Eating Right

I was trained the same way most physicians are trained in nutrition, and I suspect the same way that most other people in the health care industry are indoctrinated.  For years, I thought the equation for weight was simple.  Input equals output.  If your input in terms of calories are greater than your output, then you gain weight.  If your output was greater than your input, you lost weight.  Simple.  I recited the food pyramid to my patients diligently, and suspected that most people who thought they were following the correct diet and who did not lose weight were really not as strict as they thought.  If they only counted calories, they would lose weight.  I was the typical 35% cards, 35% protein, 30% fat diet guy.  When I started to hack my own diet and exercise, I discovered that at least for me, what I had been taught was all wrong.  Now I eat at least 50% of my calories from fat, and approximately 30-35% protein, with the rest being carbs.  I don’t eat bread or pasta.  I eat sweet potatoes only on a leg or back workout day (large muscle groups).  I have lost body fat, my waist size is less than 30 inches, and I am 56 years old (soon to be 57). Turns out there is new science validating some of this information.  As we get older, the body does not like to let go of fat.  You have to trick it into thinking there is lots of fat around.  It really works.  If you are a male in your 40’s or older, change the way you eat.  Combine it with variations of high intensity interval training.  You will feel better, and you will lose the body fat.  I should add I suspect the situation is more complex for women.


Lean Body Mass

I used to think that weight control was just an issue of calories in versus calories out.  Now I have to face the fact that what I was taught many years ago, and spouted off with regularity may not be exactly correct.  I know from my own personal body hacks that the old paradigm of low fat diet did not work, especially after age 50.  I actually eat much more fat in my daily diet.  My morning  starts of with 2 cups of coffee with a single teaspoon of brown sugar, and a spoonful of MCT oil.  I then drink a 42 g Myoplex EAS protein shake (Chocolate of course!) in between seeing patients.  A couple of spoonfuls of natural peanut butter helps.  I also eat 2 handfuls of pistachios, and well as 2 handfuls of almonds.  For lunch, I have protein such as chicken breast and salad.  I have a mid-afternoon snack of greek yoghurt, and then hit the gym.  I usually lift weights for 50-60 minutes, but I don’t take more than a 3-5 minute break between sets. I then do 30-40 minutes of cardio, either treadmill or stair stepper.  I try and do high intensity intervals if at all possible, but sometimes my body just is too tired, so i just try and be persistent and complete 40 minutes of some type of cardio with a minimal heart rate of 100.  As I am finishing my weight lifting part, I take 25 grams of cold ultra filtered whey protein, 25 grams of casein, and 5 grams of creatine in about 12 – 16 ounces of water.  I learned a lot by researching proteins before I made my purchase.  A good general rule of thumb is look at the ingredients on the side of the protein package.  If it is high in cholesterol (greater than 10-20 mg per serving), it is not a good quality protein.  Then I have dinner, usually protein and vegetables.  By sticking to this regimen, my waist size is 30, and my body fat is the lowest it has ben since I was a teenager.  By the way, interesting factoid that most people don’t know.  Waist size of 40 inches or greater in men an 35 or greater in women is an independent risk factor for cardiovascular disease.  In plan English, this means that even if you are not diabetic or have high blood pressure, you are at an increased risk for heart attacks and strokes if your waist size is greater than 40 inches or 35 inches in a male or female, respectively.

Medium Chain Triglyceride (MCT) oils

OK so I am in my third week of about 3 teaspoons of MCT oils.  I must confess I have not noticed a big difference in the way I feel, but I will reserve final judgement until I have completed 6 weeks of using the MCT oil, and then make a decision about continuing to take it daily as a supplement.  The possibilities are either:

  1.  It does not really make you feel better or give you more energy as its proponents claim
  2. The effects are subtle, and not clinically detectable, but maybe the blood work will be a better indication of the effects of MCT oil
  3. I am not taking enough of the MCT oil to make a clinical difference in the way I feel
  4. I altered too many factors at the same time as staring the MCT oil, including starting on a ketogenic lifestyle, doing more cardio, splitting up cardio into 20 minutes in the am, and 20-30 minutes in the pm
  5. The MCT oil I am taking is not “therapeutic enough” and there are better ones on the market

I am inclined to think it is #1, but I will reserve judgement until I have taken it for 6 weeks, and then stop to see if there are any changes.  Stay tuned…

Ketogenic Diet Diary

So far, so good.  Up to 3 teaspoons of MCT oil daily, without any side effects.  Some observations so far:

  1.  Once you get into it, you tend to pay attention more to what you are eating, and I find myself not eating that cookie with my coffee, or snacking on the cupcakes that the drug rep brought over that I would never have thought about before
  2. Combining high quality protein with a salad is truly delicious
  3. I really like kale, which surprised the hell out of me
  4. I think I am sleeping better, although that may because of the cardio I added
  5. My overall attitude about everything is better
  6. I do not get the usual fatigue after lunch like I used to even with a reasonable carb lunch
  7. I have lost maybe about 4-5 pounds, and maybe a little strength, but overall it has been a positive experience
  8. I plan on doing this experiment for 6 weeks total, combining the diet with 20 minutes of elliptical in the am and 30 minutes of some type of cardio in the pm as well as 45 minutes of weight training in the pm
  9. Be interested in anyone else who has tried the ketogenic diet giving me their thoughts and experience

Ketogenic Diet

So I started on a ketogenic diet about a week ago, in order to reduce my body fat and get into better shape.  Not that I am in horrible shape, but I wanted to experiment to see how it made me feel.  Like most people, I get the fatigue symptoms after lunch, and generally have lost some of the high intensity energy I used to have.  I guess part of that lack of energy could be from being 55 years old, and 8 year of college and medical school, 8 years of general and vascular surgery residency, and 24 years of clinical vascular surgery practice can do that to you!  I have already learned a few things and some observations

  1.  MCT oil is palatable in coffee, but do not start of with a tablespoon of oil.  It will most likely lead to diarrhea, and you won’t take it again!  Start of at just a teaspoon, and slowly increase it over a week or two.  I am now up to 3 teaspoons a day, and no problems
  2. Take high quality proteins that are low in fat such as skinless chicken breast and salmon or tuna.  I eat less red meat, mostly because its sometimes hard getting a lean cut of meat, and animal fat tends to be more saturated fats which is what I am trying to avoid
  3. I am loving using more olive oil in cooking and salads
  4. I really enjoy eating a handful of nuts daily, including almonds and peanuts
  5. I dont feel guilty about snacking on a tablespoon natural peanut butter when I am hungry
  6. Not sure about the bulletproof coffee concept will have to research that further but it seems like a large calorie dump from butter
  7. I can definitely feel a difference within one week in terms of decreasing my body fat.  I am going to keep a picture diary weekly to make sure that it is not an illusion
  8. I also added a 20 minute cardio session in the morning.  It is well known that splitting cardio into 2 sessions increases your metabolism over a 24 hour period better than doing all the cardio in one session.  It also makes is easier time wise to split it up, and less strain on my body.  I used to love running, but my orthopedist told me if i keep running, I may need knee surgery 10 years down the line, and that just seems like a hassle that I don’t want to get into. So I do about 20 minutes of elliptical work, getting my heart rate into the 130’s in the am.  Sometimes I will do a shot run to break up the monotony.  In the evening, I lift weight for 45 minutes, and then do 20-30 minutes of cardio, mixing it up between kettle bell swings, and the stair stepper machine.
  9. The kettle bell is really much more difficult than I had imagined, and I think I am going to concentrate on learning more about it.  It really gets my heart rate up, strengthens my core muscles, and there are many different exercises I can do with it