Health and Fitness in One Page

Over the last six years I have tried to answer the question “What is a Healthy Lifestyle?”. The following is a brief summary of what I have learned. By applying these principles I am in better condition in my late 50s than I was for most of my adult life. I dropped 50 lbs in a couple of years while increasing my muscle mass resulting in my body fat dropping from 33% to 15% measured using DEXA. I went from not being able to run 1 miles without pausing to completing the big sur marathon, did all five passes on the deathride, and completed backpacking trips covering more than 45 miles in a day with >15k ft elevation change. I was unable to do a pull up and now can do weighted body weight pull ups and can now squat almost twice my bodyweight.

Left (30 years old) / Right (57 years old)

Sleep At Least 7 Hours

There is ever increasing evidence that sleep is absolutely critical to a mentally and physically healthy life. Sleep scientists believe healthy adults need between 7-9 hours of quality sleep each night and children require even more sleep. While we don’t yet fully understand all of the ways sleep impacts our health, there are a number of important processes that are primarily activate while you sleep, particularly during the deep, delta wave stage such as:

I experienced the importance of sleep first hand when after a nine month period of sleeping <4 hours/night my body rebelled. For a week I was so exhausted I couldn’t get out of bed for more than an hour. After I partially recovered my boss gave me a copy of the book The Promise of Sleep written by one of the pioneers in sleep research. I learned my lesson, but the damage was done. It took me more than 10 years to be back to “normal”.

I am now very careful to get enough sleep. When I cut my sleep short I am very aware of it the following day. The days following a night that I didn’t get enough sleep my resting heart rate rises by at least 10 bpm for several days and I have a tendency to gain weight. There are numerous things which help me sleep well:

  • Go to bed at a consistent time
  • Get up at a consistent time which provides enough rest. I am not shocked awake by an alarm, I naturally wake up.
  • Use a chilipad to keep the temperature slightly cool.
  • Use a mask over my eyes to keep the “room” dark while sleeping
  • Take a calming walk before bed and avoid things that will aggravate (no Internet / computer use right before bed)
  • Associate bedroom with rest… e.g. don’t do work in the bedroom, no TV
  • Avoid caffeine after lunch
  • Avoid eating food, especially junk food, within a couple of hours of bed.

Eat Healthy Foods

Lifehacker’s the only three things everybody agrees on is a good starting point when developing a healthy diet. What’s the optimal mix of meta-nutrients? Whatever works for you. A combined Stanford and NIH study found that when it come to weight lose, that neither low fat or low carb was superior. My rules:

  • Eat as many non-starchy vegetables as you can, especially those that have deep colors. The caloric density of these vegetables is small enough that you will not eat too much. The vegetables are packed with health promoting micro nutrients and nutritional building blocks. This will also get your fiber consumption up to an healthy level. Fiber is critical to your micro-biome health. These days I strive to have 50% of what I eat by weight to be vegetables.
  • Limit or avoid highly processed food including white flour based bread & pasta, food filled with ingredients you can’t pronounce, and that are high in sugar such as fruit juices.
    • Minimize the sugar in your diet, and eliminate any products that have added sugar. There has been significant evidence since the 1960s that sugar is directly linked to a number of health issues including heart disease.
    • Eliminate all “foods” which are high in trans-fats. There is significant evidence that trans-fats have only negative impacts to health.
  • Eat enough protein to maintain your muscles. A good rule of thumb is >=.5grams/1lb of lean body weight. There is strong evidence that there is no benefit to eating >1.3grams/1lb of lean body weight.
  • If you eat meat, focus on cold water fish and free-range / grass fed animals
  • If the vegetables and enough protein don’t give you enough calories: focus on whole foods which contain resistant starch, beans, lentils, and/or nuts. Feel free to eat fresh fruit in moderation. I believe berries and pomegranates are some of the healthiest fruits. Be aware of what food will make you feel more satiatied.

A great resource for thinking about healthy eating is Reframe Health Lab’s Healthy Eating page which contains links to a short screencast and several resources available on the Internet. It’s worth noting shifting to a mostly plant based diet (eat your vegetables!) is not only good for your health, but for the planet as well because of the inefficiencies of animals converting feed into tissue we eat. For example, cows require at least 8x the amount of feed as we get by consuming them.

I have tried a variety of diets: south beach, the zone, ketogenic, basic 30, vegan, with and without intermittent fasting. Most diets I was on for at least 6 months. I didn’t find any diet significantly better regarding weight management or optimizing bio-markers. Today, I don’t follow a particular diet. My “diet” is never to run a deficit which is more than 22cal/1lb of body fat (what a non-keto metabolism can extract in a normal day), and shooting to get enough protein which for me is between 70-110 grams / day. Normally this means calories are fairly evenly split between carbs, fats, and protein.

Stay Active… Move!

Our bodies are made to move and our brains are made to direct that movement. One of the most natural and health promoting activities is walking.  Walk at least 30 minutes each day, getting a total of >=7,500 steps. There is a huge advantage of getting to just 5-7K rather than they typical sedentary 3K. It is also highly recommended to walk right after you eat because it can help with glycemic control. My experience is when I am walking 15-17K steps / day everything seems to be a bit better. Besides the physical benefits, walking engages our brain, strengthen our creativity, and ability to focus. It’s best if you walk outdoors to get the benefits of movement and the exposure to nature.

Vigorous exercise has many positive impacts. It helps control stress hormones, strengthens the circulatory systems and metabolic systems.  It is often recommended that we should engage in at least 30 minutes of physical activities that raise your heart rate to above 80% maximum 3-5 times a week. The current recommendation is >=150 minutes of aerobic activity / week. I think it best to have 2-3 of these exercise periods focused on developing strength, ideally doing “heavy” work. What’s most important is consistency. Pick activities that you will stick with.

My personal routine is running and/or biking everyday, alternating between a recovery pace and 60-120 minute HIIT/speed workouts. I found that HIIT sessions of 60 minutes (typically warm-up, Little intervals, 10 minutes threshold pace, cool down) produce significantly better adaption / results for me than similar duration static workout at threshold pace or a more compressed time doing tabata intervals. Five days a week I do the The Simple Six for basic strength. I generally get in 12-20k steps each day. Whenever possible I turn work meetings into walking meetings, and time with friends and family are often walking in our neighborhood or on hikes. Whenever possible I walk or biking rather than using a car (grocery shopping, commuting to work, etc).

Your strength will degrade as your age. Peter Attia encourage people to think about Healthspan. In a podcast (I can’t find) he talked about how much strength he would need to develop now, so his 65 year old self could catch a 60lb grandchild leaping into his arms. For a bit of inspiration watch this video.

Some people are really into stretching. I haven’t found a lot of value in stretching as a specific activity. What I have found is that it’s important that the body is warmed up before do something really strenuous. This could be stretching, mobility focused exercise, or just taking it easy for the first 10 minutes.

The last thing to keep in mind is that we often componsate for weakness or pain by changing the way we move. If you are having issues with chromic injury, work with someone who can help you analyze the way you move / perform tasks.

Have Strong Social Connections

The Harvard / MassGeneral Adult Development Study started in 1939 has studying the the lives of two cohorts and now their children found that the strongest predictors of a healthy (and happy) life was an individual’s quality of social relationships. Researcher Susan Pinker found that the secret to living longer may be your social life due to the correlation between social connections and people who are 100+ years old / live in the “Blue Zones”.

For me social connections come from four sources: family, church community, work, and long term friends from past… many of whom I met in school. A key to keeping connections is taking initiative! Inviting people over for dinner or for a hike. Calling people up on the phone just to connect.

Spend time in Nature

One of the best things you can do for your health and wellness is spend some time outdoors among trees and other sources of natural beauty. USDA&USFS jointly published Health and Wellness Benefits of Spending Time in Nature cites a number of studies which have shown time spent in nature, especially when combined with walking has a significant, positive impact to people’s physical and mental health. The podcast Hidden Brain episode Our Better Nature: How The Great Outdoors Can Improve Your Life covers similar material in greater depth. They found that a three day retreat in a forest made significant improves in a number of bio-markers, and that these improves persistent for several weeks. People who got a three day vacation in a city saw no improvements in their bio-markers. The WSJ journal had an article about the benefits of spending time outdoors. A study in Nature’s Science report for that the minimum effective dose for time in nature was around 120-190 minutes in a week, with not additional benefit over 300 minutes. Other studies found the practice of forest bathing helped general health and lowered hypertension; time in forests saw increases in anti-cancer proteins, lowered parents stress, and increase resilience in children.

Jackie and I take a several hour hike in a forest at least once a week, typically Saturday morning. Several times a week we try to take a walk around sunset to enjoy the changing sky. We regularly will take longer duration trips to destinations known for their natural beauty.

Practice Mindfulness

Thanks to Paul Roy to mentioning that something should be added…

There is a growing body of scientific evidence, not to mention millennia of traditions / wisdom that a intentional mindfulness in the form of meditation or contemplative prayer literally re-wires our brains for the good producing improved physical and mental health. There is stunning imagery from fMRI scans while people practices these disciplines showing changes in the areas of the brain that are activated. Mindfulness can improve empathy and gratitude which in turn leads to more joy in everyday life which results in a significant protective effect to health. Gratitude and joy, unlike happiness are not dependent on external circumstances, but rather are an internal response which we can choose.

Though I am not Catholic, I found the Spiritual Exercises of Saint Ignatius to be very helpful. A while ago I wrote about how start with the mind and spirit might be the best way to improve the human condition.

Push Beyond Comfort Zone

Humans are the most adaptable species on the planet. Our adaptability comes from our bodies natural ability to physiologically adapt to highly varied conditions as well as our ability to transform the environment we live in. Civilization has favored adapting our environment to provide a “comfortable” experience rather than encouraging people to exercise their physiological adaption “muscles”. I believe we need to periodically move outside our comfort zones so our body doesn’t “get lazy” and adapts to changes. Example of the adaptability we should cultivate:

  • High Intensity Interval Training (HIIT) produces better performance improvements than more static training in short periods of time.
  • Short duration exposure to heat (sauna) and cold (ice baths)
  • Periodic fasting reset several human systems and can be an effective treatment for several conditions.

Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.

I Corinthians 6:19-20

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