HOW TO MAINTAIN A HEALTHY EATING LIFESTYLE

           We tend to engage in mindless eating and when we have these other physiological and psychological states we tend to want to escape that. Again, it's creating this uneasiness and so we escape from self-awareness and from the things that are bothering us and turn to food as a coping mechanism. Let me share with you some tips to maintain a healthy weight. Portion control. 

                 

                  Well, that's obvious but one of the rules is don't eat until you're full, but rather until you're no longer hungry and there is a gap between when you're feeling satiated and when you're feeling full and if you can learn to stop when you're feeling satiated you're in a better place. struggling with wanting to eat the foods that they so much enjoy. You'll notice that some of the more commercial weight programs are trying to let patients know or people know rather that you can engage in some of those foods that you really like, but you must do it in moderation. HOW TO MAINTAIN A HEALTHY EATING LIFESTYLE

                    

                    It is important to eat healthy foods. It's important to remove all the unhealthy foods from the house because those are temptations that will drive you towards them. Be mindful and enjoy the meal. we often make reference to the Mediterranean diet as a healthier diet but the Mediterranean eating habits are also something to be mindful of. The meals in Southern Europe tend to be longer. People engage in social interaction and they tend to enjoy the meal. American restaurants tend to rush you out. We tend to eat quickly, and we have a tendency to overeat. Eating small meals rather than overeating at one meal. Well, in talking with individuals, they often say, I've been raised to clear my plate. One trick that can be used is to use a smaller plate. That might be helpful. Increasing physical activity. Now, what comes to mind, I can think of numerous individuals that we work with, ,

                        I would ask if I could take a look at their smartphone. We would track their activity and we'd see that actually they were very inactive, and so their body compensates and does not draw down on any of its weight in calorie reduction. One of the things we strongly recommend is to increase your walking, your activity. At least 150 minutes a week of vigorous walking in activity. If you're driving to the mall, park at the stall that is furthest away from the entrance, so it forces you to walk. Obviously taking the stairs over escalators, elevators as always. Monitor your alcohol intake. We know that alcohol has got calories, so practice moderation and increase your water intake instead. 

  

                         Then importantly, eating high-protein foods and decreasing your carbs has been shown to be helpful people often will eat in hiding. They'll take their food into another room. mindless eating and don't eat out of a container or package where you have no ability to actually modulate and recognize how much you are taking. In closing I'll just say that, to have good health and good weight, we need to keep our brain healthy as well, so we want to strive for healthy eating. Taking into consideration some of the tips I just shared with you, obviously regular exercise and activity, keeping your brain active is critically important. HOW TO MAINTAIN A HEALTHY EATING LIFESTYLE

    

                       You can do that through a number of ways, including positive social connections and something we hadn't mentioned, She focuses on both general and preventive cardiology as well as unique needs of women's cardiovascular health. The title of her talk and one of her areas of research is intermittent fasting for weight loss and improved cardiovascular health, intermittent fasting and how it can be beneficial for weight loss and cardiovascular health. One thing that you will not hear me talk about or use the term is dieting. Intermittent fasting is a lifestyle strategy and it is based on the principles of our circadian rhythm. Our ancestors, the caveman and hunter-gatherers, really conformed to when the sun came out, they ate, and they had physical activity when the sunset, they went to sleep. 

                       They really conform to their circadian clock. Unfortunately, in today's society, we have access to food all the time so we are not limiting our food intake to during daylight hours. We eat all the time. My patients will typically tell me that they eat a late dinner. They finish around 7:00 PM, and then they'll have a couple of snacks after dinner. That's very characteristic of how most of us eat. We eat all day because we have that opportunity. One thing that we've seen in modern society is we're not sleeping as well as our ancestors did. this circadian clock is really important to our metabolism and we should really be trying to conform our lifestyle patterns with our circadian clock. 

 

                         What do I mean by that? When the sun is out, that's when we should be eating, when it's dark, we really shouldn't be eating so we should really try to end our meals when the sun sets. When should we consume most of our calories? Well, the best time would be earlier in the day because that's where we have peak insulin sensitivity. That's where we metabolize our calories better. This is something that we have gotten away from, but we need to get back to because fundamentally, our body and our metabolism is driven by the circadian clock. When we don't follow the circadian rhythm, what we see is we get a lot of diseases including insulin resistance and diabetes, fatty liver, heart disease, and cancer. In studies both in animals and humans, what we've seen is when we conform more to the circadian lifestyle, that is aligning our eating and activity patterns with the circadian clock, a lot of these parameters get better. Intermittent fasting is a way of conforming to our circadian biology.

                           The very specific type of intermittent fasting that really focuses on our circadian clock is time restricted eating, which is what I do a lot of work on. On the Internet, you'll see tons of different fasting programs. Some of them get hyped by different celebrities, but I don't recommend most of these types of fasting regimens to my patients because many of them are not safe especially if you're on a blood pressure medication or you have diabetes. The pattern that seems to be most safe is time restricted eating. What is time restricted eating? It's basically eating within a limited period of time. A typical time restricted eating who have higher blood pressure, higher hemoglobin A1c tend to have more heart attacks and strokes.HOW TO MAINTAIN A HEALTHY EATING LIFESTYLE

                      

                            We saw in this small study that time restricted eating in addition to losing weight can help with improving all these parameters because it's not just about losing weight, it's about losing weight and improving your body from a cardiometabolic standpoint. What we see in our studies and in the studies of other investigators is that the benefits of time restricted eating go way beyond weight-loss. Typically when you lose five percent of your body weight, your body cholesterol goes down, or the bad cholesterol, 3-5 percent. But in our study, just losing three percent of your body weight resulted in an 11 percent reduction in the bad cholesterol. We think this is because when you go from a fed state to a fasting state, you're fundamentally shifting what you're using as fuel for the body. You're going from utilizing glucose to ketones. Ketones have so many beneficial effects. Many of you have heard about the ketogenic diet which results in very profound weight-loss, but that's not really a safe diet, especially because it can increase the bad cholesterol levels.

                            Fasting is a very safe and effective way to get into a low grade state of ketosis and it improves inflammation. It also increases resistance to stress. Ketosis, especially low grade ketosis has numerous beneficial effects on the body. We've seen that in our clinical studies, including improvement in blood pressure and a decrease in body weight. This is a review that I did for the American Journal of Preventive Cardiology, really summarizing the dietary recommendations. multiple things that you want to do. When you do all these strategies, that's when you get the most profound effect. That includes paying attention to the quality of your food. HOW TO MAINTAIN A HEALTHY EATING LIFESTYLE

                                 A lot of patients tell me that they are vegan, but their vegan diet consists of plant-based processed foods and other chocolate and other unhealthy things that may be technically vegan but not healthy. You really need to focus on getting a good amount of fiber and protein as well as good carbohydrates and having that balance. Of course, the quantity is important, if you over-consume healthy foods, you're still going to gain weight. As I highlighted the timing of when you eat is important. Ideally, you want to limit your food consumption to about 10 hours a day. This is just a video that I created for a conference, just talking about all the different things that we as providers and patients need to be thinking about. What is it exactly that we're eating? How many calories are we consuming? How are we consuming it is, are we fasting? What is our meal frequency? Are we having small frequent meals or are we having large meals? Then of course exercise. For everybody, these parameters are slightly different and that's when you need a physician to help you customize this. But if you try to optimize these parameters, this is going to lead to better cardiometabolic health.

                        He's a world expert on some metabolism and intracellular signaling. Energy Metabolism Molecular Insights. and that is to introduce you to something that you've probably learned in high school and that's the first law of thermodynamics, transformed from one form to another, but can't be created or destroyed. Now why am I telling you this stuff about physics? Well, if energy can't be created or destroyed, then energy balance is really decided by calories in calories out. Remember, calories are a measure of energy. That it follows that you can only gain weight if you have calories in are more than calories out, you can only lose weight if you expend more calories than you eat. Really it's pretty simple actually when you think about it. Now we know it's really more complex than that. food intake or eating is a complex process, it's governed by many things that tell us when and how much and where and what to eat? We also know that what we do with those calories after we take them in is also quite complicated actually.

                                     How we decide whether or not to store calories, whether or not to burn those calories? I'm going to talk today mostly about the energy expenditure side of this equation. The first thing I'll tell you something that most people are surprised to hear and that is that physical activity or exercise and other forms of physical activity is actually a fairly small component of overall metabolism. By far, the biggest part of energy expenditure is in the resting metabolic rate. That's the first thing I think that people are surprised to hear. Another surprise is that energy intake and energy expenditure, actually eating and metabolism are really intricately linked together. This was really elucidated by studies from my colleagues at Rockefeller University, put them in the hospital where they had complete control over their diets and measured their metabolism. What they saw was very illuminating. When they increased the number of calories in their diet, they saw a pretty big increase in their metabolism. This is the resting metabolism.  HOW TO MAINTAIN A HEALTHY EATING LIFESTYLE

                                        When they put them on a caloric restriction diet, there was a corresponding decrease in metabolism, and this has been reproduced by many investigators. It's very clear that our bodies are trying very hard to adhere to a set point to defend our body weight. Now this became even more complicated every one of these contestants had a reduction in their metabolism to go along with their weight loss. That was what was expected by the Hirsch and Leibel studies. What was surprising though is that he followed these patients or these contestants out for several years. Invariably all of the contestants gained the weight back. The majority of them had a further decline in their metabolism. a metabolic memory of their obesity. It really looks like there are very strong forces that promote weight maintenance and prevent us from losing weight because of lots of reasons and what's the main reason for this? The main reason is evolution.

 

                                   Our bodies haven't caught up with the idea that we have free access to food as you heard from Pam and other speakers today. We think our bodies think that there's a famine just around the corner, so we're very efficient at storing energy in preparation for their famine. How do we study this? Well, we can actually look at this in a mouse and to try to understand this link between diet and metabolism. The mouse is a very good model of metabolism for humans. We know that if we put mice on a diet that's high in fat and high in calories, they predictably gain weight. As they're gaining weight, we can measure all kinds of things in these mice, including energy expenditure. What we see when we measure energy expenditure is interesting. Just like in humans when we start these mice on a high-calorie, high-fat diet, we see this compensatory increase in metabolism, but for some reason it peaks out after just a few weeks and then starts to decline, and if you look out after a couple of months, you see it's actually below where we started. HOW TO MAINTAIN A HEALTHY EATING LIFESTYLE

                                        This is what I was talking about before this memory of obesity. The big question is, what's happening in this transition? What is really causing this decline in energy expenditure in obesity? To tell you the truth, we don't really know yet, a lot of people are interested in this. We're studying this in my lab and a lot of labs are interested in trying to understand this. Now we think the key to understanding this decline in metabolism is to study the fat cell. The fat cell is a very interesting cell and it's a cell that is able to store a lot of our energy, is the first place that we go for energy storage and when we need energy. 

                                        You see all these little marshmallows here, these are the fat cells, and these are amazing cells. They can expand and contract as we need energy. You can see here if we put these mice on a high-fat diet, by the way, this looks exactly the same tissue in humans, if we put them on a high fat, high calorie diet, these fat cells dramatically expand the store a lot of fat, and then if we take them off the diet, they'll shrink back down. Now we were very interested in studying the control of energy metabolism in these cells, and we know that energy storage is regulated by the hormone insulin, which instructs the cell to take up and store energy. Energy expenditure is controlled by the hormone adrenaline. The balance of energy is really under the regulation of these two hormones.

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