I’m Overweight.

Dr. C

Or at least you would think so if you looked at my body mass index (BMI). I have written about the very imperfect science of the BMI scale before here on my blog, but I thought it deserved to be revisited. BMI is basically a height to weight ratio that comes up with a number designed to make it easy for clinicians to decide if a person is overweight or obese. Before the BMI scale was invented it was hard to assess someone’s weight and say that it was appropriate because height is also an important factor in weight. BMI combined those two.

Calculating BMI is relatively simple. You need your weight in pounds and your height in inches. Take your weight and multiply it by 703. Take your height and multiply it by itself (height squared). Now divide the first number by the second number and you have your BMI. To see my calculations or do your own click this link. My BMI falls in the “overweight category” with a score of 26.2. However, my body fat percentage is about 18%. This is well within the acceptable range for a 33-year-old man. (And I clearly do not look overweight!)

BMI misses many things when calculating whether someone is at the proper weight.

The problem for some people, like athletes, it does not take into account muscle mass. A person that is heavily muscled will always be overweight according to the BMI. As a matter of fact, I have been considered “overweight” since college despite always being is relatively good shape. If we look at professional level athletes, most of them would be considered obese!

I understand that not everyone is an elite athlete. What about the elderly? BMI is not ideal for them either. In the United States that equates to about 43 million people. Many times an elderly person will fit nicely into the BMI by being considered “ideal weight” for their height. This can be significantly misleading. Why? In the elderly muscle mass begins to drop. It happens to all of us. However, with this drop in muscle mass comes a drop in weight. As weight is lost a person is likely to fall into the “ideal weight” category even though they should be concerned about muscle mass loss. This loss in muscle mass causes a loss in strength and stability, increasing the risk of falls and increasing the risk of osteoporosis. Another problem with muscle loss is the change in your body composition. As muscle mass is lost one’s body fat percentage increases. Body fat percentage is a great indicator of health. The lower it is (within reason) the healthier you are, generally speaking.

BMI also fails to take into account many other health factors like diet, exercise, inflammatory markers, nutrient status, stress load, chemical exposure, social well-being, mood stability, and a whole host of other things we know have a large impact on our health. However, it is still widely used as a primary assessment of one’s health. As I said, it’s an imperfect science. In my opinion, it’s so imperfect it should be eliminated.

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35 Points From A Body Transformation Contest

Recently, I entered into a 6-week body transformation challenge at the gym I belong to. It’s called KDR Fitness. Great place. It began February 10th and ended March 22nd. It was technically 41 days long. I decided to enter because I needed a kick in the butt to get back to the gym. In the previous year gym days were hard to come by. With a brand new baby and practice, my gym time was way down. To top it off, I had a neck injury that took me completely out of the gym for 3 months at the end of the year. As a consequence my body fat had increased to 21.7%. Not ideal for me. During the contest, I recorded my diet and exercised in order to lose body fat and gain lean mass. I wore a heart rate monitor for all of my workouts to calculate my calories burned and generally keep track of my workouts. Here are the things I learned:

  1. I started at 21.7% body fat.
  2. By the 4th week I was down to 19.4%
  3. By the end of the 6th week, I was down to 18.4%
  4. I gained 3.7 pounds of muscle in 6 weeks.
  5. I lost 7 pounds of fat in 6 weeks.
  6. I missed the gym.
  7. I worked out 25 times in 41 days.
  8. That’s 4 workouts per week with an occasional 5th thrown in.
  9. I ate MORE food than I had been eating and was able to lose fat and gain muscle.
  10. I burned 15,655 calories in 25 workouts.
  11. Each workout was about 1 hour.
  12. Each workout burned an average of 626.2 calories.
  13. The range of calories burned was 273 all the way up to 958.
  14. It is not that hard for me to avoid grain.
  15. I can count on one hand how many times I ate grain in 41 days (and it’s less than the whole hand).
  16. Cheat meals are important.
  17. This was a typical day in terms of food intake:
    Wake Up: 6:15
    Food for the day:
    Breakfast: 6:45 – 3 eggs, mixed veggies, and cheese cooked in butter. Coffee with organic half and half.
    Snack: 10:15 – 3 large beef and veggie meatballs, carrots, celery, and hummus.
    Lunch: 12:20 – Chicken breast, mixed peppers, 1 whole avocado.
    Snack: 3:30 – Protein shake, steamed broccoli.
    Workout – 60 minutes – protein/carbohydrate workout drink
    Dinner: 6:45 – Meatloaf, steamed broccoli and cauliflower with olive oil.
    Snack: 9:15 – Greek yogurt and banana.
  18. Food preparation is key.
  19. Eating 6 times per day isn’t that hard IF you’re prepared.
  20. Eating a lot of vegetables is fairly easy IF you’re prepared.
  21. You don’t necessarily have to count calories if the quality of your food is good.
  22. You can eat A LOT of food if you are working out hard and still lose weight.
  23. Burpees get easier the more you do them.
  24. Working out more consistently makes you want to workout more consistently.
  25. Using the scale to measure your progress is a bad idea.
  26. My weight changed from 190.9 to 187.6 in 6 weeks. Hardly encouraging if you’re just looking at the scale.
  27. Body fat analysis is far more informative.
  28. You only have time for the gym if you make time for the gym.
  29. You don’t need to be in the gym 7 days/week.
  30. Two busy people (my wife and I) can each take turns working out during the week and get great results.
  31. You should be willing and able to do an extra workout or two from home if you need to.
  32. You can turn snow blowing and shoveling your driveway into a workout quite easily.
  33. Body mass index (a measure of height to weight) is a terrible health assessment tool. According to it, I am “overweight.” This is because my lean mass is high, not because I am actually overweight.
  34. My basal metabolic rate (calories I burn at rest over 24 hours) increased from 1,835 to 1,870 over six weeks.
  35. The area of my body that gained the most muscle (as percent growth) was my left arm.

I was on a team of three and our entire team (Bro’s before Hoho’s) did very well. The winning team will win $3,000. I’ll find out in a couple of days which of the 18 teams won the contest. That’s not the important part, but it sure would be nice!

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5 Foods You Should Never Eat!

Have you heard the news? There are five foods you should never eat. And here they are for your viewing pleasure.

1. There

2. Is

3. No

4. Such 

5. Thing

Confused? You shouldn’t be. There is no such thing as a food you should never eat. There are a lot of foods that you should eat sparingly. Ice cream, bread, pasta, white potato, potato chips, french fries, and any fast food come to mind. But even those can be eaten every great once in a while without fear. However, you shouldn’t have ice cream on Monday, pasta on Tuesday, french fries on Wednesday, etc. and expect to feel healthy, lose weight, avoid chronic disease or whatever your goal is. That kind of thing can add up. 

Eating food that is bad for us once in a while will never cause you to be unhealthy. It has no more potential to cause you to be unhealthy than eating healthily every great once in a while does to make you healthy. It’s the consistency that matters.

The exception to the rule:

There’s always one, right? If you have a food sensitivity or food allergy it is best to avoid those foods all the time. Do not cheat with those. Cheat with something else. For some this can be a life or death thing (i.e. an anaphylactic allergy or celiac disease). 

I think this is an important concept as we all can be consumed by the information we see in the media and from health gurus telling us to “eat this” and “don’t eat that.” We have to remember, they have an agenda – it’s to sell books, get ratings, and generally be as polarizing as possible. That’s what gets attention and sometimes the information is lost. 

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3 Common Prescriptions That Don’t Work!

The overuse of medication is getting out of control. Want proof? The 3 drugs listed below are among the most widely used drugs in the world, yet they don’t work! Don’t believe me? Check it out below!

Common prescriptions that don't work JPG

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Lesson from wearing a heart rate monitor for 24 hours

I decided to see how many calories I would burn in 24 hours by wearing my Polar heart rate monitor the entire day. I thought I had a pretty good idea just how many calories I would burn in 24 hours based on other tests, but I wanted to test two things. First, how accurate are these heart rate monitors, and second, if it proves accurate, how close was I to being correct. Based on my body fat testing (done by bioelectrical impedance) my basal metabolic rate is about 2100 calories per 24 hours. Basal metabolic rate is defined as the rate at which the body uses energy while at rest to keep vital functions going, such as breathing and keeping warm. With that knowledge in mind, I assumed day-to-day I probably burn about 2500 calories (after all, I’m not at rest ALL day). That would be on a non-workout day. However, I wanted to do this test on a day I exercised. So with all that information I calculated I would burn about 3,000 calories in 24 hours on a workout day. Here is what I learned:

My total burn was 3,238 calories in 24 hours. Not too bad. I was a little low on my assumption, but I also assumed my workout would burn 500-600 calories. It ended up burning 800 calories. That makes my estimate just about spot on.

24 hours. 3,238 calories.

24 hours. 3,238 calories.

Sitting is bad:

While seated and doing desk work (like I am at the moment), my heart rate touches the high 40′s but is mostly in the low 50′s range. While standing and doing miscellaneous work stuff, my heart rate is in the mid 60′s to low 70′s. This makes a huge difference and is congruent with research that shows people with sedentary jobs have higher rates of cardiovascular disease and higher mortality rates. The lesson? Get up and move.

I don’t eat enough:

In the back of my mind, I knew this. There are plenty of days where I get busy and cannot have a mid-morning or mid-afternoon snack. I need to be better about that, especially on the days I exercise. In the 24 hours I also kept track of my calories with a calorie-counting app. According to it, I consumed just over 2,500 calories. Clearly a deficit, but not necessarily a bad thing. It all depends on what you’re going for. For me, I know I do better when I at least approximate my caloric expenditure.

Heart healthy:

My average heart rate over 24 hours was just 64 beats per minute. This number is quite good. I was happy to see it. My maximum heart rate was 179 during my workout.

Burn, burn, burn:

I burn through just over 100 (somewhere between 100-110) calories an hour while awake and just under 100 calories an hour while sleeping (about 80/hour). This total excludes my exercise for the day. That is about what I expected it to be.

My heart monitor seems to be pretty accurate:

Based on the body fat testing and basal metabolic rate calculation, my heart rate monitor did a pretty good job accurately predicting calorie burn in accordance with the bioelectrical testing I did the week before.

I think the moral of the story is if you want to have the wiggle room in your diet to eat more food, you need to get up and move. I challenge anyone to try and eat 3,200 healthy calories today. It’s much harder than you think. The more you move, the more muscle you build which only adds to your ability to burn energy.

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New Guidelines on Cardiovascular Disease Miss Mark

Well, they’re at it again. New guidelines on reducing cardiovascular disease risk have been released. They’ve called these “much anticipated,” however, I call them “inconsistent with research” and “likely to cause more harm than good.” The guidelines, appearing in Circulation, are likely to change clinical practice, unfortunately. They are the result of collaborations among the American Heart Association, the American College of Cardiology, and other organizations.

Essentially, it makes it far easier for physicians to prescribe statins (cholesterol lowering medication). It will likely result in tens of millions more Americans begin put on these medications.

Let’s start with the things that I do agree with in the new recommendations.

Obesity

There’s no single, ideal diet for weight loss. Intensive, supervised lifestyle changes for at least 6 months received strong endorsement. This is important. We offer professionally supervised weight loss programs at our office for the simple reason that it reduces the risk of many diseases and it can be very difficult to manage alone.

That’s it. That’s all I agree with. The rest of the recommendations fail to actually focus on the problem: INFLAMMATION! They focus far too much on treating cholesterol without any actual targets in mind to treat.

Inflammation

“The traditional view of atherosclerosis [hardening of the arteries] as a lipid storage disease [cholesterol accumulation] crumbles in the face of extensive and growing evidence that inflammation participates centrally in all stages of this disease, from the initial lesion to the end-stage thrombotic [clot forming] complications.” This quote is from a great study that reviews the mechanism behind cardiovascular disease. I added the information in the brackets to make it easier to understand.

The pharmaceutically-driven marketing and media would have you believe that high cholesterol alone will cause it simply to accumulate in your vessels eventually narrowing them so much they can no longer deliver enough blood to your brain or heart. Or alternatively, the narrowing causes a clot to form only to be dislodged and sent “downstream” where it gets caught in smaller arteries causing a heart attack or stroke.  This just isn’t true! Want to know what actually happens!!!?

How you actually get atherosclerosis:

Inflammation is central to this process. It begins with inflammatory changes in the cells that line your blood vessels. These cells are collectively called the endothelium. The cells begin to express adhesion molecules. These molecules do what they sound like – they make things stick! However, they don’t make cholesterol stick, they attract monocytes (a type of white cell), which then travel through the walls of our arteries (BAD) under the influence of various proinflammatory molecules designed to attract more white cells. Once within the arterial wall, the monocytes continue to undergo inflammatory changes, transform into another type of white cell called a macrophage, swallow up cholesterol, and they become what is called a foam cell. T lymphocytes (another type of white cell) also migrate into the arterial wall, where they release proinflammatory cytokines (messengers) that amplify the inflammatory activity. Through these inflammatory processes, the initial lesion of atherosclerosis, called the fatty streak, is formed. This continues to evolve to cause the dangerous atherosclerotic plaque, but every step along the way involves inflammation!

There you go – as you can see, it is not caused simply by the accumulation of “too much” cholesterol as it floats through your blood stream. It all starts because of inflammation. Without the inflammatory process the white cells of our body cannot penetrate the walls of our vessels. If they cannot get into the walls of our vessels, they cannot swallow up cholesterol and begin to build plaque. It really is that simple.

So what causes inflammation?

That’s a great question and very easy to answer. Poor diet and low levels of exercise cause inflammation to build leading to atherosclerosis. A diet that is high in refined sugar increases inflammation. A diet that is low in antioxidants (brightly colored fruits and vegetables) increases inflammation. And exercise is inherently anti-inflammatory; therefore, low levels of exercise drive up inflammation. Here are the basic diet and exercise recommendations everyone should follow:

Diet

Every time you eat, have a source of healthy protein (chicken, fish, grass-fed beef, bison, etc.) and a fruit or a vegetable. Make the emphasis on vegetables. Keep grain (yes, even whole grains) to a small portion of your diet (no more than once per day).

Exercise

Combine resistance training with cardiovascular training. Get at least 45 minutes of moderate activity 3 times per week. High intensity interval training is very beneficial.

If you incorporate these things into your life, you’ll avoid inflammation and you’ll live a long, healthy life without statins!!!

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Twice Baked Cauliflower

Twice Baked Cauliflower

As the air cools, I can’t help but think of yummy comfort food. You’ve heard me say it before, “I’m a casserole addict.” I love them. I think they’re easy and leave leftovers so this momma doesn’t have to think of something new for dinner every night. However, as you probably know I want them to be healthy and for us that means not being loaded with starches like potatoes and pasta. This recipe is from my mom who saw it on pinterest.com and it fulfills my health request. Good ole cauliflower…we love the stuff and you may remember a couple posts here and here(link pizza crust and bread)with some of the more creative ways to use it. It is often used to replace other starches. For example, some people make mashed cauliflower instead of mashed potatoes or riced cauliflower in place of rice. So, why not twice baked cauliflower! It’s delicious, hearty and just hits the spot on a cool evening! We serve it with whatever protein is on the menu. Enjoy!

Twice Baked Cauliflower
(Makes 6-8 servings; recipe adapted slightly from The Low Carb Gourmet.)

Twice Baked Cauliflower Ingredients

Ingredients:

1 large head of cauliflower
4 oz. cream cheese (do not use fat free)
½ cup sour cream (I used Greek yogurt) (do not use fat free)
¼ cup minced green onions
Fresh chives to taste, diced
¼ cup freshly grated Parmesan cheese (if you only have finely grated Parmesan, use a bit less)
6 slices bacon, cooked until very crisp, fat blotted with a paper towel and then crumbled
1cup sharp cheddar cheese (do not use fat free)

Instructions:

Preheat oven to 350F/180C. Cut out stem and core from cauliflower, and cut into small pieces. Cook in large pot of boiling salted water until cauliflower is tender, but not overly soft. Drain well and mash with potato masher, leaving some chunks. Mix in cream cheese, sour cream (or Greek yogurt if using it instead), green onion, chives, Parmesan, and 3/4 of the crumbled bacon.

Spread evenly in a medium-sized glass casserole dish. Sprinkle with cheddar cheese and reserved bacon. Bake 30-35 minutes, or until hot and bubbly.

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