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A Progress Report On My "Groundhog Day Diet": Yes, I Still See My Shadow

by Dr. Len February 02, 2011

Today is February 2nd, and it's Groundhog Day.

 

For me, it is the first anniversary of my Groundhog Day diet, so it's a good time to reflect on whether or not I met my personal goal set last Groundhog Day not to repeat the diet mistakes of the past, and try to maintain my weight for a whole year.

 

Was I successful?  Partly yes, and partly no.  But the good news is I did better this year than I did in the past, so that's a start-as long as one has a long term view of life. More...

Filed Under:

Diet | Exercise | Prevention

And Now A Message About Your Weight (Just What You Want To Hear This Time Of Year)

by Dr. Len December 03, 2010

I hope your Thanksgiving holiday was a happy one, and that you are looking forward to a pleasant December.  But vigilance about your health is not taking a holiday, as two new releases yesterday--one in a medical journal and the other from the Centers for Disease Control and Prevention--are bound to make you think twice about that extra helping of stuffing you ate while enjoying your Thanksgiving meal.

 

The first report is in today's edition of the New England Journal of Medicine, and written by a number of authors--including a colleague of mine from the American Cancer Society, Dr. Michael Thun--who examined the interminable question of whether or not being overweight as well as being obese can impact how long you will live. 

 

This article will give the boot to the old adage that you can never be too rich or too thin.  The scientists don't say anything about being too rich--we will have to leave that one to the psychologists to answer--but they do suggest that in fact you can be too thin.

 

The other report, from the United States Department of Health and Human Services offers statistics on the rate of obesity in the United States today, and sets goals for what we can accomplish in reducing those rates over the next decade. More...

Filed Under:

Diet | Exercise | Prevention

The Follow-up...If You Are Interested

by Dr. Len July 26, 2010

1)The son in law came in at 1:35, #11 in his class.

 

2) The wife came in at around 2:35, but she did finish after walking a portion of the 5k run at the end.  And just finishing was a terrific accomplishment in our eyes.

 

3) The 19 yo daughter finished around 2:25, running strong at the end. She won 3rd place in her group.  There were only 3 entrants.

 

4) The real hero was in the 15 yo son. He is in good shape and was doing well until the final run when he developed terrible leg cramps. He had to walk the entire 5k, part of it "straight legged" and the last 1/2 mile limping severely. He made it across the finish line--unassisted--at 2:56, which was 4 minutes before he would have been disqualified. He got a second place award, since there were only two entrants in his age class. He showed incredbile determination.  We are very proud of him.

Filed Under:

Exercise | Prevention

You Can Do It If You Try!

by Dr. Len July 25, 2010

 

A lot of experts write and talk about getting more exercise and making the commitment to a healthier lifestyle.  I am one of those folks who think staying active is important, especially as we get older.

 

But there are many out there who just can't seem to get it done.  One excuse or another, whether it is time, work, travel or other obligations-whatever, we just can't seem to get where we need to be when it comes to our health.

 

So forgive me while I take a personal moment to share with you my pride and admiration of someone very close to me who has made that commitment for the sake of her health and well-being to do something special, something they never dreamed they would be able to do.

 

More...

Filed Under:

Exercise | Prevention

"Choose You" Is All About You--And Us

by Dr. Len May 04, 2010

Today is a special day at the American Cancer Society as we launch our brand new “Choose You” movement, which is designed to inspire women to take action and put their health first in order to stay well and help prevent cancer.

 

As I reflect on this moment while here in New York with other volunteers, friends and Society staff, I can’t help but think of how difficult it is for any of us these days to try to take care of ourselves given the frequently hectic, overcommitted and overstressed lifestyles that many of us face every day.

 

At heart, that’s what Choose You is all about: finding time for women to take care of themselves, making the commitment to do just that, and creating a social network that supports their efforts and gathers their friends and family around them as they strive to develop and maintain a healthier lifestyle.

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Filed Under:

Diet | Exercise | Prevention

Groundhog Day Diet: Overcoming Everyday Challenges

by Dr. Len March 16, 2010

It’s been about six weeks since I wrote about my “Groundhog Day Diet” so I thought it might be time for an update.

 

For those of you who are unaware, this is my annual diet ritual that—like many of you—I start every January to lose the same 20 or 30 pounds I have gained over the prior year, only to try to lose it again. 

 

(The inspiration for the name as you may have already guessed was Bill Murray’s movie of many years ago where he was consigned to live the same 24 hours again and again as he reported on the annual Groundhog Day “celebration” in Pennsylvania.)

 

For those of you who have no interest in my successes and failures of the past 10 weeks, you can move on.  But for some of you who share my frustration over trying to heed the call to eat healthier, you may find some inspiration in the struggles, solutions and outcome of my most recent dieting adventure.

More...

Filed Under:

Diet | Exercise | Prevention

Groundhog Day Diet: Will Your Shadow Be Smaller?

by Dr. Len February 02, 2010

It’s Groundhog Day, so maybe this is a good time to offer a quick recap of my progress on what I call my “Groundhog Day Diet.” 

 

The “Groundhog Day Diet” is my name for the program I started four weeks ago to lose the same weight I lose and regain every year, hoping that maybe—just maybe—this year will be different.  (The diet is fondly named after the movie Groundhog Day which starred Bill Murray, where he repeated the same day, day after day after day.)

 

The only reason I am bothering you with this is the knowledge that I am not alone.  Many of you out there go through the same ritual every year.  And, if you are like me, four weeks into the process is about when you think it’s time for a splurge or have some other event(s) come up in your life that leads you astray, like this Sunday’s Super Bowl.

More...

Filed Under:

Diet | Exercise | Prevention

Weight Loss And Health: Incentives, Not Punishment

by Dr. Len January 11, 2010

Ah, yes…Happy New Year (even if we are already half way into this new month.  My, how time flies)!!!

 

And with the New Year come new or repurposed resolutions, many of which are years old.  Among those resolutions—you guessed it—are losing weight, getting (more) exercise, and trying to once again try to stay healthy.

 

This New Year brings with it a new twist on the old resolution gambit, and that is how health care reform may—read that “may”—impact your focus on losing those long neglected pounds by penalizing you if you don't succeed. 

 

But maybe we should put aside the politics, and concentrate on innovative ways to “get into the game,” as is now happening in my hometown of Thomasville in southwest Georgia.

 

First, the thing about weight loss:

 

Every year we try to lose it, and every year we usually gain it back, maybe even with a few “bonus” pounds.  I’m not going to go into that discussion again, having done it many times in the past.

 

However, I will say that I am just like a lot of you.  Every year I make the pledge, usually get off to a good start, and inevitably falter.  This past year has been no different, and as I have mentioned in prior blogs, my travel schedule doesn’t help matters. 

 

That will not deter me from trying again, and hoping that maybe this year will be the year. So far, so good, with 6 pounds gone this past week and my resolve intact.  Come back in another couple of weeks and maybe I will tell you about my further hoped-for success. 

 

The sad part of this story is that I gained much of this weight over two or three months prior to the holidays, only to pump it up another couple of pounds during Christmas and New Years, in no small part due to my wife’s excellent cooking (and maybe a bit of my own barbecue).  It was no mean feat to gain all of those pounds, and I promise you I feel it.  (I call this phenomenon the “Groundhog diet,” after the Bill Murray film where he keeps reliving the same Groundhog Day, over and over and over again.)

 

Now I am back on the wagon, doing what I need to do.  We will see what happens.  Only time will tell.

 

However, there is some help here in my hometown.  And I think it is actually an interesting story, one that could possibly be duplicated in your community as well.

 

The program/concept is called “Team Lean”, and it is a community-wide weight loss program now just getting started for the third year here in Thomasville, Georgia.

 

Sponsored by the local YMCA, Archbold Hospital and Flowers Foods among others, Team Lean reaches out to over 18,000 people in the Thomasville community. Last year, over 1400 people participated, which to me is an astounding commitment.

 

The plan is fairly simple: form a team of four or five people, pay $50 a member for the ten week “competition”, and see which team loses the most weight.  Weigh-ins are done weekly, and the results are published in the local newspaper.  There are a large number of exercise classes for all ranges of fitness, held at the local Y as well as other training programs in the city.  Even the restaurants get into the game, advertising and promoting their “healthy choices” menus.

 

This really is a community-based effort.  The concept started at another YMCA in the area, and has been taken up here in Thomasville with enthusiasm.  I have to admit that I am impressed with the way the program is run, including the booklets, graphics and T-shirts that are all part of the program.  And when Team Lean starts, it truly becomes the talk of the town.

 

I especially like the fact that my wife has joined, because as you may have found out as well, losing weight on your own is a tough road to hoe.  Having company and companionship on the journey makes it just a bit easier. 

 

I also appreciate the fact that when my wife gets on her team and commits to her diet and exercise program, those same cooking skills that helped me gain the weight are terrific at helping me lose the weight as she changes from the “Southern cooking load ‘em up with fat, butter and salt cookbooks” to the “get-lean/healthy eating” varieties.  (By the way, her team is called “Five Flabby Fannies.”  Go figure…)

 

At the end of this ten week journey, there are cash awards given to the most successful teams.  In fact, since Team Lean started in 2008, over 30,000 pounds have been lost, and almost $100,000 in cash prizes have been paid out.

 

So that is how one town deep in the Southern farm belt is dealing with obesity on the community level.

 

Which brings me to the question of why all of this is so important politically in this era of health care reform. 

 

That’s because there is a movement afoot to charge you more for your health insurance if you happen to be one of the unfortunate millions in this country who are overweight and obese.

 

Last week, the American Cancer Society Cancer Action Network, the American Diabetes Association, and the American Heart Association joined over 100 other organizations to express their concern about language in the Senate-passed bill health reform bill that would allow employers to charge employees thousands of dollars more in health insurance premiums (up to 30% or even 50% of a plan’s premium) if you don’t meet your employer’s pre-set “health targets.”

 

The practical implication would be that your employer could require you to lose weight or pay up.  If they were “nice,” that might mean 5 or 10 pounds.  But it could also mean getting into lean, mean fighting shape—which is unrealistic for almost all of us including yours truly.

 

Incentives such as workplace wellness programs would be OK according to the organizations that signed on to the letter.  But tying behaviors to health insurance premiums should not part of a reform program.

 

The sad reality is that losing weight—as an example—is hard to do.  There are few strategies that are successful in the long term.  Yes, there are those beautiful people on TV shows who work hard every day (all day in fact) at losing weight, and keep it off for long periods of time.  But that is not the medical reality that we physicians are familiar with.

 

Like Jessica Rabbit said in the movie, “I'm not bad. I'm just drawn that way.”  Weight loss has a lot to do with genes and environment.  Choice plays a role, but it is not choice alone that dictates our body types.  And if you live in a community where it is dangerous to go outside to take a walk, or where there are no grocery stores that offer attractive, affordable fresh meats and vegetables, you are just plain out of luck.

 

And now, with the Senate-passed bill in hand, you may not just be out of luck, you may be out of cash—and lots of it.

 

The short version: incentives, yes; punishment, no.  That’s the position of the American Cancer Society and many other respected health-related/focused organizations.

 

So that is where I am starting my New Year: trying once again to pursue the elusive goal of getting at least close to a medically-desirable weight along with my dear wife and partner. 

 

To help us along, we have a strong community program which provides the support and the social environment to make it happen (even our friends who had us over for dinner last night substituted skinless chicken breasts for ground hamburger in their delicious chili).

 

We want to be successful, but we want to do it on our terms.  Speaking as someone who has tried to “get it right” when it comes to diet and exercise, I know from personal experience how hard it is to do.

 

Being penalized as part of a government program for trying and failing to get there just doesn’t make sense, when there are so many other proven ways to get to where we want to go. 

 

We need to build on success--not punishment--when it comes to improving the public’s health.

 

 

Filed Under:

Diet | Exercise | Prevention

It's Time (Again) To Talk About Excess Body Fat

by Dr. Len November 06, 2009

I think it is time for one of my irregular updates on a favorite subject, and one of my personal failings: being overweight or obese.

 

The information yesterday from the American Institute for Cancer Research (AICR) that excess body fat (who doesn’t have excess body fat???) causes an extra 100,500 cases of cancer every year in this country didn’t help matters.

 

First, let’s talk about the science.

 

Since my colleagues at the American Cancer Society first published their research on the impact of overweight and obesity on the incidence and deaths from cancer several years ago, there has been an increased recognition of the role that weight plays in increasing deaths from a number of cancers.

 

The sad truth, as we have known for some time and confirmed once again yesterday by the AICR, is that people still don’t get it, that being overweight or obese can increase your risk of developing and dying from cancer.   Just like high blood pressure, heart disease and other maladies, how much you carry around every day makes a real difference in your risk of getting cancer.

 

The information from AICR highlights some of that increased risk:

 

Every year, 49% of uterine cancers, 35% of esophageal cancers, 28% of pancreatic cancers, 24% of kidney cancers, 21% of gallbladder cancers, 17% of breast cancers, and 9% of colorectal cancers are linked to excess body fat. 

 

That translates into the total number of cancers related to excess body fat every year, which is 100,500!!!! (For comparison, the American Cancer Society estimates there will be a total of close to 1.5 million new cases of invasive cancers diagnosed in the United States in 2009.)

 

We don’t know for certain why this relationship exists.  As noted by the AICR, the strongest evidence is that excess fat increases levels of sex hormones and other hormones in our bodies that may be related to cancer growth.  There is other research that suggests excess body fat lowers immune function and increases oxidative stress in the body, which in turn can cause damage to DNA and lead to cancer.

 

And then there is the other side of the issue, namely what is the relationship between excess body fat and survival once a cancer has been successfully treated.

 

According to the AICR, overweight and obesity are associated with poorer outcomes.  So, they say that the “take-home message” for cancer survivors is that it is not too late to become physically active, since regular physical activity improves cancer survival. 

 

Again, the reason this occurs isn’t known with certainty.  It may have to do with the fact that insulin levels are lower in people who exercise, and that may have a positive influence on survival.  The report also notes that higher insulin levels are associated with inactivity and overweight.

 

So where does that leave us?

 

Once again, we need to repeat after me: maintain a healthy body weight, and if you are overweight or obese, it’s time to get with the game.  And eat a diet that emphasizes plant sources for energy, like fruits and vegetables.

 

I wish it were that easy.  I have opined here time and again about my own problems with weight control.  I know the pain and agony of trying to lose weight.  I have spent countless years at the effort, including long hours on the exercise machines.  And yet, even after some modest success, I find it is so easy to fall off the wagon.  But I keep reminding myself that the trick is to get back on, and keep trying, and that’s what I am doing, once again.

 

We all have stresses in our lives that compete with our good intentions to do better and either get healthy or stay healthy.  For me, the major stress is a fairly intense travel schedule with lots of meals in hotels or restaurants, where I have little or no control over how the food is prepared.  Sometimes it seems that no matter how polite you are when you ask to have your food prepared a certain way, it frequently seems like a “random walk” when it arrives on your plate with the sauces and butter slathered everywhere you didn’t want it. 

 

And then those are the little snacks that show up everywhere, whether on the plane, at a meeting, in an airport or just walking along the street or driving in the car.  100 calories here and 100 calories there can add up real quickly to real pounds, before you realize what you are doing to yourself.  So you get on the treadmill or take a walk for an hour and realize that all you have done is burn off a couple of cookies.  Talk about frustration!!!!

 

So you inevitably end up with those too frequent moments when you say, “I don’t care.  I am going to treat myself and the heck with it.”  That emotion is usually followed by something like buyer’s remorse, when you realize the next day that those 10,000 steps only went to pay back a small portion of last night’s gluttony.

 

I could go on and on, but what will that accomplish?  I bet almost everyone reading this blog has had the same experience. I know the odd are that that is the case, since the majority of us in this country are currently overweight or obese. I have lots of company.

 

The report from the AICR is simply one more reminder that what we eat and what we do when it comes to our daily activity over a lifetime truly impacts our health and the length of our years.

 

So I will do the same thing I am going to ask you to do, and that is get back on that wagon.  Do what you need to do, do what you can do.  And then we can all help each other do what is best for our health.

 

And while I’m at it, maybe this is a good time to wish everyone a happy Thanksgiving.  Just don’t eat too much stuffing with the turkey.

Filed Under:

Diet | Exercise | Prevention

Repeat After Me: "Prevention Works!!!"

by Dr. Len August 10, 2009

For once, some good news: Plain and simple, prevention works. 

 

“The message from our analysis of the data from the EPIC-Potsdam study is clear: adopting a few healthy behaviors can have a major impact on the risk of morbidity.  The participants with all 4 healthy lifestyle factors had a reduced risk of major chronic disease of almost 80% compared with those with none.  These results applied equally to men and women.”  So say the authors of a new research report that appears in today’s issues of the Archives of Internal Medicine.

 

But wait a moment.  As pointed out in an editorial in the same issue, this really isn’t news.  We’ve known this for a long time. 

 

So if we know so much, why can’t we do something about it?  That, my friends, is the $64,000 question.  Or perhaps that figure is really outdated.  Today, it’s the multibillion dollar question.  Just go ask the folks in Washington.

 

The research took a lot of effort, but is stunningly simple in its theory. 

 

The researchers followed over 23,000 people in Potsdam, Germany for around 8 years.  They measured four markers of a healthy lifestyle, including: never smoking, a body mass index less than 30, performing 3 ½ hours a week of legitimate physical activity such as bicycling or sports, and following a healthy diet including a high intake of fruits, vegetables, whole grain bread and low red meat consumption.

 

After entering the study, the researchers followed the participants to see if they developed cancer, diabetes, a heart attack or a stroke.

 

The good news was that almost everyone had at least one healthy behavior “marker,” and only 4% had none.  On the other end of the scale, 9% had practiced all four elements of a healthy lifestyle.

 

The impact of doing the right things for one’s health was dramatic:

 

  • If you had all four healthy behaviors, your chance of getting a serious illness was reduced by 78%.  The impact of a healthy lifestyle was the same for men and women.

 

  • Having a BMI less than 30 had the greatest overall impact, followed by never smoking, physical activity for 3 ½ hours a week or more, and adhering to good dietary habits.  Having a BMI less than 30 was a very strong protective factor with respect to diabetes.

 

  • Never smoking exerted a stronger protective effect on heart attack and diabetes than on stroke and cancer.

 

  • Physical activity reduced diabetes and heart attack more than cancer

 

  • A healthy diet decreased the risk of cancer, diabetes, stroke and cancer.

 

  • If you never smoked and had a BMI les than 30, you had a risk reduction of 78%, similar to someone who practiced all four healthy behaviors.

 

  • You can mix and match the healthy behaviors, but all of the combinations had a benefit in reducing serious, chronic disease.  The combination with a surprising effectiveness on reducing risk was physical activity and healthy diet, which was greater than the researchers had expected. Even current and former smokers reduced their risk of serious illness if they practiced other healthy behaviors.

 

So what does this study tell us?

 

First, as noted at the beginning of the blog, prevention works.  No surprise there, I guess, since the authors themselves point out there have been several studies which all point in the same direction.

 

But it also leaves open the question that frustrates so many of us:  If we know so much, why is it that we accomplish so little when it comes to diet, exercise, smoking cessation and maintaining a healthy body weight?

 

As the authors note, “Although improvements in some behaviors have occurred, notably the decline in the prevalence of smoking, substantial proportions of the population still engage in behaviors that are not conducive to achieving and maintaining health.”

 

They go on to say, “The data from the EPIC-Potsdam study show the unfulfilled potential of preventing chronic diseases.  Adhering to the recommendations for the 4 lifestyle factors considered in our analyses can potential yield enormous reductions in the onset of major chronic disease such as (cardiovascular disease), diabetes and cancer…”

 

“Our results and these of others emphasize the importance and urgency of continuing vigorous efforts to convince people to adopt healthy lifestyles.  Because the roots of these factors often originate during the formative stages of life, it is especially important to start early in teaching the important lessons concerning healthy living.”

 

Not exactly what I would call a news flash, but nonetheless a very important message for all of us to hear and incorporate into our daily lives.

The editorial which accompanied the article, written by David Katz, MD from the Yale University School of Medicine, points out that we have known for some time that tobacco use, diet and physical activity account for a huge number of premature deaths in the United States every year.

 

As noted by the writer, “If ever a matter of public importance belied the notion that knowledge is power, this decade of underutilized knowledge was it.  And if we are once again to be updated in 2013 (regarding the number of premature deaths),there is little cause to think, based on our progress to date, that we will have fared much better across an informed expanse of 2 decades, although progress in tobacco control warrants honorable mention.”

 

Not a very ringing endorsement of our progress in helping people lead healthier lives, is it?

 

Some people say we are trapped by our genes.  Dr. Katz points out that “even gene expression submits to the power of lifestyle…With the knowledge we have already in hand, we can nurture nature.”

 

“Across an expanse of policies, practices, programs, personal responsibility, and political will yet to be mustered and some cases yet to be devised—we have miles to go before we sleep.”

 

Couldn’t have said it better myself.  Now that I think about it, I have said it myself, time and again and again and again.  And so have many others.

 

We are frustrated in our efforts to change behaviors, and clearly need to find better ways to get to the goal. 

 

Hopefully—and this is the political message of this blog—our current national debate about health care reform will get back to the core issues facing us as a nation, one of which is how we pay for and encourage prevention.

 

Knowing you can reduce one’s risk of getting a serious disease by 78% to me sounds like a very powerful incentive to make changes. Now all we need is the personal and national will to get the job done.

 

Somehow, we need a huge attitude adjustment around prevention and healthy lifestyles. 

 

How we get there is the billion(s) dollar question.

 

 

 

 

 

 

Filed Under:

Diet | Exercise | Prevention

About Dr. Len

Dr. Len

J. Leonard Lichtenfeld, MD, MACP - Dr. Lichtenfeld is Deputy Chief Medical Officer for the national office of the American Cancer Society.

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