Pay it Forward Day

So yesterday was Pay It Forward Day. 
I think the overweight/obesity epidemic is something that requires a societal change, and most of all, support from each other. 

A while ago, I wrote my father an email, and I find myself forwarding it to a few people at work.  I'm going to share it with you all here.  Now keep in mind, I'm not a doctor, I'm not a nutritionist, and I've not yet won my battle. But these are the things I've picked up along the way:

You asked for some information regarding the GoWear Fit device that I'm wearing. The links to their Web site are below, as well as to Amazon.com (where there are reviews, and it's a little less expensive). You get 3 months of the Web application with purchase of the devise. If you sign up for 1 year, it's 7-8 bucks a month. That's two Starbucks chai lattes.

In typical Robby fashion, I didn't want to give you that information in a vacuum, so I've provided a ton more information to you.

I love you lots! Good luck.

-Robby

Equipment:
For monitoring:

GoWear Fit/BodyBugg Web site (has information about the system; is also the Web site I was showing you that compiles the data and where you enter in nutrition information): http://www.bodymedia.com/

Monitor (necessary)
Display unit (optional but very useful):

For food: (I cover this below) –
– electronic food scale
– measuring cups (consider keeping a set at work)
– lots of Ziploc bags and Tupperware containers that can be transported and/or microwaved (I recommend the .5 cup ones (for sauces/yogurt) and the 2 cup ones for meals (don't fill it!)

For exercise:
– good pair of sneakers (spend some money on a good pair, and replace sneakers once a year)
– comfortable work-out clothing
– Body Glide (helps with blisters/chafing)
– consider getting a set of free weights for home (10-20lbs) so when you're watching golf, you're also doing bicep curls
– consider getting a heart rate monitor that goes on under your clothing and around your chest (the GoWear fit does not monitor heart rate) [I recommend this for anyone who is over 50, has a history of heart issues in their family, who is obese]
– water bottle (don't need anything fancy, but I prefer re-using a bottle than buying one that contributes to landfills)
– ice packs in case of injury (helps with swelling)
– heating pad in case of injury (helps with bruising)
– any support braces that your ortho deems necessary

For lifestyle:
– full body mirror (the more you exercise, the more you'll appreciate this)
– soft tape measure (measuring key points on your body will help you track progress)
– accurate electronic scale (use it once a week. No more, no less)
– a reasonable goal outfit (a reward/motivation)
– a workout partner, a trainer, or a class (to get support)

Body Mass Index
BMI is a rough predictor of health as it doesn't necessarily differentiate the weight (ie, between fat and lean muscle) – you're better off having a fat analysis – such as DEXA, iDEXA scan or a BodPod analysis.

BMI is a multi-step formula – and either you can learn the formula or just go on one of the many Web sites that will calculate it for you:

http://www.nhlbisupport.com/bmi/
http://www.bmi-calculator.net/

Please ignore any of the links they might send you to for weight loss pills, weight loss plans, etc. All you really need to know right now is what I'm putting in this email.

BMI Classifications
18.5 or less Underweight
18.5 to 24.99 Normal Weight
25 to 29.99 Overweight
30 to 34.99 Obesity (Class 1)
35 to 39.99 Obesity (Class 2)
40 or greater Morbid Obesity

Waist Circumference:
Another measurement to keep in mind –
http://www.mckinley.illinois.edu/Handouts/waist_circumference/waist_circumference.htm

The math behind weight loss
1 lb = 3500 calories
2 lbs = 7000 calories

Losing 2lbs a week is a healthy way to lose weight in a way that will not shock your body and will result in long-term weight loss (ie, it's not a fad diet, it's lifestyle change)

There are 3 ways you can accomplish the math – and I will use 1lb/week as the example:
1. burn 3500 extra calories a week
2. decrease your caloric intake by 3500 calories a week
3. some combination of burning and decreasing

For example:

	Burn	Decrease	Mix of Burn/Decrease
Monday	700	400	Burn 300
Tuesday	300	300	Burn 300
Wednesday	500	700	Decrease 700
Thursday	500	800	Decrease 650
Friday	750	200	Burn 450
Saturday	651	500	Decrease 900
Sunday	100	600	Burn 200
Total	3500	3500	3500

Either way, it adds up to 3500 calories, or 1lb.
Now, if you are exercising, keep in mind that you might not lost that 1lb or 2lbs a week, because your body composition is changing from less fat (weighs less) to more muscle (weighs more) – and you might even see a weight gain. Fret not. As long as you're sticking to the math, eventually your body will catch up to you. Also, fret not if one week you lose nothing and the next week you lose 4 lbs, because the average is 2 lbs. And that 2lbs is healthy. Keep in mind that your weight will fluctuate because of many things you can and cannot control. The important thing is to focus on the numbers, they will always come through for you.

Basal Metabolic Rate
This is how many calories your body uses without any activity. Also known as "resting metabolic rate." Again, it's a fun formula or you can use one of the many calculators online. Your BMR changes with age and weight:
http://www.bmi-calculator.net/bmr-calculator/

There are various equations and multipliers that you can use to get your (BMR x activity level) but for right now, focus on your BMR. This is the number of calories your body needs to sustain its weight. If you do nothing more than look at that as a dietary target (not going over it) and keep up your level of activity, you will lose a moderate amount of weight.

Keeping a food diary
Until you've been doing this for a while, you need to keep a food journal. This will keep track of every meal, snack, and drink you intake. There are three helpful tools for this process: (1) notebook or the BodyMedia Web site (2) electronic kitchen scale (3) measuring cups/spoons (4) caloric guide (like Calorie King 2010) . Once you get in the habit of measuring your meals and/or their component parts, you'll get a sense of how large a portion is, areas you need to improve, and setting goals for yourself, like getting all of your fruits and vegetables in for a day, or cutting down portion sizes of bad things, etc. NEVER EVER EVER EVER starve yourself (never go below 1400) as it will mess up your metabolism. If you go over your caloric intake limit (BMR x Activity Level), then you need to exercise more, or reduce something densely caloric (fat/protein) the next day.

Types of food:
If you eat a well-balanced diet, you will not need any supplementary vitamins or minerals. Once you have one or two weeks of food journaling under your belt, look at it (either yourself or with a doctor/nutritionist) and assess where you are. Are you eating enough fruit/vegetables? Are you eating too much red meat and not enough fish? Where can you cut out empty calories and replace them with good calories?

A motto that I have come to love (coined by Michael Pollan) is "Eat food. Not too much. Mostly plants."

That needs a little bit of explanation. You can pick up his book ("food rules") for a longer explanation, but in short it means this:
1. Eat food – stuff that your great-grandmother would recognize. Whole fruits and vegetables, healthy pasture raised meats (btw, kudos for getting those Delmonico steaks – I hope you spaced them over 4 meals!), whole grains, etc. If it has more than 5 ingredients, has unpronounceable chemicals, or makes healthy/dietary claims DO NOT EAT IT. A tomato off the vine makes no claims about your health, but then again, it's a fresh tomato and does not need to. Celebrate the simplicity and freshness of food, and you're on the way to better health (and might lose a few pounds in the process). (PS: Great Grandma would not recognize artificial sweeteners)
2. Not too much – portion size in america is so distorted. We evolved as hunter/gatherers. We'd walk a few miles, stumble upon something edible (yum, berries!), eat a few and then keep walking. The meat was few and far between. Farming greatly revolutionized this – made it so we had more food readily available (subsistence) and then became industrialized to the point where we have too much food available. Consider eating off a bread plate, fill it (horizontally, not vertically), and then waiting 20 minutes to see if you're hungry. Then drink a glass of water. Still hungry? Eat a vegetable. The rough guide is that your stomach is a little than your fist. How many fists are you putting in your mouth at each meal?

3. Mostly plants – okay, sure, our appendix is no longer necessary as we are not eating plant-only diets, but we still need plant. Plants of all colors. They not only provide vital nutrients, but in terms of caloric density and "volumetrics" – we can eat more plants and feel full. Or eat less meat/fat and feel less full. We need plants and their vitamins to not only fuel our bodies, but also to help regulate them. Ahem . . . Fiber. I'll say no more.

Meal Planning:
I know this seems labor intensive – but I just wanted to make a few quick points: USE YOUR FREEZER. If you make a meal, divide it up into microwaveable containers by portion size. Maybe put one "leftover" in the fridge for the next day. When fruits and vegetables are in season, prepare them and freeze them (like freezing fruit, tomato sauce, veggies). There is tons of information about what you can freeze and what you can't. For instance, I freeze a mixture of cilantro, garlic, lime, and jalapeño into ice-cube sized bits so that when I want to make salsa or guacamole, it's ready to go.

The thing about meal planning that I want you to consider is looking at your dietary needs over the period of a few days or even a week. It's way to easy to be mindless about food when you're eating meals out, or just buying things and then cooking them. Be careful and considerate about your meal plan and how you spend your money. It's a great lesson in terms of financial and caloric economics.

Hydration:
Aim for 64 fl oz of WATER a day. Juices and caffeinated teas do not count. I'm talking about pure unadulterated H2O. If you are exercising, you shouldn't need Gatorade or any other electrolyte drink full of calories UNLESS you are (1) exercising too much (such as a marathon) or (2) not drinking enough water during the day. Your pee should be clear by mid-day.

Getting exercise:
Walking 2 blocks is not exercise. That's lifestyle activity. I'm talking about the things that make you sweat and use your muscles. Get a clearance from your primary care physician/your orthopedist to exercise (in terms of intensity and duration). You need a combination of aerobic exercise, resistance/weight training, and flexibility/core work. Consider full-body activities like swimming or jogging. And don't injure yourself. Variation is key. Never make it so your body can predict the workout you will get. If you don't get the body monitor, you'll also want to record your exercise somewhere.

Sleep:
You say that you have trouble sleeping. I would look into getting tested for sleep apnea. Once you start losing weight, the sleep apnea has a strong probability of going away.

Also, the more you exercise, the more your body will need the sleep/recovery. Make sure you find your sweet spot for sleep (for me, it's 8 hours) and set that as a goal. Turn off the lights and the TV before going to bed. You need to ease your body and mind into wanting to sleep. Simulating sunset and quieting your brain can help with that. It's a good time to meditate, quietly reflect or pray. If you are in bed for an hour and can't sleep, maybe read something, but give your body a chance.

This is lots of information to process – but please ask me or your doctors if you need any clarification or you have any questions.