About Me

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As the principal owner of Central Massachusetts Podiatry I wanted to create this blog to help my patients, friends, fellow athletes and fellow physicians become more acquainted with our treatment approach and be able to follow along with my athletic endeavors and views on all things life and health related. I have completed seven Ironman triathlons, numerous marathons including nine Boston Marathons and three 100 mile ultramarathons (Vermont, Leadville and Javelina Jundred, finishing in 19 hours, 38 minutes and 17th overall). Having had the highs of qualifying for both the Boston Marathon and the Hawaii Ironman, to the lows of sustaining a double pelvic stress fracture in 2009, there is much perspective I can offer, both personally and professionally.

Dietary Fundamentals of Weight Loss

This topic is remains one of the hottest topics out there right now, and one that has many different ideas, theories, and applications.  I’m not going to go on about what I think is the best way; I’m going to go on about what makes sense to me, and what I try and do to stay lean.  What I will talk about is not mine, but a mixture of what I’ve read, studied and lived over the past years when nutrition really became a priority in my life. 

As a Podiatrist, I treat people every day who want to lose weight, but tell me they can’t because their foot hurts, and they can’t exercise.  In another blog post to come I’ll talk about why the exercise part is what lead to the foot pain, but for now I want to talk about how to lose weight irrespective of exercise.  Weight loss is, after-all, more about diet than anything else. I used to believe, as has been force-fed (sorry about the pun) to us for the last 50 years, that in order to lose weight, you need to take in less calories than you burn over the course of a day.  The “experts” adhered to what they believed was the Law of Thermodynamics with regards to calories… and treated ALL calories as being equal. For this very reason, many diet centers and nutritionists have people weigh their food, count calories and restrict the amounts of what people like to eat.  I don’t know of anyone who likes to do that, nor do I feel it’s sustainable.  Another unsustainable method to many weight loss programs is by having you eat foods that are high in salt, low in fat and taste, and in general, completely unsatisfying and leaving you constantly hungry.  Sign me up?  No thank you!  If any weight loss is going to be effective and lasting, it has to be satisfying, sustainable, and most importantly, make sense.  I love food!  I eat a LOT of food!  Yet, I weigh the same now as I did my freshman year in college so many years ago.  It’s not because of high metabolism.  It certainly has to do with my passion for endurance sports, but it mostly has to do with the choice of foods I eat.

The Basics of Burning Fat for Energy

The human body loves fat!  It keeps us warm in the winter and protects us for long periods against starvation.  We have a layer under our skin made of fat, it surrounds vital organs and our cell membranes (surface of every cell in our body) is made of it.  So I eat fat.  It’s tasty and sustaining, two of the three prerequisites of my idea of a sustainable weight loss or weight management program.  Fat is also the Best energy source we have in our bodies.  Calories are the measure of energy in the body.  You consume calories in the form of food and certain fluids, and burn calories not just with activity, but with the basic operation of the body.  This is termed the Basal Metabolic Rate, or BMR.  It’s like a car that idles; it uses a baseline level of fuel, and the fuel consumption goes up when the car starts driving.  Faster the car goes, the more fuel you burn.  The body is the same way.  Foods are broken down into three Macronutrients; Fat, Carbohydrate and Protein.  For each gram of Fat, the body can use 9 calories.  For each gram of Carbohydrate or Protein, the body can only use 4 calories.  This makes Fat the optimal fuel.  Here’s the most important part to understand with burning fat:  If you want to burn fat, you must force your body to utilize the stored fat for energy!  The body is designed in fact to do just that.  It’s what babies drink in breast milk, and what our hunter gather ancestors ate in the lands 50,000 years ago.  The problem that modern societies have is the convenience of supermarkets, fast food restaurants, processed foods and an overall dependence on getting too many calories in the form of Carbohydrate.  Not just any Carbohydrate, but the wrong kinds of Carbohydrate.  Carbohydrate is the body’s term for sugar.  Human beings crave sugar.  That’s why it tastes so good.  BUT, in the old days of our pre-historic ancestors, they didn’t have Candy stores or McDonalds.  So they didn’t give their bodies the wrong kind of Carb.  They ate nuts and berries and animals that all have optimal amounts of the right kinds of Carb.  The wrong kind of Carbohydrate are the types that raise your blood sugar levels rapidly, and force a release of insulin.  Insulin is what’s responsible for getting the carbohydrate out of the blood stream and into the liver, muscle, and brain to be stored as Glycogen.  The more of the wrong Carbohydrate in your blood (that which raises your blood sugars quickly, also termed HighGlycemic carbohydrates or foods), the more insulin released, and the quicker the Carbohydrate is taken out of the bloodstream.

I apologize for the length of the science discussion, but it’s really important to understanding the next part; stick with me.   Most humans can store up to 150 grams or so of Carbohydrate in the muscle, liver, and brain.  It’s stored as Glycogen.  Each and every one of us can only store as much Carbohydrate as we can handle.  So when our diets are disproportionately high in Carbohydrate, we will be consuming far more Carbohydrate than we can store.  So if we have insulin that does a wonderful job (except in Diabetes) of getting the Carbohydrate out of the blood, but we can’t fit any more into the Glycogen, then where does it go?  If you’ve guessed Fat, then you’re Right!  Our body does a terrific job of saving what you eat just in case you want to starve yourself later.  OK, that’s not relevant these days, but the human body today is the same essential machine it was 50,000 years ago when Starvation was a real risk!  The body just doesn’t know any better.  Also, back to the insulin, if you eat the higher glycemic or wrong Carbohydrates that rapidly raise your blood sugar levels, then the insulin will be produced in amounts that actually lower your blood sugar to below normal.  That is why we feel sluggish and tired in the 30-60minutes after eating (those types of foods of course).  And what happens next is a physiologic phenomenon that again dates back to pre-historic times.  When the blood sugars drop below normal levels, the brain thinks that we are in starvation mode and triggers the hunger response.  That would also explain why we are hungry again shortly after eating a huge Chinese food meal!  Is it starting to make sense??

What to Avoid 

We want to avoid foods that rapidly raise our blood sugars and cause insulin to surge.  This is the best way to force the body to burn Fat for energy as the body will prefer the 9 calories per each gram of Fat over the less efficient and effective 4 calories per gram of Carbohydrate.  These are foods that are generally higher on the glycemic index and one’s that our body would crave if placed on a table in front of us.  Unfortunately, they are also staples to most of our diets!  Grains!!!  That’s right!  Bread, pasta and rice (though not as bad as the 1st two).  It’s true that whole grain is a lower glycemic entity than its processed counterpart, but it’s still a grain, and the body will prefer its presence in the body, and use its measly 4 calories rather than going after the fat that’s sitting on your thighs, hips and butt which it knows will be there at a later time. 

Some people are very lucky and their hormonal responses that control insulin levels are stronger than others.  Meaning, it’s the insulin release that ultimately leads to the production of fat with the intake of carbohydrate, and some individuals do better with insulin than others.  That’s why some people eat poor diets rich in carbohydrate but don’t seem to get fat.  Others, many others as is evident with the obesity epidemic of today, aren’t as lucky. If you have propensity to gain weight, and you want to change your body composition, and do so in a sustainable and enjoyable way that allows you to eat rich, whole foods, you must give up the carbs/grains!  It’s that simple, though obviously it’s not easy to do.  The less carbohydrate you eat, the more weight you’ll lose, regardless of how much fat you eat or exercise you do (Exercise is a different topic, but realize that intense exercise followed by high carb energy drinks and bars is NOT helpful).

How do I eat?

The more I read and try and learn, the more I realize that I have so much to learn. But the principles of losing weight or staying trim remain; limit carbs and grains as much as possible.  If I’m to eat grains (pasta, bread, and rice), I’m going to do so after a period of intense exercise where I know I’ve taken from my glycogen stores.  Therefore, I know that there is a place to store the new Carbohydrate I’ve consumed.  I eat high fat dairy and real butter when I do dairy.  I eat a lot of eggs, including the yolk.  I eat a ton of salad (all organic), with a lot of color (nature’s antioxidants), avocados, and have olive oil and balsamic vinegar dressing, if at all.  I eat a lot of organic chicken, fish and grass fed beef.  Roasted sweet potatoes (another carb that probably isn’t best if you want to lose weight), broccoli, and other root vegetables (roasted in olive oil with salt and pepper) are staples to my suppers.  Sweet potatoes are higher in carbs being a Starch (another type of carbohydrate), but they are lower glycemic than regular potatoes and thus don’t spike the blood sugar levels as much, but again, should be avoided if trying to actively lose weight.  Plus, with my exercise, I do need the extra carbohydrate to replace the lost glycogen from exertion.  Currently, I’m working on the next phase of diet progression and looking to transition my sports and running to low carb as well, even during marathons.  Read this article if interested…and read to the end!  I eat a lot of almonds and walnuts and berries.  I’ll have the occasional beer or glass of wine and drink my coffee every morning.  These last items aren’t necessarily part of what I was talking about, but if you can eat the right kinds of foods the vast majority of the time, then you are doing alright.  Also, I’m not trying to lose weight.  If I were, I’d be a lot stricter.  When shopping, my wife, or I will typically stay in the perimeter of the store where the foods that come from the Earth, not lab or manufacturing plant, are kept (Wegman’s has thrown a wrinkle into the basic Grocery store navigation).  

Where do you go from here?

There are many books out there, as I’ve mentioned before, and it goes so far beyond this brief post.  The one that made the most sense to me was ThePrimal Blueprint, by Mark Sisson.  It can be repetitive, but it’s necessary as the subject matter can be difficult to get as you can probably tell from this blog.  He has a great blog as well on Marksdailyapple, though he can be a little too opinionated at times and overly critical of anything not “Primal.”  It’s not necessarily a bad thing though, as he is both passionate and consistent, backing his words up with as many studies and facts as he can to support the message.  TheOmnivore’s Dilemma by Michael Pollan is a very entertaining book that will help you WANT to avoid grains and corn by the mere description of the cattle industry in the first part. The books that probably answered most of the questions I had and now sits atop my list as the most important, are by Gary Taubes, with his books, Why We Get Fat, The Case against Sugar and Good Calories, Bad Calories.

It is really important to remember that each of us is made up differently, and our bodies adapt in different ways and at different speeds.  What works for me in terms of specific food choices may not work for someone else, yet the science is universal and the principles remain the same.  Some people have allergies or medical conditions that may make any dietary change difficult, so it is often best to work with a nutritionist and/or clear any change with your Medical Doctor first. 

This is probably more than enough for most people to get started with.  My suggestions would be for anyone trying to lose weight, try to do it the right way, not necessarily the quickest or easiest way.  There is no easy way to do it.  You will need to put in the effort and make the changes necessary if you want to reap the rewards.  If you base your weight loss efforts around what you eat (fuel in the engine), then you will get far more gas mileage for the proverbial tank of gas, and your body will last longer and be healthier.  Exercise is truly a wonderful and necessary thing, but the diet must be the mainstay of weight control, or you risk relapses and weight gain every time life throws you a curve ball.  You don’t have to be perfect, you just need to know how to do it, and do it the best that you can.  If you want to “cheat,” and have something that you crave, then you should do so with a clear conscience.  Chances are however, if you are true to eating the right foods for your body, then the foods you crave now, you won’t be once your body starts feeling better, has more consistent energy, and looks better in your own eyes.

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