Healthier U

By Eric Cohen, PN1

Ramadan is the 9^th month of the Islamic calendar and is observed by Muslims as a month of prayer, spiritual reflection and self-improvement.  During this time, most adult Muslims, among other practices, fast (sawm) from sunrise to sunset.  This fast prohibits both eating and drinking.

Because the Islamic calendar is a lunar calendar with less days than the Gregorian calendar, the timing of Ramadan moves around from year to year – meaning the length of the fast changes from year to year and from location to location, depending on the position of the sun.  In 2021, in Toronto – the fast initially runs from approximately 5:15 am to 8:00 pm, lengthening to 4:20 am until 8:35 pm by the end (about a 15 hour fast).

Each day, before dawn, Muslims observe a pre-fast meal (suhoor) and, at sunset, they break the fast with the iftar – a small meal, followed by prayers and then the main meal.  While this may sound like a good way to lose weight (although this is not the intent of Ramadan), in reality, studies show most people gain weight during this period.  Why would that happen?

Ramadan is similar to intermittent fasting – which is very much in vogue these days.  And as we know, intermittent fasting (which means you refrain from eating for a certain period of time each day), only works for weight loss if you consume less calories than you would otherwise.  In reality, people are so hungry after their fasting period – they often eat as much as they would have eaten had they not fasted, or even more – resulting in no weight loss or even weight gains.

So, how can Muslims ensure they don’t gain weight during this period?  By concentrating on the same things you should be doing outside of Ramadan.  Eating healthy, nutritious foods in the right quantities.

For suhoor – the morning meal – don’t overeat to prepare for the day.  But make sure you are eating complex carbs and proteins, which will help you feel full for longer.   Examples include overnight oats with protein powder or eggs or cheese with whole grain bread, and you should include some fruit.

For iftar, try to start by having just water and fruit (like dates)  before the prayer, avoiding the fried appetizers.  This is the point at which you are hungriest and normally start to eat quickly and ‘recklessly’.  By eating and drinking a little bit before the prayers – it will quench some of that immediate hunger and help to ensure you’re not ravenous when the main meal starts after the prayers, therefore allowing you to make better, more mindful, choices.

For the main meal – you will want to avoid fried foods and rich desserts, but most importantly, don’t use this as an opportunity to make up for missed calories, which you can easily exceed.  Just try to eat a normal meal – including proteins, starch, vegetables and fruit.  Remember, you are probably eating this meal after 9:00 pm, so the more fried, sugary foods you eat, the more likely it is to impact your sleep.

A couple of other things to keep in mind:

• Because of the early morning meals and the late-night prayers, many people become sleep deprived, which further leads to making poor nutrition choices.  Recognizing this will help you to realize you have to be even more conscious and mindful of your food choices.

• Coffee can be a problem, as many people can’t have it late at night without affecting their sleep.  And many people will get headaches from caffeine withdrawal during the day.   The best way to avoid this is to start reducing your coffee intake a few weeks before Ramadan starts, so the headaches won’t happen.  Have coffee for suhoor, but for iftar, try decaf coffee or tea, which has less caffeine.

• Continue your normal exercise routine.  Studies on athletes during Ramadan have shown their endurance and performance actually improved during Ramadan (but their strength didn’t).  Rather than making you more tired, exercising during the day will actually boost your energy for the rest of the day.

January 12, 2021|Healthy Eating, Obesity, Weight Loss

Many people decide that New Year’s Eve or New Year’s Day are great times to make resolutions regarding things they hope/desire/wish will happen in the upcoming year. Resolution means a firm decision or expression of intent to do something – but how firm are they really? To be achievable, they should be things we have control over – hoping Covid19 is eradicated is not really a resolution, but deciding you will get vaccinated when it’s available is.

According to studies undertaken by a wide range of sources around the world, most New Year’s resolutions cover three things – Fitness, Finances and Weight Loss/Healthier Eating. Tangerine conducted an online survey in 2018 that showed 69% of Canadians made a New Year’s resolution that year. Of those, 54% resolved to improve their physical well-being and 32% wanted to improve their financial health.

But other studies show that over 80% of people are unsuccessful at achieving their resolutions, with most of them over by mid-February. I was one of those people regarding my health. Every New Year I would tell myself that THIS YEAR I’m going to lose weight, but come December, I was heavier than the year before. Why does that happen and if so few are successful, should we even bother with them? Is it even worth thinking about resolutions?

Forbes Magazine outlined three reasons that resolutions fail, and I think they are pretty close to the mark:

• It’s your consciousness that needs to change before your behaviour can change.
• You don’t have an accountability structure to help you sustain change.
• You are actually scared of, and completely resistant to, achieving this big goal and you won’t let yourself.

If you are aware of these reasons and are willing to try to overcome them, then there is no reason not to consider one or two New Year’s resolutions.

The keys to making a resolution work, including losing weight and/or improving your eating habits, are:

1) Realize that before you can achieve success, you’re going to have to change your thinking and your habits. As Charles Duhigg says in his book, The Power of Habit, “Most of the choices we make each day may feel like the products of well-considered decision making, but they’re not. They’re habits… More than 40% of the actions people performed each day weren’t actual decisions, but habits.” Duhigg goes on to explain how we can change those habits – but it requires consciously changing how we think and act. While it’s not easy, it’s not as difficult as many of us think. (In a future blog, I’ll get more into the cue-habit-reward loop and how we can work on changing our habits.)

2) In order to make these changes initially, and more importantly, to make sure they stick, we need a program to follow – whether it’s eating, fitness or finances. We don’t intuitively know how to do it so we have to learn what we need to know. People have different methods of learning and it’s important to know what works best for you (reading on your own, joining a class or listening to experts), but having a mentor or coach is an important part. Having a program to follow and a coach to work with will go a long way to ensuring that you reach your goals. Even accomplished athletes like Dustin Johnson (golf) and Novak Djokovic (tennis) continue to use coaches because they realize not only can they still learn and improve, but they also know that without them, bad habits will start to creep back into their performance.

3) Overcoming obstacles is another good reason for following an established program. When I started losing my weight, I really didn’t tell many people, probably because I thought if I wasn’t successful, I would look foolish. Others who have tried to lose weight before, and maybe were successful for a short period of time, are thinking more about previous failures than about how they will succeed this time. Or you may worry about alienating friends. Whatever the concern – by having a detailed plan of attack and a monitoring/reporting feedback loop, you are already well on your way to achieving your goal. And you will quickly learn that a lot of people you thought might not want to help will likely go out of their way to help you succeed. Having a support system in place is another key to success.

In the final analysis, there are no downsides to identifying ideally one, or at most two, New Year’s resolutions that you would like to focus on, as long as you keep it focussed on things that you really want to do. But you have to realize it won’t be easy, you’ll have to make serious changes to your lifestyle and you should look for a program that will work for you not just for this year, but on a permanent basis, ideally guided by a coach/mentor that you trust and can talk to and a support system to keep you motivated and on track.

Eric Cohen, PN1

Nutrition and Weight Loss Coach

December 1, 2020

By Eric Cohen, PN1, Weight Loss and Nutrition Coach

One of the biggest challenges people think they have in losing weight and then maintaining their weight loss is a lack of willpower. I said ‘think they have’ because people misunderstand what they need for long-term success. They blame their lack of willpower each time they gain back some or all of the weight they lost.

While willpower can be defined as ‘control exerted to do something or restrain impulses’ (Oxford Languages), motivation is defined as ‘providing a reason to act in a certain way’ (dictionary.com).

Looking at those definitions, willpower has a negative connotation – restraining or controlling things that you want to do. On the other hand, motivation has a positive connotation – giving you a reason to do things.

So, when people tell me that I must have great willpower to have kept my weight off for 16 years and to avoid things that I now understand aren’t good for me – I realize it’s not willpower, it’s actually finding things to motivate me and keep me motivated. I don’t believe my willpower is any better or worse than anyone else’s.

If that’s the case – where does that motivation comes from?

Each person is different and has to find their own motivation. But whatever your motivation – it comes from understanding yourself, understanding nutrition and understanding what works for you. You may be motivated by health issues, by how you look, by wanting to do certain things or wanting to be a role model to someone else. It doesn’t matter what it is – what matters is that you find it and understand it.

Finding this motivation could take time and you could go through a lot of ups and downs along the way. But the key to getting through those ups and downs is to realize very few people are perfect (I only know of one perfect person and anyone who knows me can probably guess who that is ? ). We will all go through those tough times – but it’s important to see them as what they are – opportunities to learn. To learn about ourselves and about what makes us do things – good or bad.

If you believe, like I do, that all the world is a classroom and every day of life is a lesson, then certainly your efforts to lead a healthier life are included in those lessons. And while it sounds trite to some people – TODAY really is the FIRST day of the REST of your life. Each day you get to start over and realize that as long as you make the right decisions TODAY – you are moving on the right path. Whatever happened yesterday is gone – but should not be forgotten. It is your chance to learn from what you did – about yourself, about what drives you and about what influences you. And to make changes as you go forward.

We’ve all heard the quote that ‘the definition of insanity is doing the same thing over and over and expecting different results’. I don’t know who came up with it (it’s been commonly attributed to Einstein, but that’s unlikely) and it is certainly not the medical or legal definition, but it is useful for understanding why we have to change our perspective and our actions from time to time if we really do want to succeed.

But what does this mean for our real, day to day living? It means that in order to succeed in losing weight and keeping it off – you can’t rely on developing some magical willpower all of a sudden that will let you fight off urges and cravings and bad habits that you’ve been giving into your entire life.

It means that you have to find the things that motivate you – avoiding or postponing that hip replacement surgery, getting off and staying off those cholesterol or blood pressure pills, being able to look after and care for those people you love, seeing your children or grandchildren grow up, climbing that mountain (or other bucket list items you have), fitting into clothes that you can buy in a normal store and look good or just being able to walk comfortably.

But these motivating factors can’t be a one-off event like a child’s wedding or a reunion, it has to be something ongoing, something long-term. A one-off event means once it’s past, the motivation is gone too.

And once you find what motivates you – whether it’s one thing or five things – don’t hide it. Put it on your phone and your computer as your screensaver, print it out and put in places around your house so you’re always looking at it (on the refrigerator, by your bed, by your workstation, hanging from your car mirror instead of those fuzzy dice). And when you are presented with a choice – rather than fighting with yourself to avoid the bad choice, use that motivation to remind why you should be making the right choice. And you’ll be surprised how often this will lead you to make that right choice.

According to McGill University’s Office for Science and Society, “North Americans spend over $50 billion a year on various kinds of diet programs and since the 1920s, there have been roughly 23,000 different kinds of diets published”.  Assuming we are mostly fairly intelligent people, that must mean our weight is going down (or at least holding steady at a healthy level) and we must be in pretty good health.

But, no!  We are still seeing people getting heavier and heavier and having more and more weight-related health issues.  As a matter of fact, according to the Public Health Agency of Canada, 64% of Canadians over the age of 18 were overweight or obese in 2017, with an economic cost of over $8 BILLION per year (not to mention the emotional cost).  Between 1981 and 2007/09, obesity rates roughly doubled among both males and females in most age groups.  And along with that, weight related illnesses like certain cancers, Type II Diabetes, sleep apnea, high blood pressure and cardiovascular issues continue to increase.

So, if we have so much information about dieting and spend so much time and money on dieting, why are we continuing to get heavier and sicker?

In my view, ‘dieting’ is exactly the problem. If you look up the dictionary definition for diet, you will find “a regimen of eating and drinking sparingly so as to reduce one’s weight, as in ‘I’m going on a diet’ ”. 

The problem with that is two-fold:

• Eating sparingly suggests not eating enough or always being hungry or giving up some food groups that are required for good health – not a nice way to spend the rest of your life and certainly not something that sounds good for your overall health.
• I’m going on a diet’ suggests that we will start on this thing and at some point, end it – but then what happens?  In most cases, somewhere around 90 or 95%, we go back to the way we were before the diet and gain back out weight – plus more!

It should be obvious by now that diets, especially fad diets, are not the way to go.  Anything that has you taking in less calories will cause you to lose weight.  But is it healthy and sustainable in the long-term?  Overwhelmingly NO.  So what is the answer? 

The answer is changing your lifestyle by learning how to eat properly.  You can eat in a healthy, nutritious manner – resulting in long-term weight loss without being hungry or give up tasty food!  It’s a matter of understanding proper portion sizes, food preparation and planning, nutritional requirements and having the tools to deal with situations that can/will arise.  The thought of making changes to live by for the rest of your life will scare a lot of people, but it is the only way to make it work permanently.  Not massive changes at the start, but gradual, incremental changes as you learn and witness the results.

One of the biggest advantages’ humans have, but also one of our biggest challenges, is that we are omnivores – meaning we can eat just about anything.  It’s an advantage that allows us to live practically anywhere on the planet and survive on what we can raise locally or import.  But it’s also a challenge because when you can eat everything, you often do.  It also means we spend a lot of energy deciding what to eat.  As Michael Pollan explained in his book, The Omnivore’s Dilemma, “When you can eat just about anything nature has to offer, deciding what you should eat will inevitably stir anxiety, especially when some of the potential foods on offer are liable to sicken or kill you.  This is the Ominvore’s Dilemma, … for omnivore’s like us a vast amount of brain space and time must be devoted to figuring out which off the many potential dishes nature (or the processed food industry) lays on are safe to eat… Many anthropologists believe that the reason we evolved such big heads and intricate brains was precisely to help us deal with the omnivore’s dilemma.”

Compare that to monophagous animals like the Koala bear, which only eats Eucalyptus leaves, the Panda bear, which only eats bamboo shoots, or the Black-footed Ferret, which only eat Prairie Dogs.  When they get up in the morning, they don’t spend any time thinking about what they are going to eat today (although they may wonder more than humans about where they will find their food – they aren’t going to a supermarket or Macdonalds), they can spend their limited brain power on staying away from predators.

It’s estimated that people make about 35,000 decisions every day – that’s one every two seconds!  And a lot of those are related to eating.  How much easier would it be if pre-planning or even just better understanding of your food intake could help you reduce those decisions, freeing up time for more important ones.

And while many of us may eat (or think we eat) healthy much of the time, it often goes off the rails when things like stress (global pandemic anyone?) or boredom hit us or we face pressure from others.  At that time, our decision-making abilities often go off the rails as well and we fall back on ‘comfort’ foods, over-indulging or give into peer (or familial/cultural) pressure.

That’s when having pre-determined strategies and tools come into play – providing the knowledge and playbook that will allow you to realize what is happening and ensure you continue to make the proper choices.  It’s really about using those big heads and intricate brains in a new way – using them for their real purpose – ensuring we survive.

Eric Cohen, Certified PN1

Weigh Loss and Nutrition Coach

By Eric Cohen

May 16, 2020

I don’t know about you, but I’m getting tired of listening to, and reading, supposed ‘Nutritionists’ and ‘Health Experts’ telling me it’s okay to gain 15 pounds during the current Covid-19 pandemic.  While it’s never a good idea to give yourself permission to gain weight, it’s even more important to stay healthy during a pandemic.

Giving yourself permission to gain 15 pounds actually means gaining more like 25-30 pounds.  How many people can actually flick the switch at 15 pounds and stop gaining weight once you’re re-introduced those bad habits you’ve been working to eliminate.

And after all of your hard work to get your eating under control and lose weight, you’ll quickly realize it takes a lot more work to lose the weight than it did to gain it.  Think back to the last vacation or Christmas when you gave yourself permission to gain weight thinking you would lose it later.  How long did it actually take you to lose the weight (if you were even able to) that you gained in that one- or two-week period?

And while we’re stuck at home, close to the kitchen, many of us are also moving less.  Garmin, a maker of fitness tracking tools, just released a study titled The Impact of the Global Pandemic on Human Activity. Aggregated data from millions of their users show a reduction in steps taken from April 2019 to April 2020 of 12%.

So where does weight gain combined with reduced activity levels put us with respect to this pandemic?

Recent reports on the impact of Covid-19 showed that a disproportionate number of people that have been hospitalized had high blood pressure, obesity, diabetes or a combination of these.

A paper published in the Journal of the American Medical Association analyzed data from about 5,700 Covid-19 patients admitted to a dozen hospitals in New York City, Long Island and Westchester County (part of the Northwell Health system) between March 1 and April 4.  It showed that nearly 60 percent of those hospitalized had high blood pressure, 40 percent were obese, and about one-third had diabetes. Smaller numbers of patients suffered from other chronic illnesses, such as heart disease, kidney disease and chronic respiratory illnesses. 

Dr. Leora Horwitz, an associate professor at NYU Langone Health, found, as part of the study of Covid-19 patients, that obesity was the most significant predictor of disease severity after age.

Other smaller reports from New York City area hospitals have also highlighted obesity as a complicating risk factor. One hypothesis is that obesity causes chronic, low-grade inflammation that can lead to an increase in circulating, pro-inflammatory cytokines, which may play a role in the worst Covid-19 outcomes.

So, by eating a healthy diet of whole foods and continuing to get regular exercise (even just going for walks), you not only keep your immune system operating at peak efficiency, helping your body to fight off invaders, but you also improve all of the other systems that the disease can either attack or that will allow the disease to infiltrate.  

And best of all, you won’t have to worry about how you’re going to lose those 30 ‘new’ pounds you put on (because we never really re-gain old fat) once we conquer this disease and get back our freedom.