Once Upon a Thigh: February 2008

Table of Contents

Letter from the Editor

I went to the MMH Physician Challenge meeting Wednesday and got a great packet of material for weight loss. It's not too late to join. Call the Cardiac Rehab and talk with Will this week. For 3 months, $20 is a bargain. You will get weighing, measurement and fat content. Let me tell you the % of fat was a real eye opener.

Remember, we put down fat in the abdomen because of increased insulin in the blood stream. If we are not doing weight bearing exercises, we will decrease the amount of muscle we have and that allows for an increase of % fat. I was surprised myself, so we all need to kick it into gear and just DO IT (exercise). They will print out a computer program for exercise specifically for you if you desire and also help with meal planning. If you get the calories from the dietician, Susan B. Clark, (you can call her at the hospital), then I can get you a 2-week menu plan.

If you join the Physician Wellness Challenge, you can use the exercise equipment in the evening or weekends for a small charge of $12.00 per month.

Remember that next month we will be meeting at the meeting room at the hospital and then on April 2nd, we will have a pharmacist come to our meeting at the office.

How do you make exercise more fun? Email your answer to forecasteditor@diabetes.org.

Congratulations!
Congratulations to:
  • Maxine B. for losing 10 lbs., she is on to another 10 lbs.
  • Amy for losing 15 lbs. just since sleeping better (remember the affect of Melatonin on weight loss?).
  • Susan for losing 50 lbs.
Way to go! Let me know about the rest of the group.

Time to Downsize
I came across this great article in Diabetes Forecast for February. Sue Robbins who is a dietician reminded us of the importance of eating smaller portions. She said the obesity rose in 31 states in 2006 and no states had a decrease. We talked previously about plate size: should be maximum 8" across. She states that since 1960 the average area of a dinner plate has increased by 36%. Since we do not want to waste food (remember being told to clean your plate by parents) we eat what is on our plate.

If we consistently ate a 4 oz. piece of roast beef vs. a 3 oz. piece, it would cause a weight gain of approximately 8 pounds in one year.

Sue told of a research program conducted at Cornell University. She brought 65 "highly motivated students and spent 90 minutes explaining that if they were presented with a one-gallon bowl of snack mix, they would eat more than if they were presented with 2 half-gallon bowls. Six weeks later these same students were invited to a Super Bowl party. Half the students were led to a room where a one-gallon bowl of snack mix was served, and the other half went to a room where two half-gallon bowls were served. Despite their lesson, the group presented with the one-gallon bowl served themselves 53% more snack mix than the other group and ate most of what they took. After the event they were asked if the size of the bowl influenced the amount they ate. All but two said it had no effect. So despite being educated about portion size these students still ate more when they were presented wit a larger bowl. What's the lesson here? In order to change our behavior we need to promote the habit of eating smaller portions. Here are a few suggestions:
  • Use smaller plates and bowls
  • When eating at a restaurant split a meal, or ask for a doggie bag and put half your meal away before you start eating
  • Buy individually packaged snacks or repackage large bags into smaller containers
One thing that Sue did not list was one that has worked at our house this last week. Write down everything you are eating including the amount. It is a very interesting psychological influence for the positive. Susan Clark will actually tell you the amount of calories if you send your weekly intake to her email. Call her at 359-6522. Power of Touch
Untie Your Knots: Self massage can stimulate blood flow by breaking up knots or tight spots and increasing flexibility. Use your thumbs to press firmly in a circular motion for 30-40 seconds; release and repeat. For difficult areas lie down and roll your body back and forth over a tennis ball.

Hold Hands: You feel better when you hold someone's hand, stress decreased, and you increase your serotonin, which is a natural antidepressant. Hold your partner's wrist and use your forefinger and thumb to squeeze at the base of the palm. Hold for 20 seconds and repeat, moving your way above the wrist. Now it is your turn.

Play With a Pet
10 minutes playing with a pet can reduce blood pressure or overall risk of dying from a heart attack. So when my mommy kitty lays on her back with feet stretched to the sky, I am going to take a minute and help her feel better. She is extending my life, if I do this.

"Time spent with cats is never wasted." -- Colette

What Is Your Excuse For Not Exercising?
  • 33%: I'm just too tired
  • 21%: I'm too busy
  • 9%: I'd rather start tomorrow
  • 8%: It's too cold/hot/rainy/snowy outside
  • 8%: I spend all day chasing my kids/dog/spouse
Favorite answer: Exercise is against my religion.

The Skinny on Fat
Fat is active. It doesn't just quietly give us warmth. It is completing biochemical changes over the entire body. When there is too much on board this organ short circuits the rest of the body. Excess insulin sends energy to the fat cells, causing them to plump up, multiply, and end up in places fat shouldn't be: muscles, liver, and deep in the gut.

Fat cells are not programmed to die, like our normal cells. They plum up with triglycerides and multiply when they can't expand any further.

The HYPOTHALMUS in the brain responds to hormones released by the fat (leptin), which normally signals the body to slow down food intake and burn more energy. But when there is too much leptin, we don't hear their message.

Heart and Vascular System: An increase in inflammatory factors occurs when there is a surplus of fat which raises blood pressure and risk of atherosclerosis. Cytokines trigger system wide inflammation and obesity is a pro-inflammatory state. Cytokines can also make tissues resistant to the effects of insulin which promotes salt retention and increased blood pressure. Chronic inflammation has also been linked to cancer.

Pancreas: Too much fat and we see an increase of insulin and fat cells plump with unused energy.

Liver: Fat becomes stored here when there is an excess and in extreme cases, inflammation and scarring can cause cirrhosis, liver failure and the need for a transplant.

How to Reach a Healthy Weight
  • Get Sleep: FIVE HOURS OR LESS AND YOUR BODY DOES NOT HAVE THE HORMONE THAT TELLS YOU THAT YOU ARE FULL. You need at least 6-8 hours.
  • Use a Pedometer: 30 minutes a day will help your heart, but to lose weight, you may need up to 60-90 minutes daily. Now, that is not always possible, so get a pedometer and aim for 10,000 steps daily. Just wearing a pedometer increases the amount of steps you take by 2,000 to be exact, almost an extra mile of walking.
  • Avoid Sugary Drinks:Soft drinks contain fructose and high fructose corn syrup, both of which increase weight. Cutting out a can of Coke a day saves 15 pounds a year. I had one patient who gave up her soda and lost 50lbs.
  • Wait 20 Minutes Before a Second Helping: It takes a few minutes for your brain to know the food has gotten to your gut.
  • Solve Other Problems: We often turn to food to help us feel better. From Southern California Kaiser Permante Medical Group, "If you don't attack that behavioral problem, all the diet advice in the world won't help."
Try and be as lean as possible within the normal range of body weight. Why do you have trouble losing weight? As you eat more and exercise less your hormones adjust and guard the status quo. The amount of leptin is proportional to the amount of fat you have stored. When the hypothalamus of a person at a healthy weight sees a higher level of leptin than it expects, it tells the body to ease up on food intake and boost energy burning. Fat cells do not go away, but losing pounds thins the fat cells and keeps them from packing in triglycerides again.

So try for 30 minutes of moderate activity, 5 days per week. The message is simple, unfortunately it is difficult to do: eat less, move more. Increase fiber and you will be full and then stay out of the kitchen.

Staying on the slim side does not necessarily signal an absence of visceral fat. Remember visceral fat wraps itself around abdominal organs. That is why checking on % fat is important. A moderately lean woman is 23-30% body fat; for men it's 13-20%.

Nifty Diftys
  • Green and Black's organic 1.2 ounce impulse bars (190 calories or less) or Larabar's Jocalat (180 calories) are a great dark chocolate that helps with heart disease.
  • Extra sugar may increase your risk of getting pancreatic cancer-so watch those regular sodas. Those who drank regular soda 2 times a day had a 90% greater risk of developing the disease. Those who added sugar to their food and drinks 5 times daily or more also had a higher risk. Improve your odds by cutting out one soda a day.
  • Snack foods that refer to fruit (with words or images) on the package don't actually contain fruit
Secrets to Weight Loss Success From Former Fat Girl by Lisa Delaney
  • "I simply couldn't imagine who I would be if I wasn't a Fat Girl anymore." Lisa answers, "Fat can be a way of protecting yourself."
  • "Some overweight women are comfortable with who they are and how they move in the world. But there are a lot of women out there who are Fat Girls in their heads as well as in their bodies and they see themselves in the book. Being a former fat girl isn't measured by how much weight you've lost, it's more about how you handle yourself in life-your ability to set boundaries, to say no, to take risks despite the fear of rejection."
  • "You talk about how much you used to eat, but not about hunger. How much did actual hunger have to do with your eating? I didn't feel hunger, physically. It was so wrapped up with how much food was on my plate. I finally got in touch with hunger when I went on Weight Watchers. I had to get used to a pasta bowl that wasn't full."
  • "Some people who stop overeating take on other addictions such as obsessive exercising. Did you? It's easy to become obsessed with diet and exercise when you're trying to manage your weight. This can be dangerous territory for women who are predisposed to eating disorders. At first I exercised every day. I had to make exercise as much a part of my day as brushing my teeth. But then I had to look at how much it-exercising, dieting, weight-was controlling my life. I became more balanced when I realized I wouldn't blow up if I had a bite of cake or missed a workout."
  • "Exercise makes you feel powerful, capable, strong. At home a million things compete for your attention-the closet that needs cleaning, the phone call that needs to be made, not to mention the bag of Doritos in your pantry. You spend so much mental energy fighting the whiner in your head that part of you wants to curl up on the couch with a snack and that it's better to find a track or gym where you can do your thing and come home. A trainer's great, too. You only have to think about getting there with your gym clothes."
You can do this, we are a team.

-- Carol

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