Tag Archive for: weight

Today!

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I’ve said before that in my opinion, the single most important thing you can do to limit the problems of aging is to get to a normal body weight and maintain it. If you’ve been overweight most of your life, as I have been, that can be a real challenge. While the research on what’s called Blue Zones is somewhat controversial, all we have are the observations of different researchers over the years. What seemed obvious to me, as a professional observer, is that people who lived longer seemed to be a normal weight for their height. And to me, that is the absolute goal to work towards.

It’s not easy, and it’s not going to happen overnight. But whether you’re 20, 50, even 70, if it takes you five years to get there, you’re still relatively young. That means that when you do get to be 80, you’ll actually be 80 instead of having died when you were 77. When do you begin to eat less, eat better, and move more to get to that normal weight for height?

Today. No matter how long it’s going to take, you begin today.

Insider Conference Call

I’ve been asked about cyanocobalamin, a synthetic form of vitamin B12. That’s the topic of the evening along with answering personal and product questions. If you’re not an Insider, become an Insider by 8 p.m. Wednesday evening and you can join in the conversation.

What are you prepared to do today?

        Dr. Chet

I’m Alive: V2.55

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When I opened my eyes this morning, I knew I had another year to do what I was created to do: teach people how to be healthy and fit. For those of you who are new readers or those who need a refresher, here’s the story: when I wake on May 10th every year, my superstitious belief is that I have at least one more year to live. My dad died on May 10, 1969. In case you’re wondering, I’m version 2.0 (my father was the first Chester John Zelasko), and it’s been 55 years since my father died. It makes no sense in the real world, especially for a guy who’s a scientist, but every May 10 is a milestone for me.

Last weekend as I pulled into the parking lot where I work out, there was an SUV with a number of plastic bags on the roof arranged in no particular order. As I walked past it, I couldn’t help but notice the car was packed to the ceiling, including the passenger’s seat. In fact, it encroached on the driver’s seat. I don’t know how anyone drives without being able to see the rearview or sideview mirrors, but I guess that person somehow managed. I could speculate whether they were moving or living in their car, but here’s how I saw it.

We all carry the baggage with us—memories of every time we didn’t complete a goal we set, especially health goals. We know the foods we should eat and the ones to avoid. We know that exercise will make us fitter, stronger, and more flexible. We know we have supplements and/or medications we should take for our health or to deal with conditions we may have. In retrospect, we ask ourselves why? Why don’t we do that?

It may not be the only reason or reasons, but I think we carry the baggage of past failures with us. And we continue to lose fitness, strength, and on and on. You know the worst sentence I can think of? “What difference will it make now?” It will make a huge difference. Can you walk your daughter down the aisle, or will you need a walker? Will you need a wheelchair in five years, or can you postpone that? Will you still have the flexibility 15 years from now to take care of your own personal needs, or will you need someone else to bathe you and clip your toenails? In 20 years, will you still be chugging along, or will you be so heavy you can’t stand up without help? I can think of hundreds of examples, but insert your own. It matters.

The important point is that you can change your trajectory. Joining a workout group or taking charge of your diet can make a world of difference in your future, so stop putting it off till next month.

I have my own baggage to deal with, so this version is going to overcome as much of it as I can this year. I’m going to spend the year encouraging you to do the same. We have things to do, and we just have to find a way to drop the baggage and get out of our own way to be the next version of ourselves. All the people who need you will be glad you’re making the effort.

What are you prepared to do today?

        Dr. Chet

Eat Less, Eat Better, Move More—for Life

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In Tuesday’s Memo, Dr. Donal O’Shea suggested that there’s compelling evidence that eating less and moving more won’t result in permanent weight loss because the set point theory is just too strong and will defeat the effort of 90% of the people. However, he didn’t provide any evidence that’s true. I’ll give him the benefit of the doubt, because every study done on diets shows that people do gain back some or all of the weight they lost. He attributes that to the complexity of obesity.

The Complexity of Obesity

Take a good look at the graphic used in the heading. What you can’t read are the 198 determinants (all those gray lines) that contribute to obesity. He narrows them down to just seven categories, five of which are not under the control of people once they are fat. In case it’s difficult to read, here is the list.

  • Societal influences
  • Food production
  • Activity environment
  • Biology
  • Individual psychology
  • Food consumption
  • Individual activity

He also gives a compelling argument that the immune system, working in conjunction with fat cells, causes inflammation in a variety of ways which prevents people from losing weight.

The problem that I have is two-fold. First, it seems the last three are under the control of the individual: eating, moving, and deciding to do so. The exterior forces are what they are, but biology can change. Aging is the perfect example of that.

As for immunity, here’s the real question about the immune system: is it cause or effect? The increase in inflammation is remarkably similar to the increase in cortisol found in people who are obese. Is it the cause of obesity or is it the result of being obese? It makes a difference.

Why Medication Won’t Be the Permanent Solution

Before I get into this, I think that medications may play a role in the solution for some, maybe even most severely overweight people. But they will not be a permanent solution, and the reason may be found in the proteome. You may remember that those are the proteins coded for in our DNA; they range from hormones such as insulin to catalysts for other chemical reactions. There are about 5,000 proteins that are the most researched, but with about 20,000 genes, there may be at least 15,000 more genes that are not researched. That doesn’t count the post-translational modifications, modifications made to the protein as it’s being made; the total could get into the millions.

It’s unrealistic to think that a combination of three, five, or even ten receptor agonists will solve obesity and not cause issues elsewhere in the body by interfering with the production of other necessary proteins. I’m not suggesting that temporary use to get the bulk of weight off an individual won’t be a good way to start, but it’s not a permanent solution as I see it, even if you can afford to take it the rest of your life.

The Bottom Line

The issue with O’Shea’s approach is that it comes from a strictly medical perspective. A nutritional solution isn’t considered and somewhere along the line, just like with gastric bypass, people will exceed their desired caloric intake and regain weight. Why? Because they haven’t learned anything.

Remember, in those seven categories he cited, food consumption and activity levels are under the control of the individual. That means both the quantity and the type of food as well as the amount of activity are under the control of the individual. I’ll say it again: it was, it is, and it will always be about the calories—how much you take in versus how much you use. Take in more than you use, and you gain weight. It’s that simple.

Obesity is complex because our bodies are complicated, but this is still my recommendation: eat better, eat less, and move more. If I were to add two more words that I’ve implied but haven’t stated, they would be “for life” because the only way to hold on to your progress is to keep working on your lifestyle.

What are you prepared to do today?

        Dr. Chet

References:
1. SETU. Understanding Obesity: Rethinking Diagnosis & Treatment. 2024.
2. Nat Chem Biol. 2018 Feb 14; 14(3): 206–214.

Should You Forget “Eat Less, Move More”?

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Eat less. Eat better. Move more.

If you’ve been reading the Health Memo for any length of time, you know that’s my simplified solution, my mantra, to the problem of excess body fat we face in the U.S. and around the world. That’s why an article about an endocrinologist from Ireland who said “Eat less, move more is not the treatment for obesity—get over it” caught my attention. The quote was taken from a talk and interview given by Dr. Donal O’Shea that included a series of recommendations to primary care physicians on how they should approach the topic of excess body weight with patients. He went on to suggest that in a short time, medicine will have solutions for obesity that will essentially render obesity obsolete. Semaglutide is just the first jab at it—pun intended.

I went a little further and listened to a talk by Dr. O’Shea in which he went into detail about why 90% of weight gain is irreversible in 90% of the people. Then he used this example: if you donate a pint of blood, your body will replace it over the next six weeks to get your body back to its blood-volume set point. He says your body weight also has a set point and once it’s raised, it cannot be reversed; no matter what you do, your weight will return to its set point. Therefore, medications such as semaglutide and the ones being developed that will impact other receptors are the only solution.

Should we just buy stock in pharmaceutical companies and forget about nutrition and exercise? Dr. O’Shea is a good scientist and is certainly compassionate toward patients. But is he correct? No, and I’ll explain why on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. Eilish O’Regan. Irish Independent. 04-28-24
2. SETU. Understanding Obesity: Rethinking Diagnosis & Treatment. 2024.

Three Tips for a Healthier Year

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Most people look at the New Year as a time to make some changes to eating and exercise habits to accomplish health goals. For many, it’s reducing their body weight; for others, it’s getting fitter. But health is more than body weight and fitness. Many of us want to improve our diets, lower our blood pressure or cholesterol, become more flexible, or

take better care of our teeth, and for some, managing pain and other health conditions is a goal. Here are three tips to help you become healthier by the end of the year.

Tip 1: Use Available Technology

In a blog from the business builder Seth Godin about using technology, the final line was, “Working harder is rarely a better plan than finding better tools.” The quote was related to business, but it applies to health as well. Sometimes the tool is information; I hope that’s one of the reasons you read the Memo. I’ll have a lot more info coming to help you get healthy in 2024 from webinars, courses, and maybe some live events.

Sometimes, the tool is a device like a smart watch or a specific type of monitoring technology. I recently got a Kardia ECG monitor to collect data on my ECG. With other tools, you can monitor your blood pressure, oxygen level, and blood sugar to determine your patterns. But you must master the use of that technology for it to be helpful. The same is true for any exercise equipment you choose to use. That leads to the second tip.

Tip 2: Know Why You’re Doing What You’re Doing

If you’ve ever heard me speak in a seminar, I always tell people when it comes to taking a dietary supplement, you should know exactly why you’re taking it. Some are non-specific for overall health like a multivitamin-multimineral, but you may be taking a supplement for a specific reason, such as taking ginkgo biloba for increasing blood flow or coenzyme Q10 for more energy. You should know the reason for anything you’re taking.

This is my addition for 2024: you should also know why you’re taking every medication you’re taking. Have a thorough discussion with your physician or your specialist to determine why you’re taking each medication, what its purpose is, and whether you’re taking the lowest dose to get a positive effect. And then you must be able to test that impact somehow. Either you’ll have less pain, more flexibility, lower cholesterol or blood pressure, or some measurable benefit, or it’s time to change things.

You could apply that to foods and exercise as well, but supplements and medications are usually more purposeful.

Tip 3: Be Consistent

It seems I’ve talked about this forever, but you must try a change in lifestyle for at least 90 days to know if it works. You have to be consistent and track the health benefit somehow. Weight and blood pressure are easy; I still use a small notebook to track calories as I work to get to a normal body weight. For pain and digestive symptoms, you can find pain and symptom scales; this pain scale is on drchet.com. Then find a way to record the results every day—electronically on your computer or smart phone, or pencil and paper. I track workouts and total calories on an Excel spreadsheet; Paula has recorded her weight in a paper calendar most of her life.

You have to be able to go back and see any changes or patterns. How will you know you get fewer migraines if you aren’t tracking each one you get? That applies to every change you’re making.

If you can use these three tips, your 2024 will be less frustrating. Not everything works for everybody, but there’s always another approach. If one doesn’t work, go to the next. As long as you pay attention, you’ll finish the year healthier than when you began.

What are you prepared to do today?

        Dr. Chet

The Bottom Line on the Blue Zones

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The docuseries on Blue Zones demonstrated that it really isn’t complicated to live to 100: find a purpose, a reason to get up every morning, remain physically active, eat reasonably with a focus on plant-based sources for food, and develop a social group that can provide support through the various stages of life.

The docuseries ended with the writer working to create Blue Zones in different cities throughout the USA. That part is complicated because it involves community buy-in from government, health and healthcare officials, as well as professionals from nutrition, exercise, and community planning.

The Most Important Thing

After giving it a lot of thought, I’ve come to the conclusion that the most important thing that anyone can do to live well to 100 is this: get to a normal body weight and stay there. Not everyone who actually was 100 years and older was thin, but they had already made it to 100.

Getting to a normal weight reduces your risk of just about every degenerative disease and reduces the stress on your joints; Paula adds that it also greatly expands your clothing choices. You may never be able to do the splits like the man in the photo, but you’ll be able to do more than you do right now. Genetics is always there to blindside us, but even with that unknown, we can be in a better position by being a normal body weight and maintaining it.

The Blowback Was Instant

I spent last weekend with several thousand people, and I enjoyed every moment. I was asked many times what is the most important thing to be healthy, and my answer was always the same: find a healthier way to eat that you’re willing to stick to for the rest of your life, get to a normal weight, and stay there.

Some replied that “if I got to that weight, I’d look like a skeleton.” Then they would tell me what weight they think they can get to; I gave no quarter, no permission to say that’s good enough. How long that takes you to do could be one, three, maybe ten years. If you’re 43, that means you’ll be 53 and that’s just when everything begins to decline body-wise. You’ll be better able to handle it.

Here’s a simple way to start that you can begin this minute: cut out sugary and ultra-processed foods as much as you can. Then you can go on to find more vegetables you like, learn to cook with less fat, and so on, but you can say no to that donut or cookie right now.

What should you weigh? Here’s a link to the BMI chart at drchet.com. Note that there are guidelines to determine whether you’re big-boned or small-boned, and that affects your goal weight.

The Bottom Line

I would ask nothing of others that I wouldn’t do myself. Getting to a normal weight within a year is my goal; redistribution of that weight may take another couple of years. So what? I don’t know if I have the genes to live to 100, and I don’t know whether that’s my goal. I just want to be able to live like I want every day I’m alive.

No matter your age today, you can help yourself live well longer, and it starts by getting to that normal weight. I know you can do it.

What are you prepared to do today?

        Dr. Chet

Childhood Obesity: A Family Thing

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I hope you took some time to scan the Executive Summary of American Association of Pediatrics Guidelines for Physicians. If you couldn’t, here are the three things that stood out to me.

Screening by Pediatricians and Primary Care Physicians

The focus of the guidelines was to assess risk factors for degenerative disease such as heart disease and diabetes in children who exceed the 85th percentile of the normal growth charts, indicating overweight, and 95th percentile, indicating obesity. The guidelines recommend beginning at 2 years of age and continuing through 18.

Were there recommendations for the use of medications and bariatric surgery in children over 12 and 14 respectively? Yes, but they were referrals to specialists for evaluations, not a blank invitation to write prescriptions.

It Must Be a Family Thing

Without exception, the guidelines recommend intensive health behavior and lifestyle treatment. “Health behavior and lifestyle treatment is more effective with greater contact hours; the most effective treatment includes 26 or more hours of face-to-face, family-based, multicomponent treatment over a three- to twelve-month period.”

That’s not the same as giving Mom and Dad a diet for the child and sending them on their way. Family-based programs have demonstrated great success, but it has to be a family thing.

It’s All About the Money

The summary also talked about obstacles to the family-based treatment approach. The major obstacle is money:

  • Money for training pediatricians and family practice physicians on how to assess childhood obesity.
  • Money for training more people to teach and work with families—it’s labor intensive.
  • Money for public health and community programs that can support the family-based approach.

It’s a situation we’ve seen many times: Everyone knows how important preventive healthcare and early treatment is, but no one wants to pay for it. But maybe we shouldn’t always look to government to foot the bill; maybe schools, community organizations, and churches could offer programs for their members. If what we’ve always done isn’t working, let’s try something different.

The Bottom Line

The guidelines introduce a couple of new approaches for those with the most severe weight problems, but the focus is on intensive nutrition and behavior-change training for the entire family. That’s not just “Here’s a diet and exercise program, and I’ll see you next year.” The guidelines give a reasonable approach to help the future health of the nation. The approach is simple: Eat less. Eat better. Move more. What they’re saying is that healthcare professionals need training to be able to do that effectively as a team in a reasonable family-based approach. That’s the right approach as I see it.

What are you prepared to do today?

        Dr. Chet

Reference: Pediatrics e2022060641.https://doi.org/10.1542/peds.2022-060641

New Guidelines on Childhood Obesity

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If you pay attention to health news, you know the American Association of Pediatrics issued new guidelines on how to treat childhood obesity. Depending on where you read or listened to how those guidelines were presented, all you may have heard is that kids over 12 can get medications to help with weight loss and teens over 14 can have gastric by-pass surgery.

Then the experts weighed in (no pun intended). One pediatric physician predicted doctors would just pull out the prescription pad and not address the root cause of obesity. Psychological experts said this is going to cause increases in disordered eating, which includes anorexia and bulimia.

This story hits home for me because food was love in a Polish household like mine. I’ve been overweight since I was around eight years old, and it’s been a life-long struggle to get to a normal BMI. But even at my heaviest, I was nowhere near the weight many kids are today.

Is that all that was in the guidelines? You can read the summary at the link below. Then on Saturday I’ll break them down to get the bottom line.

What are you prepared to do today?

        Dr. Chet

Reference: Pediatrics e2022060641.https://doi.org/10.1542/peds.2022-06064

Aging Stressor: Excess Body Weight

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The last major stressor that comes with age is excess body weight. The first book that I ever bought in grad school was about obesity. In it, there was a chart of almost 100 health issues that were linked by research to carrying extra body fat and one that was not. In the 40 years since then, the list of negative effects of obesity has grown.

If you remember my answer to the question from last week’s Memo about what one thing would I do differently in my life, that’s the reason I chose getting to a healthier weight and staying there. Pick a body system, any system, and you’ll find the deleterious impact of excess fat on that system. Immune system? Yes. Joints? Yes. Liver? That too. Pancreas? Yes—and on and on and on. That’s why it’s important to get to a healthy weight as young as you can and stay there.

But what about now? It’s been a 50-year fight for me, and I still have not succeeded to the extent I would like. Getting to a healthy weight is not about a specific diet or foods or anything other than one thing: the quantity of food we eat.

I’m going to give you the simplest approach to losing excess body fat I can with two ways to do it.

  • Use a smaller plate when you eat meals and fill it only once. Moving from a dinner plate to a salad plate will cut off about 20 to 25% of the calories you eat. You can use the same logic with smoothies or cereal or soups. Smaller portions yield fewer calories.
  • As an alternative, reduce your caloric intake by 250 to 500 calories per day if you already track your food intake. That’s it.

Can you work on the quality of food? Sure. How about fewer carbs or less fat? If you want. What I’m saying is that to attack the excess body weight you carry, you have to attack your number of calories and eat fewer of them. Start with the sledgehammer to break down the wall. You can get to the chisel later on to fine-tune your lifestyle.

That one benefit of being overweight? It reduces the risk of osteoporosis. I don’t think that’s worth the hundreds of other risks it increases.

Aging with a Vengeance

The first Aging with a Vengeance webinar will be on Super Bowl Sunday; the topic will be increasing muscle mass. I’ll be covering a specific strength training program together with nutrition approaches including diet and supplements. The approach is based on the practical application of the most recent research. The first Memo of 2023 will give details on how to sign up for the webinar and the materials you’ll get.

Have a Very Merry Christmas from all of us at DrChet.com! Talk to you again on January 1, 2023.

What are you prepared to do today?

        Dr. Chet

Worst Stressor: Split Decision

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I intended to talk about the single most negative stressor that we face as we age, but I couldn’t pick just one. When I say stressors, I mean things we have to deal with every day, not a singular event such as an auto accident. Smoking would be the easy choice, but it doesn’t impact as many people as it used to. Here are my two choices.

Too Much Weight

Someone asked me a simple question before an Insiders Conference Call: if you could do one thing differently when you were young to improve your health, what would it be? Without hesitation my answer was I would have gotten to a normal body weight and maintained it. Being overfat impacts you as soon as you try to get out of bed: you have to overcome gravity. And it doesn’t stop there.

Every system, every organ, and every cell in your body is impacted by excess fat. Some effects are worse than others, but every cell is impacted in some way. If you can avoid gaining the weight to begin with, that’s ideal. If you’re like me and you didn’t, it’s a lifetime challenge to get to a normal weight and maintain it. I’m still working at it.

If you’re still a youngster in your 20s, 30s, or 40s, don’t postpone weight loss. Do whatever it takes to get to a normal weight (short of drug abuse or eating disorders), then develop a healthy lifestyle to keep your weight down. Even if you’re older, you can still lose weight just as my mother-in-law did in her 80s.

Chronic Pain

There are some people who don’t know what it’s like to face pain every day, but the majority of people face the daily challenge of having their lives impacted by pain as they get older. It may be joint pain in the knees. Lower back pain afflicts many. It may be nerve damage from prior accidents. But as we age, pain is the stressor that may be present all day, every day.

There is no magic wand for this stressor. For some people, if they didn’t have to think about pain, they could do so much more. Instead, it’s trying to find the right everyday changes that can make life bearable.

The Bottom Line

I think you can understand why it was a split decision. In addition, these two stressors affect each other: being overfat can make the pain worse, and having pain can prevent us from exercising to help with weight loss. It doesn’t mean there are no stressors of aging we can deal with—there definitely are. That’s what we’ll talk about in my upcoming program Aging with a Vengeance.

On next week’s Insiders Conference Call, I’ll talk more specifically about the stressors of aging and what we can do about them. Become an Insider by 8 p.m. Wednesday, December 14, and you can join the Insider call at 9 p.m.

What are you prepared to do today?

        Dr. Chet