What is This Guy Thinking?

The New York Times is running a new series (part 1, part 2, subscription needed after 7 days) on the incredible development of humans over the last 100 years, from sickly beings who died in their 40's, to today's bigger, stronger, and longer living boomers. The general theory is that significant improvement in nourishment from the womb to the first two years of life have lead to this trend.

But the real issue that I find interesting is the individual the Times reporter chose as a representative of the new age. The particular man protrays himself as strong, fit, and ready to outlive his ancestors. He maintains he "eats well", and walks in the evenings with his wife to remain fit. The reporter defines him as "exuberantly healthy". He's 45 years old, he weighs 200 pounds, he's 5' 9" tall.

Folks, his BMI is 30. He is therefore obese at the margin, at a minimum, servely overweight. Here's a man in the "precontemplative" stage if I've ever seen one - he has no idea he's in trouble. My question is, why not? He may well live longer than his ancestors, but unless he shapes up, not nearly as long as he could...

Harvard Healthy Eating Pyramid in the News

Well, if you go to news.google.com and search for "Harvard Healthy Eating Pyramid" [HHEP] you aren't going to get any hits, but that doesn't mean that HHEP isn't in the news.



Taking a closer look at the HHEP, we can see it could be called:

the Low Glycemic Index/Load pyramid, limiting refined carbohydrates and encouraging vegetables and whole grains.

Taken a step further it could be called it the vegetarian pyramid - neither red meat nor poultry are required elements of the pyramid.

And going to the extreme, the HHEP makes a fine vegan pyramid simply by lopping off the top three HHEP tiers, a step which would not seem to bother the creators of the HHEP.

Which brings me to the following news stories:

First of all, there is a story I mentioned a couple of days ago; namely, the Australian Study on the effects a low glycemic index on weight loss. While it gets a bit confusing on who was fed what, the main take away is "in the high-carbohydrate diets, lowering the glycemic load doubled the fat loss. It was also noticed that LDL ... levels decreased in [a] diet with carbohydrates comprising 55 per cent of total energy intake, protein 15 per cent of total energy intake and a lower glycemic load (75g)". The Study concludes: "In the short term, our findings suggest that dietary glycemic load, and not just overall energy intake, influences weight loss." ["The short term" refers to the 12 week length of the study.]

And then there is this report from the American Diabetes Association that a vegan diet (no animal foods at all) out performed their own diet in terms of reducing the participants' use of diabetes related drugs at the end of the 22 week study period. In addition, those on the vegan diet lost twice the weight and had more success in lowering their cholesterol. I was, however, disappointed to see that part of the reason for the success of the vegan diet (including a 50% lower drop out rate) was that there was no limit at all on calories. While I understand that the main effort of the study was to see if diet could help control diabetes, from my own personal experience, I know you can have low cholesterol, normal glucose, eat nutritious food, yet still be obese, with all the attendant health problems. Control of calorie intake is a key parameter of good health, and my own refusal to take calories into account for over 6 years lead ultimately to the ICU.

My point here, of course, is that the Harvard Healthy Eating Pyramid is at the bottom of many food and nutritional studies going on today, all we have to do is look for it. The implication for anyone attempting to lose substantial amounts of weight is that for any number of reasons, the HHEP is as good a basis as you can get for starting to revamp your diet.

When I first began to try and lose weight I had never heard of the glycemic load, or transfats, or even of "whole" grains. Yet as a practical matter, by following the philosophy of "getting rid of" the one food I ate too much of, what I actually did was significantly reduce the glycemic load of my diet, as well as the transfats intake. As a resut I dropped 35 pounds, reduced my cholesterol from 220 to 155, and yet I remained obese because I refused to count calories, an incredibly simple step once I started.

It's unfortunate that the dynamics of behavorial change can usually prevent early adapation of something like the Harvard Healthy Eating Pyramid and calorie counting - I know in my case it could have saved me from atrial fibrillation, sleep apnea, heart failure, and pulmonary hypertension had I been able to shorten my contemplation and preparation phases. What could it save you from?

The Glycemic Load

Every single time I think I have this nutrition thing wrapped up, another subject pops up - it's like peeling back the layers of an onion. Anyway, I need to explain Glycemic Load before I can continue with further discussions about the application of the Harvard Healthy Eating Pyramid.

The Glycemic Load (GL) is a refinement of the Glycemic Index (GI). I found a pretty good discussion of the glycemic index/load in the June 2001 issue of Harvard Women's Health Watch. I will paraphrase a rather lengthy article to get to the crux of the matter in a shorter period of time...

The Glycemic Index measures how fast and how far blood sugar rises after eating specific carbohydrates. So, in general, foods high on the Glycemic Index will raise blood sugar very quickly, lead to glucose spikes and crashes as I mentioned here, which can cause hunger (even immediately after a meal), leading to overeating. So any diet should attempt to avoid high GI foods as much as possible.

The problem is, the Glycemic Index is based on 50 grams of the specific carbohydrate; however, a serving of a food may have nowhere near 50 grams of carbohydrate. In an effort to refine the glycemic effect of a standard serving of a specific food, a formula for Glycemic Load (GL) was derived to take into account the actual amount of carbohyrate in a serving: Glymeic Load = "Glycemic Index" x "carbohydrate in one serving" / 100.

Take for example, watermelon and baked potato:

• watermelon: GI = 72 (high), but GL = 4.32 (low), since a serving has only 6 grams of carbohydrate
  
• baked potato: GI = 85 (high), and GL = 25.5 (high), since there are 30 gm of carbohydrates in a potato

This Australian site will calculate Glycemic Load for a wide range of foods and brands, and also has a good FAQ on all things glycemic.

It was difficult to find what constituted high and low Glycemic Loads because all I was able to find were commercial sites such as this one, but I am now confident that a GL of 10 or less is low and a GL of 20 or more is high. These values correspond to a GI of 55 or less being low, and a GI of 70 or more being high. Together, GI and GL should allow you to refine your diet plan to exclude those carbohydrates and foods that will cause glucose spikes and crashes.

A List of Phytonutrient Fruits and Veggies and Selected Glycemic Index Foods

A new study out of Austrailia finds that a diet high in low Glycemic Index carbohydrates is best for losing body fat and reducing LDL cholesterol. Yea, Harvard Healthy Eating Pyramid!

Straight from Wikipedia: the fruits and vegetables the California Cusine wants you to eat (for a longer list by phytonutrient, go here):

The top 12 phytonutrient rich foods

• soy – protease inhibitors, beta sitosterol, saponins, phytic acid, isoflavones
• tomato – lycopene, beta carotene, vitamin C
• broccoli – vitamin C, indole-3-carbinol, sulphoraphane, lignans
• garlic – thiosulphonates, limonene, quercitin
• flax seeds – lignans
• citrus fruits – monoterpenes, coumarin, cryptoxanthin, vitamin C, ferulic acid, oxalic acid
• watermelon – lycopene
• pink grapefruit – lycopene
• blueberries – tannic acid, lignans, anthocyanins
• sweet potatoes – beta carotene
• chilli peppers – capsaicin
• legumes: beans, peas, lentils – omega fatty acids, saponins, catechins, quercitin, lutein, lignans

[]

Other foods rich in phytonutrients

• cranberries – ellagic acid, anthocyanins
• green tea – quercitin, catechins, tannic acid, oxalic acid, lignans
• red grapes and wine – quercitin, resveratrol, catechins, ellagic acid
• papaya – cryptoxanthin
• carrots – beta carotene
• brassicates: kale, cabbage, brussels sprouts, cauliflower – lutein, zeaxanthin, sulphoraphane, indole-3-carbinol
• nuts and seeds – resveratrol, phytic acid, phytosterols, protease inhibitors
• artichoke – silymarin, caffeic acid, ferulic acid
• onions – quercitin, thiosulphonates
• apples – quercitin, catechins, tartaric acid
• spinach – oxalic acid, lutein, zeaxanthin
• mangos – cryptoxanthin
• pumpkin – lignans, carotenes
• eggplant
• shiitake mushrooms
• dried apricots
• squash

And, straight from Prevention.com, the Glycemic Index for selected foods. Because of problems trying to copy this list, I recommend you go directly to Prevention.com and use their print button.

NOTE: Prevention.com suggests potatoes are fine inspite of their high GI value, but you know what Harvard School of Public Health thinks of them! High GI foods are fine for those who exercise a lot, otherwise it might be best to avoid them.

The Harvard Healthy Eating Plan on the Road to Reduction

When it comes to the Harvard Healthy Eating Plan and the Road to Reduction, there's some good news and some bad news, but the main thing that I keep in mind is that at the end of the day what is most important is the calories eaten, because if I don't lose the weight then good health is a mirage.

Good News

For the most part, I believe I have the red meat and refined carbohydrates under control. I rarely have any meat at home, and the times I order a nice steak out are becoming fewer and fewer. And we long ago gave up white bread, white pasta and white rice here at home. Does it mean that I won't eat them in restaurants, of course not, but restaurant meals are not a significant part of our diet. As the last step in getting with the program, I'm making the switch to wheat bagels and sweet potatoes, and dumping the grits.

Fish, poultry, legumes and nuts are not much of a problem either, though I may have to get a better idea of exactly how many servings I have every day - it is likely I have too many now.

I would say I am perfect on fruit! Two to three servings a day is exactly how much fruit I feel comfotable eating, and I will work to improve variety. I added a small orange daily because of its position in the"the top 12 phytonutrient rich foods".

Dairy is also not a problem. I have already cut back my consumption of nonfat dry milk, and those horrible nonfat "american cheese" slices. I am also giving nonfat cheddar cheese another chance. If it doesn't work out, then I guess I will just reduce the cheese in my cooking. I still like creamy pasta sauces, and my only solution may be to learn how to make my own.

Bad News

Eggs: I think eggs are one of the best foods on the planet, I eat at least two every single day, and I have absolutely no intention of changing that.

I will also not give up pizzas - so I will probably never completely cut out the refined carbohydrates, trans fats, and cheese - but hey, they're veggie pizzas! That must count for something.

So that leaves these problems:

• Veggies, I don't eat enough of them.
• Oils - I pretty much cut them out to save calories.
• Refined carbohydrates: my diet "wheat" bread is really white bread in disguise.

The diet bread is an interesting situation. It is VERY low calorie, only 35 calories a slice, and I allow myself to eat a lot of sandwiches because of the low calories. Yet, there are many days I tell my wife: "Today was just one of those days that I could never fill up, and I just kept eating all day long." If I look at my food log for those days, guess what - those are days when I eat the most sandwiches - egg sandwiches, sardines, veggie burgers, salmon - whatever, one right after the other.

So let's suppose that the bread in each one of those sandwiches causes a little glucose rush, an insulin spike and a mini glucose crash - just like HSPH describes. Is it possible that by eating each diet bread sandwich, I make myself just hungry enough to want ANOTHER sandwich?

Cutting out the diet bread, on the face of it, is difficult to do - each slice of my wife's 100% wheat bread is 100 calories, nearly 3 times a slice of my diet bread. But I found that by trimming the crusts, I can cut each slice to 68 calories (by weight).

So today, I tried my usual egg sandwich on the trimmed down whole wheat, and surprise, surprise, I wasn't hungry until lunch. At lunch, I ate leftovers [first time I EVER had leftovers from a meal I cooked] from last nights veggie, brown rice and legume dinner, and surprise again, I wasn't hungry until dinner tonight. End result, today I only ate 2204 calories and I feel comfortably full... [My target is 3030 calories/day.]

Well one day doesn't make a trend, but it sure is hopeful. I've learned that I can use the high calorie whole wheat bread and maybe cut way down on the total number of sandwiches I eat.

And I learned something about veggies too. I was worried about how to work more of them into my diet, because, let's face it, veggies aren't necessarily "comfort food". But with my lunch today I realized that by sauteing the veggies in a little oil and adding some rice I could turn them into comfort food at an acceptable calorie expense.

All in all, it does appear that I can bring my diet into alignment with the Harvard Healthy Eating Plan - after a couple of weeks I'll bring up this subject again and report how it all worked out.

California Cuisine Redux PLUS the Glycemic Index

Lost in the hullaballou over the Harvard Healthy Eating Pyramid was the California Cuisine Pyramid, which was really the basis for the current line of inquiry. Let's recall that California Cuisine placed fruits and vegetables at the base of its pyramid to emphasize their impotance in healthy nutrition. And not just any fruits and vegetables either , but phytonutrient fruits and vegetables. This, of course, begs the question: what the heck is a phytonutrient vegetable?!

Well, I am not about to begin to define a phytonutrient vegetable (or a phytonutrient fruit for that matter), but suffice it to say that, broadly speaking, a phytonutrient is what I might call an antioxidant. Wikipedia has an excellent discussion here, as well as a list of foods high in phytonutrients. Lecture 9 of the UCLA Nutrition Lecture Series has a discussion by the author of the California Pyramid on the objectives of the pyramid and the foods in it. Suffice it to say here that the designers of the California Pyramid did not want people fulfilling their fruits and vegetable requirements with corn, and the most popular vegetable in the US : french fried potatoes!

Just for the record, the Calfornia Pyramid calls for 5-11 servings of fruits and vegetables a day, stressing the importance of consuming a good variety of both.

Turning attention to the Glycemic Index (GI), a good discussion , including a list foods and their GI, can be found at Prevention.com. In a nutshell, low GI foods cause a slow and gradual rise in glucose and insulin; whereas high GI foods cause the rapid rise and severe spiking in glucose and insulin we have already discussed. If you are thinking that white bread, white pasta, white rice, and white potatoes are high on the GI, you are smoking! [By the way, the article at Prevention.com suggests ignoring high GI's for certain foods - don't you believe them! There are other foods providing the same nutriants without causing havoc with your gulcose and insulin.]

So here's where we are: the Harvard Healthy Eating Pyramid suggested an "abundance" of vegetables as part of the daily diet, but were quite vague about defining how much vegetable constituted an "abundance" and, indeed, any discussion of what vegetables would be appropriate and provide the most benefit. Ditto fruits. [For an example, I recently added raisins as a "fruit" to my diet because I wasn't keeping up with 6 fruit servings a day. But I always felt that raisins were probably more like candy than fruit because they were so sweet, and indeed, raisins have just a one point lower GI than table sugar!]

Armed with my lists of high phytonutrient foods and low GI foods, I am now ready to take on the Harvard Healthy Eating Pyramid and see how well my current diet fits into their plan, and, if necessary, what changes I might make for a better fit.

The Rap on Refined Carbs, Red Meat & Dairy

Note: The sources for the following comments are derived exclusively from the content at the Harvard School of Public Health/Food Pyramids and a similar article from the Scientific American published at mindfully.org, unless otherwise noted.

So What The Heck is Wrong with White Bread, white rice, white potato, white pasta?! I spent a lot of time comparing the nutrition labels on white rice and brown rice trying to figure out why an extra gram or two of fiber and protein was supposed to make such a big difference. Of course, that wasn't it at all, though it's part of it.

The main problem with refined carbohydrates and white potatoes is the interplay of glucose and insulin (a hormone necessary to process glucose). A boiled white potato, for example, raises blood sugar (glucose) levels higher than eating the same calories in plain table sugar. The spike in glucose in turn causes a spike in insulin and a resulting crash in the glucose levels. These spikes adversely effect cardiovascular health - and the rapid decline in glucose can lead to feelings of hunger even after a large meal, resulting in increased overeating.

Furthermore, overweight, inactive people can and do become resistant to insulin. Studies have found that people resistant to insulin need more and more of the hormone to process the glucose, thus aggravating the spike and crash cycle in glucose levels, which in turn leads to even greater hunger and more overeating. Ultimatley, excess glucose builds up in the bloodstream, setting the stage for diabetes. (see Insulin Resistance and Pre-Diabetes, National Diabetes Information Clearinghouse)

Fortunately, exercise keeps the insulin working the way it should (which probably explains why virtually the entire population of Ireland was able to sustain itself on potatoes for many decades) and the consumption of fiber rich foods (you know, whole wheat bread, rice and pasta) can lower the risk of diabetes and coronary heart disease.

Red Meat (beef, pork, and lamb). The main rap on red meat is that it is high in saturated fat which has been conclusively linked to an increased risk of coronary heart disease, diabetes, and colon cancer (the latter may be related to the carcinogens produced during cooking). To which I might add the fact that most of our beef supply is routinely fed large quanities of antibiotics as the cattle are fattened in what might politely be called unhygenic feedlots. If this is news to you, google a few stories on feedlots and antibiotics...

Dairy Products. Once again, the main culprit is saturated fat - three glasses of whole milk have the same saturated fat as 13 strips of bacon! While non-fat milk is a viable option for cooking, coffee, and cereal, non-fat cheese is a loser. But it takes 10 pounds of milk to make a pound of cheese, so you can just imagine the saturated fat. [Here's an entrie site devoted to "NotMilk", and an editorial relating excessive dairy consumption to obesity.] Finally, high calcium intake has been related to increased risk of prostate cancer. HSPH recommends just one glass of milk a day for most people, and perhaps an additional supplement for women after menopause.

And there you have it, the low down on white bread, red meat, and milk according to the Harvard School of Public Health [with a little added editorial from Bob].

Pyramid Thoughts

Well, my head is reeling, so many food pyramids! The lastest 2005 update is here at the Harvard School of Public Health (HSPH). [Not posted due to copyright]. (Obviously, there is other great content at the HSPH.) Evidently, the USDA food pyramid has been under fire for some time, and the California Pyramid recently posted was like the first salvo.

A schematic of the Harvard Healthy Eating Pyramid from mindfully.org:

1. Red meat and butter USE SPARINGLY
2. White rice, white bread, potatoes, pasta and sweets USE SPARINGLY
3. Dairy/calcium supplement 1-2 servings
4. Fish, poultry and eggs 0-2 servings
5. Nuts and legumes 1-3 servings
6. Vegetables IN ABUNDANCE
7. Fruit 2-3 servings
8. Whole-grain foods at MOST MEALS
9. Plant oils (olive, canola, soy, corn, sunflower, peanut) at MOST MEALS
10. Exercise and weight control
-Multiple vitamin for MOST people
-Alcohol in moderation (UNLESS CONTRAINDICATED)

WHOA! Knock your sox off or what? Exercise and weight control are the foundation of healthy eating? Look at the low fruit servings - I thought I was supposed to have twice the servings every day. Alcohol recommended? (Not to get too excited, moderation = one (1) drink a day. "Contraindication" is something like heart failure or sleep apnea which can be made worse by alcohol.) OK, the "Food Pyramids" article from HSPH is a great place to get started, and almost required reading.


The Harvard School has several bones to pick with the latest USDA Pyramid (at right):
1) the pyramid is so abstract as to lose meaning, 2) is unduly influenced by agribusiness commercial interests, 3) does not discourage refined starches (grains), 4) does not differentiate between red meat and other protein sources, and 5) over emphasizes consumption of dairy products.

I don't know if I'm unusual or what, but I suppose I haven't paid much attention to the food pyramid over the years, USDA's or Harvard's. But now that I am powerfully motivated to lose excess weight and improve my health, the food pyramid has become much more relevant, and has encouraged to me ask questions: exactly why are "refined starches" (white bread, white rice, white pasta) so bad; if plant oils are so important, how the heck do I get them into my diet given they are so high in calories and so low in the "fullness factor"; in fact, how well can I fit the foods I eat into the food pyramid at all? Will I have to change substantially what I eat?

I think these questions are important to answer if I expect to incorporate any heathful food pyramid into the Road to Reduction, and I intend to address each of these areas in upcoming entries.

More on Nutrition

My earlier post today on the Calorie Restriction Society got me thinking about nutrition again, and I came across this fascinating site at the UCLA Center for Human Nutrition. One striking feature is the California Cuisine Pyramid - notable because it has replaced the bottom tier of the pryamid with fruits and vegtables, and moved the grains and whatnot to the second tier - a change that immediately caught my attention as I have noticed lately that my own diet has been a bit sparse on the vegetable side. I was also able to find this handout of recommended servings based on the Calfornia Pyramid (it's for a "healthy college student", but looking it over I can't figure out why a "fat old guy" can't use it too).

In any event, if you look around the UCLA Nutrition Center you will find things like a complete Basic Nutrition lecture series, physican education for treating obese patients (is your doctor doing all he should?), and another close look at vitamins, minerals, and the RDA. I haven't even begun to scratch the surface yet myself.

The Calorie Restriction Society

No, this is not some highfalutin weight loss group, rather it is a group of individuals who restrict their calorie intake anywhere from 25% to 55% to achieve longer life expectancy based on scientific research.

Obviously, anyone who is going to reduce their caloric intake by 55% is going to seriously consider the consequences, and the research by this group into weight loss and nutrition is quite applicable to those of us trying to lose significant amounts of weight. I highly recommend perusing The Getting Started and Risks portions of the CR Guide, as well as the FAQ. Just for example, their suggestion to limit the amount of Omega-3 fat is interesting to me since I go out of my way to include it in my diet.

The CRS also has some great recipes which are very good and appropriate to any diet. This is where I got the idea for my "xtreme oatmeal"!

DOWN 41 !

Well, as of today I'm down at least 41 pounds since March. Suffice it to say I am happy. Of course, maybe a lot of that weight is water weight as I am drenched walking in this heat, but on the other hand, my calorie deficiencies have been high.

Those deficiencies might have gotten too high yesterday. I wasn't able to complete my workout or walk this morning as I felt quite dizzy and weak after a few touch toes. First I thought it was the heat, then I realized I was starving - and indeed, a little food fixed me up in an hour or so.

I really really try not to be hungry - don't want my body to go into starvation mode! Here's what I think happened yesterday to conspire to get me in that fix:
-yesterday was a light calorie day anyway - only 2620 calories out of my target 3030
-I have been exercsing at a level consistent with "high activity" on Nutrition.com.sg so that my calorie deficiencies have been huge, last night it was 2500 calories
-with 240 calories coming from 1/2 a Starbucks muffin, 142 from a beer, 15% of what I did eat was pretty worthless
-finally, I went to bed a bit hungry - normally I never do this, but it was late and I didn't want the food to sit there. And I woke up hungry a couple of times during the night.

My wife often asks why I eat a couple of hundred calories some nights just to get my calorie count up. I've always said that I just don't want to under eat by too much, which is exactly what I think happened yesterday...

Five Stages of Behavioral Change

My doctor mentioned something about the five stages of behavorial change, so I decided to see what I could find, and there it was, a conceptual model devised at the University of Rhode Island [this model was created in the cancer research department, but clearly applies to serious weight loss].

Transtheoretical Model
Stages of Change

Five stages of change have been conceptualized for a variety of problem behaviors. The five stages of change are precontemplation, contemplation, preparation, action, and maintenance. Precontemplation is the stage at which there is no intention to change behavior in the foreseeable future. Many individuals in this stage are unaware or underaware of their problems. Contemplation is the stage in which people are aware that a problem exists and are seriously thinking about overcoming it but have not yet made a commitment to take action. Preparation is a stage that combines intention and behavioral criteria. Individuals in this stage are intending to take action in the next month and have unsuccessfully taken action in the past year. Action is the stage in which individuals modify their behavior, experiences, or environment in order to overcome their problems. Action involves the most overt behavioral changes and requires considerable commitment of time and energy. Maintenance is the stage in which people work to prevent relapse and consolidate the gains attained during action. For addictive behaviors this stage extends from six months to an indeterminate period past the initial action.

It fairly jumped out at me that steps 1 - 3 of the "Road to Reduction" are a combination of contemplation and preparation, while step 4 is clearly the transition between perparation and action. Maintenance, of course, is built in and is not a separate step in the road to reduction. Little wonder that I haven't had much trouble with the "action" part of the plan - I had twelve years of contemplation!

Anyway, a more complete overview of the model can be found here - haven't read it yet myself.

Binge Eating

Not much is known about "Binge Eating Disorder", this article at athealth.com is typical of those I found googling the subject. It's remarkably similar to the official US government article found at womenshealth.gov. Neither site offers much in the way of help to get in control of the situation.

The first thought that came to mind when I considered writing this blog entry were the days when I would grab a tub of margarine, a loaf of bread, and stand there in front of the kitchen window just slathering up one piece of bread after anohther - 10, 11 ,12 slices - without taking a breath. I remember feeling pretty peaceful and calm after each episode. But today I was also thinking: holy cow! How many calories was that!? A thousand - 1200 for the bread? At least a half a tablespoon of margarine per slice, another 400 calories. Sixteen hundred calories in a few minutes!? And I want you to hold that thought, because we are going to get back to it shortly.

Bread was not the only item that I binged on. Saltine crackers, with margarine (scooped right out of the tub) or peanut butter, actually any kind if crackers or cheese, half gallons of ice cream, chips of any kind, buckets of KFC. I am sure there were others, but you get the idea.

Somehow I manged to give up bingeing (or then again, maybe I haven't, hold that thought too). I only remember that I did give up the chips in the car first (I replaced them with more fequent stops for McNuggets, so you can see I had a long way to go). The battle for ice cream (which was more with my wife than with insatiable cravings) was initially resolved by the onset of winter, but the following summer we compromised with pints bought less frequently.

Saltine crackers are the one item for which I can remember the thought processes I went through to give them up. I can remember buying them in the carefree days without a thought. Somewhere along the line I evidently decided that eating an entire 4 stack box of saltines was a bit over the top (my wife, by the way, does not eat saltines). So I tried "fat free" crackers, didn't work, I just used more margarine. I tried no-salt crackers, ditto the margarine. I can remember standing in the aisle at the supermarket really thinking hard about why I was buying them and the likely outcome, and I can remember saying, "Oh, what the hell" and tossing them in the cart. I finally cut back by buying only two stack boxes, which were frequently consumed before the groceries were even unpacked. I also rememebr the last box I ever bought: my wife and I were driving to Long Island, so I bought a 4 stack box, thinking I would eat two stacks over and two stacks back. When I found I had eaten all four stacks and we hadn't even gotten there yet, I finally realized I couldn't ever control myself and saltines. Haven't bought a box since.

I really couldn't say exactly how I gave up those binges. But I know one thing, it took a long time. And I sure didn't get rid of them all at once, one binge kind of morphed into the next as I gave up one food after another. The last binge habit I acquired was in January of 2006 wherein I would buy one of those speciality baked breads (you know, the ones baked with olive oil) and go home, heat up more olive oil and garlic and dunk away. Of course I saved "some" for my wife. Well, that one ended with the "medical event".

Lets go back to two things I said: #1) when I bought those saltines, even though I knew darn well what was going to happen when I got home, I never even once made a direct connection between my weight and the consumption of an entire box of saltines in an afternoon. Contrast that with #2) when I said that as I was reminiscing about my bread binge days the first thing that occurred to me was the enormous costs in calories. Even just remembering the event, I immediately mentally calculated the 1000's of calories consumed.

What's the big deal? The big deal is now that I have admited that my ability to know when I have eaten enough is defective, I rely absolutely on an artifical method of reporting back to me calories consumed. Which in turn means I have trained myself to automatically calculate calories eaten, or about to be eaten, as I go along through the day. Bingeing can no longer be cost free. I may not actually be able to control my bingeing, but if I indulge it's going into my calorie log and I can see the cost. I can see that I have exceeded my calories for the day. I can see that if I exceed the calories for maintenance of my current weight I am putting on weight today. It is no longer an abstract event ("oh, I just can't control my binges")- it is a real event with real consequences ("good lord, what have I done!).

Bingeing, when you get right down to it, is just one specific example of impulsive behavior. When I look around to see how I "controlled" my bingeing here's what I find:

A long list of foods that aren't allowed in the house:
crackers
ice cream
speciality breads
cheeses (except no fat)
any kind of meat greater than one meal
chips of any kind
dips of any kind
cookies
really, junk food of any kind
non diet soda
etc

I only allow myself:
1 alcohloic drink a day (if that)
1/2 cookie (out) a day
1 small package of turkey breast a week
1 can turkey spam a week
only recommended portion sizes for:
rice
pasta
legumes
etc

I ask you, does this really sound like a person who has gotten over his binges? Or does this sound more like a person who has dealt with impulsive behavior in one particular area? Because the main way to control implusive behavior is through a clear set of rules (I will find my reference for this), and I sure as heck think that's what we got here, a whole bunch of rules, food by food.

I don't for a second think that I have gotten over my binges in the sense that I no longer crave large amounts of certain foods. What I do believe is that I have created my rules, and that my calorie log helps me enforce those rules by being really specific about what will happen if I break them.

If this all sounds pretty artificial, well it is. Let's remember, I am obese in the first place because my body either does not send, or does not listen to, signals of fullness that someone like my wife hears loud and clear. If I do not implement an artifical system to provide those signals, then I am doomed to a life of obesity.

Sites for Weight Plan Do-It-Yourselfers

This entry identifies sites that have been influential in helping me integrate calorie planning, nutrition, and exercise into a complete weight loss and maintenance strategy.


Diet Plans

The Mayo Clinic Diet: a weight loss program for life. I have been remiss in not posting this site earlier. The Mayo Clinic has an excellent lifestyle/weight loss section - just don't get sucked in by their very low calorie diet (VLC), I just don't see how anyone of size could sustain this program. If you have never been to the Mayo site, there is a wealth of information there, take time to look around.

SoYouWanna Lose Weight is typical of the diet plan genre:

• calculate how many calories you are eating now (or keep a calorie log for a few days)
• eat 500 calories a day less (how you will know that is vague)
• exercise enough to burn an additional 500 calories/day (ditto above)
• and voila! you save/burn 1000 calories a day and lose 2 pounds a week
  

Not my cup of tea, but as I say, it's typical, and fairly blunt and straightforward.

About.com has a comprehensive exercise and weight loss section, although the structure and layout of their site sometimes leads you to confuse the ads for the articles. Their ADAM Weight Loss Guide takes you through a complete survey of the "road to reduction" and covers all the bases: nutrition, calories and exercise...


Four Effective Weight Loss Plans - A UK study comparing Atkins, Weight Watchers, Slim-Fast and Rosemary Conley's plans. To me, the results after 12 months are discouraging - less than 25% of participants were still in the programs... but the article is upbeat about the 6 month results...hence the title.


Nutrition

the dietdetective.com - a comprehensive site covering diet, nutrition and exercise - highly recommended for a day or two of surfing

the Westerly Sun - a hometown newspaper with an excellent archive of short, wide ranging articles on dieting and nutrition.

Micronutrients - the vitamins, essential minerals and other compounds required in small amounts for normal metabolism. Although this article was originally written for cancer research, don't let that put you off. It is an excellent discussion of the vitamins and minerals you need for good metabolism, and importantly, it identifies those elements where supplemenation may be required. This article at the same site recommends that all adults take a daily vitamin supplement.


Heinz Handbook of Nutrition, 9th Edition, 2003, distributed by the Heinz Corporate Research Center is a 250 page handbook (PDF format) packed with all kinds of nutritional information - plenty of discussion on vitamins, minerals, fats, proteins, and carbohydrates. And, no, it is not some sort of advertising vehicle for Heinz ketchup! Some good stuff for dieters too: for example, it clearly supports the idea that the best time for cardio is in the morning BEFORE breakfast. (Metabolism/Lipolysis and Beta oxidation, page 56.)


Eating to Lose Weight - no this is not some quack diet, this is actually a fairly intelligent, though basic, article written by a nutritionist at a site that specializes in back pain. It addresses the need to maintain muscle mass (that darned exercise, again!), how much fat to have in your diet, and a few practical ideas on extracting the most satusfaction out of the food you eat.

Exercise

Want to Lose Weight? Exercise! is an excellent overview article on all facets of exercise and weight loss, much easier to follow and understand than the University of Texas papers. In particular it discusses your metabolic rate and how to prevent your body from going into starvation mode. I noticed that the article recommended a calorie intake for weight loss equal to 10 calories a pound at your current weight. I was quite surprised because just by chance that is exactly the upper limit of my calorie intake right now, and I am quite comfortable with it...

The Gator Aide Sports Science Institute has [apparently] funded two studies at the University of Texas at Austin which are most relevant in understanding the role of exercise in weight loss.

FAT METABOLISM DURING EXERCISE. There are a number of articles I will eventually put up for this subject - this is one of the more complex ones. Keep in mind a couple of things: "VO2Max" is the maximum amount of oxygen you can supply your body during exercise - the actual value increases as your exercise progresses. "25% VO2Max" is the oxygen level assoicated with a "comfortable walk" (see The Science of Fat Loss) - this is the minimum level for burning fat during exercise.

Also Energy Balance and Body Weight Regulation . More than you probably ever want to know about what it takes to get your body to lose weight! Nevertheless, if you can wade through it a couple of times, it provides some interesting insights.


The Only Diet Book You'll Ever Need

The Hacker's Diet by John Walker

The chapters "Eat Watch" and "The Rubber Bag" are essential reading for anyone undertaking the construction of a diet plan. My plan was already underway for over a month before I came across this book - these two chapters in particular put a lot of things in perspective for me. The book is online and free.

The Road to Reduction

The trick to making a significant and sustainable change in one's diet is breaking the process down such that your diet and weigh loss plan is an evolution and not a revolution. In this post I want to show I how accomplished that for myself. Unfortunately, I took things a bit out of sequence, and you should keep in mind that I completed step three before beginning step one - other than that - this is my personal "road to reduction".

Basic Assumptions

I) My body's ability to determine when I am full is defective, and therefore a central feature of my diet plan has to include a method to artifically signal me that I am full. [This idea is from John Walker's "Hacker"s Diet" - highly recommended.]

II) The math of weight loss is very simple: one pound represents 3500 calories. To lose weight I must eat fewer calories then I expend - when I have expended 3500 calories more than I have eaten, I will lose one pound [no matter how long takes]. That's ALL there is to it.

STEP 1 - Where Am I?

The first small step is to find out where you are, specifically, how many calories you are eating to maintain your current weight. This is pretty easy, just go to nutrition.com.sg/nutrition calculators/calorie calculator/ and fill in the blanks, for me it looked like this:

height: 77 inches
weight: 346 pounds
age: 60
Daily Calories Needed to Sustain this Weight
Activity Level:
....Sedentary: 3628 calories
Lite Activity: 4186
....Moderate: 4883
Very Active: 5581

I like this site because it is very clear about activity levels - aerobic workouts can easily be substituted for walking. One thing about walking is that DISTANCE, not speed, determines the activity level. So compute the distance you walk each day and derive your activity level from that. For accurate measurements and motivational purposes I highly recommend a pedometer.

For me, at the start my activity level was clearly "lite" - I walked about 20 minutes a day, 6 days a week.

So this ends step one - very easy - at which point I now know that [on average] I eat 4186 calories a day and that maintains my weight at 346 pounds. I am also ready to start losing weight! All I have to do is eat less than 4186 calories a day and I will lose weight! How hard can that be?! But wait! How do I know how many calories I eat? Good question!

STEP 2 - Artificial Fullness Signal

I am/was fat because I don't know when to stop eating [I used to say because I "can't" stop eating]. Although I didn't know it until I read John Walker's book, what I needed was an artifical feedback system to say: "STOP! you're FULL."

Well, my method is the calorie log (John has another). Yes, I write down every calorie I eat, and I keep a running total. Yes, I take a notebook when I go to a friend's house, and yes I come home and take the time to calculate the calories of everything I ate there to the best of my ability. Yes, I measure everything, even the butter I put on my toast. Yes, when I cook I write down every single ingredient and calculate the total calories and measure how much of the finished meal I eat, and how much my wife eats.

No, I don't have a life, but only twice in 125 days have I ever gone over my upper limit (sedentary calories at my actual weight), and I am convinced that my body is already beginning to listen to some fullness signals on its own.

Some diet writers say it's too burdensome to keep a food log, others say keep it for four weeks or 12 weeks or whatever. I say, I need to know when I am full, without my food log I have no idea what I need to eat by the time dinner comes around, without it I am certain to overeat. I have no idea how long I'll keep my food log, but it sure hasn't occurred to me to stop it yet.

STEP 3 - Start Losing Weight

No, I didn't miss a step, what more do you need? You know how much you are eating to maintain your current weight, you have an artifical feedback system to tell you when to stop eating, what more do you need? Just stop eating something! Log it (well, log what you eat, not what you don't eat!). At the end of the day, did you eat less than 4186 calories? If so, you just took your first step toward losing weight.

There's no one to tell you what to stop eating. For me, I took to heart something I read: "everyone eats too much of something". I looked around, and no kidding, I ate too many potato chips. I would buy a bag of potato chips so I could drive an hour in my car, as matter of fact I would buy 2 bags, one for the return trip. So the first thing I stopped eating was those chips, and I have not bought a bag of chips since - I don't want too.

So I suggest that you pick some junk food you eat too much of, and just don't eat that one thing anymore. Or if that's too harsh, pick 3 things. Don't eat thing one on day 1, thing 2 on day 2 and thing 3 on day three.

How many calories in those "things"? If you chose well, say 300. So at the end of 7 days you have not eaten 2100 calories, at the end of 12 days you have not eaten 3600; you have lost 1 pound in less than two weeks - that's a VERY successful rate in many diet plans.

So let's recap. You give up one thing a day (maybe the same thing everyday, or maybe a selection over different days), you keep EVERYTHING ELSE exactly the same. You log everything you eat because you want to see those missing calories, you want to see that by giving up one thing you are eating only 3886 calories a day, and losing one pound every two weeks. And you also want to make sure that you don't make up the one thing, by eating two other things - but I really don't think that will be a problem.

I wish I'd had my food log, and diet plan, when I started giving up my junk foods, because it would have given me focus, it would have let me see the results, it would have been an incentive to keep on giving up junk and NOT replacing with other junk.

I stayed in "Step 3" for 12 years. I lost about 30-35 pounds and then stabilized. I was ready to move on in 2000 (after "just" 4 years in "Step 3") but I didn't have a plan, and I didn't make a plan until, well you know, I had that medical event.

You too can stay in "Step 3" for as long as you want. There's no pressure. You have all the time you need to work out specific problems. Suppose you have a binge thingy, suppose you eat 2000 calories extra of ice cream. You write it down. Holy COW! You just ate a week's worth of "things". Your artificial feedback log is screaming "FULL ! FULL! FULL!" Now, it's not abstract. Now it's not just "oh what a bad person I am" - it's like, what the heck have I done now! I gotta get rid of this ice cream. And you can just keep on like that in step three - just gaining control over one food at a time. "Sacrifices" so small and so gradual that you never really notice. But all the time your food log is telling you that you are eating less and enjoying it more.

I mention ice cream because it's the one food that caused a riff between my wife (Ms Skinny) and I. She liked Friendly's Chocolate Ice Cream (excellent by the way). It only came in half gallons, so it worked like this: she would buy it and eat one [small] serving. In the next 24 hours I would eat the remaining half gallon. Oops, no ice cream next weekend, my wife would buy another. I said: this ice cream has got to go, no more! She said: you don't have any self control! I said: Ya Think! that's why it's got to go! Winter came and the ice cream finally went. We did better with the big can of salted nuts: she "hides" it in her office. That works. Next thing you know, she'll want a mini freezer, and you know, that might just work too.


STEP 4 - Moving On

At some point in time, Step 3 is no longer going to be adequate. Maybe you run out of junk foods to eliminate, but you still have weight to lose. Maybe you get exicted enough to move on in just a couple of weeks when you find out that you really can eat less and not be deprived. Maybe you'll be like I was: your diet is finally nutritionally balanced, your blood work's great, but you're not losing weight. Whatever, you'll know you're at Step 4 when you are as interested in your health and fitness as you are in losing weight. Step 4 is when you commit to a life long healthy weight plan. Myself, I entered, and completed, Step 4 in the ICU.


Step 5 - How Much Should I Weigh?

It seemed to me that the first step in a weight loss plan should be to figure out how much I should weigh! But figuring out how much I should weigh has been a process in itself, and it will surely be refined as I move forward. But right now I calculate my target weight using a BMI (body mass indicator) calculator. For no particular reason I use the one at Nutrition.com.sg. By experimenting, I found the highest weight that produced a "healthy" BMI reading (24) for my height (77") is 206 pounds. So that's my target: 206 pounds.

Step 6 - How Do I get There (206) from Here (346)?

Once I decided where I was going (206), it was not immediately obvious to me how I was going to get there. I googled things like "weight loss strategy" until I was blue in the face, and I never could find a comprehensive plan on how to lose weight. I found a lot of fragmented ideas [some of which have been very useful], but not a plan.

So I fell back on something I'd read long ago [and have not been able to find again on google] that said, in essence, if you want to weigh 206, eat like you're 206.

So I went back to Step 1, filled in the calorie calculator for 77", 60 years old, but now I said I weighed 206 pounds, and in a second I had the answer: I had to eat 2878 calories if I engaged in light exercise, and 3358 calories if I engaged in moderate exercise to maintain a weight of 206 pounds. As a practical matter my exercise was increasing, so I picked an intermediate calorie target of 3030 calories a day.

And now, you can see that calorie log becomes all important. How the heck do I know when I've eaten 3030 calories? If I knew, I wouldn't be here. So the log tells me where I am as the day goes on. Should I have a salad for lunch, a pizza for dinner, skip the before bedtime snack? My body doesn't have a clue. It just eats anything and everything that comes along - like a PacMan. Oh sure, it feels stuffed sometimes, but it never says "FULL!" - only my log does that.

But wait, there's more! One of the greatest features of this strategy is what happens when I reach my target of 206 pounds: Nothing. That's right, nothing happens. I'm not going off a diet, I'm not transitioning from diet to maintenance mode - I'm already doing what I going to do when the weight loss part of my program is over. I'm controling my calories at the right level, I'm eating nutritional foods I like, I'm exercising the way I should - everything's in place to sustain my weight loss as long as I live. I will have fully implemented a life style change!

Step 7 - Exercise

Unfortunately, the mechanics of weigh loss don't allow for an exercise free strategy for the simple reason that your body, in its infinite wisdom, doesn't just munch on your fat cells to make up for those calories you're not eating, it also munches on your muscles and, heaven forbid, your BONES too!

So if for no other reason than to keep from becoming a muscleless whimp, you have to come up with an exercise program to remind your body you need those muscles. And what's worse, once you start moving around and exercising, your body only burns fat in the presence of oxygen, which means you have to exercise with sufficient energy to breath hard! Of all the nerve!

Walking is one of the best exercises for losing weight [and it helps with the bones too], and I have always liked to walk, so it's not much of a problem for me. I have expanded my walking from about 6 miles a week to about 20 miles. That's about 40 minutes twice a day most days of the week. I also lift a few weights and do some old fashion calisthenics to try and build some upper body strength.

There's lots of info on the web on exercising, and your own prgram will be one of those elements that evolves as your program moves along.

Step 8 - Nutrition

In all probability, you became interested in nutrition in during step 3, least ways I did. You have to replace that junk food with something, and most likely you made at least some effort to replace it with something a bit lower in calories. This is were I did a great disservice to myself not having that calorie log, and in the end, spent way to long in Step 3.

In any event, by the time you reach step 6 and are trying to keep your calories to a specific limit you will find you are a lot more interested in nutritional foods than you ever used to be. I mean, you just can't keep scarfing down those burgers and meet your calorie targets. On the other hand, it is important to realize that you don't have to give up anything in particular. You can eat anything. The only thing is, you have to write it in your log - why, because you know without that log you won't "remember" it, and you might have trouble feeling full without the reminder.

There are other aspects to nutrition that are important. For example, the fat content in your diet is important. On the one hand, the NWCR says most successful dieters eat about 24% of their calories from fat, which is a bit below the 30% usually recommended. On the other hand, you do need fat, you even need some saturated fat, so you have to keep a balance. What I do is use my calorie log to figure out my fat grams for one day a month. It's a pain and takes a while, but I think it's worth it - excess fat is one thing your body doesn't handle well. It turns out that somehow I "naturally" keep my fat intake to about 28% calories.

One way to get a start on being aware of nutritional issues is to read the health columns in your local paper, or news.google.com or whatever. Actually the Wall Street journal has an excellent library of health articles online. Anyway, these columns usually give you a good start on googling the various issues and soon you will find you have a pretty good library yourself on health issues and nutrition. Remember, this diesn't all happen at once, this is a growth process, and evolution.


THE END

Yep, that's it, that's my diet plan. It's not finished by any stretch. Things happen. Like right now I trust myself to put 1/2 teaspoon of butter on my bread, and no more. A VERY small thing, but for an obese person who never controlled his food before, it is a giant step. I now use measured amounts for everything - used to be I used a whole can of this, a whole package of that, but I am learning that I can be satisified with the same serving size "normal" people eat. And, surprise, I am finding that as I control portion size, I now have room for new foods in my daily diet. In other words, diversity.

For a quick review of the Road to Reduction go here.

Sidebar: Why I Don't Think Diet Plans Work

I should more accurately say: why I don't think diet plans work for most people.

While studies at the National Weight Control Registry (NWCR) indicate that about 50% of people losing 30 pounds or more do so as part of a formal plan (eg Weight Watchers) - the overall numbers themselves are low [only about 5000 total ], indicating to me a high rate of failure no matter what plan is used, considering all the 1000's of people trying to loose weight.

I think diet plans fail for several reasons:

1) One size fits all.

While I would give all diet plans the benefit of the doubt and assume they are based on a nutritionally sound program, they cannot, by their very nature, adjust themselves to all the cultural, ethnic, regional, genetic, etc differences that abound in our society. So by their very nature, a diet plan must be somewhat "foreign" to every participant, and therefore untenable to most participants in the LONG RUN.

2) Dietary Limitations

Many diet plans limit the foods you can eat - there's low carb/ high fats, low fat, Mediterranean, etc. I was on Atkins twice, but it got to the point I would kill for a carb. I couldn't keep it up. Same with the low fat diet I was on, one day I had to have a milk shake. The next day it was sausage, and that was all she wrote.

Although the NWCR has studies showing that successful weight losers limit their food variety, I believe people in general need some variety in their foods or they can't stay with the program LONG TERM. In any event, I know I can't.

One other problem with these diets is that people on them (like me) think they can eat ALL THEY WANT as long as it's low fat, low carb or low whatever. The fact is, calories count.

3) Transition

In the end, as everyone knows, the number of people who can sustain significant weight loss over time is extremely low. I think one reason for this is #2 above - they just can't take it any more.

But another reason, I think, is transition from diet to "not diet". I know that when I hit a snag on my diets (like that milkshake) - I felt it was all over, the end, finished. Part of the reason I felt that way was because to me, a diet was something separate, something that had a beginning and an end, not something that was part of my life forever. What was I thinking? Was I thinking I could just go back to the way I was? Frankly, I don't think I was thinking much of anything - all I thought about was "losing weight", never once did I consider what I was going to do when I got there [a moot point, as it turned out].

Now I think differently, now I think that when I reach my target weight I had better be doing whatever it is I'm going to do for the rest of my life or I won't be able to sustain my weight loss for the LONG TERM. I think that too many people think their diet is over when they reach their target weight. But actually it's not the end of the diet, just the end of the beginning.

Why Didn't I just DO IT?

A couple of great weight loss bloggers and achievers posted some comments yesterday urging us heavies to stop trying and JUST DO IT! (ie lose weight, amongst other things).

Unfortunately, it's just not that easy to get started on a new lifetime weight loss program, at least it wasn't for me. Looking back, these are some of the things that kept me from making a sustained effort to lose weight:

1. Portion Size - Be Real!

Years ago, the first time a doctor ever spoke to me about losing weight, he sat down with me with a little pamphlet that looked like a Dick & Jane reader, and explained to me that I should eat 3oz of chicken for dinner. I'm sure he said other things, but when he said I was supposed to eat 3oz chicken, he lost me. That was the most ridiculous thing I had ever heard. If I ate chicken, I ate a chicken, you know, the whole thing! I changed doctors.

2. I Have to Give Up EVERYTHING, FOREVER

It's been said that you can loose weight on a diet of doughnuts, and you probably could. But as a practical matter, high calorie foods with little actual nutritional value have to go, so I always felt like I would be giving up "everything" I liked for the rest of my life. But lost in that fear were two realities I seldom considered: 1) I actually might WANT to give up some of these foods as time went by, and 2) I might discover new foods just as rewarding as the ones I gave up. As it turned out, I didn't have to give up anything altogether anyway, unless I wanted to.

3. I'll Have to be HUNGRY for the REST OF MY LIFE

This was my number one concern - I don't know how many times I said: "I am NOT ging to be hungry for the rest of my life.", or "I guess I'll just have to STARVE for the rest of my life, that's all there is to it", whenever the topic of a diet came up. But the simple and plain fact is - I am not any more hungry on a healthy diet that provides the right number of calories than anyone else is. So yes, sometimes I get hungry, people do get hungry, but most times I'm not - I would have to say this hungry thing is the greatest myth there is in the weight loss racket.

4. I wasn't really scared.

I'm 60 years old. I have been fat since maybe the late 20's and obese since I was 43. I had just two doctors sit down and give me the what for on being fat - there was Dr 3oz Chicken, and a really great doctor who really did scare me, but who I didn't see again. The rest of my doctors were in the "you really should lose weight camp" - and of course I really should have lost weight, but that was hardly enough to get me going.

I knew the risks of eating high fat foods - everyday I saw articles in the papers, signs in the doctors offices' and the results of my blood tests that pound home the cause and the risks of high cholesterol. So I fixed that, since 2000 I have been a poster boy for good blood tests. But where were the signs and articles and tests for sleep apnea, pulmonary hypertension, heart failure... things that are a direct result of obesity and can kill me just as well as blocked arteries.[ I blew off sleep apena tests for years because I thought that the only problem was snoring] The only place I saw this stuff was at the cardiologists, by which time I already had the problem! [ I think the media and the doctors have to get it together and get beyond bemoaning the high rate of obesity, and start hammering home the facts. ]


So HOW DID I DO IT?

Let's face it, I knew that Twinkies weren't good for me. I knew that having a liter of COKE a day (or Pepsi or Dr Pepper) wasn't good for me. I am not an idiot, I can read. But what I didn't have was a good way to go about replacing a bad diet with a good diet. I didn't have a way to just DO IT.

When I considered a new diet, the scope was awsome: I had to give up foods I had eaten all my life, I had to eat stuff like salmon I didn't really like, I had to "exercise", I had to pay attention to calories, I had to pay attention to portion size [there's that 3oz chicken, again!], I had to have "will power". Whatever I did, I had to eat less today than I did yesterday and I had to do it forever. No matter how much I wanted to lose weight, it was like some force was out there ready to smother me and make my life miserable.

Take for example, this "fact" from About.Com (a site that I normally think has a really great weight loss section):
15 Facts for Weight Loss "Newbies"!
Fact 3: Get Ready for Big Changes
To lose weight effectively, you will have to permanently change four aspects of your life: 1.) what you eat. 2.) how you eat 3.) your behavior and 4.) your activity level. Losing weight is hard work. Keeping it off is just as hard ... if not harder.

I don't know about you, but I hardly found this kind of exhortation motivating!

As I said earlier, I was able to get a start on the diet thing by slowly eliminating all the junk food from my life, so that by the time I had my "medical event", all I really had left to do was count calories, and that has turned out to be surprisingly easy.

I had only a few days to come up with a plan that had eluded me for years, but it turns out that fear is the mother of invention, and the whole thing came together by breaking it down into small little peices.
{to be continued}