This issue I will give you my thoughts regarding the biggest (forgive the pun) health problem confronting human-kind – excess body fat.

• Currently 60% of males, 50% of females and 33% of children are overweight and we continue to put on an average of 10 gms of fat per day.
• Fat people in my experience are not 'jolly happy people' – instead they likely to suffer from a plethora of physical and psychological problems including heart disease, strokes, diabetes, cancer, arthritis, sleep apnoea, low self-esteem, depression and skin infections.
• There is a great saying – 'genetics loads the gun, environment pulls the trigger'.
• Our ancestors ate real, whole, natural, unprocessed food and expended a lot of energy to find it. We live in an environment where we expend virtually no energy and eat artificial food which is loaded with calories (i.e. energy).
• The majority of people who become overweight do not have a medical condition (e.g. hypothyroidism) or slow metabolism causing it – it simply results from a long-term energy imbalance i.e. more calories consumed than expended.
• In physics at school we learnt about the 3 laws of thermodynamics (e.g. energy cannot be created or destroyed). I would like to add a 4th law – Dr Tom's Law of Mimimal Energy Expenditure (also known as the Law of Laziness). This law simply states that humans (and animals) will spend the minimum amount of time, effort and energy on the basics of life e.g. obtaining food and shelter. It is obviously far easier to pick up a drive-through KFC order than catch a chicken, pluck it, clean it, roast it, dig some potatoes, peel them etc.
• All calories count – if you eat 5000 calories a day and burn off 3000, you will put on weight even if the calories come from a healthy source e.g. lean meat or poultry or healthy fats.
• Once you are overweight, your metabolism is permanently altered – you will metabolise food differently from someone who has never been overweight.
• It is much more difficult than most people think to lose body fat and keep it off.
• Small things count – every nutritional indiscretion (e.g. biscuit, piece of cake, commercial muffin, pie, slice of white bread or soft-drink) will jeopardize your chances of successfully losing weight.
• There is a difference between weight loss and fat loss – a lot of weight loss programmes will cause you to lose glycogen stores (i.e. sugar stores in your muscles and liver), water and muscle mass but minimal fat. The Atkins diet, where people often lose 3-5 kgs in the first few days, is a classic example of this.
• The worst thing that can happen on a fat-loss programme is losing muscle mass. Why – muscle is the main tissue in your body where fat is burned. Using a car analogy it is obvious that a V8 car is going to use a lot more fuel than a 4-cylinder car. The more muscle you have, the bigger your fat-burning engine and hence the more fat you metabolise at rest (this is known as your resting metabolic rate). Yo-yo dieters are a classic example of this – every time they go on a new diet they lose more muscle mass, slow their metabolic rate further and end up storing more fat when they finally return to normal eating.
• There are no quick fixes to successful fat loss – acupuncture, hypnosis, rub-on creams and lotions, passive exercise equipment (e.g. machines that vibrate your body), body-wraps that 'rid your body of toxins' and 99% of diets are a total waste of time and money. If any of these products or techniques actually worked, everyone would use them and no-one would be overweight.
• It is impossible to spot-reduce e.g. you can do 10,000 sit-ups every day but unless you burn off the 20 kgs of fat rolls covering your abdominal muscles, you will never get to see them.
• The only way to successfully lose body fat is to follow Dr Tom's 5th Law of Thermodynamics: To lose body fat you must spend more energy than you take in i.e. exercise more and eat less.
• In the early stages of a fat loss programme, it is easier to lose fat by eating less e.g. if you have a meal of 'fish and chips' it would take an average of 6 hours of walking to metabolise this single meal. It is obviously easier to eat something healthier (e.g. a subway sandwich) than to spend 6 hours trying to walk it off.

Specifics Of A Successful Fat Loss Programme

The human body is a machine – a complicated one, but a machine just the same. I often use car analogies because cars are also machines but are often easier to understand. Imagine the following scenario – from tomorrow onwards you set yourself a goal to completely empty the fuel tank in your car as quickly as possible (although you still have to get around in it to do your usual tasks). How would you do it? When I present this question in my health seminars the most common answers are these:

• Start off with as little fuel in the tank as possible (i.e. do not over-fill it).
• Use 'clean' fuel i.e. the optimal fuel source – you can't burn diesel in a petrol engine.
• Drive a car with a large engine e.g. a V8 instead of a V4.
• Leave the car idling even when you are not in it ( you could in fact make it idle faster by resting a brick on the accelerator).
• Drive the car as fast as you can.
• Drive the car up a steep hill and/or add some extra weight e.g. fill it up with people or tow a caravan.
• Take the car for a long drive.
• Drive the car inefficiently – i.e. accelerate and brake frequently.

Would there be any benefit in the following:

• Subjecting your car to hypnosis?
• Taking your car for a sauna or wrapping it in special herbal solutions to rid it of toxins?
• Putting it on a machine that vibrated the car to help burn off the fuel?
• Taking it to an acupuncturist?
• Starving it of fuel completely so that it didn't go at all?

The answer to these should be a fairly self-evident 'No'. The solution to the problem simply involves modifying 'energy in' versus 'energy out.

Hopefully you are beginning to see some parallels with achieving weight loss in humans. If our aim is to empty our fuel tanks (i.e. lose body fat), then we need to adopt similar strategies:

• Put in as few calories as possible – this should be achieved first by eating better and then by eating less. Starving yourself (e.g. by going on some ridiculous diet) is self-defeating because your engine won't be able to run at all.
• Put in 'clean' food – as I have stressed in previous articles, the biggest problem in our modern diet is that we no longer eat real naturally-occurring unprocessed food as nature intended i.e.large amounts of uncultivated vegetables and moderate amounts of game (sea-food, meat, birds, eggs), nuts, seeds and fruit. Dairy products, cereals and grains have only entered our diets in the last 10,000 which is very recent in evolutionary terms.
• Increase the size of your fat-burning engine by building up your muscle tissue. The average New Zealander loses 25% of their entire muscle mass through disuse between ages 20-60. Muscle is the key to good health. A weights/strength/resistance/muscle-toning programme is the single most important step you can take to improving your overall health (even more important than doing a cardio programme). This topic will be covered in much greater depth in an up-coming article.
• You can increase your basal metabolic rate (i.e. the amount of energy your body burns at rest) in 2 ways: increase the size of your engine (i.e. muscle mass) as previously discussed and/or do some cardio-respiratory training every day (e.g. walking, running, swimming, cycling, rowing, kayaking, tramping etc).
• The faster you go, the more total calories you burn while exercising and more importantly afterwards e.g. someone who runs at top speed for 30 minutes will burn far more calories than someone who walks at a leisurely pace for the same length of time. Forget about trying to burn off just fat calories by doing low intensity exercise by keeping in your 'fat-burning zone'. We will see in an upcoming article that 'the faster the better' in terms of both fat loss and overall health benefits. This is Dr Tom's 6th Law of Thermodynamics: 'What you put in determines what you get out' (this applies equally to food as well as to exercise). If you are seriously de-conditioned (i.e.unfit) you will obviously need to build up exercise intensity gradually. If you are over 40, have other health problems or have a strong family history of heart disease it is important to get a medical check-up before embarking on a high-intensity exercise programme.
• Adding extra resistance to your cardio-respiratory sessions will also increase total energy expenditure e.g. running up a hill with a day-pack full of bricks (been there, done that) is obviously harder than walking on the flat.
• The volume or total amount of exercise is also critical – someone who walks an hour a day will get double the results of someone who only walks half an hour a day (assuming that they walk at the same pace).
• Doing activities that you are not used to will use more energy because you will be less efficient at doing them e.g. try rowing, swimming, mountain biking, kayaking or cardio equipment at gyms (e.g. cross-trainers, ellipticals or steppers).

A More Specific Fat Loss Programme

Before we take a look at the specifics of a 'fat-loss' programme bear in mind the following facts:

• Weight is a very poor measure of body fatness because it doesn't take into account frame size, bone density and muscle mass.
• There is a big difference between weight-loss and fat-loss.
• To lose body fat you must spend more energy than you take in (i.e. energy out must be greater than energy in).
• The majority of diets (e.g. the Atkins Diet) and other 'quick fix' solutions will cause your body weight to drop but this is largely the result of water, glycogen and muscle loss, not fat loss.
• In this day and age of instant results and instant gratification it may be difficult to accept the fact that there are no 'quick fixes' to fat loss – exercising more and eating less doesn't sound as appealing as a herbal solution that 'melts your fat away while you sleep'.
• Losing body fat is difficult and requires long-term commitment, effort and consistency – whatever you choose to do will need to be continued INDEFINITELY (another reason why diets don't work).
• Small things count – we live in such an 'obesogenic' environment that every day without exercise and every nutritional indiscretion will compromise your chances of reaching and maintaining normal body weight.
• People who are grossly overweight (BMI > 35%) should consider drugs (e.g. 'Xenical') or surgical options (e.g. stomach stapling) to help them lose body fat because the risks of developing serious health problems are so high (e.g. diabetes, heart attacks, strokes, cancer and arthritis).

OK – now for the specifics:

Nutrition:

• Try to eat approximately 10% less than you are currently eating – this can be achieved by either eating better (i.e.eating large amounts of vegetables and moderate amounts of legumes, fruit, nuts, seeds, berries, whole grains, fish, lean meat and eggs) or by eating less (i.e. reduce serving sizes by 10%).
• Reducing by more than 10% will put your body into starvation mode – you will become ravenous, lose muscle tissue and eventually 'blow-out' and over-eat.
• Drink 6+ glasses of water per day.
• Eating a bowl of soup at the start of your meals has been shown to reduce the total amount of food eaten.
• Eat slowly – it takes 20 minutes for your brain to receive 'full signals' from your stomach.
• Have a big breakfast (30-60 minutes after your early-morning exercise), a moderate lunch and a small evening meal.
• Eat when you are hungry, not when you are bored, tired, depressed etc.

Exercise:

• Increase the amount of 'incidental' exercise you do every day e.g. use stairs, chew gum, fidget, move around when talking on the telephone, go for a lunch-time walk, walk or cycle to the shops, avoid using remotes, deliver a message in person rather than by email, park your car 5 minutes from work, carry your shopping in a basket – in other words, whenever there is an opportunity to burn a few extra calories, take it! Incidental exercise is probably more important in increasing overall energy expenditure than planned exercise.
• Aerobic (cardio-respiratory or heart-lung) exercise e.g. walking, jogging, cycling, rowing or gym activities (e.g. classes, steppers, cross-trainers, ellipticals etc.) should be done 4-5 days a week. The results you get will be proportional to the time and intensity of exercise i.e. the longer and harder the better. In my experience it is difficult for most people to lose significant amounts of fat with less than 60 minutes of aerobic exercise a day. For a multitude of reasons swimming is not very effective for fat loss (although it is good for improving heart-lung fitness). Exercising first thing in the morning on an empty stomach will cause greater fat loss than exercising after having eaten (although having 1-2 cups of black coffee or tea before exercise may help to mobilise fat stores).
• Muscle-Building Exercise – should be done twice a week (this will be covered in detail in another article).
• Any other exercise is a bonus e.g. pilates, yoga, Tai Chi, chopping wood, playing tennis and gardening.

The two most important factors determining long-term success are prioritising exercise and being consistent. Never let a day go by without exercise it is the single most important factor determining your long-term health (or lack of it)!