Tag Archives: Obesity

Straight, No Chaser: Childhood Obesity

August 4, 2015Cardiology/Heart, Diet and Nutrition, General Health and Wellness, Pediatrics/Kids Health844-SMA-TALK, Behind the Curtain, Obesity, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Here’s the thing. Adults have control over and choices about how to live their lives. In the overwhelming majority of cases, children do not. Yet, in the overwhelming majority of cases, adults have control over their children’s health.

Amazingly, approximately one of every three children between the ages of five to 11 is either overweight or obese. It’s not too late. If you’re looking across the breakfast table at a child that’s overweight or obese, please take the time to learn about childhood obesity, the consequences of allowing it to continue and the proactive steps you can take to ward off those consequences. Read on.
If by chance you’re thinking that you have no idea if your child is obese or just looks that way because everyone else in the family looks that way (is “genetically predisposed”), perhaps the first step is to get a better understanding of normal vs. abnormal.

No matter you perceptions of how “good” or “healthy” it may look, normal is less a function of appearance than a reflection of your heart and other organs’ abilities to perform their tasks. Using the heart as an example (and admittedly being overly simplistic), it is a muscular pump serving the purpose of moving blood around the body, delivering oxygen and nutrients to the cells of your various organs. The more weight it has to pump against, the harder the task becomes, and the heart will eventually increase the pressure to compensate (i.e., develop high blood pressure). The sooner this process starts, the more at-risk you are for the consequences of the development of high blood pressure and other conditions (including cancer) down the road. Beside high blood pressure, other health issues associated with childhood obesity include the following:

Breathing problems
Joint problems
Diabetes
High cholesterol

It is important to acknowledge that “big” is not always unhealthy. The amount of body fat changes with age and based on where children are in their growth curve. A physician will take these things into consideration when you have your child evaluated for clinical obesity. On the other hand, please understand the social pressures children may face at school from being overweight. If they perceive a problem to exist, one does.
In the next Straight, No Chaser, we will discuss in detail what you can do to help children who are obese. To no one’s surprise, a heavy dose of healthy eating and physical activity will be on the prescription. As a prelude to that conversation, I will suggest that you should not be placing a child on a diet without a physician’s order. Healthy eating habits will be the way to go.

Overall, just remember that either the positive or negative habits children learn are likely to last a lifetime. As a parent, you will be best positioned to guide children along the appropriate path.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Healthcare Disparities

April 24, 2015General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, colorectal cancer, Conditions and Diseases, death rates, Diabetes, healthcare disparities, HIV, Hypertension, immunizations, infant mortality, Influenza, life expectancy, Obesity, periodontitis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

In large part, this blog exists to inform individuals of all backgrounds about the risks that lead to abnormal health outcomes. Our hope is that once you discover the risks, you’ll be sufficiently equipped and incentivized to take the simple steps provided to improve your health.
Disparities are abnormal outcomes of a different variety. Disparities in healthcare lead to premature development of disease and death. The culprits are often insufficient access to care, culture barriers, habits and even discriminatory practices. It is critical for all involved, i.e., individuals, healthcare planners and practitioners, to understand these causes so that everyone can adjust habits and apply resources to combat this health hazard affecting both individuals and communities.
For the last 25 years of my career, I’ve had the unfortunate privilege of addressing this topic in national forums, including before the National Urban League, before the National Medical Association, recently, in the NAACP’s The Crisis magazine and in Straight, No Chaser to extent that our service provides you with the information that can make a difference in your lives. Unfortunately for some, it’s almost never that easy.

As a statement of fact, according to the Center for Disease Control and Prevention (CDC) Health Disparities & Inequalities Report  of 2013, African-Americans suffer global health disparities that result in the following outcomes.

Life expectancy: In 2011, the average American could expect to live 78.7 years. The average African-American could only expect to live 75.3 years, compared with 78.8 years for the average White American.
Death rates: In 2009, African-Americans had the highest death rates from homicide among all racial and ethnic populations. Rates among African-American males were the highest for males across all age groups.
Infant mortality rates: In 2008, infants of African-American women had the highest death rate among American infants with a rate more than twice as high as infants of white women.

The following disparities were also reported:

Heart disease and stroke: In 2009, African-Americans had the largest death rates from heart disease and stroke compared with other racial and ethnic populations, with disparities across all age groups younger than 85 years of age.
High blood pressure: From 2007-2010, the prevalence of hypertension was among adults aged 65 years and older, African-American adults, US-born adults, adults with less than a college education, adults who received public health insurance (18-64 years old) and those with diabetes, obesity or a disability compared with their counterparts. The percentages of African-Americans and Hispanics who had control of high blood pressure were lower compared to white adults.
Obesity: From 2007-2010, the prevalence of obesity among adults was highest among African-American women compared with white and Mexican American women and men. Obesity prevalence among African-American adults was the largest compared to other race ethnicity groups.
Diabetes: In 2010, the prevalence of diabetes among African-American adults was nearly twice as large as that for white adults.
Activity limitations caused by chronic conditions: From 1999-2008, the number of years of expected life free of activity limitations caused by chronic conditions is disproportionately higher for African-American adults than whites.
Periodontitis: In 2009-2010, the prevalence of periodontitis (a form of dental disease) was greatest among African-American and Mexican American adults compared with white adults.
HIV: In 2010, African-American adults had the largest HIV infection rate compared with rates among other racial and ethnic populations. Prescribed HIV treatment among African-American adults living with HIV was less than among white adults.
Access to care: In 2010, Hispanic and African-American adults aged 18-64 years had larger percentages without health insurance compared with white and Asian/Pacific Islander counterparts.
Colorectal cancer: In 2008, African Americans had the largest incidence and death rates from colorectal cancer of all racial and ethnic populations despite similar colorectal screening rates compared to white adults.
Influenza vaccination: During the 2010-11 influenza season, influenza vaccination coverage was similar for African-American and white children aged six months to 17 years but lower among African-American adults compared with white adults.
Socioeconomic factors: In 2011, similar to other minority adults aged 25 years or older, a larger percentage of African-American adults did not complete high school compared with white adults. A larger percentage of African American adults also lived below the poverty level and were unemployed (adults aged 18-64 years) compared with white adults of the same age.

Identifying disparities is a good start. However, to reduce them it is necessary to identify and implement solutions, both individually and institutionally. To this end, we will explore best practices in future Straight, No Chaser posts. Feel free to ask any questions you have on this topic.

This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK (844-762-8255) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd. Please like and share our blog with your family and friends. We’re here for you 24/7 with immediate, personalized information and advice. Contact your Personal Healthcare Consultant at http://www.SterlingMedicalAdvice.com or 1-844-SMA-TALK.

Straight, No Chaser: Let's Boost Your Metabolism

February 19, 2015Diet and Nutrition, General Health and WellnessBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

It would be improper for me to have dragged you through the mud for three days and depressed you into thinking you can’t improve your situation. Hopefully, you’re not feeling that way. You should now have a better understanding of how the body works, how to count calories and how to compare yourself to a baseline for health. What left is giving your body a leg up on your efforts. Yep, I’m talking about boosting your metabolism. Any of you that have been with me for a while know that means I’m not promoting something you’ll find in a bottle, although there are many good supplements that can assist in that effort. I’ll refer you to your (or my) favorite personal trainer for those considerations. As always, I want to offer you the tools to be self-empowered. To that end, here’s five Quick Tips to boost your metabolism. Why five? Because five is easier to implement than six. Once you get these five down, let me know, and we can get a bit more intricate.

1. Eat smaller meals, and eat more frequently. It’s true. More meals more often is better, but only if they’re smaller. Calorie counting is still a major part of the equation. The point of more frequent meals is preventing the body from going into starvation mode, which slows your metabolism as the body attempts to conserve energy. If you do this, you’ll discover those meals are smaller and you will get closer to eat more appropriate portions than we typically do. Also, make those in-between meals healthy choices like a handful of fruits or nuts.
2. Prime your pump. Remember, it’s all about your heart’s ability to efficiently move blood around the body anyway. The healthier your heart is, the better your metabolism will be. You need aerobic exercise that increases your heart rate for 20-30 minutes at a time. Learn your target heart rate for your age, and exercise to get into that range. Your metabolism will better approximate that of a fine tuned machine rather than a sputtering old car.
3. Weight train. This is very simple. The more muscular you are, the more calories you will burn, especially relative to someone of the same weight who is obese. Not only will you become a finer calorie-burning machine, in this case you actually will look better! Add weight training to your exercise regimen.
4. Choose the fish (and not the fried variety). Fish oil contains substances called omega-3 fatty acids (EPA, DHA) which increases levels of fat-burning enzymes and decreases levels of fat storing enzymes. Daily ingestion has been shown to help by approximately 400 calories a day.
5. Enlist a personal trainer. Everyone needs help and motivation. Some of us need a lot of help and a lot of motivation. We also need expertise. There’s nothing more frustrating than working hard yet not seeing any results because you’re working incorrectly. A good trainer can put you on the path, supervise your regimen, and hold your hand through the process. The minutia of age, sex and body habitus considerations that also play a role in this can be managed by a good trainer. Your ideal trainer will have knowledge of nutrition, wellness and supplements that are tailored to your specific considerations. This will get your metabolism revved up!
By the way, if you’re into green tea, caffeine or spicy/hot peppers, enjoy them for their other benefits, but don’t expect them to contribute significantly to your efforts to improve your metabolism. At least that’s what the consensus in the medical literature points out.

Finally: yes, it’s true that metabolism naturally slows with age (starting as early as age 25); everyone has heard that fact. However, here’s what you don’t usually hear: that’s not inevitable and is more a result of your becoming less physically active than just aging. That demonstrates the need for you to be even more diligent in your efforts. Good luck, and I welcome your questions and comments.

Straight, No Chaser: Healthy, Sustainable Weight Loss – Let's Get Started

February 18, 2015Diet and Nutrition, General Health and WellnessBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

How to Lose Weight, and What is Healthy Weight Loss (AKA, How Much, How Soon and How)?
Let’s start with the How. Commercial voice: “You should contact your physician before starting any weight loss routine”. We ended things on the last post talking about the caloric balance equation, which (simplified) means you need to get off your derriere, and close your mouth. Without getting too technical, to lose weight, 1 pound equals 3,500 calories, so your net caloric intake must be cut by at least 500 calories per day to lose a pound a week. Here are some Quick Tips to cut calories (and I will not be discussing any of the popular diets or medical remedies (with one exception in the next post); you can see your physician or nutritionist about those. Besides, guess what? Most of you don’t need a fad diet. Keep it simple. And…more importantly, you should be more concerned with healthy regimens that help you keep the weight off, not drastic efforts that have proven to have quick short-term but unsustainable long-term outcomes).

1) Work out: If you can sprint, do so. If you can’t, jog. If you can’t jog, walk. I like working out while watching sports, because my heart’s pumping anyway. Weight training at the same time is even better. Once you hit a good exercise regimen, your metabolism will improve, making weight loss that much easier. By the way, the next post is on metabolism; stay tuned.
2) Hungry? Start counting calories. Use this standard to determine what your daily calorie intake should be. Meal plan so you don’t exceed that level. Remember the caloric equation to lose weight: Amount expended minus the amount eaten should be 500 calories a day. In the next post, I’ll give you a Quick Tip for an extra 400 calories a day you can lose.

3) Still hungry? Try brushing your teeth. Don’t laugh. It actually works. And it gives you nice teeth. Otherwise try drinking water or chewing calorie-free gum. All these are nice, simple inexpensive appetite suppressants.
How Soon? It’s natural for anyone trying to lose weight to want to lose it very quickly. But evidence shows that people who lose weight gradually and steadily (about 1-2 pounds per week) are more successful at keeping weight off. Healthy weight loss isn’t just about a “diet” or “program”. It’s about an ongoing lifestyle that includes long-term changes in daily eating and exercise habits. Think health instead of weight, and the weight will improve.

How Much? If you were my patient (but you’re not!), I’d tell you to forget about ideal body weight and BMI – for now. Focus on a modest weight loss, like 5-10% of your current weight. Even this success will improve your blood pressure, cholesterol and blood sugar levels. Once you accomplish that goal, do it again. So even if the overall goal seems large, see it as a journey rather than just a final destination. Seek to learn new eating and physical activity habits that will help you live a healthier lifestyle. These habits may help you maintain your weight loss over time. To that end, I love healthy challenges. Try a 30-day water instead of pop (soda)/coffee, etc. challenge, or even better, give yourself a 30-day ‘fruit for dessert challenge’ or ‘salad of your choice for lunch’ challenge. When that’s done, immediately do it again. Learn to integrate healthy habits into your quest to lose weight, and you’ll increase the odds of having sustainable weight lost. At the end of the day, it’s been well established that those who maintained a significant weight loss report improvements in not only their physical health, but also their energy levels, physical mobility, general mood, and self-confidence. Good luck, and check back for the next post on how to fine-tune your metabolism!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight

February 17, 2015General Health and Wellness, Health PreventionBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

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.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight No Chaser: Examining Obesity – Is It Really a Choice Between Health and Happiness

February 13, 2015General Health and WellnessBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

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.
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Straight, No Chaser: Health Disparities

April 14, 2014General Health and Wellness, Public Health844-SMA-TALK, colorectal cancer, Conditions and Diseases, death rates, Diabetes, healthcare disparities, HIV, Hypertension, immunizations, infant mortality, Influenza, life expectancy, Obesity, periodontitis, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Life expectancy: In 2011, the average American could expect to live 78.7 years. The average African-American could only expect to live 75.3 years, compared with 78.8 years for the average White American.
Death rates: In 2009, African-Americans had the highest death rates from homicide among all racial and ethnic populations. Rates among African-American males were the highest for males across all age groups.
Infant mortality rates: In 2008, infants of African-American women had the highest death rate among American infants with a rate more than twice as high as infants of white women.

The following disparities were also reported:

Heart disease and stroke: In 2009, African-Americans had the largest death rates from heart disease and stroke compared with other racial and ethnic populations, with disparities across all age groups younger than 85 years of age.
High blood pressure: From 2007-2010, the prevalence of hypertension was among adults aged 65 years and older, African-American adults, US-born adults, adults with less than a college education, adults who received public health insurance (18-64 years old) and those with diabetes, obesity or a disability compared with their counterparts. The percentages of African-Americans and Hispanics who had control of high blood pressure were lower compared to white adults.
Obesity: From 2007-2010, the prevalence of obesity among adults was highest among African-American women compared with white and Mexican American women and men. Obesity prevalence among African-American adults was the largest compared to other race ethnicity groups.
Diabetes: In 2010, the prevalence of diabetes among African-American adults was nearly twice as large as that for white adults.
Activity limitations caused by chronic conditions: From 1999-2008, the number of years of expected life free of activity limitations caused by chronic conditions is disproportionately higher for African-American adults than whites.
Periodontitis: In 2009-2010, the prevalence of periodontitis (a form of dental disease) was greatest among African-American and Mexican American adults compared with white adults.
HIV: In 2010, African-American adults had the largest HIV infection rate compared with rates among other racial and ethnic populations. Prescribed HIV treatment among African-American adults living with HIV was less than among white adults.
Access to care: In 2010, Hispanic and African-American adults aged 18-64 years had larger percentages without health insurance compared with white and Asian/Pacific Islander counterparts.
Colorectal cancer: In 2008, African Americans had the largest incidence and death rates from colorectal cancer of all racial and ethnic populations despite similar colorectal screening rates compared to white adults.
Influenza vaccination: During the 2010-11 influenza season, influenza vaccination coverage was similar for African-American and white children aged six months to 17 years but lower among African-American adults compared with white adults.
Socioeconomic factors: In 2011, similar to other minority adults aged 25 years or older, a larger percentage of African-American adults did not complete high school compared with white adults. A larger percentage of African American adults also lived below the poverty level and were unemployed (adults aged 18-64 years) compared with white adults of the same age.

Straight, No Chaser: The Week In Review

September 8, 2013General Health and Wellness, The Week In ReviewBlood pressure, Cardiovascular Disorders, Conditions and Diseases, health, Hypertension, Obesity, Pressure, Specific SubstancesJeffrey Sterling, MD

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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Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight

September 5, 2013General Health and Wellness, Health PreventionBody mass index, Diet, Diet (nutrition), health, Obesity, Shopping, Weight gain, Weight loss, Weight Management, WordPressJeffrey Sterling, MD

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

September 4, 2013Cardiology/Heart, General Health and WellnessBMI, Body mass index, health, Mexico, Obesity, Overweight, United States, WordPressJeffrey Sterling, MD

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

September 4, 2013Cardiology/Heart, General Health and Wellness, Health PreventionBMI, Body mass index, health, heart health, mental-health, Mexico, Obesity, Overweight, overweight and obesity, physical attractiveness, United States, Weight Management, WordPressJeffrey Sterling, MD

obesity4

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.

‘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?

August 31, 2013General Health and Wellness, Health PreventionCalorie, Diet, health, Institute of Medicine, Obesity, Physical exercise, United States, Weight lossJeffrey Sterling, MD

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.

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