Break time

I’m fried after the last 2 weeks of work, and it just won’t stop.  My wife and I have a mega-cheat meal planned for tonight, a buffet dinner before a concert.  I did my HIIT this morning, but don’t feel like much else.  Can’t wait – for both the meal and the show.

Your Friends May be Making You Fat

As with many habits, be they good or bad, health appears to be closely tied to social rituals and the behavior of those in one’s social circles. Consider smoking: how many times a day do I hear “I only smoke when I’m out drinking” or ” . . . only with my friends”, etc. Friends are good and all, but not worth smoking for.

So, why are friends so influential on our weight? According to this NPR bit, the people we hang out with do indeed influence our lifestyle to a significant degree.

I’m sure I’d have a hard time getting in shape if I hung out with nearly anyone on a regular basis. Think about it: every social function is based on food. I probably would feel far too awkward carrying my plastic containers of chicken and sweet potatoes that I diligently prepared at the beginning of the week while my friends indulged in burgers and fries. There are minimal, if any, healthy food options when you eat out. Yeah yeah yeah, so and so has a salad with low-fat dressing – too bad you could make that salad (and even a better salad) at home for 1/10 the cost. Plus, restaurants are in the business to make money – they will be taking shortcuts, which means they will use the cheaper, fattier ingredients to cut costs.

I have a patient, a woman in her 50’s who is morbidly obese, has Type 2 Diabetes Mellitus and all the other metabolic syndrome and cardiac risk factors typically associated with it. Every time I see her, we discuss her weight, and she renews her vows to make a change before the next time we meet. She confided in me once that she was once able to drop 15-20 pounds, but when she did so, her “friends” distanced themselves from her, making snide comments and frowning upon her success because they were never able to achieve the same. She regained that weight and hasn’t made any progress since.

I can absolutely see the findings from this article taking place on a daily basis. Sometimes we all need blinders and need to be selfish for once; you have to take charge, because no one else genuinely cares about your fitness.

My pre- and post-workout shake

Since I am new to the whole weight training, strength training world, I am always reading about tips and trends to maximize results. Of course a lot of that is driven by piddly data (if any at all) and, most of all, marketing. So, I never get too excited about the ridiculous array of fat-burning, muscle-building, energy-enhancing, woman-attracting, macho-man-making products on the market. Those who stand by a product have probably just been directed there by a friend or lifting partner who offered their uneducated, biased advice – another victim of good marketing.

The one consistent “supplement” you will see among bodybuilders, weightlifters, and the like, is protein powder. It’s easy to make protein shakes with milk or mix protein powder in certain foods like oats (I’ll stick with the shakes). It serves as a boost to one’s daily protein intake and also may contribute to more effective muscle-building when used before and after workouts.

I picked up a popular brand name of whey protein powder and have been using it with my weightlifting workouts for the past couple months. Prior to that, I was actually using a different kind of protein supplement, but it contained an inordinate amount of fat (and tasted phenomenal!). I encounter enough fat in a day – it didn’t make sense to keep doing that. This newer protein supplement however, just didn’t taste as good and was a bit hard for me to chug down. So, I started buying frozen blueberries in bulk and have been blending it all together for one amazing protein shake with a healthy slurry of antioxidants.

See detailed nutritional info about blueberries at World’s Healthiest Foods.

1. Welcome to my kitchen. Here are my ingredients (10-12 oz. skim milk, two scoops of protein powder, and 1 cup frozen blueberries).

2. Put them all in a blender and blend away.

[What setting? You mean you haven’t figured out that all 20 functions are the same?!?!?

I have a sensible blender: Off-Low-High]

3. Half before my workout. Half after my workout. Incredible stuff! Using frozen fruit makes it seem like a malt rather than just a liquid mix.

I almost forgot: here’s the nutrition info on the shake, compliments of FitDay. I know it seems like a lot of calories, but it’s not a big deal when you’re working out like an animal. For one, it’s a double serving of the protein powder recipe – I’m a pig. Plus, if you’re trying to pack on muscle, excess calories are a good thing.

Why “diets” don’t work

Why does eating have to be a pleasurable activity? I’m still not sure what the evolutionary advantage of that is. Sure, it makes sense that we should want to supply ourselves with adequate nutrition (so as to have enough energy to propagate the species – that is the point of evolution, after all), but it’s far too pleasurable to overeat. You would think that by now the human body wouldn’t be driven to stuff itself as if it wasn’t sure when the next meal would come by, but maybe we haven’t gotten over that glitch yet.

Almost 2/3 of the US population is overweight or obese, and the future direction doesn’t look so bright. We’re going to be seeing an incredible increase in Type 2 diabetes mellitus, both in adults and sadly also in children. So why don’t the plethora of diets work? They all claim to be effective, don’t they?

“Diets” are meant for a short term only. Therefore, one’s diet should not be a “diet”. Follow? When people generally think about diets, they think of the diet as a short-term remedy to their problem with being obese or overweight. Whether or not they will admit it, their ultimate goal is to “finish their diet” and return to their normal eating habits that they have acquired over the years.

Diets only work if incorporated as a lifestyle change. Anyone can lose weight on a “diet”. If you restrict any aspect of your diet, you will probably be reducing your calorie intake and thereby drop some pounds. This diet may take some time to produce results, but as we know all too well, we are not patient creatures – we want instant results. Resorting to old habits will result in a return to one’s old body habitus, and this is the fate of most diets.

Diets are too restrictive. I love junk food, pizza, and pasta just as much as the next guy, but I’ve learned that I cannot maintain a healthy body by eating everything I like. I’ve also learned that I cannot maintain a healthy body by completely avoiding those foods that I like. Huh? The point is that you need to be allowed some flexibility, to indulge in your favorite foods on occasion. You need to learn how to incorporate these “cheat meals” into your diet just as you need to learn what foods should be your staple food items.

Diets are antisocial. Nearly every social event in our culture is based around food or accentuated with food to some extent. How on earth can anyone stick to a diet when you have commitments to be a part of these functions? People are not going to stick to a diet if it means that they cannot fully participate in important events without guilt.

Healthy eating is time-consuming. Two words: fast food. Sure beats preparing a salad or other home-cooked meal.

Diet without exercise is like trying to achieve wealth by cutting spending but not working to earn money. Study after study shows that exercise is a critical complement to diet for weight loss goals.

Some day, I’ll put together a tirade about the fad diets on the market. Here’s the punch line: they’re nothing to shout about.

Does your neighborhood affect how much you exercise?

A recent press release points to a study in the Urban Studies journal that highlighted the impact of neighborhood type on exercise. Basically, the following neighborhood characteristics were associated with less exercise:

• higher levels of poverty
• lower levels of education
• more families headed by women

The author’s interpretation of these results was that individuals are less likely to spend recreational time outside when they perceive a higher level of danger in their neighborhood. It certainly makes sense: anyone would be far more comfortable being active outside in a neighborhood that feels safe than one that appears “shady”. Also, one could assume that a poorer neighborhood would have less access to indoor exercise equipment, whether it be individually owned or at a gym. It would be interesting to see the difference in the density of fitness centers/gyms between the neighborhoods examined.

Another interesting finding from the study was that the impact of neighborhood characteristics on exercise was more pronounced in women than men. I wonder if this difference was due to a) concern for safety and/or b) child-rearing duties. There are obviously many complicated socioeconomic factors in play here – I don’t dare speculate too much.

But, income alone was not a reliable predictor of exercise. Lower income did not necessarily associate with lower amounts of exercise. As I discussed in a previous post, fitness is not exactly a luxury. I’m reminded of this every time I see mention of the wealthiest individuals in the world or the “Billionaire List” – ever take a look at how many of them are grossly overweight? Money doesn’t buy fitness. [And don’t think Bill Gates is thin because he’s a fitness guru – he looks like an under-eating waif who’s been a stick figure his entire life. I bet he can’t do a single pull-up.]

How do I find time to workout?!?

Why I got nothing accomplished this week:

Monday: hospital & clinic x 14.5 hrs + on-call

Tuesday: mtg, hospital, & clinic x 15 hrs + on-call

Wednesday: precepting x 9 hrs

Thursday: hospital & clinic x 12.5 hrs

Friday: hospital, clinic, & deliver baby x 11 hrs

Saturday: hospital + on-call

Sunday: hospital + on-call

Grand total 130.5 hours 

Granted, the intensity of on-call time is variable – mostly phone calls, but still attached to an electronic leash and quite limited as to what I can do. For example, at least when I’m on-call, I can work out at home. It would suck to get paged to go to the hospital in a hurry, but I’m sure they’d understand.

I had just been reflecting on how availability of time is a factor in one’s ability to make significant lifestyle changes. This week, however, I exceeded the threshold of comfort. As much as I like working my tail off, I place high value on sleep. It’s often difficult to balance work and exercise, but I think it’s important to make room for both. I failed this week, but there were some unique circumstances at work that demanded excessive time on my part. I’ll have to keep a log of a “slow” week for comparison.

What does each pack of cigarettes REALLY cost?

NY Times article

Interesting, very interesting.   I’m not sure what they mean by “discount rates”, since the link to the actual paper is broken.  That’s obviously a population average.  Try pulling the numbers on someone who dies of secondhand smoke, though.

What is required to get in shape?

Something got me thinking about fitness and lifestyle changes today. I was trying to pin down what exactly is the difference between individuals who are able to make significant lifestyle changes and/or transformations from those who continue doing the same self-destructive things that led them to their current state of affairs. So I started thinking about what is required to get fit.

Time? Absolutely

But, you may notice that there is not necessarily a correlation between how much free time someone has and how fit they are. In fact, I might even argue that I normally see the opposite effect (Time on the hands goes wasted – or certainly not to fitness pursuits). For example, I work more in a typical week than 98-99% of my patients do, and yet I manage to find time for my workouts. My days start early and end late, but I still get one (often two) workouts fit in to a typical day. There’s gotta be something more . . .

Resources? Not really

There is no cost associated with walking/running or even lifting most weights. I could find a thousand things in my house that I could use for hand weights. Instead, I chose to invest in a set of weights with barbells and dumbbells with a much-used weight bench for the sake of convenience. I stock it with weight plates that I buy on sale from the cheapest place in town I could find. Despite what some people might contend, just because I’m a physician, I am by no means living in the lap of luxury (my student loans alone could buy many a house – Uncle Sam has a chokehold on my finances).

Energy? Definitely

Having the energy to get through an exercise regimen is highly dependent on nutrition and a decent foundation of well-being (i.e. no major medical complications). But plenty of people have all sorts of energy to work every day, go out on nights and /or weekends, travel, etc. and they still don’t manage to exercise. So what is the all-important factor?

Discipline! This requirement is perhaps the most important.

Any of the other requirements can be directed to other ventures and not get one any closer to their goals if not used properly. For example, how many stories have you heard about treadmills sitting in someone’s basement holding laundry? The resources are available and there is likely time and energy to do at least some exercise, but it never gets attention. I’ve encountered hundreds (maybe thousands) of people who have ridiculous amounts of time on their hands and plenty of desire to “get in shape”, but give up on a fitness plan for any number of reasons. This phenomenon happens predictably every year.

For me, in order to make the changes that I have made so far, I had to set aside the comfortable alternative of “doing nothing”. Believe me, it’s far easier to sleep in every morning, grab quick and fatty foods, eat to my content, and sit around watching TV when I come home from work. I absolutely wish that life were that easy. Unfortunately, there’s no substitution for a disciplined approach to fitness.

I’ve learned what it takes to keep my body in a healthy state. After letting it go for a few years, I’ve had to work harder to get back on track, but now I’ve learned some lifelong habits that will maintain a good level of fitness.

A clean day of eating

Here’s the FitDay page view on my food intake from Thursday of this week. I would have had it posted yesterday, but insanity struck at work. On that morning, I made a plan to stick to my routine diet – my exotic choices of chicken and sweet potato fries. Do I ever get sick of them? Not yet.  My goal is to keep my ratio of protein:carbs:fat at 40:40:20.

I aimed to eat every 3-4 hours on that day, and I committed myself to avoid any sweets. At one point in the late afternoon, someone brought in Dilly Bars and sundaes from DQ. It took a little discipline not to pick one up, but I felt pretty darn good after overcoming that temptation. Out of curiosity, I also had to look up the nutrition info on a Dilly Bar – yowzers! Imagine plugging those numbers into my diet that day – it would have looked awful.

I am human, of course, I ate pizza for lunch yesterday because it was readily available and free.  Oh well – back to good eating today.

Food shortage

You may have caught the recent news releases that predict a food shortage in the US, due to the growing population in developing countries and their growing desire for certain foods.  I’d say that the obesity epidemic in the US suggests that there is actually plenty of fod to go around and more – it’s just not used wisely.  Also, think about how much food gets thrown out: at the end of a night by a restaurant, unsold items at the grocery store, in nearly every household after meals, etc.  Sounds like someone has an agenda.

Keep in mind, our government is intent on producing ethanol as a renewable energy source, which of course is processed from corn.  It’s not an efficient energy source, otherwise it wouldn’t require government subsidies and initiatives to encourage its use.  But now we’re burning our food supply, when that food supply is supposedly at high risk of depletion.  Some days I just wanna move outta here.

Finally I found a no-nonsense article that touches on this contradiction, or is it just a dilemma?  I don’t know – I hate politics.