Saturday, January 26, 2013

Fat Chance

If you want to skip to the specific recommendations out of the book, scroll down to the section in purple below.

Part of what I do to motivate myself is read books about diet and exercise and health. The topic interests me, and it affects what I actually do and eat.  So the latest one, picked from hearing interviews with the author on the radio book tour circuit, is Fat Chance, by Robert Lustig. This is much more about health than about diet, and has added to my understanding of what is going on inside me and everybody else.  I've read a lot about how we metabolize fat and sugar and this book didn't contradict what I thought I knew, but adds depth to this in a very relevant way for me.

Dr. Lustig is a pediatric endocrinologist, where for decades he has worked with children that have extraordinary weight problems, sometimes as incidental to much more serious problems.  Here, in the order I happen to remember them, are some of the observations in this book.

He starts from the premise that Gary Taubes introduced me to:  we don't grow fat through sloth and gluttony, ie not through eating too much and moving too little. Turn that upside down: we eat too much and move too little because of genetically and environmentally driven imperatives.  When a teen age boy eats his way through the whole refrigerator in a few hours during his growth spurt, we don't say he grows tall because he eats. We say he eats because he is growing tall. So it is with our body shape and our weight: how much we are driven to eat and how much or little we move is a result, not a cause, of our body chemistry.  Why our body chemistry is driving these imperatives is not necessarily (yet) well understood and agreed to, but never-the-less this point is critical:  it is not just a matter of will power.  Not only is it not our fault for being a slothful glutton, but even if we exercise more and eat less we might not lose weight. Taubes cites research on squirrels that are genetically driven to add weight in the fall - they can literally starve to death from organ failure while their body chemistry is diverting food energy to fat deposits.  Lustig has plenty of examples as well of abnormal children whose bodies are driven to add fat. He has to change something in their interior chemistry for them to be able to lose weight.

Lustig also distinguishes between health and fat.  Part of it is by distinguishing between types of fat: subcutaneous fat (big butt fat) and visceral fat (beer belly fat). It is the second that is unhealthy, and it is the fat that coats your internal organs. You can be skinny to the outside eye but be coated with visceral fat inside. He notes that a significant portion of "normal weight" people have unhealthy diets and internal fat. A significant portion of overweight people are quite fit, though they may have big butts. You might be better off being slightly overweight than underweight, at least in terms of how long you live.  But being morbidly obese certainly drives many major health issues. It is the collection of symptoms known as metabolic syndrome that comes from being obese that he is targeting his effects at.

Sad news: Lustig says pretty much no one will lose weight from exercise. Your body will compensate, and you will burn less calories when you sit and and sleep, and your appetite will increase. However, exercise is still the magic bullet for health.  You are probably swapping bad visceral fat for muscle or better (if unsightly) big butt fat, and there a gazillion other benefits.

Lustig also distinguishes between carbs, going much deeper than Taubes. He goes down to the molecular level of different sugars to discuss how they impact our health. His conclusion as I understand it: fructose is the worst for us, whether it comes from cane sugar or high fructose corn syrup. Anything that tastes sweet is bad.  But fiber offsets the bad impacts of fructose. This is why fiber-rich starchy foods can be fine for us (including whole fruit, but not fruit juice or even smoothies). He goes deep into the hormonal system (makes sense, he's an endocrinologist), and frankly I decided not to try to follow it all.

This was the first explanation about how both meat-centric low carb diets and bean and whole grain vegan diets can be equally healthy that made any sense to me.  Being a bread-itarian won't work - white rice and white bread, even without sugar, are calories that will drive fat storage. He also notes that processed food almost always has eliminated fiber and added sugar, and explains why that makes perfect sense from the producer's point of view: it actually makes it last longer. Our industrial food system requires us to make, package, and ship food over long distances and times. Grocery store bread will last on the counter for up to a couple of weeks, in contrast to home made bread which goes bad in a day or two.

Lustig is careful not to paint anything with too broad a brush. He distinguishes between ethnic populations, nations, and specific genetic conditions. He has a sweeping survey of environmental things that might be bad for us. We can't change our genetics, but we can change our environment and what we eat, and thus change our biochemistry.

So what does he recommend we actually do as individuals?  First, he says he really doesn't care much about weight, only health.  But we can do three things:  eliminate the poison, and take the two antidotes.

The poison is sugar, and it is insidiously everywhere.  Almost everything that has a bar code on it has sugar added to it. He sees no reason to ever drink any sugar.  Soda, frappuccinos, and fruit smoothies are almost equally bad for you, according to Lustig. He also condemns artificial sweeteners, for driving certain chemistries or responses. He actually recommends a national level public health intervention to counteract sugar's pervasiveness in our food, and in the meantime, he notes that only Americans above a certain income level or in a certain environment can afford the time and money to find, cook and eat foods without sugar.

The two antidotes:  fiber and exercise.  He makes a persuasive case that fiber causes our bodies to process sugar differently and better. He notes that the new Atkins prescription aims at many grams of fiber from vegetables, but few people achieve those levels (me included). Meat is so much easier to prepare, and it lasts longer and can be frozen and defrosted more easily.

I won't go into the benefits of exercise, which we all believe. It adds muscle, and it lowers insulin resistance, and it counteracts depression. We should all do more of it. Yes of course.

So what does this mean for me? I have not lost any weight this week, according to my weekly averaging. My body seems to be stabilizing a few pounds above where it was before the holidays. No. I can't allow this. I have tracked my food faithfully for the past few weeks, and my carbs have been around 100 grams a day, (this is about a half to a third of a normal American's diet, according to Atkins) with 10-20 grams of fiber (about average for Americans, but less than recommended). Yesterday's food was crazy, with grazing all evening while home alone. I'm going to go purely Atkins for a couple of weeks, and see if I can blast through this plateau.  I am also going to up the exercise, only to try to keep the body from shutting down. I'm going to hunt for fiber, and fill up on hunks of meat (not sausages or meatballs). I'll try to erradicate sugar, including no nightly treat - only a weekly one. We'll see how it goes, because I don't control my life completely but I've been at this long enough to know some of the things I need to do.

Monday, January 21, 2013

Too Much Weight on the Issue?*

(*With apologies to my friend Alice for stealing her line)

I weigh myself every single day, and I have for nearly fifteen years. I've got twenty-five years of records in total. I really like seeing the actual numbers, turned into a picture that tells a story.  This is what I do, for my profession and for my pleasure: I take numbers and make them tell a story. I turn data into pictures, turn points into patterns.  Information is data in context, and nothing makes context better than arranging the data into beautiful patterns, where the color, the shape, the weight of the lines help tell the story.


Do I spend too much time thinking about what the scale says? Isn't this really about being healthy and strong?

Well, no. Actually, a whole lot of "this" is about how I look as well as how I feel. And there is zero doubt in my mind that lower weights on the scale translate into looking better as well as moving better.

But why weigh myself every single day? Some days it's up, some days it's down.  Am I really ruining my day on the days it is up? Well, no, again. Because I weigh myself every day, I don't put too much weight on any single day. Weights are really volatile, and they bounce all over the place. I weighed myself several times over the course of a weekend, and there was a total of seven pounds variation in roughly 24 hours!



But the longer term trend is the truth. It is the fact. But I need to separate out the trend in the data from the daily variation. How do I do that?  There are several ways to do it. Weight Watchers and many other programs use the weekly weigh-in, which over a long period of time does show an actual trend.  But with several pounds variation in the course of a day being possible, a one time check in each week is not giving you a lot of information to act on.  Was the loss this week because I did everything right, or because I didn't have a lot of salt yesterday so the water is down?  The long term trend is true, but the weekly number does not give information you can actually act on.

I read about doing a weekly average back in the early 1990's in The Carbohydrate Addict's Diet.  Weigh yourself every day, then take the average at the end of the week. The seven-day average shows an authentic trend - up or down from the previous week.  This makes so very much sense to me!  Short term variations are ignored, wrapped into the weekly trend. But I don't have to wait for weeks to figure out if what I am doing is working, if I am actually losing weight.

So am I losing weight now? Let's talk a look at the data:

1/1/2013 154.7
1/2/2013 155.8
1/3/2013 155.1
1/4/2013 153.7
1/5/2013 154.9 154.6
1/6/2013 152.6
1/7/2013 153.2
1/8/2013 152.3
1/9/2013 152.9
1/10/2013 153.6
1/11/2013 153.4
1/12/2013 152.6 152.9
1/13/2013 152.7
1/14/2013 153.2
1/15/2013 151.8
1/16/2013 153
1/17/2013 151.7
1/18/2013 151.8
1/19/2013 152.4
1/20/2013 152.8 152.4
1/21/2013 153.6

The numbers on the right are the weekly averages - so yes - I *am* losing weight.  If I was only weighing myself once a week, and saw a 0.5 pound loss, I would have to reject it as not meaningful.  But half a pound on average for the week is true.

Let's turn the data into information, but adding context.  The scattered points are the actually daily weights. The line connects the weekly average dots. There is still a lot of weekly variation, but the trend upwards since this summer is also crystal clear. The daily scores would obscure the trend.

For many years, each year I bought an attractive wall calendar with big boxes for writing in, and hung it on the wall of my bedroom near the scale. I'd write down the daily weights, keep mentally calculating the weekly average, and every few weeks type it into the computer for calculations and graphing.  But this spring I went ahead and splurged big time on a Withings wi-fi scale. I step on it, and it sends the data right to the internet over my wi-fi.  I can look at it on the computer, on my iphone, on my ipad. I can export it to my computer at home for making my own graphs and charts.  It connects to other apps, notably my food tracking app, MyFitnessPal.

It also makes its own graphs and by some math I don't get to peek inside of, it shows trends in terms of a band of variation and a trend line.  It's kind of pretty, but since I don't understand what its doing with the ranges and trend, I don't put a huge amount of weight on it. (Sorry Alice, two times I stole your line in one post!)


So weighing myself daily is useful and not a lot of work. I don't worry too much about any one number, but I get the trend very clearly laid out for me. So this is just the right technique for me.

Sunday, January 13, 2013

Checking In

Keeping track of my resolutions and commitments...

I'm right on track with the very concrete commitment of 750 words each day, and they are often in the morning, which I think is the best use. I've done my words while sitting at my computer with coffee first thing in the morning, and on the ipad while sprawled on the couch when even starting the computer is too much work. I've done them at work - the least desirable I believe- and I've done them at night on the ipad in bed. I'm finding it helps me be focused, and I am living a very self-aware life, which mostly I think is good. This blog is useful in that way, too, but it is too public for certain things. So the daily writing forces me to put into words all of the things churning in my head - or at least some of them. I do worry that in the writing I decide on a course of action, and then I fail to see it through. I once read (in one of those many studies recapped casually in the news) that planning to do something gives just about as much psychic lift as actually doing it. This has both positive and negative implications: one can think about eating deliciousness, achieve the good feelings, and then move on (in theory); equally, one can plan to run, think it through and enjoy it, and then not do it (very much in practice). But I digress.

I have also done my mile every single day. Sometimes, it's been fairly slow on the treadmill in the basement, watching tv on the ipad or reading a book on the kindle, but a mile is better than nothing at all. I do plan my day thinking about when I will get in this activity. And I've also decided to try to get in a 5K distance at least once a week - so far every Sunday. I'm just in now from a jog/walk outside in the 100% humidity but relatively warm day. This is one of the first times all year I've gotten the heart rate up into "vigorous" territory, and I want to keep doing it. But I am very lazy. The fact is I've made a very tiny activity commitment, one that is almost impossible for me to decide not to do, because its so very tiny. And it is so very much better than nothing. It makes me feel so good, to take a walk, its very nearly being elevated in my mind to the state of religious practice.

I'm also really trying to lose weight again, because it drifted up. I'm focused on very low carb eating, and I've found a way to eat that is working for me right now. It does take a lot of planning to make sure I can execute it well, however. The basic plan is only protein and green veggies for breakfast and lunch, and limited carbs for dinner, followed by a treat.  I've found I really need the treat to have any chance of making this work.  I like meat and veggies, but they are more work than reaching for prepared food.  I have to have fresh vegetables, and I have to have meat to cook that is not frozen, and I have to have the time to cook them. This is harder than I could have imagined, especially when I am trying to make one meal for the whole family. Because the kids are teenagers, they do have their own plans and schedules and family dinner is not an every day affair. I am eating prepared foods - frozen dinners - on most of the nights we don't eat together. That gets balance and portion control both, though there is some work to make sure they are not carb and sugar heavy. They tend to have a high percentage of rice (the ones I buy) but because the total portion is small the number of carbs is low. I'm aiming at staying below 100 grams of carbs a day (tracking via My Fitness Pal) and that includes a sweet treat as well.  While I did not specifically track my food during The Big Loss, I'm pretty sure I ate frozen dinners very often at night. At that time in my life, most week nights were spent home alone, and that really worked well for me. I cooked on weekends, and counted on left overs for lunches during the week.  This way of eating is sustainable for me, but I haven't been doing it long enough to see if I will actually lose weight on it.

P.S. [added later] I really like the way I feel for having jogged over a third of my 5K. I really wish I could set up my schedule where I do this more often. If I want to actually progress to running longer distances faster and stronger, I've got to do this at least three times a week. But right now, I'm too tired in the mornings, don't have time during the day, and totally exhausted at night. Hence the tiny commitment to stroll at least a mile. But, I think I need to remember and remind myself how good this feels.

Sunday, January 6, 2013

Good Habits

I went out for a walk today, to get in my mere mile. I was wondering whether my modest goal was preventing me from aiming at a more ambitious one. Just to prove it wasn't, I went on to take a longer walk and elected not to listen to the iPod, but instead continue my inner dialogue that had got me that far.

I have been reflecting on my resolutions, and also diving into my history. Today I set out to enumerate the good and healthful things I already do, the fruit of resolutions past.

I weigh myself every single day. I have for years. Knowing the facts and charting progress is considered essential to making changes. I've got the facts on this one, for sure.

I don't do doughnuts. This is comprehensive- I don't do bagels either, or cereal or even oatmeal. I listened to my body and permanently changed my eating habits. Basically, I've learned that carbs in the morning make my body and mind crazy, so only by exerting inhuman willpower could I end up having an ok day calorie-wise. So much easier to eat eggs or cheese or steak or tuna--or even nothing--first thing in the morning than to make myself crazy. Those few days a year I go off course in the morning are usually based on a conscious choice about the rest of the day (Christmas morning Julekage) or else some reckless self destructive urge. What I've gotten better at the past few years is planning ahead to make sure I've got the right food in the house for a good start to the day. I'm pretty good about lunches, too. I try to bring a meat and vegetable leftover from home, or else go out and buy a salad. Lately, however, lunch has slipped a LOT. I blame a combination of food trucks for easy access to deliciousness, and the very high stress and unhappiness at work. So this is an area of focus for me. Right now, I've got a fridge full of lunches for the week. I still have a very high emotional attachment to after dinner sweets, and so very often that is my downfall in the calories department. But that is another story. This is about the good stuff.

I try to incorporate vegetables into dinner, and fruits into snacks. I have improved a LOT in these areas in the past couple of years. The fruit push has definitely been driven by the fruit loving family I buy and prepare food for. My brother in law is also a big vegetable guy, wanting leafy (cooked) greens at every single meal. The kids are maturing, and eating some more of the cooked vegetables. I get a bag of overpriced local veggies delivered every other week and I try very hard to make sure they get used up. I'm in Whole foods a couple of times a week. For a while last year, my secret evening wicked snack was blueberries and mascarpone, a quarter cup of each mixed together and savored slowly. I will have to look for when the South American blueberries are coming back. Cherries from Washington state are one of my favorite snacks, and of course there is local peach mania at the appropriate time. Right now, my girl has a thing for pomegranates, and she prepares them and we split 50-50. Try eating a half a pomegranate one seed at a time with a spoon. That can satisfy a non-hunger snacking drive, or at least keep you busy for a good long while. Fruit juice and a crunch and chew. Very satisfying.

I like to exercise. Not always, and often the desire to be a slug is overwhelming, but I know more than just intellectually that I like exercise. I feel it, I want it. This started for me in the early 90's, in my forties. Before that, i liked doing active things, but i specifically did not like "exercise". Now, I do the strength training at the gym, and took the advice of a friend not to give up the one thing that really works for me consistently. And walking is my go-to comfort exercise. Twenty years ago, it would have been inconceivable to put those words together ("comfort" and "exercise"). Now, the reason I've got the one-mile resolution is because I know it works. I sorry I'm not running, and I will try (sorry Yoda) to get back to it, but I know I want to move and today is a good example of exercise to both de-stress and to fuel the creative juices.

I have an increased awareness of how I look, and how clothes look on me, and how they make me look and feel. I have a lot more confidence in selecting my clothes every morning. I put a big mirror in my bedroom a couple of years ago, and I use it. I get rid of clothes I don't like, much more ruthlessly than in the past. If not returnable, screw the money anyway. Launch it to a new life, and stick with stuff I like.

I think and read and write about this stuff, and I've gotten a lot more social about it. While of course I have a lot more private stuff I think and write about, for diet and exercise and general health both being mindful and more social is really good. So thanks, guys.

So I weigh too much. So I'm not as fit as I would like. I still do many more things right than I used to do, and I'm making improvements all the time.

- Posted using BlogPress from my iPad

Saturday, January 5, 2013

Review of "Progress" - not so much

I have been keeping track of my weight for twenty-five years!  I have no memory of specific weights before then, and if I wrote anything down, I can't find it now.  But for 25 years I've got data points.



I've been blogging for three. I started this specifically for some motivation. And its been really motivating. Besides weight loss, I have increased my fitness considerably. (Which by the way just came in handy as my 60-pound, 13 year-old dog had a seizure and I rushed to the vet in the middle of doing this post. She couldn't walk, and I was able to get her into the car though it took setting her down three times in the process.)

But all my weight loss progress was made in the first year and a half. I didn't choose maintenance, I just plateau'd, and then started to backslide.


So these graphs tell me I am perfectly capable of losing weight. I just have to actually do it.

They also tell me that I have a lot more success if I cut out the sweets and breads. Going low carb is the way to do it for me. That's how I did the Big Loss, and that is what I was doing to get back on track in 2008-09. This is what I'm striving for now. I'm not willing to go Atkins for life. But, to lose weight, I've got to cut the carbs. My current food tracking system, My Fitness Pal, does the nutritional analysis as well as calories. I ignore their suggestions of how to divide up between fat-carb-protein, because they are way too high on the carbs. But I think I'm going to be a meat eater for serious for the next while.

Atkins is also big on the vegetables. Green leafy vegetables. I'm on a roasted brussels sprouts kick (fell into it at Thanksgiving, thanks to my fabulous hostess!) and that will help. Atkins says two salads a day. Or a salad and some cooked greens. So that will be part of my focus now.

Looking back on my New Year's posts from the past couple of years, there is a resolution I made last year that I didn't stick with for very long at all. It was to eat only at the dining room table, sitting down, not watching TV or some other consuming focus away from the food. I want to try to do that again, though I keep forgetting. I just ate while posting, not good.  Got to keep reminding myself!

It's good to have history, because my memory is colored by the way I want it to be. It's very good to look back over the past three years and remind myself that the first half went pretty well, and I'm still much better off than I was.


Thursday, January 3, 2013

The Extra Mile

I am full of things I want to do more of, or less of, to make myself better in every way. But I've decided to only make two actual commitments as resolutions. By making them very concrete, controllable, measurable, and ambitious without being impossible, there is a good chance these resolutions will actually add to my self esteem instead of just give me something else to beat myself up for not doing.

Resolution number one:  Go the extra mile. Literally. Walk (or run) an "extra" mile or more every single day. I mean Every. Single. Day.  No banking them ahead of time, or making up for misses. I want at least 365 miles behind me at the end of the year.

My thinking on this: I want to make it a habit. I also believe walking has the power to lower stress and make me feel better all over - though the actual aerobic benefits will be minimal at best, if I just stroll a bit. But it is still better than some days I've had, where I am a total slug, just curled up under my leaf and not moving except to eat.  My mile will be about 100 calories, about 3,000 steps, nothing that will really pay off in terms of weight loss or fitness. But it is so very achievable. I've got a treadmill in my basement, and I can go downstairs for a half hour at two miles an hour and then climb right into bed. So I will. I started a couple days before the new year, so I'm five in a row right now.

The rules:  "Extra" means that it is an intentional walk, not incidental to moving around the house or office building. It certainly can be on the way to something else, if I choose walking versus metro or driving. And certainly, I could jog or run instead. So this will be between 12 and 30 minutes a day.

Resolution number two:  Write 750 words every day for the month of January.  A few days ago, I wrote about the 750 words website. I've signed up for the January challenge, and I've done eight days in a row so far, since I didn't way for the year to start. I think this is helping, though yesterday was the most scattered. I haven't yet figured out exactly how to use this or what it is doing for me, but it's a DIY form of therapy I want to try. So I'm not resolving for the whole year, but to carry it through January 31.  I'll report on progress and decide what to do after that.

I have a whole long list of things to do more of:

  • Spend more time with the kids
  • Talk to more people at work
  • Spend more time with friends
  • Cook better food
  • Run
  • See more movies
  • Play piano
  • Spend time with my mother
  • Manage my money better
  • Yada yada yada
And I'll try. (Sorry, Yoda, but there is a "try", not just a "do or not do".) But I'm not committing the way I'm committing to walk and write.