Thursday

191219

Workout of the Day

73

Karen

For time:
150 wall-ball shots

♀ 14-lb. ball to 9-ft. target
♂ 20-lb. ball to 10-ft. target

Post time to comments. | Compare to 181103.

Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent Upon Capacity for B Cell Recovery

3

This 2018 paper on the Diabetes Remission Clinical Trial (DiRECT) reports the small share of diabetic subjects who fail to achieve glycemic control with weight loss differ only from successful responders in the ability of their pancreatic beta-cells to return to normal function. The DiRECT study thus further establishes that diabetes can be reversed through diet alone. Significantly, it also reinforces the importance of early intervention, as a diet started soon after diagnosis (before stressors have begun to degrade pancreatic beta-cell function) is more likely to successfully reverse diabetes.

Read MoreRemission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent Upon Capacity for B Cell Recovery

Comments on 191219

76 Comments

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Doug Brubacher
December 17th, 2021 at 11:32 pm
Commented on: 191219

CFWUx2

17:44

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Kang Gyeong Ho
December 16th, 2021 at 10:41 am
Commented on: 191219

남(m)/46(Korean age 46 Western age 46)/171cm/92kg/211216/

For time:

150 wall-ball shots

♀ 14-lb. ball to 9-ft. target

♂ 20-lb. ball to 10-ft. target

Post time to comments. /

오늘기록 14분29초/

지난기록 16분23초/

목요일 저녁와드

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John McCash
June 3rd, 2021 at 9:23 pm
Commented on: 191219

Beginner: 75 wall shots; 5:50

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Kury Akin
April 5th, 2020 at 1:03 pm
Commented on: 191219

7:34 9kg bag of rice (sets of 30 with a few seconds breather)

8:42 181108

(edited)
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Clint Michael
February 9th, 2020 at 3:52 pm
Commented on: 191219

13:26

Rx’d

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Matthew Aukstikalnes
February 6th, 2020 at 2:17 pm
Commented on: 191219

RX - 7:44, compared to 7:58.

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Jeff Chalfant
January 9th, 2020 at 10:19 pm
Commented on: 191219

rx 9:05 (13sec pr) last time sets of ten with timed rest. This time 17-16-15-14-13-12-11-10-9-8-7-6-12


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Jeff Chalfant
January 9th, 2020 at 10:27 pm

Woke up with unexplained sternum/upper back pain. Probably from working a few explosive pull-ups into rest day. Also tweaked my meniscus walking to the bathroom (aging sucks) this morning so I was hesitant to do this one but felt no pain or discomfort during and the knee feels fine now. Next time shorter breaks during the first few sets.

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Jeff Chalfant
January 9th, 2020 at 10:31 pm

Next time try 15-15-14-14-13-13-12-12-11-11-10-10

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Cy Azizi
January 3rd, 2020 at 8:28 pm
Commented on: 191219

13:52

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Morgan Greene
January 1st, 2020 at 7:59 pm
Commented on: 191219

5:44

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Fabian Delaflor
December 31st, 2019 at 8:42 pm
Commented on: 191219

150 thrusters

first 37 @#20 dumbells

the rest @ #15 dumbells

10:45

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David Swicegood
December 29th, 2019 at 12:18 am
Commented on: 191219

5:23 @ 12 lb ball


rx

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Ignacio Robert
December 28th, 2019 at 10:53 am
Commented on: 191219

5.32 RX

M 43/95 k/ 181 cms

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Dan Kremer
December 28th, 2019 at 2:29 am
Commented on: 191219

7:37

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Jade Teasdale
December 28th, 2019 at 1:02 am
Commented on: 191219

9:34 RX

Not great, but a PR... on very sore legs! Can’t complain!

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Philip Uemura
December 24th, 2019 at 8:48 pm
Commented on: 191219

9:50 used 16lbs basketball

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Chase Hiland
December 23rd, 2019 at 10:25 pm
Commented on: 191219

M/35/5’10”/190


Rx’d 6:24

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Joseph Alaimo
December 23rd, 2019 at 8:19 pm
Commented on: 191219

5:22 (rx) 115 reps in a row to start

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Alex Pham
December 21st, 2019 at 9:49 pm
Commented on: 191219

10:56

Rx

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Robert Norbryhn
December 21st, 2019 at 9:38 pm
Commented on: 191219

6:37, last 6:14.

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Olivia Leonard
December 21st, 2019 at 4:16 pm
Commented on: 191219

7:59 rx

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Thomas Wade
December 21st, 2019 at 2:20 pm
Commented on: 191219

11:05 rxd

6.0 180 48

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Il Xlll
December 21st, 2019 at 4:20 am
Commented on: 191219

10:33 @20kg barbell

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Giuseppe Petrillo
December 20th, 2019 at 9:07 pm
Commented on: 191219

7:00 rx’d

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Jeffrey Howard
December 20th, 2019 at 8:40 pm
Commented on: 191219

7:10 - Rx

After watching my video, I misscounted and did 149/150 reps.

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Jeffrey White
December 20th, 2019 at 7:40 pm
Commented on: 191219

M/34/175lbs


8:07 RX. I believe it’s a PR buts it’s been a couple years since I’ve done Karen!

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Clarke Read
December 20th, 2019 at 5:16 pm
Commented on: Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent Upon Capacity for B Cell Recovery

Going back to the DIRECT trial:


https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext


(Unfortunately, it’s paywalled)


The intervention during the weight loss diet was “a low energy formula diet (825 - 853 kcal/day; 59% carbohydrate, 13% fat, 26% protein, 2% fibre) for 3 months followed by structured food reintroduction of 2-8 weeks (about 50% carbohydrate, 35% total fat, and 15% protein). Per the original trial, 46% of subjects following this intervention (which also included cessation of oral anti diabetic and antihypertensive medication) demonstrated remission of diabetes. That initial trial found a close relationship between weight loss and diabetes remission; this trial builds on this by demonstrating a particular biological phenomenon - that is, restoration of pancreatic beta cell function - stratifies those who respond and those who do not.


JR Wild and Richard Feinman are correct to argue this very-low-calorie diet is also a highly carbohydrate restricted diet - in fact, that is part of the reason this study is featured on the site. With the composition above, these subjects would be consuming fewer than 500 calories of carbohydrate per day. If we assume (and this is likely a conservative assumption) they consumed a 2000-kcal 55% carbohydrate diet at baseline, this would be a more than 50% reduction in carbohydrate intake.


What I find most compelling about the literature of diabetes remission is that multiple interventions - very-low-calorie diets, highly carbohydrate restricted diets, even (per Aseem Malhotra’s Pioppi diet) a heavily modified Mediterranean diet, alongside the more mainstream solution of bariatric surgery - all drive reversal/remission of a condition that much of the clinical community considers to be chronic, progressive and irreversible. It is not a coincidence that these diets all involve severe restriction of refined carbohydrate and sugar. In other words, we could just as easily frame this literature as a relatively robust data set supporting the clinical efficacy of a single intervention, applied in different ways (specifically, sufficient carbohydrate restriction, with or without calorie restriction, to meaningfully suppress insulin and drive rapid liver fat clearance) to different populations. Given the fact that no pharmaceutical intervention I’m aware of has matched the efficacy of ANY of these dietary interventions, I’d suspect we have a roster of choices to make available to drive diabetes remission. Changes to the composition of the diet (i.e., carbohydrate restriction, independent of calories), quantity of the diet (i.e., calorie restriction), and possibly exercise can be leveraged to achieve this specific metabolic state.


This study helps illustrate what that metabolic state is. As other pieces have shown, liver fat and then pancreatic fat clearance and restoration of beta cell function is coincident with resolution of fasting insulin, then first-phase insulin response, then fasting glucose. As the other two commenters have noted, these biological and biomarker changes are intrinsically linked. This study also shows clearly that in some subjects, the decreases in organ fat content are insufficient to drive complete functional restoration, explaining specifically why these interventions are not universally effective, even within compliant subjects. This, to me, suggests two things - (1) the correlation between overall body weight and diabetes is not causal, but is mediated by the fact that fat gain leads to organ fat storage and (2) ANY intervention that drives rapid organ fat clearance will, in the majority of subjects, also drive rapid diabetes resolution. Current data - clinical and anecdotal - points us to a series of established interventions for #2, but I would suspect any intervention that achieves the same would also be effective. If we’re looking at future research directions, then, they would logically be to establish (A) the full suite of interventions, combining diet and exercise, that can achieve that organ fat clearance, and the markers that may help us predict effectiveness in specific subjects and (B) any tools that may drive restoration of pancreatic beta-cell function in those non-responders.


It would seem we have a cure for diabetes. The question is how best to implement it, both individually and at scale.

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Andrea Ferendeles
December 20th, 2019 at 5:03 pm
Commented on: 191219

Rx 6.40

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Scott MacArthur
December 20th, 2019 at 4:40 pm
Commented on: 191219

9:53

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Ryan Cook
December 20th, 2019 at 1:24 pm
Commented on: 191219

8:15. This was almost more mental than physical.

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joseph griffin
December 20th, 2019 at 12:32 pm
Commented on: 191219

34/m/190lb

12:49 rx

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Claire Fiddian-Green
December 20th, 2019 at 12:30 pm
Commented on: 191219

7:42 Rx. Compare to from 181103 7:55 Rx.

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Nicholas Rossin
December 20th, 2019 at 10:55 am
Commented on: 191219


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Jade Teasdale
December 20th, 2019 at 6:03 am
Commented on: 191219

Did the SDLHP, Push Press & Row WOD! (subbed row for: Single Under Jump Rope) No Rower! Results there!

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Pavel Stas
December 20th, 2019 at 4:34 am
Commented on: 191219

6:30 rx

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MJ Hurley
December 20th, 2019 at 1:20 am
Commented on: 191219

Getting back into fitness, health, and CrossFit


Long way of saying I have no excuses and I’m out of shape. Lets. Go.


35/m


12:40 as rx’d

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Andrew Sylvia
December 20th, 2019 at 12:49 am
Commented on: 191219

17:12 Rx

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Michael Bishop
December 20th, 2019 at 12:27 am
Commented on: 191219

Just under 10 minutes


my shoulders just didn't have much today

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Shane Azizi
December 19th, 2019 at 10:46 pm
Commented on: 191219

18:17 Rx

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Charlie Pokorny
December 19th, 2019 at 10:45 pm
Commented on: 191219

9:12 Rx

So so - PR from a few years ago is 7:27.

m/51/5'11"/200#

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Christian Simpson
December 19th, 2019 at 10:32 pm
Commented on: 191219

Rx, 1st Karen ever...8:40

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Christopher Voght
December 19th, 2019 at 10:28 pm
Commented on: 191219

8:47 Rx, PR


181103 9:45

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Tripp Starling
December 19th, 2019 at 10:18 pm
Commented on: 191219

Oh man, there’s a reason that’s a named workout. Fran cough...

Rx in 11:18

Goal was sub 10 couldn’t hold after 5 minutes. Tried 8/7 every :30

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Antonio Larco
December 19th, 2019 at 8:23 pm
Commented on: 191219

9'19" rx

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Michael Arko
December 19th, 2019 at 8:19 pm
Commented on: 191219

45lbs barbell thrusters

9:36

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Michael Arko
December 19th, 2019 at 8:21 pm

Last year, 2 x 18lbs dumbbells (36lbs) 9 mins flat; so this was 7% more time with 20% more weight -- roughly even?

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Nicole Deaver
December 19th, 2019 at 7:04 pm
Commented on: 191219

5:33 (PR)


Compare to: 6:37(PR)


Not Rx, but I’ll take a new PR!

Only have a 10# ball to use for wall balls and garage ceiling 8ft.

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Shaun Stapleton
December 19th, 2019 at 6:33 pm
Commented on: 191219

35/195/5’9/M


Rx 7:28 (1:13 PR!)

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Eric Love
December 19th, 2019 at 6:08 pm
Commented on: 191219

8:15@16lbs

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Jacob Cram
December 19th, 2019 at 5:55 pm
Commented on: 191219

5:44 Rx

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Steven Odom
December 19th, 2019 at 5:29 pm
Commented on: 191219

Rx’ed

6:44

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Steve Day
December 19th, 2019 at 5:06 pm
Commented on: 191219

Subbed 150 DB Thrusters w/(2)20lb DBs

8:42

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Nathaniel Robichaud
December 19th, 2019 at 4:59 pm
Commented on: 191219

No ball no wall...

2*20lbs DB thrusters

6:53

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Jon Wilson
December 19th, 2019 at 4:27 pm
Commented on: 191219

8:59 (PR)

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Evan Saber
December 19th, 2019 at 2:48 pm
Commented on: 191219

10:56 RX


Old time: 8:20... some how less fit 🤷🏽‍♂️

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Jim Rix
December 19th, 2019 at 2:24 pm
Commented on: 191219

With 20# DBs

10:45


181103: 100 wall balls in 6:07

DBs felt more difficult to me. I hit 90 today at 6:07, 100 in 6:59.

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John Clarke
December 19th, 2019 at 1:42 pm
Commented on: 191219

6:54 - 16lb ball, 10 foot target.

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Eric O'Connor
December 19th, 2019 at 1:23 pm
Commented on: 191219

Those of you that have done this workout know that some pain is to come! Faster athletes will complete this workout in under 6 minutes and a great goal is to have everyone finish in under 10-12 minutes. I highly recommend most people break this workout into short-manageable sets with small rest breaks (no more than 5-7 breaths). This usually ends up being more sustainable for most people and may lead to less soreness than high-rep sets. Here are some scaling thoughts:


Wall-ball Shots: The volume of reps is high! For experienced athletes, I will have most of them attempt this workout as prescribed. For athletes that are new or where I think the volume will lead to excessive soreness, I will scale the reps and/or weight/height. I’m ok with being a little cautious on this one!

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Dave DeCoste
December 19th, 2019 at 12:09 pm
Commented on: 191219

7:42 Rx

This is a PR for me. Previous PR was 8:43 in Jan ‘17. Legs are burning!

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Mike Andridge
December 19th, 2019 at 11:32 am
Commented on: 191219

DL's before wod

then scaled Karen to

150 thrusters with 15# db's

12:29

m/49/175

I'm at the point with my left knee where I could either

not go below parallel and only go a bit faster or go full range of motion below parallel and go a bit slower.

Chose full range of motion-below parallel. screw the clock. me vs. me.

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Jim Rix
December 19th, 2019 at 2:26 pm

Good choice.

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jr Wild
December 19th, 2019 at 11:18 am
Commented on: Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent Upon Capacity for B Cell Recovery

Compared to Virta Health ketogenic approach, this DiRECT fares almost as well. 800kcal "soup" means also less carbs (400kcal) and probably less frequent eating -both good. Re-intro of food happened along "recommendations", and interestingly the weight loss was mainly maintained. Usual care, as usual, was useless in both Virta and DiRECT. The decease is progressing under usual care, everywhere in the world.


The metabolic rate is ca. 4-fold in visceral organs, which would explain nicely, why the fat loss happens first and fast in liver and pancreas after intervention (less insulin messing around). The function of pancreas is revived...at least partially.


The loss of insulin secretion gradient likely fails to act as a flip-switch to suppress glucagon = suppress enough the liver glucose release. Prof Noakes referred to a real time baboon portal vein measurement, where they could conclude that liver never stops releasing glucose into circulation, but is being suppressed though. Failure here might lead to constantly higher clugose levels.


Enough with speculation, I have no way of being sure of the above. Prof. Feinman is correct; the establishment likes this "soup" approach better than ketogenic intervention, it is closer to "recommendations". The "pill" here is commercial TDR, with keto there is less control for doctors. Wonder, patients given the informed choice, who would take "soup and hunger" and who "steak without potatoes" ...?

JR

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Sebastien Fitzpatrick
December 19th, 2019 at 11:12 am
Commented on: 191219

8:31 Rx


I’m bad with high volume wall-ball shots. But my lifetime PR was 8:53 so I’ll take it!

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Jim Rix
December 19th, 2019 at 2:25 pm

A PR is a PR!

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Evan Saber
December 19th, 2019 at 2:50 pm

Man. I missed mine by almost 3 minutes lol. Not feeling my best today, but moving forward!

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Antoine Vial
December 19th, 2019 at 11:07 am
Commented on: 191219

9'18''

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Stacey Thompkins
December 19th, 2019 at 10:34 am
Commented on: 191219

M/45/6'2"/180#


Sub'd KB thrusters with 26.5# KB's reps as rx'd

8:57

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Hank McKibban
December 19th, 2019 at 6:22 am
Commented on: 191219

8:31 rx

181106 - 8:14 rx

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Chris Sinagoga
December 19th, 2019 at 4:58 am
Commented on: 191219

Champions Club Scaling Notes


RANT

So do you remember that teacher in college who would say, "now you all paid for a 4-hour class so I want to make sure you get your money's worth." I would have paid double for Professor Eaton's oblivious ass to let us out an hour early. Anyway, the thing that I always fight with on these days as a coach is the obvious, "what do we do with the rest of the session?" Honestly, nothing. Let them out early. A session is done when a session is done. Sometimes we go overtime by 5-20 minutes if we aren't getting what we want, and if the workout is Karen then the session will probably be done early. Don't be Professor Eaton.


PURPOSE: test.


NEW TO CROSSFIT VERSION: as is


TRAINING VERSION: your workout is done when you stop. This will emphasize stamina and give you a better idea of your tolerance for discomfort. You can probably always do one more wall ball if you really wanted, so have a consequence for giving in to it.


PRACTICE VERSION: 3-sec. descent on all 150, emphasize going butt back but staying on the ball of the foot. turn the timer off.


GROUP VERSION: as is, read the rant.


INJURY VERSION: pick one movement you can do and do a lot of it.


WARMUP:

Squat - obvs

Push-up - elbows on wallball

Kb swing - core to extremity prep

Pull-ups - spend some time hanging

Jump rope - always


GENERAL FEAR LEVEL: 8

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QiHui Xing
December 19th, 2019 at 4:23 am
Commented on: 191219

RX:6'26''

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Steven Thunander
December 19th, 2019 at 4:14 am
Commented on: 191219

Globo scale: if you do not have a wallball sub 150 dumbbell thrusters 15/20lbs. If you have an appropriate weight ball but no wall throw it 10 feet into the air and catch it 150 times. If you do not have any equipment today do 150 burpees.

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Steven Thunander
December 19th, 2019 at 4:15 am

2x dumbbells on the thrusters; be explosive on the movement.

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Richard Feinman
December 19th, 2019 at 3:59 am
Commented on: Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent Upon Capacity for B Cell Recovery

The most important aspect of therapy for type 2 diabetes is the role of low-carbohydrate and ketogenic diets because of the overwhelming effectiveness in bringing about improvement and remission and, at the same time, the resistance of the medical establishment to recommending it or even acknowledging published results. This paper characteristically does not mention the background on low-carbohydrate diets although we usually expect scientific papers to cite previous work by others. (It does mention bariatric surgery however).


The paper is about the effects of a very low calorie diet. How low? Well, it isn't easy to tell. One might expect that a breakthrough approach to diabetes, as this was touted, would have the description of the diet as a salient feature of the report. The information is hard to find in the summary or even in the original study but from the protocol it turns out that on "Week 0-12: a commercial micronutrient-replete 825-853 kcal/d TDR (soups and shakes)...." In other words, the intervention was 12 weeks at about half the caloric level of the Minnesota Starvation experiment (https://www.apa.org/monitor/2013/10/hunger). The astounding thing is that a third of the patient did not respond in terms of glycemic control and remission of diabetes and the current paper is about how great it was anyway. Something is not right here.

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Bryan Rosen
December 19th, 2019 at 1:33 am
Commented on: 191219

Warm for 191219:

GENERAL WARM-UP


3-5 minutes of rowing at an easy pace


AMRAP 5

25-ft banded side step (both directions)

Hold bottom of squat with a medicine ball for 30-seconds


1 set of 10 reps squat therapy

1 set of 20 glute bridges


SPECIFIC WARM-UP


Wall-ball shot

5 medicine ball goblet squats

5 medicine ball push press to target

2 sets of 5 wall balls

1 set of 10 cycled wall-ball shots at intended workout pace

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Juan Acevedo
December 19th, 2019 at 1:27 am
Commented on: 191219

INTENDED STIMULUS

.

Benchmark day! One of the most important contributions of CrossFit is that of giving an operational and elegant definition of fitness. Thanks to this we can measure it, and hence improve it. In the traditional implementation of our methodology, benchmark workouts are there to measure our fitness and give us meaningful data points of our progress. In this context, the intended stimulus is that of measuring. That does not mean that you necessarily have to do it RX or that you need to do the same scale you did in a previous attempt. It also does not mean that if you don't improve today from earlier efforts your fitness is stalling or regressing. It just means that your mindset should be that of observing where you are and how you can improve.

With that in mind, let's analyze this lovely little piece. Karen was first introduced as a part of a "Wall Ball Exercise" in 030729. The objective was to get all 150 repetitions in under 6 minutes. And then do some pull-ups, for five rounds, I know fucking insane. From then, it became a remarkable benchmark. The purpose of this workout always has been that of being a fast sprint. If scaling today, put yourself in that position. Can you get this done, under 6 with a lighter ball? If you can't, weight is not your problem, conditioning and speed are so, consider using more lighter balls in your training, and build that engine. If you can, then weight up! Now, even though this is a benchmark, going in with the pressure of having to PR is super counterproductive. Chill. You are fitter than before, have fun and see what happens.

And always remember Benchmark Girls are named after badass women that defied preconceived notions of what women should/shouldn't or could/couldn't do in training. Be humbled by these women and honor them with your best effort. Women like these are making the world a better place and will make it even better in the future.


Here's how the original "Wall Ball Exercise" went --it might serve you as a template:

1/2 minute – 12 shots

1 minute – 25 shots

1 1/2 minutes – 37 shots

2 minutes – 50 shots

2 1/2 - 62 shots

3 minutes – 75 shots

3 1/2 minutes – 87 shots

4 minutes – 100 shots

4 1/2 minutes – 112 shots

5 minutes – 125 shots

5 1/2 minutes – 137 shots

6 minutes – 150 shots


OPTION 1

For time:

150 wall-ball shots


♀ 12-lb. ball to 9-ft. target

♂ 16-lb. ball to 10-ft. target


OPTION 2

For time:

150 wall-ball shots


♀ 10-lb. ball to 9-ft. target

♂ 14-lb. ball to 10-ft. target


OPTION 3

For time:

150 wall-ball shots


♀ 6-lb. ball to 9-ft. target

♂ 10-lb. ball to 10-ft. target

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