Suggestions for Good Health

Blue Zones is a good place to start. However, if I were to give advice to my younger self, I’d focus on:

  • Sleep: Get a full night’s sleep and take a midday nap for a total of eight hours.
  • Food: Limit eating to four consecutive hours a day. Eat mostly plants. Drink powdered psyllium and water to stave off hunger feelings in the off hours.
  • Exercise: Walk/run for 16,000 steps a day or 8 miles, incorporating a full range of movement. Include some weight-bearing activity or physical training twice a week.
  • Social: Cultivate a social environment for flourishing among family, friends and your larger social circle. Be a positive, creative person and look for the same in others. Relentlessly prune relationships that are predominantly negative.
  • Being & Doing: Find something to do that leaves the world slightly better than you found it and promotes good sleeping, eating, exercise and social habits. The Buddhist idea of the Noble Eightfold Path is a useful model of how to be and what to do.

Visual Guide to Portion Sizes

From http://myrealfoodfamily.com

Also, the National Heart, Lung and Blood Institute has a discussion on how portion and serving sizes have changed over the years.

Diet is key. While it is possible to reduce your weight by increasing the amount of exercise you do, it often doesn’t stay off because you need to continue that exercise regime to keep it off. As the saying goes: you cannot outrun a bad diet.

Once you have your diet under control, it is also useful to consider the guidelines for physical activity that I have referenced before and perhaps done in combination with a monthly 45 minute physical fitness test.

To put it another way, if you worked your way up to doing a running 10 miles every week, did it for a year and kept your diet the same, it would burn ~700-1500 calories a week, which would result in weight loss of between 10-20 pounds a year.

How Not To Die

“The vast majority of premature deaths can be prevented through simple changes in diet and lifestyle. In How Not to Die, Dr. Michael Greger, the internationally-recognized lecturer, physician,
and founder of NutritionFacts.org, examines the fifteen top causes of
death in America—heart disease, various cancers, diabetes, Parkinson’s,
high blood pressure, and more—and explains how nutritional and lifestyle
interventions can sometimes trump prescription pills and other
pharmaceutical and surgical approaches, freeing us to live healthier
lives.”

https://nutritionfacts.org/book/

Found the app Daily Dozen on F-Droid. The list of things to eat is in line with most nutrition information you hear, but the book looks worth a look.

Do X. Evaluate. Do X Differently.

“Why don’t you just try X for 30 days and see if your life gets better?

Today, roughly two-thirds of the population will make New Year’s resolutions. The most common resolutions:

  • Eat healthier
  • Get more exercise
  • Save money
  • Take better care of ourselves
  • Read more
  • Make new friends
  • Learn a new skill / hobby

Looking at this in the context of having recently read James Clear’s Atomic Habits, he makes a really interesting point that these kinds of improvements require tackling three aspects of the problem: identity, systems and goals.

For example, instead of resolving to eat better, we might resolve to become vegetarian. This is adopting a new identity that shapes the kind of food choices we make into healthier alternatives. You could also make it smaller, and maybe adopt an identity as a “water-drinker”.

You can extend these to the other resolutions. Instead of resolving to exercise more, decide to become a runner. Instead of saving money, you could become a person that pays cash or pays your entire credit card bill every month.

Identity feeds into systems. If you are going to become vegetarian, will you eat dairy and eggs? If you will occasionally eat meat, say during Thanksgiving, how often will you need to eat a vegetarian diet to think of yourself as vegetarian? What does a healthy vegetarian diet look like?

Same goes for running. How many miles and how many days per week do you need to run to think of yourself as a runner?

These, in turn, lead to goals. If you run sporadically, then setting a consistent schedule will result in more exercise, just as consistently eating vegetarian will result in eating better.

Goals have the problem that life gets in the way, and we give up on them. If your goal is to run a marathon, you cannot continue if you get injured or develop a cold that prevents you from following a training program. If you think of yourself as a runner, being sick is only a momentary set-back. But, the minute you know you can run again, you need to start. Otherwise, you aren’t proving to yourself your identity that you are a runner.

The start of a new year is an excellent time to think through the kind of person you want to be and the identities you want to adopt. But, the beginning of the month, of the week or each new day are good times to start trying to be a different, better person too.

Don’t let the inevitable failures that life throws in the way of each of us stop you from pursuing being the kind of person you want to be. The question isn’t whether you always eat healthier, but whether, in the main, you are eating better than you were before. You need to have systems and goals in place to get feedback on your progress, and you need to build in flexibility to change course. Do, evaluate, and do it differently. The goal is to be the person you want and not the number of miles you ran in a given week, that’s just the feedback.

Obesity in America 2018: 7 charts that explain why it’s so easy to gain weight – Vox

“Sure, it’s possible to have a small, healthy meal at a restaurant. But researchers have found that people typically eat 20 to 40 percent more calories in restaurants compared with what they’d eat at home.”

—Eliza Barclay, Julia Belluz, and Javier Zarracina. “Obesity in America 2018: 7 charts that explain why it’s so easy to gain weight.” Vox. August 9, 2018.

Key take aways: eat at home, reduce portion sizes, drink water, eat a variety of foods, and reduce sugar intake.

The Fallacy of Calories In / Calories Out as a Mental Model for Weight Control

One of the common comments people make about weight control is: “It’s just calories in / calories out.” It’s true, but it’s also wrong in important ways.

For example, one of the things that we know happens once people reach their thirties is that they start to lose 3-5% of their muscle mass per decade. In medical terms, this process is called “sarcopenia with aging”, and it accelerates further when most people reach their seventies.

So, “sarcopenia with aging” is slowly reducing “calories out” for most people older than 30, and this subtly shifts the equation of “calories in / calories out” over time. It’s a force that requires that we either:

  1. Consciously change our eating habits to reduce calorie intake as we age
  2. Work to reduce sarcopenia through a program of strength training

But, doesn’t the human body’s homeostatic mechanisms guide us to reduce intake as we burn fewer calories? Yes, it does. Except we live in a cultural environment that makes every effort to disconnect eating from feelings of hunger. Make sure to eat three square meals a day is an idea that puts food consumption on a predictable schedule. From there, the concept has evolved further, where food has become primarily a recreation for many people.

Consider the ever expanding “holiday” and spectacle seasons. Is it a coincidence that the Super Bowl (or pick your holiday/spectacle of choice) party is an excuse to eat and drink in ways that make weight control difficult, if not impossible?

The same dynamic is in play with ever increasing portion sizes and richer, more calorie dense food.  Movie theaters sell large tubs of popcorn, soda and candy to justify increased prices, which offset decreased ticket sales. Whether you are talking about eating out in restaurants or convenience food, there are billions of dollars being spent delivering just one message: “Eat more.”

Why? Imagine if everyone in the United States cut their calorie intake by 100 calories a day, how many billions of dollars of revenue would that cost food companies in a year? Conversely, the opposite is also true. More calories equals more revenue.

In the context of this dynamic, the “calories in / calories out” argument is problematic. On one level, it suggests that weight is an individual problem. It is as if the billions spent on food marketing, the dearth of sound nutritional advice available to most people, the socio-economic constraints of food availability, etc. are all irrelevant. On another level, the idea of an “equation” implies that “calories out” is a viable approach to a weight problem, and it is why exercise is so often offered as a solution.

But, the treadmill, the elliptical machine, the stationary bike, the aerobics class or other cardio exercise is not how you address the problem of “sarcopenia with aging”. And cardio exercise, by itself, is not enough. There is a saying, “You cannot outrun a bad diet.” Unless you are someone like an elite endurance athlete logging +100 miles of running a week, the only way to bring weight under control is to eat less, not more. Exercise can be an important catalyst for changes, making them happen faster. But, exercise can also undermine weight control as it drives increased appetite and can make it more difficult to eat less.

We need to eat less in an environment where we are always incentivized to eat more. Saying “it’s just calories in / calories out,” is like saying, “Just eat less.” It’s correct, but it’s missing taking into account many of the factors that make that so hard.

 

2018 Experiment: Ketogenic Diet

Background: A ketogenic diet is centered on fat as the main source of calories. While approaches vary, it typically involves getting >66% of total calories from fat, a gram of protein for every kilogram of weight, and minimizing carbohydrates to the degree possible, which means absolutely less than 50 grams and ideally, less than 20 grams. There have been studies done that support this approach, and there are books and articles on the Internet that explain the ketogenic diet in great detail.

I have been following a ketogenic diet since November 1, 2017. I lost 10 pounds in two months. I plan on continuing a ketogenic diet, with some reasonable flexiblity, through 2018.

Methods: The goal is to eat 70% fat, 20% protein, and as few carbs as possible. To get this high level of fat, I put coconut oil in coffee, drink coconut milk and add olive oil to food. Protein is mostly from tofu, egg whites, some seafood, and protein powder in water. Throw in some nuts and green leafy vegetables, and you have most of your calories for the day.

When feasible, I’ll use the Fitbit site to track macronutrients like fat since they have a nice database or products where you can scan the barcode of packaged food and get nutritional information.

A common problem with the ketogenic diet is low fiber intake. I am supplementing with whole flake psyllium, avoiding products like Metamucil since they have added sugar to make it more palatable. I’ve found just gulping a lot of water along with the psyllium mixed with water works fine to get the mixture down.

I will consider the diet a success if I can get my weight down a total of thirty pounds and keep my average weight below that level for the remainder of the year.

Results: I’ll do a quarterly review of my progress.

Discussion: TBD.

Conclusions: TBD.

The Case Against Sugar

“In America today, nearly 10% of the population has diabetes; more than two-thirds of us are overweight or obese; and one out of 10 kids are thought to have nonalcoholic fatty liver disease. The journalist Gary Taubes blames all of these afflictions on one culprit: sugar.”

—Gary Taubes. Interview with Doug Fabrizio. The Case Against Sugar.” RadioWest. November 24, 2017.

Fuller treatment is available in his book, The Case Against Sugar. Add this to other classic discussions on the topic like “Sugar: The Bitter Truth.”

Also, it might be that refined sugar is the most obvious culprit and that building a diet around carbohydrates, which is a new feature that developed along with farming, might be the problem, which makes this a much bigger problem than just the “Western Diet”. See The Ketogenic Bible for a full discussion.