Physical fitness and weight management are among the most popular topics brought-up by patients. Patients tell us of programs they have started before asking us, their medical doctor, for advice. I am concerned by the trust patients often put in advice coming from television, the internet, or a friend-of-a-friend. They often do not check medical qualifications of the source of information nor check for unbiased evidence of a program’s effectiveness. Many situations are found to be a waste of money at best, or dangerous at worst.

The fact is that achieving physical fitness and controlling body weight is achieved through personal discipline in one’s diet and exercise routine. Most viewers will turn off this video on hearing diet and exercise because they would rather believe the lie that the work can be done for them with a pill or other simple solution. That is disappointing not because they stop watching my video, but because they perpetuate this myth instead of disciplining themselves.

I’ll address both diet and exercise. They both play a role in weight control and fitness, but the benefit of each is slightly different. Diet will play more of a role in losing weight. Exercise will play more of a role in achieving muscle tone and definition.

I do not like to make dietary recommendations complicated. It doesn’t have to be complicated. Simply limiting the total calorie intake is much more of a factor in controlling weight than subtle nuances of proper diet. In the end, it is simple addition which WILL result in weight loss. The discipline involves using the mathematical function of addition EVERY time you eat. I personally did this for nine months straight before reaching the point where I was able to stop. I’m talking about calorie counting. For now I don’t care where the calories are coming from. We can fine tune that as we go. First you just need to track total caloric intake without missing any item that you eat.

I used to hate counting calories. I remember doing an assignment in health class as a young student. I had to look up every food, and most prepared foods had unknown amounts of both known and unknown ingredients. I hated trying to track calories when I knew that my calorie values used for various foods were probably wrong.

Now there is a simplified way to count calories with much improved accuracy over the old days of looking up values of separate ingredients in a book. The age of smart phones and mobile data plans has brought us a great tool to help. Now we have free apps on the iPhone and Android like My Fitness Pal.

You can install apps like My Fitness Pal on your mobile device and get started using it in about a minute. Both individual ingredients or prepared foods can be found and added to your food diary with the tap or your finger. Many restaurant and brand-name food items can be selected to get exact calorie values. The total calories eaten increase as you go, with a display changing to indicate how many calories you are able to eat for the rest of the day. Your total daily allowance is based on your personal data entered when you first get the app. Your personal data includes your age, height, current weight, desired weight goal, and desired rate of weight loss.

Have fun using this app to help you limit total caloric intake. Be sure not to eat less than 1200 calories daily. Watch our other videos on exercise and diet to improve your fitness when you are ready for the next step. Click on the short video titled, “Why Fitness,” if you do not know if you need to change your fitness level. Until then, this is Dr. Mark Vaughan telling you to stay in good health.


Basic Exercise

Welcome back to the Auburn Medical Group program for fitness. Our first video introduced calorie counting using an app like My Fitness Pal. In this video we will discuss the basics of physical exercise.

I have to start with a disclaimer. Starting an exercise plan is harmless for most people, but if you have an injury, a pain, or a chronic illness you should consult your own physician before starting a new exercise routine.

The most important type of exercise is aerobic exercise. This is activity which raises your heart rate to be able to provide enough oxygen to your muscles to support their increased use of energy. There are many benefits to aerobic exercise besides just weight control.

Aerobic exercise also increases stamina and decreases fatigue, it strengthens immune function, and it decreases risk for several health problems, including but not limited to heart attack, stroke, diabetes, and some types of cancers.

Almost any form of exercise can be aerobic if it is done vigorously enough. The way we measure aerobics is by checking the heart rate or pulse. This can be done by checking your pulse at any of several easy to feel arteries including the carotid artery in the side of the neck and the radial artery near the thumb side of the wrist. The heart rate is measured in the number of beats per minute. The target heart rate achieved varies depending on your age. A general formula to determine your maximum heart rate is to subtract your age in years from 220. This number is close to the maximum rate your heart can beat, although it is a little under for most people. You want to get your heart rate somewhere in the range of 60 to 85 percent of your maximum heart rate during your most intense exercise. Some general maximum goals for different ages (are listed in this table) would be in the 160’s for teenagers, in the 150’s for people in their 20’s, around 155 for people in their 30’s, around 150 for people in their 40’s, 140 for people in their 50’s, the 130’s for people in their 60’s, and 130 for people in their 70’s.

Try to keep your heart rate within 20 beats per minute of these numbers without exceeding the recommended maximum. You can use the link in the description to use the calculator provided online by North Shore Medical Center in Massachusetts:

When just starting a new exercise routine I recommend not even trying to achieve a particular minimum heart rate. It is very easy to injure yourself when starting out. Never push past what feels comfortable when starting out. Then start with small goals, like just achieving your goal heart rate for a couple minutes at a time, and gradually increasing. Eventually you want to achieve 150 minutes per week of aerobic exercise.

There is an excellent free app I used when starting to run called “C25K” which provides directions to take you from not exercising at all to running 5 kilometers over a period of 9 weeks. I recommend it for people without certain disabilities who are in generally good health.


Basic Nutrition

I like to keep nutritional principles as simple as I can. It can be very complex, but for most people just paying attention to a few simple basics will make the most impact. It is rare for a person in the developed world to have specific nutrient deficiencies requiring supplementation with the exception of Vitamin D in many elderly.

The most common nutritional problem in my patients is not a deficiency, but an excess of types of nutrition. The biggest problem, both in health impact and literally large size is simple carbohydrates. These are sugars. They are found in sweets and starches. This includes potatoes, rice, bread, pasta, crackers, and chips.

These foods stimulate the body to put food in storage instead of using it for building muscle or using it for energy. The result is that more food is converted to fat and put in storage in the body. These foods also stimulate appetite instead of satisfying hunger, so you eat more than when you eat other foods. These foods are surprisingly high in calories. See our Basic Fitness video for more information on calories.

You may have noticed that I have not pushed for a low-fat diet. Most people will achieve weight loss and lower triglyceride and cholesterol levels through decreasing total calorie intake without specifically trying to reduce fat intake.


Why Fitness
There are several reasons to maintain physical fitness. Being overweight puts you at a higher risk for heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers. Many patients also report having more energy and sleeping better when they are fit compared to when they are overweight. The NIH considers a BMI over 25 to be overweight. This is not a perfect definition, but it works for most people. Exceptions would include very muscular people. The NIH BMI calculator can be found with the link in the description of this program.

Mark Vaughan, M.D. is the Medical Director and founding member of the Auburn Medical Group, an independent Family Medicine practice in Auburn, California. He speaks on general medical topics on the Auburn Medical Group YouTube Channel. His handle for Twitter and Instagram is @doctorvaughan.

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