Physician, Heal Thyself

Reached June Goal Today!

2011-03-15T07:20:00.000-07:00

So I hopped on the scale this morning and was rewarded with a happy number, my June 1st weight goal.

I have simply been eating small amounts frequently (every 3 hrs or so), tracking calories thru the DailyPlate.com, and increasing exercise.

I feel great and it has not been hard at all, just required a bit of persistence. My trainer Jasmine at the High Point Regional Fitness Center has been super, motivating me to stay on track, without making me feel so sore I couldn't function.

So now I have to plan a new goal. Will aim for an additional 20 lbs by June 1, which will be hard, but at least I have some momentum going.

Wish me luck.

Down 17 pounds!

2011-03-03T06:07:00.000-08:00

I am 3 pounds off my June goal, and very excited about the progress.

Eating frequently, never missing meals, not saying no to occasional junk food (tacos and birthday cake over the weekend) and feeling great.

Exercise is getting easier, etc, etc.

Simply tracking with the DailyPlate.com and following Intuitive Eating - total cost $10 for the book.

Feeling better - Priceless

Diet soda = poor appetite control

2011-03-01T06:23:00.000-08:00

I used to be a diet soda junkie, esp in Med School and Residency, but have virtually stopped drinking them after reading many reports on how they seem to increase weight gain.

However, over the weekend, I picked up a big bottle of diet cola with a couple videos on a whim. What I noticed was that I have crazy cravings for comfort food and ended up finishing the leftovers from dinner, which were not exactly health food.

I have not had these kind of feelings in months and it was striking to me. The only real variable was the diet cola. Definitely plan to avoid this in the future, especially in the evenings when eating in front of the telly is a risk.

Just an anecdote, but definitely fits with the research.

Down 15 pounds!

2011-02-24T10:38:00.000-08:00

I continue to use TheDailyPlate.com for calorie tracking and the suggestions of Intuitive Eating, along with a small amount of exercise when I have time and have consistently dropped 2lbs/week, while not feeling like I am dieting.

Amazing.

Intuitive Eating + DailyPlate.com

2011-02-09T09:47:00.000-08:00

I wanted to say again how impressed I am by this combo of teaching and tracking for weight loss.

I have been doing this now for approx 6 wks and have lost 13 lbs, but most impressively I have not felt like I was dieting, and have not been hungry most of the time.

One of the tenets of Intuitive Eating is to "honor your hunger" and listen to what your body is telling you. When I have practice this, I have been consistently suprpised to find my caloric intake to be within my goals and this is evidenced by the consistent weight loss.

I have also stocked up on Power Bars, which are 240 cal each, and have a good carb/protein/fiber balance, in order to have a relatively healthy snack available at all times, and find myself eating 1-2 a day when I get hungry. Easy to eat and track.

Down 13 pounds since Jan 1!

See link for book on Amazon:

http://www.amazon.com/gp/product/0312321236/ref=pd_lpo_k2_dp_sr_1?pf_rd_p=1278548962&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=1591796822&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=0TXPM1J42PWZXVM6ACGZ

Intuitive Eating

2011-01-29T20:02:00.000-08:00

On the recommendation of Angel Schroeder, I have been reading Intuitive Eating, and making a point to eat when I am genuinely hungry.

Have not finished the book but so far it seems to be in line with what I know about nutrition, metabolism and weight gain/loss.

Today I ate when I felt I needed it, which seemed like I snacked too much, however when I tallied my calories at the end of the day was still within my target.

The Bet

2011-01-28T05:42:00.000-08:00

I have been toying with the idea of a motivational bet, to keep me on track, since just knowing I need to lose weight and get fit has done dinkus for me over the past 10 years.

On my FB page I suggested donating money to a charity, but as that's a win/win, I'm not sure its the best idea, and we already do that anyway.

A psychologist friend suggested writing a check to an organization I hate and having someone mail it if I fail, but I am torn about that idea as well.

So I have decided that since I hate being out in a swimsuit in public at my current weight, that I will post a full body shot of myself on my public FB page if my goal of 1 lb/week is not met by June 1, which would be a goal weight of just under 230.

If I meet that, I will renew the bet for the next quarter or so.

Since neither I nor my viewers want that to happen, I think I will get the encouragement I need!

What do you think?

Exercise & appetite

2011-01-25T06:09:00.001-08:00

Recent studies have shown that very vigorous exercise may actually interfere with weight loss due to disinhibiting hunger control, i.e., when you work out hard and burn off stored sugar from the liver, your resulting hunger may cause you to consume more calories than burned. Net effect - no weight loss, and even minor weight gain.

I have heard this complaint over and over again from patients who have joined a gym, and have not lost the weight they hoped.

I am therefore trying to keep my workouts light for starters, with heart rates maxing in the low 140s, which my trainer apparently agrees with. Right now its 3 times a week at the gym, but plan on 5-6 when the initial soreness improves.

Yesterday was a good meal day with calories not exceeding my goal, though it took some discipline between 8 and midnight, my danger zone.

Getting back on the wagon

2011-01-24T06:24:00.000-08:00

So work and life have gotten in the way of my own health in the past year, which is the same story I have heard from hundreds of patients.

My goal however is to join my family which have all taken up speed skating, a sport which I once enjoyed but now find painful due to my weight and lack of fitness.

To kick things off, I have enlisted a trainer at our hospital fitness center, with 2 meetings a week to make sure that I show up. We are starting slowly to avoid injury, but it feels great to be in a gym again.

Secondly, I am trying to get group support from my Facebook friends on my Henry Dorn MD page, which like Weight Watchers seems to be an effective way of staying on track.

I am also considering a wager too in order to keep me focused. Amber Kelly, a great local counsellor & friend, suggested that I write a check to an organization which I dislike, which will be cashed if I fail to meet my goal. Like McDonalds.

Anyway, I need to watch the calories and bump up the fitness.

At least being on the skates makes me PAINFULLY aware of where I am and where I need to be.

Goal is one pound per week until July 1 for starters. Wish me luck!

After dinner struggles

2010-02-04T05:57:00.000-08:00

I am sure I am not alone in my struggle to control my appetite after dinner. The kids need to eat early (about 2 hours sooner that I would eating on my own), and by 10-11PM I am starving again.

Especially if I am watching TV or something passive.

Now the obvious solution is quit watching TV, but hey, a man needs his guilty pleasures, right?

Last night I did pretty well with a huge salad, but had to add an extra breadstick to cure the munchies.

This will be my biggest long term hurdle, and something I need a long term plan I can stick with.

I'm back!

2010-02-03T11:30:00.001-08:00

I have dropped the ball on the blog and the diet and paid the price!

10lbs have snuck back on me and I know what I need to do.

So, I am making a new commitment to follow my own advice, and get back on the program.

So far today, I had a so-so breakfast of 1 cheesebread stick with coffee, but a good healthy frozen dinner for lunch, at under 300 calories.

Stocking up on easy to prepare veggies.

Plan to knock these pounds off before the spring!

Bad boy.

2009-10-13T11:15:00.000-07:00

I have been negligent about blogging and diet and it shows. I gained back about 5 pounds.

Need to get back in the groove.

Had my sites on 200 by New Years. Will settle for sub 215.

Perspective on universal healthcare - please read

2009-08-21T12:32:00.000-07:00

This is not related to my other blog posts but I wanted to pass along a letter I read from a Brit which may be enlightening to those in the US who have been biased against universal healthcare.

My husband, an English teacher, also wanted to get the facts from someone who has experience with national health care. He asked a former student (who is now working as a MD in England) what he thinks of this whole conundrum and whether an 85 year old person can have a necessary operation under the UK health system. The reply was very interesting, and is reproduced below.

"As usual the debate on healthcare
reform is being reduced ad absurdum. There is not rule that says an 85 year
old person cannot have an operation. It all depends on the medical status of
the person and the benefit that the operation will have to a patient.

Medical care in the UK is given free at the point of delivery based on
medical need, not the ability to pay. If an 85 year old person has a need it
needs to be balanced with the risk of the operation to the individual and
the needs of others for the same intensive care bed after the operation. If
the 85 year old person does not need an intensive care bed they are likely
to get their operation, even if they do they are likely to get their
operation but it may be delayed if a 25 year old person has a car accident
and jumps the que (line) into the ICU bed.

The point that the scare mongering congressman made is that all 85 year old
patients in the UK have the right to be considered for an operation and they
have had that right all their life where as the 85 year old patient in the
USA will have to deal with co-pays and deductibles and bureaucracy and bills
and may not feel empowered to even attend the doctor because until they were
65 years old they did not have medical care at all.

When you come to see a doctor here in the UK you don't pay, you don't sign
anything no one is counting how often you came or looking at what conditions
you have -- you simply get the care you need -- that may be different from
the care that you want. Much of the care for people who have insurance in
the states is care that scientifically they don't need or is of marginal
benefit.

The best example is the yearly pap smear. Medically a low risk patient probably needs
one every 5 years. The pick up rate for a screen every 5 years is 87% when
you increase the frequency to every 3 years it jumps to 96%. The increase
to every year jumps to 97%. In the USA women are told to go every year. The
false positive rate is about 20% Therefore, 20% of the women who are being
screened are being told they may have cancer when they really don't -- this
leads to a lot more tests and a lot more potential harm in the USA because
you are screening 3 times as often with only a very marginal benefit. And
who makes all the money from that -- doctors who should know better. It will
and does lead to women having unnecessary surgery and even death from
complications. The major point is though that all Women in the UK get their
pap smears because it is free where many American women wont because it is
not.

There is truth in that we do not spend as much on the elderly but that is
more a national attitude than a government policy. Here there is a more
straightforward expectation that you have to die of something sometime and
when people of an elderly disposition get their fatal illness -- which
necessity dictates they must get, the British are more reserved and resigned
to the fact that they will die someday. There is none of this heroic
fighting against the odds that goes on in the USA. That is not to say we
don't try to do the best for people but at the same time they aren't
throwing good money after bad trying to save the life that just can't be
saved. We also care better for people. We have a hospice network and our
terminally ill mostly die at home with a nurse and sometimes me by their
side, not in a hospital hooked up to machines which is what happens in the
USA.

The NHS has its problems and is wasteful but its waste provides a peace of
mind that no American will ever imagine. It is coupled with a Welfare State
that ensures you will not starve. Everyone has a right to be housed and
everyone has a right to subsistence. It isn't great for some but it allows
most to feel that they are not alone in the world.

The longer I live over here the less I am proud of the USA. My cousin in
Ohio is currently being treated for Leukemia. She waited 30 days of feeling
deathly ill because she had to wait for her workplace based insurance to
start before she would go to the doctor. Then she missed too much work and
she lost her job, Ohio Medicaid picked up the tab but now she has no money
and she had to be unemployed for 60 days before she can claim disability.
That is not a moral society and the richest country in the world should know
how to deliver health care and basic welfare to its poorest without making
them into criminals. My cousin is a nurse and she has been treated badly by
the system. It would have never happened here.

Basically, the example that the congressman brought up would never happen
because we would never have gotten to the point that an 85 year old woman
would need an operation. We would have taken care of the problem years
before because that woman would have had health care - free healthcare --
her entire life!

The UK wants the NHS to be better but it would never and will never trade
its system for something like the US or even Germany. The NHS and the BBC
are 2 institutions of which the British Public are incredibly proud and they
have given the BBC to the world. We are going to keep the NHS for ourselves."

The Perils of Going Home & Getting Serious Again

2009-08-12T18:31:00.001-07:00

It seems that I need a strategy to deal with travel, vacation and family visits, as far as my diet goes, since I have had set backs every time I have gotten out of my new routine. This has happened despite packing healthy snacks, and planning meals. It seems the triggers to eat badly still have quite the hold on me, and I need extra vigilance. Any suggestions?

So having bounce back a couple pounds during my time away, I am getting back on track.

Today I resisted a lovely looking cheddar scone for breakfast and instead had 2 bananas and a slice of walnut bread from Grateful Bread, and of course a cup of coffee, with skim milk.

Lunch I unintentionally missed due to a hectic schedule but breakfast carried me over.

For dinner for the family, I made a large green salad, with parmesan & lightly dressed, followed by a makeshift Pasta alla Bolognese, made with ground turkey (which was in the freezer).

In the interest of time, I partially browned the turkey but placing the frozen meat in a hot pot with few tbs olive oil, and scraped off the browned meat as it cooked and thawed. Midway thru I added a large chopped onion and 1 shredded carrot, & towards the end a couple cloves of diced garlic cloves. I added 1 cup milk (skim as thats what I had), and reduced it over med high heat.

The meat had a chunky texture which is not what Bolognese calls for, so before the liquid was reduced I used an immersion blender (the kind on a stick) and ground the meat finely in the pot which gave just the right texture.

I then added 1 can diced tomatoes, salt, 1 bay leaf and a bit of marjoram, a milder cousin of oregano. Because the kids were starving, I cooked this quicker than usual of med heat and stirred frequently for 10 minutes. Finally I added 90% cooked pasta to the pot with a ladle full of the pasta water and simmered it until the pasta soaked up the excess liquid.

Pretty damn good for mock Italian, fake beef, wham bam Pasta alla Bolognese, lower in fat than usual (no butter, whole milk or beef fat) and on the table from frozen in 30 minutes.

And I didn't over eat! No more weight gain!

Julie & Julia + Awesome Chinese in High Point!

2009-08-11T20:04:00.000-07:00

So tonite, my wife and I decided to go out for an impromptu date. We have both been looking forward to seeing the new movie Julie & Julia, based on the book which was based on the blog that inspired this blog. Very, very enjoyable, especially Meryl Streep's portrayal of Julia Child, one of my heroes.

Before that though, we went to a new Chinese restaurant in High Point, which was recommended to me by one of my Asian patients as being the only authentic one in the area. This was Full Kee Restaurant off Eastchester, near Wendover. Absolutely perfect. I have eaten truly good, authentic Chinese food only a few times, and then in large northeast cities. This was equal to any of them.

We asked the owner George Yu to cook whatever he like for us, and he promised to please. We started out with Szechuan Eggplant, which was garlicky and rich, yet delicate and not at all spicy for my wife, who has a more delicate tongue than I do. Amazing.

This was followed by Ful Kee Shrimp, which was shrimp prepared 2 ways, in both a cream and sweet & sour sauce with brocolli. The cream shrimp were slightly crispy, but not battered, and lightly sauced and were as good as any shrimp I have EVER eaten., and I have had some shrimp!

Finally we were served Steamed Sea Bass, which was served with scallions and ginger, and was perfectly prepared. Could not have been better in my opinion.

All the dishes were light, and bore absolutely no resemblance to what has become the standard chinese fare in the US. No heavy, sweet generic brown sauce with limp veggies and a dollop of MSG. This is the real deal, according to those who know better than I, and we will certainly be back very soon. Mind you, this fine dining comes at a slight premium, but the service and atmosphere was spot on, and we felt it was a relative bargain.

One aspect of the meal that was notable in terms of my diet, was the portion size. We shared 3 dishes and which was just the right amount of food for a special meal. Definitely not the typical huge platters of marginal quality stuff that we usually find at American Chinese restaurants. @ dishes shared would have been enough for a fairly low-cal dinner, but we were splurging. If we all ate out like this, portion-wise, obesity would be far less of a problem, I feel.

As for the rest my day, the morning grub consisted of a light breakfast (fruit/coffee) and lunch (350cal frozen dinner) , so overall a great food day.

Diet Drinks = Diet Killer

2009-08-10T18:53:00.000-07:00

I used to be a diet cola junkie. This started in high school, and by the time I was in medical school I could easily drink a couple 2 liters a day while studying.

I have cut down a lot lately, mostly because it was affecting my sleep. Over this past weekend though, I noticed a phenomena which hadn't been obvious to me earlier.

My biggest hurdle with my diet has been cutting down on snacks after dinner. I had gotten into a good pattern, allowing myself veggies and fruit after dinner if still hungry, but no high calorie snacks.

My family visited my parents over the weekend, and my mother, being the good Southern host that she is, always keeps the fridge and pantry stocked. There was a bottle of Diet Coke which I helped myself to, encouraged by the summer heat. That evening after what should have been a satisfying dinner, I remained ravenously hungry and really blew my diet on chips, chocolate, cheese (the 3 Ch's!). I simply could not get rid of the gnawing feeling of hunger.

The only thing I could attribute it to was the diet cola. The next day, I refrained from the cola but did have several cups of unsweetened coffee, and felt fine after dinner. So the caffeine was not to blame.

This fits with a recent Swedish study which showed that diet soda drinkers gained as much weight as reg soda drinkers, with a hypothesis that perhaps the sweetness without the calories caused the body to crave more calories afterwards, as if it is "getting even" after being tricked.

All I know is the diet soda seems to be a diet killer for me and will be avoided in the future.

Now I don't mean to imply by my title that diet drinks can kill you, so all you Coke & Pepsi lawyers can back off.

Breakfast - Coffee, banana

Lunch - Thai vegetable soup, 1 cup white rice

Dinner - 1 slice pizza, huge green salad.

222lbs (-18) , BP 124/75, P64 - thats all

2009-08-05T11:56:00.000-07:00

Very happy about results today

Day 35 - Slacker (blogwise) - Down 14 pounds though!

2009-08-01T21:03:00.000-07:00

First off, a big thanks to those who have posted comments. It really motivates me knowing someone is actually paying attention, if only passingly!

So I haven't been posting regularly his week, but have been staying on a good diet.

I believe I have had something for breakfast every day, which is unusual for me, unless it had been a muffin or danish at the doctor's lounge. Now it is a BIG handful of nuts if I am rushed, 1-2 pieces of fresh fruit (usually bananas), maybe a cup of yogurt, and coffee with lots of skim milk. I have had leftover pizza (1 slice), a cheese sandwich, big bowls of granola as well, which all start the day off better than sugar.

Lunches have been almost exclusively frozen dinners at work, which are usually 3-400 cal, with veggies and other good stuff. I have been getting the posher, organic ones on sale which I like to think are a bit healthier. Then again, just about anything is better than the burger and fries that had been my mainstay.

If I happen to be over at the hospital, I get a big veggie plate from the cafeteria, usually 4-5 servings, which is VERY filling and low cal.

Dinners have been smaller servings of the same stuff I have always eaten, which could be almost anything, since I love to cook. I basically fill my plate once, and only allow myself veggies if I want seconds.

One big thing I have found is that TV is a trigger to snack. 100% of the time, I feel the urge within minutes of turning on the tube. If I am busy doing other stuff, even killing time on the web, I rarely get the munchies. I am not planning to give up my shows, but I know now I need to be on guard when I plop my less & less fat butt down on the recliner.

I have even started using some 20lb dumbells for a little upper body workout when watching TV, to make it a good thing.

Today at the office I weighed 226 (!), which represents about 12-14 pounds of real weight loss. Now this I know is more than I recommend to my patients, but I was really pigging out there before, and it takes a pile of calories to maintain that sort of weight. I calculate that at my ideal body weight of 160-180, I should be consuming about 1900-2000 cal/day, so that is my target amount to eat, ballpark. My goal is to teach myself what a normal amount of calories is for my height and frame, and get used to eating that, rather than do the crash diet thing, and eat an amount that is not sustainable.

I am paying attention to the amount of calories only as a teaching exercise for myself, but have zero plans to keep tabs on it down the road, once good habits become ingrained.

Honestly, I did not think I could do it due to truly meager willpower when it comes to food, and often joked that the only way I was getting back in my old clothes was going to be a good case of cholera or similar wasting illness. Thankfully that does not seem to be the case.

My size 40 pants were getting snug a month ago, and now I can button up some old 38's without holding my breath. Down to 1 chin again, which I seem to remember is the normal number!

Day 30 - A New Week

2009-07-27T21:05:00.000-07:00

For the weekend, I visited my family, and like many others, find that going home often involves reverting to old habits. The house was stocked with chips and other temptations of old and I allowed myself to indulge, but not the the same degree as before. When I weighed in, I found I may have added back a pound, but that's hardly a major setback.

And so, with a new week ahead, a new commitment to a healthy diet.

Breakfast - Fruit, coffee, milk

Lunch - 350 cal frozen dinner

Dinner - 1 can Progresso soup, large salad, 2 handfuls plain almonds.

Not hungry after dinner :-)

Day 26 - Getting blogged down

2009-07-23T20:10:00.000-07:00

So despite my lack of posting this week, I have still managed to stay very mindful of what I put in my mouth, and continue to lose weight, a total of 12 pounds so far. The biggest differences are portion size and choice of snacks. I have avoided seconds of entrees at dinner, but have allowed myself additional portions of veg if unsatisfied. These have been mostly steamed, so very low cal, and I do love 'em. Snacks have been mostly unsalted nuts (the salt encourages overeating I have found), fresh fruit, salads, etc, instead of cookies, dinner leftovers, chips, etc. From my weight loss I must be consuming at least 1500 cal a day less than before, which says more about what I was eating then, than how much I am eating now.

I truly did not believe I was capable of this kind of discipline about my diet, as I have been using food as a comforter, especially when my schedule has not allowed other recreation. So the blog has helped my awareness greatly, and I need to keep it up, for the sake of maintaining the new changes.

Hopefully I will eventually get some comments on the blog, if only to let me know someone else is reading, to keep me on track. That sounds like begging I know, but it does feel a bit like sending messages in a bottle!

Will be going out of town and off line for the weekend, so thats my excuse for the next few days, but will put up a decent post on Sunday.

Day 24 - Staying On Track

2009-07-21T05:26:00.000-07:00

So the weekend off, without blogging definitely put me off track, and I find it amazing how easily I can lose momentum. So I am blogging yesterday today, and plan to be more diligent, at least until I reach my weight goal of sub 200.

Reflecting on positives, I have consistent eaten breakfast over the past 3 weeks and I believe that has made a substantial difference in how good I feel during the day. Lunches have all been relatively low-cal, in the 300-400 range, and I have not succumbed to the burger run. I have also avoided entirely sodas and sweet drinks, and get my morning caffeine from 1-2 cups of coffee with skim milk. (Coffee or colas in the PM mess up my sleep as I get older, so those are a no-no.)

The biggest improvement has been avoidance of high calorie, after dinner snacks, when I am reading, on the computer or watching TV late at night. These I believe are one of the chief sources of my weight gain, as I tend to eat pretty healthy food during the day.

I have limited these snacks to salads with very light dressing, unsalted nuts (1-2 handfuls max) & fresh fruit. TV watching is the worst though, as I feel pangs of hunger almost immediately after turning it on, just like one of Pavlov's dogs. The clear answer would be to severely limit TV consumption, but sometimes I like everyone else just need to zone out for a while.

Breakfast - Whole grain cereal with skim milk, coffee

Lunch - Marie Callenders frozen dinner - 400 cal

Dinner - Mixed green salad with goat cheese, peaches, blueberries, balsamic vinegarette + leftover chicken salad (made with apples & cilantro)

Day 23 - Perfect is the Enemy of Good

2009-07-20T08:27:00.001-07:00

So over the weekend of traveling and family duties, I decided to not worry about the blog, and was not so very strict about the diet, snacking with healthy food when hungry and eating a bit more after dinner.

I was resigned to gaining back a pound or two on Monday, but in fact lost 2 more more pounds!

Granted, I did a lot of manual labor (for me) and was generally busy, so I burned more than I do during the week.

Very pleased so far.

I think the lesson learned is taking a break from strict dieting may not be a step back, as long as things remain in moderation.

Day 19 - On the road again

2009-07-16T11:32:00.000-07:00

Nothing to write about. Did pretty well scrounging healthy food on the road.

Breakfast - Bowl Swiss Muesli with 100 cal Craisin pack, with skim milk, coffee

Lunch - Marie Callenders Penne Chicken Modesto - 400cal (excellent)

Dinner on the road - Wendys Grilled Chicken, no mayo, Huge salad at Ruby Tuesdays

Day 18 - The Munchies

2009-07-15T13:28:00.000-07:00

Tonight was a struggle. I was very hungry after arriving home at 7:30 and couldn't wait to eat dinner. I had a large portion of leftover chicken curry on rice, but 30 minutes later I was still having strong cravings.

While cleaning my daughter's room I came across some chocolate she had stashed away (for how long who knows) and I couldn't resist having a few pieces.

Still hungry I ate a couple ounces of goat's cheese (was on sale at supermarket) on about 6 small slices of a baguette type loaf of bread.

Still hungry I decided to do what I had done on earlier nights and fixed a large green salad with a couple tablespoons of the Thai dressing I "invented" and that finally did it. My guess is that I consumed 500 cal over what I had hoped for today, but at least the snacks (minus the chocolate) were healthy. In the past I have been know to demolish a bag of chips, half a container of ice cream or whatever else I could get my hands on with little prep.

Perhaps next time I will try to fill up on something like the salad before I get into trouble. Diets are not supposed to be perfect, with no forays into "pleasure foods", and I am not berating myself about it. But clearly, I need to have a plan in place for next time, and make a mental note to keep salad greens, fresh fruit or the equivalent in the fridge always.

Breakfast - Swiss Mueli, skim milk, coffee

Lunch - Moosewood Cafe pasta with pesto - 370 cal

4PM snack - Amy's Organic Spinach burrito - 310 cal

Dinner - 1 bowl Chicken Curry & rice

After dinner Munchies - 4 small pieces of chocolate, 6 small slices baguette with goat cheese, large green salad with Thai dressing

day 17 - No Waste = Mo' Waist

2009-07-14T18:22:00.000-07:00

Having grown of as the child of someone who grew up during the Depression, I was often admonished about not wasting food (or anything else for that matter). I really took this to heart and have been in the habit of cleaning off the kids plates, even when its bad fast food, telling myself not to let food go to waste. No waste = More waist, for me at least.

After dinner tonight I had a little revelation. I had cooked more pasta than I intended, thinking my son might be hungry, which he was not. We therefore had at least 1 large serving left after dinner.

My instinct has been to save it for a late night snack, or eat it while doing the dishes, but tonight I decided to just discard it and cook a lot less next time to prevent having leftovers. I did however eat the rest of the steamed broccoli and cauliflower, at least 50 guilt-free calories!

New Rule

So my new rule is to let uneaten food go to waste, especially when it is something like a half-eaten Happy Meal! Or if there is enough for a decent meal later, then wrap it properly and refrigerate it immediately, to reduce the temptation.

Breakfast - Banana, yogurt, coffee

Lunch - Large green salad with vinegarette, bowl veggie soup with 2 slices whole grain bread

Pre dinner snack - 3 small slices of baguette with goat cheese

Dinner - Seared salmon steak (4 oz) with dill, brocolli & cauliflower, egg noodles

Day 16 - Hectic workday, nothing special diet

2009-07-13T19:42:00.000-07:00

On Sunday I made the mistake of not going to the grocery to plan some good meals for the week. One of the things that made the last 2 weeks easy was having lots of easy to prepare, healthy food available. I need to remember that.

Breakfast was the usual cereal with nuts and berries - I feel like the guy in the old Grape Nuts commercial, or a bear. Still, I have eaten breakfast every day for the last 2 weeks, and that is surely a record.

Lunch was a scarfed down organic tamale - healthy enough but eaten too fast between tasks to enjoy it.

Dinner was likewise on the move. I ran through the hospital cafeteria on the way home to take my son to T-ball. I had hoped to find several nice veggies to make a healthy dinner, but all they had was sauteed zucchini, so I got a triple portion. My thin wife is not on a diet so I grabbed her a chicken sandwich and fries.

The zucchini alone was not satisfying enough, so I ate about a quarter of her sandwich and fries, which weren't so good as to make me want to clean the plate.

Overall, not a bad day, but with more planning would have been more satisfying, dietwise.

I did hop on the scales this morning hoping to see sub 230, but I was the same 232 that I was on Thursday or Friday. A little discouraging, as I was losing so fast in the beginning, but that is the trap of dieting - easy initial weight loss with a plateau. Need to ramp up the exercise, but its 11PM and all I have done is toss the baseball around with my son for 15 min - his limit. Not exactly what the doctor ordered.

Will do some stretching before bed, just to feel like I have done something. Plan to do better tomorrow. (famous last words...)

Day 15 - "So Doc, what about exercise?"

2009-07-12T10:24:00.000-07:00

I decided in the beginning of this experiment, that 1 major life change at a time was enough. I didn't feel I could cope with sore muscles on top of being a bit hungry. Now, 2 weeks into it, I am pretty settled into my diet routine, and not suffering from any significant cravings.

Therefore, today I am going to start Phase 2 of my weight loss plan, increasing my daily exercise. This should be pretty easy to do since recently I have been getting almost nil.

I started last night with some upper body exercises with a couple 20 pound dumbells that I have had for years. I simply did some curls, military presses, triceps extensions and pullovers while watching a movie, enough to feel it this AM.

Being that its a Sunday, I decided to put my workout to practical use, and mowed the yard with an old fashioned push mower. We have 2 of these, an Agri-Fab Silent Reel (pictured) and a Sunlawn. Both of these are modern mowers, much easier to use than anything your parents or grandparents may have owned, an make the job a snap, if the grass isn't too long. All of the good ones are a bit pricey, but keep in mind, they always start, don't require gas, and will last decades if cared for. I found the Agri-Fab on ebay, like new, for about $70 shipped.

To cut the entire yard takes me about an hour with this mower, compared with 45 min with the powered walk behind one. A good basic workout, cheaper than a gym membership and makes my wife very happy. Plus you can do it at 6AM on Sunday morning if so inclined and no one will complain!

Addendum - I did a little research and pushing a reel mower as above burns about 2.5 cal per pound body weight, so over 500 cal per hour for someone like me. This is about the same as walking 4 miles per hour. Additionally, I used a pedometer, which showed about 2500 steps.

Just thought you might like to know.

Breakfast - cereal with fruit & nuts, skim milk.

Morning snack - banana

Lunch - fruit & nuts (not enough)

Dinner - large bowl pasta (4 oz dry) with fresh spinach and tomato sauce, nutmeg & parmesan added

Exercise - mowed yard with self powered mower - 1 hour

Day 14 - Same Salad, New Day! / New rule

2009-07-11T17:38:00.000-07:00

Once again, I listened to my own advice and had a good breakfast before scooting out the door this AM. There is no doubt that it makes a difference in the day, and my hunger level. The paradoxical added benefit is that showing the body calories early in the day, ramps up the old metabolism, and helps to lose weight. All of my patients who weight 300+ basically eat 1 meal per day in the evening, and I was slowly getting there myself.

I was out on a little day trip with some friends who wanted to stop at a Dairy Queen for lunch, my first fast food in 2 weeks. DQ did have a nice turkey sandwich on the menu though, which I ordered without mayo, and a couple large glasses of water, and that did the trick. I can't say I really wanted the fries etc, especially after the progress I have made in the last 2 weeks.

As I write I am wearing a pair of jeans that I was about to donate to Goodwill, since I never thought I would fit in them again. Just 2 weeks!

For dinner, I made another big Thai-ish salad, similar to the one I had last night that was so wonderful.

Since I used the last cucumber & red bell pepper last night, I substituted broccoli (lightly steamed and chilled) and carrot strips (use a peeler), which I added to the spinach, asparagus (also lightly steamed and chilled), chopped nuts , cilantro and my new favorite dressing. (for those not following along diligently, this is simply 2 parts bottled Thai peanut sauce, 1 part rice vinegar, or a little less white vinegar, and honey or sugar to cut the vinegar's edge a bit. It's color is a not so appealing brown, but wow. In the end I like the first night's pepper and cucumber combo better, but both were satisfying.

I wanted to also mention the benefit of steaming some veggies for a salad. There are many raw vegetables which benefit not only in color and tenderness by cooking gently, but also in terms of nutrient availability. By that I mean that some vitamins and nutrients are poorly absorbed from when eaten raw, but are released by cooking. Steaming instead of boiling prevents these from being leached away into the cooking water. Some plants even contain enzymes which inhibit absorption of some nutrients, but these are mostly inactivated by heat. (Spinach is one which provides more iron and antioxidants in the cooked form - for more read this and this) Nonetheless, any veggies are better than none, I like a raw spinach salad.

Addendum to diet rule - "Don't eat in front of TV, it causes overeating."

Unless it is a giant low cal, high fiber salad, or other fresh fruits or veggies, in which case eating in front of the TV might help non veggie lovers to consume a bit more.

Just watch out for high fat additions such as dip or dressing.

Breakfast - cereal with nuts and berries (redundant but who cares)

Snack - handful nuts, H20

Lunch - Dairy Queen turkey sandwich, no mayo

Snack - Sweet and Salty granola bar

Dinner - small bowl leftover pasta with tomato sauce, huge bowl of Thai salad #2

Day 13 - Awesome Thai Salad

2009-07-10T20:33:00.000-07:00

Dinner started as a struggle to find something my 5 year old would eat. His older sibs are omnivores, and eat most anything put in front of them, especially veggies, but this one is trying my patience. After nearly coming to a stalemate, he agreed that pasta with "red sauce" would be OK.

Not wanting to cook something separate for the adults, I started the pasta and began to explore the fridge for salad options. I started with a 1/2 bag of baby spinach, to which I added thin sliced cucumbers (cut on a cheap japanese mandoline/slicer - get one, it makes this sort of thing a snap and the results look great), red bell peppers cut in strips, diced cashews, cilantro leaves, and fresh baby asparagus, which I popped in the pasta water for about a minute, then rinsed in cold water. For dressing a combined a couple spoonfuls of bottled Thai Peanut sauce, the kind used for marinade or satay dipping sauce, with a spoonful of rice vinegar (milder than most other types) and a sprinkle of sugar. This was used to lightly dress the salad, which ended up tasting awesome I definitely recommend trying this dressing with similar ingredients, including bean sprouts, peanuts, shredded cabbage, thai basil, etc.

I ended up eating a small bowl of the pasta, and 3 large bowls of the salad.

I also weighed the cashews and craisins I have been munching on, and it turns out a handful of each comes in at 1 oz. That is about 150 cal for the cashews and 130 cal for the craisins, together 280 cal, which is a hearty snack, but one can see how mindless munching could blow a diet pretty quickly.

One final note - Today I tried on an old leather jacket of mine which has been too tight to wear and it fit! (although a little snugly) Since it does not give a bit when zipped up, it really lets me know if I have lost some of the jiggly yellow stuff.

Breakfast - 1 bowl whole grain cereal with handful each cashews and craisins + skim milk.

Lunch - 1 bag of beef jerky (about 250 cal), grabbed while running errands

Dinner - 1 bowl pasta with tomato sauce, 3 bowls Thai salad.

Day 12 - Rush, rush, rush - Top 100 Diet Tips

2009-07-09T16:42:00.001-07:00

Although I had a fairly light schedule today, I had to squeeze in time to eat. Breakfast was grabbed on the way out the door, lunch was between surgeries and dinner was between work and T-ball. Fortunately I had some healthy stuff ready to go, so I didn't end up eating crap as usual. This is one of the pitfalls for many busy adults - eating bad food because there is not enough time to make something better, or no decent options when out.

The key, according to those who know about this sort of thing, is to be prepared. Just having a big can of nuts on the counter, some nice fresh & dried fruit, and some good leftovers in the fridge has made my week MUCH easier. This also allows one to nip hunger in the bud, before it becomes a raging monster, hell bent on a large bag of Doritos.

So far I have eaten 11 breakfasts in a row (likely a record for me as an adult), really cut down on the after dinner snacking, while eating more throughout the day, to prevent being starving in the evenings.

For more tips compiled by people who know a lot more than I do, check out Top 100 Diet Tips

Thats all I have for today.

Breakfast - Banana, nuts, dried fruit, coffee, running out the door.

Lunch - Big serving of sauteed italian veggies (zucchini, bell peppers, squash, etc), baked cauliflower - a la High Point Regional Hospital cafeteria, squeezed in between cases

Dinner - bowl of pasta salad, running out the door.

Day 11 - Birthday Cake!

2009-07-08T07:19:00.000-07:00

So today happened to be my birthday. I decided when I woke up that I was not going to be Crazy Diet Person and refuse cake, or whatever else my family might offer me. I think what is important about proper eating, is not to deny oneself special treats, but not to make them an everyday event. Not being one who craves sweets, I can't say that I was especially looking forward to having birthday cake, but if a 20 oz Porterhouse had been plopped on my plate, I would have put a hurting on it and not felt the slightest bit guilty. As it turned out, I had a healthy dinner and 2 half slices of cake (we had 2 kinds), and enjoyed it.

Moderation is the key, and so far I have felt very successful with that, while eating some pretty great food.

Breakfast - large bowl of whole grain cereal with cashews and craisins, skim milk, coffee

Late lunch - 1 bowl pasta salad

Snack - Cashews & Craisins, again (can you tell I like this combo?)

Dinner - (Made by my wife) Awesome Curried Chicken & Rice Salad

(Chopped up chicken (room temp), cooked rice (room temp), grapes cut in half, chopped pecans, diced celery, sweet pickle relish, mayo, curry powder, salt/pepper to taste - amazingly simple and everyone loves it. The pickle relish and curry powder are mandatory.)

1/2 piece cheese cake, 1/2 piece carrot cake, with a candle on top

Day 10 - Mindfulness & Diet Control

2009-07-07T10:21:00.000-07:00

According to the all singing, all dancing Wikipedia, the Buddhist concept of mindfulness is 'a mental state, characterized by calm awareness of one's body functions, feelings, content of consciousness, or consciousness itself'.

In writing this blog I have realized that although I have put a great deal of thought into my cooking in the past, I have never been very mindful in terms of how much I have eaten, or how much junk I consume in addition to those carefully planned meals. There are so many taste temptations surrounding us, from the plate of cookies some kind soul brought to work, to the half eaten bag of chips one's child left on the couch. Not to mention the pot of deliciousness on the stove, when more is prepared than can be reasonably consumed at a meal.

I am really appreciating the value of the food log, recommended by dietitians, as not just a tool for the clinician to analyze a clients intake, but to help the dieter to THINK about what he or she eats, followed hopefully by the why.

In addition, I have been able to look back on this last week and really reflect on how I felt in the first few days, when my body was physically fighting the reduction in calories, and how I was able to deal with that temporary discomfort. (Boy do we in the USA hate discomfort!)

This reminds me of another Buddhist teaching, the Four Noble Truths, which deal with suffering as an integral part of life and spiritual growth. I will not even begin to elaborate on this concept as I am all but ignorant in this realm, but do believe there is some value in examining this further. (Funny though that the Buddha is often depicted as being pretty obese!)

That's all I have for today, but am grateful for being able to share my little adventure in getting control over my weight.

Breakfast - Cashews/Craisins, coffee w skim milk

Mid morning frozen spinach ricotta stuffed shells 300 cal

Lunch - rice w/ green beens, lg serving est 250 cal (hospital cafeteria)

5 PM snack on the run - 4 handfuls of cashews mixed with Craisins - Redundant but great combo.

9PM Dinner (finally) - Delicious bowtie pasta salad with ham, blue cheese, rosemary and pecans, made by my darling wife. 1 small bowl only (I could have eaten 5)

Article on obese physicians from Medscape

2009-07-06T12:40:00.000-07:00

I found this article on Medscape while trying to see if my blog pops up on Google Search. Thought others might find interesting, as it reflects what I am trying to do.

Is that white-coat feeling a little tight? Many physicians are overweight or obese for the same reasons our patients are.^[1] Many of us do not eat right and get enough exercise.^[2] We work long hours, making it seemingly impossible to squeeze regular exercise into our busy daily routines. We eat on the run and unhealthy food (often served in our own hospitals) is commonplace.

Physicians rally against obesity, and yet, we are not doing all we can. Sadly, those of us who fail to embrace lifestyle recommendations in our personal and professional lives promote a public perception that lifestyle change is ineffective or unrealistic.^[3] Despite dramatically increasing obesity rates, we have failed to improve our dismal obesity counseling rates.^[4] The physicians who fail to recognize and treat obesity are often the ones who personally fail to heed lifestyle recommendations,^[5] and these doctors may sometimes lose credibility with their own patients.^[6]

I know we can do much better. First, we must recognize that the human body needs at least an hour of exercise daily for optimum health, and every able-bodied physician should strive to achieve this. Second, we should eat at least 5 servings of vegetables and fruits daily, and third, those of us with excess body fat should literally count our daily caloric intake and aim for about 12 calories per pound of ideal body weight.^[7]

If we can commit to these goals, both as individuals and as a medical community, imagine the example we would set! As individuals we will feel better and stronger, and as a medical community we'll serve as better role models for our patients. To succeed in healing others, we must also heal ourselves.

That's my opinion. I'm Dr. Michael Dansinger, Obesity Researcher at Tufts-New England Medical Center.

Day 9 - Learning from mistakes

2009-07-06T09:35:00.000-07:00

Dinner was not planned, as was like one of those cooking challenges to make a meal out of a fairly random group of ingredients. I would have gotten a C-, but I learned something, and that is valuable. Apparently, common button mushrooms and tuna are not a match made in heaven, but mushrooms, spinach and goats cheese are. A more terrestrial meat like chicken or beef would have improved things. I also learned that even covered by, a lasagna REALLY needs sauce on top to prevent the top noodles from becoming something slightly tougher than shoe leather. On the plus side, I was NOT tempted to have seconds, so maybe I am onto something - healthy but unappetizing meals!

Breakfast - 1 slice whole grain bread with goats cheese, 1 cup coffee skim milk

Lunch - 1 bowl rice with chicken curry, kiwi fruit

Afternoon snack - 1 cup yogurt with strawberries and kiwi fruit plus chopped cashews and Craisins (dried cranberries, great crunchy/chewy addition)

Dinner - Tuna/spinach/mushroom lasagna experiment - next time use beef or chicken, needs more sauce to prevent top pasta from drying out

Late night snack - low fat plain yogurt, honey, strawberries, cashews craisins - super snack, unsure how many calories but less than a bowl ice cream for sure

Day 8 - Grazing + Chicken Curry dinner - 235 lbs

2009-07-05T20:39:00.000-07:00

Weekends are always weird for me food-wise, since I do not have to adhere to a strict schedule. In the past, I would often skip breakfast, and even forget my coffee, sometimes getting a caffeine withdrawal headache! (I admit it - I'm an addict)

Today was no exception, but the knowing I was going to write about it, kept me in the game. I ate a light breakfastof goat cheese on whole grain bread and a banana before heading to the hospital, but lunch was mostly nuts and dried fruit, which I nibbled while during chores around the house. Not surprisingly, I was extra hungry before dinner. Diet error #16 - don't skip meals.

Chicken curry - shortcut style

Boneless chicken thighs had been on sale, so I had a big pack in the fridge which I decided to turn into a chicken curry. Normally I try to be a purist & cook exactly as directed by my guru Madhur Jaffrey (though she doesn't know I'm her disciple - I highly recommend her book Madhur Jaffrey's Indian Cooking, my copy of which is dogeared and curry stained), measuring all freshly ground and toasted spices myself, but today I punted. Thanks to a jar of Patak's curry paste I spied on a back shelf, the prep time was reduced considerably, but the taste was only passable, IMO.

I did take the time to slowly fry a mix of finely diced onions, ginger and garlic, which is the essential base to many curries. The commercial curry paste, some plain yogurt, the chicken and a can of tomatoes were added and the lot simmered for a couple hours. Serviceable result, but not as "bright" tasting as the scratch version.

I served this with cardamon scented basmati rice (just toss a few cardamom pods in the rice cooker - nice), some basic raita (yogurt with diced cucumber, cumin, and mint leaves - I leave out cayenne in deference to my bride) and a pseudo-Indian cabbage dish I came up with. This was simply chopped cabbage steamed with about 1/2 inch water in the pot, and seasoned with a teaspoon of mustard seeds and a pinch of asafetida which I fried in canola oil, and poured over the cabbage. Pretty mild, but a decent accompaniment. Would appreciate any ideas for unusual cabbage dishes, as I love the stuff, and would like to jazz it up sometimes.

I used little plates for dinner, which helped to moderate my serving size, but I still had a pretty hearty sized portion. Still, given the high veg content, low fat yogurt, etc, not too decadent.

No post dinner excursions to the kitchen either, so I have to say a very good week for me. Let's see if I can keep it up.

Day 7 - 4th of July/Birthday Party/ Goat cheese

2009-07-04T13:36:00.000-07:00

Today is a very special day - my wife's birthday. Everyone else always seems celebrating something as well, lots of hoopla and fireworks. Perhaps I should read the paper more often.

Therefore, dinner was a few of her favorites - ribs, asparagus and the salad are high up on her list. Although barbecued ribs are not exactly low cal/low fat, I did well by only eating a few, instead of my usual rack! Meanwhile, I filled up on the salad & fresh veggies, so all in all, very satisfying while not being diet breaking.

We did discuss that my sense of proportion and serving size is definitely a bit of a problem, as I served her a "little salad" which she could not finish. I need to get out of the Supersize mentality. Will try using smaller plates, which has often been suggested by dieticians.

We had birthday cake, but not having a very sweet tooth, it was easy for me to pass on, in favor of finshing my wife's salad.

Rergarding Goat Cheese aka Chevre - this is an often overlooked cheese here in the US, but has an amazing tangy taste that works especially well with fruit, in my opinion. It has fewer calories, less fat and more protein than similar cheese made from cow's milk, and is more easily digested. 9 times out of 10 it is OK for folks who are lactose intolerant! It also provides more calcium and fewer carbohydrates than cream cheese.

A bit pricey, but a little goes a long way in terms of flavor, and that is perfect for someone trying to cut down! Quality over quantity...

Finally, on the hospital scale this AM I weighed 236 lbs, which doubtfully represents 4 pounds of weight loss, but is a good sign nonetheless. My goal is 1 pound per week, which only requires a 500cal/day reduction.

Breakfast - coffee with skim milk, bran muffin, banana

Lunch - Sardines (love 'em) with mustard/dill sauce on whole grain rye with spinach, kiwi fruit.

Snack - banana, yogurt 80 cal

Dinner - Strawberry, chevre (goats cheese), cashew & spinach salad with balsamic vinegarette, barbecued ribs, corn on cob, steamed baby asparagus.

Day 6 - "Just the facts, ma'am"

2009-07-03T08:05:00.000-07:00

I am busy on call, so not enough time for a lengthy post, so just the facts, ma'am. I do notice already that I am less and less hungry after dinner as well a before breakfast. A good sign.

Breakfast (6 in a row)

Large cup coffee with skim milk

Bowl leftover stir fry with rice, about 1 1/2 cups

Lunch - Grateful Bread Baking Co. 'Luigi' Sandwich - Ham, Pesto, Cheese on Sunflower bread - highly recommended!

Late afternoon, remainder of stirfry, about 1 cup

Dinner Leftover Italian Pot roast (6 oz meat)/ 1 cup polenta

Large Spinach/mushroom/parmesan/chopped egg salad (see photo)

Day 5 - The Daily Plate/Eat Smart bagged veggies

2009-07-02T11:50:00.000-07:00

I found a great web site today called The Daily Plate which makes looking up nutrition info on foods super easy. Here's what I had to eat today.

7AM - Apple (on the way to a delivery) - 55 cal

10AM Amy's Spinach Tofu wrap (between patients) 310cal

2PM Moroccan Stew - (between patients) 170 cal

3 cups coffee with skim milk, 75 cal

5PM Grilled tuna sandwich with spinach, on whole grain bread - 400 cal

7PM Stir fried boneless chicken thighs with broccoli, snap peas, carrots on sticky rice - 400cal

Total 1410 cal

Obviously , my calories were mostly at the end of the day, which is one reason I had to make the tuna sandwich before dinner - I was fairly hungry when I got home. Clearly it would have been better to eat a "beefier" lunch, but today was one of those days when lunch was missed in favor of work. A diet no-no. I'll have to make sure I have some cashews or similar high protein snacks, for the next crazy day.

All in all not bad, and I am not famished as I write at 9:30 PM. Actually I was surprised at the 1410 calories, since I felt like I ate a lot at dinner, but it was 70% green veggies, which don't add many calories but are filling a full of nutrients.

One last note, though I am usually a chop it yourself kind of guy, I opted tonight to use a bag of Eat Smart Vegetable Stir Fry from the fresh produce section, which had broccoli florets, snap peas, shredded broccoli, carrots and red cabbage. The packaging uses the new BreatheWay technology that keeps the contents from getting soggy and rotten, and I have to say works beautifully. The broccoli and peas were super crisp, much better than the one I usually get under the sprayers in the fresh produce aisle. As if they came right out of the garden.

I tossed the whole bag into a very hot Chinese wok after the chicken, canola oil, garlic & ginger, and a dash of soy. The cooking process took about 60 seconds, but then I have a pretty powerful stove which scares my wife. Your mileage may vary.

Note - While Chinese restaurants usually use peanut oil for its high smoking point, canola may be a better compromise for health and high temperature. Extra virgin olive oil smokes at too low temp and is waste of money for this purpose, since the delicate flavor you pay for is lost in the fire. Grapeseed oil is also an option, with a neutral flavor and med high smoke point.

The label on the veggies says they can be microwaved in the bag by piercing the bag with a fork and 'waving them for 3-4 minutes. These can then be added to precooked meat chunks (think leftover steak, chicken breast or pork chop) with a dash of soy sauce from one of the little packets that most of us have in a drawer somewhere, for a great low fat, high nutrient/fiber meal. No excuses not to eat something fresh and green and hot, even at work!

Just a suggestion.

Day 4 - Late night cravings

2009-07-02T04:21:00.001-07:00

Around 8 PM, after getting home from work, I had a big bowl of canned Progresso soup, to which I sauteed some chopped peppers, onions and garlic for flavor and to add some veg. High sodium but low calorie dinner.

At 11PM, I was not yet ready for bed and decided to watch Nova on Tivo. Shortly after starting the show I started feeling very hungry. Since I had such a light dinner, I decided to fix a snack, which turned out to be a big shredded broccoli salad (store bought broccoli coleslaw mix in a bag) to which I added olive oil and vinegar, salt and pepper. (I did consider using ranch dressing until I checked out the label which showed 200 cal per 2 tbs serving, and passed.)

Very filling and took about 20 minutes to eat due to high fiber content.

Admittedly though, I went against the advice I pass along to patients, to avoid eating while watching TV. Research shows this causes overeating, and the recommendation is to eat only in the kitchen/dining room, and to not bring the king sized bag of chips in to the den, for what will likely be a 2000 calorie snack.

At 11:45, I couldn't watch deep sea squid anymore and crashed, only to be called an 30 minutes later by the hospital for orders - welcome to my world. Still, another good day diet-wise.

Day 4 - Boring leftovers/yummy Moosewood Moroccan Stew

2009-07-01T11:46:00.000-07:00

Success again - I made it to breakfast without snacking after dinner, but I had to drink a few large glasses of water to put something in my growling stomach.

I made sure to eat breakfast again this AM, but nothing special, just a bowl of bran ceral, skim milk and coffee (gotta have my coffee). That makes 4/4.

For lunch I ate a few small slices of leftover London Broil (very lean cut, great taste - more on this later), some rice and spinach, all from the fridge and into the microwave.

Moosewood Moroccan Stew

I picked up a pile of these on 2 for 1 sale at the grocery, and they make great mid afternoon snacks. VERY tasty, loaded with veggies and only 170 calories. (Click on image for details) From the much touted Moosewood Restaurant, one of the granddaddy vegetarian joints in the country, and associated with the fantastic cookbook of the same name. Highly recommended if the price is right.

So far so good today.

A Brief Note on Chopping Bell Peppers

2009-06-30T17:30:00.000-07:00

Chef-types will undoubtedly laugh at this but I am unashamed to admit that for years I made the task of cleaning bell peppers much harder than necessary. I cored out the pepper like an apple, washed out the seeds, then halfed the pepper before slicing, taking care not to let the knife slip on the steep curve of the edge of the pepper.

The trick it seems is to simply cut the meat off the core in 4 or 5 pieces as pictured above. These nice flat chunks can then easily be sliced into strips, and then rotated 90 degrees and diced. This easily saves a minute per pepper.

Remember though, a sharp knife slips less and is therefore safer when used properly.

Day 3 - Dinner - Temptation

2009-06-30T17:18:00.000-07:00

On the way home from a very funny 5 year old swim meet, which was a little like watch baby chicks leave the nest, my son requested McDonalds. As a treat I let him get a Happy Meal, which I recognize as being kindergarden crack. I planned on eating leftovers, but smelling his fries in the car was like having someone light up a cigarette after going cold turkey for 2 days. Fortunately I was able to resist but I wanted to document how hard it was, to remind myself to be kinder to patients who are having a hard time with junk food.

Anyway, I made it home and heated up the leftover pot roast and polenta from Day 1, added some frozen peas briefly simmered with diced onion and red bell pepper left over from breakfast. Note to self - nice color combo for Christmas.

So 2 hours later and I admit, I am still a bit hungry, but considering I have been eating about half my normal consumption, thats not too surprising. Still, 3 days in a row and I have done pretty well, thanks to the blog. Just 10 hours until breakfast!

Day 3 -Lunch - Not very Fast Food

2009-06-30T10:17:00.000-07:00

My wife called and asked whether I would pick up a Subway sandwich for her for lunch, and so at noon I headed over. It took almost 20 minutes to get 2 sandwiches, after standing in line with the lunch crowd. I thought about how that compared with my cooked from scratch breakfast which took 4 minutes. Not exactly "fast food".

Praise for the Veggie Max/Veggy Patty sandwich

After noticing how tired a high fat/carb lunch made me feel, I began looking for options that didn't make me want a siesta.

Subway has a great veggie patty that locally is called the Veggie Max. I order it on whole wheat, toasted with cheese and a pile of toppings (spinach, tomatoes, cucumbers, olives & banana peppers today) without any dressing (lots of fat/calories) . The veggie patty is moist enough that with the cheese, no mayo or other is needed. Remember though that mustard is always very low cal.

The 6 inch sub has around 450 calories, fairly low fat and as satisfying as anything else on the menu , and actually tastes great. (It looks far better in person than the rather poor snapshot I made.) I will not eat any kind of "diet" food that doesn't taste wonderful. Life's too short.

Click for nutritional info

Day 3 - Mexican omelet in 4 minutes

2009-06-30T05:54:00.000-07:00

So I went to bed thinking about breakfast, probably because I was a little hungry. In the fridge were several red bell peppers which I buy lots of when on sale, and a carton of truly free range eggs given to me by one of my patients. This called out mexican omelet to me.

A word about free range eggs

I had been a bit of an egg skeptic in the past, not really appreciating the difference between the various grocery store varieties. (I will note that I was not a big egg eater until fairly recently, after some strange childhood imprinting - probably overcooked Easter eggs.) It was a leap of faith buying organic or Omega 3 enhanced eggs which tasted and performed the same to me. A few months ago an Amish patient came to me and as a gift, brought 2 dozen freshly collected eggs from their farm. (Likely her midwife told her I liked to cook!) These I was told were the real deal - eggs from free range chickens which had been allowed to eat bugs and run around outdoors and do whatever else rogue chickens do.

That night, I decided to cook a big omelet for the family. When I cracked these open I was startled by the dayglo yellow yolks, which I learned comes from the varied diet.

These cooked up extra fluffy, but the real revelation came on the fork. These tasted rich and custardy unlike any eggs I had tasted before.

Research shows that hens raised in this fashion produce eggs which are much healthier for us and the fat and cholesterol they contain has far less impact on heart health than the "factory" produced ones. Try these ASAP if you know or can find a local farmer. I can't yet attest to the taste of the occasional free range ones found in the grocery.

4 minutes start to finish.

With my master plan in mind, I tossed a heavy nonstick pan on medium heat to warm up.

I sliced a quarter off a red bell pepper and diced it, followed by 1/2 of a small onion, also diced.

These were tossed into the pan with a little olive oil.

2 eggs were beat lightly with a pinch of salt and poured into the pan. Finally a tbs of grated cheddar cheese and a sprinkle of chili powder completed the dish. Much better and faster than anything I could have grabbed on the way to work, and I am now 3 for 3 breakfasts.

Day 2 Tuna Rice Bowl - (Tekka-don)

2009-06-29T15:22:00.000-07:00

After work I ran by the grocery to see what was fresh on special. I always hit the meat section first, then the produce section, the fill in the gaps.

As it turned out, sashimi grade tuna was on sale for $4.99/pound. Normally I would by a heap of this and freeze most of it, but I am trying smaller portions all around, so I selected a single, 1/2 pound piece.

In produce, broccoli crowns were 1/2 off and I picked up a bunch of spring onions. Over in frozen, some of the organic dinners I mentioned earlier were 1/2 off, and I grabbed a dozen for lunches.

Tekka-don

I first ate this in Japan while visiting a friend in Nagoya, at a "family restaurant" called Skylark, which is like a slightly upscale Dennys. I saw someone else order it and our host located it on the menu. This ultrasimple dish is totally Japanese, but requires little technique or knowledge.

Start with Japanese style rice, in this case a California grown version recommended to me by the local Asian market. 10 minutes start to finish in an automatic rice cooker (a cheap and indispensable kitchen accessory for anyone who eats rice at least once a week). The rice is seasoned lightly after cooking with a few tablespoons of rice vinegar, a sprinkling of sugar and a dash of salt, then fluffed gently.

While the rice was cooking, I simply dice the raw tuna finely, in this case 4 oz per serving, which I then seasoned with a splash of soy sauce. I knew I had leftover nori (sushi wrap seaweed) which I cut into fine slices (roll the sheet first, then slice - much easier). 1 finely sliced scallion completes the dish.

When the rice cooled slightly , it was placed in a bowl, and topped with the diced tuna, scallion and nori. Nothing could be simpler. I beefed up the dish this time by adding a cup of steamed broccoli, which I chopped and added to the bowl.

Not sure how many calories, but very low fat, somewhat exotic, extremely satisfying and undoubtedly healthy eats.

Now to make it to bedtime without snacking.

A Plug for Frozen Dinners / Shopping Tips

2009-06-29T09:07:00.000-07:00

A few months ago I realized that in the rush to cram in lunch between morning and afternoon clinic, that I was eating a lot of junk food - burgers from across the street etc.

So one day as I was grocery shopping I notice a lot of promotional specials on frozen meals, especially the more expensive organic ones. These were often 2 for one deals that would run for a week or so, before the prices jumped up. Since we have a freezer at the office, I bought a big pile of these , and have been popping them into the microwave for a quick, healthier lunch.

$2.50, 460 cal organic burrito bargain

For example, today I had an organic veggie burrito grande with chile verde sauce. At first glance it looked like 230 calories, but I the read that serving size was 1/2 burrito. Nonetheless, 460 cal beats a burger and fries any day, and the ingredient list "looks" better. These were normally over $5 each, but at 2 for one, a bargain lunch.

My recommendation would be to check the paper or web for specials at your local groceries, and it seems that the better ones often have the better deals on good products to get you in the door. The little Healthy Choice, Marie Calenders, Weight Watchers meals are often marked down, and are better than fast food choices 9/10, but not always!

I will note for completeness that I did well with a bowl of bran cereal and low fat milk for breakfast, so that's 2 days in a row!

Eat well, be well.

Day 1 - Pasta alla Puttanesca/Italian Pot Roast on Polenta

2009-06-28T18:08:00.000-07:00

I have been rereading "Julie & Julia..." a fun little book, soon to be a "major motion picture", that started as a blog, in which the author Julie Powell spends a year cooking thru Julia Child's "Mastering the Art of French Cooking". As I read it, I thought to myself, if she, a marginal cook but good writer could blog about cooking, then I, a marginal writer but good cook could blog about eating. And so here we go.

Breakfast

This morning for a change I followed my own advice about never skipping breakfast, and sat down with my son to a bowl of bran flakes and mild, along with a large cup of Sunday morning coffee. I had already been thinking about the blog and wanted a good start. Afterwards, I poked my head out the door and when the 90 deg heat and humidity hit me, decided against mowing the yard, and lost out on an opportunity to exercise.

Lunch - Pasta alla puttanesca

For lunch I had a small bowl of leftover pasta alla puttanesca, one of the most decadent tasting but extremely healthy dishes I know of. Legend has it that the dish originated in the Naples area, and was prepared in brothels, and its strong savory aroma would to entice sailors inside, as if they needed any additional encouragement. (puttana is italian slang for prostitute).

I had made it the night before after surveying the pantry and noted that I had all the ingredients. In addition, my wife was out of town and does not care for one of the chief ingredients, olives.

My recipe last night was simply 2-3 tbs olive oil heated in a pan, 1 can anchovies, a small handful of ripe olives pitted and chopped, a large spoonful of capers, 2 chopped garlic cloves, a teaspoon of red pepper flakes and half a jar of generic spaghetti sauce (I usually use a can of tomatoes). This was simmered a few minutes and a cooked box of pasta, in this case penne was added to the sauce for a couple more minutes until the extra moisture was absorbed by the pasta. 15 minutes total prep time and most of that was boiling the pasta. Don't worry about the anchovies, they only add richness and salt and virtually no fishy taste.

This dish is loaded with Omega 3s, antioxidants, etc, and all of the fat calories are good ones, that is, ones that increase your HDL or "good cholesterol".

My error however was to cook such a large amount, when I was the only one eating - my 5 year old has not developed such a debaucherous palate yet. I therefore made the mistake last night of dipping into the leftovers while watching TV - one of the things I specifically advise my weight loss patients against. (Studies have shown we overeat if the TV is on during meals/snacks, therefore best not to eat while watching. If hungry, eat in the kitchen before resuming couch potato activities). So I ate 3/4 of the total dish from dinner to bedtime, which was at least 1500 calories. (1600 cal per box of pasta - 8 servings).

Today, I did better and only had 1 bowl of the still delicious pasta for lunch, probably 4-500 calories.

I ate a handful of popcorn during the afternoon as I cooked dinner for my wife. I should note that as I love to cook and she loathes it, I am the head chef in the family, though she probably puts as many meals on the table as I do, given the amount of time I am away at work. More times than not, the kids prefer mom's meals to mine as well!

Dinner - Italian potroast on polenta/grits with spinach

I found some chuck roast in the freezer that I had bought on sale and decided on making a pot roast.

To save time, I simply placed the still frozen meat in a heavy enameled cast iron pot, along with some olive oil and set to med heat to brown on each side. This worked pretty well, but I did need to pour off some of the juice the meat gave off, so that it would brown and not just boil. After both sides were done, I removed the roast and tossed in a coarsely chopped large onion and red bell pepper and sauteed them a few minutes. I then added 2 cloves garlic, a bay leaf and some fresh oregano from the garden (grow your own herbs - its easy and MUCH cheaper), and the remainder of the jar of tomato sauce from last night. The meat was returned to the pot and simmered on lowest heat about 3 hours.

Continuing on the Italian theme, I cooked up some polenta, otherwise known as grits in these parts, with a little bit of chicken stock added to the water for flavor. We are lucky enough to have a local old fashioned stone mill, so these were stone ground yellow grits, which I believe are the exactly same species as polenta. Most grocery store grits are a bit different, but are better than nothing. Just avoid the instant type.

To green things up, 1 pack of frozen spinach was simmered in 1/2 cup water and seasoned with nutmeg and a pinch of salt. (Buy nutmegs whole and they keep a long time. Just run them over a grater - much better than the preground stuff, which loses its potency almost immediately.)

I served a 4 oz portion of the meat on top of the "polenta" along with the sauce and veggies, and a nice big spoonful of spinach on the side. Easily a $12.95 dish at a decent restaurant, as Jacques Pepin would say, and total ingredients were less than $10 for at least 6 servings. (I make this point, since we are all looking for ways to conserve nowadays, and I am a big believer in cooking something special from a cheaper cut of meat.)

Most importantly for me, I did not go back for seconds, despite how good it tasted, and refrigerated the leftovers immediately to reduce the temptation. I must admit, I am still a bit hungry as I write this 2 hours later, but I think blogging about it will help me make it to bedtime without ruining my diet for the day.

A Brief Disclaimer

2009-06-28T17:48:00.001-07:00

Although I am a board certified obstetrician/gynecologist, which includes training in primary care and general medicine, I am not a nutritionist or registered dietician. These professionals have extensive training in this field and I make use of them whenever possible in my practice. Therefore, I invite anyone who is, or who has greater knowledge about nutritional issues to correct me if I make an incorrect statement.

That being said, I have read fairly extensively about food, cooking and nutrition, and hope to pass some of that information along as I apply it to myself.

An Introduction - 240 lbs

2009-06-28T14:05:00.000-07:00

Twenty years ago, at the beginning of medical school, I experienced a prideful moment regarding my health.

Someone was doing sports physiology research, and wanted volunteers from the class to undergo a series of exercise related testing. At the first station, our vital signs were checked. I was asked if I felt OK and replied that I did. She stated my blood pressure and pulse were unusually low and whether I exercised a lot. At the time I had been cycling and inline skating quite often, which accounted for my 54 bpm pulse and 90/50 blood pressure. My weight was 147 lbs, height 5'9" which gave me a BMI of 21. I was told that my cardiovascular health was that of an elite athlete and that my lower body strength was excellent as well. (We won't talk about my pathetic bench press results!)

Bottom line though, was that I was in good shape.

In medical school I tried for a while to keep fit, but as classwork demands increased, the time I spent exercising decreased. I also began to eat a lot of comfort food (a.k.a. junk food) while up late studying or when on call at the hospital. When I hit my clinical rotations, especially surgery, the residents would often take us down to the cafeteria after early morning rounds saying, "you'd better eat now, because you may not get a chance to later." Most days we did get some time for lunch, and the same mantra was repeated. If I was on overnight call, we often ran downstairs at 9PM, just before the cafeteria closed, with the warning that "it may be a long night, you'd better get something to eat now". I should mention that the food service was run by the local Johnson & Wales Culinary School, which meant that there was always something good to eat.

Fast forward to today.

I weigh 240lbs, and get winded if I have to climb several flights of stairs. Although I am on my feet all day, I get very little real aerobic exercise. I tried skating with my kids recently at the local rink and had to sit down after just a few laps, compared to the miles I used to skate. The extra weight put also stress on my ankles I had never felt in the past.

In my job as an OBGYN, I am asked several times a day by patients about weight loss. I expertly discuss the recommendations for 10,000 steps a day, small frequent meals, reducing processed foods, etc, etc, but am hardly a good example of that, and feel like a bit of a hypocrite. Like 99% of my patients, I want to do these things but can't seem to do it on a consistent basis.

The Cockroach Experiment

Not long ago, I was told about some research, which showed that cockroaches performed better when observed by other cockroaches. This involved a clear plexiglass maze which the roach had to navigate, and the presence or absence of his or her buddies outside, observing (or whatever cockroaches do in this sort of situation). This "observer effect" clearly applies to higher species, and is explains in part why we humans tend to perform better when we know that others are aware of our performance.

Given that the internet is the biggest plexiglass box imaginable, I am hoping that the presence of readers will help me reach my goal - to become more healthy & lose weight. Perhaps, if I can set a good example, others may benefit as well. Time will tell.