Dr. Pamela Peeke, award-winning author of Fit to Live, joined us for an online chat with the Discovery Health Community. Here are your real health and fitness questions, and her answers!
Question: If you could encourage people to eliminate one food from their diet, what would it be? What about adding one food to their diet to change their health?
Dr. Peeke: I would eliminate refined sugars, and I would add fruit, which is natural sugar.
Question: Is it OK to drink pop in moderation? I started the challenge yesterday and I had a craving for pop, but I measured myself out 4 oz and limited my entire day to just that 4 oz. Is that ever OK?
Dr. Peeke: It's all right to do diet colas, but if you remember in Fit to Live, Christine was drinking 40 ounces of fully sugared and caffeinated soda a day, which was getting her into trouble. Therefore, having 4-8 ounces of a diet cola, preferably decaffeinated, is OK. My preference is clearly water or tea instead of colas or sodas.
Question: I have been working out intensely for the past month. My eating habits are pretty good. I don't eat out, and don't eat red meat or pork. I eat lots of veggies, chicken and fish, and no fried stuff. I have not lost a pound or any inches. What am I doing wrong?
Dr. Peeke: Number one, you may be eating appropriately in the quality of the food, but not the quantity. Beware of eating mountains of quality food. It's time to rein in the portions, especially if you are a woman over the age of 30.
Question: I think I'm having trouble with portion control. What do you recommend?
Dr. Peeke: Portion control is the greatest challenge of all. So it's very important to start paying attention to how much you eat.
Question: Bally told me to only eat 1500 calories. How do you know how much of those calories should be protein, carbs or fats?
Dr. Peeke: OK, here's the percentages - anywhere from 20-25% protein, 25% fat, and 50% carbohydrates. The carbohydrates should be mostly vegetables, with the rest split between some fruit and multi grains.
Question: I have a beer belly (both upper and lower abdominal is fat) without the beer drinking, and I also have love handles. I am looking for a great workout that will target these areas.
Dr. Peeke: You have a beer belly without the beer? I'd guess you are over the age of 40, and as a woman you have to pay attention to quality and quantity of food after the age of 40, even if you've never paid attention before. This is the time to be mindful and aware that you can pick up more belly fat and especially fat deep inside the belly, which is highly associated with heart disease, diabetes, and cancer. So it's time to rein it in and get that physical activity as well.
Question: I drink Rock Star Sugar Free Energy drink. What do you think of these?
Dr. Peeke: Again, be very careful. Read the labels, and realize that many of these drinks that say they are energy drinks are also laced with caffeine, as well as ginseng and other herbals and related chemicals that make you feel speedy. Just because it's sugar-free doesn't mean it's safe. Read the label!
Question: Is peanut butter good or bad?
Dr. Peeke: Peanut butter is fabulous, depending on how much you use. If you get an organic peanut butter, it has lots of fat, but if you use a small quantity appropriately, it's quite delicious. Or buy reduced fat peanut butter, which is a favorite of mine. It makes a wonderful snack if used on a multi grain cracker, for instance.
Question: I'm constantly arguing with my mom about my children's sugar intake. She says fruit sugars are ok, but I thought fruit sugars can also be bad if not in eaten in moderation. Can you put our argument to rest? Can fruit sugars be abused too?
Dr. Peeke: Absolutely! Any sugar can be abused. Anything in moderation. You can eat one apple, but you don't want to eat six at one time. That's a lot of fruit sugar So it's all about appropriate servings and portion sizes.
Question: With so many fad diets that you try, I've been told it messes up your ability to lose weight so my question is how do you level out your body to get it back on track?
Dr. Peeke: Stop the fad diets now and go back to basics. In my book "Fit to Live," I make it very clear that your ability to lay down a strong calorie-burning foundation is doable by avoiding radical diets and instead following my three precepts: quality, quantity, frequency. Clearly the quality is important. The quantity: rein it in, especially if you're over 40. Frequency: eat every 3-4 hours, smaller balanced feedings and your appetite will be reined in, as well as the total calories you ingest.
Question: Dr. Peeke, I have started working out, but I am so hungry all of the time, even more so. How can I help this?
Dr. Peeke: Be careful you don't mix up hunger with appetite. Most people do. Hunger addresses the issue of what do I need. Appetite addresses the issue of what do I want. When they work together, it's magic. But be careful when appetite goes off on its own, and you're in a constant state of I want, I want. This is the essence of cravings as well. If you are truly hungry, with a growling stomach, headache, etc., then you're undereating and you need to start eating small balanced feedings every 3-4 hours. If it's appetite that is the problem, the good news is eating every 3-4 hours solves that problem too. Then all you're left with are some bad habits. If you're stressed out and you eat, you need to learn how to handle stress better.
Question: What were your snacks today?
Dr. Peeke: My snacks included yogurt with sliced almonds. Another was a Gala apple with 2 low fat string cheeses. In the past, I have used chocolate protein powder with skim milk to make a protein drink.
Question: How many grams of sugar should you have in a day?
Dr. Peeke: Again, going back to what I said before, 50% of your diet is carbohydrate. Of that 50%, we're looking at the majority being vegetables, which are low in sugar. Next is whole grains, then fruit. If you're talking about sugar in general, natural sugar, then that's the kind of template you're looking at. If you're talking about refined sugar, it is important to try to minimize this as much as possible. Don't worry about the total grams; just stick to the basic template of mostly vegetables and complex carbohydrates. Also, try to eliminate white sugar from your diet as best you can.
Question: How do you feel about artificial sweeteners? What is your recommendation for people about diet drinks, Crystal Lite, or other products?
Dr. Peeke: Generally, Splenda or sucralose is fine with me in moderation so long as it does not lead to a binge. People react to sugar substitutes differently. There are natural sugar substitutes you may want to try. Stevia is one, another is agave which, although it has the same number of calories as refined sugar (50 calories/teaspoon), is much sweeter, so you only require 1/4 the amount of refined sugar. So you get a better deal all the way around.
Question: I was wondering is it normal for skin to change because of weight gain?
Dr. Peeke: Maintaining a healthy weight allows you to have a healthy glow and clean pores. When you gain weight because of self destructive eating, it's easier to accumulate blemishes, and especially in the absence of physical activity you actually appear to look older and age more rapidly.
Question: Does a low calorie intake produce a low metabolism?
Dr. Peeke: Absolutely. Never starve yourself, because it contributes to a lowered metabolic rate. Instead, allow yourself to eat every 3-4 hours to stoke or stimulate your metabolism.
Question: I know I'm supposed to eat 6 small meals, but I'm just not that hungry! Should I force myself to eat every 2-3 hours even if I'm not hungry?
Dr. Peeke: It's not 2-3 hours, it's 3-4 hours. And you don't have to eat 6 small meals, you can do 5.
Question: Is there such a thing as too much exercise? Bally's recommended I come in 4 days a week, but I would like to come in every day. They suggested against this. Why is that?
Dr. Peeke: You could come in every day, but you'd have to be careful about overtraining your body. Also, it's not healthy to be living in a gym every day. It's important to get variety and diversity, so that means get out of the gym and get outdoors, take a walk, be social with friends, do other things that are gym-free. Don't be living in the gym. So working out no more than 4 days a week is appropriate.
Question: What is the best way to kick start your metabolism?
Dr. Peeke: The best way is to get up and move. Actually, I'm watching someone dance right in front of me. Just get up and move - it works like a charm. M-O-V-E!
Question: Dr. Peeke, I lost my job that kept me active for 8 years. Now I'm a stay at home mom, not nearly as active. I feel myself putting on weight, especially in my belly, butt and thighs, the worst places! I have a closet full of size 3 jeans that are starting to get snug! What can I do to get back to the way I was?!
Dr. Peeke: What happened was you lost your job, and now you're a stay at home mom and you can't fit into your stuff any more. The solution is this: you'll have to find ways to increase your activity. As I said in "Fit to Live," you have to adapt and adjust. Adapt and Adjust to your new situation. If you are sedentary, you'll put on weight. Take the kids to the park. Get up and move more.
Question: I am a post-menopausal 51 year old not on HRT. Have been training for running a marathon since mid August, eating 'clean' and have not lost one pound!!! WHY??!!!! I need to lose weight because it is around my middle - which is the worst place it can be!
Dr. Peeke: First of all, it depends on how much you have around your middle. If you're already slender with a body fat below 25%, take a tape measure across your belly button. If you're below 35 inches, you're in the safe zone. If you're above, you're not. One of the great myths is that running a marathon will result in great weight loss. This does not occur. You have to be careful about how much you eat when you're training for a marathon, because your appetite is definitely up. It's also normal for women who are post menopausal to have 3-5 pounds' worth of what I refer to as a "menopot." It's completely normal. Read my book "Body For Life for Women," as it explains where the menopot comes from and what to do with it, especially postmenopausally.
Question: I'm beginning to incorporate Pilates into my exercise routine. How do you feel about Pilates? How often should I do Pilates in order for it to be an effective part of my exercise? And, can Pilates help me to be Fit to Live?
Dr. Peeke: Pilates can most definitely help you become Fit to Live. Pilates works the core, which is exceptionally important to maintain a healthy and strong back. As well, it is a wonderful adjunct to endurance training and weight lifting.
Question: What is an appropriate level of strength training versus aerobic training?
Dr. Peeke: I recommend strength training 2-3 times a week. It's important especially for women to emphasize the upper body because they so rarely use it. One day, it's good to do chest/shoulders/triceps in that order. The next session, back and biceps. A third session could potentially include legs, or you could integrate legs in the other two sessions. It depends on how much time you have. It is important to do some form of aerobic training at least 5 days of the week. And quite frankly, it's important to stay active every day of the week that you can. Increase your activities in daily living. Just get up more! Every single step counts, like pennies in a piggy bank.
Question: I work two jobs. Both are in an office setting and I sit on my tush 12-15 hours a day. Any cubicle exercises you can recommend?
Dr. Peeke: So many people sit on their tush all day. Cubicle exercise really involves stretching - getting up out of your chair and stretching. One of the best things to do is yoga, some salutation or quite frankly using your chair as a place to be able to do other exercises. If you look in my book "Fit to Live," you will see a whole list of exercises you can do in a chair. How about squats? All you have to do is cross your arms in front of you and stand up and sit down repetitively as many times as you can over the course of 30 seconds. Can you do 10? How about 20?
Question: If you're really trying to lose weight, would you tackle diet or exercise first? Sometimes both can be overwhelming!
Dr. Peeke: I would first do physical activity. Simply get up and move. Anyone can do it, and it will most definitely make you feel better: so much better that it will be easier to eat well.
Question: Is there a point where women don't need to do weight training? If they are just looking to burn calories, isn't cardio enough?
Dr. Peeke: Cardio is never ever enough. You must always include weight training, always. It is important to incorporate weight training to help strengthen bones and muscles throughout life because it is important for you to be able to be physically independent and strong. This never ends. You must pay attention to your strength as well as your cardio which gives you endurance.
Question: I walk. Is that enough? I walk a few miles a day, but I don't really break a sweat or anything. Do I really need a gym?
Dr. Peeke: Walking is fantastic, providing you challenge yourself. You should be walking close to 4 miles a day, and you can do this faster by picking up the pace and picking up the intensity. Then you have a true workout, and you don't need the gym.
Question: Talk to us about fitness as we age. What are your recommendations for people over 40, who aren't active right now? Where do they start?
Dr. Peeke: In order to start, what you want to do is take small steps. Literally! Get up, begin to move. That means grab a pedometer and look at the total number of steps you take every day. Let's say it's 3000 steps; your goal is 10,000 steps. Increase your total number of steps each day by 500-1000 gradually over 4-6 weeks until you're comfortable with 10,000 a day. Six weeks is the usual training time to be able to achieve greater endurance. With regard to eating, the best thing you could do is start the day off well with a healthy breakfast. Then sit down and get organized. Look at where the key times are during the day when you fall apart. The solution is to have a plan. If you fail to plan, you plan to fail. And then, begin to establish simple, small step new behaviors to substitute for old, destructive habits. So it's important to substitute that regular bacon in the morning with a turkey sausage. There, you gave yourself something good in the place of something not as healthy! It's all about small steps.
Question: What are some workouts I can do at home when it's winter and I can't go to the gym?
Dr. Peeke: Workouts you can do at home, assuming you have no exercise equipment, could include using your own environment. How about going up and down your stairs? Stairs are always a great exercise, as you could clearly see by viewing my new show "Fit to Live." Another thing is to buy a core ball or abdominal ball and perform your abdominal exercises on a routine basis in your home. Get a stretching or yoga mat and perform simple basic stretches and strength exercises right there in front of a mirror at home. Any time you lift, push or pull, you're weight lifting, so time to clean that closet and that garage! That's called increasing your activities of daily living.
Question: I had gastric-bypass surgery May 10th. I weighed 290 and am now at 175. The weight has come off so easily, but I know I need to exercise more. My question is, does it matter what time of day I exercise? I usually have more time in the evening but have read that you shouldn't exercise before bedtime.
Dr. Peeke: I absolutely disagree. Fifty percent of the population does perfectly fine exercising before going to bed, because they don't overexcite. The other 50% does get excited. Personally, I can exercise an hour before going to bed. So try an experiment and see if exercising keeps you from sleeping. If not, welcome to evening exercise!
Question: Dr. Peeke, what is the biggest mistake people make towards their health and fitness?Dr. Peeke: Unrealistic expectations. People think they can change overnight, and it doesn't work out that way.
Question: So much has been made in the news lately about stress and belly fat. Can you clarify?Dr. Peeke: The connection between stress and belly fat is something that was a core of my research at the National Institute of Health. If you read my first book, "Fight Fat After Forty," you will see how I define the relationship between stress and fat. Chronic stress stirs up stress hormones, which increases appetite for refined sugar and fat.
Question: You do a ton of work with women and their special challenges in weight loss. What does a women need to know, if she's embarking on a new plan alongside her husband? What special considerations does she need to make?
Dr. Peeke: She needs to keep her own goals and expectations unique to her and her needs. What she should not do is compare herself to her husband. That is lethal. Men will change their nutrition and activity habits in different ways than women. Women tend to caregive everyone except themselves, so women have to watch out not to forget themselves in the caregiving process.
Question: I am almost 59 years old. I exercise daily and try to eat right...emphasis on the try. If I try to increase my level of exertion, I'm exhausted. I seem to be losing ground instead of gaining. How can I increase my fitness without exhausting myself?
Dr. Peeke: Stop trying, and do. I'm hearing a lot of "try," but what I want to hear is "do." You have to build a solid strong foundation of metabolism and endurance and the ability to burn calories. You can't do it with multiple jump starts, and then long periods in between. Consistency is the answer.
Question: How soon after starting do you see results?
Dr. Peeke: Immediately. Your energy increases, sleep improves, memory improves, enjoyment of life improves. And over the course of the first week, you see that you are improving your body composition depending on what you needed, whether it was dropping fat or building muscle. But after just 24 hours, you will feel remarkably improved.
Question: I decided to lose 1 lb./wk on 1-1, I also decided to quit smoking the same day. I am having larger than normal stress in my life because of being a caregiver of my disabled son, so I'm taking Paxil to help me cope. Tuesdays are my weigh in days and to my dismay I gained 1.6 lbs., but lost 15.4% of my body fat. I am constantly snacking, but it is on veggies and low fat foods. Has my body gone into shock and that's why I'm not losing more weight?
Dr. Peeke: Here's the deal: You've got a lot of things going on at once. You stopped smoking, and that affects metabolism and appetite. So you have to be careful not to overeat, which is easy to do if you're not smoking because of the change in appetite. Two, Paxil is associated with weight gain. You might want to have a conversation with your doctor about taking a different drug, or whether you even truly need a medication. Perhaps behavioral therapy might be the way to go. A 15% body fat drop is a very large drop, so it sounds as though you have been removing excess body fat for quite some time. So at this point in time, if you want to increase the ability to drop more weight, what I would do is increase your muscular ability to burn those calories. What's going on with your weight training and your endurance activity? If you've hit a plateau, increase the intensity and you'll increase caloric burn.
Question: Did the people who are now Fit to Live use the diet/exercise program in the National Body Challenge?Dr. Peeke: They used my book, "Fit to Live." In the book, what I did was outline a simple template for including physical, mental, and nutritional assessment that helped them to achieve their goal to be fit to live.
Question: How did you get into this line of work? What were you doing before you joined the fight for fitness?
Dr. Peeke: I'm a physician and a scientist. My laboratory was at the National Institute of Health. I have always been interested in a more integrative approach to health. In all of my books, including "Fit to Live," you'll see that I approach the human being in a holistic manner. My background also includes graduate degrees in public health and public policy. As well, I am an athlete, so I walk the talk.
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