The Life Plan (7 page)

The major cause of insulin resistance is poor nutrition and lack of exercise. As your body fat increases, your insulin receptor sensitivity plummets. As insulin sensitivity drops, insulin secretion from your pancreas increases, triggering a multitude of changes, which include damage to the lining of your heart’s blood vessels (endothelial dysfunction), interference with the enzymes that break down fats in your blood, and interference with your kidney’s ability to get rid of sodium (causing high blood pressure).

Remember, the more resistant you are to your insulin, the more insulin your body needs to make in order to maintain your blood sugar levels. And more insulin equals more body fat. Both aerobic and resistance training have been shown to reverse insulin resistance. The more you burn fat for energy (as opposed to glycogen) during your aerobic training the more sensitive you become to the insulin your body produces. As your body fat disappears and your muscle mass increases, your insulin resistance diminishes, taking a huge burden off your pancreas, so that it can now secrete less insulin throughout the day. The greater your sensitivity is to insulin, the more effective you become at removing sugar from your blood and tapping into your fat stores for your energy needs. You also reduce your need and desire for consuming extra calories because your body can now tap into stored body fat more efficiently. It’s physiologically impossible for you to burn your body fat for energy when your insulin levels are high.

Controlling insulin levels is the primary objective of my nutrition plan. This can best be achieved by eating small meals and carefully controlling your intake of carbohydrates, limiting your choices to those with a low glycemic index (most vegetables and fruits, and a few of the whole grains). It is also important to always eat a high-quality, low-fat source of protein with any carbohydrate we consume. The ratio (gram/gram) of protein to carbohydrate needed to achieve ideal insulin control is between 0.5 and 1.0. Diets that stay in this range are proven to result in a greater loss of body fat than diets with ratios below 0.5. Nutritional programs with protein-to-carbohydrate ratios below 0.5 are the high-carbohydrate diets promoted by the USDA Food Pyramid, the American Heart Association, and Dr. Dean Ornish. They all result in excess insulin production and elevated fasting insulin levels—the root cause of heart disease and the obesity epidemic.

A recent study in the
American Journal of Nutrition
compared diets with the same number of calories but different protein-to-carb ratios. The diet with a protein-to-carbohydrate ratio of 0.6 (similar to my Life Nutrition Plan) keeps insulin levels low and maintains a positive nitrogen balance. The diet higher in carbohydrates and lower in protein, such as the American Heart Association Diet (with a protein-to-carbohydrate ratio of 0.25), tends to increase insulin secretion and produce a negative nitrogen balance. A negative nitrogen balance means you are breaking down your muscles to provide energy for your body. A positive nitrogen balance, on the other hand, indicates that you are building muscle mass.

As caloric requirements are reduced, you will find that you are eating less food and thereby reducing the number of free radicals (the unstable atoms that are produced when food is converted to energy) produced when these foods are digested and stored. Many scientists believe that if we can reduce free-radical production in our bodies, we will reduce the damage they do to our cells and dramatically slow the aging process. In addition to exercise, watching your overall calorie intake is the only proven way to slow the aging process to date.

Lastly, when you structure your nutrition program around keeping blood sugars and insulin levels in check, you will get another big benefit—increased muscle size. In just four to seven days of eating “clean, “you will have your blood sugar and insulin levels in the ideal metabolic range, and by two weeks you will no longer be plagued by feelings of hunger, deprivation, and cravings. You’ll experience a marked improvement in your mental focus, exercise endurance, strength, optimal health, muscularity, and leanness.

Another problem with elevated blood sugars is glycation (or glycosylation), the process in which sugar molecules floating around our bloodstream become attached to proteins and nucleic acids and produce new, and very dangerous, chemical structures. Ninety-nine percent of all cellular activities depend on a vast array of proteins in our bodies, and when sugars bind to them they become dysfunctional and create major problems.

These glycated proteins are called advanced glycation end-products (AGEs), and they attack collagen (used to make ligaments, tendons, and other connective tissue vital for muscle strength and growth) and nucleic acids, which are vital to the synthesis of new proteins. Glycated proteins become very “sticky” and adhere to the inside walls of blood vessels, causing endothelial dysfunction, which leads to vascular dysfunction—the inability of the artery to properly dilate and constrict. This causes the buildup of plaque, which obstructs blood flow to our hearts, brains, hands, feet, eyes, muscles, the penis, and other vital organs. Over time the function of all of our cells and arteries becomes seriously compromised, with significant health consequences, including both mental and physical deterioration.

Glycation is an entirely passive process and does not require any chemical reaction. It is simply dependent on the number of sugar molecules in our bloodstream—the more there are, the more AGEs we form and the more we pollute our bodies.

Glycation is considered one of the most significant biological markers of aging. Many authorities believe that glycation is most responsible for the development of degenerative disease. Glycation is also associated with chronically elevated insulin levels. Insulin not only promotes central obesity (big bellies) but also prevents our fat cells from converting their stored fat into the free fatty acids that we can use for our energy needs. Because we are unable to tap into this huge energy reservoir, we get tired and hungry between meals when our blood sugars are low, and we are subsequently driven to eat more sugar-containing foods to satisfy our energy needs.

This promotes a vicious cycle of unstable blood sugars, elevated insulin levels, high rates of glycation, and uncontrolled eating, which persists and actually worsens over time. Slowly we poison our metabolic systems and hurt each and every one of our cells and our arteries.

The amount of glycation that is occurring in your body can be measured by the Hemoglobin A1C test mentioned in Chapter 1. You want your value to be between 4.0 and 5.5 percent—the lower the better. Typical levels seen in type 2 diabetics are between 8 and 11 percent. If your level is between 5.7 and 6.4 you are likely to be insulin resistant. Glycation levels are directly related to the speed at which you are aging—the higher they are, the faster you are going to age and the greater risk you have for developing an age-related disease.

When glycation rates are controlled and kept low by the right nutrition and exercise programs, insulin levels are also kept low. In the face of low insulin levels we can tap into the huge energy storage depot in our bodies (our own body fat) for our energy needs, and before we know it, we become lean, muscular, and healthy. This is truly a winning situation not only because we look and feel great, but because excess body fat is another very important biological marker of aging and disease.

If you follow my specific nutritional recommendations in combination with my exercise program you can minimize glycation and add 10 to 15 years to your life. That is, 10 to 15 more years of vitality, productivity, and great health—not 10 to 15 more years in a nursing home.

The first and easiest measurement you need to know is the actual size of your spare tire. This alone has been shown to be a better predictor of future heart attacks and type 2 diabetes than body mass index. It is very easy to determine if you have too much intra-abdominal fat, and you don’t need any fancy, high-priced laboratory tests to do it. All you need is an inexpensive cloth tape measure. Simply measure your abdominal girth, or waist circumference. And I don’t mean the “low waist, “where most of us wear our pants, but rather the “high waist”—at your belly button, where you are the largest. If your waist circumference is forty inches or greater your risk for life-threatening disease increases dramatically. Remember that visceral fat is the first place you gain . . . and the last place you drop the weight. But don’t get discouraged—you can get rid of stubborn belly fat, just as I have, by following the Life Plan.

Next, you need to know your current weight. Simple enough: Step on a scale. But this number isn’t enough. Most healthcare professionals rely on a formula called the body mass index (BMI), which takes into account your current weight and height to determine whether you are overweight. This index is calculated by multiplying your weight in pounds by 705, dividing the result by your height in inches, and then dividing again by your height in inches. If your BMI is between 25 and 30 you are considered heavy, and if it is greater than 30 you’re obese. Currently, BMI is also used by doctors, nutritionists, and other health professionals to assess health risks.

This simplified approach works fairly well when we look at large populations, but because it takes into account only weight and height, it misses what really is increasing your risk for diabetes, strokes, cancer, arthritis, and premature death—“fatness.”

Being overweight is not the problem. Being overfat is. Overfat means carrying around too much body fat, which is actually what profoundly influences our health, physical and mental performance, and appearance. Every man who is muscular is considered overweight according to the BMI, even if he is lean—because of his increased muscle weight. At the same time, there are plenty of men who have a great BMI but have way too much fat and very little muscle mass. Unfortunately, almost 70 percent of adults in the United States are considered fat. It is the second leading cause of preventable death in the United States, and will soon be the first; smoking is still more deadly than fatness.

Many doctors agree with me that the measurement we should be focusing on is our percentage of body fat. This can help us determine an individual’s ideal body weight, degree of fatness, and risk for disease. In the following table, I have listed the percentages of body fat for men according to their age that correlate with excellent to poor health/fitness ratings. This can be used as a general guideline to help you achieve your ideal body weight.

Excellent

<11

<12

<14

<15

<16

Good

11–13

12–14

14–16

15–17

16–18

Average

14–20

15–21

17–23

18–24

19–25

Fair

21–23

22–24

24–26

25–27

26–28

Poor

>23

>24

>26

>27

>28

You can measure your body fat in any number of ways, but the most common tool is skin-fold calipers. You can buy your own or get tested at your local gym. However, the results are only as good as the tester. The test requires someone else to determine the thickness of skin folds at various sites on your body. The measurements are then plugged into an equation to determine your body fat percentage. But there are more than 100 different calculations to choose from. Make sure that your tester is using the most accurate equation, or you may come up with a result that is completely misleading.

The gold standard for measuring body fat percentage is the DEXA scan, which many doctors like me can perform right in their office. A DEXA scan also tells how many grams of muscle tissue you have, so it can track gains in muscle mass resulting from your fat-loss/muscle-building program.

Body fat of more than 25 percent puts men in the obese, high-health-risk category. As a general rule, I believe that no man at any age should have greater than 15 percent body fat if he wants to remain optimally fit and healthy. At age 72, I work very hard at keeping my body fat below 10 percent, and at this percentage, I feel the best, have far greater energy, move better, think better, look my best, and have the lowest risk for disease.

My best motivator during my transformation was my “before” photo that I sent to the Body-for-LIFE competition. Every time I didn’t feel like dieting or exercising, I would just look at that photo of myself on my boat and remember how much I didn’t want to be that man anymore. So take a photo of yourself today, keep it in your cell phone or in your wallet, and look at it often. For the most honest assessment, take the picture wearing a Speedo: It’s probably the only time you will ever wear one.

Your genetics do set the lower limits for your desirable and achievable weight, but the decisions you make regarding your food and exercise are what will ultimately affect your weight loss. The first step in losing body fat is keeping an accurate account of what you eat every day. For one week, record in the food journal I’ve provided in Chapter 8 every little bite and gulp and calculate the number of calories you consume every day, by working off the calorie information on food packages. The caloric value of fresh foods, such as fruits and vegetables, and proteins are readily available on several diet and nutrition websites like mine, www.DrLife.com. At the end of one week, total up the calories you have eaten and divide by 7 to get your average daily caloric intake. This number gives you the precise number of calories you need on a daily basis to maintain your present weight.