Dr. Kevin Most: Working off those holiday calories with diet and exercise

Dr. Kevin Most

Well by now I assume that most of you are like and me and did not listen to my advice last week. I will admit that I did not exactly follow what I recommended all of you to do. If you feel a bit guilty this week, you should not, you are definitely in the majority.  Many of you probably said” I will start my diet on Monday or I start my exercise on Monday” Well its Monday, so I thought we might discuss the thoughts around diets as well as how to pick and start an exercise program. The timing of this is good as many will also make this as a New Year’s Resolution so doing a little homework up front should be helpful.

Believe it or not 50 million Americans go on diets every year. We spend $33 billion every year on weight loss products and we still have a problem with weight control in this country with 70% of us having more weight than recommended. Estimates run as high as 90% failure rates on diets that are unsustainable. We really are not that great holding on to our weight loss wins,  researchers tell us that only 16% are actually able to maintain that weight loss for over a year. Physicians will often recommend losing weight but the individual must figure out what is the best diet and exercise plan that they can continue in order to succeed.

The study of diet and its impact beyond weight is also being researched. We all know that inflammation is not good for our body, we feel it after an injury where we actually have pain from the inflammation and we take Advil to help. We know that inflammation triggers asthma so keeping down that inflammation helps us minimize those attacks. Well we are now seeing that some of the foods we eat as well as how we diet and exercise will actually cause impact the amount of inflammation in our body. Fortunately a lot of what we know is also captured in the diets listed below. We know that sugary foods and other carbs will cause inflammation in everyone. There is now work being down to see if specific foods actually impact you differently and if avoiding them will decrease your inflammatory response. We know that healthy oils will decrease inflammation, probiotics will often reduce or prevent inflammation in the intestines. Your doctor may order a test called CRP or C reactive protein which is a blood test that monitors overall inflammation in the body.

Let’s start with diets, I must say personally I am not a fan of diets, over the years we have many fad diets that have come and gotten much attention. Atkins, South Beach, Vegan, Paleo………. The list goes on. There are few “hot” diets right now so perhaps a minute or two to discuss a few of them. If forced to rank the diets that I think make the most sense and are probably the safest I would go with the following diets that have been ranked by the US News and World Report.

DASH Diet- this is a diet that many cardiologist recommend to help with blood pressure control.  It is made up of Fruits, Vegetables, whole grains, lean protein and dairy that is low fat, low sodium. The diet highlights foods to stay away from as well including fatty meats, sodas, sweet desserts and full fat dairy. It is something one would expect from a cardiologist. You will lose weight with this diet and from a heart health view it makes total sense. It is ranked high when viewed from a sustainability view. Tied in rank #1

Mediterranean Diet- This diet attempts to mimic the diet of those living in the Mediterranean countries where longevity of life is clearly noted. It is a diet that is high in fruits and vegetables. Unlike the DASH diet it is ok with fat intake as long as it is healthy fat like that found in fish, nuts and olive oil. There is a big assumption here as the reason for the diet is based on a region of the world where health and longevity are common, and heart disease is found much more rare than in the US. What it does not take into consideration is how much of that longevity is associated with genetics as well as the active lifestyle in these countries. Tied #1

MIND Diet- Now this is a diet that is a combo of DASH and Mediterrean diet. The claim here is that it is protective against Alzheimer’s disease. Now let’s be clear that the research has not been done yet to prove this claim. Overall it sounds like a reasonable diet. In this diet individuals are told to eat “Brain healthy” food groups. This includes leafy green vegetables, other veggies, nuts , berries, whole grain, fish and poultry. They are also encouraged to drink wine and use olive oil. The big thing about this diet is to avoid red meats, butter and stick margarine, fried foods, and fast food. Rank  tied for #5

Weight Watchers- this diet has been popular for many years and probably will continue to. The good thing about this diet is it requires the individual to think about what they are going to eat, how much and when. It gives the patient some flexibility on what to eat as it is focused on weight loss. For this diet it comes down to a point system. You each day get a specific number of points and during the day you note the food and volume you consume and you strive for a set goal. Foods that are healthy and high in nutrients and low in calories have fewer points than chocolate custard donuts. The program also provides instruction on cooking in a healthy way. This diet has held the test of time as it gives the ability to have some foods in moderation and yet work towards a goal. Rank #4

Keto Diet. This diet promotes weight loss thru fat burning. The goal of the diet is to quickly lose weight, feel fuller and boost your mental focus and energy. They promote that by slashing your carbs and instead replacing them with fat you enter a condition called ketosis. This forces the body to break down both dietary fat and stored fat into ketones. This forces the body to rely on fat intake and not sugar for energy. This is common to low carb diets but with Keto you have severe restrictions to carbohydrate intake.  This diet may have a place with some pediatric patients who have hard to control seizures. Neurologists have known this and may use it as part of their treatment plan for the child with hard to control seizures. It is also being studied to see if it plays a role in Parkinson’s and Alzheimer patients. Many books and blogs are written about this diet. Most recently a concern has been raised that being on this diet raises your chance of diabetes. It still remains a popular diet although it is ranked #39 in this system

TLC Diet- this is a diet that has a focus on cutting Cholesterol while eating healthy foods. It promotes veggies, fruits, whole grain breads and lean meats. It allows for great flexibility. It is rated high in heathy diet scores and rates pretty good in both short and long term weight loss. Ranked #5

Mayo Clinic Diet- This is a diet that focuses on life style as well. It focuses on 15 key habits initially and for the first 2 weeks you don’t count calories and snack on veggies and fruits. The next phase is understanding how many calories you need to either maintain or lose weight safely, and where those calories should come from. This helps set a pattern for how to eat healthy in the future. Mayo then brings in the need for exercise and builds you up to do 30 minutes of exercise a day. The other interesting thing is they teach you that you cannot eat snacks or sugar while watching TV. They teach you to minimize your or eliminate your fast food dining. They complete this by teaching you how to eat by serving size versus calorie counting. It is rated #8 and is a sustainable diet.

I hope this gives you an idea of what to look for, the most important part of a diet from a health view is the sustainability of the diet. You often hear or see individuals who jump on a diet and lose a substantial amount of weight only to not be able to sustain it and see the pounds come back from lifestyle issues. This is thought to increase your chances of diabetes and is certainly not good for your clothes budget. Slow and steady wins the race, education about dietary intake is important as is knowing your health risks and acting accordingly.

You notice Mayo was the one diet that brings activity into the picture. I am often told by friends that they are going to start running or working out to lose some weight or get in better shape. Exercise is a lot like diets, if you pick the wrong one it either does not work or is no sustainable. The individual who never enjoyed running will not all of a sudden enjoy a five mile run, never lifted weights in the past, why do you think today will be the day you will enjoy it? I make a couple of recommendations around exercising. The most important is to talk with your physician to make sure your heart, back, lungs ……. You name the body part, can tolerate the exercise you are thinking about. The individual with chronic back pain will probably not tolerate the pounding associated with running and perhaps biking would be better based on their previous or current ailments.

I strongly discourage anyone from going out and buying exercise equipment cold, meaning you walk into the store and try a few and then buy one. There are many stories of how well that equipment works holding clothes in the future. The beauty of health clubs right now is that they are trying to get members, and will often offer a trial membership. Trial memberships are great for a few reasons. They allow you to see if the location, timing, facilities and equipment are what you would need or desire. It also allows you some time to see if this would fit easily into your daily schedule and budget. It also allows you to try different equipment to see which ones you enjoy and will use.

Health clubs are great for that individual who is determined and focused to work out, and has time in their day to do it. The goal should be to have 30 minutes of good cardio work out every day. Understanding how that fits in your day easily is the biggest challenge for many who go to the health club. Driving, parking, changing, waiting for equipment, showering, dressing, driving the time starts to add up and in some cases gets to be a burden, next thing you know you are paying for a health club that you don’t use.

If you go to a club and find a piece of equipment that you like and find that using it 30-45 mins a day is enjoyable that now opens the option of purchasing that equipment for your home. If you eliminate the cost of the health club this will cover the cost of the equipment. Having it in the house is one thing, making sure it is in a place where you will use it is more important. For example, I like a specific elliptical machine, so I purchased one, I placed it in the guest bedroom ( rarely will you work out if you have house’s guests) and it is in front of the TV. Watching the news for 30 minutes while working out makes the time fly by, and showering in your own home is probably pretty easy.

For those of you who need guidance and inspiration in order to exercise, Orange theory may be for you. This is a franchise fitness center that are popping up all over the place. It is a specifically designed one hour training session that has coaches leading the sessions as you move thru strengthen cardio and stretching exercises while being monitored for your heart rate. Coaches monitor and encourage you to work harder or makes sure you are not pushing it too much. The program is designed to work and improve at your own pace. The unique thing is the classes end up being filled with individuals that you encourage and support you. If you are an individual who needs guidance and inspiration to work out this may be a good option for you.

As we get closer to the holidays the thought of a health related gift always comes to mind, we will discuss them in the upcoming week, but hopefully you listened today to make sure you don’t make the mistake of the $1200 laundry post.