sulmoney has too much free time

It is! If it is the right kind. Like carbs, there is more than one type of fat; in fact, there are plenty, and no matter what, you need fat in your diet. Fat allows for better vitamin absorption, especially vitamins A, D, E, and K. Your brain is approximately two-thirds fat, and needs fat to function. Eating the right kinds of fat can actually prevent you from accumulating body fat. Certain fats can help reduce the risk of heart disease and stroke. It can even lower the risk of certain cancers, including breast cancer. Also, your skin actually gets better with certain fat intake. So, sign me up for burgers and fries with a milkshake? Not so fast.

The big baddie is saturated fat. Saturated fat, or “solid fat”, is the fat you can see. When looking for a tasty steak, one thing you look for is marbling, which is a higher fat content, which when cooked properly, gives steak its to-die-for taste. It also contributes to heart disease and cancer. The choice is yours! Sources of saturated fats include high-fat cuts of meat, high-fat cheeses, whole milk and cream, butter, ice cream, and palm and coconut oils. The recommendation is that no more than 10% of your daily calories should come from saturated fat, so our mythical figure on his 2000 calorie diet should take in no more than 200 calories, or 22g of saturated fat/day. I personally think this is still too much, and try to avoid it as much as possible. 

The good fat are the unsaturated fats: polyunsaturated, monounsaturated, blah blah blah. The differences is not really important. So where do we find these good fats that we should be using to make up our daily fat intake? Nuts and seeds, vegetable oils, and fish. You hear so much about omega-3 and omega-6 fatty acids, and they are what make up our polyunsaturated group. They are good for everything listed in the first paragraph, and you should not shy away from taking them in.

So, take home message from this topic: avoid your solid fats like butter, fatty meats, and stuff with cream in it. Look for leaner cuts of meat, or trim the fat from the meat if you cook your own. Switch to skim or low-fat milk instead of whole milk. But do not cut fats out entirely! Things that you should incorporate into your daily diet are stuff like almonds and walnuts for snacks, using natural nut butters, using extra virgin olive oil, eating fish like salmon, and eating avocados. 

Thanks to Dr. Atkins, carbohydrates (or carbs) have become the food enemy. The amount of people one hears who are eating “low-carb” or “no-carb” has skyrocketed. What needs to be realized with the Atkins program is that Dr. Atkins himself was never able to provide a rationale on why his program worked for people, and his findings or theories were never published in a peer-reviewed medical journal. With that being said, there is some benefit in a low-or-no-carb diet, with a specific modifier: complex versus simple carbohydrates.

Simple carbs are simple sugars, which are highly refined and offer little to nutritional value to the individual ingesting them. They also bump the sugar levels in the blood rapidly. When limiting carbs, this is the type of carb one wants to cut down, or even avoid as much as possible. Things that include simple carbs are things like table sugar, white flour/bread, honey, milk, candy, lighter chocolates, fruit, juices, and sodas. 

Complex carbs are made up of a more complex chemical structure, take longer to digest, and do not raise the blood sugar level as much or as rapidly as simple sugars. Fiber is a major component of complex carbohydrates. Complex carbs are found in vegetables, whole wheat products, and oatmeal. 

So, what’s the take home message? We need carbs in our diet, as they are the major source of energy in the body. It is best to load up on our complex carbs, and limit our simple carbs to eating limited fruits. Fruits are seen as an exception because there are so many other vitamins and minerals that are associated with eating the fruit. When looking for sources of complex carbs, look for foods that are whole wheat; read the ingredient list, and if “whole wheat” is not the first ingredient, put it back on the shelf. Look for things that are high in fiber. Eat real oatmeal. And eat your veggies.

Sorry for the short hiatus; I am currently on night call at the hospital, and try to fit these blog entries in during some down time, and well, sometimes there just is not down time. Anyways! So last time, we talked about calculating the number of calories we need in a day, and then subtracting a certain number to get a daily goal for weight loss. The next step is figuring out how we make those calories up during the course of a day.

The concept of macronutrients was brought up in the last post, but quick recap:

• 1g carbohydrates = 4 calories
• 1g protein = 4 calories
• 1g alcohol = 7 calories
• 1g fat = 9 calories

I throw alcohol in there because so many people overlook the fact that it does in fact has its own nutritional value, and can not be ignored. 

So, let’s say you got your daily calorie goal being 2000 calories in a day. You have plenty of options of how to make up your 2000 calories. You could eat 500g of pure sugar. You could have 5 pounds of ground turkey breast. You could eat 2.5 sticks of butter. Each of these options will get you 2000 calories. But neither of these options is really good for you. You need to have balance in your life, and in weight loss, an ideal ratio that has worked for me is a 40/40/20 split of carbohydrates/protein/fat. There are many other splits out there as well, but this one I have stuck to recently, and has worked wonders.

Again using our 2000 calorie daily goal as an example, using the 40/40/20 split, this mythical figure would aim for getting 800 calories from carbohydrates, 800 calories from protein, and 400 calories from fat daily. You figure this out by multiplying your calorie goal by 40% for carbohydrates, 40% for protein, and 20% for fat. The next step is dividing these specific calorie goals by their corresponding nutritional values to get a target g/day goal. So again, for this person, 800 calories of carbohydrates is equivalent to 200g of carbohydrates, 800 calories of protein is equivalent to 200g of protein, and 400 calories of fat is equivalent to about 45g of fat daily.

Now, this is where tracking what you eat comes into play. You have to keep track of your meals, and their corresponding values to fill in your chart, and then use that to guide what you will eat next. Again, those food diary apps are wonderful for this, as they track and break these down for you. For example, it’s coming down to afternoon, and you are starting to get hungry. You look over your chart and see that you are way ahead of where you should be for fat and carbohydrates for the day, because for breakfast, you ate a bagel with a generous slab of cream cheese on it, and followed it up with a burger and fries for lunch. So, are you going to grab that cupcake for your co-worker’s birthday?

In the previous post, I pointed out that it is important to track what you eat for the purpose of information gathering, so that we can put that data to work for you. There are many schools of thought about how to go about losing weight, but getting down to the bottom of it, it comes down to calories in versus calories out. When you are alive, you are burning calories. Whether you are sitting down reading this, sleeping, running a marathon, or even eating a cheeseburger, you are burning calories. Every process in your body requires energy to run. That is why we ingest sustenance; to fuel our bodies to perform the activities of daily living.

Everyone has a different caloric need, depending on age, sex, height, and activity level; it is also important to know that this number changes throughout one’s life. When you are a growing teenager playing multiple sports, you need to eat a lot more than a middle aged call center operator. To calculate this number, we use something called the Harris-Benedict Equation. Click on that link, enter in your numbers, and see what your daily caloric intake should be to maintain your weight.

Now, with the number in hand, we want to take 500 calories away from that to create a 3500 calorie deficit per week, which somehow or other works out to about 1 pound lost per week, which is a more than healthy weight loss rate. Now, how you make up these calories is very important, and there are 4 macronutrients that contribute to making up your calories: fat, carbohydrates, protein, and alcohol. Yes, alcohol counts too! I will tackle how to make these macronutrients work for you in the next post…

So much extra stuff that you did not even realize it. Tackling the topic of nutrition and analyzing what exactly you eat and drink forces you to do exactly that: analyze what you ingest. The first thing you have to do is keep a food diary. Once you start writing down every-single-thing you eat and drink during the course of the day, only then will you realize what your actual diet consists of. All the extra little snacks during the day, that extra stop at Starbucks, that Snickers bar to get you through the afternoon, that glass of orange juice, it all adds up to something, and every-single-thing counts.

So there a couple different ways to approach this. The way that I recommend and have been doing recently is using a food diary. Personally, I use myfitnesspal, which I think is great because it automatically syncs everything up if I add it from my iPad, iPhone, or the main website. It has a good food database already there, and adding your own recipes is really easy as well. It also does a great job of breaking everything down graphically and numerically.

Anyways, there are plenty of different sites/apps that you can use and that are available, but the most important thing is actually using it and being honest to yourself. You have to enter every-single-thing you ingest into it. Use it for a week, eat as you normally do, and then just look at results. What you see may surprise you, in many different ways. Right now, this is the information gathering stage. Putting that information to work for you is coming up next.

Hard work. Discipline. Motivation. Blah blah blah. The way to do it is not a secret at all. The hardest part about it is the commitment to it fully, and knowing why it is that you are doing what are you doing. Have a reason of why, and then remind yourself of why when you are going through the work of it. The mindset is the most important thing about it. Once your mind is made up that you want to lose weight, anyone can do it.

Aside from that, there are a few things you do need to follow. I will just give a basic outline right now, then attempt to break each one down further in upcoming posts.

Nutrition

Nutrition is so important in weight loss. It is oh so simple to realize that eating at Five Guys everyday is not good for you. But the nation as a whole has not been educated properly on what to eat. The way the food industry is currently set up in America is to get you to eat more and more food. The way that this is done is by supplying cheap food that is not nutritious at all. As a result, America has become a country of overfed, but undernourished people. It is cheaper to go through a drive through at McDonald’s then it is grab a proper meal. If you are serious about fixing your diet, do not go on a diet; instead, you have to change the whole way you nourish yourself.

Exercise

You have to do it. Period. The benefits of exercise are innumerable: better cardiovascular strength, better physical strength, better mental health, better sexual health. You will just become a better version of yourself top to bottom. And we can all benefit from that. The main issue that people do not understand about exercise is what exactly qualifies as exercise. Everyone needs to recognize what his or her own personal expectations are, and then push those. The famous saying “no pain, no gain” is absolutely correct. To see results, you have to feel like you worked.

Expectations

I lost 50 pounds…over 10 months. Those are amazing results, but people lost more quicker, and people have lost less slower. Everyone is different. The most important part is knowing that this is not something you do over a week and expect to see amazing results; this is a life change. I tell people that I did not care for my body for 28 years; undoing it and fixing it will not happen overnight. Lastly, you can not lose 50 pounds without losing 1 pound. And then 2 pounds. And 3 pounds. And so on.

300. That’s what the scale responded back to me when I stepped on it in May 2011. That for me was the point where I said enough was enough. I had let myself go for far too long. I didn’t even know what my weight was at that time; I kept telling myself or other that it was “around 280”, but the truth was that I was afraid to step on a scale because I didn’t want to see that number. But there it was. And the time had come to stop it.

I have always been a big boy, and honestly can not remember being a normal weight at any time in my life. Growing up, it was always, “It’s ok, it will even out as you get taller”. I kept getting taller, but my weight never evened out; it kept going up as my height did. I was always teased about it, but I never seriously attacked the issue head on, just always told myself, “It’ll get better sometime later”. And that is the biggest problem with obesity in childhood and young adulthood: denial. Denial is such a strong emotion, and it allows us to put things off that need attention now, or just ignoring a massive issue. It was only when I accepted that this was something that could kill me that I put a plan into action.

Being in the medical field and going through medical school, all the problems associated with obesity hit you over the head. Spend a day in the hospital and you realize how many health issues are a direct result of obesity: hypertension, type 2 diabetes, heart disease, liver disease, strokes, high cholesterol, osteoarthritis, infertility, some cancers; and that is just scraping the surface. The health care costs associated with obesity are staggering: $147-210 billion per year, depending on your sources. And this is mostly preventable.

One day during my surgery rotation, I was part of an operation where we amputated a diabetic below the knee. There is nothing quite like sawing half of someone’s leg off to remind you how real diabetes is. And neurology service? Forget about it. Seeing people who survive strokes, and just how neurologically devastated they are is unforgettable. These events destroy not just the individual, but their families as well. 

Aside from the obvious health issues, there is so much more. I could not participate in the things I wanted to because I weighed too much. The things that I used to enjoy and partake in before, like playing a pickup game of basketball, or dancing bhangra with my friends and teammates, I just could not do it anymore without getting winded quick fast. I could not shop at the mall anymore. And for a guy that worked at Express for over 2 years and kept my eye on the fashion scene and trends, that sucked. And with the current move towards skinny jeans and slim fit clothing, I was locked out of the whole scene.

So, the time had come to save my life. I wanted to avoid having to take medication like so many people. I wanted to be able to do the things I wanted to do, and the things I enjoy. I wanted to dress how I wanted to. I wanted to live long enough to be able to dance at my grandchildren’s weddings. So, that’s why.

Hi. So I have been kicking around this idea in my head for a bit of time. I have not been regularly updating the blog at all since…I don’t even know. Life updates: I finished doctor college, and started doing my residency in Psychiatry at Virginia Commonwealth University (VCU) in July 2012. I also got engaged to the person most dear in the world to me, which made me the happiest man on this world. Also, I lost over 50 pounds…so far. Life has been pretty damn good this past year.

So, the reason I am writing this is because I have been asked numerous times, “How did you lose the weight?!”. I would tell them, but it is something that is a bit more complex than just do this, don’t do that, ta-da! So I wanted to write it all down, and then I could just point people to here and they could use my own experiences as a guideline or motivation for themselves. Also, it is motivation for myself to continually improve, as I have not yet reached my physical goal. So what better way to keep myself on track than to put it all out there? I have many topics to cover, and will do one topic daily (hopefully!).

People, even though I have an MD after my name, this is not medical advice or a strict guide of what to do. Always contact your physician before embarking on a journey like this. To our health, our greatest asset!

bhangrapulse:

We are back after a long hiatus involving alien abduction and a host crossing over to the dark side. On the heels of the successful Elite 8 Bhangra Invitation 2012, Bhangra Pulse interviews one of the brains behind the biggest and most hyped competition each year, Waleed Mahmood, to talk about what makes a team, and a competition, Elite.

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