The common knowledge about heart health is that fat is the enemy. In recent years we’ve tweaked that idea with the concept of “good fats” in moderation, but basically “low fat” has been the wisdom we’ve heard from doctors, the media, and the government.

Peter Attia is a surgeon with an extensive background in mathematics and statistics who has been intensively researching heart health, weight loss, and many related physiological processes for the last several years. The problem, Attia, says, is that the actual scientific research points in completely the opposite direction: it fingers carbohydrates, especially sugar, as the heart killer, the clogger of arteries and generator of flab. Fat, according to the research he’s talking about, is not just benign–it’s crucial, because we still need a source of energy in our diet, and if we cut out fats and carbohydrates we have nothing left but protein, which isn’t a great source of energy and is comparatively very expensive to boot.

So the idea is to eat enough fat to feel sated and to keep consumption of carbohydrates, especially sugar (and especially especially high-fructose corn-syrup, a.k.a. HFCS) low.

If you find yourself thinking that Attia is some kind of obsessed weirdo with unscientific ideas about fats, I suspect you may change your mind if you read some of the in-depth, highly analytical posts on the subject he has on his Web site, eatingacademy.com. (It’s just an informational site, by the way: he’s not selling anything.) Though come to think of it, it might make the case a little more clearly and effectively if you just take a look at the guy. Does he not look like he understands something about weight loss, heart health, and physiology?

So I encourage you to take a look at his site. If you’re concerned about cholesterol, which was the main thing that got me interested in Attia’s writing, here are a few key points as I understand them:

• Cholesterol is an important material our body uses to repair cells, and without it we’d die–yet as we know, it can cause heart attacks, strokes, etc.
• Almost every cell in our body can manufacture cholesterol, and the great majority of cholesterol in our bloodstream is cholesterol our bodies have made.
• Very little of the cholesterol we eat stays in our body: most of it isn’t absorbed. (Attia explains the how and why of this at length.)
• Therefore, the amount of cholesterol we eat doesn’t have much to do with heart health at all.
• By contrast, carbohydrates–especially sugars–tend to cause cholesterol to embed itself in artery walls and build up there, a condition called Atherosclerosis.
• It’s not the total amount of cholesterol in a person’s bloodstream that indicates danger of Atherosclerosis, but rather the number of cholesterol particles, because the particles can be different sizes and carry different amounts of cholesterol, and it’s the smallest ones that are most dangerous.
• The usual “cholesterol test” most of us have been given measures only the total amount of cholesterol and are therefore fairly useless in predicting Atherosclerosis and related conditions.
• Less common tests that measure the number of cholesterol particles in our blood are much better indicators of heart health. (By the way, yes, “good” versus “bad” cholesterol still comes into play.)

Don’t take this from me, because I’m no expert: Attia has a lot more information on it at his site. However, I’m hoping the above conveys the idea well enough for you to decide whether or not you’re interested in hearing more about it on Attia’s site. He’s obsessed with this topic, and for good reason.

I’m not saying, by the way, that I know all this to be true and accurate. However, I’ve found the evidence compelling enough to have shifted from a low-fat diet to a low-carbohydrate (and high-fat) diet over the past couple of months. Since medical tests have revealed I have the beginning of plaque buildup in my arteries, in a way I’m literally betting my life that Attia’s right. If he is, that would explain why greatly limiting my cholesterol intake didn’t seem to help my cholesterol count, and why years of eating just the kind of diet the traditional “wisdom” on the subject dictates led me to the beginnings of Atherosclerosis.

An important, related note: if you do switch to a much lower-carb, higher-fat diet, please, please do so in a way that takes into account your carbon footprint. Red meat, for example, makes a much worse impact on climate change than plant-based foods–unless you’re getting pastured or grass-fed meat, which is close to carbon neutral . It doesn’t matter if you’re as healthy as a horse if ten years from now you and your family are drowned in the latest superstorm, or are starving due to a global famine brought on by changing climate, droughts, floods, and pests. I don’t mean to be a wet blanket here, but it’s important for me to mention it. If you’re interested in becoming part of the solution to climate change rather than the problem, check out the things I’m posting at www.faceclimatechange.com and consider switching to much more local food sources; see www.localsource.me .

Science Daily reported recently that a new study by researchers from St. Luke’s-Roosevelt Hospital in New York City and Columbia University seems to have found a link between how well we sleep and how badly we eat. In the study, people who were didn’t get enough sleep tended to feel hungry more often, eat more, and gain more weight. While this doesn’t mean we can somehow “sleep away the pounds,” it does suggest that sleeping well makes it noticeably easier to eat well–and we already know that eating well, in turn, helps us sleep better.

In other words, paying special attention to getting enough sleep, which for most of us means making a decision to go to sleep earlier at night, can help us eat better and feel more healthy, which in turn can help us sleep even better: a snowball effect, though I can’t tell you whether the effect would be small or large.

You can read the Science Daily article here, or click on the following link to see the abstract for “Alterations in sleep architecture in response to experimental sleep curtailment are associated with signs of positive energy balance” from the American Physiological Society.

Disclaimer: I’m not a doctor or a nutritionist or a health professional of any kind. Don’t take anything in this post as official advice: I’m just documenting an experiment I’ve been trying.

Is breakfast really the most important meal of the day? For years I assumed it was. When I was a kid, I vividly remember a public service announcement starring Bill Cosby in which he illustrated how, if you don’t start the day with a good breakfast, you “run out of gas.” (Sadly, YouTube has failed me in finding that clip. Maybe my memory has glitched and it wasn’t Bill Cosby. Someone else on the Internet thinks it was O.J. Simpson.) Also, it just seems like common sense: food is fuel, and if you don’t fuel up at the start of the day, you won’t have any energy.

Except that I’ve been skipping breakfast most days for weeks now, and if anything I’m more energized–and freakishly, less hungry!–in the mornings. What gives?

Tempting ourselves because we’re not hungry?
About six weeks ago, I tweeted about  an article called “The Breakfast Myth” in which J. Stanton makes some thought-provoking points about breakfast. One that particularly struck me is how much breakfast often resembles dessert or snacks: it features sugary, starchy, and fatty foods like sweet cereals, pastries, sweetened yogurt, pancakes or waffles or french toast with syrup, toast with butter, bagels, granola, or even sweetened “protein bars.” True, there’s always the traditional fat-and-protein breakfast of eggs and bacon or the like, but at least here in the U.S., the snack/dessert breakfast seems to predominate.

There are a lot of different conclusions we could try to make from this information, but Stanton’s struck a chord with me: the reason we’re eating these treat-like foods for breakfast could be that we’re not really hungry in the morning, and so especially tempting foods are the only thing that can get us interested in eating. Sure, we’re used to having a meal at that time, and out of habit (both mental and physical) we expect to munch on something soon after we get up, but are our bodies really clamoring for food?

I can’t speak for anyone else’s body, but it appears that my body isn’t. In the past six weeks, I decided I would only eat breakfast in the morning if I were actually hungry. As a result, I find I eat breakfast, on average, maybe twice a week. I seem to be more likely to be hungry in the morning if I’ve had an intense workout the night before or (interestingly) if I’ve had a lot of sugar the night before–something I try to avoid.

I do sometimes feel mildly queasy for short periods during the morning, but this hasn’t felt like much of a problem. I’ve also found that sometimes when I feel as though I might be hungry, I’m actually thirsty, and some water hits the spot wonderfully.

The history of breakfast
Ever wonder where that saying “Breakfast is the most important meal of the day” came from? Stanton answers that question (I was also able to find some evidence to support his conclusion), and the answer isn’t some nutritional authority or medical association. Did you ever read Franz Kafka’s short story “The Metamorphosis” (“Die Verwandlung“), in which a young man named Gregor Samsa wakes up one morning to discover he’s turned into a giant cockroach? It appears to come from that story. The earliest appearance of that statement appears to be this passage:

The washing up from breakfast lay on the table; there was so much of it because, for Gregor’s father, breakfast was the most important meal of the day and he would stretch it out for several hours as he sat reading a number of different newspapers.

Gregor’s father is not especially demonstrating good nutrition or productive habits. He’s not making a general statement about human physiology. He’s not even an actual person! So let’s throw that one away right along with “It takes 21 days to form a habit” (it doesn’t: see “How Long Does It Take to Form a Habit?“).

Stanton suggests that humans didn’t evolve to eat breakfast because early humans wouldn’t have had anything lying around to eat when they woke up. That seems like a bit of a stretch to me: why not have a few berries or a root or some smoked antelope haunch sitting by, as long as you have a fire to keep the predators away? Whether I have an evolutionary explanation or not, though, I’ll go with my gut–literally. Generally speaking, it says it doesn’t want breakfast.

Other problems that didn’t come up
Some problems you might expect to see with leaving out breakfast haven’t materialized for me. As I mentioned, I have at least as much energy as when I ate breakfast, and possibly more. This may have to do with how we metabolize sugars (and starches, which break down into sugars): they can cause insulin spikes in our bodies that clean out all the sugars and can lead to a sugar crash, not to mention the mid-morning munchies (which I also haven’t had when skipping breakfast). I haven’t been eating more later in the day, either: so far, I have yet to find any ill effects at all. There have been studies, too, to try to determine whether people who miss breakfast make up the calories by eating more later in the day. As a rule, it turns out, they really don’t.

I should mention that by hungry I don’t necessarily mean I want something to eat–I mean that my body is actually asking me for nutrition. If some morning I start hankering after, say, toasted maple bread with marmalade, I just ask myself “Would you still want something to eat if it were some beans, or baked chicken breast?” Usually, the answer is no. Apparently, in those situations, my mouth just wants something entertaining to munch on. I generally don’t oblige it. Taste bud boredom is not the same thing as hunger.

But what if I like breakfast?
Of course, there’s no reason to give up on breakfast if it’s working out perfectly well in your life. If you’re happy with your nutrition and your morning routine, especially if breakfast gives you a little quality time with the family or something like that, then I say hey, bring on the English muffins.

On the other hand, maybe you’d like to lose some weight, or your mornings are very hectic and tied up in large part with making, eating, and cleaning up after breakfast. Alternatively, maybe you just want to see how you feel if you don’t eat breakfast. In that case, you might consider giving a no-breakfast-unless-you’re-actually-hungry approach a try.

Better breakfasts
Another alternative to consider is healthier breakfasts, especially ones that don’t have much in the way of sugars and starches and instead emphasize protein and fiber, perhaps with a modest amount of healthy fat. This rules out most of the traditional breakfasts and instead suggests things we’d be more likely to think of as dinners: meat, fish, poultry, other kinds of protein (like soy and seitan), some dairy, beans, and vegetables. Eggs are still in, and nuts work to some extent, although they have a lot more fat for the amount of protein they offer than some other protein sources and therefore are something that’s best eaten in moderation.

I started eating these kinds of “dinner” breakfasts when I tried Tim Ferriss’ “slow carb” approach to eating (which gave me some new nutritional tricks, but which overall I can’t really recommend), and I’ve certainly found I’ve been more satisfied by them and more energetic throughout the day than with sugar-and-starch-heavy breakfasts. Beans especially are great to have at multiple meals (though don’t eat the liquid they’re cook in, so as not to have to experience the traditional complications) because they offer vitamins, minerals, and plenty of protein and fiber to help keep hunger away for a good long while.

I have to admit, I rarely felt hungry in advance for a breakfast of, say, fish, kale, and lentils–but I almost always found once I started to dig in that I really enjoyed the food. On reflection, it doesn’t surprise me that I wasn’t hungry for them, since it appears I’m not especially hungry at all in the mornings; I had been used to the “treats for breakfast” mentality. Perhaps if I’d been raised in Japan, my stomach might think differently.

A Japanese breakfast

I’ve said already that I don’t have any credentials as a nutritionist or physician, and I’ll repeat that now just for emphasis. Who knows? Skipping breakfast may be the quickest route to some terrible disease. However, I’m betting the opposite, that listening to my body and not eating in the morning if I’m not hungry is going to be the most healthful approach I can take. For you, I wouldn’t even want to venture a guess, but here’s to whatever your healthiest breakfast turns out to be, whether that’s a traditional one, protein and vegetables, or nothing at all.

UPDATE: After a couple of months of experimentation, it seems that for me, at least, skipping breakfast results in plenty of energy and low hunger, but overall to conflict with even minor weight loss. It might be due to other factors, but when I tried to lose five pounds while skipping breakfast, I found the scale just didn’t budge. Please don’t take that as some kind of final determination in either direction, but it’s a bit of extra grist for the mill. These days I skip or eat breakfast as it suits me, and I don’t have the anxiety about skipping it that I used to when I do skip.

Top photo by lesleychoa
Japanese breakfast photo by herrolm 

Between late 2005 and early 2010, I lost more than 60 pounds as I gradually got the hang of exercising regularly and eating well. From a starting weight of 238, I dropped in fits and starts to 175 while adding a substantial amount of muscle. For the first time in my life, people were calling me “thin” and worrying I wasn’t eating enough (though they don’t need to worry: I’m nowhere near starvation). Since then, I’ve remained fit and active, even while my weight goes modestly up and down within a healthy range.

It’s not just about diet
Eating habits are an important part of getting fit, but in many ways they’re both the harder part and the less important part. The other key piece, of course, is exercise. Does the word “exercise” bring to mind images of people sweating on treadmills while being slowly bored to death, or running beside the road at 5:00 in the morning? Because while it can take that form, exercise can also be easy and appealing. After all, it’s not automatically true that when we use our bodies, we’re uncomfortable or unhappy–in fact, the reverse is closer to the truth. If jumping into hard-core, sweaty, “no pain no gain” exercise doesn’t appeal to you, there are many more tempting ways to get started. The wonderful thing about this is that regular exercise, especially in certain forms, becomes a “keystone habit”: that is, a positive change in behavior that encourages other positive changes.

Walking
I’ve heard it said that walking burns about as many calories per mile as running, but this turns out not to be true. In fact, if you look at net calories burned (that is, how many extra calories we’re burning while exercising compared to the amount we burn to maintain basic bodily functions even if we’re just sitting on the couch), running burns about twice as many calories per mile. Since a typical running speed is in the neighborhood of twice the typical walking speed, this means running burns about four times as many extra calories per hour as walking. (If you’ve heard that walking and running burn about the same number of calories or are just interested in the topic, see this article for some details and the study on which the statement is based.)

However, so what? The time advantage may mean a lot to someone who has no time to walk, but it’s often much easier to make time for walking than for running. There’s little need for special clothing or for showering afterward, so walking is actually a bit more efficient than it might seem in the time department. Walks are also a good way to spend time with friends or family members and a free activity that’s good for everyone involved. Walking lifts moods and provides a good opportunity for conversation. Walks can provide quality time with a romantic partner, children, or adult family members. They can make it possible to meet and interact with neighbors, and they are often an excellent way to improve mood (see “The Benefits of Quick, Easy, Pleasant Exercise“). Walking isn’t just exercise: it can be a mood booster, social time, family time, time to yourself, or a way to get from Point A to Point B (and not be dripping with sweat when you arrive).

Other easy ways in
Other easy kinds of exercise can be more strenuous but more entertaining. Dancing, for example, can often keep a person interested and happy for hours while providing anything from a mild to an intense workout. Speaking from personal experience, you don’t even have to be very good at it to both enjoy it and get the exercise benefits.

In the same way, any safe activity that keeps us in motion and keeps us engaged provides an avenue for exercise as entertainment. At our house, for example, both kids and adults play the outdated “dancing” video game Dance Dance Revolution. Taekwondo is nearly always engrossing for me, in the same way that kickboxing or rock climbing might be engrossing for someone else. Other options include team sports, group walks and bicycle rides, hiking, swimming, and paddling.

Limitations
It’s true that going for a walk twice a week or going out dancing every once in a while alone isn’t likely to make a dramatic difference in health–but it will make some difference, and even if it just means a few pounds lost over a month or two, that’s progress in the right direction. What’s important is that when any kind of exercise–whether it’s easy and entertaining or energetic and effortful–becomes a habit, that habit provides both a sense of competence and a metabolic boost that can set the stage for more improvements, with the end result of a dramatic change for the better.

Photo by Natodd

In the first post in this series, I brought up the question of a perfect approach to willpower, some kind of zone we could get into that would make us automatically able to make the good choices we want for ourselves–exercising more, dealing better with people, eating healthier, working harder, stopping dangerous behaviors, or anything else. Lately I’ve gotten a glimpse of a frame of mind that is something like that zone, a frame of mind that has been making willpower much, much easier for me. Unfortunately, it’s not a single, simple change–but the pieces of it are ones we can master. Here are the ones I’ve been able to puzzle them out so far, and though I’m talking mainly about weight loss, the principles are the same for any other willpower challenge.

1. Resignation
This might seem like an odd thing to emphasize, but it’s become clear to me recently just how essential resignation is. Resignation is saying “OK, so this will be painful or inconvenient or unpleasant sometimes. I can deal with that.” Resignation is saying “I’ll embrace hunger, or loneliness, or whatever the challenge is for me, and find out what there is in it I can enjoy.”

Ineffective fad diets often claim they can help you lose weight without going hungry, or while still eating foods you love. It’s not impossible to lose weight without going hungry very much, or while eating foods you love, but it’s much easier if you’re willing to eat food you find boring, dull, and insufficient. If that sounds joyless, consider: what’s the best source of joy anyway? Yes, it can occasionally be delightful to eat a doughnut, but more often it’s just vaguely pleasant and we don’t pay that much attention anyway. Feeling successful, healthy, strong, and capable, however, pays off in joy consistently.

2. Going toward, not running away from
To eat well, it’s much easier to focus on getting healthy food than on avoiding unhealthy food. To quit smoking, it’s much more motivating to focus on how many non-smoking days one has had so far than on missing smoke breaks.  The more we think about things, the more our brains automatically configure themselves to be ready to do those things. If we spend a lot of time thinking about activities we’re trying to stop or do less of, it will make it harder to avoid them. Instead, we can focus on things that carry us forward.

3. Consistency and commitment
I don’t know how much this is my particular personality and how much this is true for most people, but it’s far easier for me to stop doing something I’m used to than to do just a little of it. For example, in 1985, concerned about environmental impact and mistreatment of livestock, I stopped eating meat, seafood, and poultry. I continued as an ovo-lacto vegetarian for more than 20 years, at which point I found that there were health issues for with my diet as it was (notably, it turns out that I’m allergic to soy and needed to reduce cholesterol consumption), and I added seafood and poultry back in. Vegetarianism was sometimes inconvenient, but it was never difficult. Similarly, I go years at a time without having any caffeine–coffee, chocolate, most sodas, etc.–because my body doesn’t handle caffeine well. That hasn’t been hard either.

By contrast, it can be very hard for us when we try to ration unhealthy foods or TV watching or Internet usage. Rationing seems to encourage us to think more about the things we’re trying to minimize, which as I’ve mentioned causes trouble. So the most successful attitude toward healthy eating for me has turned out to be “I’ll try to make healthy food choices every time.” Yes, there will be situations where I don’t have many good choices, and there may even be situations where I choose something less healthy because that’s the choice that makes sense to me at the time, but my practice now is to stop myself before any “recreational” eating choice and see if I can’t find a perspective that makes me happy to skip it. Not that this is always easy: more on that below.

4. Awareness
In order for me to make good choices, I have to realize it when one of those choices is in front of me. If I have four pieces of pizza in my belly before I remember to think about what I’m eating, then it’s already too late. Accordingly, the first thing I practice is being aware of making a choice. The second thing I practice is being willing to think about my motivations for making good choices. It shocks me how often I’ll realize I’m in a situation where I need to make a good choice and my first inclination is to not think about it. When I get past that and focus my attention on what I’m trying to achieve in my life, it becomes much easier to make the good choices. It’s when I don’t notice the opportunity or do notice but don’t allow myself to think about it that I run into problems.

5. Knowledge
I should say that any positive change needs to be founded on real knowledge. Meaningful facts–whether it’s calorie counts for eating well, knowing that people who have tried to quit smoking before are more likely to succeed when they try again, knowing what markets are available for the novel you’re working on, or really understanding the question of cardio versus strength training–facilitate reaching our goals, while lack of information gets in our way. For instance, if I try to lose weight but don’t realize that some of my “diet foods” are high in calories, I’m very likely to give up, because I’ll see I’m not making any progress.

So those are the pieces–at least, the ones I recognize so far. In the third post in this series, I’ll talk about how these pieces fit together and what it feels like to be fully engaged in changing a habit for the better.

Photo by sean dreilinger

Since I started this blog more than two and a half years ago–actually, no, since long before that–I’ve been quietly searching for the perfect state of mind, the way of thinking or being that would make willpower simple. It always struck me that people sometimes go through experiences that affect them so much that their actions are completely different from that time forward, even though all that changed was their thoughts.

I was talking to an acquaintance the other day about her father. He’s been a diabetic for decades, but he never really got into the habit of checking his blood sugar regularly. It’s hard to blame him: who wants to draw their own blood twice a day for life? A few days ago, though, he called his daughter on the phone and told her something was wrong. His speech was slurred, he couldn’t stand up, and his daughter feared he was having a stroke. She called an ambulance.

The paramedics were able to rule out a stroke, and it turned out that the problem was just that the amount of insulin her father was taking was off. He should have been testing his blood sugar so that his doctor would know if it was getting too low (in this case it was much too low–a little lower and it would have sent him into a coma) and be able to adjust things accordingly.

You might not be surprised to know that my friend’s father is now checking his insulin religiously. Poking yourself with something sharp every once in a while suddenly stops feeling like so much of a nuisance if it’s going to prevent you from collapsing on the floor and going into a coma.

What does this have to do with willpower? Well, I’ve always wondered. On the one hand, I’ve thought, maybe it’s possible to jar ourselves into that state of complete dedication to making the smart choice, over and over again, in the same way my friend’s father was jarred. On the other, maybe that only applies to really traumatic experiences.

A little more background we’ll need to make sense of this topic: I’ve never had a friendly relationship with food. I’m one of four kids, raised in a household where the food budget was sometimes very tight. The kinds of food we liked weren’t always easy to come by, so if something was served that we considered especially good, we’d scarf down our first portion to get seconds before it was all gone. In this and other ways, we all learned some bad ways of dealing with and thinking about food, and for me this has been an issue into adulthood. I was unhappily overweight for years, gradually gaining mass, until about seven years ago, when I finally understood about exercise. I’d always thought it was something that you tried to put up with: I had never realized that exercise could be something you crave, and yet regular exercise made that transformation for me, and with that change along with some hard work to eat better, I eventually lost more than 60 pounds.

Over the past six months or a year, though, I hadn’t been bothering as much about fitness, having family matters to deal with that were a more important place to put my time and attention, and recently I realized I had started putting weight back on. The idea was very unappealing to me, as you can probably imagine, and I focused on the problem to piece together what I knew about willpower so that I could find a state of mind where I didn’t just eat well, but craved eating well–just like I crave exercise. I may have found it, but it’s not as simple as I once imagined it might be. I wasn’t scared into changing my life. Instead, I began looking at things in a different way. In my next post, I’ll talk about what that change of attitude was and how to get to it.

Photo by Chris Rimmer

Blogger Dr. Grasshopper, who practices internal medicine in a large urban hospital, posted this today: “Why Your Doctor Comes Across As An A**hole.” Does your doctor seem uninterested in you? Do you feel hurried out of the examining room? Do you ever feel like your big concerns are being brushed aside? Dr. Grasshopper’s post and the article it strongly recommends (“Neuron overload and the juggling physician” in The Lancet) help shed light on issues you and I might not have considered before. They also cover some interesting points about what needs to be fixed in our health care system. They’re the kind of thing practically anyone could benefit from reading in terms of understanding more about their health, their insurance, and their health care providers.

How we’re like doctors
But I have an additional reason to point to the Lancet article in this post, and it’s that many of us have the same problem those doctors do: too many things to juggle with a brain that is designed to only ever juggle one thing at a time.

In my post “How to Multitask, and When Not To” from a couple of years back, I talk about neuroscientist John Medina’s observations on how attention and focus work. His two key points are:

1. We can only focus our attention on one thing at a time, and
2. Every time we change our focus, we have to do extra work, and we increase the likelihood that we’ll make an error.

For example, if you’re studying from a textbook while sorta-watching a TV program in the background, then you’re creating constant interruptions as your attention moves back and forth. Every time you start paying attention to the program, your brain has to shut down everything you were thinking about what you were reading and then fire up pathways that relate to the TV show. When you look back to the book, the process has to happen again in reverse, but with a good chance that some of the pieces you had in your head a moment ago won’t be included in the re-activation and will be lost.

The benefits of single focus
Even if you only pay attention to 10 minutes of TV during an hour of studying, the number of times you go back and forth between those two things will make your studying much, much less efficient. It’s much better to study for a solid block of time and then watch TV for a solid block of time: you’ll remember more and still have more time to pay attention to the TV show (if that’s what you want to do with your time).

OK, most of us reading this already know that watching TV while studying doesn’t work well. The reason this applies to so many of us is that the same thing is true for any situation where we’re trying to give attention to two things at once–like trying to figure out what to do about a scheduling conflict over the weekend while composing an e-mail at work. It gets even worse when our attention is distracted by many different things.

An example
This is what can sometimes happen to me: I’ll be working on a computer task (for example), be distracted by a new thought about a writing project, realize I need to arrange something for one of the kids, then recall I still haven’t returned a friend’s phone call, then remember that I was supposed to be working on the computer. Each change of focus comes with an inefficient changeover of my mental setup, and the whole process is likely to be enhanced by stress at having so much to worry about and guilt at not getting more of these things done. What’s worse, I may not be staying with any of these tasks long enough to make actual progress.

How not to fall into this trap
The solution is a good organizational system that’s always kept up to date (so that you don’t have to worry about whether or not there’s something in it that you haven’t checked or updated recently) and setting up tasks one after the other, never intermixed if you can help it. (See my post “Useful Book: Getting Things Done” for what I suggest is the gold standard for organizational systems.) If you add to that organization and focus a habit of getting rid of tasks and distractions that aren’t important in your life–or at least getting comfortable with giving them such a low priority that you understand they may never get done–then you have an approach that can yield a much calmer, more productive, and happier day-to-day existence.

Will this help doctors? Maybe not. After all, the problem doctors face is that they’re required to do more work than they can do effectively and at their highest level of skill. Insurance companies and related forces prioritize doctors’ practices. Fortunately, most of us are the ones prioritizing our own lives.

Photo by lovefaucet

Dr. Grasshopper has a marvelous blog about starting out as a young doctor (no, it’s not exactly like Scrubs) and about helping writers understanding medicine, health, and the human body: it’s called “How to Kill Your Imaginary Friends.”

In today’s post, Dr. Grasshopper reminds us to please, please not be a dumba**: see a doctor if your body is acting funny. Alternatively, the post could be considered to be an explanation of how to die unnecessarily at the age of 46 (just a few years older than me). Please read it, for yourself or for a dumba** you love: “Still Alive. I Am, At Least.“.

Men (latrophobes particularly), Dr. Grasshopper is particularly talking to us.

Photo by musical photo man

Here’s Andrew’s final update for his 31 day attempt to lose 20 pounds:

Well team,

Start weight on Feb 28th was 200.8 lbs.  Today’s weight: 193 flat.

I aimed for a 20 lb loss in 31 days.  Was the book even 50% correct?  No.  Was the book even 40% correct?  Just about right. I lost 7.8 lbs out of the desired 20 lbs.

Did I adhere to the regimen perfectly?  Yes.
Did I employ a cheat day each week per the book?  Yes.
Did I use the recommended dosage of vitamins and supplements?  Yes.
Did I employ ice baths and ice packs?  I used ice packs occasionally and only used one hellish ice bath as the book only called for those techniques to lose that grueling last 10 lbs
Did I do exercises before and after meals i.e. air squats and push-ups?  98% of the time.

What went wrong?  I suppose my body needed some time during the 1st week to even get into the swing of things.  I did experience a lot of weight swing throughout the process.  However, and despite the rather large jerks up and down, the end result was very good.

I feel great.  I added a bunch of muscle.  My energy is through the roof.  My heart rate is better than when I started.  I sleep better.  Allergy season barely affected me.  I do not tank during the day or yawn after meals.  When I do eat, the food is piled high, I leave the table stuffed and I am hungry by the next meal.

7.8 lbs in a month is successful if you ask me.

April’s goal is to lose 12 and then May’s goal is to lose an additional 5 so I end up at 175, down from the original 200.8.

Total inches lost (used a neck, waist at naval, waist at widest part, both upper arms, both forearms, both calves, both thighs and my shoulder width):

Total inches:	249,	248.5,	248.5	,246.25	,246.25	,247.75

Why the fluctuation in inches?  1) measuring yourself with a tailor’s tape is a pain in the ass. 2) I dropped fat but I added muscle in my thighs, gluts, calves and biceps.

Good luck everyone and I will post my results at the end of April.

Congratulations to Andrew! His effort has been amazing, and his results, while not a miracle, seem very strong to me. Even the most concerted weight loss efforts normally can’t (and shouldn’t!) cause a loss of more than two pounds of fat per week, although The Four Hour Body asserts that it can accelerate healthy weight loss well beyond that mark.

Andrew’s success rate so far is about 1.76 pounds net body weight per week, and it seems likely that he gained more than enough muscle to put him over 2 pounds of fat loss per week. Especially sustained over a month, these are great results, despite the limitations of scales for measuring fitness (see “Why Weighing In Is a Poor Way to Measure Progress“. After all, the other available options aren’t much better in most respects, unless you can manage and afford professional bodyfat measurements on a regular basis).

What I don’t think we saw over this past month was a validation of any mind-blowing results of the Slow Carb Diet as laid out in Tim Ferriss’ book The Four Hour Body. This isn’t to say I think it’s a bad plan: on the contrary, I’m following it myself at the moment (though in more limited ways than Andrew), and generally speaking, the people I know on it have experienced increased energy and strength, though only sometimes actual weight loss. Better yet, people using the diet seem (in my limited experience so far) to be largely free from hunger and to enjoy their “off-day” or “cheat day” enormously.

The biggest drawback I know of so far is the “carb hangover” that can last for up to two days after cheat day (so three days in all–nearly half the week), resulting in low energy and less buoyant mood. Also, people I know who are following this plan, as I mentioned, are not all losing weight. However, if one follows it as carefully and energetically as Andrew, speedy weight loss (speaking in relative, healthy terms) does seem to be possible. How much of it is simply limiting calories through eating very healthy meals of protein, vegetables and legumes, and how much is exploiting human body chemistry through Ferriss’ many special tactics? I don’t know, and I’ll be interested to eventually find out.

And especially of interest here, how did Andrew manage to adhere so effectively to his diet plan? That’s a subject I hope to discuss with him soon, but his clear goal, his comfort with the idea that the goal was an ideal and not a restriction, and his constant sharing of his progress probably helped. I hope to talk to him more about the subject; stay tuned.

Photo by Bristol Motor Speedway & Dragway

Here are some recent updates from Andrew, who we’ve been following for several weeks as he tries Tim Ferriss’s Four Hour Body approach in an attempt to lose 20 pounds in 31 days (see “Andrew’s Challenge: 20 Pounds in 31 Days“). By last week, it seemed clear that while he was making good progress, 20 pounds was going to be too high a target; he’s now estimating 8.5 pounds lost by the end of his month of effort, which even when we don’t take into account any muscle he may have gained is an impressive amount.

End of 3rd week measurement for TI:

246.25 total inches.  This is down from the start measurement of 249.  Not thrilling results of course but here are the main changes in measurement, despite overall loss of inches:

Waist around navel: smaller
Waist around largest part (a**): smaller
Both thighs: larger
Calves: same or slightly smaller
Upper arms: exact same
Shoulders: potentially .5 inch smaller or the exact same
Forearms: smaller
Neck: smaller

The revised goal or expectation (20 pounds down to 8.5 pounds) seems perfectly fine to me from a self-motivation point of view. True, 20 pounds is more inspiring than 8.5 pounds, but the 5.2 pounds Andrew has actually lost is likely to be better motivation than any merely hoped-for results, as long as it’s thought of as an improvement over the start weight instead of as falling short of the desired weight at this stage in the game. In other words, there doesn’t seem to be anything wrong with setting a high goal as long as it keeps you on the right track and you aren’t discouraged if you fall short of it.

One of the advantages of Ferriss’s approach is that it involves four substantial meals each day (breakfast, lunch, a smaller second lunch, and dinner). The meals are not necessarily exciting or varied, but they’re fairly tasty, very healthy, and they’re filling, so that after an initial adjustment period, physical hunger isn’t a serious issue. In this respect, at the least, Ferriss’s system has a major advantage.

Keep on keeping on, Andrew, and thanks for the updates!

Photo by Arthur van Dam