Merry Christmas

As we celebrate Christmas in a couple of days, remember that this is a time of peace and joy although it’s sometimes hard to remember with the hustle and bustle of this season. Whatever your faith, whatever you believe, put the devices away, turn off the TV, and take some time to think about what this season means to you. Remember the best of times you’ve had during this season. May peace overwhelm you.

I get my new knee tomorrow. I’ll be celebrating while rehabbing, and it will be a pleasure.

From all of us here in the Zelasko household, we wish you a Merry Christmas, peace, and joy.

What are you prepared to do today?

        Dr. Chet

Your Holiday Eating Plan

Over the years, the topic of “How should I eat during the holidays?” comes up over and over. We all want to try to avoid gaining the five to ten pounds during the weeks from Thanksgiving through New Year’s. Depending on your activity levels during the past year and a half with COVID restrictions, you may already be dealing with some extra weight. I think there are two parts to the solution of preventing weight gain during the holiday season.

Increase or Begin to Exercise

In my experience working with people, the holidays are so busy they stop doing what can help deal with stress and extra calories: exercise. Even a 20-minute interval session (found in the Basic Health Info section on drchet.com) can do wonders for relieving stress, and that may help you eat less when those extra calories are available. Or when it all gets to be too much, declare it’s time for your walk and take off.

Exercise isn’t designed to burn a lot of calories unless you really work out strenuously or work out for hours, but it helps keep your metabolism going: you use up your short-term fat storage, and your muscles continue to use energy to recover. It’s an effective way to help prevent weight gain.

Have an Eating Plan

The most important way to eat during the holiday is to have a plan. Strategize. You know when the holiday foods, treats, and goodies are going to be available; decide how you’re going to approach them. Here are the three most popular ways people have said they use.

To Here and No More
Many people decide in advance what and how much they will eat whether at parties or holiday meals. Maybe someone makes the best taquitos you’ve ever eaten and you want to have several. That’s fine. Skip other calorie-laden treats such as the cookies you’re not crazy about and opt for calorie-free drinks instead of calorie-heavy alcohol. Hosts will never be offended when you turn down a drink because you need to save room for the stupendous taquitos.

Another example: Paula and I almost never make cookies other than for the holidays—and when we make them, we’re going to eat our share. Baking days include a lot of soups and salads rather than heavier meals to at least partially make up for all the cookie calories.

Be wary of two things: sugar and salt. Both make you crave more so when you set a limit, you have to stick to it.

Just One Meal
Let’s face it: like Thanksgiving, most holiday gatherings center around one meal. Eat everything you want but in smaller quantities. This is similar to the first approach, but involves more foods you might only get at the holidays: oyster stuffing, gravy with mashed potatoes, or Mom’s special dessert. Eat the foods you love but in reasonable quantities. You can eat more lightly the day before and day after to compensate.

Stay the Course
You’ve worked hard to get your weight to where you want it to be, so you decide to stick to your meal plan. Adjust it to account for the holiday foods but don’t deviate. All foods count; stick to what has worked for you.

One more point: forgive yourself if you fall off the plan. It happens. Put it behind you and get a fresh start the next day.

The Bottom Line

The idea of holiday gatherings is to enjoy the company of others, and part of the celebration is food and drink. Decide on an eating plan, stick as close as you can to your workout plan, and you may not have to start the year by resolving to lose what you gained over the six weeks of the holiday season.

What are you prepared to do today?

        Dr. Chet

The Bottom Line on Fasting

In the past four Memos, I’ve focused on explaining fasting. The questions I left you with on Saturday were: “Is it worth it to fast? Is it effective? Is there science to support it?” The answer to all three is yes. I think it can be summed up in one quote from the reference.

“In response to starvation, mammalian cells enter either a non-dividing or a low-dividing state and invest energy resources in cellular protection against various insults.”

While the statement is complicated, it means that metabolism is decreased. That allows the body to shift energy sources from glucose to fat metabolites such as ketones. The body focuses on reducing the production of proteins that can be destructive, such as inflammatory hormones, thereby protecting cells. It also helps improve the immune system so it functions better. The stress of reducing food intake in a controlled fashion helps cells function better.

The research review is available for free; it goes into more detail but demonstrates that fasting is beneficial when used properly. The bulk of the research is on the two- to-five-day fast with fewer than 1,000 calories on the fast day; I’ll use a two-day version before my knee replacement next week to help my body prepare. Just be sure to check with your physician before you fast if you have any metabolic issues such as diabetes or if you take medications, both of which can be impacted by restricting food.

Wednesday is the final scheduled Insider call of 2021. This may be the time to join to help you achieve your health goals in 2022. Hope to see you (or hear you) at 9 p.m. Eastern Time.

What are you prepared to do today?

        Dr. Chet

Reference:Trends Endocrinol Metab. 2018 April; 29(4): 271–280.

Fasting: Two Approaches

It’s time to get into some real fasting. While there’s nothing wrong with the abstinence approach, abstinence is not really fasting. I’m going to cover two different approaches. The first is known by the moniker 5:2. That means you eat reasonably five days out of the week and you fast two days per week. The second is a straight fasting approach of limiting calories per day that has been used in conjunction with cancer treatment. There’s no specified times to eat in either case, and you can drink any calorie-free beverages of your choosing.

The 5:2 Fast

The 5:2 fasting diet was originally developed about 10 years ago by a British physician/journalist. It’s become commercialized over the years with new additions and materials but essentially, this is how it works:

  • For five days a week, you eat your normal diet. The goal is to eat healthier, but there are no restrictions on the number of calories that you can eat.
  • For two nonconsecutive days of the week, you reduce your caloric intake to 750 calories per day, spread out over the day as you want. Again, the goal is to eat healthy food—and wouldn’t you know it, healthy food is generally low in calories! Your intake should include plenty of vegetables.

That’s it. It’s a way you can eat for the rest of your life if you want to. If you add some exercise and choose a better diet, you could lose weight and get some of the benefits I talked about in earlier Memos.

The Two- to Five-Day Fast

This approach is closer to a true fast than anything else because there are no gimmicks. The goal is to help the immune system and other organs by focusing less on growth and more on repair. This approach was developed by Dr. Valter Longo and has the most research behind it.

The goal is to eat healthy. A vegetarian approach with very low protein can make it very beneficial. Because this is a very low calorie fast, you have to check with your physician before you do it. Here we go:

  • Day 1
    Eat up to 1,200 calories, primarily from vegetables with some protein. Soups and broths make this approach easier. If you wanted to use shakes or smoothies, that’s acceptable as long as you stay under the 1,200 calories for the day.
  • Day 2 through Day 5
    On these days, your calories are restricted: 300 to 500 calories per day. The calories should come primarily from vegetables and again soups and broths are desirable.

When I use this approach, I generally do two days: one 1,200 calorie day and one 500 calorie day, and then eat normally the other five days. You have to be mentally ready if you’re going to do additional days. Eat when you want, whether a single meal or spread throughout the day. The choice is yours.

The Bottom Line

The last four Memos have talked about fasting and abstinence in relation to food intake. The question is why do this at all? Is there science to support it? Is it worth doing? That’s for next week.

What are you prepared to do today?

        Dr. Chet

Fasting: Abstinence Models

How did you do on your 18:6 abstinence from food if you tried it? The ratio of abstinence to eating can vary. I asked you to try an 18:6 approach. Personally, I did fine—that’s just about my normal eating pattern anyway. I’m going to give you one version of an abstinence model today. I’ll give you two versions of a fasting model on Saturday.

The objective was to avoid food for 18 consecutive hours. The clock begins after your last meal the evening before. If you like to eat late or go out with the gang, that means that you might finish eating at 10 p.m. You wouldn’t eat again until at least two o’clock the following afternoon. Then you would have six hours to eat, ending at 8 p.m., and then the cycle begins again. Just to be clear: you don’t start the clock on the six hours for eating until you actually take your first bite of food. That’s why your last meal might have been 10 p.m. on one day because you didn’t start eating until 4 p.m., because let’s face it things don’t always go to plan.

The question: what do you eat during those six hours? Everybody seems to have an opinion. You could use a ketogenic or Paleolithic approach or you could eat a Mediterranean diet. You could also stuff yourself with all kinds of junk food. Regardless of which approach you decide to use, the goal is to eat better for maximum benefit. You can drink any calorie-free beverages of your choosing.

I’ll give you two different approaches for a fasting plan on Saturday. Until then, if you haven’t tried it, see how you do, with the same proviso for people with serious medical disorders.

What are you prepared to do today?

        Dr. Chet

Fasting vs. Abstinence

Before I talk about the differences between fasting and abstinence, I want to make it clear that I’m in favor of both approaches when used wisely. I don’t think either is the way you should eat for the rest of your life, but if you have specific objectives to control your weight or to reduce your risk of degenerative disease such as cardiovascular disease, type 2 diabetes, and even reduce your risk of cancer, I think they both can be beneficial. Let’s look at the pluses and minuses of each.

Definitions

Fasting is a controlled reduction in the number of calories eaten in 24 hours.

Abstinence is the complete avoidance of food within a given time frame, whether that’s complete days or specific hours of the day.

Pluses and Minuses: Fasting Versus Abstinence

The pluses:

Both fasting and abstinence take in fewer calories than the body needs, which can help with weight loss if sustained long enough.

Fasting can help you handle hunger because you’re eating something eventually.

Fasting can also force your body to deplete all glycogen stores, depending on the source of the calories.

Abstinence forces the body to use all storage forms of sugars; then it uses stored fat as a fuel, increasing the supply of ketones for fuel.

When fasting, calories can be manipulated during the day to ensure you can eat before exercise if it’s required.

With abstinence, no thinking is necessary; you don’t eat anything when you’re abstaining from food.

The minuses:

With abstinence, you’re taking in no calories, so hunger can become an issue.

If you need to eat before you exercise, abstinence will limit the time of day you can exercise.

When fasting, deciding what to eat and when to eat it requires planning; that can be challenging for some people while making life easier for others.

There are more pluses and minuses for each approach, but I think that these are the most significant upsides and potential downsides of each.

The Bottom Line

As I said at the beginning, I’m in favor of both approaches. They both have merits and challenges—the key is using them wisely.

Next week, I’m going to give you examples of abstinence and fasting and how to use them. In the meantime, give the abstinence approach a ride around the block. Don’t eat for 18 consecutive hours on Sunday or Monday (that includes the time you’re asleep, limiting your eating to just six hours; you get to decide whether to eat the first six or last six consecutive hours you’re awake.) You also get to decide what you’re going to eat. Don’t try it if you have a severe metabolic disorder such as type 1 or uncontrolled type 2 diabetes.

What are you prepared to do today?

        Dr. Chet

The Fasting Dilemma

I hope you all had a wonderful Thanksgiving. Because we’ve entered the “weight-gain portal” time of the year, let’s talk about the fasting craze that some people are doing and the rest are thinking about trying. As I see it, the problem is the lack of clarity in terminology and subsequently the execution of a fasting program. Terms such as “5:2” and “16:8” are thrown around. What exactly is a fast? What can it do for a person? What’s the best way to do a fast?

The problem begins with defining the term “fast”; there’s no consistent way the term is used, and that includes in the methodology of research studies. Fasting can mean avoiding all food and in some cases drink. That definition can describe fasts done for religious purposes as well as the fasts talked about for weight loss and controlling metabolism.

Another definition of fasting is severely reducing calories; if you lower your intake from 2,000 to 1,400 calories to lose weight, that’s a fast. If you’re drastically reducing calories for two to four days to help reset your immune system, that’s also a fast. But if you’re not consuming any calories, whether for a specific number of hours per day or a whole day, that’s more accurately called “abstinence from food.” Is that a big deal? Yes, and I’ll explain why on Saturday.

What are you prepared to do today?

        Dr. Chet

Happy Thanksgiving

Paula, Riley, Jamie, and I would like to wish every one of you a Happy Thanksgiving. Normally, we would send these good wishes next week, but after a battle with brain cancer, Jamie’s sister passed away on Thursday leaving behind two young children. With the activities associated with passings, it seemed fitting to take care of family needs next week.

At times like these it can be hard to feel thankful, but we’ll always remember the time we had with Nicki and all the love she shared with Jamie and Riley. I know that many of you will remember Nicki and her family in your prayers, and we’re grateful for that as well.

While you spend time with family and friends, remember that life is short no matter how long you live. Take the time to appreciate all those people in your life, family or not, and let them know it.

One of the things that you can do is to begin or continue to work on being the best version of yourself. You may or may not live one second longer, but you will be able to live every day you’re alive. That means the time you spend with those you love and who love you may be even better.

I’ll see you in the next Memo on the 30th. Insiders, I’m still available when you need me.

What are you prepared to do today?

        Dr. Chet

Cancelled!

Thank you all for the prayers, good thoughts, and well wishes. I’m going to hang on to them for a while. My surgery was cancelled for this morning; Paula and I didn’t find out until we arrived at the hospital at 7:30 to check in. I was not alone. My surgeon had three surgeries cancelled for today; multiply that by many surgeons times several days, and you get an idea of how many people were disappointed. The surgery will be rescheduled for a date to be determined.

Why was it cancelled on such short notice? Because the hospital was overrun with COVID hospitalizations over the weekend. They have sufficient staff but no beds, even for an outpatient knee replacement surgery such as mine. I don’t know what it’s like where you live, but there’s a significant COVID resurgence in Michigan with no end in sight.

I’ll keep doing the prehab and be even better prepared when the knee replacement is rescheduled. I hope the reader who has had her aortic aneurism surgery postponed for the third time lives until her rescheduled surgery.

I looked at the data again since we got home: over 80% of those hospitalized haven’t been vaccinated. Take it from someone who understands the science—get vaccinated. It’s not a guarantee, but it puts the odds in your favor and helps all the people who need hospital beds.

What are you prepared to do today?

        Dr. Chet

Prehab Is Over

One of the tests I took in preparation for surgery was to measure my levels of Staphylococcus aureus. In this case, they tested the nasal area, a common area for this serious pathogen. The test came back at zero. I was pleased because for the past three years I’ve been taking a Bacillus probiotic called Bacillus coagulans. You can check out the research by reading this Memo from 2018. It doesn’t mean I couldn’t get an infection, but zero is a good starting point.


Now on to Surgery

I’ve stretched and strengthened my legs about as much as I can in preparation for my knee replacement. My core is as strong as it ever has been. I’ve gotten as fit as I can within the limitations my knee has given me. As I said a while ago, the more pain you put in before the surgery, the less you’ll have after the surgery.

We’ll put that to the test beginning Monday afternoon. Many, many surgeries have been cancelled here in Grand Rapids because the hospitals are overrun with COVID patients; if I had not prepared by being a regular exerciser and doing the prehab, I might have had to spend the night rather than having outpatient surgery, and then my surgery might have been cancelled, too, but we got confirmation Friday that it’s on.

I’m really eager to get this done and get on with life; I’m ready for rehabilitation. My goal is to walk into the hospital and then to walk out. The medical staff probably won’t allow that but as long as I know I could, that’s fine with me.

Thanks for all the prayers and good wishes—keep them coming. I won’t write Tuesday’s Memo until I’ve recovered from the anesthesia and taken the first steps. I still plan on doing the Insider Conference call on Wednesday night so all Insiders will get the first-hand Dr. Chet version of the knee replacement experience.

What are you prepared to do today?

        Dr. Chet