Category Archives: web

EFFING!

My long-suffering readers know that I am not famous for using intemperate language in this and other blogs.
The taken-aback, perineally loyal Rambophile may wonder, “Pagla gaya kya?”, which is a Hebrew expression meaning, “I love him, V Day to D Day!”. Speaking of which, incidentally, I posted on Facebook that I was wondering if, at my tender age, I should be celebrating this:
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Tender, incidentally, is not a politically correct word, in this age and context.

Do check out my short piece called ‘Microvalentine’s Day’ (old post).

Before I wade into another mile of this nonsensical ramble, I should set the record straight:
I don’t mean Effing in your kind of effing sense.
This is a radical, new verb. My invention. It intends to describe an activity that “uses E-sources for Food and Fitness.”
Brilliant, wouldn’t you say?
So, let us carry on about Effing.
This post, following on from the earth-shaking previous one titled ‘The Fat Loss Plateau and Beyond’, is focused more on the same, by popular demand.
I promise you I will talk sense, and will not bore you with statistics and evidence. I will, instead, use my anecdotal example.
I started working out in the gym an year ago. I found I was getting stronger, but I knew I had a long way to go before I could be considered fit. I also found that I had lost only so much fat in spite of a lot of effort. This is the very common conundrum that is called the fat loss plateau.
I used certain tricks that are threatening to make me the next Adonis with a six-pack neck (anywhere else, it is all so passé, so upwardly upper class!).
I got a free account in FitDay. This made me focus on exactly what I was eating on a daily basis. The results astounded me. Take a look.
This is a typical day’s intake when I was working hard and yet seeing no fat loss worth the name:

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You can see that a huge truck-load of calories was coming from carbohydrates in the flour and other grain sources, apart from sugars. Luchis are fried breads, aloo dum is fried potatoes in gravy, and samosa is a savory- fried flour pastry stuffed with spicy potatoes and a few minor vegetables.
I decided to cut that out. On the day when I fast and then break it, eating gustily in the four-hour window (read previous post on the subject linked to above), see what happens:
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I still ate rice and pancakes (the Indian equivalent) but I logged less than a hundred grams of carbs (and far too low of the proteins I need), and only half the calories I could have eaten. But that was because my mother cooked for a family get together, and who can miss out on mothers’ cooking, right? Incidentally, you can see how badly balanced a South Indian vegetarian diet is (the last four items were ‘aloo curry’, ‘sevai’, ‘kirai’ and ‘appam‘) from the chart. The names ‘ON’, and ‘ON’ powder refer to the whey protein supplement made by Optimum Nutrition. Casein is ‘channa‘- milk protein.

So, I cut out grains from my diet. I checked again, another day:
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I was still eating some rice, and worse, I was getting a lot of calories from the occasional ‘treat yourself’ sweets and the modest alcohol I drank on a given day (a get-together of family or friends). This was revealing: in spite of a conscious effort, I was still letting things slip, thereby blunting the results. I became more vigilant. Look at the typical IF day chart now:

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Violá! I was hitting the sweet spot: I was actually consuming more proteins and fats, and getting closer to the 50 grams daily dose of carbs I was looking for. I think a carb intake of up to 100 grams daily should be good enough for fat loss, especially if you eat clean and keep within your total caloric requirements. Think Primal Living.

So Intermittent Fasting works well to reduce total calorie intake, but you have to be very careful and diligent if you want to reduce your carb intake. Too often, even geniuses can eff up with their resolve, allowing the calories to slip in.
If there is one thing for the reader to take home now, it is the fact that so much of your intake is what you would forget when asked: “I don’t eat at all, but I still gain weight!” The blame is shifted to last year’s hysterectomy, gall bladder surgery, thyroid problems, baby, genetics, and even the weather!

Eating clean will bring in results, especially if you are active physically, and not merely doing what my son said (when asked about his exercise of the day), “I worked out my fingers really hard, playing FIFA World Cup on my Playstation!”

Keeping an online journal lets you be objective in analysing your results:
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So, I know how much tighter I should control my food, or when to be a little easier on myself, without losing track of the larger goals.
I also keep a mini-diary in the site, like this:
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So you think you burn a thousand calories in the treadmill, so you can hog that dinner tonight? Look at this:
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I believe I burn more than 3500 calories a day, but that does not make an effing difference to the computer! So, sadly, we have to believe the records. Moral of the story:
Keep your food journal diligently, and learn from your mistakes. It takes 5-10 minutes a day. It gives you more rewards than Twitter/Facebook/blogging, and other things for which we try to carve out some time.
Happy eating, this Valentine’s Day! Incidentally, if you think of gifting me a bottle of Ballantine’s for next year’s V Day, think of a fifty year old single malt instead. It’s twice my age!

THE FAT LOSS PLATEAU AND BEYOND

Long post alert!

Many of you may not have realised (as I have not) that this blog has become one of the most Googled sources of fat loss info in the web.

Oh, sorry! I had initially set for this intro to the post to appear in 2025, so let us not move that far ahead. Restart (not you, moron)!

I am writing on fat loss because of the insistent demands of many of my wild-eyed fans like her. “Rambodoc”, they say in different accents, “When will you shine the light on my fat? When will I lose that handle around my waste waist so that I can start looking as young as you, you delishius hunk of meat, you..” And many, many words to that effect. No, Rads did not say any of this, but we can all expect her, as a mark of her eternal gratitude for this post, to send me one of her used 7-series BMWs or, if she feels cheap, the keys to a property in Manhattan (such low prices these days!) or somewhere. Anywhere, actually.

Okay, let us now get serious here. Restart.

Fat loss stops after the initial effort in a program of diet and/or exercise. This is common knowledge. Let us first see what are the reasons for the fat loss plateau:
1. You are not working out the right way.
2. You are working out the right way (maybe you even have a great coach) but you are not eating right.
3. You are eating less calories, working out long, but your metabolism is too slow, i.e., your body burns calories slowly. A common ‘note to self’ by women, men, older men and women, hypothyroid men and women, post-menopausal women, and some other groups we may have forgotten about.
In the next few thousand words (kidding!) I will give you the juice from the research of around 935 (again!) research articles without boring you to death with the sources.
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(Fat people are easily seen everywhere even in India)

Let us simplify issues: if your body needs 2000 calories as its basic metabolic demand (known as BMR or Basal Metabolic Rate), and if you spend another, say, 400 calories in your activities, then you would need to eat less than 2400 calories a day consistently to run a calorie deficit. Right? Many of us know that you will lose a kilogram of fat if you run up a calorie deficit of around 7000 calories. So, a 500 calorie deficit a day should result in the loss of one kilo of fat in two weeks. A pound a week. Clear?
There are lots of compounding issues to this simple equation, but you still have to keep touching base with this simple reality to achieve fat loss:
Calories burnt must be greater than calories eaten.
The most important way to accelerate fat loss is to eat less calories. Not in working out. Trainers are fond of saying that “you can’t out-train a bad diet”. Very true. Unless you are Michael Phelps who, at last Census, was not known to have met a fat loss plateau.
“Oh, no! He is going to talk of diets? Not again?!” Was that you saying that? Can you see me nodding my head sympathetically, like a politician at election time?
Some more basic truisms:

All diets work. But only for some time.
Diets don’t work by themselves in the long run.

What do we do then? Studies show that only 5 percent of people on a supervised diet manage to sustain weight loss. The rest fail. That includes you and me. Let us, therefore, rephrase this:

Diets don’t work; lifestyles do.
If you do lifestyle, you never feel that you are doing something special or stressful. It comes naturally.
What is this stupid, airy, hair-splitting, you ask?
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(a typical dinner of mine, and ALL mine!)

Many people (author included) follow a lifestyle where you mimic the lifestyle of primitive man (an animal who probably did not have obesity). Which means:
* Eat whole foods that are available in nature.
* Don’t eat processed foods (meaning colas, diet colas, bread, cake, pasta, noodles, biscuits, etcetera).
* Avoid grains (rice, wheat, corn, etc.) and artificial sugars.
* Don’t eat meals at a religious rhythm (like 3 meals a day or 6 meals a day).
* Mimic the movements of primitive man (imagine Caveman Rambo with a pointed object hunting a bore boar): sprinting, waiting, sprinting again, crawling, pulling, pushing (imagine wrestling the boar before killing it finally), lifting heavy weights (taking the hunt back to the cave) and then eating it. If he fails to kill it or find some other source, he starves till the next time.
How will you do this in your 9 to 5 life in the US, UK or India?
Easy. Try these:
1. Don’t jog or walk. Sprint (as if chased by a wild dog in heat) for a few short seconds (take 20-30). Rest for a while (as many seconds as you ran or even a minute). Repeat ten times, or six, depending on your ability. That, ladies and gentlemen, is called High Intensity Interval Training (HIIT) or the Tabata workout (Tabata kept a work:rest ratio of 2:1).
In other words, stop wasting time on those cardio machines in your gym or at home. Four to twenty minutes of hard effort (including the rest periods) is enough cardio for you. A month into this, watch yourself improve your stamina and reduce the inches gradually (remember, you have to give your body time- think of one or two years, in many cases).

2. Push or pull your body weight in major, compound exercises like pull-ups (most women I see are unable to do this unless they are well advanced in fitness), push-ups (keep doing ten more than yesterday), squats, and burpees (the best of them all, I think).

3. Stop doing machine-bound training. In other words, don’t waste time in isolation exercises like biceps curls, preacher curls, pectoral decks, ab trainers, etc. You are not going into a bodybuilding competition, are you? If you want maximum bang for your buck, do the bodyweight exercises above, and also do weight training (squats, deadlifts, or anything that involves pulling or pushing a free weight against gravity).

4. Don’t waste time on ab exercises. Do a couple of planks, holding on till you die. You will have done more than enough for your abs and core stability.

5. Didn’t I say ‘crawl‘?! Yes, I did.
You can do mountain climbers, which is not really crawling, or you can actually go on your hands and feet and climb the stairs, first straight up (head first) or reverse (feet first). This would double as a great cardio workout as well.

Anything else about these exercises? Lots, but suffice it to say that you should train harder than you think possible, and not merely go through the motions. Only then can you see results! Each workout should have a decent volume, which means you could do, for instance, three sets of ten reps for each exercise, with 30-60 seconds rest in between sets. Be strict with the rest periods, avoiding chatting and vacantly meditating.

Let us now move on to nutrition, the cornerstone of fat loss management.

Most people are eating way too much to see results. They are also not eating enough proteins, which reduces their muscle building abilities.
One way to address a fat-loss diet is to cut down on carbs (carbohydrates). This is one of the most tried and tested ways of achieving fat loss. Most of the benefits of a low-carb diet accrue from a total caloric deficit. If you are given the liberty of eating loads of fats and proteins (as in the Atkins diet), you won’t be able to eat all that much for too long. Result: lack of variety in foods leading to weight loss. Someone even lost weight on one month’s continual fast food (McDonald’s, etc.) diet!

Low carb diets are often difficult for many people to follow, for cultural and habit reasons. In such a scenario, losing weight is more difficult, but a caloric deficit needs to be created.

Eating six meals a day (a popular advice for most people) is largely impractical in the long term, not least because designing a diet with such low calories is difficult. Imagine a meal with only 300 calories, for example (if you need to eat six meals within a caloric budget of 1800)! In this regard, a more doable lifestyle is IF: Intermittent Fasting.
In IF, you fast through the day, and then eat within a four hour window. You can choose to fast once a week, or every day, for 15 hours, or 24 hours. Your choice. One of the big things going for IF is that celebrities (like myself) endorse it. I fast for 24 hours once a week, and 15 to 18 hours one or two more days in the week. IF is a lot of posts on its own merit, and check my resources at the end of this chapter post, if you want to learn more. Suffice it to say that it reduces blood insulin levels, is a great way to eat ‘normally’ and yet maintain a caloric deficit. I have found that on the days I fast and then eat in the four hour window, I can’t exceed 1400 calories (I don’t pig out with junk food)!

Does when you eat matter in your fat loss plateau?

Is fasted cardio better than cardio in fed state?

Is breakfast the best meal?!

Dinner is the best meal, and you should avoid breakfast like the plague!

Controversies, controversies! Forget all this, and stick to the basics:
eat clean, work out hard, and be happy. Get enough sleep. Drink less. Be active physically. Read fitness articles and blogs. Enough!

So, if we can sum up, how does one overcome the fat loss plateau?
Reassess your diet (definitely keep an online food journal like FitDay), start IF, train harder than you ever have, change the way you are training, avoid long duration aerobic cardio in lieu of High Intensity Interval Training. Take adequate rest and get enough sleep.

Blogs on Fitness/ Primal Living I silently follow (in no particular order at all):
1. Turbulence Training
2. Fitness Black Book
3. Brian Devlin
4. Health Habits
5. Tom Venuto
6. Caleb Lee
7. Straight To The Bar
8. Mark Sisson’s The Daily Apple
9. Muscle Hack
10. Go Healthy Go Fit
11. Alwyn Cosgrove
12. Son Of Grok
13. Robertson Training Systems
14. The Nate Green Experience
15. Gym Junkies

IF Resources:
1. Brad Pilon
2. The IF Life
3. Leangains

Science-based Nutrition/Fitness sites (heavier stuff):
1. Lyle Macdonald’s Bodyrecomposition
2. Alan Aragon
3. Dr. Michael Eades

I heartily recommend any and all of the above, and I think they contribute hugely to the needs of the public seeking help over the internet. I am also very grateful to them for their advice and availability for people like me and you. I am quite sure I am missing out on some of the others I read, but I hope I can include them later.

Disclaimer: I am not a Fitness or Nutrition guru. I use my medical knowledge and apply it to my personal quest for health and fitness. If you feel the need to heed my advice, you are welcome to, at your own discretion and risk. If you suffer from any physical or mental disease or infirmity, please consult your doctor and get properly (mis)guided!

TWEETING, TWITTING, SHI…. SAME DIFFERENCE?

I am using this post to publish some random thoughts that wouldn’t fit in any other category than ‘random thoughts’. So I thought I would post them like people do in Twitter, a site that proves once again that the greatest and most successful inventions these days have to be the most apparently useless ones. Okay, enough to ‘provocate’ (which is, you might agree, a much more ‘punchy’ word than ‘provoke’) Twitterers (or whatever they are called).

But, first, the soft sell: follow me at Twitter.

Here are my random thoughts of the day (without the 140 character limits):

Dell Computers are taking $99 from customers if they want local American voices answering their phone calls. It would be better to ask them to pay $999, and give them an iMac or something. Do Dell computers really work? Can you give me the serial number of the one that does?

Arun Shourie wants to take out Pakistan, Bush-style: “Two eyes for one, whole jaw for a tooth”. What say we send him and Sunny Deol to take out the LeT camps across the border?

A patient of mine who needed surgery for gallstones tells me, “I don’t want to take the risk of surgery, I want some medicines”. To which I replied, “You know what, that is like me saying the stock market is too risky, I am investing all my money in lottery tickets these days!”

Pre-payment penalties for home loans are going to go, says the Economic Times. Now that Mr. Chidambaram is Home Minister, we will face payment penalties if we pay the home loans. Home loan waivers, as Ramesh Shrivats said, are the way to go!

Pranab Mukherjee had a hacking cough while gargling away the smell of the Hilsa fish he had for lunch. The Pakistanis immediately readied their army for war. You see, when he speaks English threatening dire consequences, they think he is just gargling, and vice versa.

Now I need to get back to work.

WORLDS APART!

My daily life is replete with ugly sights, foul smells, and sad sounds. Such is the life of practising doctors. I had accepted this long back as a part of surgical life, and trained myself to disconnect my non-professional life from the feedbacks of life with the sick and suffering.
A very minor taste of this:

My nephew, award-winning car designer Harsha Ravi, lives in a different world, as do many of you.
Here is what he is up to. Take a look.

Is it small wonder, then, that I strongly discourage youngsters from getting into medicine? With so many things to be passionate about and excel in, why choose medicine, with all the tensions, ugliness, etc.? What do you think?
One other thing, too: I consider youngsters like Harsha to be not merely lucky to have lives like this, but also smarter, in that today’s kids know what not to do!

Pics: patient pics mine; others from Harsha’s article.

IRAN AS THE WORLD’S ROLE MODEL?

According to certain highly educated and qualified people, Iran could be a surprising model for the rest of the world. No, not just in creating nuclear plants and forcing the West to blink, but in their system of allowing organ trade.
An article in Nature India underpins this point along with some interesting ethics issues. If you do not have access to Nature, you could get the same article here. The author of this piece is a familiar name to some of the readers of this blog, as we have discussed some of his earlier publications.
What is the beef of the article?

In India, a huge demand exists for about 200,000 kidneys, with an estimated annual sale of 2000 kidneys. By making organ sale illegal, this market is pushed underground, and organized rackets thrive by working outside the society’s laws and regulations. One of the spin-offs is the phenomenon of organ theft. Such an organ harvest is obviously illegal. Organ theft and organ sale, however, are not the same thing. Every sane person will surely condemn the stealing of a poor man’s kidney, but if such a person volunteers to sell it for money, would it be all bad?

AFIRMATIVE ACTION: A NEW ERA BECKONS!

Science fiction becomes official policy.
According to this article:

Yesterday the Department of Defense announced the creation of the Armed Forces Institute of Regenerative Medicine, which will go by the happy acronym AFIRM. According to DOD’s news service, AFIRM will “harness stem cell research and technology … to reconstruct new skin, muscles and tendons, and even ears, noses and fingers.”

“Not another stem cell article”, you decry? Among the new developments in medical labs, we have watched with fascination the creation of artificial livers and other tissues. Now, this research is going to be the focus of the US Department of Defense. This could potentially re-arm the amputees of war. This could restore limb function and mobility to those whose spinal cords have got damaged in accidents and bullet injuries. Think of restored vision, too. The benefits could spill-over into civilian health care as well.

Don’t underestimate this development. This could change life for ordinary human beings in a way politicians, bombers, terrorists and environmentalists cannot. More strength and more money to AFIRM, I say!

NO KIDDING ABOUT KIDNEYS

Finally, someone echoes my thoughts exactly!
An article in The Liberty Institute website says things I would have.
The topic is the kidney scam and the free market. There are several others, even better, on the same subject you can easily find there.
Check it out.