Take care of your body. It's the only place you have to live. - Jim Rohn
Fifteen years ago my primary physician made a wise observation: “Odds are that something other than HIV will kill you -- stop living to prove me right.”
That was a subtle way of noting that, in the three months since recovering from a severe bout with hepatitis A, I had gained back the 30 pounds lost and more. Not only was I teetering over 200 pounds at 70.5 inches in height, my waist was over 38 inches around, my blood pressure often ran 150/95, and my total cholesterol was high despite a hereditary disposition to low HDL. My body weight was almost 20% fat. If I kept these stats, in fifteen years or less according to the Framingham Risk Calculator [shameless link to my organization’s website], I would be looking at a 10% risk of heart attack over the 10 years to follow.
Knowing that my father suffered heart attacks at 43 and 48, I took my doctor’s words as a challenge to live by numbers beyond my viral load and CD4s.
Like most people struggling with the same realization in mid-life, I had to accept responsibility for the two main causes for my condition: eating crap and sitting on my ass. I also had to be responsible for fixing these habits in what has often felt like a two steps forward, three steps back journey… and I had to learn how to re-interpret these measures along the way as my body would change in manners that might make me seem grossly unfit by other measures. I mean, after 15 years of regular exercise and better eating, I currently make a Body Mass Index of 33 look fantastic!
So, there I was in late October 1998, walking into a gym and meaning business for the first time since my recovery from coma in early 1982. A behemoth gym at that, built in the iconic shell of a former supermarket with rows of weight machines and cardio equipment and three spacious group exercise rooms on the ground floor and a cavernous, testosterone-filled weight room in the basement.
Based on memories of what worked well in the past, I took comfort in elliptical machines, the inclined leg press, and a variety of machines. Within a week I was finding that dripping with sweat after 45 minutes of hard work at 5:45 a.m. felt refreshing. Another week gone by, and having a day without 30 to 60 minutes of some form of strenuous physical activity felt wrong. The change in brain chemistry brought about by routine moderate to intense exercise would keep me coming back over and over, whether I was working at my job or not and even when work had me out of town during the week for over two years.
At the same time I found eating habits that suited my new activity level and my desire for a more healthy cholesterol profile. Doughnuts in the morning were replaced by eggs scrambled with salmon. Fast-food burgers gave way to salads. Snacking on candy and chips became grazing on raw veggies or nibbling on a small handful of nuts. Soon, friends and family thought I was losing weight too quickly, and my physician noted deficiencies in important minerals and electrolytes.
In response, I consulted with a nutritionist at a local HIV services organization. Indeed, I had over-corrected with diet and exercise. The nutritionist had me keep a food and activity journal, and then she introduced me to a Basal Metabolic Rate calculator. While my body needed over 4,000 calories a day, I was barely eating 2,000, and I was failing to get adequate calcium, potassium, and sodium. I started eating low-fat cottage cheese or cheese sticks with fruit as snacks while adding more veggies to meals with lean meats and fish. The weight loss tapered to a more sustainable level, and my body had more material for building lean muscle.
Eventually, I entered a maintenance mode where my challenge has been to keep intake in balance with output while consuming appropriate amounts of macronutrients (e.g. protein, “good” and “bad” fats, sugars, fibre), vitamins, and minerals. I’ve used a variety of wearable technology, online, and mobile tools to assist. And I’ve incorporated yoga and other movements to improve flexibility in the face of gravity and aging. Instead of enduring cycles of excess and deprivation, I’ve learned to enjoy moderation overall and to let myself eat crap from time to time in exchange for added activity or compensating dietary restraint.
As of my last lab encounter on September 30, at age 48 my 10-year risk of heart attack was down to 2%.