Getting Healthy

It has been most frustrating over the past years to watch my weight gradually climb – and every time I managed to lose five pounds, they’d all come right back and bring a friend. At one point I mentioned it to my rheumatologist, but she said it wasn’t a problem and she was more concerned about getting inflammation under control. But the cardiologist told me, “The computer says you need to lose about 30 pounds.”

Well, the computer was being conservative because it was more like 40-50 pounds that I wanted to lose. I tried counting carbs. I tried AIP. I half-heartedly tried a few other things (I could have stuck with them if they showed results, but gave up when they didn’t seem to work). Finally, I started researching nutritional theories. And while I’ve learned tons and feel a lot better, it wasn’t showing up on my scale.

Painful joints teach us to be efficient in motion. Instead of exercising faithfully and blithely running up and down stairs whenever the need hits, we learn to plan our activities carefully and send family members to fetch things for us. This can result in significantly reduced movement — which eventually leads to weight gain. At long last, I’m finally figuring out how to lose weight – not to be fixated on a number on the scale, but in an effort to improve my health as much as is reasonably possible given my sucky health challenges.

This year for my birthday my husband bought me some coaching sessions with a health coach (to be clear, this was not some passive-aggressive hint; I’ve been on this health coach’s wait-list for months; hubby is extremely supportive of doing whatever it’s going to take to get me healthy again). And I’m learning a few things.

Basal Metabolic Rate is a thing. I’d never heard of it. BMR estimates how many calories the body uses to maintain a baseline of life just sitting on the couch, not doing anything. So your BMR tells you how many calories you need to eat to live if you want everything to stay the same. As you add activity, you also need to fuel that activity so would need more calories. And if you don’t want everything to stay the same (you want to lose or gain weight), you would take in more or fewer calories than needed based on BMR. There are lots of free BMR calculators online and they all seem to have slightly different results. This is the one that provides results closest to what my health coach came up with.

Calories count. Perhaps this seems obvious to some people, but I’d had the vague impression that counting calories was outdated, and that it was more important to look at macro-nutrients and get the right proportion of protein:carbohydrates:fats. Turns out that these approaches are not mutually exclusive. We should be looking at both calories and macros. I’m not sure why so many people are emphasizing counting carbs without any acknowledgement of the role that calories play in the equation.

Restrict calories to lose weight. But how much? Conventional teaching says 3,500 calories equals one pound, so if you cut 500 calories per day, you should lose one pound per week. Stick with it for a year, and you’ll lose 52 pounds in that year. That’s the theory, but it doesn’t actually work that way in real life. In all honestly, I’d bet most people don’t know how many calories they’re eating to begin with, so have no gauge to determine what that -500 level would be. Add in the fact that different people have different metabolisms. I can see metabolism illustrated most clearly by looking out in my pasture. Our horses all eat the same thing; one is fine grazing in the pasture year-round, but one gets fat and will founder if we don’t pen him up and severely restrict what he eats (this type of horse is called an “easy keeper”), and another horse drops so much weight that his ribs stick out if we don’t supplement extra calories for him even though he eats all day long. So while that 3,500 number is an easy guideline to teach and cite, real people have real lives and real metabolisms that call for customization.

For my situation (other people would have their own unique situation), the health coach recommends eating about 250 calories a day below the BMR number. It comes down to eating nutrient-dense food, and not munching on empty calories.

Protein is essential. At my last session with the health coach, a follow-up after implementing his initial recommendations for a bit, I was told to increase my protein intake. It’s still something I’m trying to figure out. Apparently when we are trying to lose weight, our bodies are lazy and target the easy calories to burn, which means that we start to burn muscle instead of fat – not at all our goal! We need extra protein to build muscle and convince our bodies to burn fat stores instead. It sounds like precise recommendations vary based on personal genetics. For now, my goal is to get 30% of my calories from protein – which works out to a lot more protein that I’ve been eating!

Fat has a lot of calories! While fat makes things taste good, and makes us feel full, it hogs the calories. The rule of thumb is that proteins and carbs both have about 4 calories per gram, while fats have 9 calories per gram. It’s supposedly why fattier cuts of meat contain more calories than lean cuts of meat. It also explains why that healthy salad ends up having a not-so-healthy zillion calories when we add avocado and olives and salad dressing. So on the one hand we need fat to feel full, but on the other hand, too much fat will use up our entire day’s worth of calories without providing necessary vitamins and minerals. It’s worth taking the time to figure out how much you need, and skipping what’s not necessary.

Veggies matter and they’re not equally beneficial. We can’t eat tons of lean protein for all our calories. Not if we want to be healthy long-term. About 40% of our calories should come from carbohydrates. That means eating veggies, not roots nor grains, and limiting sugary fruits. The more I’m learning, I like the variety provided by Dr. Terry Wahls’ categories of produce. Dr.W recommends eating – every day:

  • Leafy greens like lettuce, spinach, kale, arugula, bok choi, and leafy tops from things like dandelion, chicory, turnips, radishes, and beets — these provide vitamins B, A, C, and K (Dr.W calls them Vitamin BACK).
  • Sulfur-rich foods like asparagus, alliums (onions, garlic, leeks…), brassicae (broccoli, cauliflower, kale, radishes, cabbage, Brussles sprouts, turnips…), and mushrooms.
  • Antioxidant-rich brightly-colored fruits and vegetables, getting at least three colors every day
    1. Red group: raspberries, strawberries, red huckleberries, tomatoes if tolerated (AIP omits all nightshades, including tomatoes), beets, red cabbage, cherries, red grapes, pink grapefruit, rhubarb, watermelon…
    2. Orange/Yellow group: squash & pumpkin, carrots, mango, papaya, apricots, peaches, nectarines, sweet potatoes, yams…
    3. Blue/Black/Purple group: blackberries, marionberries, blueberries, boysenberries, elderberries, dates, figs, plums, prunes, grapes, olives
    4. Green group: artichoke, celery, avocado, cucumber with skin, zucchini with skin, honeydew, kiwi, all the leafy greens

Dr. Wahls tries to make it easy and says to eat three cups from every category every day, but I think that’s just to make things easy and the exact quantities aren’t based on research (although I think the categories are). There’s no reason to think that a 6’4″ man and a 5’2″ woman have the same nutrient requirements, so there should not be a single blanket recommendation. It’s a good starting point, though, to recognize that we need a LOT more vegetables than most of us eat, and that we need a variety of foods to get a variety of vitamins.

Steak with mushroom-huckleberry sauce, green salad, and mashed cabbage.

I’m enjoying the challenge of planning meals that provide nutrients instead of just filling our stomachs (even if it is a bit of a challenge when we’re away from home). Instead of a “what should we eat?” approach, I choose a protein, varying from day-to-day what our protein source is, then try to round out the meal with a leafy green, a sulfur source, and something brightly colored – again, varying from day-to-day.

Keep track of everything that goes into your mouth. Apple has an app called Nutrients that I really like for looking at all the micronutrients in food, but for ease of use (ignoring micros), I like the free version of MyFitnessPal better. Take a minute to customize your setup: under goals MFP lets you enter your daily calorie goal, and then adjust the macro ratios to get the app to calculate how many grams of protein:carbs:fat that will work out to each day. Then, throughout the day, as you enter everything you eat, you can track your progress toward those nutrient goals. I’ve found it most helpful to enter things before I eat. Eating something and then entering it afterward can lead to, “Oops, I shouldn’t have eaten that” moments. Writing it down helps because 1) it helps to know what you’ve eaten, 2) there are times you won’t eat something you shouldn’t because you don’t want to have to write it down.

* * *

Another tool I recently discovered and am finding interesting is called Body Weight Planner. It was referenced in a Today’s Dietician article titled “Farewell to the 3,500 Calorie Rule.” This tool can be found on the NIH’s website. Body Weight Planner lets you enter your current and target weight, current activity level, and date by which you want to lose the weight. It will then estimate how many calories you should be eating every day to reach that goal and provides a cute little graph estimating your progress.

The trend line is easy to see, and people can visualize that some folks will lose weight faster, while some will lose slower. Additionally, the graph shows pretty clearly the tendency that people have to celebrate with cake & ice cream when they finally reach their goal, bouncing up a few pounds.

If your goal is not realistic, Body Weight Planner tells you that, too. You can then take more time to lose the weight, or change your goal weight, or add some exercise. If you decide that you want to add some exercise, there’s a place to indicate that you intend to change: the “physical activity change” feature lets you add walking/cycling/jogging/swimming and then makes calculations to reflect your adjustment.

The results section tells you how many calories you should eat to maintain your current weight, given the activity level you entered. Obviously, if you enter inaccurate info, then your results won’t match up. It also tells how many calories to eat to lose at the indicated rate, and then says how many calories you’ll eat to maintain your goal weight.

The Resting Metabolic Rate calculated by this tool is fairly close to the BMR my health coach came up with. I fiddled with the timeline until the daily calories matched what my health coach recommended. If the model is accurate (and I stick with it), I should reach my goal weight by Christmas!

If you, too, are including weight loss in an effort to get healthier and want to buddy up, I’ve created a new MFP account and am WarmSocksOnMFP. Feel free to send me a friend request over there.

* * *

Exercise is as big a challenge as planning healthy meals. For now, I’m sticking with exercises from my physical therapist. I’m hoping that at some point, my health coach can suggest exercises I can do at home that will spare my joints and spine, yet allow even more improved health.

1 thought on “Getting Healthy

  1. Hope your plan works. Please keep us informed… rooting for you. I have had some success with intermittent fasting, combined with healthy eating. Have lost 16 of the 76 pounds RA gave me!

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