Lifestyles for Life

     Here I am with 'dos pacientes' high up in the Andes of Ecuador.  Everywhere you look are normal-body-weight, vigorous folks who could walk the average American into the ground.  Are they poor?  Yes, by American money standards.  Are they unhappy?  Hardly.  I think Americans could learn a lot from some of these 'underdeveloped' nations.

     If you are an avid lover of exercise and if excess weight is not an issue for you, you are hereby excused to move on to other parts of this website.  If not, please read on.  And remember... please don't bite off my finger.  Look to where it is pointing.

      America has the dubious distinction of having the most obese population of any country on the face of the planet.  And most frightening of all, the fastest growing population is our children.  The number of medical problems that are a direct result of our ever-increasing waistlines is INCREDIBLE.  An obese sedentary 60 year old can easily have hypertension, Type 2 diabetes, high cholesterol, acid reflux disease, gout, obstructive sleep apnea, coronary artery disease and terrible arthritis of the low back, hips and knees.  The expense in doctor’s office visits, hospitalizations and prescription medications can be lifestyle limiting.  So how did we come to find ourselves in this predicament???

     The answer is complicatedly simple.  We have lost our roots.  We come from a long line of ‘hunter-gatherers’ who don’t hunt or gather anything anymore.  I’ve had the privilege of spending time in Europe, South America, and Southeast Asia.  You rarely see obesity in these areas.  Why??? BETTER FOOD CHOICES AND ACTIVE LIFESTYLES. PERIOD!!!  Yet Americans still try and figure out how to have it all.  How to shove 30 hours of living into every 24 hour day.  How to keep our weights reasonable with dieting and pills (if we try at all).  How to be over-budgeted so that the possibility of exercising is waylaid in the name of extra job hours to pay for the things that own us.

                           THE TRUTHS OF A HEALTHY HABITUS----

1. A calorie equals a calorie equals a calorie.  If you eat 1500-1800 calories everyday for the rest of your life, your body style will change for the better. Whether you choose to eat all protein, all carbohydrates, or all fats, or a more healthy balance mix-of-all, your body will change.  The problem is this:  in our 'eat-on-the-run supersized-humongo-portion' society Americans are clueless as to how quickly they have consumed a day's worth of calories.

2. Exercise is critical to a healthy lifestyle.  If you only calorie-restrict, you will lose pounds of both fat and muscle, which keeps your body fat percentage relatively high.  Muscle is your metabolic engine.  The more you have, the more calories you burn.  If, on the other hand, you exercise with regular aerobic activities, like daily walking or biking, and strength training, your muscle mass increases, thereby increasing you metabolic rate. Remember to ‘start low and go slow.'  Never push yourself to the point of breathlessness (anaerobic metabolism).  Warm up before and cool down afterwards.  Stretch those muscles.  If something hurts, stop.  Pain is your friend.  A good basic reference is THE FITNESS BOOK by the American College of Sports Medicine. 

3. Get a healthy 'binky.'  It is a frightening world in which we live.  Towers are being razed…the first 15 minutes of ALL the local news is about who killed who and how…children are stolen out of their bedrooms as their parents sleep in the next room…self-responsibility is a concept of the past, everyone is a victim, lawsuits fly like geese headed south.  We all need to feel safe and secure.  After our mothers disposed of our original rubber binks, we soon found ourselves searching for other ways to feel safe, using cigarettes, alcohol, food, television and other diversions.  How about if we were to use exercise instead?  Stressed???  Go for a walk instead of smoke.  Angry??? Yoga anyone?  Depressed???  Close up the cheese doodles, get off the couch and head to the gym.  I often recommend counseling to patients with excess weight issues to help them explore why food has become so much more than a fuel in their lives.

     Folks, our country is in a health crisis.  As our population ages and the boomers start heading like lemmings towards the cliffs of advancing age, death and disability will be coming earlier and in greater numbers than we can imagine.  The health care costs will be tremendous.  The truly unbelievable thing is, WE ARE DOING THIS TO OURSELVES!!!  If we would ALL on a daily basis focus some of our other fervors into an excitement to maintain this precious machine that we have been given, the dividends down the road would be great.  Some of our hard-earned retirement dollars will be actually spent on enjoying our retirements.  What a concept!   Remember, if we don’t take time today to be healthy, statistically we will most likely have to take time in the future to be ill.

     By the way, for those of you who think that I don't know how difficult the war with weight can be,  I have struggled with excess weight all my life.  I reached my maximum of 220 pounds in medical school, nearly sixty over my current weight.  I have tried many diet plans in the past, some to which I would be ashamed to admit. After finally realizing the truths that I am sharing here with you today, I have been able through healthy eating and regular exercise to change my body style to a new slimmer one and to maintain it for the past few years.  You can too!

On Exercise

            PRINCIPLES FOR A SUCCESSFUL EXERCISE PROGRAM

1.  Find An Activity That You Enjoy.  Walking is suited for most everyone and has many advantages. Easy to do, inexpensive and available year round (check out your local mall during inclement winter weather days...most open early just to accommodate walkers). How about country line dancing? Yoga at the Y??? Be creative. If weight or joint pains are a problem, think about swimming or water aerobics. If you still can't think of ANYTHING, try this technique. I have many patients who, because of illness or accident are confined to a wheelchair. When I ask them what would they do if they could get out of that chair, the list usually comes at a fast and furious pace. Picture yourself in that situation and all that it would mean to your life. So, what activity would you choose now?

2. Start Low And Go Slow.   If total inactivity is your present baseline, then set reasonable goals. Maybe for you, 10 minutes a day is all you can handle. On a week-to-week basis, never increase your program by more than 10%. For example, if last week you exercised 100 minutes, then this week your goal would be 110.  Also, avoid being a 'weekend warrior.'  Here is that recipe for disaster.  Take one person.  Restrict all activities Monday through Friday.  On Saturday and Sunday, exercise as hard as possible for as long as possible.  On Tuesday, call 911 to assist the now extremely sore person out of bed.  Is it any surprise that people would want to avoid exercise if this is how they always felt afterwards?

3. Exercise With Others.  'Misery loves company'-- an appropriate adage for the newly converted athlete.  Habits are hard to change.  Notice I said hard, not impossible.  It takes about 30 days to establish a new set of behaviors into your daily life.  Support from others can be critical during this time period. There are many wonderful groups like Team In Training that support various causes like leukemia, asthma, arthritis, and multiple sclerosis research, to mention a few.  Choose a cause 'dear to your heart,' make a difference and get in shape to boot. 

4. Be Consistent.  Sudden, rapid changes in your training regimen are a sure way to experience pain.  Being inconsistent is a great way to make sudden rapid changes.  And don't neglect yourself during the inclement weather months.  Try and be active at least 5 days a week, 52 weeks of the year.  

5. Prioritize Your Exercise.  Every night, before you go to sleep, plan your next day's exercise.  Begin to see it as it is, because it is just as important for your health as your meals.  Set your clock 30 minutes earlier, and get up and walk for that period of time.  Be careful with the 'I'll exercise tonight' plan. Most Americans are spent by the evening and only the MOST MOTIVATED of folks are able to drag themselves onto a treadmill when getting under the covers is what they really want to do.

6. Don't Forget Strength Training And Flexibility.  There is more to your fitness program than cardiovascular conditioning.  Your heart is certainly your most important muscle, but don't sell all the other ones short.  They too need to be kept strong and flexible to avoid injury.  Your body is a loop.  Have a heart attack and you won't be exercising your leg muscles for awhile.  Pull a leg muscle, and your heart will likewise be on the back burner until your leg heals. 

7. Learn To Enjoy The Process.   'Motion is lotion...Use it or lose it.'  Our bodies are machines, meant to be used.  Yet exercise to many people is akin to having a root canal sans anesthesia.  Many others, however, find it to be a welcome part of their day-to-day existence.  It burns both calories and stress, strengthens the heart, keeps the joints lubricated and builds self-esteem.  What is not to like?   The sooner Americans accept the fact that there is no shortcut to a healthy body, the sooner we can get to the job at hand: eating better and exercising regularly.  This is frightening and liberating at the same time. Frightening in that there is no easy solution, no one diet that works better than another, no diet pill that is the solution.  Liberating, like when Dorothy Gale learned that the Ruby Slippers, which she had with her all along, were her ticket out of Oz and back to Kansas.  Each one of us has the innate ability to make these changes.  

8. Get A Baseline Physical From Your Physician.  In the year 2005, you need to sign a waiver in order to serve the neighbor's kids Froot Loops for breakfast.  Here is mine.  If you are older, have multiple medical problems, have been chronically sedentary or simply have not seen a physician in a long time, it is a good idea to schedule a thorough history and physical examination with your primary care provider.  This would include a blood pressure measurement, a calculation of your BMI, or Body Mass Index <click here>, a thorough cardiovascular and musculoskeletal examination, a fasting sugar and cholesterol profile, and a resting EKG. Based on these, your physician may order an E.S.T., or Exercise Stress Test in addition.  Once you pass with flying colors, then you are off to enjoy a new more active lifestyle.  Bon Voyage!!!