Dr. Mike’s Healthy Lifestyle Advice: Exercise Research
Regular exercise is synonymous with weight loss and living a healthy lifestyle; Here’s a little bit about energy expenditure.
A little bit about energy expenditure.
Our Basic Metabolic Rate (BMR) is the energy our body uses to sustain life on a daily basis; the energy necessary to sustain all biomechanical reactions and bodily systems. The BMR consumes about 60 to 70% of the total energy at a rate of 1kcal/kg/hour.
The thermal effect of our digestive process demands another 10% of that total energy. We have no control over our BMR and thermal digestive effect; however we can control the energy WE spend; it’s called activity or exercise! Exercise can demand anywhere from 10-40% of the total available energy.
Example of energy expenditure: A 75 kg person burns 100 kcal when walking 1 mile, and 1 pound of fat equals 3500 kcal. So this person would have to walk 35 miles to burn 1 pound of fat.
Research & Benefits of Regular Exercise:
Regular exercise results in a decrease in the loss of fat-free mass (muscle) associated with weight loss. Exercise also increases muscle mass and results in more effective fat oxidation (more fat is burned per unit of exercise).
A quick increase in fat metabolism is observed within 3 weeks of exercise at a frequency of 3x/week and within 10 days of 1-hour of exercise/day.
Exercise improves maintenance of weight loss; exercise helps sustain weight loss results. Exercise is more beneficial for maintenance than for initial weight loss and does not have a major impact on short-term weight loss results.
As an overweight or obese person loses weight, it takes more and more exercise just to maintain the weight loss.
As we all know, exercise also improves cardiovascular and metabolic health (independent of weight loss).
In studies, NO advantage is shown with supervised versus non-supervised activity in long-term. In other words, going to the gym and/or having a personal trainer does not benefit you; however initially it may be advised that a knowledgeable person assists you in the proper execution of your exercise program to assure optimal effectiveness and prevent injury!
Compliance is shown to be higher when exercises are performed home-based vs. group based. I assume that is true because group-based exercise interrupts people’s daily schedule (they have to be at a certain place at a certain time) and when people’s personal schedule changes (kids off school during summer, different job, spouse out of town etc.) they are inclined to “give up”.
A single bout of exercise can increase BMR by 5-15% for up to 48 hours (due to an increased systemic Nor-epinephrine). Example: if a 70kg person burns an extra 160 kcal/day, he/she loses an extra pound of fat every 20 days.
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Ideally one exercises 120 – 200 minutes/week for weight loss. In our Sensible Weight Loss program (SWL) we suggest to incorporate exercise within the first month of the program, even though we established earlier that exercise does not have much of an effect in initial weight loss. Why? The client has to learn the appropriate exercises, and gradually increase the frequency and duration BECAUSE when the client reaches his/her optimal body composition, exercise will be crucial to keep the weight off! I recommend you start with 120min/week and gradually increase to 200min/week. We will expand on the type of exercise, intensity, frequency and duration later!
Exercise decreases appetite short-term due to reduction in visceral blood flow and catecholamine elevations. Exercise does not increase food intake in long-term in normal individuals.
So, the key is to combine diet with exercise. You will lose more weight than diet alone and the body composition changes: increased fat loss, less lean muscle tissue loss and decrease in visceral fat. Exercise is key factor in maintenance of weight loss.
Conclusion so far:
Diet = key factor for initial weight loss!
Exercise = key factor for sustained weight loss!
Many dieters will “plateau” (unable to lose more weight at a certain stage within a popular weight loss program) UNTIL they increase exercise!
Yours in Optimal Health,
Dr. Mike
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Dr. Mike’s Healthy Lifestyle Advice: Exercise Plans
Exercise plans are great ways in sustaining health. Develop, personalize and customize the exercise program based on the results of the Body Composition Analysis (if available), current activity level and limitations, and the client’s medical, physical and psychological readiness.
Keep record of the exercises on an exercise log.
Initially, perform maximum 4 exercises in PRE-mode for a total of 120 minutes/week; for example: 4 times 30 minutes/week. As we gradually increase our exercise regimen to 200 minutes/week, I suggest we incorporate cardiovascular exercise. At this point, the patient or client has the energy reserves to successfully complete a cardiovascular workout without draining the body or causing injury. It will also provide some variety in the person’s exercise regimen. Make sure the client chooses an activity they like to do!
To increase compliance, we suggest performing the exercises from home unless the client prefers to join a gym and expresses that. At home, the client can fit in their short exercise session into their daily schedule, even if that schedule is prone to change all the time.
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A great example is a client of mine, he’s name is Steve. Steve came to me about 2 years ago for weight loss. He is construction worker and lives in an apartment by himself. He usually gets about around 5:30am in the morning and comes home after 6pm, exhausted. Steve eats fast food and rarely cooks a healthy meal. When he comes home, Steve often snacks in front of the TV and watches 2 to 3 hours of crime scene investigation episodes (NY, Miami, Las Vegas etc.). Steve has no time to go to a gym and cannot afford it either, but even more importantly he doesn’t want to miss his crime scenes! We HAVE TO make sure we FIT Steve’s exercise regimen into his daily schedule without interrupting that schedule in order to guarantee long-term compliance! In Steve’s case, the InBody520 results showed that his segmental muscle mass in the arms and core was above average, but his muscle mass in his leg would benefit from an increase. Steve has no exercise equipment at home, and he doesn’t want to invest in equipment anyway. We decided to prescribe Steve some simple squats from a chair. We instructed Steve to squat during every single commercial while watching the crime scenes. Yes, he was sore the first weeks because as you know…those commercials can be pretty long! Steve’s lean muscle mass in his legs improved fast and vastly and up until today, Steve is still doing his PRE exercises from home! The regimen does not interfere with his daily schedule: Steve does not feel he has to sacrifice and most of all he experiences the benefits.
Yours in Optimal Health,
Dr. Mike
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Dr. Mike’s Healthy Lifestyle Advice: Negative Effects of Exercise
The negative effects of exercise are not well known; Most physicians and health care professionals, including therapists, wrongly prescribe cardiovascular exercise to their patients/clients that are post-op, obese or are suffering from fibromyalgia…even though all literature and exercise physiology books tell them not too!
Cardiovascular exercise such as walking, jogging, bicycling, swimming etc. at a low intensity for a longer period of time is a poor choice because this type of exercise has NO bearing with activities of daily living (ADL’s). Cardiovascular exercise also demands too much energy from the client/patient. The post-op patient, fibromyalgia patient or obese client has NO energy reserves and is unable to “walk for 30 minutes” without depleting the body or without making the ‘problem’ worse or causing injury. On top of that, inflammation occurs with continuous exercise exceeding 20 minutes, caused by the constant friction between the muscles.
The type of exercise we need to prescribe is the type that most effectively increases energy production (ATP) in the tissues, thereby increasing oxygen levels and restoring full aerobic respiration of the cells. We are looking for the type of exercise that most effectively increases the number of mitochondria (oxygen factories) and nuclei in the muscles. That type of exercise is called: PRE or Progressive Resistive Exercise. Yes, this type of strengthening exercise is far more effective than cardiovascular exercise for the post-op patient or obese client! Don’t believe it? Why don’t you open that exercise physiology book again and learn that “for every increase in muscle tone there is a 40% increase in vascularization”. This means that there’s a substantial increase in the number of micro-circulation pathways and in the lumen of existing blood vessels. This vastly improves the circulation of oxygenated blood to the affected areas. In short, PRE is more effective in improving cardiovascular condition that cardiovascular exercise, there you have it!
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Emphasis has always been in developing endurance in patients, but strength must ALWAYS precede endurance. If not, what’s there to endure? A great example is the physical therapist who’s dragging a post-op patient with a cane or walker through the hallways of the hospital. What’s the point? Should we not build strength first, and then when the patient has regained the strength and is able to actually walk, build endurance? Makes sense, not?
The ‘Physiological law of Specificity of Exercise’ states that “Performance of a task only builds limited strength in that task.”
In Sports Medicine we always say: “Don’t play to get into shape, get into shape to play”. A football player does not just play football to get in shape for the new season. He does strength training, cardiovascular training, technical drills (throwing the ball, receiving the ball, tackling etc.), tactical training etc. Each facet or component of the game is trained!
Yours in Optimal Health,
Dr. Mike
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Dr. Mike’s Healthy Lifestyle Advice: Behavior Modification Weight Loss
Behaviour modification is crucial in relation to eating habits and weight loss. Habits, good or bad, are formed by repetition. Eating habits are no exception. If you are in the habit of snacking when you watch TV, you were reinforcing that habit until finally it became a part of you. Other habits are formed in the same way. Some of these habits are: eating while reading, eating when coming home from work or your office, eating while cooking dinner, etc.
We also find that a certain mood or emotion, and circumstances can cause us to eat …even if we are not hungry. For example: anxiety, anger, boredom, fatigue, happiness, loneliness, and nervousness all may trigger an eating response. The list is endless. Habits are hard to break. We must not only break old habits, but we must make our goal to form new ones in the same manner…which is through repetition. Make some daily commitments. Work to meet these commitments each day whether you feel like it or not. Your daily commitments will help you form good habits. Remember: “It is easier to act your way into a new way of feeling than it is to feel your way into a new way of acting.”
Resisting temptation is difficult. However, if you succeed in resisting the first time, it becomes easier to resist the next time. Before long, you will have formed the good habit of resisting temptation every time it confronts you.
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Because of the human weaknesses mentioned, we must use what has become known among weight control groups as behavior modification. It simply means changing your behavior. These techniques work only if you commit to them and consistently repeat them, so that they become a new habit and part of a new you.
1) Eat when you are truly hungry, don’t eat when you are not hungry. Therefore, plan your meals and have two or three planned snacks (fruit, health bar) available daily. When tempted to grab for food because you smell it or see it, just ask yourself: “Am I hungry”? If not don’t eat!
2) Prolong your meals by eating slowly. Putting down your eating utensil between each bite and not picking up your eating utensil until you have swallowed the bite; hesitating between bites, even if you’re eating finger foods.
3) Choose a specific place in your home or office to eat all of your meals. This will become your “designated eating place” and should not be changed. Try not to eat at your desk at work. This would make you prone to eat all day long (even when not hungry) and not just at meal time.
4) Do not do anything except eat when you sit down for a meal. Do not eat while you read, watch TV, talk on the phone, work, etc. Make yourself aware of the food you are eating. Focus on the conversation and enjoy your meal.
5) Do not keep food in any room in your house except the kitchen. Do not keep food such as cookies out on the counters. Do not store these items in “see-through” containers.
6) Do not buy junk food. NOBODY needs it! Replace refined snacks that lack vitamins, fiber, minerals, and phyto-chemicals with fruits and vegetables. Drink plenty of WATER to keep yourself hydrated, and remember that water fills you up and is calorie free!
7) If possible, serve individual plates from the stove and do not serve family style on the table. If you finish your plate, ask yourself if you are still hungry…if not, don’t get seconds (I know it’s difficult when the food smells good). Serve your meals on a smaller plate; you may not need that larger portion in order to feel ‘really’ full.
Develop a habit of leaving at least one bite of each item on your plate. If you can master this, it becomes easier to stop eating when you feel full. You will be used to leaving food on your plate… and that’s just fine!
Also, make sure you work on reducing stress and try to RELAX! Overeating is often caused by stress and over-scheduling. We also recommend you keep a record of your food intake and exercise.
All of the above are eating techniques that aid in behavior modification. Other behavior modification techniques not related to eating are to substitute activity for eating, which means exactly what it says– substitute another activity for between meal snacking. If you are in the habit of going straight to the kitchen and eating every time you walk in the house, try to change this habit by going to another room of the house when you come home. Delay going into the kitchen until the desire to eat is gone. When you are tempted to eat, try to use substitute activities such as walking, checking your e-mail, drinking water, playing with the kids or dog, calling a friend, writing a letter, reading a book, taking a bath, gardening, painting or any other activity or hobby.
I had a client who always was stressed at work when the boss was around (a few times per week). After their usual confrontation, my client would get up from her desk and walk over to the vending machines…she would buy a soda and a snicker…and vent! She consumed this JUNK not because she was hungry (she just had breakfast at home), but because it was her way of coping with the stresses at work (some people would go outside and smoke their cigarette). In order to change this ‘bad’ habit and form a new habit, we had to identify the problem and acknowledge that the junk food consumption was a mood-related impulse. We decided to substitute the walk to the vending machine with a walk around the office building; when my client would go to the vending machine and stood in front of it, she would have to ask herself: “Am I REALLY hungry or do I just want something to deal with the stress?”. If she wasn’t hungry, she should save her money! Also, we decided that my client had to bring some bottled water to work, and drink it whenever stressed and unable to go for a walk. Water fills you up, detoxifies the body and has no calories! My client has had no soda or snicker bar for over 6 months now, and saved lots of money too!
Yours in Optimal Health,
Dr. Mike
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Dr. Mike’s Healthy Lifestyle Advice: Progressive Resistive Exercise
Progressive Resistive Exercise or PRE builds the largest number of mitochondria (energy production in your oxygen factories) and nuclei as a normal response to work.
PRE is a type of strengthening exercises with emphasis on strengthening muscles in shorts sets (anywhere from 7 to 10 repetitions per set) with a high intensity (70% of 1RM) and large rest segments in between sets (2 to 5 minutes) to avoid draining the client’s energy reserves. The total duration is short to avoid inflammation.
In more depth:
The resistance or weight we use is pretty heavy, about 70% of 1RM. 1RM is the weight with which the client or patient can execute 1 complete repetition, but is unable to complete the second one. Practically, we will use our body weight and if necessary add some extra weight (dumbbells or a gallon of water etc.). In short, the client or patient should be able to complete 7 to 10 repetitions, but not much more. If it’s too easy to complete 12 repetitions or more, the weight or resistance needs to be increased. As muscles become stronger, resistance is gradually increased.
I recommend 3 sets for each of the 4 exercises. Each set contains 7 to 10 repetitions. Start with 7 and gradually increase to 10 repetitions. If 10 repetitions become easy, increase the resistance. Make sure that the patient or client takes 2 to 5 minutes of rest in between EACH set. Deep inhalation during the rest segments is recommended.
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I suggest to incorporate 3 sessions per week initially, totaling about 120 minutes.
Now, what actual exercises do I suggest? The idea is to keep the total duration short while strengthening a maximal amount of muscles. So I personally looked into the exercises our astronauts perform while in space. NASA recognized that 70% of all leg and pelvic muscles PUSH, while 70% of all arm and torso muscles PULL, and came up with the following exercises for the astronauts:
Leg presses (such as a squat) address most of the muscles in the legs and pelvis, including gluteus, hip flexors, abductors and adductors, quadriceps, hamstrings, calf muscles etc.
Pull-downs (or lat-pull) address most of the muscles in the arms, shoulder girdle and torso, including wrist flexors and extensors, biceps, triceps, latissimus dorsi, pectoral muscles, deltoid, trapezius, rhomboids etc.
Back extensions address the paraspinal muscles of the upper, mid and lower back.
Crunches address the abdominal muscles.
These 4 exercises address most muscles and muscle groups in the body and are highly effective.
Yours in Optimal Health,
Dr. Mike
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Dr. Mike’s Nutritional Health Advice: Popular Diets
Popular diets nowadays are not very hard to come by, but the USDA only approves particular one’s for both their success rates as well as health benefits both short and long term.
In 2004, the Feinberg School of Medicine at Northwestern University, conducted an evidence based evaluation of the most popular diets and weight loss programs on the market. Their quest was to find out the ‘magic bullet’ for successful weight loss.
Here’s the evaluation:
Calories:
A total caloric intake averaging 1400-1500 calories daily results in weight loss, regardless the macronutrient composition. Physical activity can enhance weight loss, but when on low-calorie without exercise, weight loss is still achieved.
Dieters who adhered to low-fat, high carbohydrate diets rich in fruit, vegetables and grains consumed less calories than those on other types of diets. This reinforces again that there is an inverse relationship between carbohydrate intake and body weight and that the statement “carbohydrates are fattening” is a myth!
Moderate-fat weight loss diets also result in loss of body weight and body fat even when food is consumed ad libidum. The mean caloric intake of individuals following general diets (USDA food group pyramid with a diet composition of 55% carbohydrates, 25% fat and 20% protein) is 1895 daily; and the mean caloric intake of those on a high-fat, low carbohydrate regimen is 2166 calories daily.
This makes absolute sense when we know that 1 gram of protein or carbohydrate gives us 4 calories, while 1 gram of fat consumption results in 9 calories.
|
Type of diet |
Total calories |
Fat grams (% calories) |
Carbohydrate grams (% of calories) |
Protein grams (% calories) |
|
S.A.D. Typical American Diet |
2200 |
85 (35%) |
275 (50%) |
82.5 (15%) |
|
High fat, low carb (Atkins, Zone Diet, Sugar Busters, Protein Power) |
1414 |
96 (60%)
Fat level range 35-60% |
35 (10%) |
105 (30%) |
|
Moderate fat diet (USDA food pyramid, DASH diet, ADA, Weight Watchers, Jenny Craig) |
1450 |
40 (25%)
Fat level range 21-34% |
218 (60%) |
54 (15%) |
|
Low- and very low fat diet (volumetrics, Dean Ornish’s, Eet more – weigh less, New Pritkin program) |
1450 |
20 (13%)
Fat level range 10-20% |
235-271 (70%) |
54-72 (17%) |
In the table above we can see that no matter what diet is prescribed, the average total caloric intake (1400-1450) is far less than the total calories consumed during the typical American diet (2200), and therefore people will lose weight on these diets. However, we already established that the results will only be short-term!
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We can conclude that it’s therefore MUCH HEALTHIER to take part in a balanced diet that does not promote one food or food group and restricts another one. These diets do NOT results is better weight loss results, but can be health hazards!
Nutrition Adequacy:
High fat, low carbohydrate diets cause deficiencies in vitamins A, B6, D, E, thiamin, folate, calcium, magnesium, iron, potassium, and dietary fiber. WOW, NO GOOD!
Moderate fat, low carbohydrate diets, which usually follow the USDA food pyramid guidelines, promote a balance of the 6 food groups: grains, fruits, vegetables, meats, dairy and fats/sugars. If 1 or more food groups are eliminated, inadequate intake of nutrients occurs. Even though I don’t fully agree with the USDA’s pyramid model (especially the dairy part), it’s a balanced approach which does not cause any health hazards.
Low fat, high carbohydrate regimens cause deficiencies in vitamin E, B12 and zinc. Individuals following these diets need to fortify with supplements also.
Weight reducing diet & body composition:
Weight loss can indicate loss of body weight, body fat or lean muscle mass, or a combination. A total daily calorie restriction (approximately 1500 calories daily) sustained over a longer period of time promotes loss of body fat, regardless the macronutrient composition of the diet. Physical activity is recommended because it facilitates loss of body fat by increasing energy expenditure, increasing lean muscle mass and increasing metabolism.
Physiological changes during weight loss:
Weight loss is directly correlated with a decrease in total blood cholesterol, LDL-cholesterol 9especially with low-saturated fat intake), and plasma triglycerides. Caloric restriction improves glycemic control by lowering blood sugar levels and insulin levels regardless the macronutrient content of the diet. Weight loss also decreases blood pressure.
Hunger, satiety and adherence to diets:
Long-term weight loss is regulated as follows:
- Insulin stimulates the uptake of glucose and proteins into the cells and possibly increases appetite.
- Leptin is a hormone released from fat cells. It increases our metabolism and assists in suppressing appetite.
- The secretion of insulin and leptin is influenced by macronutrient composition, but the mechanism is unclear.
- During weight loss, blood insulin and leptin levels drop.
Fat restricted diets (with low-caloric intake of course) offer satiety due to the high-fiber, high water content of low-fat foods which give the enhanced feeling of fullness. Low-fat regimens develop an aversion to fatty foods over time, contributing to the long-term success. High dietary fiber intake lowers insulin levels and is correlated with long-term maintenance of weight loss.
Neuro-chemical factors, gastric signals, emotional factors, individual taste preference and other contributing factors account for differences in appetite, food intake and body weight.
Yours in Optimal Health,
Dr. Mike.
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Dr. Mike’s Wellness Advice: Successful Weight Loss Program
Successful weight loss programs are at times difficult to come by, specifically sensible weight loss programs; I have come up with a specialized successful and sensible weight 7-step weight loss program that anyone can follow:
1. A correct ASSESSMENT.
2. OBEJECTIVITY.
3. CUSTOMIZED – Individualized approach.
4. Balanced and HEALTHY nutrition program.
5. Includes LIFESTYLE changes – Behavior modification.
6. SUPPORT system.
7. COMPLIANCE system – Facilitators.
We will expand on these 7 keys below:
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Key 1 - Making a correct assessment.
What caused the obesity? Why are you overweight? It’s important to get an answer to that question and identify the causative factor or factors. When we know what caused the weight gain, we can not only address these causes but also make sure we control them while trying to maintain a healthy weight.
First question we need to ask is WHEN the weight gain started?
- Post-partum (during pregnancy and after delivery of baby), during pre-menopausal period or menopause?
- As a result of a metabolic disease or chronic condition such as diabetes, arthritis, fibromyalgia which all can affect your ambulatory status or activity level?
- As a result of a trauma: a physical trauma such as a car accident, or an emotional trauma such as the loss of a spouse or family member. These traumas cause significant amounts of stress which in turn slow down metabolism. Also, many people with a lot of stress cope by eating more and find comfort in foods.
Next, what does the current diet consist of? How much do you currently consume? This is called the ‘current diet assessment’. What are your current eating habits? What is your current diet composition? Are you on the “Standard American diet” (SAD)? How much fast food do you consume? What macro – and micronutrients are you lacking? Do you use supplementation? In what circumstances do you grab for food? Are there any important environmental factors?
We also need to inquire about one’s current physical activity level or exercise regimen.
We need to look at one’s medical history and family history, and discuss previous attempts to lose weight. What diets and weight loss programs have you tried? What were the results? What was your experience? Why did you quit?
When we suspect hormonal imbalances (weight gain started during menopause or after a hysterectomy for example), we need to prescribe for a complete hormone panel and also screen for cancer (we don’t want to administer hormones when there’s a cancer present). Even a great weight loss program will produce limited results if one’s hormones are out of balance. The test results will indicate deficiencies and/or excesses of specific hormones, and with the prescription of bio-identical hormones we can safely replace these ‘missing’ hormones and re-establish a healthy hormonal balance.
Key 2 – Objectivity.
With most popular diets and weight loss programs, the scale indicates whether you lost weight or not. However, the scale does NOT indicate WHAT was lost: body fat, lean muscle mass or water? Therefore, the scale is really not an objective way of measuring the effectiveness of a weight loss program. People on a diet or weight loss program usually need to lose excess body fat and maybe even gain some muscle mass, but certainly can’t afford to lose valuable muscle tissue or water! There is NO way to really measure ‘true’ progress with a scale and evaluate the effectiveness of the program.
What we need is measure our body composition with a body composition analyzer, such as the InBody520. This accurate piece equipment measures your percentage of body fat, water balance and segmental lean muscle mass. Now, we will be able to set specific goals (eg. Lose 40 pounds of fat and gain 10 pounds of lean muscle mass), monitor progress and revise the plan of action if indicated. With the results of the body composition analysis we also will be able to design a personal exercise regimen based on the segmental muscle mass measurements.
Does this make sense? We just want to make sure you are losing fat, not muscle or water AND with a body composition analysis we can accurately monitor this! That’s what I call OBJECTIVITY. It also motivates the participants when they see objective progress is being made.
Key 3: CUSTOMIZED – Individualized approach.
We need to get away from these “One-Size-Fits-All’ approaches and customize the client’s weight loss program, including nutrition, exercise, and lifestyle changes.
Besides basing your weight loss program on the results of a complete body composition analysis, we also recommend blood chemistry labs, including cholesterol levels, lipid profile, CBC, and fasting glucose. And, if indicated, we also prescribe a complete hormone panel. We also recommend the ELISA/ACT test which reveals the food items we should eliminate from our diet. Each individual’s nutrition program will be designed based on the results of all these tests! A customized approach will be far more effective and promotes better and lasting results.
Blood Chemistry – ELISA/ACT Test.
One of the major advancements in medicine in recent years has been our expanded understanding of the immune system and its far broader and more important role in general health and wellness. Initially, it was thought that our immune system was only involved in defending our bodies
Key 4 – A balanced & healthy nutrition program.
We also have to make sure that this customized diet or nutrition program is balanced and healthy, and provides the body with all the essential nutrients it needs on a daily basis! Through nutrition and supplementation, we will try to RESTORE normal health and balance in the body, including pH levels and metabolism. An acidic pH slows down metabolism, and by introducing more alkaline foods into someone’s diet or nutrition program, we will help speed up metabolism and restore normal functioning of the body, therefore assisting in effective weight loss. We also will discuss detoxification practices and compare the most popular supplements on the market. The nutrition program of our SENSIBLE weight loss program is easy to follow, does NOT dictate participants WHAT to eat which increases compliance, and makes sure the participant is NOT starving or has to sacrifice all the time!
Key 5 – Lifestyle changes.
A diet or weight loss program that does not address lifestyle changes will ONLY produce short-term results. It’s absolutely necessary to address eating habits, emotional eating, and portion size and break some bad habits while re-learning new ones. We will provide what we call “behavior modification” techniques to assist you in making these crucial lifestyle changes.
Key 6 – Support system.
It’s hard to do things by yourself, especially when we want you to make some lifestyle changes. General website support, phone support or online support, chat rooms etc. may be of valuable assistance. However, physician support is even better. He or she understands your personal medical conditions and history, and can communicate with you on a personal level, monitor your progress and modify your plan of action if indicated; and most importantly physician supervision makes your weight loss experience SAFE! If you don’t have a personal doctor or health care professional available to assist you in weight loss, find some outside support (online, weekly conference calls with Q&A, a knowledgeable physician that can assist you personally through email or by phone etc.).
A great tip is that when you decide to enroll in a SENSIBLE weight loss program, try to involve all the members of your household; or find a friend to do it with you! How difficult would it be to try and eat healthier and lose some weight while everyone else at home continues to eat fast food and CRAP all the time? It would benefit everyone you love to participate so you can support each other, and end-up a healthier and happier family!
Key 7 – Compliance.
Compliance is one of the major reasons why people quit diets and weight loss programs. They are too difficult to follow, you feel like you are starving and/or you have to sacrifice too much…you try, but it won’t last and eventually you will quit. Overcoming compliance issues is therefore of utmost importance in establishing a successful weight loss program! Our SENSIBLE weight loss program is designed specifically to increase compliance and make it easier for the participant to follow.
The prescribed nutrition program is simple, yet very effective and ONLY incorporates foods that are palatable to the individual’s taste.
The personal exercise regimen is short, simple and effective and conveniently can fit in everyone’s daily schedule without interrupting that schedule.
Because the nutrition plan is balanced and healthy, participants do NOT encounter the well-known “plateau”. For those who may not know what a “plateau” is….it means that suddenly stop losing weight on a particular diet after you lost some. This usually discourages the participant and he/she quits. The reason why people on most popular diets and weight loss programs hit the plateau is because the diet is unbalanced and tricks the body in losing weight. The body will eventually try and protect itself from health hazards, or is unable to retrieve the necessary energy from its own resources such as muscle tissue.
Personal support and guidance, with the ability to customize, monitor progress and modify the plan of action increases compliance.
Long-term results are maintained by simple continuing to implement the nutrition program, new habits, and exercise regimen. It’s a lifestyle change and it has become part of you. You feel great, you have obtained an optimal body composition, a metabolic and hormonal balance, and you are taking the road to optimal health. Nothing will stop you!
|
Popular diets & weight loss programs |
SENSIBLE Weight Loss |
| One-Size-Fits-ALL | Individualized |
| General guidelines | Physician supervision |
| No medical history | Medical history |
| Un-healthy | Healthy |
| Subjective | Objective |
| Subjective progress | Monitor progress |
| General support (if any) | Individual support |
| Plateau | No plateau |
| Poor compliance | Excellent compliance |
| Short-term results | Long-term results |
Yours in Optimal Health,
Dr. Mike
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Besides basing your weight loss program on the results of a complete body composition analysis, we also recommend blood chemistry labs, including cholesterol levels, lipid profile, CBC, and fasting glucose. And, if indicated, we also prescribe a complete hormone panel. We also recommend the ELISA/ACT test which reveals the food items we should eliminate from our diet. Each individual’s nutrition program will be designed based on the results of all these tests! A customized approach will be far more effective and promotes better and lasting results.
<strong>Blood Chemistry – ELISA/ACT Test.</strong>
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One of the major advancements in medicine in recent years has been our expanded understanding of the immune system and its far broader and more important role in general health and wellness. Initially, it was thought that our immune system was only involved in defending our bodies
Dr. Mike’s Wellness Advice: Healthy Dieting
Healthy dieting is something that some people overlook when they want to lose weight fast. However if the dieting and weight loss isn’t sensible, the long term effects can be detrimental to your overall health.
Weight Watchers:
Established in 1960’s, Weight Watchers promotes weight loss of 5 to 10% of one’s body weight. Their strictly dictated meals are based on points. Exercise allows for more point consumption, and the latest program has a zero-point food list. Weight Watchers conducts weekly support meetings and has online support.
The ADVANTAGES are that it’s the #1 rated weight loss program by Consumer Reports. It educates the participants on food and has been proven more successful than do-it-yourself plans in the long-term. Peer-pressure seems to work. It’s a better choice than most other diets that lack balance in their nutritional recommendations.
The DISADVANTAGES are that some people are embarrassed during the public weight measurements and meetings; that the program is rather expensive; and that Weight Watchers has NOT been proven better than any other diets or programs.
South Beach Diet:
Developed by a cardiologist in Miami, this diet puts emphasis on a low-carbohydrate phase followed by increasing amounts of low glycemic carbohydrates. The diet also restricts high glycemic foods and foods high in saturated and hydrogenated fats.
The ADVANTAGES are that the South Beach diet allows for healthy fats and carbohydrates, reduces insulin, improves lipids and lowers appetite.
The DISADVANTAGE is that it is based on glycemic index (GI), which is not approved by the ADA. Read more about GI on pages xxxx in this book.
Nutrisystem:
Toxic, nutrient depleted meals are mailed to your doorstep. The system works with ‘military rations” of 1200-1500 calories/day, and is based on low GI-foods with a total intake of 55% carbohydrates, 25% protein and 20% fat. The cost is about $280/month and they offer some phone support. BAD, BAD, BAD!
High Fiber diets:
High fiber diets include soluble (fruit, beans, oats) and insoluble (vegetables, grains) fibers, with a recommended daily dose of 25-40 grams (the average person consumes about 10 grams per day).
The ADVANTAGES are reduced appetite, reduced GI-problems, improved lipid profile (protects against heart disease), and reduced risk for most cancers.
The DISADVANTAGES are a reduced absorption of minerals and the fact that many people are allergic to wheat products.
Meal Replacements:
Usually meal replacements are high protein shakes or snacks that replace a meal. In general, there’s an improved compliance versus diets alone because participants feel like they have to sacrifice less: “fast food that’s good for you”, and also feel a greater satisfaction.
Studies show greater weight loss (25-60%) at 3 months and 1 year compared to regular diets. I personally think that it’s a GREAT STRATEGY to implement a GOOD meal replacement in a weight loss program.
Ornish diet:
This is a vegetarian diet that gets 10% of the calories from fat. It allows NO cooking oils, nuts or advocados, and excludes fish. There are NO calorie restrictions.
The ADVANTAGES are improvements in blood pressure and lipid profiles. The diet also reverses angina and artherosclerosis.
The DISADVANTAGES are that the diet is very difficult to follow, and that there’s a potential for deficiency of essential fatty acids.
The Ornish diet is a prevention diet for people at risk for heart disease, and a reversal diet for people with a known heart disease.
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Fasting:
Fasting for up to 3 days is not harmful for healthy individuals, but also NOT very effective. Make sure to take in enough water when fasting! Glycogen stores deplete within 24 hours so that the burning of fat and muscle tissue follows. Ketosis puts a strain on the kidneys.
Fasting is considered too stressful and hart to do. It’s advocated as a cleansing of the body rather than an actual weight loss method. Therefore, it could be used as part of a weight loss program.
Some final considerations:
The average protein consumption should be 15% of the caloric intake. This is the absolute minimum when on a diet! So make sure you consume at least 1 to 1.5 grams of high-quality protein per kilogram of body weight when on a low calorie diet (LCD).
When consuming less than 50-100 grams of carbohydrates per day, the body becomes ketogenic. This leads to excessive protein breakdown and dehydration. Note that for every 1 gram of glycogen or protein broken down, 3 grams of water is released!
Yours in Optimal Health,
Dr. Mike
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Dr. Mike’s Wellness Advice: American Cancer Institute
The American Cancer Institute’s quest was to find out whether the advice given by popular diets and weight loss programs – about nutrition and weight loss – is based on scientific science. The Institute also wanted to evaluate the potential effectiveness and possible health risks associated with these diets. The Institute evaluated 4 books:
1. Dr. Atkins New Diet Revolution by Dr. Robert Atkins.
2. The New Beverly Hills Diet by Judy mazel 7 Michael Wyatt.
3. Protein Power by Michael Eades, MD.
4. Get Skinny On Fabulous Food by Suzanne Somers
The American Cancer Institute concluded that ALL 4 plans are essentially low calorie diets, even though they were NOT advertised as such. Each one encourages the dieter to each as much as he/she wants of a particular food while still prescribing a daily caloric intake well below average requirements. All the diets also recommended omitting certain foods or even entire food groups resulting in major nutrient deficiencies. Dr. Atkins recommends supplementing his diet and conveniently offers his own line of products.
The diets lack a balance of protein, carbohydrates and fat; and prescribe a daily intake high in protein and low in fat and carbohydrates. This is a far cry from the recommendations by AICR, AHA, ADA, USDA and the Surgeon General.
Unbalanced diets also can lead to ketosis. Maintaining these diets causes a fasting state of the body, and the body starts metabolizing muscle tissue, NOT FAT! Symptoms include muscle breakdown, nausea, dehydration, headaches, light-headedness, irritability, bad breath and kidney problems. Long-term adherence to these diets can be fatal to the fetus of pregnant women and individuals with diabetes.
All 4 diets promote loss of water weight. The diuretic effect of high protein, high fat, low carbohydrate diets give a false sense of accomplishment. The water weight also returns quickly.
The American Cancer Institute also pointed out some significant other health risks while on these diets:
1. Long-term restriction of carbohydrates leads to lack of fiber causing constipation and GI-problems.
2. High amounts of cholesterol and saturated fat increase the risk of heart disease and some cancers.
3. High risk of osteoporosis because the excess protein leaches calcium from the bones.
4. Increased risk of Gout because of the increased intake of foods rich in purines (meat, poultry, nuts, seeds, eggs, seafood) cause an increase in uric acid levels in the body.
5. Uric acid and calcium oxalate stones formed by high protein diets can cause kidney stones.
6. High protein diets cause a significant loss of fluids and electrolytes, which may cause a rapid drop in blood pressure and fainting.
7. Bad breath can also occur as a result of an incomplete breakdown of fatty acids, also called “keto-breath”.
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Conclusions by the American Cancer Institute:
The Atkins diet follows NO logic. Other cultures follow high-carbohydrate, low-fat diets. The diet is also UN-safe and most of the weight loss is due to its diuretic effect. The diet also has POOR real-world results in keeping the weight off!
Food-combining is a baseless idea. Food combining is eating specific foods in a specific order and at specific times. This “magical thinking” has no nutritional basis!
Popular notions are based on studying the chemistry of foods, and wrongly assume that sugary foods (candy, ice cream) that are composed of simple carbohydrates are absorbed immediately while starchier foods (bread, potatoes) provide long-term energy. We already established earlier that the exact opposite holds true.
All the above are some important subtleties and contradictions ignored by authors of popular diets.
Yours in Optimal Health,
Dr. Mike
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