June 2013: Annual Health and Fitness Letter

This is the tenth year of writing this monthly letter.  I have written several health and fitness letters.  I have not written one in two years.  It is about time to do so again.  The last few Health and Fitness letters have been more aspiration than accomplishment.  The truth is that I was going in the wrong direction and simply have not been motivated (could have easily used the word ashamed) to write one.
     I am again headed in the right direction and, thus, am motivated to write another Health and Fitness Letter.
     Obesity:  This week it was announced by the American Medical Association that obesity is a disease.  From the June 20 Los Angeles Times:

The American Medical Assn. voted Tuesday to declare obesity a disease, a move that effectively defines 78 million American adults and 12 million children as having a medical condition requiring treatment.
     The nation's leading physicians’ organization took the vote after debating whether the action would do more to help affected patients get useful treatment or would further stigmatize a condition with many causes and few easy fixes.

     78 Million American adults are one-third of the population.  In 1960, only 12% of American adults were obese.  While the adult numbers are eye opening, the fact that 17% of children are obese is simply astonishing.  In 1970, only 5% of US children were considered obese.  The increase in obesity in this country has been exponential over the past fifty years.  This problem has become epidemic.  Not surprisingly, the increase in childhood obesity is a significant contributor to the increase in adult obesity.
     The Los Angeles Times was right about one thing.  There are indeed few easy fixes. Food abuse is like tobacco, drug or alcohol abuse in one way.  All are difficult habits to change.  Food is unique in another way.  With tobacco, alcohol, and drugs, reform means stopping the substance abuse.  It means never drinking, smoking, or using drugs again.  No matter what, we still have to eat.
      I am not so sure I agree with the other Los Angeles Times claim that obesity has many causes.  I believe the exponential growth is fueled by one major factor:  Processed Foods.  The food companies employ an army of marketing professionals and food scientists.  The role of the food scientists is to create really tasty foods at very economical prices.  These foods get their taste from heavy doses of sugar, fat, or salt.  In general they are unhealthy.   Not only are they unhealthy and contribute to a variety of obesity ailments, they are addictive because of the havoc they play with our blood sugar levels.  The highs make us feel good, the immediate lows make us want to each more to get the good feelings back.  The job of the marketing folks is to entice us to consume more and more of these products each year.  Like lab rats, we have done just that.  I am as much of a lab rat as anyone.
     OK.  So what?  We are fat.  What is the big deal?
     The big deal is our health.  Being obese contributes to a variety of conditions that includes: 

• Stoke 
• Heart disease
• Cancer
• Asthma
• High blood pressure
• Diabetes
• Acid Reflux
• Sleep Apnea  
• Infertility
• Back issues
• Knee and hip joint deterioration

 Often times these conditions will require surgery as in hip and knee replacement.  Others such as diabetes, hypertension, and heart disease necessitate prescription medications that must be taken for the rest of the patients' lives.  Consider the following:

• A Wake Forest University study has shown every pound we lose, we relieve four pounds of joint stress on our knees.
• Weight is a huge contributor to high blood pressure.  Eating the right diet, exercising, and being at one’s target weight could eliminate the condition and the need for lifelong medication.
• For people with Type 2 Diabetes, a 5% weight loss can improve insulin action, decrease fasting blood glucose concentrations, and reduce the need for diabetes medications.

The worst kind of fat is what is known as visceral fat.  All obese people have this kind of fat.

Visceral fat, on the other hand, lies out of reach, deep within the abdominal cavity, where it pads the spaces between our abdominal organs.   Visceral fat has been linked to metabolic disturbances and increased risk for cardiovascular disease and type 2 diabetes. In women, it is also associated with breast cancer and the need for gallbladder surgery.

The good news is that visceral fat yields fairly easily to exercise and diet, with benefits ranging from lower blood pressure to more favorable cholesterol levels. Subcutaneous fat located at the waist — the pinchable stuff — can be frustratingly difficult to budge, but in normal-weight people, it’s generally not considered as much of a health threat as visceral fat is.

~ Harvard Family Health Guide

Let’s see how the insurance companies will react now that the AMA has classified obesity as a disease.   They should be encouraging all obese people to seek treatment.  Losing weight is much less expensive than treating diabetes, hypertension, and heart disease later on.  

4-1-13

6-21-13

Weight Management:  This has been a problem for me my entire life.  Given the statistics quoted above, I am not alone in this.  I have lost and gained it back several times.  Earlier this year, I was most definitely on the high end of weight roller coaster. 

Beginning April 1 of this year, I have been on a medically supervised meal replacement diet.  I eat two bars and drink five shakes a day.  Sometimes I eat three bars and drink four shakes a day.  Lately, I have been putting some blueberries or strawberries in the shakes.  This is an 800-900 calorie high protein plan.  The goal is to achieve a reasonable body fat percentage and then learn and reinforce the habits to maintain that weight and body fat level.
     Clearly, in the photos above, I do not get the basics of weight loss marketing.  I am supposed to look dour in the before photo and ecstatic in the after.  Oh well...

While this diet has not been the most social diet (think weddings and dinner parties), it is very effective.  I am down 64 pounds as of this writing an equal amount to go to achieve my objective.  I have not been hungry either.  There are days when I have to force down the last shake of the day.  While I have not been hungry, I do crave certain bad foods.  For some reason, pizza tops the list by far. 

When I began, I was definitely obese based on my percent body fat and the threshold for obesity given my age.  I was delighted a few weeks ago when I went from obese to merely overweight.  I am looking forward to a day in the next month or two when I leave behind the overweight class and enter the normal range.  I do not think I have been a normal weight for the past thirty years. 

I am doing this for a variety of reasons.  Certainly health is one of them.  I am also doing this in honor of turning sixty on the very day I am posting this piece.  I am doing this for me to be as healthy as possible for as long as possible.  It is not about living as long as possible but as fully functional as I can be for as long as possible.  It is about not being in a home or wheelchair for as long as possible.

A few weeks ago, two of my musicians buddies were talking about me.  One said "have you seen Gavoor lately, he has lost a lot of weight."  The other fellow said, "yes, it is pretty amazing."  The first then said, "he'll gain it all back."  I was not privy to this conversation.  it was reported to me NOT by the one who said “he’ll gain it back.”  I imagine I could write a whole separate bloggy bit about the dynamics at play here…

“He’ll gain it back.”  My friend did not really go out on a ledge here.  This is my track record.  This is my biggest fear.  I am most worried about gaining it all back.  I know that the real hard work will begin when I get to my weight loss target.  I am purposely not calling my target weight loss my goal.  When I do that I naturally ease up when I get to that point  My goal this time is to get to my target body fat percentage and weight and then to maintain it for the remainder of my life.

Failed diets are very common.  Again, I am not alone here.  I know many people, including myself, who have lost weight and backslid right back to where they were... or worse.  I will say this.  There is no worse feeling than doing that.  It makes motivating oneself for the next weight loss all the more difficult.  It is a horrible cycle to repeat.  I never want to repeat this again.

 People like me simply love food.  I am very good at not only eating but overeating.  With gusto.  It is, of course, not a desired trait.  I did not need the AMA to tell me that obesity is a disease.  If alcoholism is a disease which I believe it is, then my bad relationship with food is also one.  I have believed this to be true simply because of my own struggles over the years.  The losing takes a lot of fortitude and willpower.  After losing, maintenance takes just as much fortitude and will power.  The habits developed and honed over a lifetime are very hard to change.

As stated above, I have an addiction to over consumption that is every bit as nasty to overcome as quitting for an alcoholic or a heavy cigarette smoker.  It may actually be more difficult to overcome food addiction or abuse.   The smoker has to stop smoking and the alcoholic has to stop drinking alcohol.  But, the food abuser still has to eat to sustain life.

So, I have been thinking about maintenance the whole time I have been losing weight.  I have come to one conclusion.  Each of the other three times I have lost a lot of weight, I have had the goal of losing a certain amount of weight.  I would do that.  I would achieve the goal and then ease up.  Easing up, at least for me is bad, because it signals the beginning of a regression, regaining, or backsliding depending on what you want to call it. 

I have thus decided to change the terminology I use.  Instead of having a weight loss goal, I now have a weight loss target.   I am calling this weight loss period the Preparation Phase.  Preparation for what?  Preparation for the Maintenance Phase which begins when I get to my target weight.  That is the real start of what I am trying to do.  The goal is to maintain my target weight.  This goal is perpetual. 

This is a different way of thinking.  As I can never achieve this goal, there can be no letting up.  It is the relentless pursuit of an ideal.  It is the relentless pursuit of perfection like the tagline for Lexus automobiles.  Health and wellness must be a relentless pursuit and commitment for me.  There may be a point where adopted lifestyle becomes the norm... but I will not allow myself to believe I have achieved a goal.  The funny thing here is that I work in the field of continuous improvement.

I have to be successful because I never ever want to have to do this again.

Exercise:  Exercise is another key to a healthy lifestyle.  Diet alone is not enough.  We have to exercise because our work is not what work used to be.  We are sedentary.  I am sedentary.  I spend most of my day in a chair or lecturing.  I suppose if I were working in the fields in some kind of agrarian ideal, I would not have to exercise.

My exercise of choice is bicycling.  Three out of the last four years I managed, even at an elevated weight, to log 2,000 outdoor miles.  This year, because of the very late spring and work, I am off to a slow start.  I will be lucky to break 1,500 miles this year.

I have a small fleet of five bicycles.  Mostly I ride a used Schwinn Paramount that I bought a few years ago.  I like it more and go faster on it than my custom made Italian Mondonico for which I paid five times as much! My red Schwinn has a hodge-podge of older Shimano components on it whereas I have a full Campagnolo Veloce kit on my Mondonico. 

My Schwinn Paramount

Per my bariatric physician, bicycling is not enough.   He has me doing weight lifting as well.  I have been doing that for about two weeks and look forward to keeping it up.  Weight lifting for muscle maintenance and growth for older folks, and, egads, I fit this demographic, is more and more important.  It is critically important in rapid weight loss, like what I have been doing. 

I have read and am reading again a very good book, Younger Next Year by Crowley and Lodge.  The sub-title is A Guide to Living like 50 Until You’re 80 and Beyond.  It is geared toward men, very well written, and informative.  The authors point out that aerobic exercise is necessary for heart and lung health.  It builds endurance in the muscles.  The authors point out that muscles have both strength (fast twitch) and endurance cells (slow twitch).  So, strength training is needed to maintain the strength cells.  Strength and balance training is even better.  We forget or simply have never realized how complicated the very act of walking or taking stairs can be from musculoskeletal perspective.  The physics and chemistry of such simple acts is astounding.   Balance and strength will deteriorate with age… we may see it in ourselves and we certainly see it in others.  Weight training and aerobic exercise improves our general overall performance.  Even those of us with osteoarthritis, can benefit from weight training.  Keeping ones muscles sound and fit for strength and endurance helps do the work of joints and prolongs their lives. 

Given the minimal amount of cartilage left in my knees, I am counting on weight loss and strength training to stave off the knee replacement for as long as possible.

Turning 60:  We make a huge deal of birthdays that end in zero.  Why not?  They are milestones that should be noted and celebrated.  On the other hand, it is just another day in another year.  Our aging is gradual for the most part.

I read that 60 is the new 40 or 50, maybe a delusional 30.  That may be.  I remember my grandparents at 50 seemed ancient.  They looked and acted old.  Hair color and fashion has done wonders for this perception.

I do not know what 60 means these days.  Is it the new 40 or the old 70.  I do not care.  That is just rationalization for something.  I know that I do not plan to color my hair… or what little is left of it.  I will shave my head before doing that and I am not likely to shave my head even though my hair cuts are getting shorter. 

I know I will try to live with as much physical and intellectual vim and vigor I can muster.  I know I am committed to maintain the body and mind to be able to do just this.

Perceptions and priorities change with age, hopefully for the better. I will close with two copy pastes from Facebook:

First is a quote from Friedrich Nietzsche, “We love life, not because we are used to living but because we are used to loving.”  If we truly desire to age gracefully, it is more than just physical health and fitness.  Loving people close to us more will help us age gracefully mentally and spiritually.

Secondly, a ten step guide that can basically be summed up with the word “chill.”

10 to Zen

From the Facebook page Buddha Heart

1.  Let go of comparing.
2.  Let go of competing.
3.  Let go of judgments.
4. Let go of anger.
5. Let go of regrets.
6. Let go of worrying.
7. Let go of blame.
8. Let go of guilt.
9. Let go of fear.
10. Have a proper belly laugh at least once a day (especially if it’s about your inability to let go of any or all of the above).

Terror Cubed

I heard a report on NPR Weekend Edition this morning, June 15th.  It was regarding terrorist bombings in Pakistan.  A bus full of students and instructors, all women, was bombed outside the Sardar Bahadur Khan Women's University in Quetta.  Eleven women were killed instantly and at least twenty were wounded in the blast.

As despicable and sad as this was, the terrorists were not done.  Another bomb exploded  by the hospitals emergency room as the victims were being brought in for treatment!  Then terrorists took siege of the hospital killing three security guards and the deputy commissioner of Quetta.  Three nurses were killed in the crossfire when police raided the hospital.  Two of the four terrorists were killed in the gun battle with police.  The other two blew themselves up.

I am totally against terrorism but I can, minimally, fathom where extremists, revolutionaries, and others may resort to it as a tactic in whatever it is they are dedicated to and fighting for.  What completely blows my mind are these second attacks.  It is a double terror, double evil, and goes quadruple against any sense of humanity and any religion that is worthy of anyone believing in.

A bomb goes off on a bus or in a crowded place.  People are killed or wounded.  Others rush to offer assistance and a second bomb goes off to finish off those not killed by the first bomb and to kill and maim those rushing to offer assistance.  There are no words to adequately describe how I feel about the people that do this.  They should be hunted down like the dogs they are and killed.  There is no possible redemption for people like this who are pure evil.  

Now, these despicable souls in today's story have taken this egregious tactic to an even more dastardly level.  Instead of a second bomb at the site of the first bomb, they placed the second bomb at the hospital emergency room.  Then they raided the hospital and took hostages  with, no doubt, the intention of further killing.  It is an unbelievable twist on an already unbelievable tactic. 

There are no rules in terror.  But, until recently, attacking the already wounded, caregivers, and hospitals followed some unwritten rule to simply not do that.  The hate and need to create a deeper sense of fear and terror has superseded whatever sliver of morality and decency might have been there.

It all reminds me of the World War II movies in which an American plane is shot down by a German or Japanese plane.  The American pilot is able to bail out and is parachuting to a a presumed survival.  The enemy plane banks and returns to finish the job by gunning down the helpless pilot in the parachute.  What these terrorists are doing is even worse.

I am dismayed that there is not more global and universal outrage regarding this kind of tactic.  I have a feeling everyone hopes that if we just ignore this it will go away.  I am afraid it will not.

There... I have ranted.  I do not feel any better.

Government Snooping

The National Security Agency (NSA) has been in the news lately for snooping.  It seems they are reading emails, listening to phone conversations, and who knows what else.  We have been assured that they are not snooping on us now nor do they plan to.  They are snooping internationally to protect us from bad guys.  I suppose that is reassuring.

I remember the Soviet Union as being huge snoops.  They would regularly invade the privacy of their citizens looking for deviant and anti-Soviet behavior.  Back then snooping involved reading letters, bugging rooms, listening in on phone calls, and tailing people to see whom they met with.  Snooping was manpower intensive in those days.  That made me wonder just how many people they could possibly snoop on at any given time.  It was a phenomenal task to keep up with at any significant level.  Other than using the general population to snoop on each other and tattle-tale to the KGB, the KGB, I believe randomly arrested people just to put real fear into the citizenry that they were being watched.  

The NSA is taking the game to a whole new level.  They are using technology to snoop more effectively, efficiently, and on a massive scale.  They are building a massive facility in Bluffdale, Utah.  They are building a $1.2 B data farm (snoopery) that will have 1.5 million square feet with state of the art super secret computers that will take up 100,000 square feet.  A football field, including the end zones, are 57,600 square feet so we are talking 1.736 football fields of computers.  That is truly.

This new snoopery using, I imagine, the latest technology, will no doubt be able to data mine, analyze, and interpret on a grand scale.  This sounds like Orwell's 1984.  He was only off 30 years.  I imagine the ex-KGB and Soviet wonks wished they had the kind of capability we are now building.

Everyone is aghast.  The left is fearing the shadow of Big Brother and all the 1960s paranoia that goes along with it.  The extreme right is probably confused.  On one hand, they want us to nail the bad guys.  On the other hand, it is just another piece of evidence that government is too big and spends too much.

Me?

Of course, I have a totally different perspective.  Since these are my tax dollars at work, I want the NSA to use their snoopery to do good for us average Americans.  What do I mean?

1. Find all those Nigerians that keep sending me emails saying they need me to transfer $56.7M of theirs into my bank account.  Make them stop.
2. We have a No Call List law in these United States.  Simply, and in poor grammar, it don't work.  Use the the 1.735 football fields of super computers to find, track, and then prosecute (like throw in a gulag or Guantanamo) the c-level executives or owners of any company that calls anyone on the No Call List.
3. Find the people that for some reason know my penis should be larger and make them stop sending emails reminding me of my shortcomings.
4. I like the idea of a No Call List.  I think there should be a No Extreme Political Viewpoint list that covers email, twitter, facebook, and whatever else is on the horizon.  OK I get it.  You hate Obama or you absolutely love him.  I got that in your first 300 postings and you are up to 12,477 and counting.  Filter that shit out.
5. We all have an older parent, uncle, or aunt that falls for every hoaxy ridiculous email that comes there way... and then forwards them to everyone they know.  Make this stop.  In fact, find out who started these idiotic stories and fine the daylights out of them for detracting from the general mood and productivity of the county.

If they snoop my email, phone, facebook, and twitter the above is a lot of what they are going to find.  Well they will find more.  They will find two ads per day from Jos A Banks, ProFlowers, and anyone else I may have ever bought something from on line in the past ten years.

Let's hope these super computers don't become self aware like in the Terminator movies.  They will surely turn against us for making them sort through all this mind numbing crap.

Handwriting

I began a daily writing project on June 25, 2002.  The eleventh anniversary of that date is rapidly approaching.  

June 25, 2002 was the day I turned 49. My intent was to write a page every day.  By write, I meant hand write.  Since then I have never missed a day.   Until 2007 or 2008, I exclusively hand wrote in a notebook.  Beginning in February 2004, I began sending out a monthly letter.   I would type whatever theme I centered on in my daily writing that month.  I would then email out what I called an e-letter to friends and family.

In January of 2009, I put all my e-letters on this blog and moved my once a month e-letter to more of blog format.  For a few years, I have been posting four times a month.  That date began my transition from handwriting everyday to typing every day.  Buying an iPad really marked the real end of handwriting every day.  It was just too convenient to type directly and daily into that wondrous device.

On May 30th, I decided to be retro and hand write a page.

I have not handwritten a page for a few years.  I kind of miss it at times.  It has simply labor saving to type my postings into a PC or iPad.  That way I can edit and post without the added step of handwriting and then typing my handwriting.  Like the change in the US Economy, I have gotten used to the “new normal.”

Yet, there is something more intimate and old school about hand writing.  It is a different mind, eye, hand, pen, and paper interaction and interface than the mind, eye, finger, keyboard, and screen interaction and interface.  It is hard to explain, but having done a lot of both there are differences.  Perhaps it is quite simple explained by the fact that I first learned handwriting and, until recently, did all my writing that way.  It may just feel more natural and comfortable.  Another way of looking at it that with handwriting I am creating, more artistically, my own words and thoughts directly onto the paper.  I can watch a notebook fill with my scribbling.  Handwriting is more personal than typing on a screen even though there are limitless fonts to choose from.  Handwriting into a notebook, where the cover gets worn and weathered (might I use the word Patina ?) is different compared to the anonymity and sameness of a list of .docx files stored on a hard disk or cloud.

I knew a fellow, Dan Ciampa, who is a management consultant and author.  He had written a wonderful book, Total Quality: A User’s Guide for Implementation, Addison-Wesley, 1991, that I had reviewed and recommended.  Not really being a writer then, I asked Dan how he wrote.  At that time, he told me he handwrote all of his books.  He not only handwrote them but used a fountain pen, and presumably good paper, in doing so.  That left an impression on me.

I wrote this page with a very nice ball point.  My weapon of choice today is the Waterman Carene in the photo.  I call this old school writing.  Yet, real old school would be to write with a quill that had to be constantly dipping into ink.  I tried that once and hated it.  HATED it.  This led me to believe that I am biased, wired, if you will, to favor the method of writing I learned in grade school.

I often think about a moleskin or other classic notebook to write in and collect my precious thoughts.  I think of that, and yet, I used my $800 beauty – my iPad and Zagg keyboard.  I have Evernote and Pages on it.  This really is the best way to think, collect my thoughts and ideas, and turn them into written pieces and postings.

Handwriting was fun for this one day.  I feel like, for old times’ sake, I should do this once a week or once month.  I say that but realize that, really, I should focus on using Evernote even more effectively.