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The Lean Lifestyle

By Eric Van De Graaff, MD October 17, 2011 Posted in: Heart Health

A couple of years ago I had a discussion with a colleague of mine who exercises regularly, keeps herself fit, and watches her weight closely. She is a person who seems to effortlessly stay thin and whose size never varies by more than a few pounds. I was surprised to hear from her a relatively vitriolic tirade about her irritation with people who believe she doesn’t have to work hard to keep herself looking good. “You have no idea how many times I hear people tell me how lucky I am that I’m ‘naturally thin’ or have a ‘high metabolism,’ as if I don’t do anything to keep myself this way, and how I’ll never know what it’s like to struggle with my weight.” She proceeded to show me a photo of her with her sister and three brothers at a recent reunion. In the picture it’s clear that this lady was not genetically predestined to be slender, as her sister was at least 200 pounds and her brothers were closer to 300. She looked like a lone bean pole in a garden of watermelons.

I can understand her aggravation. I’ve always been thin but my family hasn’t. Nearly every member of my father’s side of the family has battled obesity and my own siblings will attest that they also tend to balloon up if they’re not careful. After I saw my friend’s family photo I asked her what she does to avoid gaining weight. Since then I’ve had occasion to discuss the subject with other people who are thin, not by nature, but through a combination of hard work and diligence, and I’ve come up with what I think is a pattern of living that I’d call the “lean lifestyle.”

Before I go into that, let me remind you about the scope of the problem and its root causes. Obesity is on the rise in every state and among nearly every demographic. Twenty-seven percent of Nebraskans are obese, as defined by a body-mass index of greater than 30 (that works out to 186 pounds for a person who is 5’6” tall), and this problem is only getting worse despite nearly heroic efforts at education on national and local levels.

So, if we all know that obesity is a problem, why don't we just do away with it? Surely it's not because people enjoy carrying around 20 or 50 or 200 pounds more than they should. I don't know of any overweight individual who made a conscious effort to grow love handles or a second chin. I can't imagine that it feels good to have to haul dozens of pounds of adipose around with you everywhere you go. Or to feel like you're giving yourself the Heimlich every time you bend over to tie your shoes. Or to torture your back and your knees by plodding around with the equivalent of a rock-filled rucksack strapped to your waist. Or to wheeze and pant like each breath is your last every time you hike a flight of stairs.

The society we've created for ourselves is a perfect incubator for obesity. Just think about it. For most of us, our jobs entail 8-10 hours a day of mostly sitting. Business people, secretaries, lawyers, accountants, engineers, salespeople, nurses and doctors spend the vast majority of their day glued to one spot with occasional shifts in position. This wasn't true a hundred years ago when farming, ranching, and factory work entailed long days of physical exertion. Thanks to modern technology, today's laborers are now free to spend more of their time sitting rather than pushing, pulling or carrying—even Nebraska’s hardy farmers work their fields in the comfort of air-conditioned John Deeres and tend herds in the cabs of Silverados. With the integration of the computer and automobile into virtually every career field we now spend more time than ever sitting at the desk or in the driver's seat.

Add to this the ubiquity of starchy, high-fat foods. We now have the capacity to cram more calories into every meal than at any point in the history of human evolution. We've progressed from hunter-gatherers—lean, wiry individuals subsisting on home-grown crops and lean game-meats—to super-sizers, looking for our next sugar-starch-grease fix all the while storing a winter’s worth of energy in the adipose around our waist.

Despite this, there are plenty of people among us who manage to fight modern society’s effect on the waistline. In speaking with people who stay thin despite their genetics and the siren song of fatty food I have come to see several pervasive themes:

  • Always stay active. For these people, the key part of the phrase “leisure activity” is the word activity. They go out of their way to walk somewhere even if they can drive; they take the stairs instead of the elevator; they design their vacations around hiking, biking, strolling, etc.; and they find reasons to be up on their feet at work and at home. Above all, they watch very little television (this seems to be a common variable that tends to frequently separate lean from obese individuals). As one person told me “no one ever got thin by sitting on a couch watching America’s Biggest Loser.”
  • Avoid fast food. Home cooking seems to be common among thinner people. “Eat food. Not too much. Mostly plants.” That’s the wisdom we got from Michael Pollan, a journalist who wrote the 2008 bestseller In Defense of Food: An Eater’s Manifesto. His position (echoed by several people I’ve spoken to) is to eat mainly fresh, unprocessed foods and essentially avoid anything that came to us from a chemistry lab rather than a cookbook. Meat, he maintains, is a better side dish than a main course (living in Nebraska, I reiterate this controversial statement at my own peril).
  • Exercise every day. Or at least nearly every day. For followers of the lean lifestyle, exercise is something that has become as much part of their day as eating and sleeping. It’s not something that comes and goes as schedules allow or whenever the New Year rolls around. My wife commented to me that she likes to go to the gym on Fridays and Saturdays because it’s always empty (implying that most people see exercise as only a Monday-through-Thursday activity). Spending a half hour on the elliptical machine for only a few days a week just won’t cut it.
  • Avoid empty calories. Sugar and ethanol are sure-fire ingredients for obesity. You can’t stay thin if you consume significant amounts of sugared sodas or beer. Not only do you get unwanted calories from these beverages but you also get a boost in your body’s insulin level shortly after ingestion. What’s one of insulin’s main jobs? Take up sugar and turn it into fat. Let’s do the math. Thirty minutes of vigorous time on the elliptical will burn about 460 calories. Your 20-oz Pepsi and half a bagel as a recovery snack? 425 calories. Considering you must burn 3,500 calories more than you eat in order to lose one pound you’ll quickly recognize that the Pepsi won’t get you there.
  • Life-long devotion to healthy living. Adherents to the lean lifestyle don’t do fad diets or purchase exercise videos from late-night infomercials. They tend to adopt healthy patterns of eating and exercise that don’t vary much over time. Looking at the foods they eat you might conclude that they are always on a diet, but they don’t see it that way—they’ve done it so long that it has become a comfortable way of life.

A million years ago our pre-historic ancestors spent nearly every moment of the day trying to locate sustenance. I’m sure food was scarce enough that if ever they became lazy and took a couple weeks off they simply starved to death. The opposite is true today. If you become complacent in your effort to stay on top of a healthy diet and regular activity, the prevailing forces of modern society—like a down-going escalator for someone trying to get uphill—will invariably add inches to your waist.

The lean lifestyle isn’t easy—even for people who have never struggled with their weight—but it is probably the best way to fight the battle against obesity and keep your body looking and feeling the way it was meant to.

Eric Van De Graaff, MD
Eric Van De Graaff, MD

Eric Van De Graaff, MD is a Heart & Vascular Specialist at CHI Health Clinic.

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