We are the Lady Docs
An intro
and
Some misunderstood info on exercise and weight loss
and
A recipe of sorts, of course
Welcome!!
We've talked about starting this blog for years -- so here we are -- and here's our story!
Two years ago, my friend and physician, Thu Tran, invited me to her house for a group fitness session with a few other physicians. She wanted to introduce us to her trainer, Troy Wentzlaff, who helped her advance from runner to marathoner to triathlete. With Thu and Troy at the helm, the weekly outdoor bootcamp grew to include about 25 women, most of whom are physicians, and others who are dentists, orthodontists, professors and other professionals. We all know exercise is good for us, but this situation offers up more than just well-designed workouts. There is an easy mix of intellectual discussion, physical challenge and emotional support that we could never have imagined or designed purposely.
We annoyed Troy enough with our talking during workouts that we decided we needed to start planning social activities outside of 'camp'. What could be better after working out than eating?! In addition to Thu's brunches after bootcamp (which surely serve up more calories than one could possibly burn in an hour), we used many excuses to have other gatherings - with kudos to Sheri Hammersley, hostess supreme. We discovered that we had many accomplished chefs among us, and could present an international buffet with little notice. At the same time, we grew to be a family. When one woman had a medical crisis in her family, she sent out a group email, and within minutes had a dozen responses, with offers from members to make calls to local experts to set up appointments. This scenario repeated itself numerous times. We all agree that we have a terrific network of wellness-minded women who are looking out for each other and have food and fitness foremost in their minds.
For ourselves, as well as for our friends and patients, we realize that there is too much information in the popular press to read; once we read it, it's difficult to know what to believe. Our intention here is to present valid information in an easy-to-read format, written by a variety of health professionals, about topics of our choice and yours. We would be honored to include you in our quest for living a healthful, satisfying life in the company of others who want to do the same.
Where to begin?? I thought I'd start by presenting some misunderstood ideas about exercise and weight loss, based on a report in a recent New England Journal of Medicine(1) that was funded by the National Institutes of Health (NIH). Many of the issues covered in this report are the same ones that my patients ask on a regular basis.
SO here we go. The first conundrum is, if I walk every day, why can't I lose weight - why doesn't my weight follow the 3500 calorie rule? Here's what the rule says: that every 3500 kcal ('calories' as listed on food labels) equals one pound. If you eat 3500 extra calories without increasing your activity, you will gain a pound. If you exercise until your favorite treadmill, elliptical, exercise monitor, whatever, says you've burned 3500 calories, you will lose a pound. The number of calories you burn doing a certain activity depends on how much weight you are carrying. Medical literature always uses a 70kg (154 pound) person as their example, so we'll do the same. If you are a 150 pound person and walk a mile per day, depending on the speed and incline, you might burn about 100 calories. In theory, if you walk 1 mile daily for 35 days, you should burn 3500 extra calories. You should lose 1 pound. If you were disciplined in your routine for 3 years, that would repeat that 35 day cycle 30 times, and you should lose 30 pounds. That just doesn't happen! Why not?
There are several reasons, but here are a few of the main ones. There is a lot of individual variation in how we burn calories. Everyone knows someone who can tear into a package of double-stuffed Oreos without gaining an ounce. Let's just decide that people like that are annoying, and move on. For the rest of us, as we exercise, our muscles become more efficient (more on that in later blog entries) and we need to do more work to burn the same number of calories. There is likely also a control mechanism that kicks in that served us well in the past, but in our current age of calorie-overload is detrimental. Ages ago, when we start to lose weight, our bodies thought we are in danger of starvation - which might have been true when we were hunting and gathering. Weight loss in those times usually signaled that there was no food available. So we preserved ourselves by slowing down our metabolism to keep the fat we had. This slowing of metabolism in response to weight loss is felt to be contributory to the yo-yo pattern of weight loss and gain that so many people experience. Once they lose weight, their metabolism slows down, so they gain weight, the metabolism re-adjusts, enabling them to lose weight more easily, and so on. Bottom line - If you continue to do the same activity for months or years on end, it will no longer have the weight loss effect it did at the beginning.
The second commonly held belief that was dispelled in this NEJM report was that setting realistic goals is important in avoiding frustration with your weight loss plan. Not true, evidently. Set your goal wherever you wish -- realistic or not -- and go for it! Period!
Myth number three - people who lose weight faster at the beginning are more likely to gain it back. The fact is, many people re-gain weight, no matter how quickly or slowly they lost it. I will offer this advice, though, just from my clinical experience. I find that when patients are on extremely low calorie diets, no-carb diets or using only pre-packaged meals, they are less likely to maintain the weight loss. I believe they never learn to shop for and prepare healthy foods that will satisfy them and help them to change their lifestyle. Eventually, habits that need to be changed include everything from what you buy at the grocery store and which foods you prepare, to bringing lunch to work and finding time in your daily schedule to exercise. So, using a weight loss method that includes changing these habits is usually more successful in the long run. In addition, when weight is lost too rapidly without attention to proper nutrient balance and exercise, there is muscle loss. Since muscle burns more calories than fat tissue while you are at rest, muscle loss means fewer calories burned by your body on a daily basis. This undermines your attempt to lose weight! Therefore, including exercise in your weight loss program, both cardio and strength training, makes weight loss easier and more sustainable.
Finally, sorry to burst your bubble, but evidently there's a myth out there that says a 'bout' of sexual activity burns 100-300 calories per person. We won't ask who's applying the monitors here, but somewhere along the line it was determined that this activity burns 3 metabolic equivalents (METs), about 3.5 calories per minute or 210 calories per hour, for a 150 pound person. This is about the same as relaxed walking. In practice, however, the number of calories might be anywhere from 3 to 300. No further explanation, just don't count on the 300. That's all I'm saying.
Well, that's all for today. In time, with our wonderful network of professionals, we hope to share with you our love for learning, fitness, great healthful foods and appreciation of the mind-body connection. Please join us and provide us with your questions and join us on this journey for a better informed, healthier, happier you.
With each blog entry, I'd like to leave you with a simple, healthy recipe. Here's the simplest it gets: for a lunch you can prepare at work, cut up an apple and spread a little natural peanut butter on it - no sugar or salt added. If you're not as concerned about the calories, put it on whole wheat toast. Or for a snack, put the peanut butter on celery - It's filling and nutritious --
Talk to you soon --
Marsha
REFERENCE:
1. Casazza, et al.: Myths, Presumptions, and Facts about Obesity. NEJM 2013; 368:446-54.
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