Happy Sunday, everyone. In the midst another all-time best week here, I got to discuss the topics I spend most of my time discussing with patients in the emergency department: high blood pressure, smoking and obesity. What that triad has in common is how they manifest in many different disease presentations. Well, at least now you know. I guess drinking and STDs will have to wait for another time. Here’s your week in review. Feel free to click the underlined topics to access the original posts.
We started the week on Sunday reviewing how the nerve gas sarin, allegedly used against the citizens of Syria, creates death and disease. Someone actually asked me why the victim in the lead picture was wearing shaving cream. That’s not shaving cream, folks. Victims wallow in their own secretions from everywhere, including salivation, excessive tearing, runny nose, diarrhea, urination, vomiting and lung secretions before they die of respiratory failure. We certain wish the best for the people of Syria and the country as a whole.
We spent Monday reviewing high blood pressure (hypertension), also known as the silent killer because yes, it can cause you to drop dead without knowing what happened. Just remember to try not to poison the pump that delivers oxygen and nourishment throughout the body (That would be your heart!). In part two of our hypertension review, we gave you numbers to know for monitoring your blood pressure and cues as to when that high pressure warrants a visit to the ER. I’d suggest you commit a few brain cells to that information. That’s information that could save your life, given the time dependent nature of treating the strokes and heart attacks that result from high blood pressure.
On Tuesday, we began reviewing smoking cessation and the benefits associated with it. We also discussed best practices in achieving smoking cessation. It remains interesting that many more people use the patch to stop (and many do so successfully), but stopping cold turkey remains the most effective way of stopping, for those able to pull it off. Consider the 10 Quick Tips I offered and consider working with your physician on the START method. I know this is a struggle. Over two-thirds of smokers want to stop, and over half attempt to stop every year. I wish you the best if you’re in that group.
On Wednesday, we took a look at obesity in America. Based on the data, it’s clear more people are choosing the pursuit of happiness (in excess) over the pursuit of health. That said, we’re still doing something right, as our life expectancy continues to increase despite approximately two-thirds of us being overweight (although we’re living longer with more disease).
On Thursday, we reviewed the health risks of obesity and introduced you to the caloric equation, which largely determines if you’re gaining or losing weight. It’s actually a pretty simple concept that you might consider learning, because every bit you lose reduces the load on your heart (in particular) and other organs. These relative, incremental amounts do matter.
Friday was a fun day, because we discussed solutions instead of just problems. We talked about how to lose weight the good old-fashioned way, reviewing how to pace yourself, set reasonable expectations and lose healthily. Just remember it’s going to take a lifestyle change, not a fad. The tortoise always did beat the hare. On Friday, we also discussed how to jump-start your metabolism, regardless of age. The Quick Tips I gave you couldn’t be simpler and do make a difference.
On Saturday, we completely switched gears and reviewed the painful topic of hemorrhoids. Don’t forget the self-help tip ‘WASH’, and trust me, your goal is to stay away from the ER or surgeon with these. Deal with them sooner rather than later, before it becomes a pain for everyone involved! Saturday, we returned to smoking – this time of the cigar variety. I had to bring the Surgeon General along to point out the cigar smoking is not a safe alternative to cigarettes. Can you believe a single large cigar contains as much nicotine as an entire pack of cigarettes? Who knew?
Your comments, concerns and disagreements are welcome. My goal is always to provide you information that you incorporate into making your lives happier and healthier, not to be the ‘health morality police’. As the obesity posts noted, there is too often a crossroads between health and happiness. When you’re younger, you really are investing in your health to secure your future happiness, because as you age, there is a much higher correlation being your health and your happiness. My mental health colleagues will be quick to tell you how the lack of health as you age leads to higher rates of depression and suicide in the elderly. Your goal is to head down the road that offers both health and happiness. And speaking of aging…
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Tag Archives: Obesity
Straight, No Chaser: The Week In Review
Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight
Earlier, we identified the differences between a ‘normal’ weight and being overweight and/or obese. Today’s goal is to help you understand specific risks of carrying extra weight. We’ll also set the table for losing weight by discussing why weight gain occurs. It bears repeating that none of this has anything to do with the perception of one’s physical attractiveness.
Let’s focus on three considerations.
1. What are the health risks?
As body weight increases, so does the risk for several different medical conditions and illnesses, including the following:
• Arthritis
• Cancers (breast, endometrial, and colon)
• Diabetes
• Gynecological problems (abnormal periods, infertility)
• Heart disease (heart attacks, heart failure, hardening of the arteries)
• High cholesterol
• Liver and gallbladder disease (gallstones)
• Sleep apnea and other respiratory problems
• Stroke
In the event that these risks are just words on a page, learning a little bit about some of them might provide the motivation needed to avoid them.
2. What is a realistic goal for weight loss? What’s the balance between family predisposition and the foods I eat?
No matter what I tell you today, it’s unlikely to turn you into a supermodel. The goal (independent of your consultation with your own health care provider) is to get you to optimize your situation based on the things you can control. Yes, genetic factors do play a role in obesity, but beyond that you are more than able to close your mouth and get off your…couch. You are able to limit your fat and caloric intake and put down the salt shaker. Yes, genetics count, but behavior and environmental (culture, socioeconomic status) consideration play at least as much of a role. These latter considerations can even jumpstart your metabolism beyond your genetic predisposition.
3. Why do I gain weight if I’m still active?
The most simple way to answer this is that weight gain occurs from an energy imbalance. You’re taking in too many calories, and/or you’re not engaging in enough physical activity. It’s an equation, and the weight gain occurs when you’re on the wrong side of the equation. It’s not much more complicated than this. Either do less of the eating, more of the activity, or both. I mentioned in a previous post on caloric counts that you must have an excess of 500 more calories expended than you ingest daily every day for a week just to lose one pound. It takes work. This is the simple answer as to why fad diets don’t work long-term. You can’t cheat the equation. The moment you stop being diligent, you’re headed in the wrong direction. Your weight loss plan must include lifestyle changes for the long-term.
In the next post, we’ll identify some very simple methods to combat obesity based on the information provided to this point. Feel free to ask any questions or submit any comments you have.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Earlier, we identified the differences between a ‘normal’ weight and being overweight and/or obese. Today’s goal is to help you understand specific risks of carrying extra weight. We’ll also set the table for losing weight by discussing why weight gain occurs. It bears repeating that none of this has anything to do with the perception of one’s physical attractiveness.
Let’s focus on three considerations.
1. What are the health risks?
As body weight increases, so does the risk for several different medical conditions and illnesses, including the following:
• Arthritis
• Cancers (breast, endometrial, and colon)
• Diabetes
• Gynecological problems (abnormal periods, infertility)
• Heart disease (heart attacks, heart failure, hardening of the arteries)
• High cholesterol
• Liver and gallbladder disease (gallstones)
• Sleep apnea and other respiratory problems
• Stroke
In the event that these risks are just words on a page, learning a little bit about some of them might provide the motivation needed to avoid them.
2. What is a realistic goal for weight loss? What’s the balance between family predisposition and the foods I eat?
No matter what I tell you today, it’s unlikely to turn you into a supermodel. The goal (independent of your consultation with your own health care provider) is to get you to optimize your situation based on the things you can control. Yes, genetic factors do play a role in obesity, but beyond that you are more than able to close your mouth and get off your…couch. You are able to limit your fat and caloric intake and put down the salt shaker. Yes, genetics count, but behavior and environmental (culture, socioeconomic status) consideration play at least as much of a role. These latter considerations can even jumpstart your metabolism beyond your genetic predisposition.
3. Why do I gain weight if I’m still active?
The most simple way to answer this is that weight gain occurs from an energy imbalance. You’re taking in too many calories, and/or you’re not engaging in enough physical activity. It’s an equation, and the weight gain occurs when you’re on the wrong side of the equation. It’s not much more complicated than this. Either do less of the eating, more of the activity, or both. I mentioned in a previous post on caloric counts that you must have an excess of 500 more calories expended than you ingest daily every day for a week just to lose one pound. It takes work. This is the simple answer as to why fad diets don’t work long-term. You can’t cheat the equation. The moment you stop being diligent, you’re headed in the wrong direction. Your weight loss plan must include lifestyle changes for the long-term.
In the next post, we’ll identify some very simple methods to combat obesity based on the information provided to this point. Feel free to ask any questions or submit any comments you have.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: The United States of Obesity – The Crossroads Between Health and Happiness
Obesity in the United States places many at a crossroad between self-esteem and health. Often, larger frames are celebrated as more desirable. Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise. Of course, our culture embraces and contributes to obesity. Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport. I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health. If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed. As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:
Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.
Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.
‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Obesity in the United States places many at a crossroad between self-esteem and health. Often, larger frames are celebrated as more desirable. Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise. Of course, our culture embraces and contributes to obesity. Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport. I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health. If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed. As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:
Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.
Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.
‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight No Chaser: The United States of Obesity – The Crossroads Between The Pursuit of Health and Happiness
Obesity in the United States places many at a crossroad between self-esteem and health. Often, larger frames are celebrated as more desirable. Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise. Of course, our culture embraces and contributes to obesity. Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport. I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health. If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed. As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:
Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.
Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.
‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Obesity in the United States places many at a crossroad between self-esteem and health. Often, larger frames are celebrated as more desirable. Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise. Of course, our culture embraces and contributes to obesity. Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport. I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health. If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed. As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:
Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.
Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.
‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Straight, No Chaser: How Many Calories Do You Need a Day?
Let’s put this post (at least the end of it) under the category of things you do but really don’t think about.
How many calories should you take in per day to function (meaning produce the energy you need for your activities of daily living)? It actually depends on your gender, your age and your level of activity. Let me start by defining the types of lifestyles, according to the Institute of Medicine. If you are in the third category (active), I doubt that you’re worried.
Sedentary means a lifestyle that includes only the light physical activity associated with day-to-day living.
Moderately active means a level of physical activity equivalent to walking about 1.5-3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
Active means a level of physical equivalent to walking more than 3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
That breaks down as follows:
- For women between 14-50, the number is right about 2000 kcal/day (calories) if you’re moderately active and 1800 if you’re sedentary.
- For men between 14-50, there’s some greater variance, but the 2500 kcal/day works if you’re moderately active and 2200 if you’re sedentary.
In short, that averages to about 600-800 calories per meal, with the low end being for sedentary females and the high end being for moderately active males.
Now consider, 16% of the calories in the average American diet come from refined sugars. Fully 50% of that total comes from beverages with added sugar.
Every 12 ounces of non-diet of pop/soda you drink contains about 150 calories.
Your average dessert ranges from 300-500 calories.
The most popular one, only one cup of ice cream, contains 270 calories.
I’ll let you take the math forward from there. However, the take home point is obvious. Suffice it to say, the link between pop, deserts and obesity has been well established. Here’s three Quick Tips for you.
- Try finding a drink with fewer calories if you want to lose calories (and weight). It’s water, not Coke, that adds life.
- Try eating your favorite fruits as dessert.
- Also, consider just walking 3-4 miles a day. It’s not that hard, if you just do it.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
Let’s put this post (at least the end of it) under the category of things you do but really don’t think about.
How many calories should you take in per day to function (meaning produce the energy you need for your activities of daily living)? It actually depends on your gender, your age and your level of activity. Let me start by defining the types of lifestyles, according to the Institute of Medicine. If you are in the third category (active), I doubt that you’re worried.
Sedentary means a lifestyle that includes only the light physical activity associated with day-to-day living.
Moderately active means a level of physical activity equivalent to walking about 1.5-3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
Active means a level of physical equivalent to walking more than 3 miles per day at 3-4 miles per hour in addition to the activities of daily living.
That breaks down as follows:
- For women between 14-50, the number is right about 2000 kcal/day (calories) if you’re moderately active and 1800 if you’re sedentary.
- For men between 14-50, there’s some greater variance, but the 2500 kcal/day works if you’re moderately active and 2200 if you’re sedentary.
In short, that averages to about 600-800 calories per meal, with the low end being for sedentary females and the high end being for moderately active males.
Now consider, 16% of the calories in the average American diet come from refined sugars. Fully 50% of that total comes from beverages with added sugar.
Every 12 ounces of non-diet of pop/soda you drink contains about 150 calories.
Your average dessert ranges from 300-500 calories.
The most popular one, only one cup of ice cream, contains 270 calories.
I’ll let you take the math forward from there. However, the take home point is obvious. Suffice it to say, the link between pop, deserts and obesity has been well established. Here’s three Quick Tips for you.
- Try finding a drink with fewer calories if you want to lose calories (and weight). It’s water, not Coke, that adds life.
- Try eating your favorite fruits as dessert.
- Also, consider just walking 3-4 miles a day. It’s not that hard, if you just do it.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress
