The Life Plan (10 page)

Nighttime awakenings with subsequent eating are very common with individuals who have NES. The food consumed is usually high-glycemic-index carbohydrates, which researchers believe is your unconscious attempt to restore the disrupted sleep cycle by increasing serotonin levels in the brain.

The key to managing this syndrome is to develop strategies to lower cortisol levels, which you can begin by systematically eliminating or decreasing as much stress in your daily life as you can. Cognitive-behavioral methods are believed to be some of the most effective techniques available for reducing and managing stress. They include identifying the sources of stress in your life, restructuring your priorities, changing your response to stress, and finally, finding methods to manage and reduce or totally eliminate the stress.

If you are afflicted with this syndrome, find a psychologist who is well trained in cognitive-behavioral therapy. Work with him or her to develop the skills you need to manage your stress and high cortisol levels. This will not only improve your life but help you gain control over your eating.

One of the goals of any health program is to develop a lifestyle that will enable you to increase your own production of hormones, including human growth hormone (hGH). hGH is measured as IGF-1 (Insulin-like Growth Factor-1). As the name implies, “Insulin-like Growth Factor-1” is structurally related to insulin. These two hormones share the same receptor sites on cells, creating a competition in which only one hormone will be predominantly effective. A nutrition program that focuses on keeping insulin levels as low as possible will enable you to increase your own natural production of IGF-1.

Because you need to optimize growth hormone levels and IGF-1 levels to achieve great health, increase your sex drive, and improve your quality of life, my plan is designed to keep blood sugars low, allowing you to effectively manage your insulin, which will help you achieve healthy levels of growth hormone and IGF-1 on your own.

I have created three basic rules to help keep you on the right nutrition track:

Rule One: Meal Frequency

Rule Two: Proper Macronutrient Ratios

Rule Three: Plan Your Day

The only way to lose body fat is to achieve a caloric deficit, either by decreasing your intake of food or by burning more calories through exercise. Exercise is, by far, the best way to achieve a caloric deficit, because it does not trigger the starvation response, it increases metabolic rate, it increases all of the fat-burning enzymes and hormones, it targets body fat rather than muscle tissue for energy sources, and it increases the sensitivity of all cells to insulin so that carbohydrates are burned for energy and stored as glycogen rather than being stored as body fat.

Scientific studies continue to reinforce the notion that the best way to eat if you want to get rid of body fat, gain muscle, reduce your risks for heart disease and other serious degenerative diseases, and not get old is to eat five to six small, balanced meals every day. When your body is presented with too much fuel at any given meal, it will store it as body fat for later use. And if you continue to take in too many calories at each meal, your body will never learn how to access this stored fuel, and body fat will continue to accumulate in your body.

Instead of eating the traditional three square meals a day, you need to trick your body by eating several low-calorie meals (200–400 calories each) every few hours. This constant feeding technique forces your body to process foods as you eat them, and then use these calories for energy before they can build up as fat in your fat cells. This technique is hands down the single most important nutritional concept for ultimate leanness and healthy aging: I learned it from bodybuilders who knew this decades before the nutrition and medical world figured it out.

If your body doesn’t get the fuel it needs, it will begin the process of
catabolism:
breaking down muscle tissue and converting it into glucose, the body’s ultimate fuel, so that it can continue to carry out your bodily functions. Not only does eating small, frequent meals prevent catabolism, but you will also feel less hungry throughout the day and will instinctively eat fewer calories. Best of all, you’ll have the energy you need to perform better during your workouts and throughout the day, and you will drop body fat like never before.

You may also lower your cholesterol levels. In a study just reported in the
British Medical Journal
, it was shown that people who eat six or more times a day have cholesterol levels that are roughly 5 percent lower than those of less frequent eaters. According to the scientists, when you eat larger meals and go for longer periods of time between meals, insulin peaks at higher levels. High peaks of insulin alter fat and cholesterol metabolism—producing higher levels of cholesterol in your blood. Frequent small meals control insulin secretion and prevent these peaks: the result—lower levels of cholesterol. While a 5 percent reduction in cholesterol levels doesn’t sound like much, it does have a large impact on your health, since it will reduce the risk of coronary artery disease by 10 percent.

The whole idea of eating more often to lose weight is one of the toughest concepts for me to get across to my patients. I know that it seems counterintuitive to suggest that you can lose weight by eating more often. I’ve got to admit, it took me a long time to believe that it works. But it really does. Once your body gets use to eating every three to four hours you become a fat-burning machine. Your body craves nutrients to keep its metabolic processes cranking along at top speed. When I eat one of my small 300-calorie meals, my body literally gets hot and my energy levels increase. The key is to not give it more calories than it needs at any one time.

Every overfat/obese man I have ever met has told me he doesn’t eat breakfast. Skipping meals—especially breakfast—in order to limit calories is the number-one reason for failing to achieve lifelong leanness and muscularity. It is also the main cause for eating the wrong foods later in the day. Every time you miss a meal your blood sugar drops, increasing your hunger and cravings, which leads, at the very least, to overeating later in the day or, at the very worst, to eating the wrong foods. Poor control invariably means you will eat foods that are high in calories and low in nutrients—the very thing you are trying to avoid. Plan ahead so that you can always eat at scheduled mealtimes. It is absolutely an essential part of your transformation program.

When you eat frequent small meals you also avoid a common problem with most diets—caloric restriction. When people severely restrict their daily caloric intake, their body rapidly goes into starvation mode. The first thing that happens when you enter the starvation mode is that your basal metabolic rate begins to slow down. With severe caloric restriction your resting metabolic rate can drop by as much as 40 to 50 percent. Next, you begin metabolizing your own muscle tissue, converting it into glucose in order to preserve fat stores—that’s right, all your hard-earned muscle starts disappearing. And, as if all of this isn’t bad enough, the activity of fat-storing enzymes increases, and your fat-burning enzymes decrease, so that you become very efficient at storing body fat. Your appetite and cravings begin to skyrocket. If you don’t have the willpower to resist these temptations, it won’t be very long before lethargy, fatigue, and a total loss of desire to train take over and your entire program will be sabotaged. Sooner or later you, like everybody who follows a strict calorie and food-restricted diet, will “fall off the wagon” and “normal” eating or binge eating will take over. The result is always more fat and less muscle than you had when you started.

There is absolutely nothing that you can do to prevent this from happening except to never allow your caloric intake to drop below 1,200 to 1,500 calories each day. This will ensure a one- to two-pound weight loss per week, which the American College of Sports Medicine (ACSM) recommends as a safe level that ensures mostly fat loss. The more slowly you lose weight, the easier it is to hold on to your lean muscle mass and take the fat off, and the more likely it will be that you don’t put it back on.

Bill is a 48-year-old surgeon who didn’t realize that his extreme girth was a sign of disease. Over the past ten years, Bill hadn’t been watching the scale, and instead was raiding the fridge whenever he felt stressed. Before he knew it, he was 30 pounds overweight, and his sexual function had decreased dramatically. He was having trouble getting out of bed each morning and felt as though he was losing his edge at work—constantly worried that younger surgeons would take over his practice.

When Bill came to see me, I first helped him identify his bad eating habits. I persuaded him to start a food diary and write down everything he ate and drank. The most important detail we uncovered was that Bill, like many men, was in the habit of skipping breakfast and not eating until several hours later. While a big lunch kept him from snacking throughout the day, he was inadvertently forcing his body into a “starvation mode” every morning. This meant that his body was storing nearly every calorie from lunch and dinner as body fat to get him through until lunch the next day. His body fat was not only collecting around his middle, it was slowing his metabolic rate for what his body perceived as an impending famine. In other words, his body was fighting to stay alive in a war that didn’t really exist.

Once I rearranged Bill’s daily eating routine, he started eating every three to four hours. His body was able to realize it wasn’t starving, and it started burning its fat stores rather than storing calories as body fat. Six weeks later, Bill had lost 15 pounds and dropped from 34 percent body fat to 28 percent. Not only was he feeling and looking better, but his energy levels bounced back and his erectile function improved.

Keeping an accurate food diary is one of the most important indicators of the success of a fat-loss and strength-building program. When people don’t keep track of what they eat, when they eat, and how much they eat, they invariably underestimate the volume of food, the number of calories, and the kinds of food they consume. A well-kept food diary will enable you to review, in the greatest of detail, your eating patterns and will allow you to make adjustments and choices that will keep you on track and assure you of continued success.

I think it is also very important to include in your diary a record of how you feel, both physically and emotionally, and monthly photos of you in a bathing suit (front, side, and back shots). As I said before, what you eat can have a profound effect on your moods, your energy levels, and the control you have over your eating. Everyone is different. Foods affect each of us in different ways, and the best way to discover how you react to a particular food is to keep an accurate record of what you eat and what it does to you. This will help you discover what
your
body really needs and wants and what it doesn’t need or want. Most people go through their entire lives and never have a clue about how the foods they eat affect their emotional and physical lives and well-being.

I have a simple rule that will help you balance each one of the five to six meals you’ll be eating every day. Each meal’s caloric makeup will consist of one-half to one part fat, two parts protein, and three parts healthy carbohydrates.

For example, if you are following the Basic Health Diet, and eating 1,800 calories per day, you’ll eat 360 calories per meal for a total of 5 meals.

Fat—150 to 300 cal/day

or 30 to 60 cal/meal

Protein—600 cal/day

or 120 cal/meal

Carbohydrates—900 cal/day

or 180 cal/meal

Protein and carbs have 4 cal/gram and fat has 9 cal/gram. You can determine the number of grams of each nutrient group you should consume at any meal by dividing the calories per meal by 4 or 9.

For example: 1 serving of Fat—60 cal/9 = 6.6 gm of fat per meal.

Protein and its amino acids are the building blocks of muscle and are an essential part of the human diet for the growth and repair of tissue. Adequate protein is necessary for optimizing hormones, increasing lean body mass, and decreasing body fat. High-quality proteins contain the most amino acids: Examples of quality protein are chicken or turkey, protein shakes, lowfat cottage cheese, lean meats, fish, soy products, and egg whites. Vegetarians and vegans need to make sure they eat plenty of high-protein vegetables such as beans, tempeh, soybeans, and tofu to meet their muscle-building needs.

A very convenient, practical, and efficient way to make sure you are getting enough high-quality protein without any added fat or cholesterol is by supplementing your diet with protein-containing nutritionals (such as protein powders, meal-replacement drinks, and sports bars). This is especially important for men who exercise, since an inadequate protein intake is related to the depletion of essential amino acids that occurs during intense training. In addition, high-quality proteins and essential amino acids have a positive influence on our hormonal and immune response to exercise, and they also enhance our ability to adapt to high-intensity training.

For years we thought that different types of proteins acted the same way within the body. However, a 1999 study, published in the
American Journal of Clinical Nutrition
, on sedentary overweight men (aged 51 to 69) with sarcopenia (muscle loss) cast doubt on this notion. The study divided the subjects into two groups: One ate meat, including beef, poultry, pork, and fish. The other group ate a lactoovovegetarian diet: only milk, eggs, and vegetables. Both groups participated in the same resistance-training programs. After 12 weeks both groups underwent extensive testing for strength and body composition changes. Muscle strength improved considerably in both groups to about the same degree. Changes in body composition, however, were very different. The meat eaters experienced gains in their fat-free mass characterized by muscle enlargement and a loss of body fat, while the vegetarians increased their percentage of body fat and decreased their muscle mass.