Eat less, walk more
Weight loss is not quite so simple
A true story
Q – how do you treat sore hips and pain in the legs?
A – you eat little and acknowledge you are 68!
That was the gist of the conversation I had the other day with my doctor. More specifically, it went something like this: -
Me – “Doctor, I find it increasingly difficult to walk without pain and without getting breathless.” I was going to go on to ask whether it could be a slipped disc, sciatica, a form of arthritis or ….when he interrupted with … “You know there is only one way to lose weight – eat less and get more exercise." To read how ridiculous such advice is, read more here.
I was appalled on a number of counts:-
I hadn’t asked about weight loss. Was he listening?
He hadn’t asked me about what I ate, how often, how much, what kind of exercise I did, how often, and how much? So how could he in all seriousness tell me how to eat and exercise?
I eat small portions, have only two meals per day, eat no snacks, my food is fresh ie non tinned, packaged, or processed. I walk, increasingly with limitation, and swim.
He had asked me nothing about the issues I had presented.
I am tired of doctors who do not listen, run with their own agenda ie non-patient centred, take no time to find out about the patient’s symptoms and story.
He looked rightfully stunned when I interrupted and said, “I have not mentioned weight! I am here because I have increasing difficulty walking and it is impeding my life. Being unable to walk much is affecting my ability to exercise.”
There was a typical, embarrassed, “Yeah, whatever…” muttering and then the conversation continued …
“So what did you hope I could do?”
“I didn’t! I am here to see what options you can suggest!” Why do doctors leave it to patients to come up with ideas for treatment if they are not offered a menu of possible treatments?
“I can prescribe some pain killers and some anti-depressants!” Typical default setting!
“I would prefer we could ascertain the cause and treat the cause. Is it an adrenal issue, discs, wear and tear, arthritis or what?”
“It’s most likely your age! You are 68! We could do a scan but that would just show your age. (Oh really?) or an MRI scan but that is only worthwhile if we are thinking of operating!”
“Oh well I shall try an osteopath or chiropractor as I feel a need for some deep tissue manipulation.”
“Oh I don’t approve of that but if you have money to waste then be my guest! I could refer you to physio but there is currently a 16 week waiting list. I know, I know, the Scottish Government say it should only be 4 weeks but in the real world we know they tell porkies.”
Now he probably thought he was being funny but it does nothing to instil hope or possibility into a patient! And certainly nothing to address the real issue of waiting lists. It is indicative of the attitude of “no one cares!”
I declined the anti-depressants and left with 200 co-codamol, a heavy heart and wondering why so much money is spent in training doctors for this low level of approach and out-of-date advice.
It's not so simple as eat leass, walk more!
Whilst being slim is not necessarily proof of being in optimal health, carrying excess weight significantly raises your likelihood of suffering health problems. But the answer does not lie in simplistic prescriptions to eat less, walk more!
I have diabetes Type II and know that metabolic dysfunction, such as insulin and leptin resistance, add to obesity and triggers inflammation; a factor linked to a wide range of health problems, including but not limited to:
Cognitive decline, dementia, and Alzheimer's (not sure about this)
Gallbladder disease (which I had recently)
Hypertension, heart disease (which I have) and stroke
Kidney disease (kidney function recently was poor)
Non-alcoholic fatty liver disease (NAFLD)
The bigger picture
Most overweight people I have known, myself included, have tried numerous diets. (I no longer believe in diets!) With difficulty they have lost a little weight then quickly gained it all back, and then some more. Some have been more successful.
To sustain weight loss we need a healthy metabolism and mitochondrial function (simplistically the production of energy in cells); many diets trigger more dysfunction than they do correct it.
For years, my various diabetes nurses have told me to “always count the calories” but it is now known, as I have always known, that calorie counting is one of the most boring, mind-numbing, difficult and most importantly, ineffective weight loss strategies that exists. All calories are not created equal and have different metabolic influence, depending on their source.
Starvation diets don't work either. Intermittent fasting does.
Movement and Calorie Burning
Zoe Harcombe's book, "The Obesity Epidemic: What caused it? How can we stop it?"
is a good introduction to why simply eating less and moving more does not help you
reduce your weight.
Exercise alone is ineffective. You cannot out-exercise your mouth.
Now, I do not deny the benefits of exercise; it helps us become and keep fit and requires
more energy to be used up than sitting or lying down.
In a recent experiment results showed the following:
Sitting burns about 20 calories per 15 minutes
Standing up burns about 22 calories per 15 minutes
Walking burns almost three times more calories than sitting or standing
An hour of walking slowly, by a person weighing 130lbs, will burn 118 calories
How much physical activity does it take to burn off favourite meals and snacks?
To "work off" a single McDonald's Big Mac, men would have to do more than 40 minutes of cardio; women just over 50 minutes. If you add a large French fries, you would need to factor in another 40 minutes of cardio for men and 48 minutes for women.
Now add in a can of soda, and that requires an additional 12 to 14 minutes of cardio for men and women respectively.
In short, to undo the damage done by this meal would require you to do at least 1 1/2 hours of moderate to intense exercise.
And that’s just one unhealthy meal! Most of us probably eat at least one per day!!
How many of us do ten and a half hours moderate to intense exercise a week?
All calories are not created equal
There are metabolically harmful calories eg net carbs. Net carbs is a calculation representing mostly just the starches and sugars in a food after some fibre and sugar alcohol contents have been subtracted.
But how many of us have the will to calculate the net carb value of food? To do so, you would have to first subtract all of the insoluble fibre (if listed) from the total carbs and total fibre. If more than 5 grams of total fibre remain, you can also subtract half of the remaining fibre from total carbs. (Oh do keep up!) Then look at the sugar alcohols. If there are more than 5 grams of sugar alcohols, subtract half that amount from the total carbohydrates. If erythritol is the only sugar alcohol listed, you may not subtract any sugar alcohols. Got it? How many of us go shopping with a calculator?
Primary culprits of net carbs include all forms of sugar, as well as most grains, which turn into sugar in your body.
It is easier to eat foods low in glycaemic index and low in insulin. (See separate pages.)
The insistent belief, by my diabetes nurses, that "a calorie is a calorie" has done much to contribute to the worsening health of the Western world.
To repeat - calories are not created equal. The source of the calories makes all the difference in the world. Groundbreaking research by Dr. Robert Lustig shows that calories from processed fructose are of particular concern.
Research shows that calories from bread, refined sugars and processed foods promote overeating, whereas calories from whole vegetables, protein and fibre decrease hunger.
Another factor is that even though the "calorie in" count may be identical, your body will burn off more of the protein calories than the carb calories.
Calories from fibre-rich carbs such as vegetables barely count when it comes to calorie consumption as they're very low in net carbs and provide valuable vitamins, minerals and fibre that nourish your gut flora, increasingly called your microbiome. This is because your body can't burn fibre so fibre adds no calories.
Fibre is not digested and broken down into sugar, which means it will not adversely impact your insulin or leptin levels.
A way of eating increasingly recommended by Dr Robert Lustig, Professor Tim Noakes, and Dr Asseem Malhotra (cardiologist) is to eat more healthy fat and moderate your protein intake. This means getting as much as 75 to 85 percent of your daily calories from healthy fats like grass-fed butter, olives and olive oil, coconut oil, avocados, raw nuts, and pastured eggs. It takes time to move effectively to a Low Carb High Fat to the point where once your body is well-adapted to burning fat as its primary fuel, it becomes very efficient at burning calories derived from fat . One of the keys to making this metabolic switchover is to dramatically cut your sugar consumption. As long as you're giving your body sugar, it will use that first. Intermittent fasting can also speed up your body's transition from burning sugar to burning fat as your primary fuel.
In a nutshell
If you're concerned about your weight and health, you need to address the quality of your food, the ratio of carbs, fats and protein, and increase your physical activity level but remember you need a lot of time in physical activity for it to make a sustained difference.
Don't make the mistake of trying to figure out which processed foods are "good" for you and which ones aren't. A far more effective rule is to simply eat real food, as close to its natural state as possible.
Cut out added and refined sugars – also included in processed foods
Choose fresh foods from the low glycaemic index and insulin index
Eat only REAL FOOD: buy whole, ideally organic, foods and cook from fresh.
This will reduce your sugar consumption, the root cause of insulin resistance and weight gain.
Buying organic is not a fad; in buying organic, you cut your exposure to pesticides and genetically engineered (GE) ingredients,
In eliminating processed foods, you avoid artificial sweeteners and harmful processed fats.
Eat smaller portions at each meal – and no second helpings.
Eat plenty fresh vegetables, as a rule, those grown above ground
Consider intermittent fasting: if you're still struggling with excess weight after you've cleaned up your diet, you may want to reconsider the timing of your meals. Intermittent fasting can be very effective for helping your body shift from sugar- to fat-burning mode. Intermittent fasting is not a diet, but rather a dieting pattern
Skip certain meals or eat your intake during a specific window of the day, and choose not to eat food during the rest eg
Regularly eat during a specific time period eg only eating from noon-8 PM, essentially skipping breakfast.
Skip two meals one day, taking a full 24-hours off from eating. For example, eating on a normal schedule (finishing dinner at 8PM) and then not eating again until 8pm next day
Give up any sedentary lifestyle – hourly, move or stand for 15 minutes. Use stairs instead of lifts. Stand when you talk on the phone.
EFT (Emotional Freedom Technique)
Introduction to tapping for weight loss.
To read about how ridiculous the advice to "Eat Less Walk More" really is, read more here