Top 20 weight loss and health tips

My goal in this series on My Health Journey has been to share what Lisa and I have learned in the last four years as we’ve each lost more than 50 pounds.

We’ve gone from being doubtful we could lose weight (and not even knowing how) to where we can confidently say we have a sustainable lifestyle that will help us maintain a healthy weight.

In blogging about this, I’ve wanted to explain how our thinking has evolved, while pointing readers to the original sources of our information…and inspiration.

But then a friend commented in a recent post, “Lee – I want to know your plan!” So I decided it would be helpful now to summarize what has been most important and helpful to us.

Here is my top 20 list:

My typical first meal of the day: Four eggs, bacon, guacamole and salsa. This “breakfast” meal is often at noon to help me maintain my 6-8 hour eating window.
  1. Stop the Sugar. Avoid fructose, sucrose, lactose or pretty much anything else that ends in -ose. Sugar causes blood glucose spikes, which raises your levels of insulin, the main fat-storage hormone. Especially avoid high-fructose corn syrup (HFCS).
  2. Limit net carbohydrates to 50g or less daily. Lower is even better, shooting for 15g per meal. Calculate net carbs by subtracting grams of fiber from total carbs. As I say in #13 below, don’t count calories, but do count your carbs.
  3. Avoid processed carbohydrates, which convert rapidly to sugar as you digest them, quickly raising your blood glucose and insulin levels.
  4. Avoid starchy vegetables. This was a hard one for me because I really enjoy potatoes in all their forms. But just as processed carbs convert quickly to sugar, so do these starches.
  5. Avoid grains. Get your carbs from something other than the seeds of grasses. This guidance came from Dr. Bill Davis, author of Wheat Belly and Undoctored. This was a relatively easy change for me because I had been diagnosed with celiac disease several years earlier, which meant I needed to be gluten-free. Going grain-free meant avoiding rice and corn, too. That was tougher, but it helped me to accomplish #2.
  6. Supplement smartly. As Dr. Davis recommends, instead of taking a scattershot multivitamin that gives a little bit of everything but doesn’t contain enough of what’s missing in the modern diet, focus on a few key difference-makers. Supplements we take daily include fish oil (3,000 mg of EPA and DHA), Kelp (for Iodine), Magnesium, Turmeric, Zinc, and vitamins C, D3 (5,000 IU) and K2. Interestingly, lots of research on COVID-19 has pointed to Zinc and Vitamin D as factors in fighting the coronavirus.
  7. Boost NAD+. I learned this from David Sinclair, Ph.D., who I first encountered in Dr. Peter Attia’s podcast. This is the most expensive change Lisa and I have made, at about $45 per month for each of us. I’ll do a future post about Dr. Sinclair’s research and NAD+, but for now I’m just putting it on my list as a preview.
  8. Optimize your gut microbiome. As Dr. Davis suggests, a one-month course of probiotics and prebiotic fiber lays a good foundation for gut health.
  9. When you consume dairy products, make them full-fat. Skim milk is the worst because it has all of the sugar (lactose) and none of the fat. Fat is satisfying. So have heavy whipping cream (or butter) in your coffee instead of half-and-half, when you’re not drinking it black. We hardly ever drink milk, but if we did it would be whole (4%) milk. Eat full-fat cheeses, too.
  10. Enjoy creamy homemade yogurt. As I previously described, L. reuteri yogurt, which I make with roughly equal portions of heavy whipping cream and half-and-half, is delicious, filling and has significant health benefits. Another recommendation from Dr. Davis.
  11. Drink water instead of milk or sweetened beverages. Don’t drink your calories. Fruit juice can have nearly as much sugar as soda. And even though drinks with artificial sweeteners don’t have calories, their taste can trigger release of insulin.
  12. Eat like your grandparents did. That means eating real food instead of something that came out of a box. Have eggs for breakfast instead of cereal. Don’t eat between meals, and eliminate after-dinner snacks.
  13. Don’t count calories. Eat until you feel satisfied. Beef, chicken, fish, eggs, bacon, ham, butter and other foods that contain both fat and protein “stick to your ribs,” as grandma used to say. Vegetables are fine too, because they tend to contain complex carbohydrates and fiber that blunt the rise in blood sugar.
  14. Eat fruit in moderation. Our ancestors didn’t have fresh fruit year-round. Fruit has fructose (see #1), so I eat it mostly in season, or mixed in my homemade yogurt (see #10).
  15. Eat dark chocolate. I have a 25g Moser Roth® Dark 85% bar as a healthy, delicious treat after my last meal most days, sometimes with a glass of cabernet or merlot. Having broken the sugar habit, even dark chocolate seems sweet.
  16. Weigh daily. I bought a bluetooth scale in Feb. 2018, which automatically syncs to an app in my iPhone and also to Apple Health, and in the first five months I lost 22 lbs. Then we went on vacation, and when I came back the bluetooth sync was somehow disrupted. Because I felt like I had essentially reached my goal, and wasn’t getting daily feedback, I lost focus and regained about 20 lbs. But since Feb. 2019 I have weighed almost every morning, including the last 259 in a row since my travels have been curtailed due to COVID-19. I’m down 38 lbs. since then, to 199. I weigh first thing every morning, and this constant feedback will alert me if I ever creep over 205.
  17. When you eat matters as much as what you eat. By confining your eating to a 6-8 hour window each day, you ensure that you will have an extended period of lower insulin levels, which is essential to getting into fat-burning mode. Dr. Jason Fung is the leading medical champion of fasting, and has helped thousands of patients reverse their type II diabetes. Lisa and I became big believers with 10 weeks of alternate daily fasting. The Zero app is a helpful tool to manage fasting and time-restricted feeding.
  18. Lift weights. Building muscle is good for your overall health and vitality, and it also increases your metabolism. Free weights are best because they involve the whole body in natural movements. My go-to exercises using a barbell are the bench press, squat and deadlift on alternate days.
  19. Do some cardiovascular exercise. I’ve been doing 20 45 minutes of cardio most days lately using a Water Rower. In my tubby days I was doing 30 minutes of cardio on an elliptical machine six days a week, without making appreciable weight loss progress. As many have noted, you can’t outrun a bad diet. I think my combination of resistance training with free weights strikes a good balance for overall health and fitness, and Lisa’s going to start working on these now too as we head into winter.
  20. Avoidance isn’t always. I still occasionally have a baked potato, pizza, pasta or my favorite ice cream dessert with fudge and an oreo-cookie base (gluten-free because of my celiac disease) that I typically enjoy for one or two weeks per year. As Dr. Fung says, “Eat that birthday cake!” When you get your metabolic health in order, you can enjoy those treats without guilt, and knowing that you’re not committing to avoiding them forever makes it easier to stick with the general plan. In fact, we’ve had pizza three times in the last two weeks, and we’re still right at our target weights.

Which of these practices have you found helpful?

What other tips do you have?

You can’t do everything at once; that’s setting you up for failure. So for a step-by-step approach to how I would make these changes if I were doing it over again knowing what I know now, see my #BodyBabySteps page.

See the whole series about my health journey. Follow along on FacebookTwitter and LinkedIn.

New Mayo Clinic Heart Health Campaign

Today at our Mayo Clinic Social Media Summit, which we have produced in collaboration with Ragan Communications, we launched a new awareness campaign about heart health. Here is the story behind the project (including the back story behind the video.) This video is the cornerstone of the campaign:

We also have a Facebook app on our Mayo Clinic page, and a contest site for friendly competition in helping to raise awareness of heart disease through this video. Here’s my profile on the site.

Note: I can’t win the contest, and neither can any other Mayo Clinic employees. But others can win Mayo Clinic books, pedometers or other prizes, including a trip to next year’s Social Media Summit. And teams can win a one-year Social Media Health Network membership for their organization.

Please help spread the word!



SXSW Health Track: One Day to Submit Your Panel

I’m honored to have been asked to serve on the Advisory Board for the 2011 SXSW Interactive Festival’s one-day health track.

From everything I’ve heard, the social health unconference in March was fantastic, which is what led Hugh and the SXSW gang to go for the full-day health track.

My problem with SXSW is the timing; it’s always around the first week of Minnesota’s high school basketball tournament, and I have a son who will be lacing ’em up for the Austin Packers for the next three years. Depending on the date for the health track, I may be able to attend, but it’s questionable.

Which makes me, I guess, a good Advisory Board member, since people serving in that role can’t be speakers or panelists.

So…I look forward to seeing lots of good panel proposals, and helping in some way to shape the event. And even if I can’t attend, I’ll definitely be following the Twitter conversation.

I’m keeping this post brief because I want to get it out as quickly as I can: the submission process for panels ends tomorrow, July 9.

Go to the SXSW Panel Picker to submit your panel today.

And I DO mean TODAY!

Or tomorrow.

No later.

Thanks to Reed Smith and Tom Stitt, co-chairs for the health track, for nominating me to the Advisory Board.

Thesis 33: Decreasing Diffusion Time for Research, Innovations


This post is part of a series related to my 35 Social Media Theses, in which I will discuss and amplify upon each of the statements I believe define the social media revolution, particularly as they relate to healthcare. I’m starting with Thesis 33 because it has particular application in an extremely exciting project I’m working on right now.

Social media will decrease diffusion time for medical research and healthcare innovations

One of the most frustrating parts of being involved in medical research is how long it takes for innovations and discoveries to spread. It’s generally understood within the medical community that it takes about 17 years for a discovery to work its way through the medical establishment, to really change everyday practice.

Social media will help revolutionize this diffusion process by making research information more accessible not only to physicians, but also to patients and consumers. And in a moment, I’m going to invite you to participate in an experiment to help prove this.

Here’s how the process has worked until this point (Because this thesis is about the dissemination of information and not about the discovery itself, we will start our discussion at the point of discovery):

  1. Dr. A’s research lab conducts a study and discovers a better treatment that could or should change medical practice.
  2. He submits an abstract, or research summary, to the annual meeting of physicians in his specialty. The abstract is reviewed by the program committee, and if they think it is interesting and valid they invite him to create a poster to be displayed at the meeting and to be discussed by other physicians and researchers. If they think it’s extra interesting, they may even ask him to do an oral presentation in one of the program tracks at the meeting. Those who attend the session or talk with Dr. A at the meeting may be stirred to change their practice, or may decide to conduct some related research of their own. News reporters covering the meeting may decide to do a story about the research findings, but perhaps one percent of abstracts submitted get news coverage.
  3. On another track, Dr. A will typically submit his research findings to a medical journal for publication. These papers are “peer reviewed” which means other physicians and researchers in the field look at the paper and decide whether they think the findings are valid and important enough to be published, and whether they’re something really new. This process of review and publication typically takes at least several months, although some of the journals are now publishing online before print, to help get the word out sooner.
  4. If the paper is published by the journal, the findings again may be the subject of news coverage, but for that to happen it requires a PR person (like me) to decide the research is likely to be interesting enough to reporters that they will be willing to develop a story. Then the reporters need to convince editors or producers that the story will be interesting enough to readers, viewers or listeners to be worthwhile. I would estimate that at best perhaps 10 percent of journal articles receive some news coverage. Of course, that varies by journal, as the the general ones like JAMA or New England Journal of Medicine or Mayo Clinic Proceedings may get one or two papers in the news, while the more specialized journals like Journal of Hand Surgery typically don’t get any mainstream news coverage.
  5. As Dr. A continues research related to the topic, this provides further opportunities for dissemination, and as other researchers in the field submit articles to journals they may cite his paper as a related resource upon which their research was based.
  6. Dr. A may be asked to visit other academic medical centers to discuss his treatment methods, which will help get more physicians personally familiar and hopefully even applying the results in their practices. He also may be asked to speak at continuing medical education (CME) courses, which help physicians get up-to-date on recent discoveries.

In the health communications system today, most participants are trying to do what’s best, as they see it. But it still takes far too long for valuable discoveries to become mainstream practice, and as a result patients don’t get the best care they could.

Thesis #33 says social media can help accelerate this process of knowledge diffusion. Here are six reasons why:

  1. Social media don’t depend on reaching mass audiences for their economic viability. Mainstream media have scarce space and time and must be able to interest an audience sufficiently large to be attractive to advertisers. The social media space is practically infinite, so researchers with a story to tell or a message to spread have no real barriers to getting to the Web and reaching the group, however small, that might be interested.
  2. Even if a condition is rare – or especially if it’s rare – it’s worthwhile to shoot a Flip video describing the latest research, upload it to YouTube, and embed it in a blog. Rare conditions are less likely to have lots of material already published, so your post is more likely to reach the coveted first page of Google results for your keywords.
  3. Social media tools can tighten connections between researchers in the same field. Whether through Twitter, Facebook or physician-only sites like Sermo, social platforms take the friction out of maintaining relationships and sharing information.
  4. Social media tools make it easier than ever before for patients with a common disease or condition to find each other and to share resources. And they don’t have to live in the same community.
  5. Physicians and patients will increasingly interact in social networks. Patients will be able to form online networks for nothing, and as we have seen with Wikipedia, will be motivated to share the latest news and research findings with each other. Some physicians will also join these networks and will interact directly with patients.
  6. Patients will bring what they have learned online into office discussions with their own physicians. They will be motivated to spread the word about a discovery that could have implications for their own treatment.

I am pleased to announce that at Mayo Clinic we are conducting an experiment this week to see, among other things, how social media can help reduce this knowledge-diffusion time for an important discovery.

Dr. Richard Berger is a Mayo Clinic orthopedic surgeon who discovered an explanation for mysterious wrist pain in many patients whose MRI scans appear normal. In the video below, he explains the injury, called a split tear of the UT ligament, and how he discovered it:

Dr. Berger has developed a simple, non-invasive test for the UT split tear, which he describes and demonstrates below:

Here’s where the social media experiment in diffusion of medical research information comes in. Dr. Berger (@RABergerMD) will be participating in a live #wristpain Twitter chat about mysterious wrist pain and the UT ligament split tear on Thursday, Nov. 12, 2009 from 4-5 p.m. EST. The format for the chat and more background information about the injury are available on the Mayo Clinic News Blog, but I have embedded a widget for all tweets using the #wristpain tag below:

  1. If you personally are experiencing wrist pain, I hope you will join us for this #wristpain Twitter chat.
  2. If you know people who have complained of nagging wrist pain and haven’t been able to get answers, please forward the information about the #wristpain chat to them. They also may ask questions and engage in discussion directly on the Mayo Clinic News Blog. The Twitter chat also can obviously start before the Thursday afternoon appointed time, and can continue afterwards. But during that 4-5 p.m. EST time Dr. Berger will be online.
  3. If you don’t have wrist pain, and you’re not aware of anyone who does, you can still help spread the word, because who knows how many of your Twitter followers or Facebook friends might have a split tear? Dr. Berger thinks it may be as common as a tear of the ACL in the knee, but because it isn’t widely known it remains undiagnosed in countless patients, as it was in Philadelphia Phillies outfielder Jayson Werth…until he came to see Dr. Berger. So please post the link to this post on the News Blog, or to this post here on SMUG, to your Facebook profile, or send it out as a Tweet to your followers. If you’d like to be even more involved, you also could do a blog post about the Twitter chat and could embed the Twitter search widget you see above in your post or in your blog’s sidebar. Go here to get the code.

As Dr. Berger says, this is a relatively unusual case of an injury that is debilitating but is easy to diagnose with a highly sensitive and specific test and also can be easily treated, with 95 percent success. It all comes down to knowing what to look for, and that depends on spreading the word.

I hope you will join us in this experiment. It’s not about getting more patients for Mayo Clinic; if it really is as common as an ACL injury, there’s no way Mayo and Dr. Berger could treat everyone. And in fact, in our News Blog post about the Twitter chat we are planning to post a list of several surgeons at other hospitals that Dr. Berger has trained in the fovea sign and in treatment of the UT split tear.

It’s about helping to cut a few years off the typical diffusion time for medical innovations, so patients with this unexplained wrist pain can get the help they need to be restored to full, pain-free function.

We have another interesting element of this experiment I look forward to announcing tomorrow morning, so stay tuned….

AED4EU and the Power of Twitter

Yesterday I posted a video in which Lucien Engelen (@zorg20) interviewed me about social media in healthcare, which he shot while I was his guest in the Netherlands earlier this month.

I interviewed Lucien that same day, asking him to tell the story about the mobile phone application for iPhone and Android that he had gotten developed and launched. It’s an augmented reality app that shows where the nearest automated external defibrillator (AED) is located, using the phone’s location awareness. In the case of someone experiencing cardiac arrest, the ideal would be for one person to administer CPR while another bystander uses a smart phone to locate an AED that could shock the heart back into normal rhythm.


I could talk more about the application, but Lucien demonstrates it briefly in this video. More importantly, he tells the story of how Twitter enabled him to find a programmer to get the project done, and how much time that saved in development.

Twitter is an amazing tool for finding information, but more importantly making connections with people. Three weeks from first Tweet to completed iPhone application is pretty amazing. In the way of the Web 1.0 world, Lucien’s analysts would have had to identify a list of companies with programming capability, build a list and then send candidate companies a request for proposals. In the Twitterverse, he could just tweet the question, directed to no one in particular, and the answer found him in less than 30 minutes.

That’s serious productivity ROI!

How about you? What’s your best story of how Twitter helped you find information quickly?

Update: Here is the AED4.EU site.