Reducing your risk of COVID-19 complications

As we’ve all heard, COVID-19 is most dangerous for the elderly, and also for those with multiple underlying health conditions.

This made me glad that Lisa and I had started our health journey in earnest in October 2016, and that we had each lost at least 40 lbs. by the time the coronavirus arrived on our shores.

While we have been taking all of the necessary precautions to avoid COVID-19, we felt good that we also had been building a good foundation of health to reduce our risk of complications in the event we were exposed.

The latest news now is that COVID-19 hospitalizations are surging here in Minnesota, and the Mayo Clinic Q&A podcast from earlier this week (embedded below) featuring Dr. Stephen Kopecky with host Dr. Halena Gazelka digs into how cardiometabolic disease (heart disease plus obesity, diabetes and the like) leads to poorer outcomes for COVID-19 patients.

From my perspective, here’s the money quote:

Cardiometabolic disease is primarily a lifestyle disease….90 percent of cardiometabolic disease is things that we can change, like our stress levels, or our weight, or our exercise, or what we put in our mouth to eat. And maybe these cardiometabolic patients are saying “I’m going to do what I want to do. I’m not going to really pay attention to (what’s best for my health) or I don’t know how to improve my health.” I mean that’s the real problem, people don’t really know. And sometimes it’s very difficult.

Stephen Kopecky, M.D., Mayo Clinic cardiologist

I think for most people the problem isn’t that they don’t care, but rather as Dr. Kopecky says, “I don’t know how to improve my health.”

That’s what it was for me. Four years ago right now I had been following the main dietary recommendations of the USDA, eating healthy whole grains and avoiding fat, and I was doing 30 minutes of cardiovascular exercise most days.

And I was 60 lbs. heavier than I am today.

My cardiometabolic health is much better now. Triglycerides are down 25 points and HDL (the so-called “good” cholesterol) is up by roughly the same amount.

And here’s my blood pressure from tonight, taken using my Qardio home monitoring device:

While I have never been diagnosed with hypertension, I do recall having systolic readings in the 140s. Now that I can measure my blood pressure regularly, I’m consistently in the Normal (and sometimes even Optimal) range.

The reason I’m blogging about my health journey is for all of those who have perhaps given up in frustration, as I almost did.

If you’ve tried to lose weight and haven’t succeeded, or if you’ve lost some through strenuous effort only to have it all come back, I think my story and Lisa’s can help with your “I don’t know how” problem.

So wash your hands and practice other COVID-safe behaviors. And by finding out how to improve your metabolic health, you’ll not only reduce your risks but also improve the way you feel on a daily basis.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.

John Bishop’s Journey

My goal in telling the story of my health journey through this blog has been to simply share what I have learned over roughly the last four years, in hopes that others would find it helpful and encouraging.

Together, Lisa and I have lost over 100 lbs. and we’re feeling better than we have in 25 years. As I have shared this series on my social networking accounts, several friends have asked to talk about what we’ve learned, and we have enjoyed the opportunities to discuss with them.

Other friends have already been putting this into practice for themselves, and are seeing great results.

One of those is John Bishop. I got to know John because he is one of our volunteer community mentors in the Mayo Clinic Connect online patient community. Over the last few months I had seen him sharing some of my posts as part of his community moderation work, and encouraging others struggling with weight issues to check them out.

But when I saw this tweet in reply to one of mine about a month ago, I set up a call to talk with him about his experience.

After our phone conversation, I asked John if he would be willing to tell his story in a guest post, and he graciously agreed. Here it is, in his own words:

I’ve struggled with my weight since my mid 30s.  I weighed 215 lbs when I left the Navy and gradually it crept up to 330 lbs in my mid 50s which was when I started being concerned that I had to do something.  I was able to get my weight down to 300 on my own and then found Weight Watchers through a friend and started their program.  Through Weight Watchers I was able to get down to 250 lbs and decided I could do it on my own since I felt I was the one that needed to make changes.

I did fine on my own for about a month, from that point until this year I was constantly trying one diet plan after another and going between 245 and 260+ lbs every few months.  As much as I tried to eat healthy and do some moderate exercise, I just could not seem to stay on track.  It wasn’t until I read @LeeAase’s health journey article on alternate fasting that I got interested in seeing if I could get my weight down to 215 lbs to help with my overall health and my current health conditions (small fiber PN and PMR).

My wife Lavon was already doing a 16/8 daily fasting so it made it easier for me to try alternate fasting.  I started with a 24 hour fast on March 24, 2020.  I planned to do a 24 hour fast every other day. When I read some encouraging results on Lee’s health journey on using the Zero app and a 20 hour fast with 4 hour eating window, I tried it and found it easy to do after a few days.  I’m now doing the 20 hour fast for 3 to 4 days at a time and while sprinkling in 18/6 or 16/8 days when needed to accommodate other plans.

One thing that the fasting and eating window has done to help me is to make it easier to stop my bad nighttime snacking habits which in retrospect are probably why my weight has always been difficult to control even when I thought I was choosing healthy snacks.

When I started my journey back in January, I purchased an inexpensive Bluetooth scale that shows weight, body fat, muscle mass, water weight and BMI.  My first weigh in Jan 18th was 244.7 and my most recent weigh in Aug 2nd was 222.4. I still go up and down during the week but I’m happy that I’m able to keep a downward trend.  When I reach my goal of 215 lbs my plan is to make a new goal of 200 which is one of those “in your dreams” goals but this time I really think it is a realistic goal and one that would be a major health improvement for me.

As you can see in the graph at right from his Bluetooth scale, John’s weight has been on a steady downward trajectory since January.

He’s down 22 lbs. in just over six months.

Most importantly, he’s no longer finding weight loss difficult, and he’s daring to dream of new goals he would not have previously thought possible.

And while the COVID-19 pandemic has caused many to gain 20 lbs. or more, John is going in the opposite direction.

John at 280 lbs. (left) and now at 222 lbs. (right).

John mentioned that the Zero fasting app has helped him and that he learned about it from me on Twitter, but I just realized I haven’t featured it yet in this series.

It’s a great fasting tool, and I’ll tell more about it in my next post.

See previous posts on My Health Journey, and to get future posts follow on FacebookTwitter or LinkedIn.

Fasting for Longevity

One of the well-established findings in longevity research is that caloric restriction (CR) leads to increased longevity in every animal model, and there is significant evidence CR also improves human longevity.

In other words, in rough terms, consuming 30% fewer calories leads to something like a 30% increase in lifespan.

An interesting finding, but few of us would sign up for that kind of regimen, going a lifetime with reduced calories.

The good news, however, is that you don’t have to do CR for your whole life in order to get most of the benefits: periodic fasting does almost as well as chronic CR.

USC Professor Valter Longo, Ph.D. has gone one step further, developing what he calls a Fasting-Mimicking Diet (FMD) that he says gets the benefit of fasting while still having some food each day. He describes the connection between fasting and longevity in this TEDxTalk from 2016:

Dr. Longo is the author of The Longevity Diet, which describes a program of a basic daily diet along with an occasional 5-day FMD. I’ve listened to him be interviewed on various podcasts and have watched several videos, and I think he does a great job of explaining the science of how fasting reboots the immune system.

If the thought of fasting seems overwhelming to you, maybe you should consider FMD. At the very least, I hope you’ll watch the video above for a primer on why fasting or FMD can improve both lifespan and healthspan.

I personally haven’t tried FMD because I have found that fasting isn’t that difficult for me, and so I don’t feel a need to mimic fasting when I can do the real thing.

In future posts I’ll describe some fasting and time-restricted eating strategies that have worked well for me.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.

We’re an n of 2

The scientific method involves proposing a hypothesis — e.g. “Drug A improves symptoms of Disease B” — and then designing an experiment, or study, to test it.

The “gold standard” studies are double blinded and placebo-controlled. Half of the subjects get the drug, and half get a placebo (or “sugar pill”) that has no expected effect. Neither the investigators nor the subjects know who is getting the real treatment. Then when the data are analyzed, it can be clear that any observed effect is the result of the drug, not wishful thinking.

And to reduce the likelihood that any observed difference is due to chance, scientists design their studies with a sufficiently large n, or number of subjects.

In an earlier post in this series, I conceded that I’m an n of 1. I’m an anecdote. Scientists tend to look down on anecdotal claims. Just because a low-carb diet and time-restricted feeding program has led to me losing 60 pounds doesn’t mean it will get the same results for you.

There could be something peculiar about me that led to this result. Perhaps it’s just a random coincidence. Or maybe just the fact that I had decided to pay attention and try to lose weight was the main factor, and the particulars of what I changed didn’t matter so much.

But together Lisa and I are an n of 2, and we’ve lost a total of 100 pounds on a low-carb diet with intermittent fasting or time-restricted feeding. And the weight loss for her didn’t really kick in until she went low-carb with intermittent fasting.

We’re also not alone. The n of those getting good results from a similar approach is much, much bigger.

And the reality is you can’t do a blinded study of a lifestyle intervention. If you’re switching from pizza and pasta to steak and eggs, you’re going to know it. And if you are going 12 hours a day or more without eating, you’ll know that too. There’s no placebo effect here.

I’m not sharing our stories to boast about our accomplishments. We did have to change what and when we ate, but it truly hasn’t felt like much of a sacrifice.

I’m sharing them because I’m frankly kind of mad that following official government policy (avoid fats, eat lots of “healthy whole grains”) made us fat.

The “eat less, move more” or “calories in, calories out” dogma is trite and simplistic, and doesn’t correspond with the reality of why we get fat.

In the 1950s and 60s nobody worked out. It was only in the early 70s that running and aerobics became “a thing.”

Obesity hasn’t tripled in the last few decades because people don’t move enough. If anything, people in recent decades have exercised much more than our parents and grandparents did.

Exercise is good and important, but its lack has not caused the obesity epidemic.

I’m sharing our stories because I’m pretty confident that among our social connections, and those we can reach through them, there are scores, or hundreds, or even thousands of people who feel as trapped and defeated as we did four years ago.

There is a better way, and there is hope for a reversal of metabolic syndrome. I want to point you to those from whom Lisa and I have learned this.

I’ve previously highlighted pioneers like Nina Teicholz, Tim Ferris, Dr. Jason Fung, Dr. William Davis and Dr. Robert Lustig who have revolutionized our thinking.

As I continue this series I plan to feature several others who also have given us important and life-changing information. Some of those include

I look forward to sharing what we’ve learned from these people and others, and the benefits we’ve seen from applying those lessons. I linked mostly to their Twitter accounts in the list above, in case you want to start following them before I get to writing about them.

Some of them are physicians, while others are Ph.D. researchers, and still others are scientific writers actively poring through the relevant research. They have applied the skepticism of the scientific method to the disastrous dietary dogma that has had such a negative record for the last five decades.

So while Lisa and I together are only an n of 2 and our experience is not definitive, we have seen good results in the last four years through applying what we’ve learned from these people and others.

What other scientific researchers, physicians or writers have you found helpful in understanding diet, lifestyle, weight loss and health? I’d appreciate your recommendations as I continue my journey of exploration.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.

Lisa’s Weight Loss Journey

In addition to being my best friend for nearly 39 years and my wife for more than 35, Lisa Aase has been pursuing health improvement and weight loss with me since October 2016.

We started just after my middle daughter’s wedding, when neither of us felt good about the size of the fancy clothes we bought for the occasion.

I was at about my all-time max of 265 pounds. Lisa doesn’t know exactly what she weighed at the time, because stepping on a scale wasn’t a positive experience. She does remember one reading of 185.

So we both resolved to try a diet, which started by getting rid of all added sugar. I’ve been telling my side of the story through this series, and for the most part it was a continual path of steady loss. Some diets worked better than others, but anything was an improvement over how I had been eating.

Lisa had some extra challenges in being post-menopausal and also having thyroid issues. When we did the Trim Health Mama plan, I lost 15 pounds in three months, while she lost three.

That was really hard for her, because she knew that previously she would have had much more significant results. I suggested that we try a different plan, and had been reading The 4-Hour Body by Tim Ferris, so we next tried his “slow carb” diet. She got better results with this, something like nine pounds in three months. It still felt frustratingly slow to her, but at least she could see some progress.

That’s when I listened to The Obesity Code by Dr. Jason Fung, and we began our 10-week experiment with alternate-day fasting. We learned that by having extended periods of low insulin through fasting we could enable our bodies to burn the ample fat we had stored.

Lisa and I found intermittent fasting (also sometimes called time-restricted feeding) both easier and much more effective than portion limitations. Instead of eating several small meals that never allowed insulin levels to decrease, we would skip breakfast and lunch every other day.

By the time we left for our 6,000-mile Wild West driving vacation in late July of 2018, we were both lighter than we had been for several years.

Having felt like we had accomplished our mission, for the next year or so we were not so diligent in managing our eating habits. I gained about 20 pounds, but was still almost 30 pounds below my peak.

Lisa probably gained a similar amount, but doesn’t know for certain. She had been scarred by her bathroom scale experience, so she didn’t weigh. But when she looked for a dress for our nephew’s wedding, she wasn’t happy with what she saw, and resolved to get serious.

This time she was confident that she knew what would work. Instead of alternate day fasting she would eat one low-carbohydrate meal a day, and to ensure that she wasn’t breaking her fast she switched to black coffee in the mornings starting in December 2019. Going low-carb also enabled her to get fat adapted, eliminating cravings.

She said she wasn’t going to weigh again until she felt good about how she looked, at which point the number on the scale wouldn’t matter so much.

Finally, on March 15 of this year she decided to step on the scale. She hoped to be under 160, which would represent a total loss of about 25 pounds.

She couldn’t quite believe what she saw. She weighed four times just to be sure. Instead of the hoped-for 158 or 159, the scale said… 152.6!

Since then, she’s lost 8 more pounds, and is under 145 for the first time in at least 25 years. In May, she began adding a little cream to her morning coffee without noticeably slowing her weight loss progress.

How does she know? Since May 19 she has been weighing every day, only missing once. A minor weight fluctuation that would have sapped her resolve three years ago is now just another data point in a long term trend that is going in the right direction.

And when our youngest son, John, was married on June 27, her dress was several sizes smaller:

Knowing how hard Lisa was working to lose weight four years ago, and how frustrated and disappointed she was at her slow progress, I’m so happy she has found that a low-carb diet with intermittent fasting gets better results with less effort.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.