Form & Func­tion with Dr. Gre­uner

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2018 will be many things, but we hope in ad­di­tion to your other plans and goals, that fo­cus­ing on your health will be at the top of the list! We took some time to talk to NYC Sur­gi­cal As­so­ciate's head doc­tor and Co-Founder, Dr Gre­uner. He is an ex­tremely ex­clu­sive and pres­ti­gious award-win­ning car­dio­vas­cu­lar sur­geon who is one of the most tal­ented in his field. He is also a so­cial me­dia in­flu­encer for health and fit­ness. We wanted to find out about how he found his call­ing to be a doc­tor, his pas­sion for fit­ness (if you haven't checked his In­sta­gram, check it out) and how we can have pos­i­tive heart health.

ATHLEISURE MAG: How did you come to be a car­dio­vas­cu­lar sur­geon?

DR. GRE­UNER: Be­lieve it or not, by ac­ci­dent. I was a NCAA ath­lete in col­lege, and an eco­nom­ics and hu­man per­for­mance ma­jor. My plan was to open a chain of ob­jec­tively mea­sured an­a­lyt­ics for top tier ath­letes upon grad­u­a­tion, and this was a child­hood dream of mine. I took med­i­cal classes to de­velop my knowl­edge of hu­man anatomy and phys­i­ol­ogy for this rea­son in school, and be­came so en­am­ored dis­cov­er­ing how the hu­man body func­tions. It’s beau­ti­ful, and com­pletely log­i­cal. I could speak for hours on this, and I read about it more to this day for per­sonal en­joy­ment, much the same way an art afi­cionado looks at beau­ti­ful pieces.

As my un­der­stand­ing grew, so did my de­sire to learn more, and soon, I had ba­si­cally filled my re­quire­ments for med­i­cal school, solely via per­sonal in­ter­est. My father and mother were in the mid­dle of a di­vorce at the time I fin­ished col­lege, and I moved closer to my father to help him through this dif­fi­cult time, as we had al­ways been very close. I ap­plied to med­i­cal school at that time where he was liv­ing, and was ac­cepted. I fin­ished, but never planned on prac­tic­ing, un­til my surgery ro­ta­tion, which fas­ci­nated me. I ap­plied to

sur­gi­cal res­i­dency and I was ac­cepted. Dur­ing my surgery res­i­dency, I ro­tated through car­diac surgery, and it was love at first sight. The rhythm, the phys­i­ol­ogy, the tech­ni­cal prow­ess, and the nerves of steel re­quired hyp­no­tized me, and I knew there was noth­ing else I would rather do.

To this day, every­one asks me why I am so happy head­ing to work in the morn­ing. The truth is, I the­o­ret­i­cally found the love of my life by ac­ci­dent…..

AM: How can we main­tain pos­i­tive heart health?

DR. G: There are so many an­swers to this ques­tion, but in short, reg­u­lar car­dio and a diet rich in es­sen­tial fatty acids and low in foods that pro­mote ox­ida­tive stress are the two main keys.

For the func­tion of your heart, or “car­dio­vas­cu­lar fit­ness,” you should main­tain at least 3 ses­sions of ac­tive car­dio where your heart rate is above 120 bpm, for at least 20 min­utes per week to main­tain your level of car­dio­vas­cu­lar fit­ness. Less than that, and you will con­sis­tently de­te­ri­o­rate with time in terms of your car­diac func­tion. More than that, and you will con­sis­tently im­prove.

The next cat­e­gory is main­tain­ing pris­tine con­di­tion of your heart, to al­low it to func­tion ef­fec­tively. Any­thing that causes tis­sue dam­age is called “ox­ida­tive stress”. I’m sure you have all heard of anti ox­i­dants. Th­ese are the chem­i­cals that act to buf­fer th­ese ox­ida­tive stress. Think of it as a bal­ance, like a math­e­mat­i­cal equa­tion. If you go into a neg­a­tive num­ber, be­cause of ox­ida­tive stress, you must take in an­tiox­i­dants to get back to a neu­tral state, and “bal­ance it out” so to speak.

Ox­ida­tive stress can come from any source, such as chem­i­cals in pro­cessed food, chem­i­cal in­jury such as smok­ing or pol­lu­tion, and even ex­tra stren­u­ous work­outs. It’s all about con­sis­tency, and aware­ness to keep you in the pos­i­tive di­rec­tion to avoid tis­sue dam­age.

AM: It's clear that you are also into health and fit­ness, why is this im­por­tant and what are the ben­e­fits?

DR. G: Yes, fit­ness is a huge part of my life, and for a va­ri­ety of rea­sons

1. its one of my main cop­ing mech­a­nisms.

I def­i­nitely have a very stress­ful job sur­gi­cally speak­ing, and I also have a sig­nif­i­cant ad­min­is­tra­tive role in a very large pri­vate prac­tice, which let me tell you, comes with some un­wanted stress. Given that role, I need some re­lease mech­a­nisms that don’t in­volve un­healthy habits, and work­ing out is one of my go to meth­ods, par­tic­u­larly cy­cling, run­ning, and mar­tial arts, all of which re­quire an in­tense amount of fo­cus and “zon­ing out” so to speak. I reach a sort of med­i­ta­tive state for lack of a bet­ter word, that al­lows me a tran­quil pe­riod and a men­tal cleans­ing for other things that may be weigh­ing on my mind at the time. Well, at least un­til the next hur­dle…..

2. It pre­serves my form and func­tion.

Lets face it. Whether we are 18 or 60, we are all ag­ing daily, and ag­ing takes its toll on the body. And none of that is mak­ing us more fit. In fact, it gets harder to main­tain lev­els of fit­ness as we age for a va­ri­ety of rea­sons. You can ei­ther ac­cept that, or fight the trend by work­ing harder to be bet­ter. I choose the lat­ter. In fact, my lap times run­ning, and some of my mus­cle func­tion­al­ity is bet­ter than where it was in my twen­ties as a re­sult of me train­ing so in­tensely th­ese days, a fact that I’m ex­tremely proud of. Now if only my back in­juries would re­spond the same way…..

AM: Nutri­tion is key. How can we stay

healthy dur­ing the hol­i­day while splurg­ing dur­ing this time of year?

DR. G: I’m a HUGE fan of cheat days. Both be­cause I love to eat prob­a­bly more than any­one I know, and also be­cause there are def­i­nite ben­e­fits to them, if your diet is on track the rest of the time. In gen­eral, I’m sure you have heard of mus­cle con­fu­sion work­outs. The ba­sic premise be­hind this, is that if you do the same work­out for a pro­longed pe­riod of time, even­tu­ally, your mus­cles be­come ac­cus­tomed to it, and you will no longer push them to the point where they need to be­come stronger, as they sim­ply be­come more ef­fi­cient. How do you avoid this and en­joy im­proved func­tion with ev­ery work­out? By switch­ing it up and keep­ing your mus­cles and body “confused” and not know­ing what to ex­pect.

It’s the same with your diet. If you keep to a strict, low calo­rie diet for a pro­longed pe­riod of time, your body is pro­grammed to pre­serve the sta­tus quo by na­ture, and it will sim­ply be­come more ef­fi­cient and lower your me­tab­o­lism in order to burn calo­ries in an ef­fi­cient way. In short, you will ba­si­cally be­come a hu­man Pruis metabol­i­cally speak­ing, which trust me, is NOT what you want. You want to be that big V8 that burns calo­ries at a rapid rate. How do you do this? By im­ple­ment­ing a cheat day once a week, where you con­sume a tremen­dous amount of calo­ries, and make your body feel like end­less calo­ries will be avail­able much like the credit mar­ket was in the 1990s. Then, just when your body is adapt­ing, which takes a few days, you pull the car­pet from un­der­neath it, and drop it back into a low calo­rie state while it still thinks that end­less en­ergy is avail­able. Just when it’s start­ing to sense that it needs to be more “fi­nan­cially re­spon­si­ble” from a calo­ries stand­point, your throw a curve­ball again and bring in fat, carbs, and ev­ery­thing that it wants. Keep do­ing this, and your body will have to keep guess­ing, and you will al­ways burn fat at a faster rate and keep it lean. Plus, you get to eat cake and fries….

AM: What are 3 work­outs that guys should do to get great abs and calves?

DR. G: You should al­ways think of gain­ing mus­cle mass as a sep­a­rate cat­e­gory than ac­quir­ing mus­cle def­i­ni­tion. A mus­cu­lar, ripped physique is the Holy Grail for most men, and there are many rea­sons most of us are not walk­ing around look­ing like Greek gods. It’s very dif­fi­cult to achieve both. To gain mus­cle mass, we have to stress our mus­cles, be­yond what they are used to stim­u­late them to grow. Most of the gym the­o­ries on heavy weights with low weight vs light weights and high reps are false. The end­point needs to be com­plete and to­tal mus­cle fa­tigue so that your body is un­com­fort­able and is stim­u­lated to adapt to be able to deal with the new level of per­for­mance you de­mand from it. It doesn’t re­ally mat­ter how you achieve that level of stim­u­la­tion, as long as you achieve it. If you are try­ing to at­tain a dif­fer­ent level of func­tion­al­ity, mean­ing strength vs en­durance, the type of train­ing you do def­i­nitely mat­ters.

This be­ing the case, I al­ways pick the eas­i­est way to look the best. And for me, that is do­ing heavy weights with low reps, as it’s the quick­est, most ef­fi­cient way to stim­u­late growth. My ab rou­tine typ­i­cally con­sists of hang­ing leg raises with leg weights, ab pull­downs with heavy weight (150+lbs) and weighted, slant bench sit ups with a 40-50lb medicine ball. When it comes time to train for an event, I switch to more reps to im­prove my func­tion. For calves I use weighted don­key presses, and weighted calf raises.

In order to al­low your mus­cles to grow, you must also give them the fuel and rest they need, much like a grow­ing child, which is why it’s dif­fi­cult to stay ripped and build mus­cle. Girls have it

so easy…..

To show off that hard-earned mus­cle, you must be in a calo­rie deficit, to make your body lose the fat and ex­pose that hard-earned mass. With­out a low body fat, you will never look good, re­gard­less of the amount of mus­cle you build.

You may ask, “When I drop my calo­ries, won't I lose mus­cle?” which is a le­git­i­mate con­cern. The short answer is, yes you will. But you can min­i­mize mus­cle loss by ma­nip­u­lat­ing your diet, as well as sup­ple­ments pro­mot­ing testos­terone, and sup­ply­ing branched chain amino acids, which are key to my rou­tine. BCAAs ba­si­cally fool your body into be­liev­ing it has bro­ken down mus­cle al­ready, so it shifts to break­ing down fat in­stead when you are in a caloric deficit, and are one of the keys to pre­serv­ing mus­cle mass when di­et­ing hard for fat loss.

AM: What are your en­ergy foods that you en­joy eat­ing that you can take with you when you have a hec­tic day and can't get out like you would like?

DR. G: I typ­i­cally bring some lean, but very sat­is­fy­ing meat cuts to work with me, which pro­mote sati­ety, but at the same time, al­low me to not over in­dulge in calo­ries. Tur­key, lean beef, and chicken are my go to choices.

The key to any diet that pro­motes a lean, mus­cu­lar physique is to avoid high blood sugar lev­els, which stim­u­late in­sulin re­lease. In­sulin is the main hor­mone in­volved in fat gain, so you want to min­i­mize its pres­ence in your blood.

The best way to do this is to avoid high sugar foods. So if you’re go­ing to snack, use high pro­tein snacks like beef jerky, or com­plex carbs, like high fiber or oat bars with low sugar con­tent. As soon as you cause a sugar spike, you ba­si­cally put your­self be­hind the 8 ball in terms of your physique. Yes, it's THAT


AM: As a stylist, I'm prep­ping a num­ber of my clients for their red car­pet mo­ments dur­ing Awards Sea­son what are food must-haves and work­outs that you would sug­gest they in­cor­po­rate into their rou­tine?

DR. G: In gen­eral, I look at work­outs and diet as try­ing to achieve two dif­fer­ent goals. How you look is 80 per­cent a func­tion of your diet, and how you per­form is mostly de­pen­dent on your work­outs. The only ex­cep­tion to this, is try­ing to at­tain a very high level of mus­cle in which case you ab­so­lutely must work out con­sis­tently to stim­u­late mus­cle growth.

That be­ing the case, diet is the key to look­ing great. You could work out all day long, but if you eat badly, you will look ter­ri­ble. If you barely work­out, but your diet is clean, you will look much bet­ter than you think, which is of­ten over­looked. Of­ten I hear “I work out, I can eat what­ever I want to­day.” Noth­ing could be far­ther from the truth. If you think about it, in a hugely stren­u­ous work­out for an hour, the av­er­age per­son would burn maybe 1000 calo­ries, or one larger slice of cheese­cake. Do the math on that. Fat loss is a sim­ple math­e­mat­i­cal equa­tion. Eat fewer calo­ries than you burn, and you will lose weight. The eas­i­est way to do that, un­less you want to work out 6 hours a day, is to keep your diet clean.

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