Weight Loss: Why Is Exercising Important?

The first thing you need to realize are the un-refutable facts about exercise and weight loss. The first is that every study that has looked at exercise and weight loss have shown that those that exercise are twice to four times more successful at weight loss. Also those that do not exercise during weight loss almost to a person put on all their lost weight within a year. Of those that do loss weight with exercise if they continue exercising 75% of them keep off their weight, while those who stop exercising 95% put back all their weight. Also when you loss weight and then put it back on almost everyone gains back more then they lost.

THE ONLY WAY TO HAVE SUCCESSFUL WEIGHT LOSS AND KEEP IT OFF IS TO EXERCISE WHILE LOSING WEIGHT AND TO KEEP EXERCISING AFTER YOU REACH YOUR GOAL.

Now I am going to tell you the other benefits to exercise that I have experienced

MORE ENERGY AND GET MORE ACCOMPLISHED:

The most common comment I get when people hear I am doing both calorie restriction and exercise is "doesn't that wipe out your energy and make you tired all the time." Well look at my facebook page and the postings for the last 4 months since I started this program. That is not the postings of someone with lack of energy and tired all the time. I can tell you that since I have started this program I have had more energy and get much more done in a day. My increased energy level and the more focused my mind has been have allowed me be more productive despite taking one and a half hours out of my day. Plus I get one and a half hours of what I call Exercise University ( a later Blog), listening to my I-pod, so even this time is used to a benefit in addition to the other benefits.

SLEEP BETTER:

Prior to exercising I was sleeping very erotically, I would wake up during the night and lay awake for an hour or two until I feel back to sleep. I was more tired during the day but this didn't translate into sleeping better. Since the fourth or fifth week of exercise I have found that I am sleeping like a log. I get a full seven to seven and a half hours then wake up very refreshed. Some of this may be due to my weight loss having cured my snoring (so my wife can also sleep better). The most common cause of snoring and sleep apnea (a potentially life threatening severe form of snoring) is obesity. A study just published this week on sleep apnea demonstrated that 65% of those who lose 15% of their weight cure their sleep apnea. So loss that weight and not only you but your spouse will sleep much better.

PREVENT DIABETES:

Obesity is the most common cause of type II diabetes. This is a disease in which the muscle cells (the largest cell mass in the body) become resistant to insulin. Well multiple studies have shown that even as little as 15 minutes of strenuous or 30 minutes of moderate exercise five days a week will prevent or reverse to some degree insulin resistance. The condition you have before you become diabetic is a condition called Metabolic Syndrome or Syndrome X. This is characterized by a waist to hips ratio greater then 0.9, high blood pressure, high cholesterol, low HDL (good) Cholesterol, high triglycerides and elevated fasting blood glucose >100. Exercise and weight loss will improve all of these.

GET INTO GREAT PHYSICAL CONDITION:

Earlier this week I posted this update to my facebook page.

Alan Koslow

is down 58 pounds today at 19 weeks of exercise and calorie restriction (1200 cal/day). But the big news is the condition I'm in. Had insurance physical last Weds. and BP was 106/67 and pulse 58. So, I tried jogging up 6 flights of stairs and my pulse went to 118. Before I started my resting pulse rate was 92/min and BP was 128/85. the first week with 20 minutes of walking my pulse went to 138 and it took 20 minutes to recover. I'm in best shape I think I have ever been in.

What else can I say. The proof is in the results and the literature confirms this. I at 56 years old and after only 19 weeks of exercise of only walking and stair climbing am in the condition of an elite athlete.

LOWER YOU TRIGLYCERIDE AND ELEVATE YOU GOOD CHOLESTEROL:

As a physician who treats patients with vascular disease I find one of the greatest challenges is to treat elevated Triglycerides and low HDL (good cholesterol) medically. The drugs we have do not work well and they have significant side effects (not health threatening, but bothersome). However, we know that regular exercise of 30-60 minutes per day 5-7 days per week will correct both of these conditions.

FEEL YOUNGER:

I feel 15 years younger compared to 19 weeks ago when I was 58 pounds heavier and in much worse condition. Now I cannot say that you will have the same results. However, i can say you will feel much better with the combination of weight loss and physical conditioning.

THE FEELING OF EXERCISE EUPHORIA:

It is hard to state except as euphoria the entire package of how I feel. I have never used any mind altering drug except alcohol when much younger (a totally different issue), but I can tell you I have been feeling a sense of euphoria since six or eight weeks into this program.

I hope that this convinces you that any weight loss program should include exercise. In a later post I will discuss a simple exercise program that almost anyone can do and how you need to ramp it up slowly as you progress. Then I will discuss post weight loss exercise programs.

Weight Loss: Common Reasons for Weight Gain.

There are many reasons that you can control that may lead to weight gain. I am just going to list them here and in the future I will Blog on all of them:

1. Lack of sleep
2. Stress
3. Use of antidepressants
4. Steroid use
5. Many other drugs, ask your doctor or pharmacist (but not the PILL)
6. Hypothyroidism
7. Menopause
8. Cushing Syndrome (excessive cortico-steroids produced by your body)
9. Polycystic Ovary Disease
10. Smoke cessation

Weight Loss: The First of Six Rules for Calorie Reduction

I have six rules for calorie reduction. If you follow all six rules with almost no exceptions I almost guarantee that you will be down to a 1200-1500 calorie diet.

The first rule, and I feel the cornerstone of any calorie reduction plan, is to eat as much fresh raw fruits and vegetables (except potatoes) as you want. This is the most critical because by doing this you both remain full during the day.

The reason this also works is that you replace high Glycemic foods with low glycemic foods. What is the Glycemic Index? The Glycemic index is a way to tell how much a food you eats effects your blood sugar and how fast that food raises your blood sugar. A high glycemic index food such as; white sugar, most breakfast cereals and almost all candies and sweats; lead to a rapid raise in you blood sugar and almost 100% absorption and utilization of the calories in the food. While low glycemic foods such as; fresh fruits, vegetables, whole grains and certain rices; take a long time to get absorbed and to raise your blood sugar.

I emphasize raw vegetables and fruits because of the difference between eating raw and cooked foods. Now I am not asking you to do a complete raw food diet or only eat raw fruits and vegetables, but what I am saying is that you can eat as much raw fruits and vegetables (except potatoes) . There are several factors that explain this. First, fruits and vegetables are composed of a high portion of water. Most of this water is lost with cooking so you get filled up more when raw then when cooked. Second is the issue of the calorie content. I need to explain how calories are measured in a food. The food is placed in a calorimeter, a device that incinerates the food to ash, and the amount of heat released above the heat applied is measured as the calorie content of that food. As you can see this assumes that all the stored energy in the food is absorbed by the body. This is not the case for several reasons including: that the body needs to expend energy to break down the food; the fiber in the food carry many of the calories away (need I tell you); and the fiber itself is part of the calorie count. The estimate is that you only process and absorb 50% of the calories of raw fruits and vegetables.

My experience has been that with this as the cornerstone of my diet (but don't worry I eat a very balanced diet, more of that in later blog) , I am full most of the time and hardly have hunger urges. The first two weeks were the worse but I quickly got over this. There are some days I eat 5 pounds of raw fruits and vegetables a day and I still have lost 1/2 pound a day consistently for the 18 weeks so far of my diet.

Weight Loss: How Much Exercise Do I Need To Do?

To loss weight you need to burn more calories then you ingest. It is actually that easy. You also need to exercise to prevent diabetes and to improve your heart health. If you burn the same amount as you ingest, you keep a stable weight. If you ingest more then you burn, you gain weight. However any amount of exercise can help your health.

If you follow the headlines it is very confusing. In the last year I have seen something similar to all of the following headlines:

• Science proves you only need 15 minutes three times a week to prevent diabetes.
• 300 minutes of exercise required weekly.
• Stay healthy with 30 minutes strolling walk per week.

All of these headlines are true. How can that be? Popular press reporting of these stories usually leave out two very important points. One is what group of subjects are you starting with and two is what are the end goals you are hoping to obtain.

You need to first decide what is your goal for exercise. It may be one of the following or a combination:

• Weight Loss
• Weight maintenance
• Heart health (discussed in a later post)
• Diabetes control (discussed in a later post)
• Reversing pre-diabetes (discussed in a later post)

Let me first say that you can loss weight without exercising. However, there are three facts that you should realize. One, without exercise your weight loss will be much slower if you are successful at all. This is because you loss weight based upon your calorie deficit and without exercise you loss weight (for example I've consistently lost 0.4-0.5 pounds everyday, if I had not exercised with the same calorie restriction I would have at most lost 0.25 pounds per day or less.) Second, studies of large numbers of people on diets show that only 50% or less of those who do not exercise loss weight and if they loss weight it is much less then those that do exercise. Finally, multiple studies have shown that zero percent, yes none, of those that diet and loss weight and did not exercise during weight loss and continue exercising after weight loss maintained it. Actually 100% were back to their pre-dieting weight or usually above it within 1 year unless they did an exercise program post weight loss.

So lets look at your goal. Remember that you can always modify these suggestions. So first for weight loss. You need to burn about 700-100 calories. Here is a calculator http://www.neversaydiet.com/tools/calories-burned-calculator?ivNPA=1&sky=ggl|hco|ns|calories|PPCA7FBa|c which you can use to see how many calories you burn for a given activity. You will see that your weight effects how much you loss. Also an important point is that walking on a level treadmill vs walking the same distance for real you burn much fewer calories as much as only 40% of walking for real. The same is true of stair climbing and stationary bicycles. This is simple physics If you are not moving yourself through space you do not use as much energy. You can compensate by inclining the treadmill or increasing the resistance on the stationary bicycle. The amount recommended to exercise is about 40 minutes to one hour daily to have a sustained steady weight loss. You may need to start slowly. When I first began, I was only able to walk 20 minutes before I pooped out. At the end of two weeks I was up to 40 minutes and then by 4 weeks I was walking a full hour. Walk till you feel like your significantly winded. Tomorrow you will walk more. (In a later post I will talk about exercises for those who cannot walk.) (I will also blog later on stepping it up as you get into condition.)

Next, how much exercise do you need to do to maintain your weight after a weight loss program? This is much more tricky. It depends upon lots of variables. How much are you eating? What is your metabolic rate? How active are you? There is no one right answer. However, I can say with out reservation that you need to keep exercising to maintain your weight loss. I recommend based upon my reading that you do at least 30 minutes fives days a week. This can be a rapid walk (about 3.5 miles per hour rate). You can increase of decrease this based upon your weight. The important thing is that you continue to exercise. Some experts recommend after you do you hour a day to lose weight you then continue an hour a day but alternate cardio with strength training. This is up to you. Please do the 30 minutes five days per week.

Please post your exercise stories. I want to hear both successes and failures. Please be frank. I also would like to hear if you went against this advice and were successful.

How Do I Start Exercising, and How Do I do It Safely

This is one of the most important questions especially since many obese persons may have medical problems. The simple answer is that you should have a full physical and talk to your physician before beginning any strenuous exercise program. I have to stick with this advice, however, many people will try to exercise without seeing their physician. Additionally the truth is that unless he does a stress test on you it is still important to do these recommendations.

So these recommendations are after you get a clean bill of health from your doctor you still need to follow these recommendations to stay safe.

Now the main reason why people get into trouble while exercising is that their heart requires more blood then they can pump or then can get through clogged arteries. The faster the heart beats the more oxygen and therefore the more blood it needs. If either the heart doesn't pump enough blood or not enough blood gets through the arteries to the muscle of the heart you can have either a heart attack or angina (chest pain without a heart attack from an oxygen hunger of the heart). Let me state clearly that if you get chest pain, pain radiating into your arm or neck or severe shortness of breath you should stop exercising and either call 911 or see your physician.

So, how can you know your limit so you are less likely to get into trouble. Well there is a rule of thumb that your maximum safe heart rate is that rate calculated by subtracting your age from 220. For example my age is 56 so my maximum safe heart rate is 164 beats per minute. To be safe you then take 85% of this number which is 139. So my maximum safe heart rate is 139. You can also use this calculator to calculate your max. safe heart rate: http://www.mayoclinic.com/health/target-heart-rate/SM00083 .

You also need to know your target heart rate. This is the heart rate you should strife to hit to get maximal aerobic advantage. You should attempt to be above this number for most of your exercise program to get both maximal calorie burn and maximal conditioning. This target heart rate is 80% of your maximal safe heart rate or for me 115 beats per minute. When you use the calculator linked above you get two numbers. The first is your target heart rate and the second is your maximal heart rate.

If you do not have significant heart disease your body will find this range. If during exercise you go above your maximal safe heart rate there may be a significant underlying medical problem and you should stop exercising until you see your physician.

If you are not hitting your target heart rate you are not obtaining the maximal benefit you can obtain from your exercise regiment.

So how should you check your heart rate. The simple way is to take a momentary break and count your pulse for 10 seconds and multiply by 6 to get your heart rate per minute. An even simple way is for approximately $30 you can get a ring or wrist device that measures your heart rate and some also do your blood pressure (more about that in a moment) . I strongly recommend the later. I recommend that you use this every day you exercise for the first two weeks and then when ever you increase the intensity of your exercise.

In regard to blood pressure. When I started to exercise I wore a wrist band that measured heart rate and blood pressure and got scared the first reading I did. I had a reading of 170/110. What was the problem? Was I in that bad shape? Did I need to see my doctor right away (I called him on my cell right then)? We realized I had my wrist at my waist adding 21 inches between my heart and my wrist level. This is over 500 mm distance. That would be 40 mm of mercury (13 times heavier then water) so my blood pressure was actually 130 over 70 and when I retook my blood pressure with my wrist at my heart level that is the value I got. Science and physics is wonderful! It always works out, you just need to know all the variables.

As you exercise you will find two things. First, when you begin it may take a long time (15-20 minutes for me) till your heart rate returns to normal and as you get into condition a very short time (2-3 minutes now) for your heart rate to come down to normal. Second, you need to exercise harder to get your heart rate to target (I am now jogging up 25 flights of stairs {two flights at a time}). Faster recovery and need for harder exercise prove you are getting into good condition. Congratulations.

My Weight Loss Odyssey

My weight loss odyssey began about 18 months ago. It was then that I realized I was massively over weight. I hit 260 ponds and at 6'3" I had a BMI (body mass index , here is the URL to calculate yours: http://www.nhlbisupport.com/bmi/bminojs.htm) of 32.5, obese by definition. I started to diet and I did several things I had heard were important. At my wifes urging I stated eating a full breakfast every day (I typically have no breakfast except my supplements {more about that in later post} and my daily dose of fiber with small amount of orange juice {again more about this in later post} , and not eating for last three hours before bed (Oprah's favorite method). Well 6 months and another 15 pounds added so I was 275 with a BMI of 34.4. I realized this wasn't working. So I tried exercise. I began mall walking. The problem was I walked erratically and did not make the commitment to doing it regularly or even everyday. I also did not control my diet. Well nine months after that and 13 more pounds I hit my maximum weight 288 pounds with a BMI of 36, I hit the criteria for Morbidly obese. It was not this landmark weight though that got me motivated (I actually did not weight myself until I decided to get serious). It was a friend of mine who was several months into his successful weight loss that got me motivated. He actually was diabetic and began an exercise and calorie restriction program that essentially cured him of diabetes {more on that in a later post}. So on May 17th of this year I got on the scale, found out I was morbidly obese and began my committed plan to loss 90 pounds with a goal of getting to a BMI of 24. I realized I would need to do three things: 1) reduce calories to 1200-1500 calories per day; 2) exercise one hour per day; and 3) tell everyone I meet that I am working on losing weight. I also realize that you never refer to it as a diet but as a weight loss program. Well today is the 18th week anniversary of starting and I am down to 234 pounds down 54 from my start and only 36 more to go. In this blog I plan to cover many topics some of them are:

• Why are americans so overweight (at least 4 blogs)
• My six rules to reducing calorie intake (one blog for each)
• How to start exercising and how do you do it safely.
• What exercise should I do
• It takes a community to loss weight
• Don't forget to ramp up your exercise as you loss weight
• Going out, what to do.
• Supplements: What are they, should I use them?
• Fiber: Why is it important?
• Myths about dieting (many blogs)
• Gastric reduction surgery, is it for me?
• Diet drugs. 1) Over the Counter 2) prescription
• I lost the weight now what?
• Plus many more

So you can see this will be a very complete coverage of weight loss. I hope you stay with me a subscribe to it at this URL: http://weightloss-sketicdoctor.blogspot.com/ That way you will get an e-mail notice when ever I do a new post.