Thoughts on exercise

Went to the Healthier Weight support group meeting in Manchester today. The presentation was about the importance of exercise in the body energy balance. In essence, whether or not we lose weight is a function of total calories (energy) in minus total calories out. Since calories out is largely related to activity levels, the more exercise we do, the more likely it is that we will lose weight. Of course it is not so simple as that - it takes quite a lot of commitment, motivation and organisation on our part to make that exercise actually happen.

Personally, I have got into quite good habits when it comes to fitting little bits of walking into my daily routine. However, it's harder to find the time and energy to fit in 'bigger' bits of exercise like long hikes, going to the gym, swimming etc. One of the things that was clear from today's talk was that this kind of activity tends only to happen if it has a very regular place in our daily and weekly routine. This us where I struggle at the moment because my job us quite variable on a day to day basis. That means I start and finish work at different times so find it difficult to fit in visits to the gym etc on a regular basis.

This is where I find having daily and weekly targets on my pedometer helps. My daily target is 7000 steps and my weekly average target is 8,000 steps. I find it quite helpful to look at it during the day - if it says 5790, for instance, then I know I only gave to fit in an extra 1210 before bedtime! This evening I went for a walk-jog for 40 minutes or so - I quite enjoyed it but am tired now. Signing off to go to bed.

Is dieting necessary?

A couple of days ago a reader posted a comment which posed some important questions. In my attempt to answer these I somehow almost deleted the original post and comment and couldn't get it back again - as a comment. However, I did have a copy on my clipboard (phew!). So, since there were some important questions in there anyway I've posted the original comment and my response below. I do hope this was OK by you Amy - thanks so much for your contribution:

Hi Theresa,

I am an avid reader of your blog - has been marked under favorites forever! I have only commented once, though....I love reading about your progress - you are a very approachable writer, if that makes any sense. Anyway, I am wondering if you could be your eloquent self and answer this question....I was banded on June 22 and had my first fill on August 12 - 7ml in a 10 ml band. Before the surgery, I asked my consultant, if he had to use percentages, what percentage of my weight loss struggle would be my own burden, and how much of the struggle would the band take care of? I hope that makes sense to you...he answered he thought the band would do about 75 percent of the work. My question to you is....since you have lost SO much in 9 months, how much of the work did you do, and how much was the band? Your loss has been amazing, and it is early days for me yet, but I am having to overtly and actively "diet" to lose....Your weight seems to have come off very steadily and consistently ...I just had to ask you to try and see your success formula. Again, how much effort was you, and how much the band? Thanks for trying to make sense of the question for me....Amy

Hi Amy,

Thanks for your kind comments and for being such an avid and loyal reader - it's nice to be reminded from time to time that there are actually people out there reading this labour of love! To your question:

My provider, Healthier Weight (Dr David Ashton), liken weight loss with the band to a three-legged stool - remove one of the legs and the stool falls over (ie the band 'fails'). The three 'legs' are (a) the band and the restriction it provides, (b) the calories that go in - what WE put in our mouths, and (c) the calories that go out - through exercise. Using this analogy the band does one third of the work and we have control over the other two thirds. David Ashton told me at my consultation that I would have to do 70% of the work and the band would do the other 30%. These percentages are regularly cited on the UKGastricBand forum.

I think I put in very little of the effort during the first two months post-op because I was swollen and bloated and dealing with healing rather than weight loss. Nevertheless I lost quite a bit of weight during that time. The next five months were the toughest for me because it took a long time to get restriction (many people get it early on but I was not lucky in this respect). I complained a lot that the band wasn't keeping up it's end of the bargain and doing its 30%. I felt I was having to do most of the work by sticking to the band rules, doing lots of exercise and being disciplined. Just as I began to run out of steam I started to get some restriction at last. The last couple of months have been a bit up and down because the band is definitely providing some restriction now, though I am clearly nowhere near as tight as some others, but holidays, celebrations and meals out have disrupted my flow somewhat.

However, through these various ups and downs, I think what has helped me achieve fairly consistent weight loss has been that I decided, right from the beginning, that I was going to change some critical eating habits. These include:

1. Always eat off a side plate and use small cutlery
2. Eat slowly, avoid distractions, chew chew chew!
3. Don't drink for at least one hour after eating
4. Don't put gravy, sauces, mayonnaise etc on anything - keep it all low fat and dry
5. Eat carbs, proteins and veg/fruit in approx equal proportions
6. Practice environmental control - remove from the house anything that isn't nutritious and healthy
7. Aim to walk 10,000 steps per day (don't go anywhere without a pedometer)
8. Keep a food diary - weigh everything, count calories, write it down

Some of this has been a right pain (!), but it's been worth it. It is said that if you do something (whatever it is) for six weeks it will become a habit. It's true. For example, I no longer have to even think about eating slowly it just comes naturally.

I understand that you, indeed I, don't want to diet now we have a band. But I think there is a transitional period between the op and reaching that ideal restriction. If this period is short then lucky you! If it's longer, as it has been for me, then there is a choice - either maintain weight (or even gain) until you get restriction, or use that time to get into good habits and 'do your best'. If like me you continue to lose weight during that time then that's fantastic - but it may mean semi-dieting to some extent.

Gosh I've rambled on (hardly eloquently either!) - I hope that goes some way to answering your question. If it doesn't or you want to ask other questions, PLEASE ask away! I wish you all the best. Just remember this is no quick fix, it's a long haul (I have to keep reminding myself of that), and a key success factor, in my opinion, is getting into good habits early, and putting these good habits into practice most of the time (probably about 80% of the time in my case - I'm no angel!).

Theresa x x

I'm in the Alps!

......Chamonix in the French Alps to be precise. We are here for a week on our second holiday of the year (yes I know, a bit greedy, but it's been a hard year). We're staying in a lovely apartment which we booked at the last minute and it has beautiful views of the glacier up valley. Our intention this week, is to relax and enjoy ourselves by getting out and about, seeing the sites and doing as much walking as possible! This place truly is a walkers paradise. There are cable cars and other lifts that get you up to the higher plateaux and ridges and you can walk from there. So, doing a long high level walk doesn't necessarily mean having to flog for miles up steep mountain slopes first.

We only arrived yesterday so just went for a gentle walk today - though having said that I've still managed to clock up about 19,000 steps on my pedometer! Although I am trying to be reasonably sensible about what, and how much I eat, I'm not going to be obsessive about it. We are mainly eating out in French restaurants and they are not known for being that vegetarian-friendly, so much of the time I will have to take pot luck! I don't think to need worry too much anyway about calorie intake because I'll be burning plenty of calories this week for sure.

I have a fairly reliable Internet connection so should be able to keep posting and keep you up to date. I hope to include a photo or two in the coming days.

Ice cream treat for a dark walk

On Bank Holiday Monday this week I decided to go for a decent walk - somewhere. After taking an absolute age to make a decision as to where I would go, I headed off for toward the eastern Pennines (east of Manchester). I ended up walking along a stretch of the Pennine Way, a 300-mile trail that goes from the Peak District in the south to near Hexham in the north east of England. Funnily enough, I've always cherished a quiet ambition to walk the whole of the Pennine Way - it takes about 21 days and local folklore is that if you can manage the first three days - you'll get to the end! This is because the first three days takes you over the highest and remotest moors of the so-called Dark Peak. It's so-called because it's composed of the dark-coloured local Coal Measures Gritstone and gives rise to enormous plateaux of deep, dark peat. The appearance of this upland moorland country is bleak and somehow threatening - but nevertheless impressive and spectacular. I would still love to walk the whole trail someday - I'd just have to find three weeks off work......

Well anyway, on Monday, I found myself walking along a section of the Pennine Way that would normally be met on about day three if you were doing the whole walk. I took in the peak of Black Hill (an ominous name, eh?), standing at 580m in the midst of a broad, windswept, dark plateau (see photo). The path began as a pleasant amble across open grassland but quickly ascended up to, and along, an exposed gritstone edge overlooking a stream valley, Crowden Brook. This was quite pleasant until the rain started to fall more heavily. Later, the route opened out onto the plateau top where the wind mercilessly ripped through my supposed windproof clothing. I met a man at the summit who was looking for a group of girls doing the Duke of Edinburgh award scheme - but at that point I hadn't seen them.

After a hastily eaten 'lunch' (at about 2.30pm!) of cold sardines and some salad (!) I bid a hasty retreat down to the more sheltered route back along the stream valley. The rain was falling hard now and the wind just as vigorous so there was no realistic possibility of being able to sit down anywhere to eat. Consequently, I only ate half my lunch. This is not unusual when I am out on a walk - I tend to get much more thirsty than hungry and I often don't eat my lunch until I get back to the car! I still haven't really managed to design an ideal 'walking lunch' though. I posted a couple of months ago about some dismal failures of lunches taken out onto the mountains with me - I still don't seem to be able to get it right. I suppose I am looking for a lunch that satisfies all the restrictions and requirements of being a bandit, while at the same time providing plenty of energy for high energy-output activity. I guess I'll keep experimenting......

I met the 'missing' group of girls on the way back and had a little conversation with them - they looked as though they needed a bit of encouragement - they were wet through, carring heavy ruksaks and looking very tired! As was I after a couple more hours of walking! I returned to the car at about 6pm, after 5 hours of solid walking. I was rather damp but not seriously wet. I was quite tired - I think walking in wind and rain is more tiring than walking in fine weather. I ate the remainder of my lunch in the car before setting off back to the warmth and dryness of home. I'd walked about 14km, ascended about 500m and clocked up 22,000 steps on my pedometer - burning about 1800 calories!!!

That evening I decided to treat myself - we went to the cinema to see "State of Play" and I ate a huge ice cream sundae! Before going to bed I did my usual calculations to see how many calories I'd burned, how many I'd eaten and the totally calorie deficit etc for the day. Even with the ice cream, I had a total calorie deficit for the day of 1900 - more than half a pound!!! Perhaps if I'd known that I could have had two ice creams.....

.....only joking!!

The photograph (from http://www.geograph.org.uk/photo/616922 ) is copyrighted but also licensed for further reuse (under the Creative Commons Licence). Copyright owned by George Tod.

Offa's Dyke walk

I went for a holiday weekend walk today along a section of the Offa's Dyke trail in north Wales. It was a beautiful day with very warm sunshine and there were loads of people out and about and lots of families out walking. The route followed a well-made path and was generally along a ridge top. There were also some long sections of uphill walking and some steep downhill stretches. There were beautiful views to be had in all directions and it was really enjoyable. I think what made it even more enjoyable for me was that I felt really fit! I stepped out and kept up a pretty fast pace all the way, including on the uphill sections. I actually surprised myself at how fit and healthy I felt. I kept thinking back to pre-surgery times and how a walk like today's would have been really tough - and there's no way on earth I could have kept up the pace I did today.

Back at home now and rested, fed and watered (!), I am conscious that although I have no particular aches in my legs or other muscles, my body as a whole feels, well, sort of empty! A bit drained of energy, I suppose, I guess this is because I am consuming generally less calories. I have attempted to calculate how many calories I have burned today. I went back to the web site I posted about in March (click on the link above to return to my original post) that lists a wide range of activities and their calorie-burning equivalents per hour. This gives a rate of about 520 calories an hour for uphill walking and/or hiking. I did the sums and basically, if you multiply normal steps (i.e. as recorded on a pedometer) by 1.44, you get the equivalent steps if your walking was 'hiking' or uphill. You can then use the equivalent steps figure to determine calories burned - for someone weighing about 200 pounds, one step burns 0.06 calories.

So today, I have walked about 12,500 steps hiking, equivalent to 18,000 normal steps. Multiplying this by 0.06 gives total calories burned of 1080. I will have eaten about 1200 calories by the end of the day, which means that my total effective calorie intake is only 1200-1080 = 120!! Since my basal metabolic rate is about 1650, this means that I have achieved a calorie savings today of about 1530 (1650 - 120) - i.e. nearly half a pound!!! Well, the walk was lovely, but that figure makes it even more enjoyable!

10,000 steps......

Apparently, that's what I should be aiming to achieve on a daily basis (or at least, averaged out over the week). I have my pedometer and according to that, I average out at about 7,000 a day. I would say that most weekdays I walk about 3,000 steps during the day while at work, then do another 3-5,000 in the evening when I get home. At the weekend I do a little more, aiming for at least 8-9,000 on Saturday and Sunday. Weekends can be quite a lot more than that if we manage to get out for a 'proper' walk in the hills somewhere.

Most of my mid-week walking is done around the local parks and streets (the latter if it's dark). At the weekend we try get a little further afield, but at least as far as Carr Mill Dam, our local haunt - it's a large area of farmland, a big reservoir and lots of woodland off the East Lancs Road near St Helens.

However, for all this sounds good, I am really struggling to reach that magical figure of 10,000 a day. At the HW support group last weekend, a number of ideas were put forward about how we can incorporate extra walking into our daily routines without making a big deal about it. Here are some of the ideas suggested:

1. Walk during lunch break. For example, if I walk to the local shop and buy a bottle of water, it amounts to an extra 1000 steps in a day.
2. Use the stairs rather than the lift. I have been doing this, despite working on the fourth floor, and I have set myself a starting target of taking the stairs at least once per day.
3. Plan a walking meeting. This is a nice idea in principle but requires the cooperation of the other party(ies). I also have a hearing impairment and find it difficult enough following conversation when walking along with someone - so this is probably not a realistic option for me.
4. Park further away. Although I still park in the work car park, I park as far away from the building as I can. Walking further to my office each day adds about 800 steps.
5. Use the toilet furthest away from the office! I'm actually moving to a different office in a few days (in the same building) and this will locate me closer to a new toilet. However, I have decided that I am going to continue to use the toilet I always have - this will add an extra 200 steps every time I 'go'!
6. Go for an evening walk. I already do this several times a week but it's not always easy. Obviously sometimes the weather is not conducive; sometimes I just don't feel like it after a hard days work; and sometimes I get home late and it is just not realistic to then go for a walk. I guess evening walks will become more attractive as the summer nears.
7. Walk during the TV ads. If I walked (or stepped on my mini-stepper) for three minutes during each ad break in a one hour TV programme, I could potentially add an extra 3000 steps to my daily count.

Here are a couple of facts you might also find useful, I did:

• Walking on the flat burns about 0.06 calories per step (60 per 1000).
• Walking up stairs (or a steep hill) burns about 0.3 calories per step.

I am definitely going to try some of the ideas that I don't already do and see if I can get my daily average up to 10,000 steps over the next two or three weeks.

Spending money and shedding pounds

I weighed in at 18 stone 2 lbs this morning - more than a stone less than when I started the pre-op diet! I expected to lose more weight in the first week or so - this is normal for most people on diets - but the weight loss is nevertheless very encouraging. I've also been shedding lots of pounds of the monetary sort - I spent over £70 on stuff from Weight To Go (the food 'arm' of Healthier Weight):

I bought a pedometer, because once I am fighting fit again I plan on working up to walking 10,000 steps a day. I am not yet sure where I'm going to find the time to do all this walking - but I guess I'll just have to make it a higher priority than all the other 'important' and 'urgent' things in my life!

I also bought some more strawberry shakes. I find these very filling and they will be a welcome drink once I start getting hungry again. I experimented with a new way to make them today - without using the blender. I just added a mixture of milk and water and stirred with a fork until I achieved the right consistency (1 packet made about 400ml). The blender is fine (and quicker, though more washing up!), but it tends to make the shake very bubbly. My stomach has been making enough bubbles of its own in the past few days so I thought I'd try putting less in!

I also bought some packets of the pre-prepared meals and soup. I won't be able to eat any of these until I get to the puree phase, but they look very nice!

I went for a 40 minute walk this morning - and it was probably too much - I was getting quite tired by the end. It was at a slow pace, over a distance I would normally have covered in much less time, but still, it was nice to get some fresh air - before the Arctic weather blows in at the weekend.