Monday, January 10, 2011

Notes on "The Park Avenue Diet Show: Log Cabin Exercises"; January 9, 2011

When Americans think of exercise, if indeed they do, it is viewed as a chore or a hardship or an unpleasant atonement for the sin of sloth. Our mechanized society, where transportation is totally automated and home conveniences make housework almost unnecessary, has resulted in epidemic overweight and obesity. But that's not true in other parts of the world.

Having traveled to remote, challenging locations throughout the world, I appreciate the role of daily exercise in the maintenance of good physical health. There are no weight-loss clinics in the villages near the highest Himalayan mountains. I took a two week trek to the base camp of Mount Everest about twenty years ago which I described to friends as the ultimate Stair Master. The Sherpa people, the famed indigenous population of this Shangri-la, do not suffer weight problems at all.

Even in the "lower" ranges of the Austrian Alps or the Moroccan Atlas mountains, everyone appears fit and trim. A walk to the local store in Badgastein takes one down a forty-five degree angled street for twenty minutes. No matter what Viennese pastry one might eat as a snack, it is thoroughly burned off after the ascent back to the train station. Was it worth it? I could hardly move my legs the day after I tried this for the first time, despite going to a New York City gym daily for twenty years.

According to the American College of Physicians, via their workshops and seminars, exercise is much less important than diet if someone is obese. Caloric control is therefore a necessary first step in any attempt to lose weight. However, as one gets closer to an ideal weight or a realistic goal, exercise becomes mandatory. Regular structured exercise is necessary for weight maintenance, for which reason I sometimes call those "last ten pounds" "exercise pounds".

All exercise programs must include strength training and cardio, and the most skillful personal trainers have learned how to teach these to their clients simultaneously. Attention must also be paid to flexibility and balance; these are extraordinarily important for aging baby boomers, especially those born in Brooklyn.

Are there psychological benefits to exercise? I feel that the ability of skeletal muscles to use lactic acid as a fuel (a property that must be developed through cardio exercise) makes an individual more energetic and upbeat. Other researchers feel that endorphins are released during exercise, but I favor the reduction of lactic acid levels as a biochemical explanation of the beneficial psychological effects.

A good personal trainer is not merely a human textbook of calisthenics. He or she must be a motivational speaker and somewhat of a psychologist. Most people who do not exercise need to be inspired, and this will jump start their participation in physical activity. For the 67% of adult Americans who are overweight or obese, this needs to be more than a temporary New Year's resolution. I didn't like to exercise at all when I was in high school and college. Then I grew up. Now it's your turn.

Monday, January 3, 2011

National Diet Day

January 2nd has been renamed National Diet Day, at least in my own imaginary calendar. I invented this non-existent holiday 20 years ago as the Associate Medical Director of the Atkins Center when I noticed patients' remorse over dietary indiscretions during the holiday season. The same people who had over-indulged in eggnog, candy-canes, and Chanukah chocolates now felt sorry for themselves. And like penitents confessing a minor sin while omitting a larger one, they "promised to themselves" a more healthful future.

This is properly labeled a New Year's Delusion, something Dr. Stanley Krippner might call a negative personal myth. The mere act of "repenting" is a supposed antidote to the wretched excess of the past few weeks or months. Self-esteem is falsely boosted by the individual's newly found self-observation, as if that in itself melts the pounds away.

And then comes January 2nd, when one's conscience and seemingly the entire "diet" industry revs ups their engines to promote weight-loss plans for all palates and sizes. The American College of Physicians notes that 95% of these programs fail their followers...or is it the other way around? When an industry giant like [name redacted] promises weight-loss via lasagna, cookies, and pizza, who can resist?

You can, if you realize that none of these supposedly "nutritious" programs dare to publish their statistics of success and failure. In tiny type, there is a message flashed on your TV screen for a microsecond: "results not typical", which I rephrase as "it is not typical for you to get results", a perfectly legal recasting of their devilishly insincere message. Those exercise programs like [redacted] and [redacted]? January is an unusually busy month for sign-ups at your local health-club, but lifting the pen to sign a contract is unfortunately the last exercise many people will do there.

Without simultaneous attention to all the components of image, not just the one an overweight post-holiday dieter might focus on, nothing will ever be lastingly accomplished. National Diet Day (and Month, actually) is therefore a form of mock penitence that cannot lead to better health. Our bodies are not aware of any holidays; diabetes and its complications can occur at any time of year. The Angel of Death, unlike many public service union members, goes to work every single day.

My imaginary holiday, National Diet Day, is a reaction to the cyclical nature of many overeaters' thought processes--eat, drink, and be merry, for tomorrow you die(t). But for the 33% of adult American not affected by overweight or obesity, National Diet Day is every day of the year. And for them, the celebration of health--and life--takes precedence over the temporary pleasures of high calorie foods. Statistically, the better your weight is, the more likely it is that you will celebrate many more January 2nds. Now there's a great reason to say "Happy New Year"!