Posted by - J. Rand Baggesen, M.D.

At the Executive Health Evaluation program at the Levinson Heart Hospital we spend hours talking with our patients about how to achieve wellness. Essential to this effort is conscientious plan to use the same discipline that most of our patient’s exhibit at work and apply it to their own personal lives. As the provider of Executive Health services to 10 of the 13 Fortune 1000 companies located in Richmond, we have the opportunity to interact with many incredibly talented people. Many of these folks are very proactive about their health, some however less so.

The Executive Health Evaluation program prides itself at delivering true preventative care with a focus on the enhanced wellness. When it comes to diet and exercise individuals seem to fall into two camps, very motivated and not so motivated. From a physician’s point of view, it’s very important to communicate to patients the essential nature that diet and exercise play in the prevention of disease.

Let’s start with diet. Humans have been on the earth for thousands of years. Our bodies have typically been nourished with small, frequent, high-fiber meals. Humans have traditionally been hunter-gatherers and our digestive systems were made to accept small quantities of food throughout our waking hours. Not until the Industrial Revolution were such large quantities of food available. This has resulted in ever increasing portions which over time have overcome our body’s ability to use these calories. Thus our ever increasing rates of obesity and diabetes.

When you eat a large meal, your blood serum levels of both glucose (sugar) and triglycerides (fats) rise. This stimulates a release of insulin from your pancreas. Larger meals equate to larger insulin release. Sometimes your pancreas gets tired and can’t keep up the demand for insulin resulting in diabetes. When your serum insulin level gets high, insulin stimulates fat cells to store excess calories. High insulin levels also lead to an elevated level of inflammation that can worsen your risk of heart attack and stroke.

Even as a physician, I find it hard to count calories, fat grams and other food intake measures. Alternatively however, I find it easy to understand what size portions of higher-quality foods I personally should eat. I recommend that my patients eat small, low fat, high fiber, moderate protein meals throughout the day. Start with breakfast, Kashi go lean cereal with blueberries and skim milk is an easy way to start the day. A good midmorning snack is some celery filled with Smart Balance omega-3 peanut butter. Lunch of a salad with a small piece of chicken or fish topped with olive oil and balsamic vinegar will keep you going. A handful of dry roasted almonds at 2 p.m., an apple at 4 p.m. provide away to nourish your body and eliminate that voracious appetite when you get home and are most likely to over eat. Dinner consisting of a protein portion the size of half the palm of your hand (4-7 ounces) and a generous portion of vegetables served on a salad plate is very satisfying. A small evening snack of dark chocolate/fruit/frozen nonfat yogurt rounds out your day.

This eating style will maintain your serum insulin and a narrow range. Your brain uses glucose exclusively for energy. Maintaining your blood glucose in a narrow range with small frequent meals will maximize your mental acuity and eliminate those sleepy times in your day. Small frequent meals will also reduce those times of hunger that lead us all too sometimes over eating.

What about exercise? When I talk to a 50-year-old they will often want to exercise to regain their 40-year-old persona. I think of wellness like investing. How do I want my patients to manage their exercise to pay dividends in the future? In other words, I think smart for a 50-year-old to maintain their body in anticipation of being 60 years old.

Thus, cardiovascular exercise is imperative. A 35-45 minute period of uninterrupted aerobic exercise daily will help control your weight, blood pressure and cholesterol over time. Exercising at a pace that leaves it difficult for you to carry on a conversation for this period of time will promote the release of glucagon, a hormone that will help mobilize stored fat, lower your blood pressure, growth of new blood vessels to your heart and a host of other positive effects.

Strength training should focus on maintenance of muscle mass and joint stability. Low weight, high repetition upper body and core strength training combined cardiovascular exercise will also do much to maintain bone mineral density. Flexibility is an often overlooked component to a well rounded fitness routine. Upper body, mid and low back, hamstring and iliotibial band flexibility should be included at the end of the balanced workout.

I am often asked about a wide variety of health supplements. While it would be wonderful to simply take a pill for the benefits of proper diet and exercise, there is nothing available that can match the benefits of taking care of your self. With the coming generation flood of people needing more healthcare, now is the time to start to invest in your own wellness, start your savings program with diet and exercise. Your health portfolio will start to grow and pay dividends long into the future!

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