Dr. Rippe's Blog

As I look over recent titles in bookstores, banners on magazine covers at airport newstands, or the promos for talk shows, not to mention a barrage of print and broadcast ads, I'm convinced once again that Americans' quest for "easy" weight loss keeps a variety of businesses afloat. If you are serious about losing weight and keeping it off (and most people really do want to achieve a healthy weight), then this often conflicting barrage of unfiltered "information" can be confusing. Losing weight or maintaining a "normal" weight status, particularly as we get older, is hard. Who wouldn't be tempted by the idea that following a special eating plan that emphasizes a particular food or food group would help one lose 30 or 40 pounds in four or six weeks? Or what about that idea that you could take a pill and go to bed and it would work overnight to rev up your metabolism and help you lose weight without changing a thing? Tempting as they may be, such approaches to weight loss are short-term at best and just myths (a few possibly harmful myths) at worst.

Over the last twenty-five plus years, my research clinic has conducted hundreds of scientific research studies on weight management that have involved thousands of participants. Our research team has also stayed abreast of thousands of other scientific studies. Although science continues to probe and learn important facts related to nutrition, physical activity, human physiology and genetics and weight gain or loss (among many other aspects), the basic mechanisms of weight gain and weight loss and maintenance of weight loss are well understood. Although each of us is an individual, our weight status depends on our balancing the energy we eat with the energy we expend in the activities of daily life. Specific health conditions or genetic/physical conditions might affect how your body uses energy, but the energy balance equation is valid for all of us: Energy intake must be balanced by energy expenditure to maintain a steady weight. Take in more energy than you expend, gain weight. Expend more energy than you take in, lose weight.

Things get a little complicated for most of us when we try to manage weight because we tend to underestimate the energy we take in and overestimate the energy we use in the activities of daily living and through planned physical activity. That's why the most effective weight loss plans typically have you keep records that record daily intakes/activities or have you follow a specific set plan. Such set plans or tracking schemes help you realistically balance your energy intake and energy expenditure.

Although individual studies may appear contradictory, the overriding preponderance of scientific evidence indicates that the most effective approach to long-term fat weight loss for the majority of people is to combine a reduced calorie diet with a plan for increased physical activity.  Reducing intake of calories by about 500 fewer calories per day than the amount of calories required to maintain your current weight leads your body to burn stored energy. Adding physical activity to the mix helps your body maintain lean muscle ( the body's metabolic engine or "calorie burner") and helps weight loss come from stored fat not lean muscle. The most successful weight loss plans or approaches (and there are a variety) build on these principals.

In the next couple of weeks, I'm going to talk about what stumbling blocks many people (and more than a few "diet plans") run into in trying to implement this principle.  And we'll look more specifically at the traps of some specific weight loss myths.

What are your long-range goals for achieving better balance in your life?  Maybe you plan to get more regular physical activity. Or eat a more healthful diet. Or spend a little more time doing things that are meaningful to you. Or achieve better work-life balance.

Whatever your specific goals, an increasing body of research suggests that the most effective way to make lasting changes is to use the small-step approach.  That means that rather than try to make large changes or a host of smaller changes in many areas all at once, that you identify small, incremental steps that you can take. In over twenty-five years of working with patients and research participants on lifestyle changes, I have seen more who stumble by trying to do too much at once than by taking a steady pace of one change at a time.

Here are some examples.  If you want to get more regular physical activity, taking a ten-minute walk on most lunch hours or right after work can get you started. Or wear a pedometer daily and try to increase your daily steps by steady incredments.

To improve healthy ways of eating, substitute fruit for sugary snacks, for example. Choose whole grain bread or rolls for your lunch sandwich on some days. Add another vegetable to dinner. Reduce portions during all eating occasions.

To increase meaningful activities, look for volunteer activities that you could do once or twice a month to begin with. Working at a local food bank or soup kitchen are just two examples.

There's a Chinese proverb that I've always found meaningful--the journey of a thousand miles starts with a single step. This wisdom can work for each of us.

As kids head back to school and signs of autumn are in the air, can flu season be far behind? Of course, with the concern all summer about the H1N1 flu virus (often called swine flu), most Americans are already on alert. How can you get accurate information about seasonal flu and H1N1 flu? The best source, in my opinion, is the U.S. Centers for Disease Control. You can find up-to-the-moment information on what you should know and do about the flu from one central website www.flu.gov.

The CDC also recommends that your whole family practice commonsense preventive behaviors at all times.

• Cover your mouth and nose when you sneeze. (Flu is mostly spread through the air from person to person.)  If you have a tissue, use that and throw it away after one use.  No tissue? Cover your nose and mouth with your shoulder or elbow if you won't be able to wash your hands or use hand sanitizer right away.
• Wash your hands frequently and after coughing. Soap and water work best. Alcohol-based hand sanitizers also work.
• Don't touch your eyes, nose or mouth to prevent spread of germs.
• Stay home if you get sick. Keep your children home if they are sick.  Stay home until you or a child has been without fever (without using fever-reducing medicine) for 24 hours at least, except to get medical care.
• Avoid close contact with others when you are sick or caring for a sick family member.
• Call your physician if you have any concerns.

For longer term protection I support the CDC's recommendations for getting the seasonal flu vaccine, including who should get this vaccine. For updated information of recommendations about the H1N1 vaccine now under preparation, check the recommended website regularly.