Can you exercise your way to a lower weight?

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Hey friends!  Back in April I had just returned from “doctor college” in San Diego and I intend to share bits of what I learned there.  Previous posts in this vein have been:

This post is about exercise and weight loss.  Specifically:  Is exercise an effective way to lose weight?

Hmmm . . . . donuts.

Anybody else have a somewhat idle piece of exercise equipment in your house?  The picture at the top of this post is my actual basement treadmill.  On the plus side, it is a terrific place to hang shirts while ironing.  On the negative side, I’m delinquent in my ironing duties.

It is a pretty rare bird indeed who doesn’t sometimes want to lose some weight.  I’m in this group.  Although I’m a rather skinny, lanky guy – I do have that bit of a gut that hangs out more than I’d like.  And I’m a runner, at least much of the time, so I’m thinking . . . WHAT GIVES?  How can I exercise as much as I do and still have weight in places I don’t want it?

I have been told it is not a dearth of exercise that is leading to a big belly, but it is an abundance of donuts.

And who am I kidding, if there is anything that ought to be in abundance, it’s donuts, I say.

Eat less, Move more

I have often relied on this phrase to sum up my advice to people about weight loss.  it is pithy and makes sense.  If you have to lose weight, you simply have to take in fewer calories than your burn.  It’s simple physics.  Eat less, move more.

When I tell people this, I usually launch into my sermon of ways in which we eat poorly:

  • Portion size.  There is no way on God’s green earth that the size of the soda at the movie theater is good or normal or OK in any way.  Or the popcorn.  Or the huge platters of food at the big restaurants.
  • Calories.  I always say eat fewer calories.  We eat too much!
  • Types of calories.  Traditional wisdom says that we should cut back on saturated fats and carbohydrates.  That, too, makes sense.

The truth is that the actual proven science behind what we eat isn’t so clear cut.  My advice to “Eat less” is good, I think, but it is not the whole story.  We need to take in fewer calories, eat more of the healthy foods, and less far less of it.  And eating a diet more reliant on plants is probably good for us and also the planet.  But beyond that, there is very little evidence that one “diet” is better than another “diet” when weight loss is the goal. That being said, paying attention to what you eat is the most important first step in weight loss.

For more of my thoughts on diet and weight, check out these previous posts I wrote:

I eat too much butter: motivating for healthier living

Just a spoonful of sugar . . . is really not good for you

 

So what about exercising the weight off?

Given the challenges in losing weight with diet and food alone, lots of us look to exercise to lose those extra pounds.  But does it really work?

This is what I learned at doctor school in San Diego this spring:

Short answer:  you can’t count on exercise alone to lose weight.  What really matters when you are trying to lose weight is to focus on your diet.  Simply starting an exercise program without changing your diet will not be sufficient for most people.

Longer answer:  exercise is an important part of long-term weight loss maintenance and overall fitness.

Photo: PH Kenny

No, that’s not me in the picture.

But it is my problem, I think.  When I am at a weight I like, exercise is a good way to stay there.  Going for a run 3 or 4 days a week for a few miles each time not only keeps me happy and fit, but it puts my body in a good balance of calories in = calories out and so I stay about the same weight.

But when I get lazy and stop exercising 3 or 4 days a week but continue eating donuts and beer, my weight goes up about 10 pounds.  And it shows up right where I don’t want it:  the belly.  So exercise helps me maintain a healthy weight.

Take home point:  once I’ve put on those 10 pounds, I do need to start exercising more, but more importantly, I need to alter my diet.

Summary:  

  • Diet + exercise = weight loss.  
  • Exercise alone = weight maintenance.

Sure, it’s an oversimplification.  Being overweight (Body Mass Index, or BMI > 25) or obese (BMI > 30) is complicated with many ways to address it (diet, exercise, medications, surgery for some).  But as for exercise: keep it up to maintain a healthy weight, and couple it with dietary changes to lose weight.

Oh, and here’s a good thing to do:  find out your BMI with this BMI calculator from HCMC.

For a lot more about diet, exercise, and weight loss, you may wish to check out “What works well for weight loss” from the American College of Physicians.

Some of this is just common sense.  But given the overwhelming amount of stuff we hear in the media, online, and anecdotally from our friends and neighbors, it’s tough to know what is good advice.  And so if anyone tells you that you simply need to exercise and you’ll lose weight, without also telling you to change your diet, you may be disappointed.  That’s the real advice!

-David

 

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10 questions to ask your doctor: my interview in the Star Tribune

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Hi, friends,

I was recently interviewed by Allie Shah of the Minneapolis Star Tribune for an article titled “10 questions you should ask your doctor.”   As I mentioned on the Healthy Matters radio broadcast last Sunday, I am posting the link to the article.

Check it out if you wish by clicking the underline link above.  Share or post as you want!

David

 

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Cool event in Minnesota: “Science: Why Don’t Facts Seem to Matter?”

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Hey, gang, just a quick post about an event I want you to know about.  It is called “Science in Society:  Why Don’t Facts Seem to Matter?” and it is happening this Thursday, June 15, from 5:30 to 7:30 p.m. Central time at the Science Museum of Minnesota in St. Paul.

 

The event is hosted by Valery Forbes, Dean of the College of Biological Sciences at the University of Minnesota and is co-sponsored by the ARCS Foundation and the Science Museum of Minnesota.  I’m excited to share a panel with outstanding people who have keen insights on science and communication.

Joining me on the discussion panel are:

  • Patrick Hamilton
    Director of Global Change Initiatives
    Science Museum of Minnesota
  • Maggie Koerth-Baker
    Senior Science Writer at FiveThirtyEight
  • Kris Ehresmann
    Director of Infectious Disease Epidemiology, Prevention, and Control Division
    Minnesota Department of Health

There is a networking portion over light snacks in which promising young scientists will be present to share their work and be recognized as ARCS Scholars.  So we get a glimpse of the future of science through these incredible scholars.  The way I see it, we need to promote science and those who pursue it as a career – now more than ever.

Register at the ARCS Foundation site here.  You get free parking and admission to the Science Museum as part of your registration so make an afternoon and evening out of it!

If you’re a person who likes to think, learn, ponder, question, explore –  and tie it all together with our collective life as a society, then join us at the Science Museum this Thursday.

And if you do attend, be sure to introduce yourself to me!

David

 

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Falls: Humpty Dumpty was just like you and me

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Sobering facts about falls in the elderly:

  • The leading cause of injury that leads to death in people over age 65 is falling.
  • That means 27,000 older adults in the US will not survive a fall in a year.
  • Nearly 1 in 3 older adults will fall in a given year.
  • That adds up to 29,000,000 (yes, that says 29 million) falls in a single year, resulting in 7 million injuries.

Ouch.  So we, like our egg-shaped friend on the wall, need to be careful!

On the radio program last week, my colleague, HCMC Geriatrician Dr. Larry Kerzner joined me in the WCCO studios for a conversation about falls.  If you missed that show, check out the podcast (without commercial breaks!) and listen on your computer or mobile device.  Click the logo here to get to the podcast:

(Healthy Matters show #439, June 4, 2017)

For now, let’s move beyond the grim statistics and learn a bit . . .

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Posted in Geriatrics and aging | Tagged , , , | 2 Comments

Special topics: Lyme disease

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Back in April I posted about medical science and what I had learned at my latest continuing education conference (the American College of Physicians conference in San Diego).  Go ahead and re-read that post to get my thoughts on how to approach medical science.  I had said that I’d be doing future posts about some of what I learned at doctor school in San Diego.  The first of those was a look at Clostridium difficile (C. diff) infections.  Now I’m tackling Lyme disease, much at my own peril since there is raging controversy about this one – at least with some folks.

Here’s what you’ll find if you read on:

  • Lyme disease basics.
  • Acute Lyme disease.
  • Post Lyme Disease Syndrome, which some call “chronic Lyme disease.”

Fasten your seat belts, here we go . . .

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Posted in Infections, Joint and Muscle issues, Quick tips | Tagged , , , | 3 Comments

Ask the Dermatologist!

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Things are very serious in the WCCO studios!

Hey hey!

A couple of weeks ago on the Healthy Matters radio show we featured two of my colleagues from Dermatology, Drs. Jenny Liu and Erin Luxenberg.  You’ll find us in the photo to the left in the WCCO studios in downtown Minneapolis getting ready for the show.

We’re obviously a pretty tense and serious group, eh?

We mostly focused on skin cancer during that show and it was really informative and fun.  If you missed the show, you can listen to the commercial-free podcast by clicking here (Healthy Matters show #434, April 30, 2017).

As usual, we get way more calls, texts, and tweets than we can get to on the live broadcast.  So for this blog post we are continuing the show, in a way, by having Dr. Luxenberg and Dr. Liu respond to some of the text questions from that show.  So if we didn’t get to your question on the air, maybe we will cover it here.

Here goes . . .  Continue reading

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“Don’t worry, at least we will die together!”

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Jerusalem, photo © David Hilden

Hi, friends!

In this post I simply want to invite you to read an essay I wrote which was recently published in a journal I admire.  Called Intima: a journal of narrative medicine, it is a literary place where medicine is explored through story, narrative non-fiction, and art.

My piece is called “Don’t worry, at least we will die together” and is an account of an experience I had back in 2015 while in Jerusalem.

In addition to reading my piece, I hope you will explore Intima and immerse yourself in any of the outstanding works that were submitted.  The journal, which originated at Columbia University in 2010, is a treasure that I hope many of you will come to know.

I haven’t posted much about my interest in Middle East issues, so I’ll give you just a bit of background.  If you do nothing else, please click on the Intima logo above and check out my essay.   For just a little more on my experience, keep reading. Continue reading

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Posted in Dr. Hilden's reflections, Humanities and Medicine | Tagged , , | 4 Comments

Quick tips: C. difficile infection will gross you out

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OK, let’s talk poop.

As promised in my April 2 post, I plan to do a series of short posts about specific medical topics since I recently returned from “doctor’s school” in San Diego at the American College of Physicians meeting.  Missed that post?  Re-visit it at “Should you trust the latest medical advice?”

Today’s post will cover C. difficile infections, or CDI.  This may be the ickiest post I’ve yet done!

First, a warning.  What you about to read may make you go “Ewwww” and may make you wonder what kind of people actually talk about this stuff in polite company.  I’ll tell you who talks about it . . . a bunch of doctors in a classroom on a sunny San Diego day. That’s who talks about it. Lucky for you, I’ll summarize here. Continue reading

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Posted in Gastroenterology, Infections, Quick tips | Tagged , , , | 5 Comments

Pets and peanuts! The scoop about allergies (VIDEOS)

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By yasmapaz from Puerto Rico, via Wikimedia Commons

 

I like dogs.  And I like peanuts.  But like many of you, I also have allergies.  Many of us have a love-hate situation with dogs, cats, peanuts, pollen, dust, mold, trees, flowers . . .

Take a look at this puppy.  Seriously, I can’t even stand the cuteness.

 

 

John B. Sweet, MD

So this past week on the Healthy Matters radio broadcast, I coerced my medical school classmate, Dr. John Sweet, into joining me in the studio.  I’ve known John for years since we actually sat together in lecture back in med school.  He listened to the professor.  I just talked in class. Real surprise, there.

Anyway, John became a terrific allergist.  So this week after the show, we decided to record a series of short videos in which John gives us a few nuggets of solid medical info about allergies.  This post features two of those videos – one about pet allergies and the other about peanut allergies.  (Spoiler alert:  no one gets rid of their pet and yes you CAN give your little ones peanuts to help prevent allergies).

Not much reading on this post . . . you get to watch videos!  We’re all about multimedia so let’s get to it.   Continue reading

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Posted in Allergies, HCMC | Tagged , , | Leave a comment

Should you trust the latest “medical advance”? And koalas too!

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Hey friends!

The plaque in this photo above was a gift from a medical student and hangs on my wall right above my desk. It is a saying reportedly from Michelangelo that I use in teaching medical students and residents fairly often.

I even gave a speech to some graduating medical students called “I am still learning.”  I don’t even think Michelangelo actually said this at age 87 but the sentiment still resonates.  This post is about learning medicine.

This past week I’ve really been going back to school.  I’m now back from several days in San Diego at the American College of Physicians Internal Medicine conference.  ACP is my professional organization, and our annual conference brings many thousands of us together to learn about the latest in medical science, pick up tips for our practice from some of the country’s top experts, and re-connect with colleagues from around the world.

In the next several posts, I am going to highlight for you some of what I learned at the ACP conference in San Diego.  Look for short posts in the coming weeks about:

  • Clostridium difficile infection
  • Lyme disease
  • Zika virus
  • Menopause and depression
  • Pain control and opiates
  • Sleep disorders
  • Restless legs syndrome
  • Blood pressure in older adults
  • Antibiotic resistance
  • Weight loss and exercise
  • Iron replacement
  • Osteoporosis

I’ll try to keep these future posts really short and helpful.

Continue reading

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Posted in Medical research | Tagged , , , | Leave a comment