What’s working for my health

Posted on by Eric

Disclaimer: Every body is different, and I am privileged to have a body that works well and adapts quickly when I challenge it. I’m also self-employed, which means I can design my schedule around the investment I want to make in my health, which is a privilege most people don’t have. What I share in this post that has worked for me may not work for everyone.

Background: I had always felt like my health and diet were good enough, better than most. Taking care of myself was never a priority, as I had been blessed with good health throughout my life. I worked out when I felt like it (especially after becoming a parent), and ate whatever I wanted. I still drank soda regularly, and loved eating greasy fried noodles, but figured I must be in good shape because I could go for a 40 mile bike ride without training for it.

But the milestone birthday of 50 a couple years ago, and doing the math of wanting to be an active part of my kids’ lives as they grow up, made me wonder if I needed to be paying more attention to my health, as did watching my father’s declining health.

So I read a few books people recommended on staying healthy, and changed my diet and my exercise routine over the last couple years. I feel healthier and stronger, and look better. A few friends have asked what changed for me, and so this post is to share what I’m doing differently, and why.

This is a long post, but here are the sections so you can jump to the section you want.

Guiding principles
Before I share the specifics of what I’m doing, these are the guiding principles:

  • Reduce glucose levels and insulin resistance, as described by Dr. Jason Fung’s book, The Obesity Code. Insulin resistance can lead to metabolic syndrome, which is a precursor for heart disease, diabetes, and strokes, so managing glucose levels is critical for long-term health.
  • Use it or lose it: Dr. Tommy Wood’s book, The Stimulated Mind, asserts that the brain and body are efficient. If you stop using a function, the body adapts to invest less resources in that function. So if you use your brain less, the brain gets less blood and oxygen because the body doesn’t want to waste precious resources on something that’s not valued. Similarly, if you use your muscles less, they deteriorate faster, especially as you get older. To stay highly functional, keep using your full capabilities.
  • Everything counts: I used to think that exercising meant at least an hour of intense effort, either at the gym or competing in a sport, and that there was no point in getting started if I didn’t have time for that. But then I heard Nsima Inyang describe the “Grease the Groove” technique of doing micro-workouts throughout the day, where even 30 seconds of exercise makes a difference, which is consistent with Dr. Tommy Wood, and Dr. Rhonda Patrick on Instagram. We have a choice, and the choices we make in each moment influence our outcomes.

So how have I applied those principles?

Why I changed my diet, and my current eating guidelines

Let’s start with diet, because that’s the part I missed for most of my life. I figured it didn’t matter what I ate if I exercised enough (calories out > calories in), and that worked for me when I was younger. But as my metabolism slowed down, I didn’t update my behavior to match that reality.

And then I learned that I was on the verge of metabolic syndrome (the precursor to heart disease, diabetes and strokes), with borderline high numbers on four of the five criteria: elevated blood sugar after fasting (high glucose levels), high blood pressure, large waistline (fat accumulation), elevated triglycerides and low HDL (“good”) cholesterol (waistline was okay, which was another reason it took me so long to adopt diet changes). That gave me more motivation to figure out how to reduce the insulin resistance that led to metabolic syndrome.

What made it real for me was wearing a continuous glucose monitor for a few weeks, and seeing how much the glucose levels spiked in my bloodstream after snacks or soda. Two cookies consumed on an empty stomach would spike my glucose to 200 mg/dl and my body would take a couple hours to recover because of the insulin resistance I had built up, likely from decades of drinking soda. The monitor also helped me realize that the times when my energy crashed after a meal were correlated with glucose spikes; when I ate less carbs, I didn’t crash.

The big unlock was reading The Obesity Code, by Dr. Jason Fung, where he tears apart the idea that weight gain is a function of calories. Instead, he makes the case that insulin is the key hormone that controls fat accumulation in response to glucose levels. To address weight gain, we must reduce glucose levels and insulin resistance by 1) eating less carbohydrates and processed foods, and 2) eating less often.

For 1), I mostly followed the 10 hacks of the “Glucose Goddess”, Jesse Inchauspe. Some specific guidelines:

  • Start every meal with vegetables. Vegetables have dietary fiber, which slows down the absorption of glucose into the bloodstream. Carbohydrates consumed alone can cause a glucose spike, but if the same carbs are consumed after vegetables, the increase is more gradual.
  • No carbohydrate snacks or drinks. Coca Cola had always been a go-to pick-me-up for me, so cutting it out had massive benefits (a 12oz can contains 40g of added sugar!). Plus I hadn’t realized that I would often feel low energy after a meal (glucose crash), drink a Coke (glucose spike), then crash again an hour later and want another Coke. Switching snacks from chips or cookies or soda to yogurt or vegetables or fruits (where at least the sugar comes paired with dietary fiber to slow absorption) kept me from replaying that glucose crash cycle.
  • No carbs at breakfast. I used to eat cereal, english muffins or toast for breakfast, or pancakes on weekends. Now I start the day with a breakfast smoothie: protein powder, blueberries for antioxidants, chia seeds and hemp hearts (for extra protein and omega-3), kale or spinach (for fiber and antioxidants), and yogurt (for protein and calcium). One tip I got from Dr. Rhonda Patrick was to not use bananas, because bananas reduce the antioxidant benefits of the berries. Changing to smoothies meant my energy stayed higher (no glucose crashes in the morning).
  • More protein. The health maxxers recommend 1 g of protein per pound of bodyweight. I don’t get there (200g of protein is a lot!), but I eat a lot more protein than I once did (and supplement with protein powder on days I lift weights). Filling up on protein rather than carbs also means I don’t have the glucose spikes and don’t get as hungry from glucose crashes.
  • Supplements. I take creatine (5-10g/day), vitamin-D and omega-3. I don’t like supplements, but there was enough evidence that I was deficient in those that I decided it was worth it.
  • Eat less carbs, especially at restaurants. Don’t eat the bread before the meal. Substitute salad for fries or potatoes when I can, and eat the salad first. Don’t finish the fries or potatoes or noodles, even though I was raised to eat everything on my plate (“children are starving in Ethiopia!”).
  • More whole foods, less processed foods. More home cooked meals, less restaurant and take-out meals. I used to go get a burger or fast food after working out; now I mostly come home and eat a salad with extra meat with maybe a protein shake.

For 2) (eating less often), the main changes were:

  • Drop the snacks. Fung showed a graph of our glucose levels if we snack, and they never return to baseline if we eat every couple hours because the body takes a couple hours to process the glucose from a meal. Eating less carbs as above also meant I wasn’t getting as hungry between meals because I wasn’t riding the glucose spike/crash rollercoaster. When I do have a snack, I try to avoid carbs.
  • No late-night snacks or nightcap drinks. Not eating after dinner lets my body get 12 hours each night without food to clear the bloodstream. My morning glucose levels are still higher than I’d like, though, so I may have to try 16/8 intermittent fasting (skip breakfast so I get 16 hours of fasting each day).
    • This change also helped improve my sleep. I sleep deeper and better when I don’t eat before bedtime, and alcohol definitively lowers my sleep quality.

I don’t follow these principles all of the time, but setting these as my default has made a huge difference. They are sufficiently flexible that I can hold to them even when traveling and eating at restaurants, and I will allow myself exceptions if I have a good reason. But generally following these guidelines has really worked for me.

My current fitness routine
The big changes for me here were doing more strength training (Use it or lose it), and incorporating more movement into my daily routines (Everything counts).

Why strength training? According to Dr. Peter Attia’s book Outlive, humans lose 10-20% of muscle per decade on average as they get older, so it takes consistent effort just to maintain muscle. Plus being strong and stable reduces the chance of injuries, which is vital since recovery is slower and more fraught as one ages. Lastly, “Increasing muscle mass enhances your body’s ability to pull glucose out of circulation and improves overall insulin sensitivity” (thanks, Google AI summary!).

So I joined a nearby gym that has group weightlifting classes, and now go 2-3 times a week. They design programs to exercise the whole body, so I just have to follow instructions. I like the group aspect, because being around other people motivates me to push myself harder than I would at home. And being nearby means I bike or walk to the gym so I add to my movement.

It took a year for me to build going to the gym into my routine. I initially tried to schedule workouts last after I set my work and childcare schedule for the week, but that meant I ended up skipping workouts regularly. Now I schedule the workouts first, and that’s made a big difference to my consistency and results. More on what enabled that change below.

This year, I’ve been adding more micro-workouts (“everything counts”). I installed a pull-up bar outside my office and try to do a set a couple times a day when I walk by. If I’m at the playground with my kids, I’ll do a few pull-ups or push-ups or dips or “Instagram tai chi” (body weight exercises, core twists and rotations); people look at me funny, but my health is now worth more to me than worrying about what they’re thinking. I’d like to add more kettlebell work and pushups at home, but I’m trying to focus on one habit at a time rather than overload myself.

The good news is that like any habit, the more I do it, the easier it gets. Because I’m in better shape, it’s easier to get started and more satisfying to do these movements. I went on a trip a couple months ago without access to a gym, and did the NY Times 7-minute workout every other day to get some body weight strength training. Investing in my strength is becoming part of my identity, to use James Clear’s framing.

Beyond strength training, I am trying to incorporate more movement into my daily life (“everything counts”). It doesn’t have to be high intensity because any movement is better than not moving. I take meetings from a standing desk because “sitting is the new smoking”. I walk or bike for most local errands, including school dropoff and pickup with my fancy cargo bike. We chose our house to be walkable to a downtown, and bikable to most of what we need, so I can minimize driving, which is better for my health and for the environment (plus for trips that are less than 3 miles, biking is generally almost as fast as driving). I generally get at least 30 minutes of movement each day, but would like to add more over time.

In particular, I’d like to add interval training to my routine to improve VO2 Max, a measure of how efficiently my body converts oxygen into movement. That would involve going all out for an interval of time, resting, then doing it again e.g. the Norwegian 4×4 protocol. Ideally I’d like to be running more often (when I went on a work trip without my kids this spring, the hotel was next to a lake and I started each day with a run around the lake and that was amazing!), but haven’t made time for that in my schedule yet. Maybe that’s next year’s project.

The last critical element of a health routine is sleep. 7-9 hours of good sleep is how the body recovers and grows. The standard advice to improve sleep is cooler temperatures, less light, no eating or alcohol or bright lights in the hours before bedtime. When I first read this, I laughed, as I had a newborn baby, and another child who regularly woke up screaming in the middle of the night. But as they both have started to sleep through the night more regularly, I can really feel the difference as my energy and focused attention have started to come back. Sleep really matters!

There’s a synergistic effect of putting all these pieces in place.

  • When I exercise and move my body more, I am more tired at the end of the day so I sleep better.
  • When I sleep better, I have greater executive function which means I am more able to follow through on my intentions to exercise and eat better.
  • When I eat better food, I am better fueled so I’m more likely to exercise, and sleep better because I’m not snacking late at night.

It’s a positive feedback cycle which makes the behaviors more self-reinforcing. But the keystone activity for me is exercise – even if I’m tired and cranky, I will feel better if I go to the gym or get a walk in than if I spend all day on the couch working or relaxing.

Results: Here’s what’s changed for me from following the above routine for the last two years:

  • I went from 22% body fat to 15% body fat while maintaining muscle mass. In fact, when I first changed my diet, I lost 10 pounds (and 4% body fat) in just six weeks (this may have been accelerated by dealing with a newborn).
  • At age 52, I am the strongest I have ever been, able to lift double the weight I could two years ago. This spring, I did 3 reps of squats at 260 pounds, and bench pressed 170 pounds. I used to struggle to do even one pull-up, and can now do 7 (and I installed a pull-up bar outside my office in the hopes of getting strong enough for a muscle up). You can check out videos of me lifting here.
  • More importantly, my body works better. My gym focuses on functional strength, so my core and stabilizing muscles have gotten much stronger. And lifting revealed that I had bad posture – my shoulders were habitually collapsed inward, which led to the bicep tendon getting inflamed. A physical therapist taught me to practice pulling my shoulders back and down all the time; that not only helped my posture, but also led to breakthroughs in lifting because I had better form, and likely improved my mental health (because the mind follows the body, and I was in a constant guarded defensive position).
  • I’m also more aligned with my body. I feel when I’m in an awkward position, and can adjust before I injure or strain something. I notice quicker when I’m triggered into an emotional overreaction – I can’t always stop it, but I can generally manage to walk away or calm down before I do something I regret.
  • I’m the calmest I’ve ever been despite the chaos of raising 3 young kids. I used to feel like I had to be working all the time to prove my worth, because I felt I had no intrinsic value. My trauma explorations have helped me address some underlying issues that showed up as constant tension and simmering anger and resentment. Those issues aren’t totally gone, but they are much reduced. I’ll likely go into what helped with that in a future post.

People have noticed the changes, and asked me what I did, so that’s why I’m writing this post.

What got me to change my approach

The changes I describe above (eat better, exercise more) are not complicated – I had heard this simple advice many times before, but never did anything about it.

So what was stopping me? I like the framework of will, skill, and structure to understand unwillingness to change.

  • Will: You don’t have the motivation to stick with it. What you’re doing is good enough, so you don’t care enough to change. This was my situation for the first 50 years of my life.
  • Skill: You don’t know how to change. You haven’t learned how to do strength training, or move your body safely, or eat more healthily. This is becoming less likely when you can get great advice from YouTube or Instagram, or hire a coach. I certainly had heard all of the advice above, and seen friends doing it, but hadn’t incorporated it into my own life. Skill wasn’t my limitation.
  • Structure: Building new habits is hard, but well documented at this point by BJ Fogg and James Clear. In my case, I knew how to exercise at home, but I wasn’t doing it. It was partially a motivation issue, but partially a structure issue – I didn’t have a schedule or place for it in my life. Joining the gym was a way to create more structure around it (a time and a place to do strength training) and that’s been really helpful for me. The same applied to making healthier diet choices – trying to make a decision in the moment was hard, but just setting the rules above and making them the default was helpful structure.

It would be easy to say that I changed because I increased my motivation and established more structure. I wanted to stay healthy and active so I could keep up with my kids as an older dad, and I had the freedom as a self-employed person to create structure to follow through on that motivation by going to the gym and making the time to prepare healthy whole foods instead of eating takeout or premade frozen dinners. Now that I’ve established new defaults, I think it will be easier to stick to them; I’ve been able to maintain these habits even when traveling, so I hope that if I ever had to go back to a real job, I would find ways to stick to this routine.

But that is not the whole answer. In my case, the real blocker was that I didn’t value my own health and well-being, so I didn’t feel I could make the time for the gym and other self-care activities (even sleep!). My first priority was to do everything else I “should” do for everybody else, both at work and at home, and unsurprisingly, that meant I never exercised because there was never any time left over for me. I felt powerless, which meant that “cheating” by not exercising or going to McDonald’s to get a Coke and a burger gave me the thrill of getting away with something.

So what changed? As I worked through some of my childhood issues, I started to realize it wasn’t selfish to occasionally take care of myself. I have value in and of myself, not solely in my service to others. And I could serve others better if I took care of myself; when I was constantly stretched and exhausted, I was cranky and resentful of the burden I was carrying, and that resentment would boil over into rage during normal parenting interactions, and I did not want to be like my mom in that way.

I also had the paradoxical belief that I was indispensable, even as I also believed that I had zero worth. The family couldn’t function without me, so I had to be there 120% of the time. That was clearly nonsense, but I wasn’t even willing to recognize it as a choice I was making – it was just the way it was with no possibility of changing.

If you’ve read my book, you know the question I finally asked myself: “How are you the problem?” I said I didn’t have time for exercise, but my wife was urging me to take more time for myself and I literally controlled my own time as a self-employed professional. So I ran the experiment (chapter 5) of signing up for the gym, and eventually scheduling my gym sessions as a top priority each week, rather than trying to fit them in after everything else.

The world didn’t end from that experiment; in fact, I felt better when I went to the gym. And, as described above, exercising more meant I slept better, which helped to increase my capacity to do things, so I could commit even more to eating better and exercising more, which unsurprisingly led to greater progress, and slowly shifted my sense of myself from “I am powerless” to “I take care of myself”.

So to answer the initial question of this section, what was stopping me from taking the simple advice of “eat healthier and exercise more” for most of my life? My own sense of powerlessness and worthlessness. I was the problem. In some sense, I knew that, but when I thought about it, I would just beat myself up for not doing the obvious things to improve my health, and fall back into a negative spiral of self-loathing.

How did that change? One small step at a time. It wasn’t one big revelatory epiphany upon turning 50. It was taking one small step (signing up for the gym), then another (experimenting with cutting down carbs in my diet), then another (scheduling my workouts first before coaching calls), then another (committing to move more each day). Each step helped to build the new, positive spiral I described above where working out more led to sleeping better led to better executive function led to eating healthier. And now that structure is mostly locked in, but more importantly, my identity has shifted from “I can’t do anything about my health – it’s just the way it is” to “I can choose each day to live a little healthier”.

And while the results have been great, it took weeks or months or years for the results to become noticeable. I had to learn to get satisfaction from taking action each day, rather than do it for future results. But now I love going to the gym and feeling strong and pushing my limits and joking around with the trainers. I enjoy the taste of healthy fresh fruits and vegetables and have realized how bad processed food actually tastes. I treasure how much better I feel after a good night’s sleep.

This has turned out to be quite the dissertation, but I wanted to share this journey as it has consumed a lot of my attention and energy over the past couple years. Investing more in my health has come at the cost of my writing – the time at the gym is time I could potentially spend writing most posts. But that tradeoff was worth it as I feel I have reached a better equilibrium point in my physical and mental health and now can invest that increased capacity back into writing. So, of course, I wanted to write about it and share what I learned 🙂

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