“If you believe in yourself and you are persistence then it’s never tool late to improve your health for the better. You know you will succeed once you decide you will never give up trying.”

Michael Dansinger, M.D. is a nationally recognized expert in lifestyle coaching for prevention and treatment of heart disease, diabetes, obesity and related conditions. He is the weight loss and nutrition advisor for NBC’s hit prime time series “The Biggest Loser”, and a contributor to the best-selling book series based on the show. Dr. Dansinger is also the Diabetes Doctor for WebMD, Director of the Diabetes Reversal Program at Tufts Medical Center in Boston, and Director of his own “Biggest Loser Style” Diabetes Reversal Program at CATZ gym in Needham, MA. In addition to all that, Dr. Dansinger is the Medical Director and lead architect of the cutting-edge heartmatters TM wellness program created by Boston Heart Diagnostics, a leader in personalized diagnostics dedicated to preventing heart disease and related events.

The Waiting Room was lucky enough to sit down with Dr. Dansinger and ask him to share the secrets to a healthy, fit life. With his extensive expertise in nutritional matters, Dr. Dansinger provided some invaluable insights into tailoring eating plans for individuals. He told us, “It’s much better to have a wide variety of options, the whole spectrum, rather than one best plan for everyone.” One of the main points he conveyed was that although there is a wide spectrum of eating strategies crosses a broad range of carbohydrate, fat and protein intake, not every diet will achieve the desired or required goals that an individual seeks. This spectrum of diets begins with the Atkins diet, which reduces starch consumption, and ends with the Ornish diet which emphasizes starch and vegetables and reduces animal fats.

Dr. Dansinger pointed out the two major criteria in choosing an eating plan. The first is to account for the subject’s personal preferences. If a certain food group is a large portion of an individual’s normal dietary intake, then the preferred eating plan for that individual should include a larger portion of that food group. Rather than trying to reconfigure a subject’s eating patterns to the plan, it is often more successful to find and implement a diet plan that is more suited to the subjects dietary habits and lifestyle.

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Another criterion is to tailor an eating plan to the individuals pre-existing medical conditions. If someone is in the high risk category for heart disease, then oftentimes the appropriate strategy
is one that is low in animal fats and unhealthy cholesterol. On the other hand, if someone is at high risk for diabetes or obesity then a plan that is low in starches and sugars may be important.

Dr. Dansinger noted his 2005 study in the Journal of the American Medical Association indicated that adherence level is much more important then the type of eating plan. Dr. Dansinger emphasized that participating in a lifestyle coaching program can dramatically increase adherence. For most people it’s most difficult to achieve long-term success without some external accountability.

When asked about the epidemic of obesity in America, Dr. Dansinger responded that much of this results from lifestyle changes in American society and unhealthy changes in the food processing industry. Our primitive ancestors relied on fruits and vegetables as the main staples of their diet, with abundant, lean protein. Unfortunately, the widespread introduction of unhealthy fats, rocessed starchy foods and sugars in readily available “modern foods” has done considerable damage to America’s health and waistline. Simultaneously, because America’s jobs have moved from agrarian and industrial sectors to office jobs, the average American tends to be much less active compared to previous generations. The combination of a hectic modern lifestyle and the ready availability of unhealthy modern foods has lead to an explosion in obesity related health problems.

Dr. Dansinger advocates substituting healthier alternatives in an individual’s daily routine. For example, instead of high fat sausage or bacon for breakfast, low fat turkey sausage or Canadian bacon could be consumed. He also warned against eating large quantities of starches, because they can be appetite stimulants. This is because the body turns starches into sugars and a rapid rise in blood sugar followed by a rapid fall is a potent appetite signal to the brain. Dr. Dansinger mentioned that his personal dietary intake consisted of protein, fruits and vegetables with only small amounts of starch.

Another important consideration in losing weight is to change eating plans if the current plan is no longer working. Dr. Dansinger labeled this innovative strategy as “dating the diet plans.” Some individuals can remain on a single eating plan indefinitely while showing consistent results. Others, however, may need to alter their chosen plan or seek an entirely new one, in order to produce ongoing weight loss or long-term health benefits.

The flip side of the weight loss coin is the exercise regimen. Dr. Dansinger’s philosophy on exercise matches his philosophy on eating plans. The exercise regimen should be tailored to the needs and limitations of the individual. Again, a one size fits all fitness routine is not going to be effective for all people. Choose a routine that is tailored to the capabilities of the individual aiming to produce long-term adherence and results.

Dr. Dansinger recently established “The Diabetes Reversal Challenge”. It is a pilot program with a group of 25 to 30 participants with varying degrees of health and mobility. All participants were required to commit to ten hours of exercise a week. The philosophy of the program was to produce dramatic weight loss and markedly increase fitness levels over a longer period of time. In contrast to the dramatic weight loss on The Biggest Loser, the Diabetes Reversal Challenge was primarily designed to reverse obesity and diabetes over a much longer time frame.

Dr. Dansinger emphasizes a “consistent and persistent” exercise regimen. One participant who maintained a consistent exercise regimen and followed the recommended eating plan with 95% adherence, was able to lose twenty pounds in the first month and seventy pounds by the end of the sixth month. Dr. Dansinger stated that similar results could be attained by many others on a similar exercise and eating plan, if the right environment could be established. Accountability and a willingness to push oneself were vital elements in any weight loss strategy. Dr. Dansinger emphasized that solo dieting and exercising are much less likely to be produce significant results, but with proper encouragement, a healthy weight and lifestyle was much more attainable.

The topic of diabetes is one that Dr. Dansinger has studied extensively. Diabetes and heart disease, he stated, have genetic precursors that can raise the likelihood of an individual acquiring them. However with the proper diet, exercise and medical care these can be avoided, stalled in their progression and even reversed. Although he advocates personal responsibility on an individual basis, Dr. Dansinger believes that much more could be done on a population level to stem the rising tide of type II diabetes in America. Dr. Dansinger voiced his support for more government intervention and advocacy for diabetes prevention, treatment and reversal.

People in the lowest socio-economic groups are at especially high risk for diabetes and there is much that can be done to reverse this growing population to the benefit of the whole country. As Dr. Dansinger assumed the role of the lifestyle coach, he emphasized that big life changes can be implemented incrementally as long as the individual maintains his or her resolve. The most important part of acquiring healthy habits is to establish a group of people around you who will continue to encourage you in your journey. It is difficult to exercise or eat properly in a social vacuum, but with proper encouragement, a newer, healthy you can be just around the corner.

Q & A:

Q: What are the foundational principles in a healthy lifestyle?

A: Both eating and exercise are obviously very important components of a good fitness and wellness program. The main driver of weight loss is reducing caloric intake.

Q: How has dieting changed in recent years?

A: We’ve seen over the last couple of decades a popular diet spectrum that has fully blossomed. It remains important today that we have a wide variety of eating strategies
available…the whole spectrum all the way from a low carb strategy on the one end which is low in sugar and starch, to the low fat vegetarian strategy higher in whole grains but very low in animal fat, and everything in between. So I’m an enthusiastic supporter of the popular diet spectrum concept and that there is no one best eating plan for all and that there is a wide variety of eating strategies available for everyone.

Q: What are your major considerations in suggesting an eating plan to a patient?

A: The main things I use to try to match an individual with an eating plan are their food preferences, their medical conditions, and their lifestyle habits. I feel I am much better at this matching process now then I was ten years ago when I first started this approach. In addition to the food preferences it’s important to recognize their existing medical conditions.

Q: Why has American obesity become so prevalent?

A: We’re genetically designed to thrive on low fat, proteins and high fiber fruits and vegetables. Throughout 99% of human existence that’s what people ate but in recent generations the food that we eat in modern times has become so severely different from natural food that we’ve crossed a nutritional breaking point. Advances in food processing technology are driving the epidemic of obesity and type II Diabetes which have become so severe in the past twenty to thirty years. The food and our environment has crossed a critical threshold of acceptability forthe human body.

Q: How important is modifying the diet plan if it fails to produce results?

A: Extremely important. I used to talk about dating the diet… In the past I have spoken about “dating the diet” concept. Many are just looking for the best one and once a person finds “the one” they get married and stay faithful to it forever. Others just prefer to sort of “date around” and change eating plans every few months.

Q: How have you implemented personalized exercise regimens?

A: We recognize that people who have diabetes or other weight related medical problems are not typically in good cardiovascular shape or have arthritis or other mobility limitations. Nevertheless, in my program we have been able to give a good two hour workout to almost anyone because the trainers know how to vary the intensity for a wide group of participants simultaneously. I’ve been fortunate enough to partner with some excellent trainers at CATZ for the exercise component of my program.

Q: What is a good approach to a sustainable exercise regimen?

A: It’s normal when you are out of shape and haven’t exercised for many, many years to feel lousy once you start. However, as you push yourself to work out, that feeling goes away, especially with persistence and consistency and is soon replace with feelings of accomplishment. Anything you can do to put yourself in the position of being pushed and held accountable seems to be the best approach for maximizing your chances of success.