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Fit at 50: Episode 3, A neurosurgeon gets a little closer to the goal of losing the gut in time for fit by 50

The ongoing struggle to lose weight, loose my gut, and get in shape continues (following the principles of the core commitment curriculum, trying to create an environment supportive of my desire to change my habits and my ways) although not as easy as it might look.  One needs to modify expectation of friends, family, and even within.  To do that requires a strategy to get their help without suggesting they have to change, and that you’re still the same, you just want to be better than you were yesterday.  This way they can support you without you appearing to be suggesting they need to change too.

FOOD:

First of all, food continues to be one of my biggest challenges as well as something I still enjoy.  While having dinner out with friends, especially after a glass or two of wine, it seems unsociable not to order and eat multiple courses.  Since I already have a reputation for having a very healthy appetite, people often expect me to be voracious, even to the point where my loving wife will continue to offer me food from her plate in addition to my own meal (she openly admits it’s part of her diet). Don’t get me wrong, I love sampling all sorts of cuisine, and who would not want to try a delicious taste of fish after I have just had a little bit of steak (well, in full disclosure, sometimes more than a “little” bit of steak)?   The challenge is learning how to moderate what you order, how to moderate what to actually eat when it is in front of you, and how to slow down the process so that you do not eat faster than your stomach and brain can react to.

ALCOHOL:

We all know (or at least we should all know) that alcohol has many effects on the brain, one of which is reducing our inhibitions.  This has been shown in life and research articles to be true, and I have certainly found that my appetite reacts the same way.  So, one of my little tricks, one of my New Year’s resolutions, in fact was that I would try (with the emphasis on try) to not have more than 1 glass (wine, beer, or any other delicious libation) until after I have had dessert.  The theory being that I tend to eat everything in front of me (sometimes even for as far as my arms can reach) once I have had 2 glasses; this remains true at home or going out.  Clearly, if I am having enough wine to cause intoxication, I will make sure that I’m not driving home, but even if the level of consumption does not reach what would normally be considered the legal limit for intoxication or impairment of judgment while driving, there is clearly some impairment of my judgment on eating because I seemed to get hungrier after that first beverage. 

So, letting people know that I am blogging about my weight loss is a great icebreaker or introduction to remind them that I may not be ordering an appetizer, or perhaps I will just be getting half a portion of an entree and an appetizer.  I am not looking to go onto one of the starvation or full fasting dietary modes (although there is significant literature to suggest that that is potentially the most beneficial long-term way to lose significant amount of weight). Instead, I’m trying to create a social environment conducive to my wish to eat less, especially to eat less of that which is not going to give me the balance of calories, proteins, and nutrients that I need to continue exercising.  Social support of my commitment to change is also important; in fact with regards to alcohol consumption, being the designated driver often makes it easier not to consume more calories from alcohol.  After all if I just pointed to my glass of water and say “hey, I’m the designated driver”, there was no more social pressure to have another round with everybody else. 

BREATHING IS FUNDAMENTAL:

While exercising, something that I find even after all these years of training at high-level kung fu and other forms of martial arts training, cycling racing, running racing, swimming racing, I still need to remind myself, “hey, breathing is fundamental.”  It seems almost the natural instinct to hold ones breath when doing something that requires a little extra concentration, but in reality that is detrimental to your exercise tolerance.  As we hold our breath, we began to exhaust our supply of oxygen in our blood stream and build up lactic acid levels.  So, it is important to constantly focus on breathing throughout the exercise in a smooth yet adequate way. 

In doing crunches, I find it easier to inhale when going back down and then exhale on the way back up.  By exhaling on the way back up, you create more room in your abdominal cavity for your muscles to compress against each other by reducing the amount of air in your lungs and the position of the diaphragm.  Not to mention you do not feel quite as much pressure and strain in your chest and for that matter, even in your head. 

The same is true when doing push-ups, jumping jacks, high knees, or any other exercise, keep breathing so that you don’t get light headed and weak.  In between individual types of exercises, such as when doing the “Daily Abs”, during the 5 seconds or so between each new exercise, that is when you want to do what my kung fu sifu and instructor, Matt Lapidus says to use “rescue breathing” — rapid, paced and pulsed breaths, not super short but not big breaths either, about 50% of your lung volume.  This will rapidly turn over the carbon dioxide in your lungs and get enough oxygen in to start the next session and then go back to the standard breathing in down out up for the next set. 

AB EXERCISES

To maximize your workout efficiency and safety, especially when doing crunches, you are only meant to get your head and shoulders off the ground just enough that your shoulder blades are not touching the ground anymore.  Once the shoulder blades clear the ground, you are pretty much done going up.  The key here is not to rush it, do not try to do as many as you can in the time allotted (you just needed to do that high school to get the Presidential Fitness award).  What matters more is good technique, which is smooth technique.  “Herky-jerky” movements will lead to more injuries than gains. 

And when I say “try” to get your shoulder blades off the ground lets face it, we have already established that (IMHO) abs are hard and that what matters more is how many times you try to get off the ground (at least early on, more than how many times you actually get off the ground).  I find that there are still some ab exercises even 2 months in, that kick my butt, especially the bicycle crunch and straight leg crunch.  The goal here is to make progress, not to give up because it seems too hard to finish perfectly.

On the plus side, I have now been able to move from not being able to do most of the exercises on the 5 minute ab exercise routine, to now being able to finish most of the exercises smoothly and cleanly on the 8-minute routine, but those 2 ab exercises I mentioned above are still troubling.  In fact, my flexibility is still not great and I have trouble keeping my legs up in the air as smoothly as the model does on the app.  By the same token, I am sure nobody would want to see me doing these same exercises, so I’d rather have her on there than me. 

HYDRATION:

Finally, one point of health that is very important to maintain your commitment to this exercise program as well as your ability to stay committed and that is not getting too dehydrated during the day, but especially during and after exercises.  The easiest way to monitor your overall level of hydration is to keep an eye on the color of your urine throughout the day.  Anytime that your urine in the toilet bowl has more than a very pale yellow color to it, any darker than that means you are dehydrated and should drink more water.  You do not want to drink so much water that your urine is crystal clear and white but just a faint tinge of yellow is all that you need.  You cannot drink too much water, situations of water toxicity are reported and in extreme cases can be fatal, but they are rare and as long as you do not drink more than 8 ounces of water at a time and react and see how you are doing and overall shoot for somewhere between 6 and 10, 8-ounce glasses of water on a typical day (hot days, extreme activity levels may make that level still not enough) but remember, caveat emptor, your mileage may vary, and make sure you check with your doctor to make sure you are healthy enough to participate in exercise. 

PROGRESS!

So, how am I doing?  I am pleased, I am happy, I am certainly nowhere near my final goal yet, but I am getting there without having to diet like crazy, eat nothing but kale (my wife loves kale, me, not so much…) and yet I am making tangible fitness and weight progress.  From the fitness point of view, I can now ride on a bike for an hour without collapsing whereas previously, well, we don’t have to say how bad I was when I first started.  In fact, I can track my power output on the Zwift app for the exercises I have been doing. 

In addition, as I have mentioned earlier, I have gone from 30-second reps of abs to 45-second reps of abs and I still feel like I have room to go.  People have noticed that I have lost some weight which is nice, but me noticing it is even better. 

I started this process at 226 pounds, last time I logged in at 218, in the interim since then, I have varied from back up to 220 (I swear I did not think I ate that much, but clearly the scale tells a different story) to back down to my current low this morning of 213.  13 pounds down overall, 5 pounds since the last posting.  At this current rate, if I could keep a gradual loss of 5 pounds a month for the next 3 months, I will be at about 200 just in time for the vacation I have planned around my 50th birthday celebration. 

Of course, I am committed to more than just getting in shape for my birthday party, I am committed to getting in shape for life. So while I will certainly enjoy myself on this trip, I will make sure I get exercise, I will make sure that I eat in moderation (and consume alcohol responsibly in moderate quantities as well) because I do not want to dig myself back into a hole after I just dug myself out of it.  Of course, I also need to watch out for injuries and other physical or psychological setbacks.  I will keep you informed, and let you know how I am doing.  Send me your stories or tell me how you are doing.

Arthur L Jenkins III MD FACS

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This blog does not constitute medical advice. For you to receive medical advice, you would need to have a two-way relationship with a physician who can examine you, not just exchange emails or comments with.

*I do not make any money to give any endorsements for any product.

At some point as I collate all of the products that I do believe in, I may very well utilize a web portal to facilitate people getting the items and products they need; at that time, I will disclose any interest that I have, but for now, I have no conflicts to disclose and only recommend those products that I truly have used, recommend, and believe in.

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