October 5, 2007

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Today marks the end of the first week of blogging. I am still waiting for blood test results. Before finalizing a meal plan, I want to discuss the blood test results with the doctor in case he recommends some nutritional modifications. Based on the exam and vitals that he observed, and absent the blood test results, he suggested that I examine the protein/carbohydrate mix in my diet. In essence, he recommended a diet higher in protein and lower in carbohydrates. Recall that my BMI (32.5), weight (244.8) and waist size (42.5) indicate that I am obese, and losing weight is my first step in a healthy lifestyle.

I have been following a diet lower in carbohydrate and higher in protein for the past four days. Fortunately for me, I like a wide variety of foods, and finding things to eat has not been a problem. As I wrote to you yesterday, planning is important. It is becoming clear to me that some of my poor eating habits include grabbing something on the run rather than thinking ahead about my nutritional intake – hence, the importance of retooling our thinking and planning for a healthy lifestyle.

Now, another big challenge looms – THE WEEKEND – that two-day period when people overeat thinking that come Monday, we can diet the rest of the week. Then the cycle starts over again the next weekend. Sound familiar? This weekend I have to contend with the LSU-Florida football game in Tiger Stadium and a food fest commonly referred to as tailgating. My patience and perseverance will be tested.

Log on Monday and find out how I did. Remember, a lifestyle change means that we are in this for the long term.

Geaux Tigers!

Bill Richardson

Nutritionist’s Response

When developing a healthy lifestyle, keep your eye on the prize. As the journey progresses, you’ll begin to see how easy it is to eat right and exercise regularly.

We are all creatures of habit. Therefore, the key is to replace old habits with new ones. Visualize the way you want to look. Hold on to that image until it becomes a reality. Set small goals and embrace eating in moderation.

For those just starting out, increasing physical activity even a little can mean a lot. Remember, physical activity is any bodily movement produced by the skeletal muscles which results in energy expenditure. You do not have to perform structured exercise regimens to improve your health. Here are a few tips:

• Start looking for parking spaces that are not 10 feet from where you’re going. Park far and walk more.
• Take the stairs instead of the escalator or elevator.
• At the office, stand up and move around every hour you’re sitting at a desk.
• Work outdoors in a garden.

Short spurts of physical activity throughout the day can add up. So while at the football game, walk around as much as possible. The more you move, the less guilty you should feel if you indulge in some tailgating cuisine.

• CDC’s Division of Nutrition, Physical Activity, and Obesity
• Too busy to work out? Work out at work! (Video from MSNBC)

Michael Zanovec

October 4, 2007

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There are many challenges with any lifestyle change. I’m starting to experience them. The first is TEMPTATION. Last evening I was at a social function, and there was enough food to feed the poor in a small country. And, a lot of the food would not be featured in any “healthy” lifestyle brochure. To overcome the temptation and still be social and enjoy wonderful agricultural products, I limited myself to some lean roast beef and some of the best boiled shrimp that I have tasted. All done in moderation! A diet soft drink was substituted for adult beverages. I had plenty to eat, ate quality food and did not indulge in the sweets.

Being tempted is one thing, but the test over time is how to maintain PATIENCE to deal with temptation. If you were only tempted to overeat once, it would not be a big deal. But with busy lifestyles like mine, daily temptations arise. I just have to, and do, remind myself that my long-term goals overshadow the short-term temptations. Always think long-term. This is not a diet to go on and then off after losing some weight – and then gain all the weight back and more. This is long-term lifestyle change, and it takes patience.

While it is early in this program, the importance of PLANNING is becoming important. It seems that we often overeat or eat poorly because we haven’t planned properly for the meals. I’m trying to look ahead in my schedule and anticipate when time constraints and stresses might occur that make healthy eating more of a challenge. The importance of planning cannot be overemphasized.

One last thought concerns PERSEVERANCE. Making a lifestyle change requires perseverance. I know that is easier to say than do. But when faced with a challenge, how does one go about dealing with commitment to change? You too can join me in this journey. Let’s persevere together.

The doctor hasn’t contacted me about the blood test yet, so I will save the discussion of blood chemistry until I hear from him.

Bill Richardson

Nutritionist’s Response

The chancellor uses a word that we in nutrition are familiar with – moderation. It really is the key to maintaining healthy weight and preventing chronic diseases. When we use moderation in eating – as we use moderation in many other areas in our life such as TV watching, reading and spending – we find that we can eat most foods that are available. Just eat a little. Any food in excess can be unhealthy. Even healthy foods when eaten in excess can potentially give us an overload of minerals or vitamins. When we allow ourselves to eat most foods, we don’t get the feeling of deprivation and, therefore, we can more easily deal with temptation. When we restrict ourselves and exclude foods from our diet, that is when temptation sets in. If we tell ourselves that we can’t have certain foods, that is when we want them more than ever. Therefore, as the chancellor says, planning is critical. It is a good idea to have healthy foods available and keep regular meal times. That way extreme hunger does not set in and with it, excessive intake of the wrong kinds of foods. It is a good idea to remove all foods that do not contribute to a healthy lifestyle so that the temptation is removed.

Read MyPyramid recommendations:

• MyPyramid: Steps To A Healthier You

Read Smart Choices recommendations:

• Smart Choices: A Recipe For Good Health

Making a change in one’s lifestyle means that the focus is now different. For example, for the chancellor, the focus is now on being healthier, losing some weight and learning new eating habits. Habits are hard to break, and it does take perseverance to stick to new habits when they are not yet automatic. That means that each time he is faced with a similar situation in the future, he needs to think about what he will choose until it becomes automatic.

Complete the MyPyramid Worksheet.

Heli Roy

October 3, 2007

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The doctor’s visit, which is strongly recommended for everyone, revealed some interesting but troubling results. My BMI was worse than I expected – 32.5. That number, unfortunately, places me in the obese range. This is a blow to my ego but reinforcement that a lifestyle change is needed. I did not like seeing “obese” in my medical records. I don’t have the results of the blood test, which will reveal much needed information about my blood chemistry. Additional information received from weight and waist measurements along with another BMI reading from the School of Human Ecology confirmed the doctor’s data. Michael Zanovec, an AgCenter research associate, collected some baseline data for me and confirmed a BMI reading of 32.4, a waist size of 42.5 and weight of 244.8 pounds. I’m a walking poster boy for someone who needs to lose weight. My blood pressure and pulse rate were excellent. My bone density was excellent.

Before I make major dietary adjustments, however, I want to go over the blood test with my doctor. Hopefully, I’ll have that tomorrow and can discuss it in greater detail.

The doc and I did discuss exercise. He suggested that I begin an exercise program consisting primarily of walking – four times a week for 40 minutes at a 4 mph rate. I’ll call it my 4-4-4 program.

As I noted earlier in the blog, we are stressing a healthy lifestyle. My goals and objectives, while different from others, will be based on the advice of the doc and consistent with baseline date gathered from the examination and measurements noted above. The BMI is important, and I urge everyone who remotely thinks that their lifestyle needs some adjustment to get their BMI checked. Ask your doctor for assistance. Also, you can contact one of our extension offices, and they can advise on where to get your BMI checked. Weight and waist measurements can be done a home.

I plan to recheck this baseline date at the end of the month to see what progress I am making. I want to get the waist size below 40 inches and see progress in the lean-to-fat ratio in my body. Then we can look at the BMI to determine if these effects are getting me below 30, which is one of my first goals.

Tomorrow I hope to discuss my blood chemistry and begin our discussion about a healthy “eating” lifestyle.

Bill Richardson

Nutritionist’s Response

“Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Bone strength reflects the integration of two main features: bone density and bone quality.” (NIH Consensus Development Panel. JAMA 2001; 285: 785-795).

Quantitative ultrasound (QUS) is a peripheral device for measuring bone quality. The heel is the preferred site because it is easily accessible, it is metabolically active, and it has a high trabecular content. The device is portable and does not expose the patient to ionizing radiation like the DXA does. It’s an excellent screening tool to determine if a DXA test is necessary.

With regard to the chancellor, the QUS indicated his T-score to be 1.0, meaning the quality (physical properties such as strength, trabecular spacing, microarchitecture) of bone in his heel is 1 standard deviation above that of the average score of a young adult healthy male.

With the DXA, measurements of bone density can be obtained and used to determine whether someone has osteoporosis. However, the particular test we did for the chancellor was designed to examine his total percent body fat, not to check for osteoporosis.

Osteoporosis affects mainly postmenopausal Caucasian women (~20%), compared with ~5% of males (typically over 75 years old). Therefore, we did not specifically test for osteoporosis. To do that, I would have done a scan of his lower spine only and then another scan of just his hips.

What we did was a total body scan which does give bone density; it’s just that it’s referring to his bone density throughout his entire body, which can be deceiving. However, based on his scan, his total body bone density score was 2.7 standard deviations above that of the average young adult healthy male.

Of particular interest was his percent body fat, which was 32.4%. Generally, males should be below 25%. While BMI and waist circumference are convenient measures to obtain, actual measurement of percent body fat is superior to use. And, since we have the machine, we might as well utilize it. I just want to make sure that readers understand the difference between what BMI is telling us and what the DXA gives us.

BBMI is just weight/height2 (kg/m2). For epidemiological purposes, this measure is a reasonable surrogate for obesity. Points of 25 for overweight and 30 for obese have been adopted by the WHO and NIH since 1998. “Obesity” is operationally defined in terms of BMI. However, the actual definition is excess fat to the extent that health is impaired.

Michael Zanovec

October 2, 2007

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Chancellor Richardson at the golf tournament.

Believe it or not, I was able to pass on the donuts at the Chancellor’s Golf Classic. Committing to a lifestyle change and making “Smart Choices” requires some discipline. However, it does not mean that you can’t eat the things you like. Reviewing the links provided in yesterday’s blog, I found a bit of wisdom – portion control. So I followed our recommendation and ate the food provided but controlled the portions. It worked! And I drink water, lots of water, rather than sport drinks, soft drinks and adult beverages.

Another healthy choice was the use of sunscreen. When you are in the sun for extended period of time, use your sunscreen!

Two questions arise that need immediate discussion relative to the subject of this blog. Am I overweight? What does my blood chemistry reveal about me? Again, looking on the AgCenter Web site, overweight can be characterized by the following: a body mass index (BMI) of 25-29.9 is overweight, and obese (such as strong word) is a BMI of 30 or more. However, that might not tell the whole story. An additional piece of information is waist size. A of 35 or more inches for women and 40 inches or more for men is considered high.

I know you are waiting for my BMI and waist measurements, but you will have to wait until tomorrow.

Blood chemistry is also important. Again, anyone starting on a lifestyle change should see his or her doctor. And we recommend a blood test. For my purposes, I wanted to determine my total cholesterol, HDL, LDL and triglycerides. Once we answer the question above about being overweight and review the blood chemistry, a lifestyle eating plan based on Smart Choices will be designed to meet my goals and objectives. The donuts of the world are safe for now.

Have you thought about getting your BMI reading and maybe a waist measurement? Our nutritionists can help you with places you can go and have a BMI.

Bill Richardson

Nutritionist’s Response

Body Mass Index (BMI) measures the degree of overweight and obesity in an individual. The measurement is calculated based on an individual’s weight and height. BMI value between 18.5-24.9 indicates healthy and normal weight. A value below 18.5 indicates underweight and a value above 24.9 indicates overweight. When the value falls between 25 and 29.9 that means that a person can be overweight. A value above 30 indicates obesity. BMI is an easy and quick tool to assess where someone falls in the weight continuum. However, it has limitations. Someone who has higher musculature may get a reading that indicates that they are overweight when in fact they are not. Further tests can be done that are more accurate in determining whether an individual is overweight or over-fat. BMI does not take into consideration body fat content, only weight in relation to height.

Waist size is an important reading to assess one’s risk for chronic diseases such as heart disease. Waist size can determine whether an individual is storing most of the fat in the abdomen or subcutaneously (under the skin). Abdominal obesity increases the risk for heart disease, diabetes, stroke and other chronic diseases. The fat stored in the abdominal area is easily mobilized into circulation. It increases blood lipid levels, which can lead to fat depositing in the arteries and narrowing of arteries in important organs such as the heart and the brain. Once the arteries have narrowed, a small blockage in the artery can lead to a heart attack or a stroke. Abdominal obesity can also lead to increased risk of type 2 diabetes. Following a lifestyle program that includes aerobic activities such as walking, running and swimming and avoiding excessive caloric intake can prevent fat from depositing in the abdominal area. Specific exercises that tone the muscles in the abdominal area can help in building the muscles and reducing abdominal circumference.

Heli Roy

October 1, 2007

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The LSU AgCenter conducts research and outreach services for a variety of issues facing Louisiana citizens. One of the initiatives we have targeted is food and nutrition. Our Web site is filled with educational information relating to healthy eating and a healthy lifestyle. Yet, how do we get people to follow the recommendations?

I will put myself forward as a case study of one. Over the next year I will provide a daily blog, Monday through Friday, of my experience in making a commitment to the recommendations that the AgCenter espouses to the residents of our state.

I completed a physical exam this past week and will include some vital sign information, i.e., blood pressure, total cholesterol, HDL, LDL, triglycerides, BMI and bone density. This baseline data along with my weight and waist size will serve to gauge progress. Yes, I will publish my waist size.

In taking on this challenge several things were important to me. First, I wanted a real-life example of how someone would and should address our recommendations. Second, I wanted to be a role model hoping that others would use my example and make positives changes to their lifestyle. Also, I wanted to stress the use of agricultural products – primarily those grown in Louisiana.

My personal goals will differ from others’ goals. I know that my weight is not consistent with a healthy lifestyle, and weight loss will be a goal. Once I review the baseline data, then the dietary recommendations will be crafted to address blood chemistry issues as needed. And, while I exercise infrequently, I will commit to a consistent exercise program that will be reported.

Finally, I will not endorse products, diets, gimmicks and things that are out of the reach of everyday people.

Today – the first day – presents a challenge right off the bat. We are holding the Chancellor’s Golf Classic to raise money to support the educational goals of the AgCenter. My challenge is to stay within the diet recommendations at events such as this one that provide many temptations. My first challenge will be to pass on the donuts. However, with each challenge comes an opportunity. I should get plenty of exercise. Log on tomorrow and see how the first day went and learn more about our recommendations for a healthy lifestyle.

Bill Richardson

Nutritionist’s Response

It is important for anyone who starts an exercise and a healthy lifestyle program to consult his or her doctor first. Adopting a more active lifestyle, while at the same time eating sensibly, is the best approach and easiest to maintain in the long run. Many studies show that individuals can lose a lot of weight quickly on a strict diet, but the trick is to keep the weight off. For that reason, adopting new eating habits slowly and making them part of a new lifestyle will assure that weight loss will be slow and steady, and that it will be maintained. You may want to begin by focusing on eating more vegetables at each meal in place of other foods. Vegetables have many healthful phytochemicals that can prevent and delay chronic disease development. Starting on a healthy lifestyle now, before the holiday season gets in full gear, is the best time to give yourself and your family a gift for the holidays.

Read more information in the following article:

• Eat Healthfully To Feel Your Best All Year Long

Read these fact sheets in our Smart Choices series:

• Eating and Exercising for Good Health
• MyPyramid – Steps to a Healthier You
• A Recipe for Good Health

Heli Roy