Americans are fatter, and sicker, than ever. And we don't have to be.
We are eating horrendously, moving and exercising less, and not getting enough sleep. This has made us fatigued, depressed, irritable, achy, and generally miserable. And if feeling terrible isn't bad enough, these habits are also making us ill--with diseases like diabetes, heart disease, and many forms of cancer, to name just a few.
What many of us don't realize is that these poor lifestyle habits are causing the cells, tissues, and organs in our bodies to "rust," or age before their time, as many of us walk around in a state of constant inflammation.
When your arteries rust, you might develop heart disease or have a stroke. When your brain rusts, you might develop dementia. Sadly, rusting can begin in early childhood, especially among overweight children. Even children as young as 10 years old have been found to have the arteries of 45 year olds. If we stay on this course, our nation's health problems, already at epidemic proportions, are only going to get worse.
As a preventive cardiologist, I can tell you that our fast-food, sedentary lifestyle is already trumping the advances in medical science that have been responsible for at least four decades of decreasing death rates from heart disease.
For the first time since I started practicing cardiology more than thirty years ago, heart attacks are on the rise in adults ages 30 to 45, the group I call "Generation S," for the sickest generation. This is the first generation to grow up eating fast food and playing video games. Without immediate intervention, for the first time in modern history we will start to see a reduction in lifespan.
Here's why we're fatter and sicker than ever before and what we can do about it:
1. We eat too many sugary and starchy bad carbohydrates
Bad carbs, also known as simple carbohydrates, are the refined, highly processed sugary and starchy foods--including refined white flour breads, bagels, rolls, cakes, cookies, crackers, cupcakes, muffins, sugary cereals, chips, pretzels, and so on--that have had all or most of their natural nutrients and fiber removed.
Because the fiber has been stripped away, simple carbohydrates are rapidly digested and release their energy almost immediately, resulting in exaggerated swings in blood sugar that cause hunger and cravings. Today most Americans eat far too many bad carbs and not enough good carbs, which is one reason we have the epidemics of obesity and diabetes in this country.
What we all need to do is eliminate bad carbs from our diets and replace them with nutrient-dense fiber-rich good carbohydrates--vegetables, fruits, and whole grains, and plenty of them. Studies consistently bear out that regularly eating whole grains, for example, translates into real-world better-health outcomes.
In fact, one study showed that those who reported eating at least three servings of whole grains daily had 10 percent less visceral (belly) fat than those who reported eating whole grains infrequently. Interestingly, the same study also showed that the fat-busting benefits of whole grains were lost when people ate them along with four or more servings of refined grains daily.
2. We eat too much bad fat
As recently as the 1980s and '90s, the conventional wisdom was that all fats were bad. Now we know that there are good fats, bad fats, and really bad fats.
The good fats are the polyunsaturated omega-3s and the monounsaturated omega-9s. Omega-3 fatty acids can be found in good amounts in sunflower seeds, walnuts, and flaxseeds, and in their oils, and in fish (particularly oily fish like salmon and herring).
Omega-9 fatty acids (also known as oleic acid) are found in canola, peanut, and olive oils; in avocados; in nuts such as almonds, hazelnuts, peanuts, pistachios, and pecans; and in seeds like pumpkin and sesame.
Numerous studies have documented a link between the consumption of anti-inflammatory omega-9-rich foods and a decreased risk for developing heart disease, asthma, breast cancer, and other cancers, as well as various autoimmune and neurodegenerative diseases believed to be associated with inflammation in the body.
The bad fats are the saturated fats, found predominantly in red meats and full-fat dairy. Saturated fat raises our bad LDL cholesterol and is associated with heart disease, diabetes, and several forms of cancer. When consumed in excess, calories from saturated fat will crowd out the healthier calories from good fats and good carbs from your diet.
The really bad fats are the trans fats, which can be found in stick margarines (but not in most soft tub margarines, now more commonly known as vegetable oil spreads), in foods fried in hydrogenated oils, and in many packaged snack foods containing hydrogenated or partially hydrogenated oils.
Like saturated fats, trans fats raise bad LDL cholesterol levels. But worse than saturated fats, they can also lower the levels of good HDL cholesterol. Researchers have concluded that trans fats increase the risk of heart disease more than any other nutrient on a per-calorie basis, even when consumed in small amounts, and that they may also increase the risk for obesity, diabetes, Alzheimer's, and cancer.
While much of the research on good fats and bad fats has focused on their impact on cardiovascular disease and cancer, new studies are continually shedding light on how "good" unsaturated fats may also have a beneficial effect on conditions such as osteoporosis, macular degeneration, multiple sclerosis, age-related memory loss, infertility, and other chronic ailments.
This exciting research is in its earliest stages, but what's important to remember is that these studies don't mean you should run out and start consuming unsaturated fats with abandon. All fats, even the good ones, are calorie-dense and should be consumed in moderation.
3. We sit too much
Today, it is possible to manage our entire lives--working, playing, shopping, and even socializing--without ever getting up from our computers.
According to recent statistics, about two-thirds of American adults report that they are physically inactive--that is, they are sedentary most of the time. And only about 22 percent of American adults say that they do any meaningful exercise at all.
To put this in perspective, the 65 percent of the population that routinely drives instead of walks, sits instead of stands, and rides the elevator instead of taking the stairs is at an increased risk for all the chronic conditions I mentioned above and will ultimately pay a high price in terms of their physical and mental health.
In short, sitting at a computer all day can kill you.
I like to think of fitness as a three-legged stool. The first two legs are cardiovascular conditioning and core strengthening. Doing both types of exercise can take less than half an hour a day of your time, and you will reap enormous health benefits in return.
The third leg of the stool is moving--that is, making the effort to incorporate more physical activity into your daily life even when you are not exercising. I'm talking about walking a few blocks instead of driving everywhere, or taking the stairs instead of the elevator, or getting up and walking over to a colleague's office instead of sending an email.
These are the kinds of simple, everyday activities that kept human beings healthy before technology rendered getting out of our chairs obsolete.
4. We don't get enough quality sleep
Unfortunately, many people still think of sleep as a luxury, not a necessity. According to a Stanford University study, 20 percent of American adults complain of excessive sleepiness during the day due to poor sleep at night.
Lack of sleep does not just leave you groggy the next day; its health implications are much broader. When we chronically miss sleep, we are more vulnerable to a whole slew of physical and emotional problems, including obesity, diabetes, heart disease, stroke, and depression, not to mention a weakened immune system.
This sounds a lot like what happens when we eat badly and don't get enough exercise, but it is absolutely true. Sleep is critical for good health.
There is no reason why most people can't get a good night's sleep, but it may take a bit of effort on your part to get there. Very often, making some simple changes in environment and lifestyle can help resolve typical sleep problems over time.
Start by de-cluttering your bedroom and removing any electronic equipment. Emailing, texting, watching TV, or exercising too close to bedtime can make it difficult to fall asleep.
A comfortable bed is also essential. If your mattress is saggy, lumpy, too hard, or if it's more than 7 to 10 years old, it should be replaced. Keep the temperature in the room cool but not too cold--about 65˚ to 72˚F. And do what you can to make sure your bedroom is quiet and dark at night.
In addition, too much stimulation from nicotine, caffeine, alcohol, or spicy foods can also be problematic. Avoid eating a big meal right before bed, since it can rev up your metabolism. Conversely, going to bed hungry can also interfere with your sleep cycle, so work in a healthy snack that contains some good carbohydrates and protein an hour or two before you hit the sack. Also try to stick to a schedule of going to sleep and waking up at about the same time every day.
Finally, if you or your partner is a snorer or if you think you may have a physical, emotional, or hormonal condition that could be interfering with your ability to sleep well, don't hesitate to discuss your concerns with your doctor. The sooner you can work on a strategy to perfect the quality of your sleep, the better. A restorative eight to nine hours every night is your goal.
It's now absolutely clear that a healthy lifestyle--eating a proper diet, losing weight if necessary, and getting plenty of exercise and a good night's sleep--is the surest, safest, best way to prevent the downward spiral that is manifested in our nation being fatter and sicker than ever before. So let's do it.
No one expects you to be "perfect." As my mom used to tell me, "Perfection is paralysis."
Just start making healthier lifestyle choices most of the time.
Dr. Agatston's latest book, The South Beach Wake-Up Call, is an urgent call to action and a life-saving program for reversing the toxic lifestyle that is making Americans fatter and sicker than ever before. Sign Up to Wake Up by taking the South Beach Diet pledge here.
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