In an age where athletic performance and body image often take centre stage, it’s easy to mistake outward appearances for true health. But as Dr. Phil Maffetone explained in his conversation with Simon Ward, being fit doesn’t always equate to being healthy—and that misunderstanding can have serious consequences.

The High-Performance Illusion

It’s a familiar sight: the lean, fast cyclist devouring chocolate cake and whipped cream-topped hot chocolate at a café stop, seemingly immune to the consequences. With low body fat and high VO2 max, they look the picture of health. But as Dr. Maffetone warns, “The question isn’t how good he is now—it’s how much better he would be if he ate well.”

Fitness without a foundation of health is a fragile achievement. Athletes may perform well despite poor nutrition and lifestyle choices, but over time, the cracks show—through slower recovery, chronic inflammation, increased injury risk, hormonal disruption, and even impaired brain function.

Sugar: The Legal Drug

One of Maffetone’s most striking comparisons is between sugar and addictive drugs. The cravings, the withdrawal symptoms, the systemic damage—all are present. “There’s so much good evidence now that sugar could be classified as a drug,” he says, especially refined and processed carbohydrates.

For many athletes, high sugar intake is masked by training volume and apparent performance. But according to Maffetone, this leads to a dangerous feedback loop: “You're not gaining weight, so you assume it's not hurting you. But it’s affecting your hormones, your inflammation levels, and your recovery.”

Aerobic Efficiency as the Real Measure

True health and sustainable performance stem from a well-developed aerobic system. Maffetone’s MAF (Maximum Aerobic Function) training method, based on heart rate (typically 180 minus age, with personal adjustments), is designed to build this foundation. However, many athletes find the early stages frustrating because it feels too slow.

But that perceived slowness is revealing. “It's a reflection of your aerobic state,” Maffetone explains. “Most people have relied on their anaerobic systems for far too long.”

Building a robust aerobic engine means becoming a better fat-burner, not just a sugar-burner. And that transition depends heavily on what you eat.

When Diet Undermines Development

If your training is consistent but your performance plateaus, Maffetone suggests it’s time to look at what’s on your plate. “The most common reason people don’t improve with MAF training is that they’re consuming too much refined carbohydrate,” he says.

The knock-on effects are far-reaching: poor fat burning, increased blood sugar spikes, more cortisol production, and impaired hormonal health. Many athletes are, in effect, overtrained and under-recovered—not from too much mileage, but from too much life stress and poor fuelling.

The Role of Lifestyle

Beyond training and diet, sleep, stress management, and social habits all play a role. “MAF isn’t just a training method,” says Maffetone. “It’s a way to obtain maximum health and fitness by personalising your entire lifestyle.”

That includes recognising the toll of chronic sympathetic nervous system stimulation (fight or flight), which raises cortisol, suppresses sex hormones, and can derail progress—even in those training ‘right’.

Health First, Performance Follows

Perhaps the most powerful message from this conversation is the call for discipline and long-term thinking. Shortcuts and hero workouts may deliver short-term results, but they often come at the expense of health.

As Maffetone puts it: “The goal isn’t just to be a better athlete, it’s to be the best human you can be.”

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Thanks for being part of the tribe — I’m here to help you stay healthy, strong, and performing at your best. ​ Simon

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