The Road to Reduction - An Integrated Strategy for Sustainable Weight Loss

May Be On To Something

2008-04-23T08:55:00.002-04:00

Well, for the first day, things didn't go badly.

When I signed off the blog yesterday, I started making those checks on the calendar every time I had an untimely urge to eat - there weren't as many as I anticipated - by the end of the day, maybe a dozen.

I had one real breakdown right before bed when I ate about 175 calories of canned potatoes - the timing, of course, was all wrong.

It's interesting that just writing this blog, and making a couple of marks on a calendar, can make me much more aware of what and when I eat. It's also obvious that I do have some problem gauging how much I eat - I thought I was very low yesterday, but when I added up everything this morning, I ate about 3200 calories, instead of the 2800 which would have been appropriate for the level of exercise.

I would have hit the 2800 if I hadn't had those potatoes before bed and skipped the half of my wife's candy bar [200 calories].

Which brings me to the question; should there be rules against certain foods: eg no candy bars, donuts, etc, ever. I'd include desserts at home (but not splitting one with my wife at a restaurant). What I am really asking is: should certain foods be treated like cigarettes - you just aren't going to have another, ever again. period.

I used to think that I would be impinged upon by never having another donut - but would I really? I mean, the benefits of never having another donut certainly outweigh the fleeting benefit (taste).

I n any event, I woke up hungry today, and that is the goal - actually be a bit hungry before eating. Those are signals I can read, and apparently, I can generate them, if I give myself the chance.

THOUGHT CONTROL

2008-04-22T09:08:00.002-04:00

Well, I just read Katiebird's comment from a well over a year ago, and it's right there with Mike Huckabee, depression-wise. I mean, she's saying that not eating has to be a focus of your life, or the weight will come back (or the eating will take over - whatever).

I just can't totally accept that - when I lost my weight, when I started and wrote this blog - losing weight was my life's focus. I read about, developed a program, thought about it everyday, watched my success, etc.

But I have other consuming projects I want to do. For example, tax season: I am a local leader for the AARP Tax Aide service, and we had a hell of a year - over 625 returns prepared, over 750 clients. There's no question that "taxes" is the focus of my life for this 3 month period - not to mention the 3 months before that which is consumed with training and planning.

My next project is my derelict boat. I have lots of projects besides not eating.

If I have to, I am getting closer and closer to counting calories, because I know that works. But I am still searching for some other form of control - one that is more adaptable and can be sustained without being the focus of my life.

The main premise of Hacker's Diet is that my body does not create or receive signals indicating that I have eaten enough. I really subscribed to this idea, and it was partially the basis for my weight loss program. Yet I don't entirely believe that anymore. I mean, yesterday when I ate that donut, I was FULL. There was no missed signal there. My body body was screaming for mercy, but my mouth wanted food.

Now I don't want to get into psychotherapy here, but I am a big (tall) guy, and as a teenager I was not allowed to free feed - I was allowed to eat whatever I could get at certain intervals. And I was in competition with everyone else for the limited amount of food that was available. (I am NOT trying to say we were poor and didn't have enough food - just that a meal was a meal, and whatever was around was all I was going to get until the next meal.) And that is how I eat now - if the food is here, I eat it, and I eat it now, even if there's no one else who might remotely want to eat it. So I suppose I still feel, deep down inside, that I may not be able to eat again for a good long while.

So the more I think of it, the more I am beginning to think that I just have a nasty habit here.

I have read, and I think that I quoted an article here, saying that stopping smoking and losing weight are not the same thing. And that's probably true to a degree. However, the physical addiction to nicotine is just 3 days - the rest is just a pervasive habit.

I just scanned a couple of web pages on "how to beak a habit", and although they don't specifically use the term, the articles are all about intercepting impulses and urges. The exact same thing in cigarette smoking.

So in theory, something like my stop smoking slogan ("Having a [donut] now won't change a thing") should work. My friends slogan of "If I still want [a donut] five minutes from now, I'll have it" might also be a good one. Also, one of these articles suggested putting a mark on a calendar or something every time an urge/impulse occurs. For some reason it sounds like a good idea to me.

I also think, for myself, I would like to have a good long list of all the things I don't like about being fat again. Yes, being relatively skinny (of course I was never actually skinny) allowed me to experience many new, and better, things, that I hadn't been able to enjoy for quite some time.

I think I will try to have some sort of program by tomorrow morning.

If It's There - I Eat It

2008-04-21T09:38:00.003-04:00

Well, at first I did OK with the house guest and his donuts -

I avoided the donuts altogether and settled for two bagels (one would have been preferable of course), and by lunch I was even hungry, which was a goal - to be hungry at meal times.

Lunch was OK - within bounds, though I did finish off my wife's french fries. But when we got home, things reverted to normal.

I was full, let's even call it stuffed, after lunch. Yet when I walked into our house, in short order I ate not only the last donut, but also half a muffin. Just to remind you, I was stuffed - I was actually uncomfortable after the donut, much less the muffin.

And this morning, I huffed down 4 slices of American cheese @ 70 calories per, as I'm frying eggs for breakfast - and I'd already had my oatmeal - I wasn't remotely hungry.

What the hell goes on in my head? It's not like I don't think about these things as I'm doing them. It's more like: "Well, this is a bad idea eating this _____. What the hell! {eat}"

What the hell indeed.

Back Again

2008-04-20T08:19:00.003-04:00

Well, here I am - back again. I have gained back probably a bit more than 1/2 of what I lost. At the moment I seem to be totally out of control. I know that I have to lose weight - there's no question. I am, for example, out of breath every time I walk to the top of a hill, or every time I try to walk into a store from the parking lot. Now I know enough to know I don't have PHT or some other terrible disease, just a lot of visceral fat around my lungs. Yet I seem to eat more everyday day rather than less.

There is a money factor too. I eat a lot of bread, bread adds $10 to my weekly grocery bill. Also, my medical insurance has offered 10% rebate if I join some sort of healthy plan at my doctors office, and "maintain a healthy weight" or join to plan to reach a healthy weight. 10% is about $900, I simply can't afford to turn it down.

When I started this blog, and started losing weight, I was motivated by a 3 day stay in ICU. That experience has passed and the experience hasn't stuck with me. This is bad. When I finally quit smoking, it was because the last 3 cigarettes I had made me feel faint and dizzy. Each one was worse than the one before. I knew I was going to die if I had another. So I quit, and it's stuck.

But I had a lot of preparation before that last cigarette, and I knew one thing. That I couldn't have even just one more cigarette because I would ne hooked again. With just one. So I never had another.

I am becoming to believe that food is the same way. If I am going to lose weight and keep it off, I just can't have another doughnut, period. Or dessert at a restaurant. Etc. Somehow it doesn't work to say you are going to limit your intake of these things. Of course when I say "you", I mean "me".

When I orginally did mthis blog, it was easy to do the main component, that is, log my daily calories. It was natural, it gave me feed back, and I couldn't understand why everyone didn't do it. Yet now it is a burden. I know that when I started going off the "diet" - "program" is probably a better term - I was depressed by three things. First of all, I hit a plateau and just wasn't losing any weight over the last few months. Secondly, there were a great number of picnics etc, and it just seemed impossible to keep on the program. But most of all I was depressed by Mike Huckabee.

Quite apart from his presidential run, Mike made news by losing 100 pounds as governor of Arkansas, and keeping it off. He also made news by actually doing real things to reduce the obesity levels among Arkansas kids. But when I read that years after his weight loss, he still had to carry around a cooler of his own food, and avoid official banquets and otherwise more or less oriented his life around not eating too much. Well, that was just too much for me. I mean, it all seemed so pointless because his experience seemed to mean that I could never be "normal" when to it came to food. That I could never teach myself not to eat too much, or adjust to not eating too much, or whatever.

But now I guess I am coming to understand that's the way it is. That I am not "normal" when it comes to food, any more than an alcoholic is "normal" when it comes to alcohol.

One thing I noticed about quitting smoking, in myself and in others when they quit, was that everyone had a slogan, or a crutch if you will, that they could use when tempted by a cigarette. My own was "Having a cigarette now won't change a thing". And that worked for me. And I am wondering if it won't work again for food. Food as an addiction is something I have touched on before, but now I think I need to investigate more fully.

Perhaps, if I can become convinced that I am addicted to food, or somehow "abuse" food like other people "abuse" drugs, then maybe I will be more capable of resisting each individual impulse to eat There were, after all, hundreds of impulses to smoke every day when I was quitting, and I resisted those. Somehow, gaining control over "eating impulses" is now much more tenable than thinking that I will record everything I eat for the rest my life.

Well, my houseguest is back from church, so I have to close. I have a great deal of reading to do to catch back up, including my own blog, which I haven't read yet! There is also The Rudd Center for Food Policy and Obesity, Food Addicts in Recovery, and the Wikipedia entry on Obesity.

And the jokes on me: the houseguest has returned with donuts, muffins and bagels from Tim Horton's. Just what I need - donuts sitting around the house. Let's see how that slogan works...

What's the Future Hold for Obese People?

2006-11-02T22:43:00.000-05:00

Back in August I wrote a comment to my post of August 3rd, which said in part:

" One problem with obesity is that I do not directly harm the person standing next to me. But one day, the cost to society as a whole will be recognized, and then I think there will be a different environment - but I have no idea what that will look like."

Since that time I have posted a number of articles that address the question of what the future will be for the obese. Some are positive, some less so.

Now we have an article from the New York Times (Oct 29) entitled "For a World Of Woes, We Blame Cookie Monsters" [also available here].

The article begins with a humorous undertone, but ends on a rather discouraging note:

"Fat people are more reviled than ever, researchers find, even as more people become fat. When smokers and heavy drinkers turned pariah, rates of smoking and drinking went down. Won’t fat people, in time, follow suit?

Research suggests that the stigma of being fat leads to more eating, not less. And if reducing the stigma suggests a solution, that’s not working either.

“One hypothesis about getting rid of stigma is having more contact with the stigmatized group,” Dr. Brownell says. But with obesity, the stigma seems to be growing along with the national girth.

He cites a famous study in the 1960’s in which children were shown drawings of children with and without disabilities, as well as a drawing of a fat child. Who, they were asked, would you want for your friend? The fat child was picked last.

Now, three researchers have repeated the study, this time with college students. Once again, almost no one, not even fat people, liked the fat person."

The article continues:

"One problem with blaming people for being fat, obesity researchers say, is that getting thin is not like quitting smoking. People struggle to stop smoking, but many, in the end, succeed. Obesity is different. It’s not that the obese don’t care. Instead, as science has shown over and over, they have limited personal control over their weight. Genes play a significant role, the science says.

... [T]he notion that anyone can be thin with a little effort has consequences. “Once weight is due to a personal failing, a lot of things follow,” he said. There’s the attitude that if you are fat, you deserve to be stigmatized. Maybe it will motivate you to lose weight. The opposite happens." As it turns out, the studies show that fat people respond to stigmatization and discriminatin by, what else, eating more.

So basically, what you can conclude from this article is that people [including fat people] are getting increasingly annoyed with fat people. Where exactly will this lead? Who knows? - but today, the future is not that rosy.

And Now - A Brief Political Interruption

2006-11-02T20:29:00.000-05:00

I urge everyone to read the following article by Kevin Tillman, brother of Pat Tillman - killed by friendly fire in Afghanistan.

Red or blue, I believe that Kevin's powerful words will resonate with everyone as he makes us think about issues we would rather not think about...

After Pat's Birthday, by Kevin Tillman

KatieBird - I'm Alive and Kickin and Living in New England

2006-11-02T20:04:00.000-05:00

KatieBird, author of Eat4Today and leader of the support group there, posted a nice comment to me. While browsing the many blogs related to obesity I can't help but notice the many that just ended in mid life - so to speak. To have someone miss mine was truly a surprise. And much appreciated. Thank you.

Can't say why I quit writing exactly - blogging does take a lot of time, and I became somewhat depressed when my weight plateaued, and there were numerous aches and pains that kept me from my full exercise schedule (not to mention the summer's heat), yada, yada ,yada...

But I think the real reason I quit blogging and became content with losing 50 pounds was that my medical event lost its punch. That is, I feel better - no shortness of breath on my walks, easier time getting up and down from chairs, cars, etc

I have new doctors' appointments in ealry December, and I will see what's what then. But to tell to truth, my wife and I couldn't quite remember what is wrong with me when we discussed it this afternoon.

So, thanks to KatieBird, I am trying to get back in the grove. My weight has stayed between 299 and 304 since I stopped writing, so I could just pick up where I left off. For the last couple of days I have been trying to log my calories again. Hasn't happened yet, but maybe just the feel of blogging will get me over the hump.

However it turns out - I will never forget KatieBird's little note. Thanks.

It's a culture war OK, but it's not in Iraq

2006-09-09T13:18:00.000-04:00

We've all read, at one time or another, that "no one chooses to be obese", and I've always taken this as an article of faith because I sure as heck don't enjoy being obese. And while the good folks of Arkansas have not exactly stood up and said "I want to be obese", some of them are standing up to say they have the right to be obese if they want to!

You remember Arkansas, don't you? The state that originated the idea of weighing all the school kids and reporting their BMI on their report cards. Well, in a follow up article, it is apparent some people are taking offense at government efforts to get obesity under control. The governor is taking flack from parents, school kids objecting to the healthy school menus, and the owner of a soul food restaurant who sems to be worried about losing business, among others.

Talk about your social norms, as the governor himself points out, efforts to promote healthy eating compete directly with "all-you-can-eat buffets, cheese grits and a local ice cream flavor called Woo Pig Chewy." In fact, inspite of success with the school child program, the number of obese adults in Arkansas has actually risen since the beginning of the governor's efforts to change "dietary habits".

None of this is too remarkable coming from a state that is in the middle of the region with the highest obesity percentage in the country. But what is interesting about this article is a couple of nuggets mentioned in passing. First of all, Governor Huckabee listed "four behaviors that have been reshaped over the years by concerted government effort: littering, seatbelt use, smoking and drunken driving." Obviously behavorial change in these situations has resulted from a change in social norms, as I have often discussed in the case of smoking - social norms and their relationship to obesity remains an issue I still have to deal with in my post on the obesity pandemic.

The other interesting nugget has to do with how Governor Huckabee manages to maintain his weight loss:

he jogs 5 miles every morning
he no longer eats at banquets and receptions
he carries a cooler of his own food in his car
oh, and he doesn't drink [alcohol!]

It's an article of faith when you quit smoking that you can never have another cigarette. period. Governor's Huckabee's maintenance regimen makes it clear that the reason I have problems with picnics is that I strill try to eat at them. [BTW, I once tried to bring my own food to a picnic - it was a rather large salad - I made the mistake of putting it down in a public place, everyone thought I brought it to share and there went my low calorie picnic!] I have given up fast food [yes, in total], most all red meat, and all snack foods (except when we have a party of course). Somehow it seems really hard to think about not eating at picnics, luncheons, my own parties, etc. But realistically, that may be so.

I'll think about it over a couple of scoops of Woo Pig Chewy.

Health Experts Warn of Obesity Pandemic

2006-09-04T09:05:00.000-04:00

The opening sessions of an international conference on obesity described the global spread of obesity as a problem bigger than global warming, a problem that threatens to overwhelm the medical systems of the world, a problem that has resulted in the number of overweight people worldwide exceeding the total number of undernourished people.

I am sorry for the absence of posts, but I have been trying to get my head around a global obesity epidemic. I mean what is that? How does it spread? Do you get it from toilet seats? unprotected sex? My neice can tend to be chunky, does she get something from me when I give her a kiss?

And I can't help but to wonder where I fit into the picture. Clearly if I died from a avian flu pandemic no one would blame me, would they? Wouldn't I just be a victim of random chance? But with an obesity epidemic it seems like I have a lot more responsibility for my condition. Why is that? What exactly is the nature of that responsibility?

We know some things about the nature of the epidemic:

The idea that obesity is the outcome of the availability of cheap food may have some substance. Consider that while obesity is now a significant factor in nations rich and poor, in developed nations the fat tend to be poor while in developing nations, it's the rich that tend toward obesity. The New York Times article addressing the robust modern American also talked about the scarcity of food 100 years ago.

And here I would like to offer an original thought, a suggestion. Is there anything to the idea that the increase in the incidence of obesity is related to the coincidental decline in smoking? It's not only the US that's restricting smoking, even the pubs in Ireland have banned smoking. And France, the most cigarette-friendly nation in the western world, is about to impose smoking restricitions. And I know for a fact that a great deal of the oral gratification of smoking can be saited with food...

One thing that the epidemic is not necessarily related to is junk food. The great hue and cry now is that it's the sugar that's causing obesity in youth. But I want to emphasize again, that I know, from personal experience, that you can be obese while eating a diet of so-called healthy food. My only point is that quantity as well as quality makes a difference, and to focus exclusively on quality misses much of the point.

But one thing that I am giving more and more emphasis to is exercise. My own immediate experience has been that exercaise, and exercise alone, has held my diet together through a month of unrestricted eating. And as I look back over my own life I see that as my exercise declined from that of an athlete in high school to a total couch potato in 45 years later, there was a definite coincident increase in my weight. So it may well be true that the idea that we have to work less physically hard than our ancestors has a significant bearing on our weight today. And as a specific example: China has joined the obesity parade, and who's getting fat in China? the city workers, not the pesants. Supports the ideas of a) plentiful affordable food, b) status symbol in a developing country 3) less physical labor...

[due to other obligations, I am publishing this article as is, in rough form, and I will complete it over the next day or so - in particular I want to address the role of social norms. In the meantime, I invite comments, statistics and references that could hep define the nature of a pandemic of obesity.]

Potholes on the Road to Reduction

2006-09-01T11:52:00.000-04:00

Well, I thought I had this all figured out: a convenient "medical event" that scared the heck out of me, years of pre-diet preparation, and a calorie counting scheme that really seemed to work. Then along came August.

The heat wave knocked the heck out of my exercise schedule. And picnics, birthdays, parties - what can I say: I count 7 days in August when I didn't even attempt to fill in (or complete) my calorie log, and 6 days that exceeded 3500 calories, well above my target of 3100 (at which, btw, I feel comfortable). That's almost half the month with out of control eating.

No doubt about it, when I am around food, I eat it. And I can't even blame it on other people: at the various picnics etc I couldn't help but notice that everyone else seemed to eat "normal" amounts - even those few who were overweight themselves.

In spite of all that I am down 1 pound as of today compared to my proud announcement of "Down 41" on July 18th. The only thing I can think of that held it together was the walking. Except for the height of the heat wave when I only walked 11 miles for the week, I managed to get in 18 to 25 miles a week - more than enough to put me in the high activity category (per Nutrition.com.sg),with a theoretical daily maximum of 3800 calories, just enough to offset those high calorie days. Is this "the value of exercise" revisited?

One other thing that might have helped, especially in the last two weeks, is the addition to two to three fish oil capsules a day to my diet per the fish oil article in my side bar.

All in all, I am happy to see August go, and I am hopeful I can return to my regularly controlled eating - but vacation looms ominously on the horizon...

Obesity - a Social Norm?

2006-08-27T14:48:00.000-04:00

A few weeks ago I suggested that one reason obesity was taking off in the US is because it is OK to be fat. Well, there is currently a fascinating article in the Wall Street Jurnal [free to the public] which is actually a debate between two economists regarding the increase in obesity, and whether it is because of exitsing social norms - especially for lower income and non-professional people - or because of historically cheaper food prices and less strenuous physical work requirements.

It was a bit disconcerting to me to be the subject of a debate between two people who could care less about my personal situation. Nevertheless, I think there are a couple of interesting points.

One argument is that both rich and poor people are gaining weight, and that statistically rich people are actually becoming obese at a faster rate than poor people (though from a far lower base). So the argument here is that it is the availbility of food at ever decreasing prices, and the more sedentary nature of the modern work force that is responsible for the gain in weight of the US population.

The other side of the argument is that the poor are mired in rut in which obesity is the social norm and therefore there is little incentive to prevent weight gain or to go through the rigors to lose weight. Furthermore, according to this argument, people in this situation have little aspiration to professional employment where there is established discrimination against obesiy, and thus lack the incentive for weight control that may be more evident in the upwardly mobile individual.

There was also this interesting tidbit: "Changes in social norms about smoking, for example, seem to have made a difference in reducing [the] incidence [of] smoking. Thus, if it's the norm in your social group to be obese, then that is one less reason to do something to either prevent or reverse a very difficult problem."

My own thoughts are that 1) in my personal observations it does seem as of the wealthy are thinner than my more natural milieu; which might be called the lower middle class; 2) and why not - the wealthy can and do shop at Whole Foods etc - eating healthily is expensive; and 3) I still maintain that just speaking up - schools, doctors, friends, whatever - is the single most important thing anyone or any organization can do. [In other words, this is a backhanded way of saying I think there must be a change in social norms regarding overweight.]

In the end I firmly believe that at this point in the campaign against obesity, social norms have (or can have) the biggest effect. Look no further than the complete reversal in smoking norms between 1968 and 2006 and the resulting effect on the number of individuals smoking. But I really recommend that you read the article for yourself and see what the issue of social norms is all about.

Perhaps the Future is Unfolding

2006-08-26T14:52:00.000-04:00

It must be that once you write about something, you become more sensitive to seeing that subject in print. Or at least it seems that way ever since I wrote a post on the Thompson MedStat study on "Lifestyle & Obesity", and concluded in a followup comment to that article that "one day, the cost [of obesity] to society as a whole will be recognized, and then I think there will be a different environment - but I have no idea what that will look like."

Well, first it was the state of Arkansas [and 15 others according to the article], and now it's the public health care system in Great Britian which is in the early stages of reintroducing the "school medical" - eliminated in the early '70's - to combat rising obesity in school aged children. As part of the program, 100's of students will be weighed to gather statistics on the current state of the problem, and "it is likely that parents of children seen to have weight problems will be alerted."

And it's not just children that have been targeted in Great Britian. "Thousands of GPs [doctors] will carry out 'intensive lifestyle interventions' after a nationwide study shows they lead to long-term weight loss. ... Impressive results from the nationwide Counterweight Project involving 2,000 obese patients found it led to sustained reductions in weight, blood pressure and cholesterol."

And in the small Australian town of Colac, the entire town - parents, schools, fast food outlets, nutritionists, and local media - got together to get the expanding waistlines of their children under control. Over a three year period, the program was a resounding success, reducing both the weight and waistlines of the children. A program such as this reenforces my personal opnion that Australia is one of the countries with the most effective programs to fight the global obesity crisis. [Singapore is the other.]

So perhaps it's becoming clear that active intervention on the part of doctors, schools and communities is going to be part and parcel of the solution to obesity. It may becoming clear that just speaking up can achieve measurable results.

PostScript

Unfortunately, I still don't think the US government has a clue. For example, the new MyPyramid.gov site is supposed to guide individuals to a healthier diet. Yet, what does it do? If I plug in my age (60), gender, and moderate activity, first thing it tells me is that I am supposed to eat 8oz of grains, 3 cups vegteables, 2 cups fruit, 3 cups milk, and 6.5 oz of meat and beans. Holy cow! I am going to starve to death! I have no idea how many ounces of grains I eat a day, but 8 oz does not sound like much! I am tempted to blow this off before I even get started - shades of Dr 3oz Chicken. There has to be a better way to motivate healthy eating styles than to immediately focus on what you can't eat any more. The Road to Reduction uses a path of self discovery, first emphasizing what is happening now and requiring only small, incremental commitments to change as the process continues. Naturally I think this is a better approach - I wrote it! In any event, it is fortunate that there are many other sites, such as the Harvard School of Public Health, that present health, fitness, and weight control in much more positive manner than the US government.

Addiction Revisited

2006-08-22T21:06:00.000-04:00

In reponse to my last post "An Addictive Aspect to Obesity?" two regular readers and fellow bloggers Sir Squishy and Kim Ayres left comments to the effect that overeating was unquestionably a food addiction.

After mulling over this hypothesis for most of the day, I find I must disagree, at least as it pertains to me.

When I think of addiction, I think of smoking - cigarettes were a requirement all the time. If I did not have a cigarette, all work, all anything, came to a halt until I got some. Whether I bummed them one at a time, or bummed a pack, or went out to where ever to buy some - work did not continue until I had a cigarette going AND knowledge that I had access to an ample supply. Working under a conditon of a limited supply was nearly as distracting as trying to work without any. I distinctly remember when airlines first started restricting all smoking on flights, the outright bans were limtied to flights of two hours or less because it was "common knowledge" that a smoker could go about two hours without a cigarette.

Contrast this to my recent visit to my brother's. He and his sons took me offshore fishing for the afternoon. Altogether, the trip was about 6 or 7 hours during which time I had one beer and bottled water. I experienced no ill effects or discomfort at all from not having any food during that time, even though I am a confirmed grazer in my natural habitat. As a three pack a day smoker I assure you I would have been a highly unpleasant fellow to be around if I had had no cigarettes for seven hours!

Or consider the following: it is an accepted fact that the average life span of a half gallon of ice cream in our house is 1.75 days. However, at no time do I ever feel that I have to go out and get ice cream to be able to work or feel relaxed, etc. In fact, I have only had ice cream twice this summer, once at the aforementioned picnic which is the only reason the ice cream was in the house in the first place.

And finally there is the Harvard School of Public Health which describes a vicious cycle in which highly refined sugars could cause some people to feel hungry even immediately after a meal, but in no way did they suggest refined carbohydrates are addictive.

I will freely admit that the only foods I feel comfortabe having in my house in unlimited quantities are fruits, vegetables, and things that need at least minimal processing (eg opening a can, microwaving, or mixing with water). Why I consume things like crackers, ice cream, cheese, etc over a couple of days when they are in the house is still a mystery to me. Nevertheless I do not feel addicted to any of these foods because without them I can continue to function just fine, thank you.

This is not to say that others don't treat some foods the way I used to treat cigarettes, and I would like to hear comments from anyone that does.

An Addictive Aspect to Obesity?

2006-08-21T12:00:00.000-04:00

Following is a news brief which I am quoting in its entirety, longer [and better written] articles can be found here and here.

Obesity Expert: 'Processed Food' Causing Obesity
August 20, 2006 9:00 a.m. EST

San Francisco, CA (AHN) - Dr. Robert H. Lustig, renowned obesity expert at the University of California, San Francisco says that 'processed foods' like potato chips and cookies, are causing obesity amongst consumers.

In his proposed hypothesis, he said the pattern of sugar consumption is similar to nicotine addiction and it takes more than just will-power to change it.[emphasis mine]

According to Lustig's hypothesis, large amounts of sugars increase insulin secretion, which in turn floods the hypothalamus, which regulates energy use in the body. In this way, insulin blocks the path of another hormone, leptin, which tells the brain about the energy requirement. This ends up with the body going into starvation mode -- the brain thinks it isn't getting enough energy, so it needs more calories and it needs to save energy.

However, some obesity experts showed disagreement over Lustig's hypothesis.

Just to be clear, a) this article presents a hypothesis, and b) some experts disagree [like that's news]. And, we have heard this rap on refined carbohydrates before from the Harvard School of Public Health, although they did not call it an addiction.

But just considering for a moment that over eating is an addiction, several thoughts come to mind as I review what was important to me when I was finally able to give up smoking.

It took many tries (7 as I recall) over several years to actually stop smoking - brings to mind the many diets that just faded away....

The physical addiction to nicotine lasts only 3 days - this was important to me at the time because it allowed me to really focus on not smoking for those three days, and gave me a sense of accomplishment when those 3 days were up. I wonder what the physical addicition to high glycemic foods is?

Then of course, there is the really bad part of the addiction to smoking: habit. I am reminded that those of us who tried to quit smoking frequently talked of our nicotine cravings. WoW! How many blogs could we turn up where dieters are talking about binge eating and food cravings? Are all cravings created equal? Hmm, I remember from "stop smoking class", sponsored by the AHA , a discussion that smoking was in large degree an oral craving. And the instructor warned us not to satisfy that craving with food. (I must have missed the class that offered an alternative.) (By the way, is there a "stop eating class" from the AHA?)

So how did former smokers handle the cravings? Well, every single person I knew who successfully quit smoking - including me - had a mental slogan used to diffuse each craving. My own was: "Having this cigarette won't change anything." Doesn't sound like much, but to me it was the one meaningful thing they said in the entire two weeks of the "stop smoking class" . The other thing we all did was get rid of any and all cigarettes - the temptation was just too great if they were left laying around, slogan or no slogan.

So anway, if over eating is at least partially a question of addiction and habit then maybe some of the strategies used to quit smoking will work:

A mental slogan to combat the cravings: "Eating this ____ won't change anything" might work for me.
A bottle of water (or something) to combat the oral addiction.
Getting rid of, and keeping away from, all foods that I find I can't control.

None of these ideas are original thinking, but together they are proven methods to fight addiction, and thinking of overeating as an addiction might just add fresh insight and new focus to an otherwise stale and unrelenting battle.

And just recently I had a lesson in #3. We hosted a picnic for some volunteers, and in spite of he fact they all knew I was trying to lose weight, they refused to cooperate and eat all the food. After spending a day thinking I could eat "just some" of the leftovers on some sort of reasonable basis, I found I had to take it all to the compost: butter, ice cream, rolls, cheese, etc. There was no way I could not eat all that food. The dog was happy though - he got the hot dogs and sliced ham.

I guess I have not yet successfully quit overeating!

The Times - They Are A Changin' ?

2006-08-18T08:54:00.000-04:00

Back on August 3rd, I suggested that obesity would remain an issue until it was no longer considered OK to be fat, until people spoke up, until it became everyone's responsibilty to ensure that "healthy eating" prevailed.

Well, would you believe that it was the state of Arkansas, that hot bed of radical reform, the home of the biggest purveyer of junk food in the world, that stepped up to the plate?

By the simple expedient of weighing all the kids in school and mailing a confidential letter to parents of obese and overweight kids, the state of Arkansas brought the steady increase in the number of obese kids to a screeching halt. All they did, all they did, was say - Hey, it's not OK for your kid to be fat.

The program was promoted by the state's governor who himself lost 100 pounds after being diagnosed with diabetes [yet another "medical event"].

Numerous news stories are out there with slightly different angles: Time, Washington Post, and Reuters are just some examples - many more can be found on news.google.com.

The Value of Exercise

2006-08-16T10:24:00.000-04:00

I've just returned from two days at the Cape courtesy of my brother the gourmet cook. Any pretense at keeping to my diet was a shambles from the moment I walked in. The food, as ever, was delicious, but I swear I have never seen anyone cook with so much butter (and I do mean butter, no substitutes). Butter disappears by the stick in every pot - frequently blended with generous quantities of extra virgin olive oil - it's like a revival of James Beard or something.

So you would be forgiven thinking that my brother and his family suffer from the same weight fate as I do - but it's not so. How so? Well his wife jogs and swims before breakfast (in winter I think it's cross country skiing before breakfast), his two teenage boys lift weights (frequently with my brother) and are active in sports from baseball to skiing, and his daughter is an avid dancer with her own group. And they all ride bikes everywhere (except of course when my wife and I come and cars are used in respect of our advanced age, or something). Anyway, there's not a chubby one in the bunch, quite to the contrary (well, maybe my brother could jog an extra lap or so.)

So there you have it folks - the value of exercise!

[In addition to cooking, my brother runs his own small gourmet food company, and in a shameless plug, I recommend you go here and see for yourself. His sauces are award winning and his zesty garlic mix - well, as they say, it can't be beat!]

Vacation, Picnics etc

2006-08-14T09:25:00.000-04:00

I apologize for the paucity of posts but 'tis the season of house guests, picnics, mini vacations and birthdays (mine included). Not to mention the occasional heat wave to slow things down (but not the grass I notice).

Anway, sometime after next weekend, things should return to normal. In the meantime, I seem to be holding my own dietwise IF I take a bit broader view and consider it a week at a time. Day to day is more of a struggle, with some days way up and others down - guess that is what it will be like for the foreseeable future - how much to eat may never come naturally.

hope everyone is enjoying this summer

What Ever Happened to my Diet?

2006-08-11T14:36:00.000-04:00

Wife said to me lst night - "Whatever happened to your diet - you used to talk about it all the time, and now I never hear about it? Are you still on it?"

Well, what happened to my diet is...nothing. It's stil there, just plugging along. The heat wave adversely effected the exercise routine, and while walking is fullly recovered, weightlifting and other execises still languish. Back on July 25th I said I would try to replace my diet bread (35 calories/slice) with whole wheat bread (100 calories/slice) because of the glycemic index load.

I was about to say that my calories had gone up a bit since starting the wheat bread, but looking back at my calorie log I see that the increase in calories was not as bad as I thought, and that the days I had trouble keeping calories down to the 3100 level seemed to be associated more with the intense heat wave during that time. Nevertheless, I have gone back to the diet bread, and I feel much more relaxed about eating than when I was using the whole wheat. I guess you might say peace of mind trumps the glycemic index load.

But back to the diet itself - it is no longer the main topic. As I have said before, how I eat now is pretty much how I think I am going to eat for the rest of my life. Sure there are small changes... I have added a small orange to my diet every day because citrus fruits were on the top 12 phytonutrient foods list, and I wasn't eating any. And I have decided that I am not going to buy any more canned soups because I am tired of getting nearly 1800 mgs of salt along with my soup. But the diet per se - the lower calorie intake - that pretty much takes care of itself now, day after day after day... Boring.

LifeStyle & Obesity: the Thompson Medstat Research Brief

2006-08-07T17:18:00.000-04:00

Well, the newspaper reports of the obesity survey discussed last time had been weighing on my mind over the weekend so much so that I finally went out and googled the actual report. What I found had nothing much to do with the focus of most news stories, and surprisingly the conclusions fit more or less into what I have been writing about in this blog.

The objective of the Thompson Medstat Research Brief into "Lifestyle and Obesity" was to make sense of the "disparity between the perception of good health and the reality of ... expanding waist lines"; namely, the fact that "despite the cold facts —64.5 percent of American adults are overweight, 30.5 percent are obese, and 4.7 percent are morbidly obese — ... more than four out of five Americans characterized their eating habits as either 'very healthy' or 'somewhat healthy.'”

As far as I can see, the news reporters read the key findings of the report to wit: 75% of "obese respondents characterized their eating habits as 'very healthy' or 'somewhat healthy', and that 50% of all respondents (obese or otherise) exercised vigorously three times a week; had a good laugh and wrote that the respondents were in denial and/or didn't have a clue about what constitutes healthy eating and vigorous exercise.

In so doing, these reporters overlooked some key statistics within the survey:

only 25% of obese respondents claimed "very healthy" eating habits, 50% said that they had "somewhat" healthy eating habits: no denial here in my opinion. These catogories were lumped together in the news stories as "healthy eating habits", significantly distorting the actual results of the survey.
there was no evidence that obese respondents significantly abused fast food, "super sizing", or snacks as compared to the rest of the population
with regard to exercise, twice as many overweight respondents reported vigorous exercise as compared to morbidly obese respondents, with obese respondents falling in between. Overweight respondents exercised at the same level as healthy weight respondents. All in all, there is nothing to suggest that obese respondents don't understand what constitutes vigorous exercise and whether or not they engage in such activity.

Indeed, the conclusions of the survey itself bear no resemblance whatever to the news reports:

"CONCLUSION
‘Sometimes’ is a very dangerous word
While very few respondents in any of the BMI categories consistently ate super-sized fast foods for the majority of their meals, snacked recklessly, or even characterized their eating habits as poor, several high risk behaviors have combined to become part of the average American’s weekly routine. Through a combination of occasional fast food meals, moderate snacking, not quite enough exercise and the belief that these habits are “somewhat healthy,” Americans are rationalizing themselves into ever-expanding waistlines."

It may well be that "Americans are rationalizing themselves into ever-expanding waistlines," but there is another possibility. As I have been hammering home again and again, as an overweight person myself I don't have a clue all right, but what I don't have clue about is when to stop eating. So those "high risk behaviors" could be as simple as an obese person's inability to keep a "running total" of calories eaten throughout the day.

Or it could be more like my own experience, wherein I did eat healthily, but I made no effort to control my calorie intake, for many reasons that didn't turn out to be true.

Survey Says: Most Obese Claim to Eat Healthy

2006-08-03T22:52:00.000-04:00

Well, I'm sure you've seen one of the 200 or so versions of this story (here's the original AP version), and the emphasis is -no brainer - on the word claim. The angle of virtually everyone is - another no brainer - denial. To quote the article: "There is, perhaps, some denial going on. Or there is a lack of understanding of what does it mean to be eating healthy..." said Dr. David Schutt.

Fact is, I feel compelled to take the take the last 6 years of lab results with me whenever I go to a new doctor because the assumption seems to be that I eat at Mickey D's 24/7. My cholesterol is 155. My triglyceride is 73. My glucose is 90. And that's how they've been since 2000. I eat healthy. (This article at commonvoice.com concludes that the survey respondents are answering truthfully; however, I do not necessarily agree with the article's conclusions.)

"The [survey] questions leave out quantity," said Dr. Jeffrey Koplan of Atlanta's Emory University. Brings to mind my favorite quote from the NY Times 2/7/06: Nothing fascinates the American public so much as the notion that what you eat rather than how much you eat affects your health.

So here's the truth of the matter: I am obese because I eat too much, healthy eating is a whole separate matter.

The article has many references to "normal weight people" - surely they are referring to overweight and obese people because right in the article it says: roughly two-thirds of Americans are overweight or heavier, and nearly one-third qualify as obese, according to the U.S. Centers for Disease Control and Prevention. But no, according to the article, "normal weight people" are the thin people.

STOP RIGHT THERE. Let's get this straight right now: normal weight in the US is overweight.

This is important. When I go to the doctors I see fat nurses, fat doctors, fat patients. Must be OK to be fat. I see fat people in restaurants, in stores, on the beaches - it must be ok, they do it. And let's not forget this story, in which the new robust American man is seriously overweight.

After I checked out of ICU, I called my friend who is fat, and said: man, you had better do something about your weight, your sleep apnea, I been there, I know. He said he'd check into it [and hasn't]. And what am I going to say - the pot calling the kettle black isn't it?

Or how about this nugget: It seems that pediatricians just don't want to call fat kids fat, for fear of hurting the children's feelings or angering their parents. Some of the doctors say they're not really sure how to get growing kids to lose weight. They say insurance companies don't recognize obesity as a disease and won't pay for its treatment. So they call it something else.

Or what about your family and friends? My wife (a thin person) says she tried to talk to me about my weight but I wouldn't listen. I don't remember, but I can count on one hand the number of friends, business associates, relatives who ever, even once, said to me, "Bob, you had better lose some weight." (My sister said she thought I would get mad at her.)

So the problem as I see it is not the food manufacturers selling junk food, or the fact I don't have to work physically as hard as my ancestors, or high fructose corn syrup. The problem is that basically it is OK to be fat. Plenty of people used to tell me I was killing myself smoking, but not too many ever said I was killing myself eating.

Well, that's fine - I had my wakeup call, and I survived it. But I think overweight and obesity is going to be a problem in this country until it is no longer OK to eat too much - healthy or not.

That means individuals, not just food manufacturers, have to prepare healthy meals for famlies and friends. That means individuals, not just restaurants, have to serve appropriate sized portions. That means individuals, not just schools, have to keep junk food away from kids (well OK, adults too). That means friends can't let friends be fat.

In the News: Unintended Consequences

2006-08-03T07:36:00.000-04:00

I was prompted to write this post by an article this morning in the New York Times: "Newly Petite in a Skin That's XL". I did a double take on the title - did it really say what I thought it did? And I did another double take because the article was included in the "Fashion & Style" section - I guess it's true that a lot of loose skin is not fashionable...

Anyway, I did some quick googling and came up with this poignant note from Syracuse.com, and this from Seattle, and, finally, some hope at commonvoice.com , which is not alone in suggesting that to fight excesssive loose skin you need to keep on losing - this article is also quite hopeful about the outcome (it's a long article, make sure you get by the ads and read to the end).

The article in the NY Times served as a reminder to me that the subject of loose skin is something I need to think about, learn about, and prepare for - in the same manner than I prepared for my diet itself - because at age 60, with 16 years of obesity behind me, I am going to have a problem.

In the News: the Obesity Vaccine

2006-08-02T07:23:00.000-04:00

Well, I suppose that everyone saw the teaser headlines on last night's TV news about the new "Obesity Vaccine", only to find out it's fine if you have a fat rat for a pet; otherwise it's probably not going to help you much in your lifetime.

However, buried in the newspaper report I read, there's an important snippet:

The vaccine targets the hormone ghrelin, a gastric endocrine hormone produced primarily in the stomach, which ... helps control appetite in animals and people... The vaccine appears to help control whether the body stores fat or burns it off. It seems ghrelin has to move from the bloodstream into the brain in order to have an impact on appetite and weight gain. [emphasis mine]

What this observation signifies to me is that John Walker's contention in the Hacker's Diet that I am fat because either I don't receive or I don't process corrrectly "fullness signals" is right on the money.

The idea that I cannot responsibly control the amount of food I eat without artificial assistance is not something I cannot hear just once and fully ascribe to [see for example, what happens when I try to wing it at a picnic or luncheon]. But each report like this one, and each experience like the picnic, leads me to more fully integrate the calorie log into my dialy life. And the more integrated it becomes, the more automatic it becomes, to the point that I can now see a time in the future when I can drop the calorie log because I have fully replaced my missing chemical "fullness" signals with a mental alternative. But not yet.

"I hardly ate anything"

2006-08-01T15:44:00.000-04:00

Well, as usual, as soon as I publish an article, along comes more information and better ideas about the same subject - this time I'm talking about the note I wrote on "will power".

The message I was after in the "will power" post was that I was just going to have to suck it up, get control of myself, and eat that salad instead of those tasty, high glyceimc index, cheeseburgers and hardroll sandwiches. But of course, that is not really the issue, and I am forever thankful to Charles Platkin for pointing it out to me. [Mr Platkin has a great site called the dietdetective.com which has more great nutrition articles and ideas than you can posssibly read in an afternoon, probably a week of afternoons.]

Anway, Mr Platkin published a column in my local newspaper - "The Westerly Sun" [July 31, 2006] which I can find neither at the Westerly Sun [which has its own great health section] nor on dietdetective.com. So I will have to paraphrase the article:

"... The New England Journal of Medicine [reported] that people attempting to lose weight tend to underestimate the amount they eat by 47%... " In particular 86% of women underestimated how much they ate in a 24 hour study period by an average of 621 calories, and 60% of men underestimated their food intake by an average 581 calories. The American cancer society found only 1% of participants could correctly estimate a portion size when asked to do so.

So there's the problem: I don't keep an accurate, timely, accounting of what I eat outside my home.

When I left that picnic recently, I told my wife "I hardly ate anything, I'm sure I'll be fine when I add it up." Whoops! When I added up those "asprin" burgers, remembered what I really had for seconds, imagined what I had on my plate compared to a tennis ball (a tennis ball = a 1 cup serving, right?), well, I was way over.

And when I left that business meeting lunch, I knew I had eaten "too many" of those hard roll sandwiches, but it wasn't until I got home that I figured I had eaten six of them!

So where am I at? Right back at the Hacker's Diet with my defective "fullness" signals, only this time on a very short term, immediate basis. But it is important to know (or more accurately be reminded) that it's NOT a question of "will power", it's a question of having an accurate idea of how much I have eaten at any given time.

When I'm at home, I fill in my calorie log as I go, and I adjust what I eat as the day progresses - and I really don't have any problem staying within my calorie goals. So it's clear that when I go out I am going to have to keep a running total of what I eat and an estimate of the calories. If I do that I think I may be able to keep control of my calorie intake. Thank goodness it's not a question of "will power" - I don't have any.

Oh yeah, and what does Mr Platkin, the diet detective, recommend: "keep track of everything you eat... even one grape". In other words, a calorie log, what else!?

"Will Power"

2006-08-01T12:19:00.000-04:00

"Will Power", "Self Control", "Discipline" - these are all words that I associate with "diet", and all imply a certain strength with regard to food that I find considerably lacking in myself.

In fact, I had hoped that I had elimianted the need for "will power" by the way I structured my diet - that is, allocacting an entirely reasonable calorie target for the day, and not being too upset if it was exceeded by 100 or 200 calories or so because, well, even thin people like my wife eat a little extra now and then.

And it seemed to work well, even pizzas and dinner out seemed to fit in the plan.

But then came the picnics and business luncheons.

I had already learned to never ever eat the desert, and to keep any alcohol consumption to 2 drinks max. But I was unprepared for the fact that even the most asprin sized cheeseburger is still 450 calories, that catered business luncheons could have delicious sandwiches on the best small hardrolls I ever tasted, etc.

In every case, there has always been a nice salad and or fruit cup available, and I ate some of that, but nevertheless when I got home and tried to tally up total calories for everything I ate- well 2000-2500 seemed to be the rule.

The results weren't devasting - even though I was as much as 1300 calories over my daily target, I was still under the calories needed to maintain my weight at it's current level, so I wasn't gaining weight or anything. But it was still disheartening.

I guess that I am finally realizing that the big three -"Will Power", "Self Control", "Discipline" - are going to be required under circumstance outside of home - a realization that's on par with the discovery that I actually had to count calories. Thank goodness it didn't take me 10 years to figure it out this time.

What is This Guy Thinking?

2006-07-30T21:37:00.000-04:00

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

2006-07-29T11:21:00.000-04:00

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

2006-07-27T14:52:00.000-04:00

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

2006-07-26T07:00:00.000-04:00

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

The Harvard Healthy Eating Plan on the Road to Reduction

2006-07-25T21:08:00.000-04:00

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

2006-07-25T14:28:00.000-04:00

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

2006-07-24T20:57:00.000-04:00

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

2006-07-23T10:34:00.000-04:00

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

2006-07-21T22:28:00.000-04:00

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

2006-07-21T15:12:00.000-04:00

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 !

2006-07-18T14:03:00.000-04:00

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

2006-07-18T09:41:00.000-04:00

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

2006-07-16T11:42:00.000-04:00

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

2006-07-14T21:19:00.000-04:00

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

2006-07-12T22:36:00.000-04:00

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

2006-07-11T21:41:00.000-04:00

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?

2006-07-10T10:38:00.001-04:00

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}

High Fructose Corn Syrup

2006-07-09T10:34:00.000-04:00

In the last couple of days I have read two important nutrition articles - problem is, I am having a senior moment and I can't remember one of them!

But the one I can remember is this article from the New York Times (which will only be available free for a week or so) regarding high fructose corn syrup. Basically, the article says that high fructose corn syrup is no better or worse for you than white suger. Now I realize that white sugar is not a preferred carbohydrate, but that is a long way from saying that high fructose is "hard for your body to process" and that your body treats high fructose like a fat.

The whole jag against high fructose corn syrup got started because some researcher saw a parallel bewteen charts in the growth of obesity and the chart of the growth in the use of high fructose corn syrup and SUGGESTED that it was an area for further research. Well, heck with further research, high fructose corn syrup has been trashed ever since.

It think the article is important for a couple of reasons: one is that it seems like all foods have the stuff and I would like to feel less guility buying them, but also because now you can make better choices buying things and perhaps feel better trading off some high fructose in one brand against megadoses of sodium in another. In any event the demise of this particular bogey-man allows us to focus on the really bad guys: trans-fats and sodium.

This is Getting Ridiculous

2006-07-08T21:13:00.000-04:00

Well tonight, when I finished dinner, I had eaten 2314 calories. That's ridiculous!

That's 2253 calories less than it would take to maintain my current weight, and it's 1044 calories less than it would take to maintain my TARGET weight!

So I forced myself, forced myself, to eat a serving of canned peaches (not even the whole can!) and a banana and that just brought me up to 2450 for the day.

What is going on here?

Was it because yesterday I was starved all day and had to eat a salmon sandiwch at 9:30 so I wouldn't go to bed hungry (total 3113 calories, right on for "lite +" exercise). Is my body really adjusting for that little splurge today?

Is it because my walking intensity is down? Yesterday I only walked in the morning, and today I did both morning and evening walk, but very slowly - why - because the arch in my right foot is killing me and I am trying to baby it. Is my body really adjusting to a slightly less intense exercise program? [But then again ... I am on target for walking 20 miles this week and that is at the high end of moderate activity.]

Is it because a symptom of heart failure is a loss of appetite and I'm losing mine?

I don't know, but today's calorie deficit ended up at 2117 calories, and that's too much. I do not want my body to go into starvation mode. I feel full, I assume it's fat and happy, but a 2117 deficit?

Anway, the long and the short of it is that over the last two weeks I have a calorie deficiency equal to 1 pound every two and a half days. That's about 12 pounds a month! I know that my actual weight at any given moment depends on how much water I am hauling around, but still...

There's one other thing I have been thinking about. I have been looking at those daily calorie deficiencies, I have been thinking about the fact that I am not hungry or otherwise exercising 'will power' to achieve those deficiencies; so I am thinking maybe I should be turning the whole question on end, and asking why I was working so really hard to eat all those calories (about 4500) to maintain my weight at 346 (or whatever). Now what was that all about?

Smokin'

2006-07-06T22:13:00.000-04:00

If you want to loose one pound every 3 days, you need a calorie deficit of 1167 calories per day.

Starting the day after I last weighed myself (official hospital weigh in) I have had the following daily calorie deficits:

6/28 -1486
6/29 -1389
6/30 -1360
7/1 -1294
7/2 -1701
7/3 -1562
7/4 -1820
7/5 -1374
7/6 -1674

that's 3.9 pounds worth in 9 days - maybe I'll hit 10 pounds a month like some of the other bloggers - they do make me envious! I am not trying to achieve large calorie deficits, they just seem to happen. Obviously I am not going out to eat much... As a matter of fact, my favorite Italian restaurant had a serious fire last week...

My walkin' is really smokin' too. Quite by chance I noticed yesterday that my two lap walk only took 34 minutes - quite a feat I thought, given the hot humid weather day after day here in the tropical rain forest (oops, I mean New England). Anway, today I added a small loop to my exisitng walk (another 400 steps or so altogether) and got the time back to 40 minutes. So that makes each two lap walk 1.75 miles, or 3.5 miles most days (depends on the rain mostly). Should also get my step count up - as I go faster I guess my stride gets longer because I have noticed my step count going down! Hardly seems fair. I do believe I am feeling better than I have for the last couple of years.

Today's Menu

2006-07-05T21:13:00.000-04:00

I have posted below today's menu. Unusual items are all the hard boiled eggs, and the can of wild salmon (in the "rice sauce") - together these items bulked up the protein to the extent it is out of control. What this does is remind me to eat more servings of vegtables. I don't try to contol fat grams explicitly, but they have always been less than 30% when I have checked - the two tablespoons of butter in the sauce are a bit unusual.

Anway, here it is. ( For the record, the "rice sauce" was terrible. Trying to replace the pasta sauces we usually use with Campbell's fat free soups is not working. "My share" is the per cent of the sauce I ate as opposed to what my wife ate - 67% is about my normal share - sometimes less if she saves some for lunch the next day.)

Item	calories	fat (g)	protein (g)
banana	101	0.5	0.3
mega oatmeal:
1/2 cup oatmeal	150	3.0	5.0
18 gm (1/8 cup) oat bran	60	1.5	3.5
1/4 cup raisins	130	0.0	1.0
1/3 cup dry non-fat milk	80	0.0	8.0
2 eggland eggs	140	8.0	12.0
2 diet bread	70	1.0	8.0
1 tsp lite smart balance	15	1.7	0.0
1 smart beat fat free cheese	25	0.0	4.0
2 bread	70	1.0	8.0
1 tsp lite smart balance	15	1.7	0.0
4 hard boiled eggs	280	16.0	24.0
1 diet bread	35	0.5	4.0
1 tbs natural peanut butter	105	8.0	4.0
3 oz baby carrots	35	0.0	1.0
2 bread	70	1.0	8.0
1 tbs reduced fat mayo+	30	2.0	0.0
3 smart beat cheese	75	0.0	12.0
large leaf romaine	2	0.0	0.2
240 gm tomato	52	0.8	2.0
hard boiled egg	70	4.0	6.0
apple	81	0.5	0.3
can sardines in water 3.75 oz	150	8.0	19.0
2 bread	70	1.0	8.0
3oz baby carrots	35	0.0	1.0
parboiled brown rice 1/4 cup+	180	1.0	4.0
"sauce for rice" (see below)	980	38.0	83.1
fat free yogart	80	0.0	6.0
totals	3186	99.2	232.4
calories		892.7	929.5
% of total calories		28.0	29.2

"Sauce" for Rice
1 cup lima beans frozen	220	0.0	12.0
2/3 cup sweet peas frozen	70	0.0	5.0
can no salt diced tomatoes	87.5	0.0	3.5
can pieces & stems mushrooms	40	0.0	4.0
2 tbs smart balance butter	160	18.0	0.0
1/3 cup nonfat dry milk	80	0.0	8.0
fat free broccoli & cheese soup	175	3.8	7.5
canned wild pink salmon	630	35.0	84.0
total	1462.5	56.8	124.0
my share (67%)	979.875	38.0	83.1

Health Consequences of Overweight & Obesity

2006-07-04T13:26:00.000-04:00

Centers for Disease Control and Prevention:

Overweight and obese individuals are at increased risk for many diseases and health conditions, including the following:

Hypertension
Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)*
Type 2 diabetes
Coronary heart disease
Stroke
Gallbladder disease
Osteoarthritis
Sleep apnea and respiratory problems
[to which I add pulmonary hypertension ]
Some cancers (endometrial, breast, and colon)

* It is possible to have low cholesterol and triglycerides and still be obese. Believe me when I say that it doesn't make you healthy. Here is a quote from the NY Times: "Nothing fascinates the American public so much as the notion that what you eat rather than how much you eat affects your health."

Natural Balance?

2006-07-02T23:25:00.000-04:00

Funny thing is happening. Most days I eat about 3200-3275 calories with hardly no pain (nice English) - as far as I can recall, I only went over ove 3300 once and that's when a friend came over for dinner with lobster and strawberry shortcake. Many days I actually eat less than 3000.

What's odd here is that I recently recalculated my target weight at Nutrition.com.sg based on a healthy BMI of 24, I came up with a target weight of 206 pounds, and a daily calorie intake of 3358 calories at a moderate exercise level. Moderate exercise is defined as walking 10.5 to 17.5 miles a week. I'm walking 16 to 21 miles a week [except one week when we were about flooded out and I only got in 14 miles] - anyway, I am well with in the moderate parameters.

So the question is - have I already stabilized my eating? I think it's possible as long as I maintain my calorie book [in which I write down every calorie all day long]. I need the book because otherwise I wouldn't be able to compensate for the odd crazy day like last Friday when I ate two bagels and an entire can of spam amongst other things. I salavged the day by just eating a large salad for dinner, but I am certain that without my calorie log I would have over eaten.

So what I think is this: while I must still use the artifical feedback of the calorie log to control [limit] my eating, my body is happy with the calorie intake it is receiving and finds no hardship with a sane diet. So I am thinking that if my body is happy, maybe I will eventually become more sensitive to its signals and learn to eat the right amount without my log.

This is not so far fetched. When I was growing up, I was not allowed to eat between meals, and there was, of course, a finite amount of food served at meals to be shared with my parents and siblings. While I was hardly starving, I was growing like a weed, and I adapted by eating everything that was available whenever it was available. To this day, I hate to throw away food, or even have leftovers, with the obvious results. As this diet progresses, I am slowly beginning to believe that I learned to override my body's "full signals" when I was younger, and that these signals actually exist, and that I can regain the natural ability to listen to them. It seems to me that my body being content with the appropriate calorie intake is an important first step.

Fine Tuning

2006-06-29T16:09:00.000-04:00

It took me a 100 days, but I have finally realized that I can do something to help lose the elusive 1 pound every 3 days. Specifically, I have realized that to some extent I can manage both my daily calorie intake and my daily exercise to help ensure that I have a total calorie deficiency of 3500 calories over a 3 day period.

As mentioned earlier, I keep a table of calories consumed for various levels of activity (measured by step counts and miles walked) calculated at my actual weight, updated every 4 or 5 pounds or so.

At the moment, the table is as follows:

actual weight: 317
. . . . . . ......... calories, miles/wk, steps/day
sedentary: . ...... 3393,...... 0,....... 0
lite activity : . . . 3915,...... 5,..... 1618
lite "+": . . . . .... 4241,..... 10,..... 3237
moderate:........ 4567,.... 17.5,.... 5665
heavy exercise:.. ----,..... 27,..... 8740

Using this table and my actual daily calorie count, it's possible to calculate the daily calorie differential.
Here's what this looks like over the last 3 days:

day 1 - 6/27 -
steps: 7010
moderate calories: 4567
actual calories: 3235
differential: 1332

day 2 - 6/28 -
steps: 7000
moderate calories: 4567
actual calories: 3081
differential: 1486
cumulative differential: 2818

day 3 - 6/29 -
steps (so far): 3650
lite+ calories: 4241
actual calories*: 3030
differential*: 1211
cumulative differential*: 4029 over 3 days, good for one pound
*estimated

So, what's the point? Well, today for example, my left knee, the weakest part of my body, is the size of a football. It would be a really good idea not to walk on it anymore today, even though it doesn't hurt walking. Knowing that I will have a big enough calorie deficiency to lose my 1 pound/3 days (provided I stay on target today) helps me decide not to walk this afternoon but rather rest my knee.

In other words, knowing where I stand in regard to losing my target 1 pound/ 3 days allows me much more flexibility in deciding how much to exercise on any any given day, on whether to eat out or not, or have pizza, or just have a big, really low calorie salad. The way I see it, the more flexible I can make my food decisions, the less constrained I will feel about my "diet", and the more likely I will succeed.

Status Report - DOWN 29

2006-06-27T15:56:00.000-04:00

Well, just in the unlikely event someone comes along and reads one of the previous posts, I thought I'd post current results. Today (6-27) is the 103 third day since my medical event, and I weighed 322 with clothes at the hospital emergency room (I weight myslef there because my scale simply assigns a random number between 320 and 325 every morning).

322 lbs with clothes is 317 in real weight. Either way, I have lost at least 29 pounds ("at least" because I don't know how much over 350 I weighed). My target is one pound every three days, or 34 lbs since day one - missed that. But 103 days is about 14.5 weeks, so I have lost 2 lbs a week and that is good. I also weighted 328 pounds in the doctor's office just two weeks ago, which means I have hit 3 pounds a week over the last two weeks - which is also not bad.

I assume my weekly loss rate has gone up mostly because I am now gaining muscle at a slower rate (I was pretty feeble in the beginning) - but also I continue to get a better handle on my calories, and end up more days 200 - 300 calories under, and I walk a lot more now - last week it was only 14 miles mostly due the the weather -but that is way under the average 18.3 miles/week of the previous month.

Well that's it = I just keep cranking along!

EXERCISE

2006-06-23T10:40:00.000-04:00

My exercise used to consist of a 20 min walk(about 2.5 mph) nearly every day. In 2005 it got to the point I was winded at every hill (I walk in the moraine, and my basic walk has five steep hills 30 to 50 steps long - I think they are similar to 3 or 4 flights of stairs. Of course, even steep hills are easier than stairs because you don't have to lift your feet the full height of a stair.)

I decided that the reason I was winded was that I wasn't walking hard enough. So I made a pair of nordic walking sticks and got going fast enough to nearly faint at the top of every hill. Mercifully, I was diagnosed with atrial fibrillation in December, and I pitched the walking sticks, and toned down my quest for endurance. But my doctors made a mistake in blaming the afib for my shortness of breath - in retrospect, no matter what my heart problems may actually be, I think ther shortness of breath was due to the layers of fat around my lungs.

Anway, subsequent to being almost killed in the effort to restore my heart rhythm, I made the lose weight decision and also began to revamp my exercise - as with my diet, my exercise is a work in progress:

Since March 18th, my exercise program has developed as follows:

1) early in the morning I do some exercises: (Note: I try to do 20 minutes of exercise before walking in the morning, and a "significant" yard project for 25 minutes or so before walking in the evening in order to get my heart rhythm up and running before beginning the cardio (ie the walk). I walk in the morning before eating anything because you are supposed to burn more fat that way - I can only say I hope so.)

group one exercises include: dead lifts, touch toes, touch toes with weights (basically same as deadlifts but with less weight), hip bends, squats. I pick a couple from the group depending on the condition of my knees, back and feet (condition means level of pain).

group two includes 30 to 50 crunches, a half dozen (very feeble) pushups, and some RAF leg lift thing which I remember from school as being very difficult (what I do now is some sissy, easy version)

group three exercises are weight lifting;

each day I do one set of exercises using a pair of dumbells - I try to separate out the muscle groups to give each a rest, there are no scheduled off days for weights (every so often I don't get to it, but most days I do the one exercise). Every other day I try to do exercises that are "compound" in the sense that many muscle groups are worked. Early on I went for reps, but after some more reading I now go for weight, and as soon as I can do 10 reps, I push the weight up. I log everything. Actual exercises:

1) Military press (compound) my shoulders are very weak - I have been stymied here at 25# for a long time, but have finally gotten the reps up to 7-7-4. I switched to a lift a few times, and that seemed to help.
2)Tricepts (behind the head thing). This exercise makes me nervous lifting all that weight over my head so I don't know how high I can go - recently I have been using 35# for 10-10-10 reps.
3) Bench press (compound) Hardest part here is getting the weights in position, now doing 7-4-4 with 35#
4) Bicepts: curls with 29# 5-5-5
5) Back (compound) One hand rowing, 39# 7-7-5. When I get to 10 reps, then I will work two hand rowing until I get the 10 reps - that's usually just a day or so.

Anway, this morning thing takes a lot of space to write up, but just 15 to 20 minutes to do, after which, I immediately go into my morning walk. My walk has evolved quite a bit. First af all it has become twice a day whenever possible - at least 4 days a week. Secondly it has become two laps, and thirdly I have added a steep hill to each lap.It takes about 38 minutes, and when it reaches 35, I will add another hill - I can add hills forever because what I do is walk down on a switchback trail (to save my knees) and then back up the hill - sort of like adding a circle to the middle of the walk.

I have also purchased a pedometer and use it to convert my steps to miles, so that I can determine my exercise level as per the Nutrition.com.sg site. I log everything. I count only exercise steps: the morning and evening walks, mowing the lawn, and certain yard projects. For the last few weeks I have been well over the 19 miles/week for moderate exercise, but have been able to keep my calories at the lower "lite plus" level. I have absolutely no idea if this will make any difference in the weight loss process, but it sure makes me feel better mentally.

I am happy to see my laps getting faster and faster - and I now mow at "full speed" beihind my variable speed mower, and I can handle flights of stairs a lot better. Things aren't perfect: I still have moments of fatigue, and sudden shortness of breath, both of which are probably realted to my underlying heart failure. But the elimination of fat layers around my lungs has clearly helped (I have, as write, lost 25 pounds, clearly all visceral fat because I can't see it anywhere!) The limiting factor is the condition of my knees, feet and back - ice packs galore, especially on my feet - if I feel pain I quit for the session

Eight Steps on the Road to Reduction

2006-06-21T21:28:00.000-04:00

A quick summary of the Eight Steps on my Road to Reduction. (A fuller discussion is here.)

1) I found out how much I weighed and how much I was eating to stay that weight.

2) I recognized that I could not control how much I ate on my own, and started a calorie log to provide a realtime, artifical method of telling me when I had eaten enough.

3) I started removing "bad" foods from my diet. I was NOT on a diet, I still ate pretty much the same things as I always ate, but at my own speed, I removed one unhealthy food after another. In due time, my cholesterol reached 155, my trigliceries 91, and I had no blockages in any artery. And, I managed to lose about 35 pounds and kept it off . Finally, during this period, I became aware of and interested in nutrition and healthy food.

4) I made the final committment to a healthier life: I devised a plan to control my calorie intake.

5) I found my target weight, and I determined the daily calories necessary to both reach and maintain that target weight.

6) {here's the diet!} I use my calorie log to limit my daily calorie intake to that determined in step 5. I can eat anyting I want, as long as I log it. If I go out, to a party , a restaurant, whatever, I carry a notebook and calculate my calories as best as I can when I get home. I measure everything, I leave nothing to my "eye" or my judgement.

7) I continually evaluate my exercise plan, and make sure that I maintain sufficient exercise for my calorie intake (EG, as I get faster on my walk, I increase the length of my walk in order to maintain the same duration; and I slowly increase the weights in my resistance exercises to reflect my increased ability).

8) I pay attention to the nutritional details of my diet. In particular I watch my fat intake. I make a real effort to exclude trans-fats (that means, for example, no commercially baked cakes etc) and to limit salt. I try to make sure I eat the recommended servings of fruits and vegetables. The net result is that although I can eat anything I want, there is a growing list of things I don't want to eat.

The whole plan is meant to be dynamic: to change as I learn more, to accomodate new ideas, to adapt to changes in my circumstances. There is no "maintenance" step in this plan because when I reach my target weight I will already be doing all the necessary things to maintain that weight.

Foods I Find Useful

2006-06-18T17:11:00.000-04:00

I have found certain low calorie foods very useful in keeping my daily calories down and healthy; these include (in no particular order):

Bread: thank goodness for Country Kitchen "Light Wheat Bread". At only 35 calories a slice compared to about 100 calories for standard wheat bread, it is a winner. Naturally it has less calories manily because it is smaller, but it still manages to taste OK, and has protein and fiber, which most diet breads are sorely lacking. It has a small amount of high fructose corn syrup, but then again I have found only two brands of regular wheat bread that don't use the fructose.

Butter: Smart Balance wins hands down - I use the regular for cooking (at 80 calories per tablespoon, it beats canola or whatever oil at 120 calories), and I use the light for sandwiches, toast, etc (one teaspoon at 15 calories is all it takes for a slice). I think the stuff tastes OK, and no trans fats period (none of this per serving BS).

Eggs: I eat a lot of eggs, the cholesterol does not bother me (my cholesterol stays around 155). I eat Eggland or other omega-3 enhanced eggs because: 1) they have the omega-3, 2) they feed a vegetarian (non animal byproducts) feed, and 3) no antibiotics. The best advantage of these slightly pricier eggs is that the are only 70 calories each, rather than 78 for a regular egg.

Oatmeal / oat bran: I found a great recipe for "super" oatmeal: 1 serving oatmeal, 1/2 serving oat bran, 2 tablespoon dried milk, and 1 servings raisins. This is not a low calorie meal, I gave up the raisins (130 calories), and it is still at least 272 calories. But is is filling and provides about 4 grams of soluble fiber which helps with the fat, among other things.

Smart Beat Cheese: tastes terrible by itself, which is good because I used to eat American cheese slices by the pound. However, in a sandwich it tastes OK, and at 25 calories and zero fat, it provides some calcium without breaking the bank.

Bagels, yes bagels. I am a big bread eater and bagels provide my bread fix. At 165 calories, plus 30 calories for Smart Balance they are certainly a better deal than 150 calories for a small piece of specialty bread (plus the butter, or worse, oil).

Splenda (sucralose): this stuff is good - it sweetens my oatmeal and takes any low fat, low calorie salad dressing and turns it into something palatable - couldn't live without it!

Boca Veggie Burgers, along with Boca ground burger - are a staple in my diet. At 60-70 calories per serving and only 1 fat gram - they replace every meat from bacon to hamburger. The boca burger and canned salmon replace beeef and chicken in all recipes.

Fish - mostly canned (wild) salmon for recipes, and canned (wild) tuna-like salmon for salads sandwiches etc. We no longer eat canned tuna. Note that the tuna-like canned salmon has little omega-3. I also eat a fair number of sardines for the omega-3, but my wife refuses to indulge. We eat salmon at least twice a week.

Well, that's it for foods that I have found to help me meet my calorie count. Other than that it is just a lot of whole wheat pasta, brown rice (ok, parboiled brown rice which is all I can take), potatoes, and lots of veggies. Hardly any meat as my wife is a vegetarian, though I do have broiled chicken breast once in awhile, and a roasted steak every few weeks.

Oops, I should mention the pizza - to get away from my cooking we have veggie pizza about once a week. After extensive research I have come to the conclusion that allocating 300 calories per slice is a reasonable guess - slices are divided as follows: 4 for me for dinner, 2 for my wife for dinner and two for her lunch the next day. We do not have pizza on Friday or Saturday night because I eat the extra lunch slices - so much for self control.

Finally maybe I should mention alcohol. I was happily having one 4 oz glass of wine a day (sometimes maybe two) until I had my medical event. Now I am trying to wean myself off the wine - it does not help the weak heart, and it worsens the sleep apnea, which is suspected as being the cause of the weak heart. Once I lose the weight I will reevaluate the situation, but for now, I am down to one or two 4 ounce glasses a week.

HOW I LOSE WEIGHT

2006-06-15T23:30:00.000-04:00

First off, I am not "on a diet". On the other hand, I continually reevaluate my diet.

The National Weight Control Registry keeps tabs on formerly obese people who have remained slim for at least a year, and from time to time does studies of the dietary habits of the registrants. One interesting discovery was that the desire to loose weight was frequently triggered by a "medical event", particularly in the case of men over 50. I had my medical event on March 14th, and on March 18th, I made the final adjustment to my diet.

I had a head start on the whole diet thing because, as I mentioned last time, I had long since given up almost all junk food. The only thing I "gave up" on March 18th was KFC biscuits and chicken strips. Not much sacrafice there, although I did love those strips.

What I did give up was calories. It was abundantly clear that it was about time to start counting calories. I could no longer ignore the simple idea that I gained weight, and kept it on, because I just plain ate too much, "healthy" food or not. So the question was: how many calories should I eat?

I turned to an old idea I had read long ago, and interestingly enough, have not been able to find again anywhere on the web. The idea was extremely simple: if you eat as many calories as is "normal" for a particular (ideal) weight, then eventually you will become that weight. (Probably the idea came from Parade - sounds a whole lot like that "everyone eats too much of one thing" idea.)

So step one was to go one of the many sites that determines your ideal weight based on your height - I kind of liked ask.com's "How to Assess your Body Weight", probably because they made it a bit more complicated and took frame size into account. The second step was to find out how many calories I should eat at the ideal weight. For that, I turned to Nutrition.com.sg. Note that ".sg" stands for Singapore - that's right, I use a Singaporian (??) site for all my calculations. [In general, I find the Australian, United Kingdom and this Singapore site much better than similar American sites - they are simply more direct and forthright with less advertising.] In any event, that's pretty much all I did for the final adjustment to my diet. It worked out like this:

Given my height (77") and frame (heavy) and age (60):

my ideal weight is 213 pounds (the range is 178 to 218)
the calories I should consume for
light exercise: 2933
"lite plus": 3030
moderate: 3422

I also keep similar information for my actual weight, recalcualted every two pounds or so:
actual weight: 323
sedentary activity: 3442
light activity: 3971
"lite plus": 4210
moderate: 4633

From day one I have written down every calorie I have eaten - if I go out, I spend a half an hour or so recreating the meal and trying to make an accurate log of what I had to eat. I target 3030 calories for "lite plus" activity (half way between light and moderate activity), and I don't mind much if I hit 3250 or so. I use the calorie levels at my current (actual) weight to try and set some (mental) limits - for example, I really never want to go over the sedentary calories for my current weight, and I like to make sure that I am targeting 1000 calories below the calories for "lite plus" activity at my actual weight. As I get closer to my target weight, these limits will no longer work, but for now they are fine.

As I write down my calories during the day, I adjust my meals depending on what I have eaten so far - dinner can be anything from a dinner at my favorite Italian restaurant to a baked potato with steamed cauliflower, depending on what calories I have left. I also log my exercise level, which is primarily walking, but includes some weight lifting etc.

The reason I liked Nurtition.com.sg is because they had a useful definition of light and moderate activity that I could apply to my life style: light activity consisted of walking 3.75 to 6.25 miles a week, while moderate activity consisted of walking 10.5 to 17.5 miles a week. For years prior to March 18th, I walked about 4 to 6 miles a week; over the last 3 months I have extended that to 16 to 19 miles a week (I include lawn mowing in that figure). I bought a pedometer to keep track of the actual milage - I don't count anything unless it has an exercise value, and I deduct about 1% from each reading, just to make sure the step count is honest (the pedometer I use is accurate to +/- 1%).

I expect that I will be eating these same 3030 calories for the rest of my life - first to reach 213, and then to stay there. I am trying to keep the exercise reasonable so that it may also be maintained for as long as possible - as I age and it has to be cut back, then so will my calories.

With the control of calories consumed, I feel I have now completed at least the dietary aspects of my Life Style Change. In my head I am already 213 pounds, it is disappointing everytime I look in the mirror and see that I am not. Yet.

How I Got TOO BIG

2006-06-13T15:23:00.000-04:00

In high school I rowed crew and wrestled and my weight was fine. In collge I smoked and drank booze, my weight was less fine. Out on my own, I was always borderline obese at 275 (obese being 30% overweight). Then in 1989, at age 43, I quit smoking, and instantaneously became obese for real - in a matter of a few months my weight became unknowable because I was off the charts (all doctors' scales stop at 350). Once in awhile I would sneak on a feed scale and weigh myself; what also worked were those veterinarian scales made for both the dog and owner to get on. The memory is vague, but I recall that the last time I got on one of those, I thought I broke it - I weighed nearly 390 pounds. I told no one.

Redemption began in 1994 - my mother died, my wife quit my small business and went off to college, and somehow it came to my attention I needed to loose some weight. I had previously been on Akien's diet a couple of times, and while I lost weight, it always came right back when I just couldn't look at another steak. So I decided then and there - no more diets. I didn't know it at the time but what I began was the one and only, the dreaded, Life Style Change.

I got my first tip on how to actually loose weight from one of those little articles in Parade Magazine, the well know health magazine included in your Sunday paper. I remember clearly the author said "everyone eats too much of something, it could be bananas or whatever." The clear implication was: if you can just control that one thing, you can control your weight. Believe it or not, that one little idea became the corner stone of my diet for the next 10 years. I did not count calories, I did not follow diet plans, because everyone "knew" diets didn't work, and the weight would come right back. So "diet" for me became the gradual elimination of "bad foods" in my diet - in other words: Life Style Change.

The first thing to go was potato chips. At that in time, I did a lot of driving a couple of days a week. I couldn't get the car started without an open bag of potato chips (think "cell phone" in the current vernacular). When I didn't get thin without the chips, I let go of the chicken McNuggets (a "healthy" replacement for the chips). When I still didn't get thin, I decided that breakfast everyday at Burger King probably was the one thing I ate too much. And so it went month after month, year after year. Somehow, somewhere, my wife's vegetarianism rubbed off, and it got too messy to cook meat in the house. My weight stabilized at what I estimated to be 365 (from how hard the balance beam bounced off the restraint). The battle had been refined by 2004/2005, and I was fighting trans fats and high fructose corn syrup rather than McGriddles. But what I had undergone was the Life Style Change, in such a slow and unremarkable fashion that I didn't notice it and felt no pain.

Practically lost sight of in the course of the Life Style Change, was the fact I really wasn't loosing any weight. Disturbing messages began appearing the Wall Street Journal (another well known health journal) to the effect that "Americans spend too much time worrying about WHAT they eat and not enough about HOW MUCH they eat." The possibility that I was eating not just too much of one thing, but too much of everything, became an increasingly nagging thought.

It all came to a head in 2005. It became clear in the spring -when I began the usual yard work- that I had no endurance. By summer I couldn't get to the top of a hill without sucking air so hard I had to stop. And as noted in my profile, the cummulative effect of 16 years of obesity came crashing down between Dec 5, 2005 and March 14, 2006. But now begins the story of how I loose the weight.