Dr. Sekula on weight loss, fitness and nutrition

While in San Diego last week, the biggest highlight for me (other than my talk, of course) was the keynote, Malcolm Gladwell. Chris Berman of espn also gave a keynote, which I did not attend. But by all accounts, underwhelming would be a compliment.

Gladwell, on the other hand, was excellent. I furiously took notes on my Blackberry and emailed them to myself – see image below.

As you can see, I gave the email an appropriate subject line: “Gladwell Lessons.” As anyone can attest, typing on a Blackberry can be challenging, but done so like this is typos galore. This is without mentioning my Blackberry seems to have a mind of its own, or at least some of the keys do. The 1, 2 and A seem to only work when they want.

I’ve had many questions about his lecture and wanting to implement some of his ideas, I set about deciphering. So, here goes.

His talk was a combination of Blink and Tipping Point. In other words, if you want to have something spread throughout your world in a Blink, you need to identify the Tipping Point. Gladwell calls this a revolution.

To accomplish this, three things are needed. You need to:

1. Leverage your skill,
2. Frame your message and
3. Employ social power.

He made this point through an example with David Sarnoff and RCA broadcasting the first ever, live boxing match between Jack Dempsy and Georges Carpentier in 1921.

First, Sarnoff knew radio. He was working for RCA. He knew how to get the fight broadcast (even if he had to have help). It helped him leverage his skill.

Second, he framed his message. “See what else you can do with a radio?” “It’s not just for news.” “It’s for entertainment.”

Third, he used social power from every store selling RCA radios. He contacted each one of them and had every radio tuned to the station broadcasting the fight. He wanted as many people as possible hearing the fight.

Some estimates were as many as 300,000 people heard the live broadcast. Amazing, 300,000 people in 1921. Within six months, RCA radios were flying off the shelves.

So, if you are in the health/fitness industry, how are you going to create a revolution? One of the things mentioned over and over again (at the meeting and from others), is that we do a good job with those who seek our services. What about the other 60% of the population?

How can we connect with them? How can we draw them in?

How can you leverage your skill to help those that need it most? How can you frame your message so they hear it? That was one of the main points in my presentation. It’s not that the energy balance equation is wrong. It’s the pervasive mis-application of it. For those needing our help the most, we don’t see the problem.

They (patients, clients, customers, etc…) fail because we blame them. It’s all their fault. So we shift. Our focus now is the behavioral aspects of weight loss. They’re not motivated enough. They didn’t write their goals down correctly. They’re eating too many/ not enough meals per day. The list goes on…

It’s why someone like Dr. Phil, who doesn’t know ATP from ketchup can write a best-seller weight loss book.

It’s also why nearly 100% of weight loss books say the same thing, eat less and exercise more, while differing in their approach to behavioral strategies. If it weren’t so ridiculous, it would be funny. All the while, all of this has underhandedly laid the failure of weight loss at the feet of those trying to lose weight.

Finally, how will you employ social power to spread your message? Twitter? Facebook? Email? Local meetings? Local experts? I’ll tell you this, however you do it, you need to have a better understanding of why people fail at weight loss attempts before you use your social power. Otherwise, it will be more of the same.

The last things I want to point out are mavens and connectors. According to Gladwell, mavens are information deciphering machines. They take it all in and make sense of it. Connectors help mavens put it in the right place.

Are you a maven or a connector?

How are you going to start a revolution?

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On March 10, 2010, the Medical Wellness Association sponsored a Medical Wellness and Nutrition forum as part of the IHRSA convention in San Diego. As an aside, Sunny San Diego? Are you kidding me? It was sunny, but, man, was it cold! The wind was blowing. Hard. Felt it to my bones. Probably not cold to someone from Minnesota, but to a Texas boy it was. And can you do something about the homeless people? The only place I’ve been where it was worse was downtown Baltimore.

So back to the forum. There were four speakers (including me), each presenting on a topic related to nutrition and wellness. I think the forum was well-received. I listened to all presentations and only one other excited me. Amy Blansit works with obese people in Missouri and she gets it. Her presentation was excellent and she’s doing a bang-up job. The other talks seemed rather fluffy.

In order to gain more attention, I badly titled my talk: “How to increase revenue with weight loss programs.” IHRSA is not the most scientifically rigorous organization. A more appropriate, but boring, title would have been: “Misapplication of the energy balance equation.” That was the focus of my talk, but no one would have attended. I spent nearly half of the two hours building this up and why weight loss programs fail (or, the misapplication idea).

For more on this, check out Dr. Eades’ blog, Protein Power, more specifically, this recent post. You can also read this post by Robert McLeod on energy balance, it’s at the bottom of the post.

The gist of the talk centered on the pervasive notion of eat less, exercise more. For overweight and obese, hyperinsulinemia equals metabolic domination, efficiency at fat storage and feeble efforts in fat mobilization. Simply eating less does not fix this and leads to failure.

Oh, and before you chime in with ASP, leptin and all the others, don’t bother. ASP is a toothpick to the bat of insulin. While the research on leptin and leptin resistance is fascinating, I have yet to work with someone where it was a problem. I know it’s there, somewhere, and I know it exists. Just haven’t run across it in my day-to-day business.

You can also view the presentation at slideshare.net.  Don’t know why, but the embed code has jacked up the first slide. It’s normal at slideshare. Below the presentation are links to a reference list and white paper.

Click here to download the references.

Click here to download the white paper. Note: I can’t find my white paper. It’s somewhere on my laptop. I’ll hunt it down and post the link in the next day or so. 

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In the last post, I detailed the 10 books I read last year. Here’s a list of books I intend to read this year. As stated, the goal is 11 books. The list contains nine, leaving two spots open. There are two reasons for this. One, it’s early and something is bound to come out I’ll want to read. Two, now that the Mitch Rapp series is complete, they will be hard to ignore.  

The Power of Less by Leo Babauta. In a world full of clutter, how is less more? Already skimmed through. Suits my style perfectly. To the point. Practical and a quick read.

4HWW-Expanded and Updated by Tim Ferris. This one is next. Can’t wait to get started. Should be in it before January is over.

Lone Survivor by Marcus Luttrell. Reading it now. After all I’ve heard, very excited to get this book. The sole Navy SEAL survivor of a mission gone bad in Afghanistan. In case you didn’t know, SEALS are badasses.

The Covenant of the Wild by Stephen Budiansky. From the back cover, Animal-rights extremists argue that eating meat is murder and that pets are slaves. … shows domestication of animals is not an act of exploitation but a brilliantly successful evolutionary strategy. Sounds like my kind of book.

The Blind Side by Michael Lewis. Because I’m in love with Sandra Bullock and I’d rather read the book than watch the movie. Plus I love me some football.

Memorial Day and Consent to Kill by Vince Flynn. No explanation needed. 

Living Life in the Zone by Kyle Rote and Joe Pettigrew. A book for men on being a better Christian.

The Vegetarian Myth by Lierre Keith. After all I’ve heard and read about this book, I feel like I’ve read it. Sadly, that is not the case. But it won’t be for long.

So there you have it. The books I read last year and what I’m going to read this year. When the open slots get filled, I’ll let you know. What are you going to read this year?

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I”m not one for New Year’s Resolutions. Don’t know why. Never have been. But most people want to lose weight or start exercising more at this time of year. Those great and I help people do this all day, but I also like to read. Books, magazines, newspapers, journals, anything, really. Not much for the pop culture type stuff, something that will keep me involved (Mitch Rapp series) or teach me something (Eades, Ferris, Taubes) is my preference.

In the spirit of New Year’s Resolutions, I decided to post a list of books I read last year, with a brief review. My resolution this year is to read at least one more book than last. In the next post, I’ll put a list of books I intend to read this year.

Books that I read last year…

Good Calories, Bad Calories, Gary Taubes. It was my 3rd time through. Each time feels like the first. I’ll read it again this year. 

Beating Cancer with Nutrition, Patrick Quillin. Thorough book on dietary practices and cancer with a focus on food and supplements. If your approach is to do all you can,  Beating Cancer with Nutrition is the book you need. 

4HWW, Tim Ferriss. I read this book in 3, maybe 4 days. It was a fast, entertaining and educational read. Read it while in Mexico last year. Karma?

In Defense of Food, Michael Pollan. After two failed attempts, finally forced myself to read it. The message is good. The writing style, not so much. Too many words. Too many long sentences. I thought Pollan was a journalist? 

Outliers, Malcolm Gladwell. Bill Gates is just lucky, I guess. The 10,000 hour rule lives!

Training Camp, Jon Gordon. A book on the importance of hard work and the desire to succeed.

23 Minutes in Hell, Bill Weise. If you’re a Christian and have questions about Hell, read this book. It will change a lot (if not everything), that’s all I’m going to say. 

The 3rd Option, Separation of Power and Executive Power by Vince Flynn, from the Mitch Rapp series. If CIA secret spy stuff is your game, this series was written for you. Mitch Rapp is a terrorist and bad politician killing machine. Is bad politician redundant?

That’s the list of books, all 10 of them. I didn’t mention blog posts and journal articles. Like I said, my objective is to read 11 books this year, which will be detailed in the next post. The list already has 9 books. One little rule: it won’t count if I’ve already read it. 

What did you read last year and what is on your list for this year? Give me some ideas for the remaining spots.

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We interrupt our regularly scheduled programming (Top 10 non-generic and generic prescription drugs) to bring you this, what appears to be a concerted effort on the part of Big Pharma to keep their precious statins high on the list of prescribed drugs. (can you blame them? Between Lipitor and Simvistatin you’re looking at 109.2 million prescriptions and $7.4 billion in sales per year!).

In case you haven’t heard, statins and big pharma took it on the chin in a new study from the Journal of the American College of Cardiology. The results showed niacin was significantly more effective at reducing carotid artery plaque than statins alone. In fact, results showed plaque continuing to grow in the statins only group while regressing in the niacin group. I’m not going to detail the study and author’s conclusions, Dr. Eades has done a wonderful job of that.

I’m not even going to get into whether or not reducing LDL prevents heart attacks. I’m taking a different approach.

Now, a normal thinking individual might conclude niacin as a better alternative to statins in preventing cardiovascular disease. Such as Dr. William Davis over at the Heart Scan blog. He’s not really normal thinking, more like forward thinking (WAY forward compared to his colleagues) and he’s been banging on statins and tooting the niacin horn for a while.

What really has me perturbed is a concerted effort to keep precious statins at the top of the prescription list. For example, a Google news search today (11/20/09) showed 800+ stories on the search term: statin+niacin. Scrolling through the headlines of those on the first page, you see phrases like, “Vitamin B niacin offers no extra benefit to statin therapy,” “Niacin may not help arteries,” “No benefit for statin patients,” and on and on.

Another example is this, a press release published November 20, 2009, which relates study details showing an approximate 1/3 drop in “bad” cholesterol levels in the US from 1999 to 2006 (study abstract here). The last sentence in the first paragraph sums it up nicely,

“But a high percentage of adults still are not being screened or treated for high cholesterol levels.” 

I’m not sure what they mean by high. As you’ll see in my next post, about 1 in 2 adults in the US are taking a statin. You would think this one-third drop would be cause for celebration, and it is among the statins crowd. But while there is a significant drop in the number of cardiovascular-related deaths, incidence hasn’t decreased.

So the question isn’t whether or not statins work. They reduce LDL cholesterol but they don’t reduce the incidence of heart disease. So why take them? Why prescribe them? It’s like the statinators and policy makers can’t see the forest for the trees.

The unfortunate (for them) news on the effectiveness of niacin, the quick-to-the-table message parroted by the media, that the incidence of cardiovascular disease has not decreased and the $7.4 billion cash cow of statins is enough to make one skeptical, or disgusted.

Your thoughts?

This post is part of the Kathleen Show, Prevention not Rx.

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Some random links on cholesterol and diabetes. They arrived in my daily research update and I’ve found them interesting. Interesting in that most of the treatments focus on a big pharma approach when simply dietary changes will work just as well.

So without further adieu, here are the ones I found most interesting…

• Could it be they’re targeting the wrong LDL particles? After all, statin therapy doesn’t care and the lipophobes certainly don’t. But according to this study from JAMA, lowering your LDL-C doesn’t necessarily reduce your risk of MI. Go figure. They seem a bit confused and hell-bent on finding a prophylactic treatment. I’ll do a full post on this article next week.
• And yet they’re told fructose is okay in moderation. Could it be all the fructose in their diet leads to liver problems? Why not tell them to control their carbohydrate intake and eliminate fructose (HFCS, specifically – see this post)? Oh no, that wouldn’t be prudent. That doesn’t fit with our ability to prescribe medicine.
• More backpedaling on the ACCORD trial. The mess that is the ACCORD trial has been discussed by Dr. Eades. It amazes me that aggressive behavior entails more intense prophylactic treatment. Could it be the danger arose from the prophylactic cocktails? Why not? Intensive HbA1C control through diet works extremely well and there is no cocktail effect.
• Red wine is good for you? What? No Glevlivet or Anejo. I’ll take a glass or two after a long week!

So there you have it. A few research updates.

Next week I’ll do a full review of the JAMA article.

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A couple of more articles pimpin’ the other benefits of statins…

Cholesterol Lowering Drugs May Help Prevent Stroke Recurrence

New Research Claims Cholesterol Drug Could Reduce Risk Of Amputations In People With Diabetes

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This article, published in Circulation: Journal of the American Heart Association concludes that heart disease risk may increase with a lack of Vitamin D. The benefits of Vitamin D and cancer prevention (bone health too!) have been known for years. In June of last year, I had a blog post regarding this. Actually, the benefits of Vitamin D have been known for a while. Read this excellent post by Dr. Mark Hyman for more details. There are many others who espouse the benefits of Vitamin D – too many to list here. So let’s get to the article. “Vitamin D deficiency is associated with increased cardiovascular risk, above and beyond established cardiovascular risk factors,” said Thomas J. Wang, M.D., assistant professor
of medicine at Harvard Medical School in Boston, Mass. “The higher risk associated with vitamin D deficiency was particularly evident among individuals with high blood pressure.” 

Those with a Vitamin D blood level below 15 ng/mL (nanograms per milliliter) had twice the risk compared to those with higher blood levels of Vitamin D.

This is important…

And somewhat disappointing…

This article by Dr. Sears indicates…

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The American College of Sports Medicine published it’s fitness trends report for 2008 in December of last year.

A pdf version of the article is here: http://www.informz.net/acsm/data/images/worldwidetrends.pdf

In surveying nearly 2,000 fitness professionals throughout the world and corroborating with internationally known fitness experts, a list of 20 fitness trends was identified. I’m giving you the top 10 and adding my comments to each.

Take a look and let me know what you think. Are your New Year’s Resolutions aligned with any of these trends? Are you a member of a health club or fitness center that offers services like these? Do you have access to these services?
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Number 1: Educated and Experienced Fitness Professionals
There is currently no regulation of Certifying agencies for fitness professionals. Anyone can offer a “Personal Trainer” cerfitication and not have standards to meet. However, more and more certifying organizations and schools are becoming accredited. This is great. Just as hiring a CPA gives confidence that certain levels of education have been obtained and demonstrated, so should it be with fitness professionals.

As a doctor, I continuously push for higher educational standards of personal trainers and you should too. After all, you literally put your life in their hands. And if a trainer you have chosen isn’t educated and trained regarding contraindications, you are taking a big risk.

Number 2: Children and Obesity
This is an important one. Reports have been saying for a while that this may be the first generation that doesn’t outlive their parents. And a big part of that is obesity and related lifestyle disorders. If we can keep physical education in the schools and take advantage of physically active based after school programs for our children, it will be a major step in the right direction.

Number 3: Personal Training
This will be a staple of the top 10 every year the survey is conducted. Learning to exercise properly, whether it be for health or sport, should be your number one priority. And a well-educated personal trainer is invaluable in that regard. Without proper instruction you are more likely to get injured and may never reach your goals.

Number 4: Strength Training
Personally, I’m glad this is in the top 10. The health benefits of strength training are simply too numerous and profound to ignore. You must incorporate strength training into your exercise routine.

Number 5: Core Training
At one time, people thought this was a fad. But it has certainly lasted long enough to be called a trend. Core training has been defined as training the muscles of the abdominals and lower back. Some include balance training too. Whatever the case, strength in the trunk of your body is needed for support. Strengthen your core and you’ll feel better.

Number 6: Special Fitness Programs for Older Adults
As you age, health becomes more important (it really should be important from day 1). And programs tailored to older individuals are more popular. Programs like these focus on increasing strength, flexibility and performing activities of daily living. As a side benefit, all of these things significantly improve your health too.

Number 7: Pilates
A form of core training, Pilates has been a staple of the fitness scene for years.

Number 8: Functional Fitness
This is a form of exercise that improves your ability to perform activities of daily living. A well-balanced program will improve overall strength, flexibility, balance and heart fitness. As you progress, you will feel more confident when performing regular tasks as your risk of injury and adverse events decreases.

Number 9: Swiss Ball
Most people refer to them as stability balls. These are the large balls most fitness centers now have. They can be used to perform an almost limitless number of exercises, focusing on training the abdominals, improving balance and overall stabilization. Core training incorporates the use of stability balls.

Number 10: Yoga
A form of mind-body exercise that focuses on flexibility, posture and meditation.

Additional thoughts by me…
I like the list and am considering posting 11-20. However, I think teasing out the differences in some of these is difficult. For example, Core Training, Functional Fitness, Pilates, Swiss Ball and Yoga aren’t all that different – at least not different enough to have their own categories.

There are a couple of things I would have liked to seen in the top 10:

1. Greater focus on dealing with chronic diseases and conditions that physical activity positvely effects. For example, there is no mention of type II diabetes, high blood pressure or heart disease. This might fall under the auspices of education, which is #1. In my personal opinion, fitness professionals could do themselves (and their industry by default) a lot of good by educating themselves in these areas, creating services to help more people and having a positive impact in the lives of people.
2. More focus on developing services to help businesses improve the health of their employees. All fitness centers and personal training studios have small businesses close to them. They should be developing programs to help these businesses reduce health-related costs. For example, we recently performed a healthy back seminar for two different companies with amazing results. Based on worker productivity, reduced sick time and improvement in back pain, the companies were able to realize savings of more than $40,000. That’s a lot of money. Click here to read our press release.

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January 07, 2008.

From a recent article posted in the San Jose Mercury News by Melinda Sacks…

I took the liberty of highlighting important benefits in each of the points. The benefits of weight training are numerous and this article does a good job of highlighting some of the more
important ones.

Even though this article is geared toward women, the same benefits listed apply to men. So you guys don’t get off that easy.

Researchers say that most women who exercise still spend the majority of their time doing cardio, often ignoring the benefits of weight lifting. But unless a doctor advises otherwise, weight lifting can provide enormous advantages for most women, according to studies from such institutions as the Mayo Clinic, Harvard and Stanford universities. As with any new physical activity, check with your doctor if you have any health issues.

Here are the top 10 reasons sports medicine doctors and fitness experts agree weight lifting is good for you:

1. By becoming physically stronger, you will make routine tasks easier and safer to perform, from carrying heavy groceries from the car to picking up the kids.
2. Weight lifting will help you lose body fat and gain lean muscle. As this happens, your body mass decreases, your resting metabolism increases, and your clothes will fit looser. For every additional pound of muscle you gain, you will burn 30 to 50 more calories a day. Weight lifting is often touted as a proven way to keep weight off as women age.
3. Women don’t need to worry about bulking up as they get stronger. Unlike men, women do not have enough testosterone to build bulky muscles. Men have 10 to 30 times more of the hormone than women.
4. The risk of osteoporosis goes down as you gain muscle strength. Weight training can increase spinal bone density significantly in just six months.
5. Risk of injury decreases when you are stronger. You will be less prone to everything from back pain to arthritis to depression.
6. It’s good for your heart. Lower blood pressure, improved cardiovascular health and higher levels of “good cholesterol” have been found to be the side benefits of regular strength training, according to numerous studies.
7. The risk for diabetes declines because weight training has been found to improve the way the body processes sugar.
8. You can start weight training at any age. Research has shown that even women in their 80s can still build muscle strength.
9. Weight lifting can improve mood and fight off anxiety and depression. One Harvard study found that after weight training for 10 weeks, those suffering from clinical symptoms of depression felt better than those who received only counseling.
10. For women in middle age, strength training can help prevent the predictable metabolic sluggishness that often occurs. Many say it is not dieting, but weight lifting that is the true secret to keeping off middle-age pounds.

 

I will comment on one thing. In the opening paragraph, the author suggests that a majority of women spend their time doing cardio. I believe this is true. In my humble opinion, walking on a treadmill for 30- to 60-minutes is like Chinese water torture. You’re better off cranking up the intensity and going for a shorter period of time.

And don’t get me started on the benefits of slow-cardio and fat burning.

It simply isn’t a good use of time in a world where we’re all busy.

Off the soapbox…

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On Friday I mentioned a new service debuting today. You can find more info on that and other services we offer guaranteed to help you achieve your weight loss goals.

• Looking for a trainer? You found one here. But what if you don’t live in or near Sugar Land. What if you are really serious about achieving your goals this year but are hesitant to just hire any old trainer? I don’t blame you! What if you’re nervous about joining a gym and just want to workout at home?
  The answer to all of those questions and more is my newest service, BSFC Remote. When you sign-up, I’ll design a workout program specific to you. It will be based on your current abilities and the goals you want to achieve. It will include a daily schedule for weight training, cardio and stretching. Every activity I give you will have illustrations showing you the exact beginning and ending position. Additionally, each activity will have a text description “talking” you through performing it. These two things ensure you will perform the exercises safely and properly – leading you right down the path of success. It’s a step-by-step guide to reaching your goals. As if that weren’t enough, you’ll have unlimited email support throughout your program. Have a question? No problem, shoot me an email and I’ll get back to you. I know it sounds good and you’re ready to go. That’s great, but you better sign-up today. I’m having a serious special on this program. A limited number of spots are available and when they are full, I’m raising the rates. So get yours today for an amazingly low price!

   

If you’re like most Americans, you want to get in shape this year. I can’t think of a better option than BSFC Remote (unless you want to train with me in person).

• Don’t forget, the day after tomorrow (Wednesday) is the free webinar on living, looking and feeling younger. I’ll be covering all the keys you need to unlock a more youthful body. But, you can’t get those keys without registering. Click here to learn how to live, look and feel younger.
  
• Don’t forget #2. Next Monday (January 14, 2008) is the first day of class for my 6-week Boot Camp. Imagine reaching all of your weight loss goals by the middle of February! You can do it with this Boot Camp. In six weeks you will do more for your health and body than you ever thought possible. You’ll burn fat, get stronger and leaner, get rid of those aches and
  pains, have more energy, and more. Like I said last week, if you live within 10 minutes of the SW Freeway and Beltway 8, you are making a mistake by not signing up. There is an AM session and a PM session, so I’ve got your morning and afternoon workout covered. We start January 14 and spots are limited (and filling up fast) so if you’re ready to change the way you feel and the way your body looks, sign-up today!

 

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That’s all for today. Make it a great day. I’ll see you soon. Until then, break a sweat today. It will do your body good. Brian

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Links for you:
Live, Look and Feel Younger
6-week Boot Camp
BSFC Remote

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