Healthy Weight, Healthy Mind: How Important Is Exercise for Weight Loss?

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017). See all of David Creel’s articles here.

Here’s a story I’ve heard many times.

I hired a trainer I saw once a week for two months. I endured grueling workouts and was pretty faithful about working out on my own several times per week. I felt great, my endurance improved, and I could hold a plank for two minutes. But I only lost two pounds. Six-hundred dollars for two pounds! It doesn’t seem fair, nor does it make sense.

I agree this doesn’t seem fair. After all, when we work hard we want results. However, if we think about it logically, the results do make sense. Compared to making dietary changes, the short-term weight loss we experience from moderate exercise is modest at best.

Shantell is a good example. She reluctantly told me she drank approximately 12 regular sodas per day. Not counting french fries, she hadn’t consumed a vegetable in weeks. She and her kids ate fast food almost every day, and the meals she prepared at home included bologna sandwiches, hot dogs, or fish sticks. She would round out her meals with macaroni and cheese, potato chips, or tortilla chips. Although she didn’t eat a large volume of food, her diet needed a major overhaul.

Instead of trying to change everything at once, we focused on simply decreasing her soda consumption.

To my amazement, after our meeting she totally stopped drinking the ten-teaspoons-of-sugar-per-can stuff. When she returned a month later, she had lost 16 pounds. She didn’t make other changes in her eating, just the soda. If we assume Shantell consumed the same number of calories she was burning at the time we first met (her weight was stable), any calorie reduction would lead to weight loss. Table 2 illustrates how decreasing her consumption of soda (a total of 1800 calories per day) could lead to almost 16 pounds of weight loss in a month. Remember, burning 3500 calories more than we absorb equates to one pound of weight loss. So the math makes sense. Although Shantell’s diet still needed a lot of work, she was able to lose significant weight with only one change in her diet.

Now let’s look at how much exercise Shantell would need to do in order to lose a similar amount of weight. She weighed about 350 pounds, so walking burned more calories for her than for someone who weighed less and walked at the same speed. Think of it this way: The more someone weighs, the more work they do when moving that weight a given distance. For example, walking a mile with a 40-pound backpack requires more calories than walking a mile without it. In addition, because of her excess weight, Shantell’s resting metabolism was higher than an average-weight woman. I estimated she burned about two calories per minute simply sitting still. Table 3 shows Shantell would burn approximately 140 net calories per mile and would need to walk about 13 miles per day to burn the same number of calories she saved by not drinking 12 cans of soda. At two miles per hour, that would be almost 6½ hours of walking each day!

If you don’t drink 12 sodas per day, this example may seem a little extreme. But even if your extra 500 calories come from late night grazing, you’ll find it hard to “undo” those dietary indiscretions with physical activity. The point of these math gymnastics is to demonstrate that burning calories through exercise is generally more difficult than saving calories by eating differently.

This is especially true for people who can only exercise at low intensity. An elite runner can burn a lot of calories during an hour of exercise, whereas someone taking a slow walk burns far fewer calories. The runner may cover ten miles during that hour, while the overweight person walks two miles an hour. Many studies back up this principle of diet-versus-exercise for weight loss. We know that, in the short run, exercise doesn’t directly cause much weight loss. When we look at the long run, it’s an entirely different story.

In order to understand long-term weight loss success, researchers study people who are good at it. Many studies show that people who lose weight and keep it off are

physically active. Data from the National Weight Control Registry and many studies conducted by Dr. John Jakicic at the University of Pittsburgh tell us that exercise is a crucial component in keeping lost weight from reappearing. Although studies vary on exactly how much exercise is necessary to keep weight off, most experts agree that engaging in 250 to 300 minutes of exercise each week will greatly increase your chances for success.

You may wonder why short-term weight loss from exercise tends to be modest, yet exercise is almost a requirement if you want to prevent weight regain. Researchers have not yet conclusively demonstrated why exercise is related to long-term success in weight loss. Although exercise, especially resistance training, may help prevent muscle loss and a lowering of metabolic rate that accompanies weight loss, not all studies support this idea. But when we look at the many other benefits of physical activity, we can draw logical conclusions about the long-term benefits of exercise.

• The longer we stick with an exercise routine, the more fit we become. As we become more fit we’re able to increase our exercise intensity for longer periods of time. The more we can do, the more calories we burn. When we’re feeling fit we gravitate toward physically challenging things that burn more calories.
• Exercise improves mood. If we feel less depressed and anxious we’re less likely to eat emotionally or be distracted from personal health goals.
• While exercising, we are not sitting in front of the TV. If we aren’t sitting in front of the TV, we can’t be eating in front of the TV.
• If we invest in our bodies by taking time to do good things for them, we probably don’t want to abuse the body with unhealthy eating. That would be like intentionally driving through the mud after a car wash.
• For those who enjoy physical competitions with themselves or others, eating is fuel for those endeavors. If high octane (healthy food) is available, we use it.
• Feeling accomplished about physical activity can improve confidence in other areas, including wise choices in what and how much we eat.

Come back each week for more healthy weight loss advice from Dr. David Creel.

Healthy Weight, Healthy Mind: Tips for Eating Smart, Part 2

We are pleased to bring you this regular column by Dr. David Creel, a licensed psychologist, certified clinical exercise physiologist and registered dietitian. He is also credentialed as a certified diabetes educator and the author of A Size That Fits: Lose Weight and Keep it off, One Thought at a Time (NorLightsPress, 2017). See all of David Creel’s articles here.

Last week I offered four eating tips to help you lose weight and keep it off in a healthy manner. Here are three more helpful hints to help you manage calories and develop sound eating habits.

5. Choose Whole Grains

Our bodies like to operate on sugar (glucose), especially when we exercise at high intensities. When we eat whole grains, complex carbohydrates break down and sugar slowly enters our bloodstream, ready for use by our brain and working muscles. Whole grain foods such as wheat bread, brown rice, quinoa, and oats are rich in vitamins and minerals as well as fiber. Whole grains can be slightly higher in calories, which you will see if you compare white bread to whole wheat bread, because they contain the germ of the seed — a source of healthy fat. Despite the slightly higher calories, you’ll probably feel fuller longer because the whole grain fiber slows the rate at which food empties from the stomach. In addition, many foods made with refined grains (crackers, muffins, pastries, cookies, etc.) have added fats and sugars that boost the calorie count and increase our drive to overeat them.

6. Eat Lean Protein at Meals and Snacks

Calorie-for-calorie, protein tends to be more satiating than fat or carbohydrates. If I asked you to rate your fullness after eating 300 calories of pasta with red sauce (carbohydrates) versus the same calories worth of cheesecake (a tiny piece loaded with fat), compared to boneless skinless chicken breast (almost entirely protein), which would fill you up the most? Studies show it would be the chicken breast. Protein is important to help us feel satisfied after eating. Thus, adding an egg to your breakfast or a low-fat cheese stick to your afternoon snack may help curb overeating later in the day.

7. Watch for Hidden Fat

For several summers during college I worked breakfast and lunch room service in a high-end hotel. Each morning, dressed in my white Oxford shirt, black pants, and bow tie, I would grab something quick to eat between orders. Oatmeal was my favorite. I wasn’t sure why, but this was the best oatmeal ever. I thought maybe the hotel ordered exotic oats from overseas, which would explain the silky texture and rich flavor. Each morning I scarfed down a bowl or two of what I thought was the healthiest thing I could get my hands on. One morning I happened to enter the kitchen when Ms. B, as we called her, was making a large batch of the good stuff. Ms. B was a sweet black lady from Alabama who called everyone Honey. She seemed to cook from the depths of her soul and her food tasted better because you know she prepared it just for you. I can only imagine she learned to cook from her mother, who learned to cook from her mother.

Having family from the South, I knew all about the fat-is-flavor style of cooking. But I couldn’t believe my eyes when I walked in on Ms. B mid-oatmeal and saw her pouring a large carton of half-and-half creamer into the oats. I never imagined someone could do that to oatmeal! That day I learned a valuable lesson about hidden fat, especially when dining out. People often underestimate the calories in food because they don’t account for added fat, especially when others prepare it. Remember, one gram of fat has nine calories. A teaspoon of butter contains about four grams of fat or 36 calories. A stick of butter has over 800 calories (think cookies), compared to an equally sized banana of around 90 calories.

Follow This Diet

In summary, there is no best diet for weight loss and weight loss maintenance. But consuming a diet that’s rich in vegetables, lean protein sources, fruits, whole grains, and low-fat dairy will make weight loss more likely and give you the best chance of preventing diet-related diseases. In addition, eating a balanced diet can make you feel more energetic and give you the fuel to exercise consistently.

Come back each week for more healthy weight loss advice from Dr. David Creel.

Weight Loss Advice from the 1930s: Eat Less, Exercise More

Topping most of our resolutions this year is a repeat from the past: weight loss. But who’s to blame for this obsessive desire to trim and slim our figure? Automation? Hollywood? Feminism? France? Here’s a 1934 doctor’s take on America’s ongoing weight-loss craze:

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Pounding Away

Originally published in The Saturday Evening Post, September 22, 1934

Before the establishing our modern knowledge of diet, it was taken for granted that the shape anyone might have had been conferred upon him by providence, and the best one could do would be to make the most of it. There was little to be done in making the least of it. Nature creates human beings and animals in all sorts of forms and sizes. A Great Dane takes many a roll in the dust, but never achieves the slimness of a greyhound; a draft horse of the Percheron type travels many a mile pulling heavy loads, but never gets small enough to be a baby’s pony. Nevertheless, the basic framework can be modified as to the amount of upholstery. Every woman knows that she can, by suitable modification of her diet and by the use of proper exercise, cause the pounds to pass away.

No one has determined certainly the cause of the recent craze for reduction. Perhaps it was the outgrowth of criticism of the female figure that was popular in the late ’90s. The textbooks of the ’90s had much to say about corset livers and hourglass shapes. The preference for the boyish form may have been the result of the gradual change in the amount of clothing worn by women. The multiple petticoats and the heavy underclothing of the late ’90s began to give way to single garments in what was called the empire style. The styles have tended toward the slim figure, covered by less and less clothing. Perhaps the change was the result of the coming of the automobile; that, too, has been a most significant factor in the change of our body weight.

A Matter of Form

Walking, up to 1900, was the accepted mode of transport for the human body in the vast majority of circumstances. Then came the motor car. Today there is in this country one motor car for each five persons, and walking is gradually becoming a lost art. Walking used to be the form of exercise primarily responsible for burning up the excess intake of food. With the gradual elimination of walking and with the coming of the machine in industry, there has been less and less demand for energy in food consumption and more and more tendency toward maintaining a slim figure by a reduction in the consumption of food. The person who takes no exercise and who eats the diet that was prevalent from 1900 to 1905 will put on weight like an Iowa hog in training for a state fair.

The suggestion has even been made that feminism was responsible for increasing the popularity of women like men. Within the last quarter century more and more women have come out of the home and into various clerical, manufacturing, promotional, industrial, and statesmanlike occupations. No doubt, the bobbing of the hair and the binding and suppression of the breasts, as well as the thinning of the figure and simplification of the costume, were women’s response to the necessity for greater ease of movement and less encumbrance while engaged in such work. A fat girl gets lots of bumps from office furniture in modern designs.

Then came the war, and with it there was intensification of all these motivations; the war made serious demands on women. The slightly suppressed desires for freedom merged into strong impulses and urges that suddenly seized every feminine mind. What had been merely a somewhat languid interest suddenly became a dominating craving. Reducing became the topic of the hour, and the craze for reduction was upon us.

It has been urged by some that the final stimulus for slenderness was a sudden change in fashions promoted by the modistes of France. Be that as it may, the French women themselves never succumbed to the craze for emaciation as did their American sisters.

The French are far too sound a race from the point of view of feminine psychology to urge the cultivation of manly traits in their women. No doubt, the French fashions did incline toward women of somewhat thinner type, but the modistes did not, like our designers of costumes, adopt an all-or-nothing policy. Individualization in form and costume has more often been the mark of France, whereas standartization and uniformity have dominated the American scene.

American manufacturers of ready-made clothing, with the beginning of the 1920s, began to produce models for slim women, hipless and bustless. As the women went into the department stores to purchase, they found it difficult to obtain anything that would fit. They came out wringing their hands and crying that most famous of all feminine laments, “I can’t get a thing to fit me.” And when a woman cannot get a thing that will fit, she is ready to fix herself to fit what she can get. There were promptly plenty of experts ready to help her through the fixing process.

To Make the Person Personable

Advertisements began to appear of nostrums to speed the activity of the body and to lessen its absorption of food. Phonograph records were sold, giving explicit instructions regarding exercise and diets. The radio poured forth systematic calisthenics and played tunes for the performance of these motions in a rhythmical manner. Plaster fell from many a living-room ceiling while women of copious avoirdupois rolled heavily on the bedroom floor. The springs and frames of many a bed groaned wearily beneath the somersaults of some damsel of 170 pounds. Pugilists who had been smacked into insensibility on the rosined floors of the squared rings became heavily priced consultants for ladies of fashion and of leisure who embarked on programs of weightlifting: Department stores offered, in the sections devoted to cosmetics, strangely distorted rolling pins with which it was claimed fat might be better distributed about the person. Shakers, vibrators, thumpers, bumpers, and rubbers manipulated electrically, by water power, or even by gas, were offered to those who cared to try them.

Out of this turmoil came a demand for a scientific study of overweight, its effects on the human body, its relationship to economics, sociology, psychology, happy marriage, the maintenance of the home, and physical and mental health. In response to this demand, research organizations in many medical institutions began to study the factors responsible for obesity and the most suitable methods for overcoming the condition without injuring the general health. Whereas, in scientific medical indexes of a previous decade, an occasional article only might be devoted to this subject, the indexes of recent years show scores of records and reports in this field.

The Do-or-Diet Spirit

The first response to the craze for reduction, as I have said, was the development of extraordinary systems of exercise, with the idea that a woman could keep right on eating the same amount of food that she formerly took and that she could get rid of the effects of this food by excessive muscular activity. Quite soon the women found out the error of this notion.

Walking 5 miles, playing 18 holes of golf, or even 6 active sets of tennis does not use up enough energy to take off any considerable amount of weight. Even the playing of an excessively severe football game removes from the body relatively little tissue. A football player, it has been reported, may be found to weigh from 5 to 10 pounds less after a football game than he weighed before, but most of this loss of weight is merely due to removal of water from the body, which is promptly restored by the drinking of water after the contest is over. Actually, the terrific strain of one hour of football burns up not more than one-third of a pound of body tissue.

Thus reduction of weight is for most people simply a matter of mathematics, calculating the amount of food taken in against the amount used up. Reduction is a matter of months and years, not of days. The investigators have shown that it is dangerous for the vast majority of people to lose more than two pounds a week. A greater loss than this places such a strain on the organs of elimination and on tissue repair that its effects on the human body may be serious and lasting.

When women found that weight could not be permanently removed to any considerable extent by excess exercise, they began to try extraordinary diets. The diets first adopted were selections of single elements. They have been characterized as perpendicular rather than horizontal reductions. The phrase refers to the nature of the diet rather than to the effect on the human form. In a perpendicular diet, the partaker eliminates everything except one or two food substances and limits himself exclusively to these. In a horizontal diet, one continues to eat a wide variety of substances, but eats only one-half or one-third as much of each. Perpendicular diets are dangerous because they do not provide essential proteins, vitamins, and mineral salts. These will be found in a properly chosen diet which includes many different foods, but smaller amounts of each. So women began eating a veal chop alone, pineapple alone, hard-boiled eggs alone, or lettuce alone. The phrase “let us alone” best expresses the proper attitude to assume toward a woman on a perpendicular diet. The constant craving for food and the associated irritability make the woman on such a diet a suitable companion only for herself, and sometimes not even for that. Certainly, she is no pleasure around a home. Among the first of the books of advice to be published on diet was one concerned only with the calories. No doubt, successful reduction of weight was easily accomplished by the caloric method, but the associated weakness, illness, and craving for food soon brought realization that there was more to scientific diet than merely lowering the calories.

The next extraordinary manifestation was the 18-day diet from Hollywood. The exact origin of this combination does not appear to be known. Perhaps it appeared first in print in the columns of criticism of motion pictures of a well-known Hollywood writer. In her statements on the subject, it was said that the diet was the result of five years of study by French and American physicians, and that the diet would be perfectly harmless for those in normal health. If the French and American doctors spent five years working out the 18-day diet, they wasted a lot of time. Any good American dietitian could have figured out an equally good combination, and probably a much better one, in an afternoon. The vogue of the 18-day diet was phenomenal. Restaurants and hotels featured it in their announcements. Hostesses, anxious to please their dinner guests, called each of them by telephone to know which day of the 18-day diet they had reached and served each guest with the material scheduled for that particular meal. It was said that a Chicago butcher bragged that he had eaten the first nine days for breakfast.

The 18-Day Sentence

The 18-day diet had peculiar psychologic appeal. For the first few days it consisted primarily of grapefruit, orange, egg, and Melba toast. Melba toast, be it said, is a piece of white bread reduced to its smallest possible proportions; then dried and toasted so as to be developed into something that can be chewed. By the second or third day, when the participant had reached the point of acute starvation, she was allowed to gaze briefly on a small piece of steak or a lamb chop from which the fat had been trimmed. Then two or three days of the restricted program followed, and again, when the desire for food reached the breaking point, a small piece of fish, chicken, or steak could be tried. Thus the addict passed the 18 days, during which she lost some 18 pounds. Then, pleased with her svelte lines, she began to eat; three weeks later she could be found at the point from which she had first departed.

For years it has been recognized that human beings need magical stimuli in the form of amulets, powders, or charms to aid in the concentration necessary for success in love, religion, health, or business. The human mind needs some single object to which it may pin its hopes, its faiths, and its aspirations. Moreover, there was the psychological appeal of mob action. There was the desire to be doing what everybody else was doing at the same time. Then there was the thrill of competition. One could hear the addicts of the Hollywood diet asking one another, “What day are you on?” And the answer came back, “I’m on the tenth day and I’ve lost eight pounds.”

With the mystic appeal of Hollywood, land of mystery, with the psychological understanding of human appetite, with the introduction of the Melba toast, the Hollywood diet swept the nation.

The Calorie Gauge

The one thing necessary to reduce weight successfully in the majority of cases is to realize just how many calories are necessary to sustain the life of the person concerned and what the essential substances are that need to be associated with those calories. Most of us enjoy our food. We eat food because we like it, and we eat without thinking what the food will do in the way of depositing fat. The researches in the scientific laboratories that have been made in the past 10 years indicate that we eat more food than we need, particularly at a time when energy consumption is far less than energy production. It has been generally assumed that the weight of the body is definitely related to health. There are standard tables of height and weight at different ages for all of us from birth to death. It must be remembered, however, that these are just averages and that any variation within 10 pounds or even 15 pounds of these averages is not incompatible with the best of health in a person who inclines to be either heavy or light in weight as a result of his constitution and heredity.

There are two types of overweight: One … in which the glands of internal secretion fail to function properly; the other … due to overeating and insufficient exercise. The glands of the body, including particularly the thyroid, the pituitary, and the sex glands, are related to the disposal of sugars and of fat in the body. In cases in which the action of these glands is deficient, a determination of the basal metabolic rate of the body will yield important information. This determination is a relatively simple matter. One merely goes without breakfast to the office of a physician who has a basal-metabolic machine, or to a hospital, all of which nowadays have these devices. One rests for approximately one hour, then breathes for a few minutes into a tube while the nose is stopped by a pinching device, so that all the air breathed out can be measured. By appropriate calculations, the physician or his technician reaches a figure which represents the rate of chemical action going on in the body. A rate of anywhere from –7 to +7 is considered to be a normal metabolic rate. A rate of anywhere from –12 to +12 may be within the range of the normal for many people. If no other special disturbance is found, the physician is not likely to be concerned about the metabolic rate within such limitations. Rates well beyond these two figures, however, are considered to be an indication of failure in the chemical activities of the body — namely, either too rapid or too slow — and measures should be taken promptly to overcome the difficulty. If the basal metabolic rate is –20, –25 or –30, the physician will prescribe suitable amounts of efficient glandular substances to hasten the activity. Moreover, he will at this time arrange to repeat his study of the metabolic rate at regular intervals. He will watch the pulse rate and the nervous reaction of the person to make certain that the effects of the glandular products that are administered are kept within reasonable limitations. If, on the other hand, the basal metabolic rate is found to be +20, +25, or +30, he will make a study of the thyroid gland and will provide suitable rest, mental hygiene, and possibly drugs to diminish this excess action. Rarely, indeed, is a person with a metabolic rate of +25 fat; in most instances, such people are thin, sometimes to the point of emaciation. There are periods in life when the human body tends to put on fat. As women reach maturity, as they have children, as they approach the period at the end of middle age, there is a special tendency to gain in weight. Men are likely to spend more time in the open air, eat more proteins and less sugar than do women, and therefore are less likely to gain weight early. The common period for the beginning of overweight is between 20 and 40 years of age; in women the average being usually around 30. Among men, the onset of overweight is likely to come on eight to ten years later.

A man doing hard muscular work requires 4,150 calories a day; a moderate worker, 3,400; a desk worker, 2,700, and a person of leisure, 2,400 calories. A child under one year of age requires about 45 calories per pound of body weight, about 900 calories a day. The number is reduced from the age of six to 13 to about 35 calories per pound, or 2,700 a day; from 18 to 25 years, about 25 calories per pound of body weight may be necessary, or 3,800 a day. Thus, a person 30 years old, weighing about 150 pounds, may have 2,700 calories; a person 40 years of age, weighing 150 pounds, may have 2,500 calories; a person 60 years of age, weighing 150 pounds, may have 2,300 calories. A calorie is merely a unit for measuring energy values. In the accompanying table examples are given of the number of calories in various well-established portions of food.

Slim Picking

The overweight child at any age is quite a problem for the doctor. Most times it is the result of a family that tends to eat too much. Children of fat people are likely to be fat because they live under the same conditions as do their parents. If the adults of the family eat too much, the children can hardly be blamed for doing likewise. Investigators at the University. of Michigan say that the normal person has a mechanism which notifies him that he has eaten enough. Obese people require stronger notification before they feel satisfied, and many disregard the warning signal because they get so much pleasure out of eating. “Pigs would live a lot longer if they didn’t make hogs of themselves,” said a Hoosier philosopher.

If a physician has determined that excess weight in any person is not due to any deficiency in activity of the glands, but primarily to overeating, it is safe to take a diet that contains a little more than 1,000 calories a day, and that provides all the important ingredients necessary to sustain life and health. A menu like the following, outlined by Miss Geraghty, provides about 1,000 calories as well as suitable proteins, carbohydrates, fats, mineral salts and vitamins:

For those who want to reduce intelligently, here is another menu that includes all the important ingredients:

If you simply must have afternoon tea, add in 150 calories that the sugar and accompanying wafers will contain.

Every woman who has heard of these diets insists that they provide about twice as much food as she usually eats. This merely means that she is talking at random rather than mathematically. These diets do contain a wide variety of ingredients, but they are chosen with exact knowledge of what they provide in the way of calories and important food attributes. Quite likely, the women who protest eat a smaller number of food substances, but it is likely, also, that they eat so much of each of these substances that their calories are far beyond the total. Furthermore, they probably fail to keep account of the occasional malted milks, cookies, chocolates, or ice cream that they have taken on the side.

From the accompanying table of caloric values, it is possible to select a widely varied meal that will provide any number of calories deemed to be necessary; and if the meal is selected to include a considerable number of substances, it will have all the important ingredients.

In taking any diet, it is well to remember that calories are not the only measuring stick for food. A pint of milk taken daily provides many important ingredients. If bread, potatoes, butter, cream, sugar, jams, nuts, and various starchy foods are kept at a minimum, weight reduction will be helped greatly.

Over the radio and in a few periodicals that do not censor their advertising as carefully as they might, there continue to appear claims for all sorts of quack reducing methods. If only most people had some understanding of the elementary facts of digestion and nutrition, the promotion of such methods would yield far fewer shekels to the promoters. It is a simple matter to get rid of excess poundage and, in general, it is quite desirable. One merely finds out first how many calories per day constitute the normal intake, and tries to get some idea of the number necessary to meet the demands of the body for energy. One selects a diet which provides the essential substances and which permits some 500 to 1,000 calories less per day than the amount required.

Under such a regimen, steadily persisted in, the fat will depart from many of the places where it has been deposited, but not always from the places where it is most unsightly. For this purpose, special exercises, massage, and similar routines may be helpful. But persistence more than anything else is required. It is just a matter of pounding away.