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James L. Holly, M.D. |
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| James L. Holly,M.D. |
| June 12, 2003 |
| Your Life Your Health - The Examiner |
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Fats, calories, sugar, carbohydrates, weight, exercise! All of these and each of these are important to consider in a comprehensive health plan for your life, but how? How can a normal person, with a busy life, balance all of the demands upon their time and attention and at the same time pay attention to diet, exercise and health?
The answer is, you must have a plan. And, that plan must balance all of the factors needed for your achieving your goals. What you can't do - or, what you shouldn't do - is to adopt an attitude of "I'll think about that tomorrow." Some of us can testify that tomorrow is here. And, the decisions you make, or don't make, will dictate how you feel, look and do tomorrow.
The following is a framework for you to consider in developing your plan for your life. In reality, if it is not your plan, it will not work. Others cannot impose a plan upon you. You must decide for yourself that it is important for you to be healthy. You can no longer blame someone else for not being healthy. You are responsible for your health. You need counsel; you need good information, but ultimately only you can make the decision to be healthy and then stick to the choices that decision dictates.
For too long, health care providers have allowed themselves to be placed in the position of being responsible for the health of others. The only person who can be responsible for your health is you. You need sound advice and, in a crisis, you need expert intervention, but fundamentally and routinely, you are responsible for the choices you make. You can make good choices and benefit, or you can make bad choices and suffer the consequences. At SETMA, we want to be your counselor - your healthcare colleague - we will no longer accept the role of being the constable attempting to impose health upon an unwilling client.
There are seven categories which concern anyone who wishes to maintain their health, recover their health, or to achieve a new level of healthiness. They are:
- Total Calorie content of the daily food intake.
- Glycemic Index of the food eaten.
- Fat content of the food eaten.
- Nutrient content, including vitamin, mineral and food group content of the food eaten.
- Physical conditioning which dictates how efficiently your body can use the air you breath to combine with the food you eat to sustain, regain, retain or maintain your health.
- Your mental and emotional well being for all of your life.
- Your spiritual well being.
Calories and weight gain
Let's look at each one of these in turn. First, if you break the bank with the number of calories you eat each day, you will be fat. Period; end of discussion. There is no "magic bullet" which will allow you to break this fundamental fact of energy metabolism. If you eat too much, the extra calories will be stored as fat. Obviously, the total calories needed each day will vary depending upon your age, metabolic rate and activity level, but if you eat more than you need, you will be fat - don't act surprised. The more active you are, the more calories you need to consume in order to sustain your present weight. The less active you are, the less food you need to take in.
There are variables here. The younger you are, generally, the more calories you burn just in living. The older you are, generally, the fewer calories you need in order to simply maintain your current weight. In fact, after age 30 years of age, in order to maintain your lean body mass - the most efficient energy burning part of your body - you need to lose one pound per year of your life. That means at age 60, in order to have the same lean body mass you had at age 30; you need to weigh 30 pounds less.
The first decision you must make in improving your health is to lose weight. That means not "going on a diet," but changing your approach to food. That means not "trying for three weeks" to lose weight, but changing your life style and watching your weight respond. That means, not making excuses with yourself because it is a "special" occasion, but sticking with your decision to be healthy when everyone around you is not. That means knowing that while you may want to achieve your ideal weight, a 10% decrease in your weight brings huge health benefits.
However, we also know that weight and calories are not the "whole picture." All of us know people who are at their ideal body weight and who are in poor health and we also know people who are overweight, some who are grossly overweight, but who are vigorous, active, involved people. While being overweight is always unhealthy, it is possible for an obese person to achieve a significant degree of positive cardiac condition.
If total carlorie intake and weight are not the whole picture, what are the other factors in our formula for life-time health?
Glycemic Index
If you want to "age well," that is, if you want to maintain good health for as long as you can, you must pay attention to the glycemic index of foods. Essentially, the glycemic index is an indication of how rapidly a food product is absorbed into your body and how rapidly it is transformed into glucose (sugar). The higher the glycemic index the more rapidly a food becomes sugar in your body. The lower the glycemic index the slower this happens.
High glycemic index foods - foods which go to sugar quickly (for information on Glycemic Levels of different foods, see The Examiner, April 8th and April 15th, 2002). Not only will the consumption of large amounts of high glycemic index foods cause your blood sugar to go up and lead to the metabolic syndrome and insulin resistance, these foods will make you hungry, which aggravates your weight problem. Low glycemic foods are filling and satisfying without creating more desire for food. And, once you break your addiction to sugar and high glycemic foods, you will feel better.
The only consideration in your health is not just avoiding being fat. Your body is a complex organism. In the right amounts, many substances in your body are helpful; in excess, these helpful chemicals become destructive. One of the most important hormones in our body is insulin. In fact, you can?t live without it, but as we have discussed in The Examiner the past two weeks, too much insulin leads to rapid aging, atherosclerosis and morbid obesity.
When you body is exposed to elevated insulin levels, it beings to ignore the message which insulin sends. Your body becomes insensitive to insulin and a number of "bad" things begin to happen. The final result is that you either develop a condition called the "metabolic syndrome" (more about that in a future installment) or at the least you become fat and increase your risk for atherosclerosis and heart disease.
Here's the picture. If you need 2,000 calories a day to maintain your current body weight, you can eat 1500 of those calories in corn, potatoes, bread and cake. Your glycemic index will be off the charts and you will begin to become insulin insensitive, even though you are not "overeating." You will discover that you are hungry all of the time, because insulin and high glycemic foods cause you to be hungry. Maintaining your weight becomes a bigger and a bigger problem and you don't know why.
The reason is your choices. If you eat a low glycemic index diet, you will control your insulin levels, thereby slowing the aging process; you will improve the nutrient value of the foods you eat. Thereby improving your health; you will maintain your weight, thereby decreasing your risk of hypertension, heart disease and stroke, and you will avoid the "metabolic syndrome."
Fats
Fats are less of a problem for those who don't over eat and who control their insulin levels, but elevated lipids (cholesterol and triglycerides) (see The Examiner, January 3, 2002) are an independent risk factor for heart disease, atherosclerosis and possibly even Alzheimer's disease. Fats are particularly a problem in today's society because of so many processed foods. If you are eating only "whole foods" -- products as they naturally occur without additives, preservatives, insecticides and chemical additives - fats are not as big a problem. However, because of processed foods, "trans fats" are bombarding us. Remember, that "trans fats" (See The Examiner, March 6, 2003) are produced by the hydrogenation of foods. Hydrogenation ruins the nutritional value of vegetable oils! The purpose of hydrogenation is to solidify oil so that it can be made to resemble real foods such as butter. The hydrogenation process imparts desirable features such as spreadability, texture, "mouth feel," and increased shelf life to naturally liquid vegetable oils. In doing so, the "real" foods are turned into "funny" foods which are harmful to your health.
In the hydrogenation process, vegetable oil is reacted under pressure with hydrogen gas at 250 to 400 degrees Fahrenheit for several hours in the presence of a catalyst such as nickel or platinum. Unfortunately, this process cannot control where the hydrogen atoms are added to the "unsaturated" double bonds. Randomly adding hydrogen atoms to polyunsaturated fats converts natural food components into many compounds, some of which have never seen before by man until partially hydrogenated fats were manufactured.
Some of the several dozens of altered compounds created in the manufacture of partially-hydrogenated fats are "trans" fatty acids. Fatty acids are the building blocks of fats, much like amino acids are the building blocks of proteins. Many of these altered compounds are detrimental to health.
As we shall see later, if you eat naturally occurring fat in moderation, but not in combination with high glycemic foods such as potatoes, bread, rice or corn, fats will not be detrimental to your health. Packaged foods, however, even if supposedly low fat, may in fact have a large amount of Trans fats which can be harmful to your health.
Summary so far
If you do not overeat; if you do not eat high glycemic index foods and if you eat principally whole foods avoiding processed foods with Trans fats, you are a long way toward doing what you can to achieve good health. Next week, we will continue with the last four categories our comprehensive health plan.
Remember, it is your life and it is your health.
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