“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.

Order Dr. Zipes’ new book, Bear’s Promise, and check out his website www.dougzipes.us.

Calculating how to lose weight is as easy as calculating how much money is in your bank account. If you deposit more money than you spend, your bank balance increases. If you spend more than you deposit, your balance decreases.

Weight loss is based on the same principle. Burn more calories than you take in, and you lose weight. Take in more calories than you burn, you gain weight.

Seems simple, right? I wish it were.

I would love to lose ten to fifteen pounds. I try to eat less and exercise more, but nothing seems to work, especially during the inactivity caused by the COVID-19 pandemic. It has been estimated that by 2030 nearly 1 in 2 U.S. adults will be obese.

Exercise alone won’t accomplish weight loss and must be accompanied by dieting. The reason is obvious. Depending on your weight and type of exercise, an average individual can burn in the range of 6 to 13 calories per minute. For example, a 140-pound person burns approximately 13 calories per minute running, while walking would burn a little more than half of that per minute. So, a half-hour run would burn almost 400 calories compared to 230 calories walking.

Since you need to burn about 3,500 calories to lose one pound, if you averaged 10 calories per minute exercising you would need to exercise 350 minutes or almost 6 hours to lose a pound. Running would require four-and-a-half hours to lose a pound.

As I have written previously, if I cut just 300 or so calories a day — roughly two slices of buttered white toast, or three large scrambled eggs, or a large bagel, or two glasses of red wine — I would lose a pound in about two weeks. Kept up for a year, I’d shed over twenty pounds, which would be fantastic and would improve my health and sense of wellbeing.

There are additional things— simple things—that might help you take off a few pounds. After all, every little bit helps.

1. Avoid soft drinks made with artificial sweeteners, like aspartame and saccharin. Even though you may dodge a few calories with them, they may increase your desire for sugary foods and have been associated with larger waists.

2. If you dine with others, pick people who are as calorie conscious as you. We tend to mirror the eating habits of people dining with us.

3. Eat off a smaller plate because you’ll pile on and eat less food.

4. Take brief breaks from your diet. You’ll return to it with increased vigor to comply, but equally important, you may avoid the weight loss plateau we’ve all experienced during dieting.

5. Avoid using computers and smart phones before bedtime. The blue light from the device suppresses melatonin needed to induce sleep. Sleep loss is a known risk factor for obesity.

6. Sleep in cool rather than warm room to increase energy expenditure during sleep.

7. Eat more slowly and stop eating when you feel about three quarters full. There is a lag time between eating and when that food tells your brain you are full. So, give the food a chance to send that message.

8. Avoid fad diets and pick one you will stick to long term. Switching to the Mediterranean Diet can result in weight loss as well as reduction in heart attacks, strokes, and death from cardiovascular disease.

9. Avoid between-meal snacks, skip dessert, and shun ultra-processed foods loaded with calories and little nutrition.

I need to practice what I teach. Happy weight loss!

Featured image: kurhan / Shutterstock

Your Health Checkup: Is the Keto Diet Right for You?

“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.

Order Dr. Zipes’ new book, Bear’s Promise.

In my last column I wrote about the benefits of intermittent fasting that shifted the body’s metabolism to burn ketones instead of glucose. Repeated fasting resulted — in addition to weight loss — in lasting adaptive responses that helped fight diabetes, insulin resistance, memory loss, and even cancer. The natural question then becomes whether eating a diet rich in ketones provides similar benefits.

The ketogenic diet is a high-fat, low-carbohydrate diet that forces the body to burn fats rather than carbs. Originally used to help treat refractory epilepsy in children, the ketogenic diet has been advocated for weight loss by replacing pasta, bread, and sugar with meat, chicken, fish, shellfish, eggs, cheese, and nuts. However, except for weight loss from caloric restriction and perhaps some benefit in patients with diabetes, no consistent scientific evidence exists that this diet provides any other benefits. In fact, the ketogenic diet may raise low density lipoprotein (bad) cholesterol levels, an unwanted outcome.

More important than quantity may be the quality of the carbohydrates or fats ingested. In a dietary analysis of more than 37,000 people, investigators found that unhealthy low-carbohydrate and low-fat diets were associated with higher total mortality, whereas healthy low-carbohydrate and low-fat diet scores were associated with lower total mortality.

For example, with every 20-percentile increase in a person’s unhealthy low-carbohydrate or low-fat diet score, the total mortality increased by 6–7 percent. For each 20-percentile increase in healthy low-carbohydrate or low-fat diet score, total mortality fell by 9–11 percent. Healthy diets linked with better survival were high in plant protein and unsaturated fat, and low in carbohydrates from refined grains, added sugar, and starchy vegetables.

In addition to diet, healthy habits can lead to a life expectancy free of major chronic diseases. Healthy habits include not smoking, weight control (body mass index 18.5-24.9 kg/m2), vigorous physical activity, and moderate alcohol consumption. Women who practiced four or five of these healthy habits at age 50 lived an average of 34.4 more years free of diabetes, cardiovascular diseases, and cancer, compared to 23.7 healthy years among women who practiced none of these healthy habits. Men practicing four or five healthy habits at age 50 lived 31.1 years free of chronic disease, compared to 23.5 years among men who practiced none.

Other Healthy Habits

In addition to these five, I would add a few more such as:

1) obtaining important vaccinations for flu, measles and other diseases

2) avoiding vaping

3) avoiding so-called de-toxifying juices since they have no proven benefits and actually lose fiber during processing, which are the healthiest part of the fruit or vegetable

4) drinking healthy tap water rather than waters supplemented with a variety of ingredients alleging health benefits since no evidence exists they improve health, they are costly (tap water costs about 50 cents/year; bottled water about \$1400/year), the plastic pollutes the environment, and some ends up in our bodies.

I could extend the list even more, but I’m sure you get the message. You can have a major impact on your own health — without expensive medical attention — by considering the information discussed above and taking action.

Featured image: Shutterstock

Your Health Checkup: The Hazards of Ultra-processed Foods

“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.

Order Dr. Zipes’ new book, Damn the Naysayers: A Doctor’s Memoir.

I’m not much of a junk food eater, although I do like an occasional Steak ‘n Shake double cheeseburger, or a Big Mac with French fries — maybe a half dozen times a year — and, more often, a grilled all-beef hot dog, smothered in mustard and drowning in sauerkraut. My mouth waters as I write this! Mostly, though, I try to eat a reasonably healthy diet, with emphasis on reasonably. However, the food experts are telling us with increasing clamor about the horrors of consuming ultra-processed food.

I wrote about this last year, making the point that ultra-processed foods are packed with artificial flavors, additives, or emulsifiers; typically contain more calories, sugar, fats, and salt than non-processed foods; and are linked to several kinds of cancer.

What, exactly, are ultra-processed foods? They usually consist of junk foods such as chips, cookies, and fast foods like prepackaged dinners. Such foods are industrial formulations with little intact food, generally containing low nutritional value, lots of calories, and multiple ingredients to enhance flavor and prolong shelf life. Consumption of these foods has almost tripled between 1990 and 2010, from 11 percent to 32 percent of daily energy intake.

In addition to studies I mentioned previously, several new reports underscore the potential harm of this bad diet. In a study from Spain of almost 20,000 people followed for 15 years, people in the group consuming the most ultra-processed food (>4 servings daily) had a 62 percent greater risk of death than those consuming the least amount. The more ultra-processed food one consumed, the greater the risk, so for each additional serving, mortality increased by 18 percent. A study of over 100,000 French participants showed that  greater consumption of ultra-processed foods was associated with increased risk of heart attacks and strokes.

A similar study from the U.S. found that individuals in the highest quartile of eating ultra-processed food — stuff like sugar-sweetened or artificially sweetened beverages, sweetened milk, sausage, sweetened cereals, and desserts — had a risk of all-cause mortality that increased by 31 percent.  A much larger study of 44,500 participants from France also found higher mortality among those consuming ultra-processed foods, but interestingly also noted that these participants were more likely to be younger, live alone, to be physically inactive, have a lower income, a lower educational level, and a higher body mass index. It is important to remember that some of these lifestyle influences can also contribute to mortality.

So, which is cart, and which is horse? Do the lifestyle patterns contribute to eating junk food or does eating junk food impact lifestyle? Very likely both are operative and affect the development of cardiovascular and cerebrovascular diseases in this population.

These epidemiological reports are observational, and direct causality cannot be firmly established. But if the mortality outcomes are not sufficiently convincing to eat a proper diet, how about gaining or losing weight? For this there exists “hard science.”

A trial of twenty inpatient adults randomized to consume ultra-processed versus unprocessed food, each for fourteen days, found that those eating ultra-processed food consumed more calories and gained about two pounds during that time period while those eating unprocessed food consumed fewer calories and lost about two pounds.

Like many of us, I’m a bit overweight and I don’t need much more convincing to limit my ultra-processed food intake than that outcome!

So, readers, eat well, exercise, stop smoking, keep your blood pressure and cholesterol under control, and enjoy good health.

But I still can taste that delicious hot dog!

Featured image: Shutterstock