Day 2 and more on BMI

Here is a link to how wrong BMI can be in reality.  Olympic Athletes who are considered overweight.  A better feel for are you getting healthier is are the pants getting looser?  It is not a sure fire method but if your weight stays the same but your pants get looser then you may be losing fat and gaining lean body mass.  If you concentrate on the scale only and not on your body composition then you could end up being skinny fat.  You could have a low weight but have little or no muscle tone.  You could have a hit fat to lean body mass percentage.

Here is what I had today.  I have excluded the glasses of water I drank.  I am trying to drink a lot of water.  This is day 2 of the no Diet Coke with lime. (or any soda)  Yes, Diet Coke with Lime is my foible.

Whey protein, frozen blue berries, ice and water, blended. Makes about a quart.  About 500 calories.

I then went running for 80 minutes.  My goal was just to do a steady run for 80 minutes without looking at the pace etc.  I ran from my home to Roy Rodgers, towards Sherwood to Grandma's farm and back, about 12 kilometers.  Took a shower and had:

meat balls (turkey) in spagetti sauce with broccoli

I also had water. (both during the run and lunch)  About 30 minutes later I was still hungry.  So I had:

Cherries, small bowl

Then I took a nap.  Slept for about 2 hours.  About 3:30 ish had a snack

Whey protein and small portion of frozen blue berries and water and ice.

Then we went out to Sushi Terriaki in Sherwood.  For an appetizer I had

On top is salmon and tuna (raw) and avocado, cucumber slices and lettuce.

For the main course I ordered the chicken broccoli without rice.

I had hot green tea (no sweetener) and ice water.

A Week of Food Porn

Okay, not really.  The Trainer wants me to photograph all food and drink that I intake.  So here it is:
After my workout I had a protein drink: (low carbs, high protein, low fat.)

Unsweetened Tea

Lunch, Baked Chicken on the bottom, steamed broccoli, some walnuts, sun flower seeds, dried cranberries, asparagus, tomatoes

Snack about 3 PM. I was hungry

Dinner, romain lettuce and poppy seed dressing, tri tip underneath, water to drink

Had 4 of these during the day and 3 16 Oz glasses at night

The Trainer

I have worked with a trainer at 24 Hour Fitness - Downtown and The Pearl Locations - for several years now.  It has worked for me.  The issues are complex and you need someone who is a domain expert in the field.  If you get sick you go to a Dr. and get professional advice.  If you get into legal trouble you hire a lawyer.  A good trainer understands body mechanics, nutrition, motivation, training techniques, and biology.  If they think The IT Band is a 80's Rock Hair Band get a different trainer.  The trainer must balance pushing you beyond what you think you can do and injury.  Like a great teacher they need to stretch you to make you better.  In working with a trainer provide them with feedback.  If an exercise hurts tell them.  Don't gut it out.  They want the exercise to be difficult in some cases but not painful.  Pain is almost always a sign you are doing something wrong.  It means you may get injured.  You want to avoid injury.

I value my trainer and have voluntarily written several as positive letters to her management and higher up the chain.  Yes, actual snail mail letters, not email.  It means more.  In future blog postings I will refer to this person as The Trainer.  Her name is not publicly important.  Since this is a public blog I would like to err on the side of privacy.  I do not want to make public their private life or interfere with it in any way.  The world is full of crazies and the last thing I want to do is expose this person to some unknown nut job.  For those of you whom I know I would be glad to recommend you to her.  At least you are a nut job I know. (a little humor folks)

The Trainer has been very diligent in the training aspects.  Very encouraging, pushes, checks up on nutrition.  I am not always the easiest to work with.  I have my foibles.  I do try to not bitch about the exercises.  After all I am paying for it and I would rather have her push me than bitch about it and still have me push me.  I want to encourage The Trainer to assist me in my journey.

How you do an exercise is very important.  I developed "runner's knee".  I was running and turning my right foot out too much.  This caused the tendon to take a sharp turn under the patella (knee cap).  It hurt. It hurt a lot.  I rested the knee for a week and tried again.  I got about .25 of a mile and it started hurting again.  I stopped and walked home. Again the rule is do not get injured. If injured do not make it worse.

I went to a GP and was told I had arthritis.  I went to a bone Dr. (not a surgeon) and he said no, you have runner's knee. Go to the physical therapist and she will help you.  I did (Providence Jel Wend Center where the Portland Timbers play).  I can only say positive things about the therapists there.  They gave me exercises to do, made sure I did them correctly, and communicated with The Trainer.  They , the therapists and The Trainer, knew their stuff.  Domain Experts.  It made a huge difference I am running again.

Fall Down 7 Times Get Up 8

It is hard to change habits; it is difficult to go outside your comfort zone.  You will have set backs.  At times I have worked hard to lose 5 lbs, taking a couple of weeks to do it.  Then one week you gain 6 lbs.  AAARRGGHH!  Frustrating I know.  Look forward, if you Fall down 7 times get up 8.  Try to learn from it.  Use it to motivate yourself.  Do not beat yourself up over it.  I have done that many times and it doesn't work.

The game of getting healthy is a game of inches.  You are going to have fluctuations.  The body is complex.  I had a meal that was very salty and I gained a lot of weight. 2 days later I was back to where I thought I was.  I didn't make a major diet or exercise change.  I found I am sensitive to salt.    I do not try to avoid salt, but I do not add extra salt to my food.  Everyone is different.  You have to find what works for you.

Be aware that the timing of what you eat is important.  Smaller more frequent meals are better than one large meal even if the number of calories is the same.  Your body can only absorb so much at a time.  Too many calories at one time and the body will try to store the extra calories as fat.  On the other hand, you don't want to starve yourself.  The body will turn down its furnace and you will get more efficient and burn fewer calories.  Also your body may start burning protein for fuel. Again not what your goal should be.  Burning protein is burning lean body mass.  Lean body mass takes more calories per day to sustain itself than fat.  To help recover from a work out you need to eat some protein.  When I say that I do not mean a 16 oz steak.  I mean an once or two of protein.  Also drink water.

It is a tricky balance.  If you fall down 7 times get up 8.

Skinny Fat, ignore BMI, and Pet Peeves

I hate to say it but people keep using BMI as a measure of obesity.  BMI stands for Body Mass Index.  Here is a link on how to calculate your BMI. The formula is basically your weight divided by your height squared.  In theory it is supposed to give you a ranking on how what percentage body fat you have.  In reality this works fine for a normal person.  Normal being what the formular expects.  In reality it stinks.  If you are fit but overweight then you may have a large amount of muscle (good) but your BMI might indicate you are morbidly obese.  if you are light weight but do not have much muscle then your BMI will be low even though you are unhealthy. Think of a cancer patient wasting away; their muscles have atrophied and they have a great BMI.  You would hardly call them healthy!

Take me. Now I have lost quite a bit of weight but my BMI says I am morbidly obese.  I know  I need to lose more fat. I need to improve my lean body mass (muscle, bone, organs) ratio to my body fat.  Why does BMI fail me?  I have a short leg inseam (29 inches).  I am 5 feet 11 inches. I have a long torso.  When I sit down on a plane my head is well above the seat back.  I have very large calves and quads.  Not fat legs but very muscular legs.  Muscle is denser than fat.   So the more muscle I have the worse my BMI will be!  There is a trainer at the gym who is very muscular.  He is a weight lifter.  I have seen him without his shirt on in the locker room and I would be surprised if he has over 5% body fat.  Yet, i am sure BMI says he is overweight.  The guy looks very healthy and is a darn nice guy.

There are better measures.  One measure is to do hydrostatic body fat testing.  I get it done at Adventist health on 10123 SE market St. In Portland out by the 205 mall.  It is very reasonable and accurate.  You make an appointment, bring a towel, and a bathing suit.  They have a locker rooms. You change into your bathing suite.  She has you step on a scale.  Then you climb into a pool of warm water.  You sit in this PVC chair that is hanging from a rope. (attached to a scale)  She tells you what to do and you are in complete control.(no reason to panic)  You put your head underwater, exhale as much air as you can.  She will tap on the pipe to tell you she got the measurement.  remember you control your access to the surface so there is no reason to panic.  She has you do this 4 or 5 times to get a consistent reading.  Then you take a shower and get dressed.  She gives you the results.  The cost is about $35.  it is well worth it.  You can see if when you are losing or gaining weight if it is muscle or fat.

This method is much better than the skin fold test.  I used to do that but as I lost weight it "said" that I was getting fatter.  I was not as The Trainer and my Endocrinologist said, your fat is getting looser, more giggly because your body is getting ready to metabolize it. (burn that stuff off)

Another pet peeve of mine is the starvation diets.  Often they give you soy protein and starve you. (800 to 1,000 calories a day).  yes, you will lose weight.  Unfortunately, soy protein is not as good for you as other proteins and can affect women's hormones, promoting fat stores. So you get lighter by losing muscle and gaining fat.  Just the opposite of what you want!  Your basal metabolic rate drops. (basal metabolic rate is how many calories you burn per day doing nothing)  You end up not being able to stay on this deprivation diet and when you add a normal amount of food, your body doesn't need it and stores it for future diets. (FAT-> Famine Anticipation Tissue)  You become skinny fat.  But you have a great BMI!

Finally, I want to say something about motorized wheel chairs.  If at all possible never get one.  There are a small group of people where they are necessary and appropriate.  Unfortunately, they have become very popular and you see very obese people in them.  If they do not get up and try to never use them again they will die in that chair.  I have a friend who is a nurse and she sees this all the time.  The chair kills them.  Those people need a lot of help and encouragement.  They are not going to get out of the chair in one day.  It is going to take months of hard work.  So please do not misinterpret what I am saying as I think they are lazy bums.  Not at all.

The Begining

For decades I have been obese.  A variety of General Practitioner MDs all had the same advice.  "Eat less and exercise more."  I would try for about 6 months to follow that advice.  I would almost starve myself and exercise as much as I could.  I would lose some weight - 10 to 15 lbs and then plateau.  It was very frustrating.  My Type II diabetes got worse.  I went on more medications.  I felt helpless to control my blood sugars.

Type II Diabetes is a terrible disease.  Basically it is the inability of the body to keep blood glucose levels in the proper range.  It has devastating effects on the body.

• Adverse effects to the cardio vascular system, (eg heart attack, stroke, loss of circulation which can lead to amputation of limbs, etc.)
• Depression.  This one took me 15 years to understand.  Note: if there are any Dr.s out there please explain this to your patients.  Swings in Blood Glucose levels are a stressor on the body.  The body reacts with the fight or flight response.  An occasional fight or flight response is normal.  If your body keeps going into that response you will increase the possibility of depression.  It would have been nice to know this when I was diagnosed not 15 years later.
• High Cholesterol and triglicerides.  High blood sugars overwhelm the liver and so the liver starts dumping the extra glucose as triglicerides and cholesterol.  Very bad.
• Neropathy  (I may have spelled it wrong).  This often feels like your feet are warm or it is uncomfortable to wear socks.  
• Compromised immune system.  You are prone to infections.  Infections can become worse quickly and lead to amputations.  This is especially true if you are a smoker.  I am not.
• Nerve damage.

Think of it as a slow death.  There Type II Diabetes is a huge problem in the USA.  

My peak weight was about 360 lbs.  I could not run 1,000 meters.  I could walk for quite a distance, but forget running.

After decades of this I went to the 24 Hour Fitness in Downtown Portland, Oregon.  There I met a trainer.  We discussed my fitness goals, lose weight, get much healthier.  I stepped on the scale and she did the skin fold measurements to determine my body fat percentage.  We confirmed that in fact I was obese.    At this point in time I was on a large daily dose of insulin, and many other diabetic drugs.

That is the beginning.