Sunday, June 10, 2018

Bye Bye Perfect Health, Hello Many Insights: A Deep Dive

So the reason I keep this journal is to record my insights into my own personal health. So today is a big one. I think I've made some big personal discoveries. But to fully realize what they are, I've had to do a lot of thinking about my life, what has worked, what hasn't, and why. I also put real weight numbers in here for the first time. Frankly, the person I feared giving me shit on this score has passed away (very regrettably - I'd rather he be alive to make fun of me!), so no reason to hide those numbers now.

When I was 17 years old, I saw a reflection of myself on a mirror that was at an angle, shattering that "fat guy looks OK" image I was used to seeing. Sort of like seeing a picture of yourself that wasn't taken by somebody who knew how to make you look "good."

I was inspired, and drove up to my Dad's office to use one of the computers up there (we had internet at home, but felt like being in solitude). This was early 1998, so logging into mayoclinic.com and looking at weight loss information was going to give you the standard low fat dogma of the time.

From this, I devised a formula: anything that had more than ten grams of fat per serving, I wouldn't eat. Also, I would not eat any fast food. I would also exercise aerobically an hour a day. For this purpose, I dragged the unused "airdyne" exercise bike into my bedroom.

This worked, worked well and worked fast. By the end of that school year I had probably lost something like thirty pounds, and I was doing better than I ever had (trust me: if you grow up fat, you try, and try, and try, AND TRY).

This success continued into the summer. By the time the new school year started, folks were genuinely astonished at my appearance. The weight loss slowed but continued, bottoming out sometime that next summer, in 1999. I entered my college career at the lowest weight I've ever been as an adult. This was good timing, since I could start this crucial chapter of my life with maximum confidence. My all time low for my *entire life* was 205ish, achieved sometime in the summer of 1999, I think. I'm 6'1", so this is still a far cry from that "Doctor's Chart" weight, but we all know that is malarkey. Pictures of me from this time show a kid that actually looked, well, lanky. Legit skinny.

It was inevitable that I would regain some. I probably gained about 10-15 lbs of the 80 lbs lost during my freshman year, but this didn't make a huge difference in my physical appearance (as can be seen from photos of my sophomore year). By the time I graduated college, I gained another 5 lbs or so, sometimes fluctuating a bit. I would exercise a ton and try to revert back to the ol' diet, at least I *thought* I did (more on this later), and usually with a lot of effort that weight would come off.  When I was lax, I'd be something like 240. I would diet and exercise (in the summer, my friends and I would go to a local field by our college and play baseball for four hours- but "baseball" meant one person hitting, one fielding, one pitching- this was enormously exhausting but great fun, and the lbs came off fairly easy from this. Like so many of my methods as a youth, this required not having a job to work).

When I was 23, I hit the upper 220s again after a summer of this, and probably in less than a year was back at 240. The next summer, I once again shed some weight with the above method, and attended graduate school in Detroit.

To not make this a super huge novel, I stayed in this "240 sometimes dipping 20 lbs below" stage from about 2002-2006. If you believe in set point theory, that was my set point during this time, clearly.

Getting married was when that set point shot way up and is more or less where I've been at since, 270-280. No, my wife isn't to blame here. It's just a confluence of multiple factors:

1. Activity level became zero - while I couldn't make being a performing musician remunerative, I was as physically active. Carrying amps up and down stairs, standing up and playing guitar for 3-4 hours at a time, even just practicing guitar for 3-4 hours a day all use energy. I'm not sure what it amounted to, but I could imagine this would increase my daily energy use by a minimum of 100-200 calories, with gigging days having the same energy expenditure as an intense one hour workout, spread out over 4-5 hours.

2. My eating discipline eroded throughout my 20s into basically the good ol' SAD. Looking back, it's funny how it starts small: let's start eating Taco Bell, because I can get the chicken soft tacos, they're LOW FAT! Sometime during my 24th year on the planet I made a great, but also disastrous, decision. This is common in dieting. You can be half right with something, but being half right is sometimes worse than ignorance. In this case, it was counting calories. Logging food intake is awesome. I absolutely recommend it. You can gain TREMENDOUS insights, some of which I'll hint at here. But if you do it merely on the thought that you can "eat whatever you want, just budget for it," you are insane. It does not work like that, at least not for me. A calorie is not just a calorie, even though it is, got that? (Sigh).

3. Every technique I had developed to push my weight back when it poked into the 245ish territory (usually my "panic mode diet diet diet" weight) became impractical in the context of adult life. Playing baseball for four hours with your buddies on a random day? Nope. Keeping my fridge mostly empty so I wasn't tempted to overate at home? Not possible when you have to keep a kitchen stocked for a family. Low impact aerobics that you do for two+ hours at night while watching movies/playing video games? No time for that either).

4. Learning the wrong lessons from the highschool diet success and subsequent failures of my 20s. I thought I had eaten a crappy but effective low fat diet, the type made fun of on Atkins/Keto boards, and my body's "insulin resistance" was to blame for failures down the road. I believe now I was wrong to thing this. I was never really going back to what I did in highschool because I kind of forgot what it was that I was really doing (because I didn't know it even then). Ah, now we get to the, um, "meat" of this post.

This year I have lost a measly 5lbs from my new "scary weight," with some inches. The attempts are as follows:

January - February: Keto. This gave me panic attacks and anxiety symptoms similar to fasting for longer than 1.5 days. A non-starter, that had mild success.

March-April - Perfect Health Diet. A great diet! Very smart. Problem is... it isn't a weight loss diet. It's a health restoration diet for malnourished people who have chronic problems. I think the science behind the diet is sound. It just made me eat more. And it's insanely complicated and difficult to follow on a day to day basis. Didn't work. Lost no weight, did feel better, cheated often due to the difficulty of maintaining it.

May - Intermittent  Fasting. Sorta worked. Definitely saw a decrease of calories per month than previous months (this is where tracking is useful- seeing long term trends that inform decisions), but not enough to move the needle much. I did, however, increase my exercise quite a bit, focusing on trading off on time consuming aerobic (walking ) for HIIT (usually sprinting). I started getting much better at making my exercise goal based- a huge help. I try to beat my (pathetic) 5k times. I challenge myself to set personal bests in pushups (25 as of this writing- not terrible for a 37 year old). My relationship to exercise feels as good as it ever has in my life, which is great! But...

You have have your calories be low enough for weight to come off or it won't happen, period. This led me to set a goal is a calorie average of 1900 calories for June (this goal is based on the realistic notion that I'll fall off the wagon sometimes). One of the big huge problems that has caused me to get fatter is how hilariously over estimating some online sources are for daily intake. My loseit! app says I should eat 2300 cals to lose two pounds per week.

No. Just. No.

This isn't because some magical metabolic issue. It's just that the formula they use is bad. There are several formulas that estimate metabolism. I've found others that put my *maintenance* calorie levels at 2380 or so, which based on my results, makes perfect sense.

So for me, 1700 cals is the number to be at, day in, day out- which also for me, means that I should really set the goal at 1500 (because you WILL go over a little bit). This is a very low amount of calories, and I'm a 6'1" man. Imagine if you are a woman or a lot shorter. Yikes.

So I've been thinking a lot on how to do this, and squaring it with my success as a teen. Here is my current thinking, with the caveat that I'm a fat piece of lard-ass, so obviously you should not take my advice.

I believe that each popular diet has a key bit of wisdom that is correct, but can lead to ruin in isolation. I've suddenly realized that for myself, the most optimal way to eat for weight loss is a combination of all of these things, and when those things are combined... it looks an awful lot like what I was doing as a kid, with just a few key insights I did not have then. Let's look at the popular diets:

1. Keto - What they get right (WTGR) - Carbs, particularly processed carbs, are non-satiating empty calories  that are going to get in the way of weight loss. Fat is not the enemy and shouldn't be feared... per se. What they get wrong (WTGW) - In versions of Keto in which fat is emphasized like a fetish, you are just going to eat too dang much. Fat is not satiating at all, and fat combined with any sort of sweetener, even pixie dust versions like Stevia et al is going to trigger overeating. Also, I don't believe all carbs are bad- potatoes seem like a healthy food. The Japanese eat rice as a daily staple and manage to outlive us while smoking like chimneys and having vending machines that dispense whiskey (Japan is so great, y'all).

2. Traditional Low Fat - WTGR - Fat is super energy dense and eating less of it probably means you eat less. It also biases you, POTENTIALLY, for higher protein which I think is good for most people. WTGW - Unfortunately, if you have a sweet tooth, this diet is ruinous because you'll just replace the fat calories with sugar ones. I have never had a huge sweet tooth, which explains in part why this worked will for me when I was 17.

3. Food Reward Theory - WTGR - Oh yes, it is so true that processed foods are designed to be SUPER TASTY and this makes you eat MUCH more. This is a no-brainer to me. This is why foods that you have to use the stove to make are harder to overeat on, especially if it isn't one of those "meal in a bag" things. WTGW - You can't just drink plain sugar water all the time, or only potatoes, for a long term solution. Those are hacks that work for a few weeks, but the fact is we were designed to eat a variety of tasty food because in nature that is how you get a variety of nutrients. To me, FRT is more of a reminder or "trick" to be aware of than a WOE.

4. Atkins - OG Low Carb, and its variants - You know, good ol' Bob had a lot right from the git, as it turns out. Did you know he prohibited you to four slices of cheese, no nuts, and only a few spoonfuls of cream per day? Yep. The OG Atkins diet was not awash in fat as many think. Turns out lean protein and veggies were pretty preferential. WTGR - Like Keto, lowering carbs is a great idea for most. Is super smart about fat, contrary to reputation. WTGW - I think the OG diet is very sound- I also think for some people, possibly myself, going very low in carbs causes some side effects that aren't so hot.

5. Fasting - All variations. WTGR - It is totally helpful to go long stretches of the day without eating. For me, like most I'd wager, the simple problem is- "I get hungry when I'm not supposed to, so I eat when I'm past my calorie goals." I mean, that's the name of game, isn't it? So if you are able to, um, swallow a bunch of hours per day without eating at all, you have less window to overeat. WTGW - I think it's a horrible non-starter when you start getting into long term fasting. 14 hours? Sure. A day? Yep, good. Beyond two days, I'm not sure this is going to work for most people. The fact is, one of the leading advocates of long term fasting has supposedly done multiple 20-30 day fasts in the past few years, and this person is very obese and has only gotten worse.

Alright, I'm sure there are other diets, but that covers the bases for me. So for myself, and I emphasize, FOR ME, what seems to be the key takeaways from all of these?

A. Control the fat. You'll end up eating less AS LONG AS YOU DO NOT OVEREAT ON CARBS.

B. Control the carbs. You can eat more carbs than fat I think, since carbs aren't as dense, but carbs, especially sweet carbs, are going to be your ruin. For myself, however, this doesn't mean no rice or no carbs anything. I know I'm doing well if I'm under 200, especially under 150 grams on a given day.

C. Eat some protein. This runs counter to some forms of Keto that seems to think protein is bad. This is nuts. Look at the diets bariatric doctors prescribe to patients to get them lean enough to operate on. These are high lean protein diets. Hmmm. Let's call Columbo!

D. Fast some. Trying to eat a little throughout the day doesn't seem to work for me, although I suppose it has been so long since I've tried the old school "eat 5 times through the day" advice, I could try it as an experiment. I have my doubts though. So for now, fasting is going to be a cardinal strategy in my efforts, except maybe on weekends when it is harder for all kinds of reasons.

Ok, so now we have what makes sense to me, now. Let's compare it to my 17 year old diet, as best as I can remember.

BREAKFAST: I don't really remember eating breakfast much as a kid. I think I had some coffee with creamer in it. 100 calories.

LUNCH: I skipped lunch at school once I started my diet because there was no way back then to know if it was less than 10 grams of fat. INTERMITTENT FASTING!

DINNER: I would usually eat shortly before getting home, and since I lived in the boonies, it was at least 3:30 by then.

I had a staple meal that I ate ALL THE TIME. It was something like 4-5 chicken breasts, a can of fat free cream of chicken soup, placed on a bed of minute rice, and then in the oven. Hmm. The chicken would be 500 calories (for a ton of chicken!!!) and a whopping ONE HUNDRED GRAMS OF PROTEIN IN ONE SHOT. A mere 11 grams of fat for all of that chicken. The soup is just 150 calories, maybe 5 grams of fat and a 22 carbs, which isn't that much.

The rice of course - this is the biggest source of "Wasted" calories in my highschool meal - it was enough rice to fill the bottom of the tupperware I baked it in- maybe 2 cups or so, that's like 300 calories, and about 80 carbs and 12 grams of protein.

This was a large meal indeed, but in total it was 950 calories. Try eating any restaurant meal that isn't in the "diet" section and I think you'll be challenged to land under a grand. And better yet, the lion share of calories here are protein- you are getting pretty much exactly what you need in one shot- and protein is satiating, so you are going to be very full on this meal.

As for carbs, yep, the rice has em', but you are still at 100 for the day so far. This would still be by any standard a low carb diet, just not keto.

But was this the only food I ate? This is tricky because of course I wasn't logging food like I do now. Memory is tricky and I could be totally wrong. But I remember what I would typically eat at night for a snack, which was airpopped popcorn. Yep, carbs, totally wasted with no nutrition, but also very energy poor. I would spray it with that craptastic fake butter spray, which while probably bad for you has little caloric value. This would allow salt to stick, which of course is what makes popcorn tasty. So let's say, three cups of popcorn, that's 100 calories. Just 13 carbs too. So now I'm at barely 1100 calories, and I was exercising for an hour. I drank skim milk then, so add on a few hundred calories a day for that. I'm sure I ate other stuff I can't remember. But since I was so slavishly low fat AND I was not pounding sugary things,* it is easy to see that on many days I was at or even under 1500 calories. No wonder the weight came off (yes, I recognize that it is always easier when you are young, and that had something to do with it also).**


*This might come as a surprise to my parents who probably remember me always drinking a bottle of orange soda as a kid. But in reality, I didn't drink that much pop, because my parents never bought it- I had to get my own money and drive 10 minutes to a store. So this was, at most, a once a day treat I got myself, and not every day. So maybe 200 calories a day at most was wasted in this manner. I was lucky they were smart about this.

**Another footnote here - what did I eat at restaurants? Yes, I just said "no" to fast food. To my parents credit, they noticed this, thought it was great, and pretty much instantly stopped bringing home things like KFC and other common "takeaway" things. In fact, my dad in particular still eats exactly like I did when I was 17, complete with fasting during the day (effectively- he eats a can of low fat soup, barely 200 calories, for lunch). My dad never regained the weight, unlike me. But anyway, when we would go to sit-down places, I developed go-to's that.... rather resembled my home meals in composition. Bob Evans meant the grilled chicken and rice meal with barbecue sauce on the side. Mexican places meant fajitas with no cheese or sour cream. Hmm... some carbs, but also a good helping of protein..... Chinese food was mostly a non-starter and remains to this day a DESTROYER OF WORLDS.

As you can see, the way I ate and exercised and lived resembles all of the key insights I've made from years and years of diet failure. But wait, you say, if you had it all figured out then, why didn't you keep doing it? Ah, great question.

I didn't know what I was doing, actually.

Doing strict low fat via the mayo clinic's advice unfortunately made me half right (or whatever percentage right). This was always going to lead to ruin. The truth is, cheeseburgers are pretty tasty. And frankly, you can totally make them work in the paradigm I state above, even with bread. Case in point, last week I ate a burger that would be a total sin when I was 17- the mighty Double Quarter Pounder With Cheese. When I was 17, I feared this because of the fat content of the burger. I now realize it wasn't the fat, necessarily, but the combination of nutrients that make foods dangerous for weight control and loss. The cheeseburger is not at all the worst thing- it has a good amount of protein- which means you'll fill up- but this is partially offset by the fat - in the cheese and burger meat- and the bread. But all in all, if you are going to spend 800 calories,  you could do it far worse.

Last week when I had the double quarter pounder, I managed an 1800 calorie day. A pretty good day! I did this because:

1. I intermittently fasted through the day, so the burger was the last thing I ate.
2. I DID NOT GET FRIES. FRIES ARE THE ABSOLUTE DESTROYER OF WORLDS. EMPTY CARBS COOKED IN FAT.
3. I ate tuna and other good protein sources for the rest of the day.

This example with the cheeseburger is vital because any diet is going to live or die on variety. It is hard to eat a super restricted diet in the long haul. Yet, you cannot just assume "eat less move more," because that leads you to the foolish thinking that you can have many days in which you engorge on a hot fudge sundae that lands at 1200 calories and be done for the day. Nope, your body full well understands that you need nutrients and it is going to make you SUPER HUNGRY to get them. So you can splurge here and there on tastier (read: fattier and sugary-er) things so as long as it fits NOT IN THE CALORIE BUDGET, but in the overall schema of brief fasting and prioritizing protein. The calorie budget is important but it should be the end of result of the above.

So a calorie isn't a calorie. But calories matter. That's the trick I'm starting to learn.

Fortunately I'm putting these ideas into practice. I had a pretty good week last week. I mostly kept to about 1500-1800 calories each day. I'm exercising regularly in sane ways that are enjoyable (mostly) and sustainable on an adult's schedule. When I'm on target, I'm getting at *least* 90 grams of protein, but more like 120 (technically I should shoot for 150, so I have some work to do here). It is still going to be hard- I already fell off the wagon a bit as the week closed. But, I am seeing some progress that I hope becomes real results. I'm writing this to show intention and accountability as I forge ahead here, as always.




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