Friday 7 January 2011

Be Healthy, part 2 (sub-section: fat management)


Friday, January 7, 2011

Be Healthy, part 2 (sub-section: fat management)



As I mentioned in the main "Be Healthy", I found when writing it that this subsection of overall health was just too large to fit comfortably in with the rest (no pun intended). While not one of the basic fundamental pillars of health any more than any other specific ailment, given that the majority of individuals in our culture have unhealthy body fat percentages, maybe it is actually worthy of its own essay. Just keep in mind that everything to follow is meant to be considered from within the context of the main "Be Healthy" essay.
(Since blogs are listed with the most recent entry on top, the main essay is immediately below this one. If you have not already, read that one first)
Having below a certain percent body fat does not automatically make you healthy...





*I've been using the term "weight" for the sake of simplicity, and out of laziness. We've all gotten accustomed to talking about weight. The common charts list something called "body mass index (BMI) which considers only height and weight. Weight is not a useful measurement. Arnold Schwarzenegger weighed 260lbs back when he competed. That gave him a body mass index of 33. In other words, he was technically morbidly obese. However, he had a bodyfat percentage of only around 6%. The average American is around 25%(male)/35%(female). The average American is right on the border between "overweight" and "obese"; judged not by weight, but by the amount of the body which is composed of stored fat. A healthy fat percentage is nearly half of what most of us are, 6-12% for men and 14-20% for women (women naturally have more fat than men, even when perfectly healthy). Our friend Arnold, despite being characterized as obese by BMI standards, had half the bodyfat of an average healthy person at only 6%. Muscle weighs more than fat. If you are trying to get more healthy, and not just look a certain way (and hopefully you are) you are exercising in addition to dieting. If you are exercising (at least if you are doing it right) you will gain muscle. Since muscle weighs more than fat, the number on the scale may actually go up, even while you need to use ever tighter holes on your belt to keep your pants from falling off.
Weight means nothing.
It is excess fat, not excess "weight", or pounds, that contributes to a host of diseases, lack of fitness, and lack of longevity. Everyone has heard the list.
Two much more meaningful measures are fat percentage and strength-to-weight ratio. The first can be measured most accurately by being weighed while underwater (fat floats, muscle does not). More feasible and convenient, you can approximate body fat percentage at home with a tape measure and any of several free online calculators.
http://www.healthcentral.com/cholesterol/home-body-fat-test-2774-143.html
or
http://www.scientificpsychic.com/fitness/diet.html
They take different measurements, so will give you slightly different answers, but they will give you a good general idea of your fat percentage.
The second is measured simply by what you can do. How many body weight exercises, such as push-ups and pull-ups, can you do? If the number is zero, you are either too heavy, or too weak, or both. This leaves plenty of room for people of different frame sizes or body types. As opposed to, for example, a list that shows your "ideal weight" based on nothing more than your height, or an arbitrary strength benchmark, it scales to the individual, and it is a reasonably objective measure. Strength-to-weight ratio makes the difference between lumbering through life in a shell that just contains you, or having your body work for you however and whenever you want. The difference between just living and being able to fully thrive. The "athletic skill level" charts by CrossFit listed in part one of "Be Healthy" takes all measurements of strength as a percentage of body weight, which means they are all measures, not of absolute strength, but of strength-to-weight ratio.
Two common mistakes people make when making the decision to take control of their health and fitness is either not tracking progress, or tracking it too often.
Remember that change comes slowly. Because it is gradual, you are unlikely to notice it if you don't keep records. An excel spreadsheet or a notebook with date, weight, measurements, and fitness benchmarks as well as any medical issues, and overall outlook on life, can keep you motivated by showing how much progress you have made when it may feel like there has been none. Taken over a long period of time, looking back at old notes and seeing the trend of improvement can be a major motivator to continue.
The best way to tell, over a long period of time whether what you've been doing is really helping is to keep records. If there are no signs of positive change, keeping records lets you know that you need to do something different.
The other mistake is the opposite extreme, checking too often. Again, change happens gradually. There will be normal fluctuations, both up and down, in both weight and strength, every day. Seeing those can be even more discouraging than not tracking at all. Pick one day a week to do an assessment, and don't step onto a scale in between; otherwise these daily fluctuations may discourage rather than encourage.

It seems to fit in with our general cultural agreement that we should never be uncomfortable, that changing body shape and composition should be easy and painless and relatively quick. We want the sort of solution where we do some very specific thing, and then the problem is solved and we never have to think about it again. We want a quick fix.
When looking at excess fat as a health issue, and not just an appearance issue - as being one small part of the greater issue of fitness in general - drugs, surgery, and extreme fad diets don't make so much sense. They don't actually solve the problem. They, like most medicine, only address a symptom.

Drugs, surgeries, herbs, special foods, exercise classes and exercise machines all make someone money. America is all about marketing.

In truth we have all known the fat loss "secret" all along. It was never hidden. But if someone wrote a new book on weight management that said "the transition will be extremely difficult and uncomfortable, and once you reach your goal you will have to make certain major lifestyle changes permanent", it would never sell enough copies to become a household word; (or even a gym word.)

In addition to the popularity of the "quick/easy fix", there has been growing for a few decades a pervasive "politically-correct" movement which says that the number one priority is not to hurt anyone's feelings. Of course making someone feel bad about themselves for its own sake is not productive. But neither is lying to people. This has nothing to do with cultural perceptions of beauty, or patriarchy, or fashion magazines. Its not about being sexy or being accepted. In part one of this essay I listed a number of examples ranging from everyday life to rare emergencies where fitness makes a qualitative difference in ability and therefor on quality of life. Having a high ratio of fat to muscle makes all of those things more difficult. And of course the list of diseases directly caused by or closely correlated with excess fat is just as long. Despite all this, there has been a cultural backlash against encouraging people to be healthy, where the emphasis is instead put on accepting one's self as is.
Imagine that concept being extended to any other area of life. In order to improve self-esteem, telling young students that if school is hard, focus on accepting bad grades, because it is not a reflection of who they are on the inside. Instead of going to college which is time-consuming, expensive, and has the possibility of failure, just learn to love yourself. Society sets unrealistic expectations for how much money a person should make, so in order to foster self-esteem, stop encouraging people to try to get good jobs. Actually, you could make a decent argument that education and income really aren't that important, that ignorance, stupidity, and poverty really aren't reflections on what kind of person someone is. Perhaps an even better analogy would be encouraging a smoker or drug addict to accept themselves for who they are, despite the substantial health risks that go along with them. People should indeed feel good about themselves. That doesn't mean we should stop encouraging people to improve themselves and their lives within their ability. After all, cholesterol, diabetes and cancer really don't care what societies standards are.
Advice on body fat management geared toward overweight people is occasionally lumped together with "media" which supposedly encourages people (women specifically) to be "unrealistically" or unhealthily thin. The reality is that anorexia is a psychological condition in which an individual sees an alternate reality (looking in the mirror at 10% bodyfat and seeing 30%). Obesity is a physical condition. While anorexia is a serious problem for those who suffer from it, it only affects around 0.25% of the population, while 60% of the population has an unhealthy level of excess fat.
Because so much of the population has excess fat stores, what we consider "over-weight" has been re-normalized - both in terms of the medical definitions, and individual perception. Having just a slight amount of excess fat is considered normal, because "normal" is measured against "average", not against healthy. As a result, many people think of themselves as having less body fat than they actually have - in some cases even people who are clinically obese.
Between these two things - people wanting quick and easy answers, and it being un-PC to say that excess fat is unhealthy, a lot of misinformation has become widely circulated and popularly accepted. Its easy to get away with since most people don't have much background in the chemistry and biology which lie at the heart of understanding nutrition.

The Fundamental Issue
Calorie balance. It's scientific fact. There are layers of complexity, but in the end it comes down to calories in VS calories out. The human body can not produce fat tissue out of air and water. It just can't be done. It would violate the most basic laws of physics. If a person, no matter what their genetic make-up, no matter what their hormone balance, no matter what their stress levels, stops eating entirely, they will lose weight. Unless one dies (or goes into cryogenic storage) the body burns calories by staying alive. While the body will try to slow down metabolism if you are in calorie deficit, the heart still needs to beat, the lungs still need to expand and contract, the brain still needs to fire neurons, cells need to regenerate. All of these things use calories. If those calories do not come from food, the body has no choice but to start breaking down fat and muscle to provide for basic life functions.
This is not to say that anyone should stop eating all-together for the purpose of losing weight. While long-term fasting can in fact be extremely effective, there are a couple of major drawbacks.
Short term fasting (24-48 hours) is actually very healthy. Not only in terms of aiding in fat management, (even with a healthy body-fat level, where total calories are not restricted), fasting every other day (continuously, one day eat, one day fast) reduces insulin sensitivity, cholesterol, risk of cancer and heart disease, increases stress resistance, and (at least in lab animals) causes significantly longer life spans. In fact, most of us technically fast every night, as it takes only 8-12 hours for the body to switch from using our last meal for fuel to using stored glycogen.
(The word "break-fast" is literally what it is)
Many people have gone on long term fasts (more than a day, as long as a month) with minimal or no ill health effects. However, there are a number of problems with complete fasting. First and foremost, it is just extremely hard. Going against one of the most basic biological drives is beyond the willpower of most people. Furthermore, unless the diet is very deliberately controlled and balanced after ending the fast, many people put all of the fat they lost back on again within a few months.
A significant danger with long-term fasting is that some vitamins and minerals (especially water soluble vitamins, C and B), don't store well in the body. Because of this, fasting is one situation in which daily vitamin pills are actually necessary.
Done excessively, fasting can eventually lead to the sort of malnutrition based conditions listed in "Be Healthy" part 1. Long-term fasting by a person without excess fat stores to burn can cause the brain and vital organs to be deprived of glucose, leading to permanent damage or death.
There are some (extremely rare) cases where a persons body is incapable of turning fat into glucose, and in these cases it may be possible to cause starvation type damage even with excess fat stores available. For this reason, if you have never successfully lost fat in your life, never restrict diet to fewer than 1000 calories a day without consulting a doctor.
The example of 100% calorie restriction is merely meant to be illustrative of the basic principal taken to an extreme. Without going into all of the details (yet), if a person consumes more calories than they burn, they WILL gain weight, (almost) guaranteed
('Almost' only because it is possible for food to pass through the body unused, especially in the case of certain illnesses)
If a person consumes less calories than they burn, every day, they WILL lose weight.
It is easy to find people who object, and claim they have "tried diet and exercise", and no matter what they do, they "can't lose weight". Therefor, they say, it does not come down to calorie balance, but rather to hormone levels or genes or processed foods or...
It is true that some biological factors (such as hypothyroid) will lower the body's resting metabolic rate. However this fact does not change the calorie balance equation. It just means that the lower metabolism has to be taken into account when determining how many calories to eat.
On closer inspection, what many people are doing for exercise tends to be less intense activities, generally done for no more time than is recommended for general health (30 minutes a day, 5 days a week). Many diets may cut out certain foods, but aren't necessarily reduced overall in terms of total calorie intake. If a person does not have an overall calorie deficit, even if a person is technically dieting and exercising, they will not lose weight.

There are simple benchmarks to tell you whether what you are doing really counts as exercise: for strength exercises, you should be sore the next day. If you aren't at all sore, you weren't really working out. You were just doing repetitive movements and killing time. For aerobics the feedback is even more immediate: you should be sweaty and out of breath. If you can hold down a conversation easily, without pauses to catch your breath, you aren't working hard enough!
A few very common things which don't really count as exercise:
-walking
-yoga
-lifting weights so light that you can easily do 15 or more reps without rest
-anything which is supposed to encourage "tone, not bulk"
(women are physiologically incapable of becoming "bulky" without steroids. Don't worry about it.)
-treadmill, elliptical, or stationary bike at a low resistance and/or low speed.
This isn't to say these activities have no value at all. Burning some calories is definitely better than none at all, (and yoga has significant benefits to flexibility and for many people for stress reduction). But they aren't exercise. You could do them for 5 hours a day and you won't increase your aerobic capacity or get any stronger.

An efficient exercise burns as many calories as possible in your limited work out time. Ideally it activates major muscle groups, core stabilizer muscles, and the cardio-pulmonary systems all at once.
A short list of examples of real exercise, (along with the calories they burn if done for an hour straight, with no rest):

Running upstairs/hill .. (1000)
Rock climbing ............... (650)
jump rope ...................... (600)
burpees .......................... (550)
running ........................... (450-700 depending on speed)
boxing / martial arts .... (400-600)
elliptical/stationary ...... (up to 400-600 on high resistance, at high speed)
mountain biking ............ (500)
rowing ............................ (450 at roughly 2min/500m rate)
aerobics .......................... (450)
moving furniture .......... (400)
swimming ...................... (370)
yoga ................................ (300)
sex .................................. (300)
skating ........................... (300)
road bicycling ................ (250)
weight lifting .................. (200)
(note that weight lifting increases muscle, and muscle increases metabolism, so the long term benefit is substantially higher)
All of the calorie burn levels vary by weight and gender and fitness level, but the relative values stay about the same. For gaining aerobic capacity, improving overall fitness, or losing weight, stay near the top of the list (or find other activities which are as much work, like a game of soccer, being a forest fire fighter, or military bootcamp). Again, this is not to say that low intensity exercises don't have value. But don't expect to get results by taking the easy route. It is perfectly possible to make the activities lower on the list intense... it's just that it is very easy to do them less than all-out, to coast on the bicycle, to swim at a relaxed pace. Running up hill or doing burpees is inherently challenging, even if you try to do them slowly.
Spend a few days doing the highest intensity exercises for 30 minutes at a time without resting, to get a feel for what real exercise should feel like.
(NOTE: if you are over 40, have been totally sedentary for years, or have medical issues, consult a doctor, or at least a personal trainer, first. Exceeding your limits too quickly will lead to injury.)
Once you know how it should feel, you can substitute pretty much any activity, so long as you do it at a level that is equally as difficult. And it is ok to occasionally do low impact work as well. Just keep in mind that if an exercise is 1/2 the intensity, you have to do it more than twice as long to get the same benefit.
Just as the body can break down fat for energy, it can, and will, break down excess muscle. Overall weight is a simple issue of calories in / calories out, and if a person is far enough obese, it may be safe to assume that any significant weight loss is in the form of fat. If, however, you are in (or close to) the healthy weight range (for your height and gender) but still have excess fat, then the goal needs to be more specifically losing fat. Allowing muscle loss while keeping fat is only going to make the strength-to-weight ratio even worse, and lower metabolism further. Yet another reason why, (even if your goal were just losing fat and not increasing fitness), you still have to do weight bearing exercise. Losing muscle won't make you less fat, even if the scale has a lower number. Exercising regularly will build muscle, which in turn burns calories 24/7, and forces the body to break down fat if it is in calorie deficit.

As with overall weight, losing or gaining fat is dependent on overall calorie balance. The average person burns, about 2000 calories in a day. Of the calories burned more than half is from basic metabolism - heart beat, digestion, thinking, etc. Even if you don't get out of bed all day, you burn (very roughly ) 1200 calories (it varies significantly depending on size, gender, muscle mass, age, and medical conditions). The rest of the calories burned each day are from moving around and doing things. Every time a muscle contracts, whether its pushing a stalled car down the street, or smiling, it uses calories to do it. Obviously the calories burned from movement are variable, and under our conscious control. Mostly.
A lot of our physical movement is actually not under our conscious control. Our brains make decisions we aren't aware of, and then has us do things without our consent. It sounds kind of creepy (at least when I put it that way) but it's true. Similar to the (mythical) "sugar high", having excess calories will tend to make us feel more energetic. We will tend to fidget more. It's one of the bodies ways of regulating itself. If you eat too much or exercise too little, you will tend to tap your toes or drum your fingers. You won't know why you're doing it. You might not even notice. If you are in calorie deficit you will tend to do these sub-conscious activities less. That will make your total calories burned each day go down. Little, non-exercise movements can add up to 350 calories in a day.
While this is largely sub-conscious, we can choose to compensate for it. Little things, like parking father from the door, washing the dishes by hand, taking the stairs instead of the escalator, or standing up instead of sitting, even though they aren't really "exercise", they all add up. Even seemingly minuscule things, like getting up to get something. Playing video games or reading a book instead of watching TV will burn ever so slightly more calories because your hands are moving, and because it takes more brain power - it actually takes more calories to think then it does to zone out!
Speaking of TV and computers, set a timer when doing any of these activities, and stick to a daily maximum. Don't get me wrong - I'm not one of those "kill your TV", "TV kills brain cells" people. I love TV. The problem is just that it is so easy to spend hours a day on it, which is time you aren't spending doing something more active. At the very least, get up and do a Tabata workout during every commercial break, or every 15 minutes.
Keeping the thermostat slightly lower than comfortable, or drinking cold water, means your body has to use calories to warm you up.
(This will be easier to stand if you follow the last piece of advice, and do some brief exercise every 15 minutes.)
I mentioned before that these sort of things won't increase aerobic capacity or strength, but they do all contribute to burning calories and they add up over the course of the day. These deliberate changes can compensate for a body which just naturally doesn't want to move around much.
Metabolism is variable too, but it is (mostly) not under our control. As has been (correctly) noted by the anti- calories-in/calories-out crowd, when a person is in calorie deficit the body naturally slows down metabolism in order to preserve fat.
It does this because we have been evolving for 100,000 years, and until a couple generations ago our food source was never guaranteed from year-to-year. Our biology has never had to deal with and adapt to a world where we have an essentially endless supply of cheap food. If we are in significant calorie deficit, the body assumes an actual famine has hit and there is a danger of starving to death. So it drops as much non-essential calorie use as possible to wait it out until the food supply returns. Key word: "non-essential". There is only so low it can be dropped. It's generally around 20% of total calories normally consumed, minimum. Even if your body shifts into "starvation" mode, you still burn at least 800-1000 calories a day, just by being alive.
In addition to lowering metabolism, and reducing fidgeting, your brain will try to get you to exercise less (by making you feel tired) and eat more (by making you hungry) if it senses a calorie deficit. This is not because your brain wants you to be fat. This is because, just like our conscious minds, the human body fears change. Gaining muscle or losing weight is much, much harder than maintaining fitness once you have it. Let that be a motivator; like giving up smoking, the transition will be really hard, but once you get past it, it will be relatively easy, and you'll feel better overall.
The fact that the body does these things to try to prevent fat loss doesn't make fat loss impossible. It does make it a lot more challenging. It means that, when figuring out how much to eat and exercise you have to take your body's natural resistance into account as well, and compensate accordingly.
Here is an example:
Say you're slightly over-fat, your weight is stable, and you exercise at moderate intensity a few times a week. Perhaps you consume and burn about 2500 calories a day (on average - exercise days it will be higher, rest days it will be lower). You decide to take control of your body, and actively manage your fat percentage as a sub-component of your over-all fitness and health. You force yourself to eat slightly less, and exercise slightly more. You burn 100 calories more each day by exercising a little more (2500+100=2600), and you eat 100 calories less (2500-100=2400).
But at the same time your body is able to compensate for that 200 calorie a day deficit (2600-2400=200) with decreased fidgeting throughout the day and a slightly lower metabolism. Your body uses 200 calories less per day, and your new metabolic baseline becomes 2400. So you are still in calorie balance, and will neither gain nor lose weight. And after 4 months with no progress, you give up in frustration. If you go back to your old habits (eating 2500 calories a day) while your body still only needs 2400, and you end up gaining more weight then if you hadn't done anything at all!
There are two ways around this. One way is to make the calorie deficit very small. If it is only 100 a day, the body will generally not attempt to compensate. This is a perfectly healthy and long-term sustainable way to go about it. However, it is extremely challenging, because with such a small deficit, one would have to be very meticulous and thorough with tracking literally every calorie. 100 calories is one single cookie, cup of yogurt, or 1/2 an apple dipped in peanut butter. Its one banana, 10 chips, or 1/10th of a hamburger. Without obsessively tracking calories, it is impossible to keep such a small margin, and tracking every single calorie gets old very quickly. The other challenge arises because one pound of fat contains 3500 calories. At a rate of 100 calories a day it would take over a year to lose just 10lbs. Most people don't have that kind of patience. One may get bored and/or frustrated far before then and give up.
On the other hand, this is the best way to make changes long term, and to avoid the common "yo-yo" weight loss and gain. After all, chances are it took years to gradually put on extra fat. It is reasonable for it to take as long to take it back off.

The other way is to have the deficit be enough to over-compensate for the body's compensation. This means a combination of an additional 200-600 calories a day less consumed than burned, for a total deficit in the range of 400-800. Even though your body may stop subconscious fidgeting, it can't stop you from choosing to get up and move around and going out to run for 30 minutes a day. Having a deficit of 400-800 calories a day from combined diet and exercise, where food is consciously limited and metabolism is kept high from a combination of anaerobic (intervals, brief sprints at a pace that can not be continuously maintained) and strength exercises, the body's attempts at conserving fat become totally futile.
Note that a calorie deficit of more than 800-1000 calories may limit essential vitamins and minerals to a dangerous degree, and so, like with total fasting, it would be important to take a multivitamin. Also, since this is combined with strength training exercise, which breaks down muscle and requires protein in order to rebuild it, the calories which are consumed on a highly calorie restricted diet should be mostly protein, in order to get enough of it.
The problem with this method is you may feel lethargic - making it even more of a challenge to work out - and you are practically guaranteed to feel hungry.

The Major Caveat to the Fundamental Issue: Hunger


It is un-PC to say so. People have been fighting the idea that fat people are lazy or gluttonous or weak-willed. Because of this, it is emphasized over and over that successful dieting is "not a matter of willpower". It is implied that it is outside of our control whether or not we give into hunger. What would be more accurate would be to simply say that all human willpower is in fact limited, for everyone, much more than most of us want to believe. As Christians have long noted, ALL humans give into temptation of some kind. Some more than others, but it is a part of the human condition. Free-will has its limits. This is true in every aspect of life where we are faced with temptation. If we don't consider drug addiction or giving into lust in inappropriate situations (like say with the really hot person we just met and really don't know that well, or perhaps with our partners, but when we are already running late for work...) to be personal failings of character, neither should giving into hunger or appetite. As I mentioned before, 93% of people who try to stop smoking fail. Nicotine is addictive. We tend to blame the makers of cigarettes for that, not the addict. And with food it is even more complicated, because giving it up cold turkey simply isn't an option. Eating some food is a prerequisite for life. Staying in calorie deficit is undeniably difficult. For some much more so than for others. That is the part which may have genetic or environmental factors: how hungry a person gets and how challenging it is for them to ignore it. Whether or not you choose to call hunger an issue of willpower is up to you.
Consider the meaning of 'brave'. Being brave does not mean feeling no fear. In a dangerous situation feeling no fear is a sign of stupidity. Being brave means feeling fear, and acting anyway. The firefighter going into a fire or cop going into a shoot-out fear for their lives, but they do what needs to be done anyway. Similarly, your genes may decide how hungry you get, and how often, but only you can decide when and how much to eat.
Much research has been directed lately into our obesity "epidemic". There are signs pointing to genetic components, hormonal components, and various food additives. But on close examination, very little of the effect of leptin, the thyroid, or high-fructose corn syrup relate directly to metabolism or digestion itself. What they primarily affect is appetite. None of these things "makes people fat". They make people hungry. Because they are hungry, they eat more. Eating more causes a calorie excess. The calorie excess causes fat gain.
Of all the factors that have changed in American life over the past few decades - how much more we drive, how much more automated our lives are, how much more processed food we eat - none is a larger difference than the difference in how many total calories we eat. Remember, a typical, mostly sedentary person requires (very roughly) 2000 calories a day. In 1961 the average American ate 2882 calories a day (note that people were also more active back then, so this was probably close to balanced). In the year 2000 we eat, on average, 3816 calories a day. That's about a 1/3 total increase. While other things may be factors, none comes close to the simple fact that we, as a nation, eat massively more than we used to - and massively more than we actually need.

Humans never had a really reliable source of food. Being omnivores, we could deal with that, since if one source dried up, we could switch to another. But sometimes its just a sucky year, and there are no good fruits OR bugs around to eat. We, like other animals without a more or less unlimited supply of food, are built to store excess calories in times of plenty to be used up in times of famine.
Because of this safety mechanism, the body doesn't generally object to a calorie surplus. It figures, just to be on the safe side, may as well accept the extra. On the other hand, in a deficit, the body screams at the mind. It can't "make" you eat when it wants, but it can make you feel like the world is coming to an end if you don't listen to it and eat. The problem then, is that for the first time in history, due to both farming techniques and cheap transportation, it is always "times of plenty". Even the poorest among us can afford enough food to get fat.
In fact, ironically enough, the poorest tend to get fatter than average. A common claim is that this is because they can only "afford" unhealthy food. This claim makes no sense. Junk food may be cheaper on a dollar-per-calorie basis, but eating less of it is still less expensive than eating too much. For example, if a burger, fries, and shake costs $3 on the "value menu", then eating just the burger means it costs $1 per meal. $1 is less than $3, and there are much fewer total calories. More to the point perhaps, is that junk food is only cheaper when considered on a per-calorie basis. However, if a person is overweight, obviously they are not in particular need of more calories. If food is considered on a per-nutrient basis, fresh produce is in fact cheaper.
Because we evolved this contingency mechanism which we no longer need, it is easy to gain weight.

The big secret which nearly all fad diet plans willfully ignore is that in order to lose fat, (without the use of drugs or surgery) it is practically guaranteed that you will feel hungry.

The single most important change, one which is absolutely vital to losing fat, is 
(to steal a phrase from my internet friend Mr Money Mustache):
"Learn to appreciate mild hunger":
"it’s an unusual feeling for a rich-world person, but once you get used to it, having a slight craving in your tummy can make you feel invigorated and warriorlike. When you are really hungry, eat a good meal. But if you’re just slightly hungry, imagine that your body has moved its suction tube from the usual “stomach” setting, over to “stored fat reserves”. It is now a positive challenge to maintain this mild hunger as long as possible, because you want to keep that suction going for many hours each day. You should still strategically throw in nutrients during this stage, like a plate of celery, cucumber, or carrots. But keep the burn going and build your hunger enjoyment skills – it can lead to a whole new level of control over your appetite, and thus you can maintain any weight you like, right down to the last half-pound."
(By the way, I am a huge fan of MMM, and highly recommend you start reading his blog immediately.  As great as I think I am, I think his blog is better.  He will help you become rich, both literally and metaphorically.)
 
If you diet, but don't exercise, your body slows metabolism and burns muscle along with fat. Exercising raises metabolism and builds muscle, in addition to burning extra calories directly. If you exercise without dieting, your body increases appetite, so you eat more to compensate for the calories burned in exercise.
In other words:
It HAS to be both
. Of the two, however, the dieting part will play the greater role.
Let's use a hypothetical example of someone who is currently gaining weight, and wants to start losing it:
The average American, remember, eats 3800 calories a day. Basic life processes only need around 1500, and with moving around in daily life, maybe 2500 total. That makes an excess intake for our example of 1300 per day. Since this hypothetical person has a daily caloric excess, they will be currently gaining weight (fairly quickly at that!) In order to lose weight you need a calorie deficit of between 100-800. That means some combination of reduced intake and increased output has to change the balance from the current +1300 to (around) -500.
That's a total change of 1800.
(1300 current excess + 500 goal deficit = 1800 change necessary to go from current to calorie deficit)
This could, hypothetically, come all from increased activity (burning 1800 calories a day in exercise) or all from dieting (eating 1800 calories less each day, which would mean going from 3800 daily to only 2000).
Burning 1800 calories a day from exercise would mean running uphill for an hour and 45 minutes (not counting any rest time) 7 days per week. Seriously; who wants to do exercise of that intensity 2 hours non-stop 7 days a week? Doing a more realistic level of exercise would require 4 hours a day (including resting between sets, at least 5 hours a day)
Compared to trying to burn that much with exercise, creating the deficit by dieting only necessitates eating less. Eating less requires no time at all, and costs less than no money. While it would take about 28 hours a week of exercise to equal 1800 calories a day, it is easy to eat 2000 or more calories in one single meal. Without seconds. Not counting side dishes. Without even a beverage. There are more than a few restaurant meals that come that way:
and it is easy to create equally as dense plates of energy at home.
While eating 1800 calories fewer each day then one is used to is a lot more doable than burning 1800 calories more each day, it is still certainly no easy task. Of course, both of these are extremes, and there is no need to do either, since one is both dieting AND exercising anyway. The point of these examples is to show that relatively more of the change in calorie balance will come from the diet component simply because food calories add up much faster than exercise calories do.


This is only an example. Individual calorie needs vary widely. To figure out the appropriate numbers for yourself specifically, the formulas on this website:
http://www.shapefit.com/basal-metabolic-rate.html
will let you approximate your own basal metabolic rate (resting calorie burn), your overall daily calorie use, and your goal calories for fat loss (or muscle gain).
It also has detailed explanations of the terms and formulas.
Note that these formulas do not take individual metabolic rates into account. If you have reason to suspect that (for medical reasons) you have a higher or lower metabolism than other people of your size age and gender, adjust the numbers up or down accordingly.
One of the most common mistakes people make when making these calculations is grossly overestimating their activity level. It might be a good idea to actually keep track for one random, typical day, exactly what you do each hour. Chances are high that you are less active than you guess.
Once you know these numbers for yourself, it is a very good idea to keep track of how much you are actually eating relative to how much you should be, at least for a few weeks. There are many free online tools to help with this. After a few weeks, assuming you see progress, you should have a better idea of what your own goal calorie intake looks like and what a calorie deficit feels like, and you may not need to keep track anymore. If you don't see progress, you can look back over the records and figure out what needs to change.
Losing fat boils down to the simple and long known issue of calorie balance. Why, then, are there about 2 million different diets and tips and tricks and drugs for it?
They are (almost) all about controlling hunger and appetite, whether they say so or not.

Most of them fail because of an over-emphasis on making it easy. Like with giving up smoking, dieting is most likely to succeed if a person goes into it with full acknowledgment and acceptance of the fact that the transition will be uncomfortable, probably very uncomfortable.
Hunger sucks.
While there are many techniques that can help keep hunger to moderate levels, in the end hunger, like all forms of discomfort, is tolerable. Like using meditation to deal with pain, it can help to remember that it is just a sensation, an experience, and a temporary one at that.  If you take the stoicism, Mr Money Mustache view, you can learn to actually enjoy the sensation, because whenever you feel it, that means you are currently burning fat to fuel your metabolism.
Perhaps due to a proliferation of public service announcements and after school specials, anorexia has gotten a lot of public awareness. Because of that, there is occasionally a perception that anyone who diets or makes an effort to lose excess fat is exhibiting an eating disorder. It is important to understand the difference between losing fat when a person currently has 40% bodyfat (healthy), and losing fat when one has 5% bodyfat (potentially deadly).
Some aspects of staying healthy require short-term discomfort. Getting vaccinations and blood tests hurt. Dental work hurts. Exercise is exhausting and sweaty and leaves you sore the next day. We don't do these things because we are masochists. We do these things despite the pain because it makes us healthy. By the same token, not eating when you are hungry does not make you a masochist. It does not make you anorexic. Being hungry does not mean you are "starving" yourself. It is in fact literally impossible to starve while a person still has fat stores (more than 5-10% bodyfat).
While it may feel like you are depriving yourself, you are actually taking care of yourself by consciously managing your health.
Hunger, and a willingness to experience it's discomfort, can actually be a tool to assist in calorie balance. As long as the body is functioning normally, hunger is a sign that the body currently has a calorie deficit. If one is trying to lose excess fat, the goal is to have a calorie deficit. Daily tracking of the calorie content of every food and calorie usage in every activity can be rather time consuming and tedious. But the body has its own built in ways of tracking. If, at the end of the day, one has no feeling of hunger at all, that's a pretty sure sign that they have had a calorie balance, (or even surplus), throughout the day. While it is still important to have at least a general sense of how many calories are in each meal, just going to bed hungry implies an overall deficit for the day. Instead of seeing hunger as a sign of self-deprivation, it can be seen as a symptom of losing excess fat and becoming healthier. Not "oh my god, I feel like I'm going to die" hungry, but at least "I could sure go for a light snack" hungry. Once you are asleep, it won't bother you anymore, and your body will turn to fat stores to fuel your dreams.

I can't emphasize this enough. It is OK to be hungry. If you take only one single thing away from this essay, let it be that. It is OK to be hungry. You don't have to eat just because you are hungry. Hunger is a sign of calorie deficit, and calorie deficit is the only possible way to lose fat. Therefor, it will be literally impossible to lose fat without feeling hunger.  When you feel it, you have to find a way to deal with it other than by eating.

That being said, and with the understanding that it will be impossible to lose fat without experiencing some degree of hunger, there is certainly still plenty of room for methods to minimize (not eliminate) hunger. It's an important base to start from to accept that change is uncomfortable, but there is not really any need to stop there.
Especially since most of the methods for reducing hunger are actually healthy steps to take anyway!
The body uses a number of different sensors and feedback loops to determine when to send a signal to the conscious mind that says "feed me", and then later that says "ok, that's enough". If you consistently fool one system, sooner or later another one is going to compensate. In order to manipulating hunger long term it may help to pay attention to more than one hunger system.
One way your body decides to tell you it's hungry or satiated is how physically full your stomach is. Another is your blood sugar level. Part of it relates to hormone levels (which are also affected by stress, disease, current fat percentage, age, activity level, and medical conditions, among other things). Yet another is simply the time of day and the pattern the body is used to.

Fill the stomach with things you need anyway, which have zero calories. Having a full stomach makes you feel full, displacing room for food.
-Drink a full glass of plain water before every meal and before every snack. Then drink another full glass after. You need to drink water anyway. Extreme college frat hazing aside, you can't realistically drink too much water.
For the purposes of hydration, any beverage counts. Soda, juice, milk, even coffee and alcohol, count towards your hydration needs. They (obviously) do not help in the context of displacing calories. In fact, they are worse than not helpful - they are a significant part of the problem. Again, going back to human evolution: in nature there are no flavored beverages.
There is only water. The feeling of thirst is designed to get us to hydrate. When we get in the habit of drinking sweet things, we add in extra calories when our body just needed plain water, and as far as your body's hunger sensors are concerned, those calories 'don't count' - you can drink 500 calories (2 standard 20oz bottles) in a minute or two, and still be as hungry as if you hadn't eaten anything. Problem is that in terms of calorie balance, they most certainly DO count.
And it doesn't matter if it is high-fructose-corn-syrup*, cane sugar, honey, agave, or all natural fruit juice. They are all liquid calories. They are all equally bad for you. If you are trying to lose fat, drink ZERO liquid calories, of any type.
*Incidentally, all of the studies on the evils of HFCS invariably compare it only to cane sugar (sucrose). This is sloppy science at best, and dishonest at worst. Honey, agave, and fruit juice (as well as actual fruit) all contain as much or more fructose than HFCS does. Any effects that HFCS has on the body would apply equally to these natural sweeteners as well. The problem with HFCS isn't that it is 'synthetic'. The problem is that it is put into so much processed foods in such massive amounts. Replacing it with any other form of sugar does not change this.
Even synthetic sweeteners such as nutra-sweet or splenda, which have few or even zero calories have been shown to stimulate an insulin response in the body. What this means is that you taste something sweet, and the body thinks it is sugar, and begins preparing for digestion. Once the digestive system is ready, when the calories don't come in after all, it gets all disappointed and annoyed, and responds by making you feel hungry so that it didn't make all those preparations for nothing.
OK, so maybe I am anthropomorphizing the digestive system, but that is basically how it works. Drinking diet drinks will actually make you hungrier than drinking water, indirectly leading to more fat gain.
-Eat lots of vegetables, with every meal. Have some more. When you do eat carbs, avoid starches, and eat only whole grains. The difference between "whole" and "refined" or "white" is mostly whether or not the fiber has been removed. Eat more vegetables. Fiber is good for you. It also can not be digested by the human body. It takes 2 to 4 stomachs to actually extract calories from fiber. (That's why cows and sheep can live off of a diet of grass, and you can't).

-When a meal has multiple courses, always eat the vegetables first. If you end up being full before everything has been finished, its better to end up not eating the calorie dense, low nutrient foods.

-Be aware of high calorie foods and add-ons (like toppings or sauces) which may be dense in calories yet not very filling. Try mustard instead of mayo, spices instead of cheese, sauces that are not oil or cream based. Like with sweet beverages, things added for flavor can sneak in extra calories without the body noticing.
-Eat high protein things, especially at the beginning of a meal and for snacks. Digesting protein (and fat) releases more leptin into the blood stream than digesting carbohydrates (starches and sugar) does.
This is a big part of why diets such as Atkins and Paleo, (although both are based on principals which have little to no scientific or historic validity), end up working for so many people. Atkins claims that carbs are too easy to digest. Paleo claims that carbs are too hard to digest. The truth is carbs are perfectly healthy. However, they don't do as much as protein and fat to quell hunger. In the context of controlling hunger in order to facilitate consistent calorie deficit, anything which provides calories without providing the feeling of satisfaction is counter-productive. Carbs aren't as bad as sweetened beverages in this regard, but they are a close second. Add to that the fact that, unlike with fats and proteins, we don't actually need carbs to rebuild cells, or for any other basic biological process, and it stands to reason that if a person is going to cut back on total calories consumed, carbs are the first things to cut back on.
That being said, take careful note that high-protein high-fat diets have been well established as very unhealthy in the long-term. Cutting back on high density carbs does not mean eliminating them, and it most certainly doesn't mean replacing them with even denser calorie animal products. It means taking the classic food pyramid, and just switching the positions of vegetables and grains, like this:
foodpyramid-full.png
-Be consistent with when you eat, in order to balance out your blood sugar levels and prevent craving inducing spikes and valleys. Being inconsistent leads to suddenly feeling overwhelmingly hungry which tends to promote binging. Since we know there are limits to anyone's willpower, better to not put ourselves in that position to begin with.
There are different strategies on this, which are basically opposite:
Some advocate eating lots of very small meals, 6 or more, evenly spaced throughout the day, or 4 small meals with frequent tiny snacks between them.
Eating frequently keeps you from ever feeling actual hunger pangs - the brief sharp pain that lasts seconds or less because you are really hungry - which can help prevent binging. In this strategy you eat before you are hungry, because when you are already very hungry there's a better chance you'll overeat. The challenge is that if you miss a single meal, you will be totally unused to ever having any drop in blood sugar, and the temptation to binge will be higher than ever.  (Note that even with this strategy, you will still feel hungry if you are in calorie deficit.  That hunger just won't be as sharp or sudden)
Others advocate having only one big meal (ideally breakfast, soon after getting up, to fuel the days activities), or even just one single meal once every other day. One advantage is that having one single meal makes it a lot easier to track calories. Another is that once the body gets used to it, it learns to regulate insulin and blood glucose better, reducing the weakness or "brain fog" many people experience from having a meal later than usual. People who alternate-day-fast tend to eat fewer calories overall, even without attempting to limit them, and a host of health benefits occur independent of calorie restriction.
The time of this day you eat this meal makes a difference. If it is breakfast, you have a whole day's worth of activities to use those calories. If it is dinner, all day as you move around you get more and more hungry and end up having a giant dinner - and then immediately go to sleep. Now you are using minimal calories, and the body stores all of that food away as fat - especially once it catches on that it probably won't get any breakfast the next morning either. Skipping breakfast and eating big dinners is a technique that sumo wrestlers use to deliberately put on extra weight for a sport where being massive is a decided advantage. Unless you happen to be a sumo wrestler in training, don't eat at bedtime (including before a nap). In fact, avoid eating anything within a few hours before bed.
Actually, that tip is valid for both methods. One thing that has been noted is a correlation between over-eating and not getting enough sleep. The reason turns out to be because if you stay up later, it gives you more time to eat! Few people can eat while they are sleeping.
(If you do, you should see a sleep disorder specialist. I can refer you. I know a guy...)
When we ignore being sleepy because we have work to do or a good show is on, our bodies - which were preparing to shut down for the evening - eventually decide that if you are going to be up burning calories, we had better feed ourselves to fuel the midnight oil burning. So we get hungry again. That episode of hunger would have never occurred were we fast asleep in our comfy comfy beds. The next time its past bedtime and you get hungry all of a sudden, instead of taking it is a sign you should eat, take it as a sign that you need to stop what you are doing and go to bed. Your work will still be there in the morning. Thanks to TiVo and internet TV, even your show will still be there in the morning. If its something due early, set the alarm to wake you early, instead of staying up late.
Ideally, try to have dinner relatively early every day, if at all, and then don't eat anything else for the rest of the evening.
The end goal is the same, whether eating small amounts throughout the day or just one big meal in the morning - eliminating the blood sugar / insulin spikes and dips which are a significant part of hunger regulation.


The 2nd method will be much harder to adapt to at first because it is so different than we are used to. Many people feel not just hunger pangs, but also cranky, weak, even faint, whenever their blood sugar drops.
This is not an inevitable part of life!
It occurs only because having the luxury of always-available food "spoils" our metabolic system. Transitioning to (for example) a every other day diet, one would have those symptoms frequently and severely; at first. But after a few days, a couple weeks at most, the body will adapt, and no longer will one be a slave to blood sugar levels (with the exception of certain medical conditions like diabetes or anemia).
Particularly if a person has extra fat stores, the body does not actually need a continuous external source of sugars in order to function. It just prefers it. Even more than with hunger, it's important to realize that the feelings associated with low-blood sugar will pass, and if suffered through for a few days may never recur again.
Consider the fact that many millions of people over the course of history have fasted, for reasons of health, religion, or protest, and managed to survive and live life just fine. Its never easy, but it does get easier after the initial shock.
Either way, the point is to not wait until you feel famished, and then eat. Either eat before you are hungry, or set a schedule or eating curfew, and stick to it.

-Eat only until you are satisfied, and then stop. Satisfied means no longer feeling hungry. It does not mean feeling "full". Feeling satiated will almost always come before a feeling of fullness - (although if eating until full is what a person is used to, one may not even notice when they are satisfied). If you eat until you feel full, you have almost certainly eaten more than your body needs. If you eat until you are "stuffed" you have definitely eaten way too much!
Appetite is closely related to, yet quite distinct from, hunger. Hunger is an actual physical sensation, such as the stomach contractions called "pangs" that occur when a person hasn't eaten for between 12 and 24 hours. Appetite is the desire to eat. Hunger is a biological response to the level of calories the body intakes relative to what the body needs. Appetite is an emotional response, which can be due to a wide variety of things. Some people may never actually experience physical hunger, because they always give into appetite before the body even has a chance to get hungry.
One of the main things which affects appetite, obviously, is hunger itself. If a person is in calorie deficit, or if they have a condition (such as hypothyroidism) which makes the body think it has a calorie deficit even when it doesn't, this component of appetite may be impossible to eliminate. The steps above on hunger can help to minimize it.
Beyond actual hunger though, anything which makes a person want to eat is affecting appetite.
Being hungry is something that goes along with weight loss. However, once a healthy body fat percentage and strength-to-weight ratio is achieved, it is acceptable - nay, necessary!!! - to then change from a calorie deficit to a neutral calorie balance (eating exactly same calories each day as you burn, no more and no less). At that point one should never have to feel hungry again!
(excepting for medical conditions that upset the hormonal feedback loops - which can generally be controlled with drugs)
But since hunger isn't the only thing to trigger appetite, the risk of slipping back into the same habits that caused excess fat accumulation in the first place always remain.
The most important life-long life-style habit change is:

eating for one reason, and one reason only: to provide sustenance and nutrition that your body needs
.

Many people eat out of boredom, or as a distraction from being sad. Find other things to do. Try a double whammy by exercising for 10 minutes whenever you realize your appetite is emotion based.

One of the most common reasons people eat when they aren't even hungry is because other people around them are eating.
Don't eat just because people around you are eating, just because it's a party or because you are at a restaurant.
Its ok to say no.
Its ok to tell people you aren't hungry.
People may look at you funny, or even resort to peer pressure, but they will ultimately understand. And if not understand, they will at least let it go. And if not, well then nuts to them! Anyone who actually wants to bully you into eating something may not really be your friend.

Seeing or smelling something delicious can make us want to take a bite, even if we don't actually need any calories. Sweet things particularly tend to be extremely calorie dense, so even "one little bite" can go a long way to undermining a diet, (especially if the goal calorie deficit margin is low).
You don't have to try a bite
of something just because someone offers.
You don't have to taste something just because it looks or smells good.

People eat just because its "meal time". Don't do that. Don't eat because of what the clock says, if you aren't actually hungry (unless, obviously, that is your method for controlling blood sugar induced hunger)

Its important to be totally conscious and deliberate about each and every thing you consume. Just like with fidgeting, all the little things add up over the course of the day.

It sounds pretty crappy, I know, but remember the purpose of eating is to provide nutrients and energy in order to live. There is nothing wrong with enjoying the food you do eat, since you do have to eat anyway; but, as they say "eat to live, don't live to eat". There are a lot of wonderful things about life besides deliciousness. Enjoy them! Play and relax and enjoy entertainment and social interactions and music and sunshine for pleasure. Eat food in order to provide your body nourishment. Never eat when you are full. Never eat when you are satiated. Never eat if you aren't actually hungry.

Not one word of this should be taken as implying that any particular food should ever be "off limits". No need to ban your favorite food outright.
All foods vary in two important relevant aspects: calorie density and nutrient density. For the purpose of fat loss, all that really matters is calorie density. For the purpose of nutrition all that really matters is nutrient density. For the purpose of health both are really important.
But neither one dictates exactly what you have to eat, nor exactly how much of it. In order to be able to eat a reasonable amount and maximize health, it's a good idea to try to eat foods which have the most nutrients for the least calories.
Its a good idea, but it is absolutely possible to lose fat on a steady diet of junk food.
You don't have to take my word for it:
http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/index.html
or
http://www.kktv.com/home/headlines/107493128.html
This most certainly isn't a good idea, but it is illustrative. The problem with this diet isn't that it is processed or that it has refined sugars or that it has carbs. The problems with it are 1) it doesn't have enough nutrients, and 2) it will leave you hungrier than a healthier diet, making it harder to maintain.
On the same token, it is equally possible to gain excess fat on healthy foods:
http://www.themedguru.com/20101107/newsfeature/overweight-kids-eat-healthy-food-study-86141584.html
Eating the right things, but eating too much of them, will still make a person fat. Having excess fat, even with healthy food choices, is still unhealthy.
The majority of "diet plans", the ones that have a name (Warrior, South Beach, Atkins, Paleo, The-Fabulous-Famous-Whatever-Diet) usually dictate exactly what, when, and/or exactly how much a person can eat. Studies of dieters indicate this may well be a part of why so many of them end up failing at changing long-term habits. One part of their early success may come from the fact that, by putting enough foods off-limits, one consumes less calories just by default. But sooner or later the body adapts to and craves the new foods, or the dieter falls off the wagon with a chocolate craving, and one way or another total calories consumed drifts back toward the old baseline. Alternatively, by considering only portion control, but not the nutrition of individual food (like Weight Watchers, for example), it is possible to have tiny amounts of extremely rich foods that add up to a lot, while still needing more food to satisfy actual nutrient needs.
The solution to both, then, is to both be aware of calorie density, and be aware of portion size.

Keep in mind that each and every bite consumed is a trade off between it, and something else you could be eating. This does not necessarily mean weighing food and tracking each and every calorie, but at least knowing the general caloric density of the broad types of food, and being able to estimate.
(As mentioned above, it is a good idea to track each and every calorie for a few weeks. This will help you learn to estimate accurately from then on.)

Imagine taking exactly one pound of different types of food. The total weight is the same, but the amount of calories in them will vary wildly. Take these examples:
FoodsCal/LbCal/cup
High Calorie

Oils3,9002000
Potato chips / Fries2,6001200
Meat2,0001100
Cheese 1,6001000
Refined Flour1,800500
Medium Calorie

Poultry900 400
Fish800260
Eggs700210
Whole Grains600400
Low Calorie

Beans350200
Starchy Vegetables
(potato, corn, squash)
350150
Fruits25065
Green Vegetables100
30
http://www.diseaseproof.com/archives/weight-loss-foods-that-make-you-thin.html

These are all rough estimates, because they are broad categories, and weight and volume measurements differ between different foods within them. However, they show the range of relative differences between the categories.
The foods that the vast majority of people's daily diets are primarily based on are 10 to 20 times as high in calories as vegetables, for the exact same amount of food!!

In just one single pound of french fries or chips, there are enough calories for an entire day.

That's less than one large bag. As calorie dense as a burger is, the large fries that comes with it as a "side" may well have even more. The range of calorie density is just massive. Compare this chart to the healthy food pyramid. Contrast it to how most of us eat. (Contrast it also to the official USDA food pyramid, which was largely influenced by the commercial food lobby!)
Notice that oil is almost 40 times more calorie dense than veggies.

Say you start with a healthy, nutrient rich, low calorie salad. Then, for flavor and variety you add in some shredded cheese, croutons, maybe some chicken or bacon bits, and then top it all off with a generous pour of oil or cream based dressing. That dressing which you think of as just a little garnishment for flavor probably has more calories than all the vegetables put together. It may even have more calories than the entire rest of the salad! All of a sudden a meal that you thought of as being down at the bottom of the list has shot up towards the top.


(Don't be like Homer)

For example, there are quite a few restaurant salads which have over 1000 calories - so this one dish, which is sometimes used as an appetizer or side, actually has close to half of one's needed calorie intake for the entire day.

No one is really surprised that long time vegans tend to weigh less than people who subsist on mostly fried foods, but this chart shows exactly why. Aside from oil, most plant foods reside all the way at the very bottom, while animal foods dominate the top.
Not on the list is alcohol, which has zero nutrients, but has more calories per gram than carbs do. Because of this "low carb" beer is somewhat silly, since the alcohol itself is a source of calories. Since it is in liquid form, like soda, alcohol doesn't satisfy hunger, but beer has anywhere from 100-250 calories per bottle.

Another way to visualize calorie density is to keep calorie size constant, and see the size of portions for different foods. The following pictures were all borrowed from: http://www.wisegeek.com/what-does-200-calories-look-like.htm
Click the image for a full size view:
(depending on your browser, you may need to click the image that comes up in a new window as well)







































Notice that some foods completely fill the plate, and look like they could actually be a meal in themselves. Others look kind of sad, and wouldn't even qualify as a complete snack. Yet, as far as your bodies metabolism is concerned...
every one of those pictures is the exact same amount of food
(200 calories each - one can of beer is about equivalent as well).

Because there is such a huge range of calorie densities, trying to limit calories by controlling portion size alone is impossible. And simply banning certain foods and then ignoring portion size won't do it either, as a few generally healthy foods, (like nuts, vegetable oils, and dairy) are dense in calories. But looking at food in terms of its caloric density gives the question a new perspective. Imagine you wanted a 200 calorie snack. You can pick anything from those pictures you want. It is absolutely fine to pick the chocolate. Just realize that its a trade off. It's not "cheating". But it does mean giving up the giant bowl of vegetables, fruit, or cereal, or the medium sized bowl of pasta or yogurt. Its up to you if it's really worth it. At the end of the day, you can only eat so many calories while having an overall deficit. How you choose to spend them is entirely up to you. Of course, the pat of butter or shot of Bailey's Irish Cream is not going to satisfy your hunger nearly as much as anything from the top of the list, and they won't give you the same nutritional value.
You have to realize, remember, and keep in mind, that which ever thing you pick is INSTEAD of something else. If you pick the 1/3 of a candy bar, or the little chunk of cheese, that's it, thats the meal. If, in our examples from above, you are starting with a baseline of 2000 calories a day, and trying for an 800 a day deficit, that means you can have 6 items from the plates in the picture above, per day. Total, among all your meals, however you split that up.
Obviously if you choose the bacon, hotdog, shot of liquor, piece of cheese, a two kinds of candy, you are going to feel desperately hungry pretty much all the time. On the other hand, if you chose the vegetables and fruit, and maybe a bowl of whole grain cereal, that amount may actually fill you up and leave you reasonably satiated. Look at that picture again, and the relative sizes of portions that make 200 calories. Imagine only being able to pick 6 of them for your entire days food. That is the trade off you are facing every time you pick a food to eat.


This visualization also shows why the "processed foods VS home cooked food" dichotomy is a ridiculous over-simplification. Yes, there is a lot of candy, junk snack food, and fast food near the bottom. But there are also a number of ingredients commonly used to cook with. Butter, cheese, and oil, are all denser in calories than even the highly-processed sugar-filled candy. If home cooking consists of lasagnas and pies, fried food and mammal meat, or is even just cooked in oil or butter, is heavy on carbs, or is covered in cheese, it will be just as calorie dense as anything purchased ready-made.
Whatever you choose to eat, it is vital to match portion size to calorie density. The denser it is, the less of it you can have.
Everything you choose is displacing something else, so choose wisely.

As I talked about in part one, nutrient density is also a variable. There are certain things we need to eat a minimum of, regularly if not every day; specifically protein, fat, vitamins, minerals, and water. Looking back at the picture, it just so happens that nutrient density more or less varies inversely with calorie density. Vegetables and fruits are higher in vitamins and minerals then meat, dairy, and carbs. How convenient!! Given that you have to eat a certain amount of the type of foods high on the picture in order to get enough nutrients, it leaves less and less room for the crap at the bottom. Since the point of dieting is health, it would be counter-productive to cut out nutrient rich food.
The point is, eat vegetables and more vegetables. And then some fruits. And then even more vegetables. Occasionally a little meat or dairy or oil or whole grains.
Occasionally does NOT mean every meal.
It does not even mean every day. As mentioned in part one, we don't need nearly as much protein as most people think. Until very recently, very few cultures ate protein and fat rich food with every meal. In order to lose fat, 50% of food consumed should be vegetables, absolute minimum.

Of course there are going to be times when you eat things other than vegetables. Even if you manage to make your diet 50% vegetable (which you should, if you really want to lose fat), you will go out to eat with people, others will cook for you, you won't have time to cook, and whatever else. It isn't necessary to cut out high calorie foods completely (or any particular food). Match portion size to calorie density. If something is high in sugar, oil, meat, dairy or refined carbs, eat just a tiny bit of it. Eat as much (non-starchy, i.e. not corn or potato) vegetables as you want.



Controlling appetite is about preventing eating when one isn't really even hungry.
When we do eat, however, it is easy to eat too much; even when one doesn't have an appetite for it.
There are ways to minimize that too:

-Use smaller plates and bowls. Seriously. A lot of this is psychological. We naturally tend to fill a container. And we naturally tend to eat as much as is in front of us. Once we start eating, we may not notice that we are satiated until the stomach actually starts to hurt, and by that time we have already overeaten - by a lot! If you fill a large plate only 1/2 way, it looks like a small amount, and it seems like it won't be satisfying. If after finishing a small plate full you actually are still hungry, you can always go back for seconds.

-Eat slower. Using a small spoon helps you take smaller bites, so that it takes longer to finish. There is a delay between eating and when the body realizes it's full, so eating slower gives the body's feedback systems a chance to catch up. By the same token, be deliberate about chewing, and wait a few minutes before getting those seconds, to see if you really are still hungry.

-Decide on your serving size in advance. Again, you can decide to have more later, but if you don't think about it chances are you just pile an arbitrary amount on the plate, and then eat it all just because its there.

-Don't feel you have to finish everything on the plate! Its totally ok to have leftovers. This is especially true in restaurants, where they typically serve 2-4 "servings" of food on a single plate.

-When eating pre-packaged foods, take a look at the serving size. If it says there are 4 servings per container, don't eat the whole box in one sitting.

-Be aware of condiments and other add-ons. Just one tablespoon of mayo - the amount you might spread on a sandwich - has 110 calories. Because oil and cream based sauces and dressings are so extremely dense, they add up really fast. Just how fidgeting burns few calories, but adds up over the course of the day, a tiny amount of added sugar or cheese or even the oil that sticks to food in a stir-fry, all ends up adding significantly to the days total calories.

-Be especially conscious when eating socially. Maybe its the distraction. Maybe its something about being around other people who are eating. For whatever reason, people eat more when they are around lots of other people. To a lesser extent, people also eat more with distractions like television, when putting fork to mouth goes into autopilot, and the mind doesn't fully register that its been eating all along.





This has been an awful lot of information.
I have deliberately avoided as much of the technical side of digestion, metabolism, the glycemic index, and the like as possible.
And it is only a subset of the bigger picture on health.
Is it any wonder that there are so many attempts to over simplify and take short cuts?

Ideally you should take all this information as a base with which to build your own plan that will work for you.

I will make my attempt at summarizing and simplifying everything I wrote into 4 simple rules, with one vitally important note. This is just one approach, and there are many others that can work just as well, (and which may work better for you).

1) No starches (commonly called "carbs") i.e. bread, cake, pasta, fries, chips, etc
2) No added sweetener of any kind. This includes "natural" sugar, honey, agave, and calorie-free artificial sweetener
3) Zero liquid calories. Drink water. Coffee or tea are fine, as long as they are straight, with no sweetener, cream, or flavoring added.
4) Daily food curfew about 4 to 6 hours after you wake up. This means eating breakfast, and possibly lunch, but nothing at all between lunch and bedtime. (Assuming you wake up between 6am and 8am, this would mean a food curfew at 12 noon.) This gives the benefits of short term-fasting, and also naturally restricts calories without the tedium of counting and tracking.
And the vitally important note is that you WILL feel hungry all the time, and that the only possible success will come from accepting it.

This plan must be done while continuing to exercise. In order to prevent losing muscle mass, it is important to get enough protein. Once you reach your target bodyfat percentage, you should GRADUALLY increase daily calorie intake until it exactly matches the calories you burn each day. At that point you should eat until you don't feel hungry, but never more than that.
The good habits you picked up during the dieting process all need to become life-long habits, or else you will gain back all the fat you lost.
For the first couple weeks I recommend tracking your calories - literally every thing you eat as well as your daily exercise, and using a calorie calculator (use Google) to make sure you are in calorie deficit.  Once you have established a pattern, and know what calorie deficit feels like, you may not need to track any longer.

Once you have reached your goal bodyfat percentage, you do not need to tolerate a constant low-level hunger anymore.  You should eat until satiated.  However, that doesn't mean that just because you are now thin and strong and healthy you have license to eat "whatever you want".  If you return to your old habits, you will return to your old bodyfat percentage.  The same steps for losing fat happen to coincide with healthy eating habits for anyone of any size.  Once you reach your goal, the only thing that should change is total calories consumed.  The rest needs to be lifelong.

Don't forget what I wrote in the beginning: everything above is meant to be considered from within the context of the main "Be Healthy" essay!
Health includes avoiding illness, fitness, and nutrition, not just being thin. Whether you or those around you are happy with how you look is irrelevant.

I am not, as you may be aware, a trained professional on any topic remotely related to all this. I'm just an ordinary guy (with a background in science), who likes to stay healthy and loves collecting information, understanding things, and putting together the big picture out of lots of seemingly independent details. I'm also someone who likes to share what he learns from others.
But I don't expect you to take my word for it.

Here are just a few of the sources from which I gathered data for this essay:
http://www.leangains.com/2010/10/top-ten-fasting-myths-debunked.html
http://www.shapefit.com/basal-metabolic-rate.html
http://www.diet-blog.com/07/the_foods_that_made_america_fat.php
http://www.munaabuawad.com/?p=25
http://www.intermartialarts.com/article/sumo-wrestler-diet
http://www.kitchentablemedicine.com/are-you-on-the-sumo-wrestler-diet/
http://www.healthygo.com/articles/averagebodyfat.php
http://jama.ama-assn.org/content/288/14/1723.full
http://www.nejm.org/doi/full/10.1056/NEJM199910073411501
http://www.annals.org/content/138/1/24.abstract
http://ps.columbia.edu/news/are-normal-weight-americans-over-fat
http://www.diet-blog.com/10/fatorexia_overweight_people_who_deny_they_are_fat.php
http://www.dailymail.co.uk/femail/article-1267883/Fatorexia-In-mirror-Sara-saw-slim-woman-Just-problem-17st-So-deluded.html
http://www.worldhealth.net/news/every_other_day_fasting_may_reduce_cance/
http://www.post-gazette.com/healthscience/20030429lifehealthp2.asp
http://www.reuters.com/article/idUSTRE5AB4HM20091112
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC156352/
http://www.usatoday.com/news/health/2003-04-28-fasting_x.htm
http://www.ajcn.org/content/81/1/69.full?ck=nck

There are others as well, but I encourage you to find your own information.
Google is your friend.
When you are done reading, get off the computer, and put what you have learned into practice!

Be healthy, my friend.

Sunday 2 January 2011

Be Healthy, My Friend


Sunday, January 2, 2011

Be Healthy, My Friend 


The word "Health" has become almost meaningless.

This is due to a number of factors, but one of the chief ones, I suspect, is marketing.
It helps to sell things as "healthy" if there is no clear idea what that actually means.
I will resist the temptation to get into that whole topic...

What I do want to do is try to remove some of the abstraction, by breaking it down into its constituent parts. While the term itself eludes a single precise definition, there's a list of components that are part of it, and those parts are reasonably concrete.
-A lack of, resistance to, and/or ability to recover from infection (by viruses, bacteria, protozoa, fungus, or parasite)
Even a healthy person may get the occasional cold, but they will get better more quickly
-A lack of, resistance to, and/or ability to recover from non-infectious-disease (such as diabetes or angina)
-A lack of, resistance to, and/or ability to recover from injury
-Longevity (how long you live)
-General fitness*
-Mental/emotional health - I wholeheartedly acknowledge that this is a very important part of overall health; however there is so much to cover just considering physical health that I won't mention mental/emotional here any further than this sentence.




Many people seem to get obsessively caught up on just one or two components, sometimes to the complete exclusion of considering the others. And as a result there are raw-foodists who can't do a single push-up, athletes who eat junk food, people who take all manner of drugs and vitamins, and others who take herbs and supplements and "superfoods", both thinking health can be reduced to just what you ingest.

When someone, be it a friend or an ad or even a doctor, claims that X food, Y herb, or Z activity, is "good for you" or "unhealthy" or whatever, ask exactly in what ways does it contribute to health? Which of the above elements does it affect, and how? Personally, I suspect that extremely few of the millions of things passed off as "healthy" stand up to that sort of test.
Just to complicate things again, some of these components can sometimes conflict with others. For example, while strength leads to resistance to injury and pathogens, the process of exercise itself is sometimes the cause of injury, and intense exercise (which is the only effective kind) tends to lower immunity (although only temporarily). Similarly, exercise lowers the risk of most non-communicable disease, but at the same time higher metabolism rates accelerate aging.

Since some components can be considered in conflict with each other, it would be hard to say in absolute terms what is the healthiest a person can possibly be. None-the-less, there is clearly a range, from someone who is sick all the time, can't walk far without being winded, and dies at 50, to the people who are still running marathons at 70.

There was a time when pathogens were the single greatest threat to human life. Undeniably, since the advent of cities, modern sanitation has made all the difference in human health. Closely following sanitation in significance would be the discovery of vaccines. Between these two, communicable disease has gone from the largest threat to all human existence to (at least in the developed world) mostly just an annoyance. While there have been times in the not-all-that-distant-past that viruses or bacteria might have killed 1 out of every 3 people you knew, about the only experience we have with them today is getting a cold or flu for a few days a year. Modern medicine has effectively eliminated the risk of death, allowing us the luxury of fighting symptoms instead of the disease itself, and even of (ironically enough) rebelling against modern medicine and deliberately returning to the superstition cures of yesteryear (so-called "alternative medicine")
Granted, there are legitimate problems with mainstream modern medicine - namely, that it has become nearly 100% for-profit, which means making money takes precedence over making people healthy. Research is biased. Unfortunately, alternative medicine, instead of rejecting the for-profit model, instead rejects science and research in favor of superstition. And so you have little white pills for $10 each made by Pfizer and GlaxoSmithKline on the one hand, and homeopathy, acupuncture, and chiropractors on the other. And as it stands today, at least in the US, those are pretty much the only options.
We have come a long long way since Smallpox killed 50% of the population of an entire country. We have basically stagnated, having cured nearly all deadly diseases, and making little progress on the rapidly mutating cold and flu viruses. There is extremely little by way of drugs (pharmaceutical or natural) that can do anything at all about infection. Before exposure, there are vaccines - the opposite of a cure, they are a small sample of the disease itself, and are designed to teach your own immune system how to kill it if it ever sees it again. For bacteria based diseases there are antibiotics. That's it.

For viruses there is nothing. Cold medicine does not fight the cold itself. It fights the symptoms. And the symptoms are actually your bodies way of fighting the virus. You get a fever because viruses thrive at 98 degrees, and don't operate as well at 101 degrees. You get a runny nose because the mucus helps block any other viruses from getting into your body while it's busy fighting whats already there. You feel tired because your body's energy is going into fighting the cold. Your body wants you to lie in bed and recover. When you take something - whether its OTC cold medicine, herbal tea, grandma's secret recipe, or even a netty pot, which reduces the symptoms so that you can feel better (in the moment) you are actually fighting your body, not the virus. Which means, essentially, that you are helping the virus. The more you fight the symptoms, and try to carry on with life as though you weren't sick, chances are, the longer it will take for you to actually get better. For some reason we have gotten it into our minds that it is absolutely imperative that we feel comfortable at all times, even to the point where treating our symptoms leads to us actually staying sick. The full list of substances which actually make you better, faster, is extremely small. The evidence for each is not terribly strong - they work in some trials, and not in others - and they only seem to work when taken immediately at the first signs of symptoms.  They are Vitamin C, zinc, and echinacea. . That's it.  And when you take it, you won't feel better (in the moment) at all.
Aside from those 3, the things which help our bodies fight viruses are simply sleep and water.
Any other medicine or remedy you take is either fighting your body, or its just a placebo.

With all of our technology, humans have not figured out a better way to fight viruses than natural evolution already did. Sanitation is really just an issue of us not making things worse. Vaccination stimulates the bodies own immune system. And Vitamin C doesn't actually attack the virus itself, but, again, supports the body's immune system.
While we can't actually cure sickness, what has been shown to prevent it, and minimize it when it does occur, is overall health and fitness*.
There are some things that modern medicine can do better than nature. Before the defibrillator was invented, a heart-attack was a guaranteed death sentence, while now people live on to have several heart-attacks in a lifetime. Vaccines have essentially eliminated the threat of true epidemic. If you have appendicitis, having it surgically removed can save your life. We have invented glasses and hearing aids and prosthetic limbs, antibiotics can cure infection. Prior to the advent of modern medicine, one of the largest killers was being born; a major threat to both mother and infant. For these reasons and many more, access to quality medical care is a extremely significant factor in the ability to stay healthy. However, like with the common cold, the vast majority of medical interventions deal with treating symptoms, not with curing the disease itself. They make the patient feel more comfortable, while not making them any healthier. With limited exceptions, modern (or traditional) medicine can't do better than the 5 billion years of evolution (or God, if you prefer) that created our bodies.
Many (non-infectious) diseases have a large genetic component. Some are entirely genetic. Some are caused or exacerbated by fetal or early childhood environmental conditions. Obviously we, as individuals, have no control over that (and as a society, unless eugenics ever becomes politically feasible, we have no control on any level).
However most of the common ones - heart disease, stroke, diabetes, asthma, and most forms of cancer - are determined primarily by individual choices.

One of the largest factors that determines how quickly a person recovers from a broken bone or a deep cut is age. But overall health is a significant factor as well. In addition, the stronger and more flexible a person is - at any age - the less likely they are to suffer injury in the first place.

Obviously longevity can not be definitively determined in advance. It is, none-the-less still a measure of how healthy you were.
Some people say that they would rather have shorter lives of full enjoyment rather than long lives on dialysis, but in reality, the people who die young have the same health problems as people who die old - they just have them at a younger age.
Significant caloric restriction is the one and only thing that has been scientifically proven to extend life span (by as much as 40%!). Good news for anyone trying to lose excess body fat, but a problem for athletes eating more in an attempt to gain muscle.



*Fitness is a component of health. But the word has become just as abstract as the term "health" itself. What is "fit"? How do you determine who is and who isn't? Well, to start with, consider the word itself. In any other context, it is meaningless without context. Something can be fit for a particular purpose. A compact car is fit for commuting. An SUV is fit for traveling off-road. It would make no sense to ask "is this car fit?" without knowing what task you have in mind for it.
In the same manner: who is more fit: a power-lifter who can bench-press 400lbs, an ultra-marathoner who can run 52 miles in one day, a gymnast who can do a double back layout, or a sprinter who can run a 100meters in 10 seconds?

It's a silly question. What would be more telling would be to ask whether the sprinter would be better at lifting weight than the power-lifter is at running; vice-versa and etc.

But what ultimately matters is what a person can actually do in real life. Outside of competitive sports, there is no reward for extreme specialization. The reality is day to day tasks require strength AND stamina AND flexibility AND agility AND balance. Emergency situations even more so.
Going back to the question of "fit for what", the answer is: "fit for real life. Fit for emergencies. Fit for everything."
Getting "in-shape" isn't about one's shape (or at least it shouldn't be). It shouldn't be about appearance or even what your doctor says you should do. It is about quality of life. Fitness can't be measured just in terms of mile times and weight lifting totals, nor in terms of fat percentage or aerobic capacity. All of those things are related, all of them are factors, but it comes down to a question of: what can you do?
Not everyone needs to be an athlete. Fitness is a quality of life issue. A person should be able to carry a big bag of groceries in each hand and walk home from the store. You should be able to sprint two blocks for the bus when you see it pulling up to your stop. To carry a baby around all day. To walk up 17 flights of stairs when the elevator is out. Open a jar that's stuck on really tight, move the furniture around, climb a fence. Join in on a random game of pick-up soccer with your friends at the park. Fitness is being able to land on your feet if you fall off a shaky ladder, or the agility to dodge out of the way when you're crossing the street and a drunk driver runs the red light. Fitness can mean the difference between escape/fighting back and being a victim. Fitness can mean the difference between saving lives in an emergency, or being one of the people who needs saving.
As those examples demonstrate, fitness itself needs to be broken down into just as many separate categories as the term "health" to be meaningful:

-Strength (of ALL of the major and minor muscle groups, including stabilizers)
-Aerobic capacity
-Endurance
-Flexibility
-Agility, Coordination and Balance

Being fit means having ALL of them. Having a lot of one does not imply having the others. Which means it is very possible to have a power-lifter, ultra-marathoner, or sprinter who isn't really "fit" in the general sense of the word. A great many exercises - including many that are very common - won't improve general fitness. Some don't improve any area of fitness at all.
The thing to look for is well rounded forms of exercise. The key word is "functional". Gym machines and exercise classes tend not to simulate anything you would ever do in the real world. In fact, most gym machines, developed with body-building in mind (which is mostly about looking strong, not actually being strong) deliberately isolate body parts.
The following chart has an absolutely excellent set of strength tests that correlate directly to being able to move around and do things in the real world, and it scales to anyone because the levels are in terms of your own strength-to-weight ratio, not some arbitrarily static number of pounds to lift:
or
Unless you plan to compete in the Olympics, there is really no point in trying to get to 'level 4'. Even level 3 will be out of reach of all but the most dedicated athletes. However, everyone should be able to do the items in level one, just as a minimum level of fitness. Below that will affect quality of life in ways which a person may get used to and not notice, but will be significant none-the-less. Once a baseline of fitness is established (if you can accomplish some things on level 1 but not others, focus on improving the weak points before moving on) striving for level 2 is a reasonable goal.
Crossfit is a chain commercial gym (or class within established gyms) which better exemplifies the concept of functional exercise than any other system (not counting their many copy-cats). If you were planning to join a gym anyway, it's what I would recommend. However, you don't have to spend any money to get fit. They have many great resources online (including in-depth essays on the principals of fitness, daily suggestions for exercises, and YouTube videos which show exactly how to do each exercise.) I personally like their style. Whatever you do, the important things are that it includes both aerobic and strength training, and that it vary at different times in order to activate different muscle groups. Stay away from all weight or aerobic machines which artificially constrain you to a fixed range of motion. Focus on exercises which use multiple different body parts at once. Especially if you are just starting out, calisthenics will provide plenty enough resistance without investing in any equipment. Push-ups, sit-ups, pull-ups, dips, squats, handstand push-ups, lunges, burpees... with zero investment in equipment, classes, or memberships, it is entirely possible to gain well rounded fitness that will improve health and allow you to do more activities in daily life with ease - all from the comfort of your own home.
That truth right there eliminates a whole lot of excuses. You just have to do it! I can't make you do it.
There is lots of information online about number of repetitions, sets, ways to make exercises easier or harder (scaling), recovery time, etc.  If you don't have a lot of free time, look up "Tabata", a technique for getting some intense exercise in just 4 minutes. You can do any exercise tabata style. You can get a free tabata timer online:
Truth is, it doesn't matter which theory you end up using, as much as that you actually do it, and do it consistently. Whatever exercise, what ever style you go with, do it intensely and be consistent!
Don't injure yourself working out - if the point is improving fitness and health, injuring yourself by over-training is totally counter-productive. Being competitive can be a great motivator for many people, but it also tends to encourage over-training.
If it is comfortable, you aren't doing it right. If, immediately after you finish an exercise, you can still do more, you weren't doing it right.  Do a little more.

Most people - especially those who are sedentary - would be surprised to find out just how much exercise is recommended, not for athletes, but for regular everyday people, just to maintain minimum levels of general health and fitness. Not for competing, not for losing weight*, just to be an ordinary healthy person. The CDC recommends a MINIMUM of 75 minutes per week of intense aerobic exercise, in addition to regular strength exercise. They go on to say that what would be better is 150 minutes of vigorous exercise in addition to strength training. This breaks down to 20 minutes a day, 7 days a week (or 30 minutes a day, 5 days a week), of running, swimming, basketball, etc, plus weight-lifting and/or calisthenics a few days per week, for at least as much time. I say that this should be the minimum everyone demands for themselves.
Every single day?
Yep.
Like, not just until I lose 5 lbs or can run a 5 minute mile, but, forever?
Like clock work.  (I mean, you do brush your teeth every day, right?)
Really, it's not that bad. Think of it as preventative health care.


That volume is to maintain health. If a person is trying to get stronger, or faster, or lose weight*, or whatever, that amount needs to be increased even more.

We want it to be something we do every now and then, when we feel like it, when we "have time".
It doesn't work that way.

The truth is, everyone, no matter how busy, has time. 30 minutes a day really isn't that much. Even if a person has a full-time job, is a student, and has a long commute, there are three 10-minute slots of free time somewhere in a day, currently filled by TV or internet or getting ready a little slow or waiting for something or someone. Spend 15 minutes eating on a lunch break, and it leaves 30 minutes for a little exercise. Riding a bike to work or running to the bus instead of walking combines commute time with work-out time.
It comes down to priorities. There are many things we do to take care of ourselves every single day. We don't just skip eating because we don't have time. We use the bathroom every day, no matter how busy we are. We sleep everyday. It is the priority. The other things in life get scheduled around it. We brush our teeth every single day, not because all our teeth will fall out over night if we don't, but because we care about the long term health of our teeth. We make time for it. The health of our bodies shouldn't be any different. If we decide that we are going to exercise 30 minutes a day, 5 days a week, then other things in life have to work around that, and that's just it. Friends come to visit, parents call, boss wants you to work late? You wouldn't skip meals or sleep for them. Don't skip exercise either. Other things can wait.
Total time spent is really important. It can't be substituted for. Doing one really intense hour on the weekend simply isn't enough to provide tangible benefits.
But simply spending enough hours isn't enough either.
Those 75-150 minutes of cardio and 45-90 minutes of weight-lifting or calisthenics exercises per week need to be intense.
A lot of what passes for exercise isn't challenging enough to stimulate improvement in the body.

As the great Hunter Thompson said, if a thing is worth doing, it's worth doing right. No where is that more true than fitness. If you don't put forth the full effort, you won't really improve. And in that case, what really is the point? You end up sweaty and tired, with nothing to show for it.
The potential benefits, not just to fitness, but to overall health, in just about every component, are outstanding! It extends from there to the ease of completing everyday tasks, like the list I had above, which improves overall quality of life. It makes a person feel better about themselves, increases the feeling of well-being in general. It has, for example, a direct, measurable effect on depression - not far behind prescription drugs for effectiveness (and with lots of positive side-effects). And if getting sick less often, being able to do more things, reducing risk of disease, recovering from injury faster, living longer, and feeling happier all weren't enough, as an added bonus it even makes a person look better too.
That's a lot of benefit.
Fortunately, it requires less sacrifice than it may seem like at first. The two main reasons people who acknowledge the benefits don't exercise enough anyway is 1) how unpleasant it is, and 2) lack of time. Time I addressed already. There is always time; the only issue is what one chooses to prioritize. The perception of unpleasantness has some basis in the physical feeling of being exhausted and sweaty and sore, but much of it comes from the sort of exercise that dominates popular culture because they are what make commercial gyms the most money.
A lot of why people burn out on exercising and give it up is because these activities are terribly boring, and on top of that they fail to produce significant results. Fortunately those exercises - repetitively moving weight machines' handles back and forth or going for miles on a treadmill or exercise bike - aren't really productive from a perspective of comprehensive fitness. In fact, even just in terms of burning calories to support weight* loss, they are not a very productive use of exercise time. Good, well balanced, comprehensive exercise tends to be much more complex (and interesting). It should actually be fun. Things like sports or martial arts, rock climbing or CrossFit. For some people, especially if they get endorphin induced "runners high", can zone out and enjoy running. Some people get into cycling for the new scenery or the camaraderie. Whatever it is, it should be something a person looks forward to, not dreads.
Another reason for the sense of unpleasantness is that modern American's, through money and technology, have the option to totally eliminate discomfort from life, and as a generation that has grown up with this option, we feel we should be comfortable at all times. We can get through life rarely if ever feeling too hot, too cold, hungry, thirsty, or tired.
I personally never really noticed how accustomed I am to the luxury of being comfortable until I spent 2 months at military bootcamp. I learned that it is actually quite tolerable to be uncomfortable. You stand in formation in full uniform in 95 degree heat. You stand there, perfectly still, while it is pouring rain and just over 40 degrees with wind chill. You stand and experience mosquito and gnats land on your face, take their meals, and fly off, without swatting at them. At bootcamp when you are hungry, too bad, it isn't meal time. And you deal with it. If it is time designated for running, or swimming, or whatever, it doesn't matter if you feel tired, you just do it. What you feel is irrelevant. And to people who have always had the ability to feel comfort, it may sound like pure hell, but the reality is that it is very easy. It is uncomfortable, to be sure. But it is temporary. It doesn't kill you.
And in the end, when you felt like you might throw-up or pass-out and you just kept pushing anyway, a little bit faster, a little bit farther, and in the end you don't collapse, you make it, you have an unparalleled feeling of accomplishment. It makes the idea of "willpower", of "mind over matter", into a real life thing. It means YOU have control over your life, over what you do, not the whims of your feelings.
I recently read a statistic that said that only 7% of people who attempt to stop smoking actually last a full year smoke-free before relapsing. That says something about our will power. But what was more interesting is that of those who do successfully quit, 80-90% of them quit 'cold turkey'. Quitting cold turkey is more effective than all other methods combined. No drugs. No replacement nicotine in the form of gum or patches or vaporizers. No gradual tapering down to fewer cigarettes over time. The physical withdrawal symptoms are very real, tangible, not only uncomfortable, but with measurable effects on the body. All of the various methods are designed to lessen those withdrawal symptoms as much as possible, to make a difficult process more tolerable. And yet, the people who experience the most intense withdrawal of all are also the people most likely to get through it. Instead of trying to feel comfortable, they acknowledge from the outset that it is going to be hard. They just jump right in and do it. They feel like shit, and they keep doing it anyway, and they come out the other end victorious. It isn't even about willpower, per say. Its about mindset.
The same thing applies to every area of life where modern life makes excess more easily available than it has been ever before in human history, whether it's choosing not to take something to easy cold symptoms, exercise, dieting, or impulse shopping.
Never before in history have humans needed to go out of their way to exercise. In the past exercise would be in the form of getting from place to place (even the bicycle is a recent invention), gathering and chopping firewood, digging and plowing and harvesting in the garden, pumping or carrying water, hunting... today we have machines to walk for us, to do manual labor for us, we have computers and internet that allow us to potentially never leave our rooms - at all! Heck, I'm on a computer right now! We even have remote controls so we don't have to walk all the way across the room to change the channel when we're sitting passively watching TV. We have headsets so we don't have to reach all the way into our pockets to retrieve a ringing phone, and then have to hold a heavy cell phone to our heads. We have power steering so that, even when we already have a car doing our running for us, we don't have to make the effort of turning the steering wheel. We have machines to wash our dishes, our clothes, our cars, and even robots to vacuum the floor. What isn't fully automated, if we can afford it, we hire someone else to do. At the hardware store the other day I found about 200 devices designed to make it easier to open a tight jar. Our technology has made us extremely lazy.
But it is what it is, and we are where we are. The only question is if that is what you want for yourself. Since most of us aren't going to abandon the city and become Luddite farmers, we have to take the time to make sure we get exercise. And if we are going to do that, we may as well do it smart.
The best way to tell, over a long period of time, whether what you've been doing is really helping, is to keep records. Push ups and sit ups in a minute, mile times, weight* and measurements (you need to take measurements to determine fat percentage - weight alone is meaningless because muscle weighs more than fat), maximum press and bench and deadlift and clean weights, even things like medical complaints or overall outlook on life. Taken over a long period of time, looking back at old notes and seeing the trend of improvement can be a major motivator to continue.
In the short term there are simple benchmarks: for strength exercises, you should be at least a little sore the next day. If you aren't at all, you weren't really working out. You were just doing repetitive movements and killing time. For aerobics the feedback is even more immediate: you should be sweaty and out of breath. If you can hold down a conversation, you aren't working hard enough.
A few very common things which really don't count as exercise:
-walking
-yoga
-lifting weights so light that you can easily do 15 or more reps without rest
-anything which is supposed to encourage "tone, not bulk"
-treadmill, elliptical, or stationary bike at a low resistance or low speed
-cruising around on a bicycle on flat roads, coasting half the time
This isn't to say these activities have no value at all. Burning some calories is better than none at all, and yoga has significant benefits to flexibility (and for many people for stress reduction). But they aren't exercise. You could do them for 5 hours a day and you won't increase your aerobic capacity or get any stronger. You would burn a few calories, but less than you would from doing a more intense activity for a smaller amount of time. And there are only so many hours in the day.

An efficient exercise gets you as tired as possible in your limited work out time. It activates major muscle groups, core stabilizer muscles, and the cardio-pulmonary systems all at once.
A short list of examples of real exercise, (along with the calories they burn in an hour of continuous activity):
running upstairs/hill (1000)
running (600-1000 depending on speed)
rock climbing (650)
jump rope (600)
burpees (550)
boxing / martial arts (400-600)
elliptical/stationary (400-600 on high resistance, at high speed)
mountain biking (500 cross-country)
rowing (500 roughly 2min/500m rate, level 5/med)
aerobics (450-500 depending on the class)
jogging (430)
moving furniture (400)
swimming (370)
yoga (300)
sex (300)
skating (300)
bicycling (250 road, flat-lands, non-racing)
weight lifting (150-350 depending on weight)
stationary machine (100-200 at low to moderate intensity)
All of the calorie burn levels vary by weight and gender and fitness level, but the relative values stay the same. Plus, more intense activities tend to raise metabolism for longer and longer times after the activity is over (up to several days!) so that the net totals are even higher.
Muscle burns calories even when at rest, so having a higher percentage of muscle means your overall calorie use rate goes up permanently. For this reason lifting weights (or doing push-ups and the like) considered over the long-term belongs much further up the list.
Rather unfortunate, then, that so many people spend their time on stationary gym aerobic machines at low to moderate intensity for the specific purpose of burning calories. For gaining aerobic capacity, improving overall fitness, or losing weight*, stay near the top of the list (or find other activities which are as much work, like a game of soccer, being a forest fire fighter, or military bootcamp). Again, this is not to say that low intensity exercises don't have value. But don't expect to get results by taking the easy route. And then again, it is perfectly possible to make the activities lower on the list intense... its just that it is very easy to do them less than all out, to coast on the bicycle, to swim at a relaxed pace, while running up hill or doing burpees is inherently challenging, even if you try to do them slowly.
Spend some time doing the highest intensity exercises for 30 minutes without resting, to get a feel for what real exercise feels like.
(NOTE: if you are over 40, have been totally sedentary for years, or have medical issues, you may want to consult a doctor, or at least a personal trainer, first)
Once you know how it should feel, you can substitute pretty much any activity, so long as you do it at a level that is equally as difficult. And it is ok to occasionally do low impact work as well. Just keep in mind that if an exercise is 1/4th the intensity, you have to do it more than 4 times as long to get the same benefit.
Sometimes, though, it makes more sense to do moderate intensity exercises. Say you are going for a hike anyway, or doing some gardening or running around with small children. All movement and everything active counts. Its just that it only counts for half as much time toward the total. If you have an active enough life, such that you spend an hour a day or more doing moderately intense activities (you can have a conversation, but not sing) you can get away with only doing more intense exercise a couple days a week (along with the strength building exercise a few days a week).
If your goal is to not just maintain health but to increase athletic performance and/or lose weight*, then total time and intensity level become even more important. Increase the minimum at least 50%, AND make all the work intense.
***There was originally a sub-section here on managing excess fat. Because it is such a complex subject, and so relevant to the health of most Americans today, it quickly grew too long to just be a sub-section. So, it has been removed from this essay all together, and will be posted separately as part 2
Nutrition is touched on briefly in part 2, because it is especially important for anyone deliberately limiting food intake to pay attention to nutrient density and making sure to get enough of what the body really needs. But everyone needs to eat! It seems the only people who really pay attention to nutrients are dieters, athletes, and those obsessed with health. The latter group, in particular, often seems to think that what one eats is the only thing that determines health, which is just plain silly (hopefully I have demonstrated that by now).

Maybe it is another symptom of our easy answers culture. If health is just a question of eating the right superfoods, we make sure to eat some of it each day, and blam, instant health!

Sometimes it seems that there isn't much room for middle ground - either someone is obsessed with nutrition, or else they don't give it a second thought. Which is unfortunate, because its really important, and its also really simple.

Until relatively recently, most foods which exist in the world weren't available in most places. For most of human history cultures have survived on a small variety of local staples, and for the most part they lived perfectly healthy lives. No one food can possibly be vital if people in most places for most of time have got along just fine without it.
Each time some new food fad comes out, this anthropological fact gets forgotten, as every health conscious person scrambles to buy acai / coconut oil / algae / quinoa / goji / soy / bee pollen / pomegranate / and of-course (though we all know its mostly a convenient excuse) wine and dark chocolate. All of these things are local to a specific region. Until a few years ago, they were simply unavailable in most of the world.
Not to mention a plethora of vitamins, oils, and herbs which are partially the all natural equivalent to the pharmaceutical industry making pills to block symptoms instead of addressing causes, and are partially nothing more than marketing by the companies that sell them.
There are some things marketed as health food which have no effect on us at all. A perfect example is enzymes. We do not need to eat enzymes. The body produces its own enzymes. In fact, enzymes which are ingested get broken down by the stomach anyway, so the only function they can possibly have is digesting some food in the stomach before they are destroyed. The only time this is useful is if a person is eating something they have no natural enzymes for; most commonly lactose pills for those who can not digest dairy. Another solution, of course, would be to simply avoid eating dairy.
True, eating vegetables and plants and (low mercury) fish and whole grains - instead of food filled with sugar and butter and mammal meat - will have an enormous impact on just about all measures of health, from disease resistance to fat percentage. But there is no particular magic bean that can do something no other food can do. As long as a diet is well balanced, and contains more food that are dense in nutrients than foods that are dense in calories, a person will get proper nutrition. With limited exceptions, if you need to take anything in pill form, that's a sure sign you aren't eating the right foods.

It is possible for an adult human to stay alive for years on nothing but glucose drippings. It would not be an ideal life, nor would it be healthy by any definition of the word, but it demonstrates that we will not simply drop dead from a few days without any specific nutrient. People have gone on fasts for various health, religious, and political reasons throughout history with no ill effects if done for a moderate amount of time. The human body evolved in a world where no one food source was ever guaranteed, and so, at least to some extent, it evolved the ability to ration. Over the long-run it is important to get all of the vital nutrients. Getting each and every one in every meal is not.

There was a time when nutrition deficits were a genuine threat. Before the days of refrigeration sailors on long sea voyages would get scurvy, from a lack of vitamin C in the diet, because they would eat no fruits at all for months at a time. A severe lack of vitamin D, especially in childhood, will cause rickets. A lack of iron causes anemia and lack of iodine causes goiters. Not having enough B3 in the diet leads to pellegra. Chances are you have never heard of pellegra. This just goes to show how small the threat of malnutrition actually is in this country, even though we have the worst diets in the world.
(American's eat more fast food per capita than any other country)
What we lack in nutritional density we make up for by eating more food total. As long as a diet is at least reasonably balanced we eventually get the nutrients the body needs - it just takes more calories to get there. The body keeps feeling hungry until it's nutritional needs are met, whether it has enough calories or not. The reason for eating nutrient dense food is not that we will be malnourished without it, but rather that we can meet our needs with fewer excess calories.


What those nutritional needs are has been known for a long time by nutrition science, but is still often misunderstood by lay people.
We need two essential macro-nutrients: Protein and fat.
(Carbohydrates are also a macro-nutrient, but there is no essential minimum intake)
We need 13 vitamins: A, B (8 kinds), C, D, E and K. But we only need a tiny amount of each. Ingesting more than the required amount usually won't do much harm (although too much of some can be toxic); but having more than the tiny amount present in a healthy diet doesn't do any good either.
We also need 13 trace minerals, primarily potassium, chlorine, sodium, calcium, phosphorus, and magnesium (in that order). The other 7 we need only in tiny amounts. (4 others, in even smaller amounts, may have some function, no one knows for sure yet)
Most of us actually get more of many nutrients than we actually need. The excess just gets filtered out by the kidneys in the case of vitamins and minerals (leading to the quote by a nutrition doctor about American's having "the most expensive pee in the world") or stored as fat in the case of fats.

Protein, in particular, gets a lot of attention as an essential nutrient, especially by athletes and vegetarians. Its certainly true that we need a certain amount of protein daily. What fewer people know is that American's actually consume far too much protein, at a level which is actually mildly toxic. A full grown adult only needs 60 - 120 grams of protein a day (depending on age, size, and activity level, with the high end only applying to hardcore athletes). There is protein in almost every food, not just the meat and soybeans that immediately come to mind.
If over the course of the day you eat one pancake, a cup of fruit, half a cup of yogurt, two pieces of bread, a 1 ounce slice of cheese, a slice of avocado, a small vegetable salad with no toppings, a cup of pasta, a cup of vegetables, and a baked potato, you have had about 65 grams of protein, already more than enough for most people.

That's without eating a single so-called "protein source"!!
Unless you are vegan, pregnant, a bodybuilder, or anemic, there is never any need to make a point of eating a "high-protein" food with every meal, or even every day.
There are different amino acids (the building blocks of protein) which the human body needs, and which not all plant proteins have. However, unless one eats literally just one type of food, the American diet is varied enough to cover it without making a point of it.
Getting enough of each amino acid is as easy as eating rice with one’s beans, so even for vegans who eat no processed food, it requires only minimal thought and effort.
I personally am vegetarian. To be honest, this is more out of habit than anything else. There are a lot of very important environmental and ethical reasons I could argue for vegetarianism, but this specific essay is about health. There isn't really any health reason to eliminate all meat from the diet. However, the volume American's eat most certainly is unhealthy. Its inclusion in the diet should be limited, sort of like this:
(Please note that no diet will keep you from aging. Only a time machine, cryogenics, or some sort of freeze ray can do that. The only thing which has been shown to increase longevity is calorie restriction. Also, as covered previously, a healthy diet should not need supplements.)
or this:
As this pyramid notes, the foods highest in nutrients just happen to be those lowest in calories. Another thing to notice is that it is almost the exact inverse of the typical American diet! Then we make up for it with vitamins and supplements. Or, we make up for it by eating a whole bunch, because even with junk food, once you eat enough of it, you get your nutritional needs met. Eating food which is low in nutrients (even if it is low-calorie "diet" food) means you need to eat more to get the minimum intake of vitamins and minerals.
Just to show how futile it is to try to find the “perfect” diet, consider the existence of anti-nutrients. These are (naturally occurring!) compounds which destroy or draw needed nutrients such as minerals or proteins out of the body. They are found in otherwise healthy foods. Some, such as bio-flavanoids (the active ingredient of green tea, dark chocolate, and wine, with supposedly magic health powers), have been shown in some studies to prevent cancer… and in others they have been implicated in potentially causing it! Certain vegetables known to be high in calcium may drag more calcium out of the body than they add to it. And yet, despite the contradictory nature of food, people are able to be healthy.
The overall point is that there is no need to stress over the details of nutrition.
Common knowledge covers it. If a person eats a varied diet, based primarily on vegetables, fruit, seeds/nuts and grain, (whether eaten straight or cooked / processed into something) with occasional (not necessarily daily) animal products, one will get their basic nutritional needs met. If a diet has regular hamburgers, pizza, ice cream, comes from fast food restaurants or the snack food section of a convenience store, it will either have too few nutrients, too many calories, or both.
Eating junk food (whether home made or purchased) once or twice every few months won’t do any particular harm. We all know the consequences of eating it more often than that. No one needs some blogger to write a section on nutrition to go into the details.
So that’s about it.
Nothing revolutionary:
  • Get enough sleep
    (This varies by the individual.  The average is 8-9, but anywhere from 6 to 10 is in the range of "normal".  If you need to use an alarm clock to wake up, you aren't getting enough sleep.  If you sleep in on the weekends, you aren't getting enough sleep.  If you need coffee to feel awake in the morning, you aren't getting enough sleep)
  • Exercise a lot more. For most of us, a whole lot more.
    (For a few - those who workout so much as to cause occasional injury - a little less. You know who you are.)
  • Eat lots of healthy food, and minimize unhealthy food.
  • Don’t smoke, and avoid most or all alcohol and drugs.
  • Avoid stress.
Start young, while you are still healthy, because it is MUCH easier to maintain than it is to rebuild!
Skip the 1001 gimmicks that promise to instantly transform your body using the “latest secret” in diet / exercise machine / magnetic massage stress relief…
(seriously, I just saw that in a catalog!)
and skip the pills and supplements and anti-oxidant drinks.
Use the money saved to invest in a tax-advantaged health savings account in case universal health insurance never does go through and you lose your commercial coverage someday.

Get regular doctor (and dentist) check-ups, just to make sure you don’t have something going on inside that you can’t see or feel.

But if you follow the advice above, the chances are much better that there will be nothing much for your doctor to find.

For many people some of this may seem like an overwhelmingly big step.

If you choose to ignore everything you just read, you’ll get no disrespect from me.
To each their own.

My recommendation is to try it, just for one month. Eat right, go to sleep early, and exercise, 7 days a week, for 4 weeks. If you don’t feel better, physically and emotionally, by the end, write or call or add a comment to my blog to tell me I am an idiot. I may even take you out to the junk food place of your choice (offer limited to people I actually know – also, you have to have actually done it for 28 consecutive days).

Ultimately, no matter what restrictions genes, luck, and age have put onto you, much of your health is in your own control.

Like saving money for retirement, healthy choices is an investment in your future happiness.

Do what makes you happy, but choose wisely.

Be healthy, my friend.