for the average person? What does this mean for people in confinement?

Cardiologists recommend light to moderate aerobic exercise for at least 30 minutes, at least three times a week to maintain good cardiovascular health. Traditionally, people have viewed aerobic exercise as running, swimming, cycling and other activities that require space. However, you can raise your heart rate to aerobic level with activities such as stationary cycling, stationary rowing or if you don’t have the equipment, you can do burpees or jumping jacks for an extended period to achieve the same result.

Based on human physiology and how the body works, what’s more effective at burning fat (both to lose weight and to get lean) – building muscle or cardio? How does this work for home-based training?

To lose weight, one has to attain a caloric deficit. This basically means one needs to get to a place where you are using up more calories than you are consuming so that your body digs into your calorie reserves to fuel the extra requirement. Therefore, weight loss and/muscle gain begins in the kitchen and is honed through activity.

Let’s get a little technical on the above – could you explain what makes up fat and muscle and how these two elements play out in the body?

Fat is made up of what is known as adipose tissue. The excess calories that you consume are converted from glucose into adipose tissue. On the other hand, muscle tissue is made up of protein, that is red and white meat as well as leguminous vegetables. For muscle tissue to grow, diet alone does not suffice. The individual must also be on a training regimen as opposed to weight loss which can be achieved to some extent through caloric deficit.

Can bodyweight exercises build significant muscle mass or is that only achievable through weight training? How can people thus adjust their muscle mass growth targets in a home-based setting?

Bodyweight exercises are instrumental in functional movement as well as muscle toning. This depends on the intensity of training. The more intense the training, that is, the higher the rep count, then the more productive the work out in terms of muscle toning and strength.

If an individual is keen on muscle mass growth, then bodyweight exercises can only get you so far. Given that the weight involved is relatively consistent, it becomes difficult to increase the load. However, this does not prevent you from being creative with your surroundings. You can make use of your kids, big water bottles, chairs and so on to increase your training load.

Confinement means easier access to the fridge, but not necessarily to the food you would normally eat – any comments on how people can adapt their diet to maintain their physical health?

During this period of restricted movement, there is a general tendency for people to slip into bad eating habits. This is not because of hunger but more so due to boredom. So how can you stay on the wagon with regards to your eating habits? 

First, try as much as possible to maintain some kind of routine; wake up at a regular time and go to bed at a regular time. This will help you maintain regular eating times.

Try to prepare your meals ahead of time and when you have eaten. Preparing food in hunger often leads to unhealthy food choices due to pangs.

Stock up on healthy alternatives; nuts, seeds and water are the key here. Steer clear of sugar!!! Sugar is like a slow acting poison.

Following on that question, we hear a lot of negative vibes regarding sugar, salt, saturated fats, processed meats…the list is endless. In today’s world where these are everywhere and hard to avoid, especially in many foods with long shelf life, how best can one navigate to maintain good health?

Coach Greg Glassman who founded the concept of Crossfit advises that you eat meat and vegetables, little starch, nuts and seeds, some fruit and NO SUGAR! This mantra captures a healthy diet in a single sentence. Try to keep it as fresh as possible. Follow these guidelines and you’ll be ok. 

What foods would you advise adults to substitute or eliminate entirely from their diets?

The only thing I am radical about is sugar. And by sugar, I don’t just mean table sugar, I mean anything that is sweet to the taste such as fruit juice, carbonated drinks, cakes, pastries and so on. These food groups are the single largest contributors to almost all forms of modern day lifestyle diseases.

Tell us briefly about the science behind the importance of water especially regarding physical health.

Water comprises about 70% of the human adult body. The brain and the heart carry the highest in terms of percentage with up to 73% of both organs made up of the essential element. Water plays a key role in our circulatory function and in the normal and efficient functioning of our muscles. There is simply no life without water.

Coming back to all the above, what are your thoughts on the importance of having a personal trainer or some form of guidance through a fitness regime, especially when you start a new routine or adjust your normal routine to training at home?

In my opinion, the primary importance of a personal trainer in your fitness journey is to have a knowledgeable sounding board to prevent injury and harm to oneself. Once we get past this, a personal trainer can help an individual reap significant benefits in health and fitness by optimizing a training regime against your specific needs as well as keeping you accountable in your regime.

Any final tips or advice for people who may be considering starting a home-based training programme? Working from home does not mean less busy schedules; what suggestions do you have for us – those who are stuck to our screens and those who are at the same time juggling caring for others (children and family members)?

Pick a method that works for you and stick to it. It can be as simple as a daily walk. The most important thing in exercising is consistency so it doesn’t matter how slowly you start as long as you just start. And stick to your routine while looking for ways to keep it fresh and interesting. Exercise is meant to be fun.