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A.
Burn Off More Calories Every Day
Along with decreasing your
daily caloric intake, you must increase your daily caloric
expenditure, primarily by enhancing your daily physical activity
(especially aerobic-based which burns off the most calories). The
goal is to build up to at least 60 minutes of exercise equivalent to
the strenuousness of a brisk walk at least five or six days each and
every week. You can do the exercise all at one setting or break it
up into two to three segments of 20 to 30 minutes per segment. At
least 60% of the total duration of your exercise should be spent
doing aerobic activity (such as walking, swimming or biking) with a
goal of maintaining 60-85% of your target heart rate (THR) for the
duration of the activity.
THR is calculated as 220 minus your age in years. 20-30% of
the total duration of your exercise should be focused on muscle
strengthening (upper body one day and lower body the next) and
10-20% should be spent on stretching. Obviously you should
ONLY start a daily exercise program if you are physically
capable of such activity. It is VERY wise to check with your
personal physician first before beginning any exercise
program.
As an example of the vital importance of exercise, we all
recognize that Sumo wresters (at least the good ones) are
extraordinarily overweight. But, during their careers (when they
consume incredible amounts of calories but also exercise
religiously), they DO NOT have excessive small LDL particles
or other signs of CV risk or pre-diabetes whatsoever (their excess
fat is concentrated right beneath the skin surface and not in the
abdominal cavity). But, as soon as their careers end and they stop
exercising, things rapidly change such that fat disappears from the
tissue beneath the skin and develops instead in the abdominal
cavity, corresponding to elevated levels of small LDL particles,
other signs of pre-diabetes and heightened CV risk. Think about
that: when they were overweight, eating excessively but also
exercising fervently, they had low CV risk; when they were equally
overweight, now eating less but also exercising much less, they had
high CV risk. So, exercise is dramatically helpful to decrease CV
risk by itself, regardless of whether or not it leads to weight
loss. You would much rather be ‘fat and fit’ than ‘skinny and
out-of-shape.’ Of course, being both slender AND fit is even
better.
Once it
has been determined (e.g. by your personal physician) that you are
physically capable of pursuing an exercise program, please begin
with the equivalent of a five to ten minute daily walk. Increase
this slowly (as tolerated by your own body) by five to ten minute
increments every week or so until you get to the level of the 60
minute daily walk (or whichever equivalent you prefer – swimming,
biking, using the rowing machine, treadmill, stationary bike, etc).
By the way, please note the increased number of calories you tend to
burn when you perform activities also involving the upper
extremities. The upper extremities are much less energy efficient
than the lower extremities so if you want to expend the maximal
number of calories during exercise, please pursue aerobic activities
using the muscle groups of your arms as well as your legs (such as
jumping rope). I would avoid running or jogging since these
activities cause way too much joint stress and eventual injury to
the hips and knees over time. Once again, unless you want
to keep the next generation of orthopedic surgeons busy, please
avoid jogging and running (speed-walking is probably fine).
Make sure you wear the
right shoes (if you choose to begin a walking program, I would
recommend a good pair of running shoes), wear comfortable clothing
and are appropriately hydrated (drinking an 8-oz glass of water
right before exercise, an 8-oz glass of water every 15 minutes
during exercise and another 8-oz glass of water right after
finishing exercise).
Stretch the muscle
groups you plan to perform strengthening exercise for several
minutes following at least five minutes of ‘warm up’ aerobic
activity. Stretching ‘cold’ muscles can lead to injury. About 10 to
20% of the
total duration of your exercise should be spent stretching.
Do each stretching exercise three to five times. Slowly stretch into
the desired position (as far as possible without pain), hold the
stretch for 15 to 30 seconds, relax, then repeat, trying to stretch
even farther. Stretching helps: 1) improve performance; 2) reduce risk of injury;
3) relieve muscle soreness; 4) enhance posture; 5) increase blood
supply to the tissues; 6) improve coordination; 7) reduce stress;
and 8) make exercise more enjoyable.
When doing muscle
strengthening exercises, don’t hold your breath. Breathe out as you
contract your muscles (push or pull weight) and breathe in as you
relax them. Use smooth and steady movements rather than jerking or
thrusting ones. Don’t ever lock the joints of your arms or legs into
a strained position. Take three seconds to push or pull a weight
into place. Hold that position for one second then take another
three seconds to lower the weight. Don't let the weight drop –
lowering it slowly is real important.
Depending on how
physically fit you are, you might need to start out with only
minimal resistance (as little as one or two pounds of weight) to
allow your muscles to adapt. Starting out with excessive resistance
can lead to injuries. Use minimal resistance the first week then
gradually increase as tolerated.
The resistance should
feel hard for you but not very, very hard. If you can't push or pull
a weight eight times in a row, it's too heavy for you. If you can
push or pull a weight more than 15 times in a row, it's too light
for you. Remember you must continue to increase the resistance over
time in order to continue benefiting from muscle strengthening
exercises. If you don't keep challenging your muscles, they won't
get any stronger. About 20 to 30% of the total duration
of your exercise should be spent doing muscle
strengthening.
Realize
the more active you are, the more calories you get to consume.
And since exercise leads to the breakdown of glycogen (a storage
product made from sugar) within skeletal muscle, the more you
exercise, the more natural sugars you get to eat – a small amount
(e.g. one apple, banana or pear) by itself right before exercise and
a larger amount along with some protein (60-75% total calories from
high-GI carbohydrates and 25-40% from protein) within 30 minutes
following exercise (with the net carbs of the meal equivalent to the
total calories burned during exercise). So if you feel like having a
bowl of healthy cereal tonight (such as All-Bran or Kashi) with some
blackberries and skim milk, you must first EARN IT by
taking a brisk walk, getting on the treadmill or exercise bike,
jumping rope, etc...
Recognize
that your cravings for ‘junk’ food are usually due to an elevated
insulin level (pathologic), and exercise is a great way
(physiologic) to lower that level. So your desire for ‘junk’ is not
a natural response to your body actually ‘needing’ any more calories
or sugar. Here’s how you can prove this to yourself. The next time
you crave some sweet, starchy and/or salty ‘junk’ food, go take a
brisk walk or bike ride (for AT LEAST 15 minutes) and make
sure you build up a sweat. When you return home, the LAST
thing on your mind will be consuming any junk. Think about it, if
your body really needed those extra calories, and you just burnt off
a bunch of them with exercise, you should want the junk more and not
less. But, since your cravings were not normal and instead related
to abnormal elevations of blood insulin, and exercise just lowered
these –
voilà, you
don’t want the junk after exercise because you didn’t really need it
in the first place. In fact, it wasn’t even you who craved it; it
was your pancreas (through its inappropriate release of
insulin).
☺
B. Eat Earlier, Exercise Later,
Get Enough Sleep & ‘Chill
Out’
Probably the most beneficial thing you can do in losing
weight (and the one with which most people have significant problem)
is optimizing your body’s BMR. The body goes through what is termed
a ‘circadian rhythm’ when it comes to its daily metabolism –
starting somewhat slow in the early morning when we are just
awakening, becoming faster and faster as the day progresses, peaking
in the early to mid-afternoon then slowing down once again as the
evening commences to reach its nadir while we are fast asleep.
Therefore, the body is at its most ‘energy efficient’ late in the
evening, is somewhat energy efficient early in the morning but is
very ‘energy inefficient’ in early to mid-afternoon. One useful
trick in modifying your own BMR to enhance weight loss is to
exercise when your body’s metabolism would otherwise be diminished
(in the evening and/or early morning) in order to ‘speed things up’
during that ‘slow’ period of the day and to eat the majority of your
calories when your body’s metabolism is enhanced (in early to
mid-afternoon) in order to burn off most of those excess calories
during that ‘fast’ period of the day. You thus receive maximal
metabolic benefit from your exercise and minimal metabolic detriment
from your caloric consumption. Try it… it really works.
One major benefit of working out first thing in the morning
is to ‘get it out of the way.’ Most people will admit that if they
put off exercising until later in the day, they’re just as likely to
find excuses why to ‘put it off until tomorrow.’ Also, if you begin
your day in a healthy manner with exercise, you’re much more likely
to continue it in the same fashion – much less likely to overindulge
with junk and reverse the wholesome momentum with which you started
the day.
Eating frequent, relatively small meals has a major advantage
in that it promotes optimal metabolism. Digesting food obviously
burns off calories so the more frequent meals you consume the higher
your BMR will be. Remember that one of the WORST things to do
is skip breakfast and lunch and then have a large, late
dinner.
Please
also recognize the importance of a ‘good night’s sleep.’ The body
(like all natural entities) functions on the principles of balance
and homeostasis. Realize that your body demands a certain amount of
sleep from you on a daily basis (obviously everyone is different –
some people may need only five hours of sleep per day while others
may require ten hours of sleep). If your body doesn’t receive the
amount of sleep it requires, important things related to your BMR
will change during the waking hours so that your body eventually
gets what it demands. You will tend to feel sleepier during the day
(thus having a lower BMR and reducing your daily caloric
expenditure) and you will tend to feel hungrier (thus probably
increasing your daily caloric intake) with cravings mainly for
refined, high-GI carbohydrates (which will increase your insulin
level and further diminish your BMR).
Another
thing to focus on is reducing your personal stress level. Remember
that stress is how you respond to your situation (whether personal,
financial, occupational or other) rather than the situation itself.
The stress response alters many things in the human physiology,
including elevating bloodstream cortisol levels which slow down BMR
and promote the development of fat within the abdominal cavity, thus
turning on the production of small LDL particles. What can be done?
1)
Live a lifestyle you can afford and don’t value any goods or
services more than your own sanity. Appreciate them for what they
are and nothing more. Money should provide security and freedom –
not enslave you. If you focus yourself on getting and/or
accumulating better and better ‘things,’ you will never be happy
since there always is a bigger house, faster car, larger bank
account, etc…
2) Focus yourself on self-improvement, learning every day,
following what you believe to be the truth and especially on
improving those individuals around you. There are two main ways of
feeling better about yourself: putting others down to feel superior
for a moment (and your mother would be ashamed); or elevating others
to feel better about yourself forever (and your mother would be
proud).
3) Understand the power of breathing. How long could you live
without food? A: weeks. How long could you live without water? A:
days. How long could you live without air? A: minutes. We rarely
concern ourselves with breathing since it is automatic. Whenever you
feel stress, close your eyes, inhale deeply and slowly through your
nostrils, fill your chest cavity with air, hold it for a second or
two and then exhale slowly through your mouth. Repeat once or twice
more. Now, don’t you feel better? Every evening, before you go to
bed, breathe no more frequently than ten breaths per minute for five
minutes (i.e. through your nose for three seconds then out through
your mouth for three seconds then repeat). This decreases stress,
lowers blood pressure and also assists your kidneys in excreting
excess sodium.
4) Recognize the power of the human touch. We need to touch
others and be touched ourselves in return. Why do you think monkeys
and other primates are always grooming each other? It promotes
social bonds and reduces stress. Once or twice a day, get a massage
(focusing on the palms, soles, scalp, neck and low back) from your
significant other and return the favor (and not just as a prelude to
intercourse). If you don’t have a significant other, go to a good
massage therapist once or twice a week. If you can’t afford such
luxuries, give yourself a massage (focusing on the palms, soles and
scalp) once or twice a day. If you find a spot that hurts, keep
rubbing until it feels better.
5) Don’t worry about things you can’t control. Worry never
helps anything, only makes you feel miserable and actually increases
the odds things will not turn out in your favor. Instead trust your
gut and your intuition. Remember that intuition isn’t always right
but when you don’t listen to it, it’s ALWAYS right. If
something bad happens, focus on turning that negative into a
positive rather than dwelling on the negative. You can respond to
any negative situation by laughter or by tears. Which do you prefer?
Laughter is a very powerful cathartic, stress-reliever and
health-promoter – laugh every day as much as possible. Remember that
any negative is also an opportunity for change and improvement. Do
you want a negative experience to ‘make you’ or to ‘break you?’ It’s
your choice – isn’t it?
6)
Focus on the NOW and don’t dwell in a past you can’t change
or plan neurotically and obsessively for a future that won’t turn
out the way you envision anyway. Don’t be a robot just going through
the motions within your own life. The only way to ensure both a
favorable past and desirable future is to make the most of the now.
Live every moment to its fullest, sucking the sweet juice from the
fruit of life that could be plucked from your grasp at any
moment.
7) Love and respect yourself. You can never truly love and/or
respect others until you start with yourself. Don’t be so hard on
yourself, give yourself a break more often than not and realize you
are only human (like everyone else) and thus fallible. We all have
our warts, burps and farts. Learn and grow because of them not just
despite them. In most cultures, the symbol of love is the heart – it
should be no surprise that love (of oneself and of others) is thus
the best answer to keep that heart as healthy as possible. Western
science is beginning to understand the strong connection between
mood disorders (depression and anxiety) and CV disease. There are
multiple examples of problems with mood directly affecting the CV
system in an adverse way. The same changes in chemical levels
associated with depression and anxiety seem to lead to distinct
injury to arterial walls. People really can 'die of a broken
heart.'
Call (239)
261-HAPI today for an appointment at the Heart Attack
Prevention Institute (HAPI) with Dr.
V. | 
