Now for the part everyone is going to hate me for…
To have been told in last month’s post (I am a Rectangle) to add something new to your lifestyle (quicker, fast-twitch movements when you work out; cross-training in and out of the gym; interval, weight-bearing exercises) in order to get the results you’re after, is one thing. That went over pretty well.
But nobody wants to have stuff taken away. Remember how much fun learning addition was in kindergarten, and how hard subtraction was? That trend seems to run throughout my life. I love acquiring stuff—knowledge, shoes, seashells—but I really resist giving stuff up—lousy habits, outdated beliefs, Ben and Jerry’s Salted Carmel Core ice-cream.
I get it. I really do, but it’s actually not deprivation if you look at it like a grown-up. It’s a trade. And when it comes to our eating and drinking habits, the incentive has to be very great in order for us to embrace change that involves overhauling our diets. It comes down to what we want more. And only you can decide for you. And you will, even if you think you’ve decided not to decide.
Years ago I had a personal training client who was about a decade older than I. Her mid-life weight gain (around her waist predominantly) was utterly demoralizing to her. She had been lithe and lean and athletic throughout her adolescence and adult life. And then, in her mid-40’s things began to change—and though she had “tried everything” she just kept getting thicker through the middle, and more and more depressed. I worked with her for over a year, and though she got very strong, she finally abandoned our work-outs frustrated and baffled.
I wasn’t so perplexed, however. Her idea of “trying everything” only extended so far. While she worked very hard at the gym, was very consistent in her workouts, and took direction regarding form and function very well, I knew that her work with me was only a fraction of the equation.
And that fraction, according to research, is one-quarter. As a general rule, in the weight loss equation, exercise accounts for about 25 percent—and diet, the other 75.
This research was not good news for me. I actually like to exercise. I’m happy to do more of it. But I LOVE to eat. And I’m not so happy to do less of it. No, not at all.
But, alas, I am vain. I’d like to say that the dietary “sacrifices” I make are strictly due to my desire to be healthier, I will admit that again, a 25/75 ratio applies here. My motivation is: 25%, reduced-risk-for-heart-attack and 75%, reduced-risk-of-not-being-able-to-button-my-jeans. (But that ratio is changing. Ha!)
A few times in my life (especially after pregnancies) I have found myself 10 to 20 pounds heavier than I have wanted to be. When I was really young, it seemed like I could just think about not going to Whataburger, and I would lose two pounds. In my 30’s and 40’s it took a little more effort, but counting calories or Weight Watchers’ points worked pretty well. In my 50’s all of that stopped working for me, and I was distressed.
And so were most of my friends—not by my weight gain, of course, but by theirs. It seemed we were all in the same mid-life boat—and that roll around our waist wasn’t a life preserver. It was clear to me that the “middle-age-spread” was a real thing—and once I understood the science of it, I figured I could come up with a new plan. And I did. And it worked. I got the weight off, and am able to maintain my happy weight without donning sackcloth and ashes and wielding a cat-o-nine-tails. It’s not self-flagellation or punishment. I do not feel deprived. It’s just the way I do things now that I understand my changing metabolism a little better. And I ate birthday cake yesterday.
The hormonal changes that occur in midlife (loosely defined by the Census Bureau as the years from about 45 to 65) have a direct and profound effect on our metabolisms. This is true for men and women alike. What worked for me when I was 34, was less reliable at 44, and by 54, the same diet and exercise regime seemed to be resulting in weight gain, not loss.
It wasn’t my imagination, and I wasn’t in total denial about my fitness habits. As I explained in last week’s post (I am a Rectangle), those hormones I took for granted in my youth, “really were useful when it came to helping me maintain my girlish figure. The estrogen was good at keeping the fat distribution on my body more hour-glassy, and the testosterone helped me maintain good muscle mass, which in turn kept my metabolism humming along burning up all those extra cookie calories. Even the progesterone helped keep fluid retention at bay.”
Reduced levels of all of these hormones made it all but impossible to maintain status quo, especially with regard to my food and beverage choices, and not gain weight—and inches around my waistline. Something had to change. Something big. Minor tweaks with my diet may have worked when I was 20. Not so much now.
And it all came down to another hormone. This time, not the waning ones (estrogen, testosterone, and progesterone), but another one that, in its valiant attempts to keep my blood clean and non-toxic, was having to work overtime just to keep up with my food and drink choices. Lack of estrogen specifically was causing my body to use starches and blood sugar less effectively. And insulin comes to the rescue. And I’m really grateful that my pancreas remembers how to make that particular hormone. For as any diabetic knows, without insulin to keep blood sugar levels stable, we die.
So thank you insulin, for helping me out. Now go away. Not forever, of course, but for a while, so that I can burn some fat here around my middle. Because any time insulin is present in the blood, fat metabolism is halted. In fact, many articles I came across in my research referred to insulin as the fat storing hormone. It is much maligned for that, but without it, any excesses in our diet—specifically carbohydrates—would kill us. We need it. But not too much of it.
It’s a tricky balance, made even trickier by age-related hormonal deficiencies. But we can’t turn back the clock, and even chemical or bioidentical hormone replacement can’t exactly replicate what our bodies did naturally. And those therapies come with their own risks.
So, what’s a girl (or boy) to do? Just let it happen? If it were strictly a matter of aesthetics, I might say, yes—at least 25% of me. But the health risks of excess adipose, specifically around the middle, are pretty well researched and documented. And it’s not the inch you can pinch that’s the problem. That fat—though not particularly aesthetically pleasing in our society—that subcutaneous fat (just under the skin), is relatively harmless from a health perspective. It’s the visceral fat—the stuff deep in your abdomen crowding your internal organs that puts you at increased risk for cardiovascular disease, diabetes, hypertension, stroke, and even cancer. Visceral fat is not inert. It produces a damaging array of inflammation-causing proteins, and all right there, seeping into your kidneys, colon, liver and other vital organs. And inflammation sets off yet more cascades of damaging metabolic processes. A vicious, visceral cycle.
So, again, what’s a girl to do? Well, I’ll tell you what this girl did. After all that research a couple of years ago, I came up with several strategies that worked (and continue to work) for me. I had 15 pounds to lose, and I didn’t want to gain it back this time. I had tried minor tweaks with my diet and lifestyle and would lose an inch or so around my waist, only to find it again the first time I ate a French fry. I wanted something more permanent.
I started by looking at advice I hated. Yes, advice I had never taken, but that I kept hearing. The first words of wisdom came from Dr. Phil. Ha! (Back when he was not quite such a sensationalist.)
“You can’t change what you don’t acknowledge.”
I am a recovering gravitophobic. Yes, there is actually a term for “irrational fear of the bathroom scale.” I went more than 15 years without voluntarily weighing myself. When I’d be forced to do it at my doctor’s office, I would stand on the scale with my back to the numbers and tell the nurse I didn’t want to know. Ha! I’m sure they really loved that since I’ve never been overweight enough to alarm anyone. But I just didn’t think I wanted to know. I’ve actually ditched doctor’s appointments when I was really sick, all because I didn’t want to get on the scale. (My doctor was kind of nazi-ish about the whole check-in protocol.)
I decided to get over that. I weigh the same whether I’m standing on a scale or standing in a hole. Might as well know the truth. And while the number on the vile little machine is just that, a number, it is the easiest way to measure progress. And I needed a starting point.
But I did one thing differently—and it really kept me from getting too discouraged when the numbers from day to day did not necessarily go in the direction I intended. I weighed myself every morning, without fail, and wrote the number down and tried not to assign too much importance to it. And then, every Sunday, I would average out the numbers. I’d add them up, divide them by seven, and come up with a number that was usually lower than the average I’d seen the previous week. Sometimes it would a four-pound difference, sometimes merely half-a-pound. But the trend was downward. Yay.
(It is interesting to note that my weight could fluctuate as much as four pounds in a single 24-hour period! I wrote an article that explains some of the reasons for this called Just Breathe .)
I learned of this strategy by looking at tips suggested by the National Weight Loss Registry, a research study that follows the progress of thousands of members who have lost at least 30 pounds and kept it off for at least a year. According to Wikipedia, “On average, registry members have lost about 70 pounds and kept it off for five-and-a-half-years when joining the registry.” Successful participants in the study weigh themselves.
They also self-monitor in other ways. They write down or otherwise record (on any number of new apps) what they eat. I know this sounds compulsive and tedious, but a big reason for my weight gain was that I wasn’t truly acknowledging how my eating habits were sabotaging my weight loss efforts. Seeing it there in black and white really gave me something to work with. But perhaps more importantly, once I had committed to writing down every morsel I put in my mouth, I became less likely to eat ridiculously. Who wants to write down: 18 cookies and a can of spam? Even though no one else ever saw my food (and exercise) diary, I saw it, and the tangibility of those words on paper helped keep me honest and motivated.
I still use those two techniques. I’ve decided on an acceptable range for my weight—a five-pound spread. Any time I cross that upper limit, I start recording my meals and snacks. Sometimes that’s all I do. And the focus on what I’m actually eating, and the accountability of having to write it down, puts me back in my zone.
Which brings me to my next two points. What, exactly, should I be writing down in that journal? How do my food choices need to change during this stage of my life? The next bit of wisdom comes from fitness author and blogger, Mark Sisson:
“The bottom line is that you will not lose fat effectively with exercise-driven weight-loss efforts unless your eating habits moderate insulin production.”
And I think I hated this advice more than Dr. Phil’s. I had always strongly resisted the notion that a strict reduction in any of the macronutrients (fats, proteins, and carbohydrates) could be healthy. I now believe I was wrong.
It turns out that my very favorite macronutrient is not even necessary for my survival. Not that I will ever give it up completely, but I could actually survive on a desert island without a single carbohydrate in my diet. And you could too. But why would you want to?
You probably wouldn’t. But, if you’re fighting the battle of the bulge, a drastic cut (yes, I mean a radical reduction) in your carbohydrate consumption may be your best bet.
Nobody wants to hear that. I didn’t want to hear that. But once I kind of understood the science behind mid-life weight gain, I couldn’t deny the science of it: Of the three dietary biggies—protein, fat, and carbohydrate—only carbohydrate can raise insulin levels in my blood. And I’ll say it again, any time insulin in present in the bloodstream, fat metabolism is halted. And insulin is present in the bloodstream, in varying levels, every time I eat carbohydrate-rich foods. And not only the obvious, sugary snacks and soft drinks, but that includes any food that is composed mainly of carbs (e.g. rice, pasta, bread, even potatoes). The addition of fat, protein and/or fiber in the food helps mitigate the insulin response—which is why an apple is a far better choice for a snack than Cap’n Crunch—but your pancreas still needs to dispatch insulin to your bloodstream to take care of the sugar, or glucose in your blood. And for a while, your fat-burning machinery is turned off. When you’re trying to lose weight, you want to keep that furnace cranking all the time. (We talked about ways to do that through exercise in my last post, “I am a Rectangle.”)
I learned that all digestible carbohydrates are converted to glucose in my blood, and insulin is required to shuttle that energy out of my blood so that I don’t die of ketoacidosis. My mission, should I chose to accept it, was to find a way to keep my blood sugar stable, so that my pancreas wouldn’t keep flooding my blood with insulin, thus thwarting my weight-loss attempts.
I cut my carbs way down. The first four days were miserable. My body was used to several hundred grams of carbs a day. I cut down to less than 70. Less than 40 on most days. I was a tad bit cranky for a few days, and then, midway through the fourth day, I noticed something great. I was not hungry. Not at all. Hunger is often a result of dipping and rising blood sugar. Without those fluctuations, I rarely felt hungry. But it took a few days for my body to adjust. By day five, I felt pretty energetic and optimistic.
Once I realized that I could lose weight and not be hungry, I said, sign me up! With the absence of carb calories, I could actually put butter on my cauliflower and yummy homemade dressing on my salads. I’m getting the extra protein that is recommended for my demographic, and I still splurge when I really feel like it. I will never say no to birthday cake. But then I have to go through that uncomfortable transition again to get back to the place where my blood sugar is so stable I don’t feel hunger.
Not everyone wants to cut carb consumption so low. But I tend to have something of an all-or-nothing mentality, so it worked better (and quicker) for me to cut out almost all simple carbohydrates until I got to my maintenance phase. Many folks are too uncomfortable with those first few days. It feels like—and actually is—a kind of withdrawal. But I have to go that low in order to enjoy the benefit of not being hungry. I can stay on any eating plan as long as I don’t feel famished. The more carbs I add back into my diet, the more I have to contend with feeling peckish, as my blood sugar levels start to fluctuate again. That said, sometimes I gotta go to Lillo’s and have their famous chicken parmesan with a huge side of linguine marinara and garlic bread. Yum.
But I decline the wine. Even the red stuff. This third bit of science will really tick you off. These words of metabolic wisdom from Dr. Mauro Di Pasquale, author of The Metabolic Diet:
“Because acetate is readily formed from alcohol, it can be worse than taking in carbs as far as affecting fat metabolism.”
Oh, I know you didn’t want to hear this. I just tried to take away your Krispy Kremes, and now I’m going after your Pinot Noir. Is nothing sacred? Recent studies have shown that even small amounts of alcohol have a large impact on fat metabolism. Large amounts, predictably, have a gargantuan effect. Funny how that works. This is never more evident than in mid-life when most of your reproductive hormones have gone AWOL. But you don’t drink “large amounts” do you? Ha! Me neither, or so I thought. Check this out:
A couple of glasses of wine. Right? Back in the day, I could polish off one of these while cooking supper, drink another with supper, and maybe have a third while watching tv.
So two or three glasses. Seems moderate to me. Ha. Not according to the CDC and the NIAAA. According to established guidelines, if I drink just the two glasses pictured, I am considered a “heavy drinker” with all the associated (scary) health risks. Even if I do that just once a week. (Yeah, right.) And what’s even more shocking: If I go ahead and drink the third with Alex Trebec within a couple of hours of my first glass, I have now crossed well over into the “binge drinker” category.
Bet you didn’t know that. Bet you hate knowing it now. (But you still can’t change what you don’t acknowledge.) Now, I intentionally filled the glasses in the picture up to a level that seemed commensurate with what I considered “a glass of wine.” But when I measured the contents, I found that instead of the measly 5-oz. portion that officially constitutes a drink (of wine), I had poured myself a double. Two doubles in the picture, only a few ounces (5.4) shy of the whole bottle. So that’s “officially” four drinks; six, if I have a third glass. Hmmm.
All of this is to say that if research shows that even small amounts of alcohol or “moderate” drinking (e.g. one 5 oz. glass of chardonnay for women, two for men) significantly interfere with fat metabolism, what happens when I drink the whole bottle?
Well, I’ll tell you. I get fatter. Yes, there is no way for me to lose weight and drink that way, without becoming significantly malnourished. Even occasionally. And though the caloric impact (nearly 500 calories in the picture) of the indulgence is huge, the metabolic insult is much worse.
Even if you could get away with the extra calories (you can’t, especially at your age, Ha!), you are powerless to change the way your body metabolizes alcohol. And actually, that’s a good thing. Without the extreme measures your body resorts to in order to get that alcohol out of your blood quickly, you might black out or even die right there on the couch well before Final Jeopardy.
Alcohol (in large quantities) is a toxin. A tasty toxin, but a toxin, nonetheless. As long as it is in your blood, a kind of poison (ethanol) is circulating to every organ in your body—heart, lungs, kidneys, brain—everything. This is not good. So your body, in a sense, drops everything, to take care of this immediate threat. You may have read that alcohol does not get converted to fat. That seems like good news, huh? And technically, it’s true. But what it does get converted to is much worse when it comes to your waistline.
The alcohol you drink passes quickly from your stomach to your intestines and into your bloodstream where it rushes to your liver. There it combines with other enzymes and is converted into acetaldehyde and then acetate—and back into your bloodstream. This sharp rise in acetate puts the brakes on fat loss. Again, as with blood sugar and insulin, the process your body uses to keep your blood from poisoning you, is efficient. (Thank you, liver. I do appreciate all you do for me.) But, unfortunately, your body can’t use both fat and acetate at the same time. It uses what is most readily available. Acetate gets burned for energy. Everything else gets stored.
Add that to your already sluggish metabolism brought on by the hormonal changes of mid-life (women and men alike), and it can seem nearly impossible to lose weight and continue to drink the way you always have. (Unless malnutrition is an acceptable option for you. Many alcoholics are frightfully thin—that’s a whole ‘nuther metabolic process, one that often ends in death.)
To add further insult to injury, there is the whole cortisol/alcohol connection. And that’s what may be largely responsible for the excess fat being distributed predominantly in the belly area. Just one bout of “heavy drinking” (and remember those two glasses in the picture put you in the “heavy drinker” category) has been shown to vastly increase the levels of cortisol—which causes your body to resist weight loss and even shift fat storage from healthier areas like butt and hips, and move it to the abdomen, where there are more cortisol receptors. Beer belly is beginning to make sense now.
I can hardly believe you’re still reading. But the bottom line is not necessarily abstinence (although that’s the route that Ted and I happily choose), but awareness. Don’t tell yourself you’re a moderate or social drinker if you put away a bottle of wine a couple of times or more a week—or month—or ever. Your liver will not believe you, and it will be all but impossible for you to healthfully trim down your midsection.
But with awareness, you can choose. What do you want more? The personal training client I mentioned earlier—the one who was distraught to the point of depression over her mid-life weight gain—did not want to try giving up, or even significantly moderating her happy hour indulgences. I didn’t press the issue, because knowing how unhappy she was about her weight made her reluctance to give up alcohol look more like an addiction issue than one of simple vanity. But that was not, nor will ever be, my call.
And again, as with reducing our intake of carbohydrates, it is a process. This one takes a little longer than four days—especially if we’ve been imbibing since adolescence. And at first (at least for Ted and me) the urge to replace all those alcohol calories with sweet stuff, was overwhelming. I suddenly craved sugar. I gained a couple of pounds before my body adjusted to my new normal. So if you only abstain or moderate for a few weeks or a couple of months, you’re not giving your wonderful body a chance to change its metabolic ways.
And it will. I’m living proof. Blood work that was done before and after I made these changes shows a slightly improved cholesterol ratio (and I consume much more fat in my diet), drastically reduced triglyceride concentration, and optimum liver and kidney function. My typically high blood pressure is now within the normal to low range. Blood sugar is stable. I weigh the same as I did the day I got married in 1992. (I know this. I weighed myself that day. And I weighed myself this morning.) Ted’s before and after stats show similar improvements.
I’m still a bit rectangular. My weight distribution has changed over the past decade. My waistline is three inches bigger than it was when I walked down that aisle, even at the same weight. I wouldn’t be able to fit into my wedding dress. But I don’t need to, do I? That was then. This is now. I am healthy. I am fit. I am happy.
And I am not a hexagon.
This is my close friend, Michele. The first photo was taken in December. The second, just last month. In less than six months, she has dropped more than 50 pounds and six inches (that’s half-a-foot) from her waist. Believe it or not, she is 50-something. I know, hard to believe when you look at that face—and body. But she is dealing with the same hormonal changes we all face in mid-life. So how does she do it?
You just read how. Every single point I mention in this article, Michele has put into practice, and more! She weighs herself daily and records what she eats and how she exercises (on the Lose It! app). She has cut her carbohydrate consumption down to less than 20 grams a day until she gets to her maintenance level. She has given up all alcohol, at least until she reaches her goal. She has lost more than 50 pounds in six months. That’s pretty quick, and weight loss this fast is best done under medical supervision, which Michele is doing too. She is closely monitored and follows her doctor’s instructions regarding supplements, medications, and lifestyle changes to the letter.
I asked her if she feels deprived. Michele responded, “I don’t focus on the food I can’t eat, I focus on what I can. I eat real food, and meal prep is so much easier and quicker with this plan—protein and vegetables. It works for me!”