All posts by Crawford, PA, Retired

About Crawford, PA, Retired

I am a retired Physician Assistant. I graduated with the second PA class of Emory University in 1974. My first job out of school was with the ER at the Medical Center in Columbus. After 1 year I moved to Roanoke, AL to work in a rural family practice with Dr. John E. Campbell, the author of the book "Basic Trauma Life Support", a textbook used in many EMT classes. Following that I worked for 3 years with the Federal Prison System, providing healthcare to imates. In 1987 I accepted a position with the University of Florida Transplant Program as a donor coordinator. The last 18 years of my career were spent in family practice and urgent care. I am now retired from clinical medicine but hope to continue to help people through this blog, articles, and booklets about healthy lifestyles.

The Calorie Balance

When it comes to taking control of your weight the two things to consider are calorie intake versus output. It’s all about the calorie balance!

Calories are not some form of gremlin that live under your bed and sneak out at night to put weight on you. Calories are simply a measurement of energy. For a scientific explanation, a nutritional calorie is the energy it takes to raise one liter of water one degree centigrade.

You take in calories when you eat or drink anything but water, and you use calories when you exercise, do work, or just simply live. The energy used resting, sleeping or in a coma is called the Basal Metabolic Rate, or BMR. That’s the starting point to determine your calorie needs for the day. BMR calculators are available on line.

If the number of calories consumed are balanced by the number of calories used during a day your weight remains stable. If you take in more than you use the excess is converted for long term storage as FAT. The opposite of this happens if you use more than you take in. Some of the stored energy is broken down and used.

For example, a BMR of 1593 calories a day means that doctors would need to give a comatose patient that many calories daily in IV fluids and tube feedings to fuel the bodily functions and maintain the current weight. But, someone awake, alert, up and moving around, needs more calories to fuel their daily activities.

Again, there are calculators on line to help you determine your calorie needs each day to reach your goal weight in a selected time. A good weight loss rate is 1-2 pounds per week. That doesn’t seem like much, but how would you like to be 52 or104 pounds lighter this time next year?

Calories are easy to come by, far easier today than they were a couple of generations ago. In the days of our parents and grandparents, the only things that came from the store were commodities such as sugar, flour, coffee, and some meats. Other foods came from the family garden, grown, picked and canned. Labor and energy were used to obtain most foods.

Today there is a grocery store, convenience store, or fast food restaurant on every corner. Intake calories are available, plentiful, and cheap. Sometimes it seems that the fast food industry is in a competition to see which can pack the most calories into one meal at the cheapest price.

Combine the abundance of available calories and the many ways we have to avoid burning calories such as motorized vehicles, labor saving tools and devices, children using computers and video games rather than active play, and it’s not surprising that obesity and poor physical fitness rates are at an all time high.

What can you do to help yourself avoid becoming obese and out of shape? First, know how many calories you take in each day. Most of that information is found on food labels, or you can check internet sites. Keep track of serving sizes. If a serving is one cup and you eat two cups, you just doubled your calories for that item. Manage the intake.

At the same time, increase the calorie output by increasing your daily exercise. Walk to the corner and back once or twice daily. Slowly increase the amount and duration of the exercise. If you try to do what you did at age sixteen, you will probably hurt yourself, or tire out quickly and quit. Consistency is the key. Marathon runners don’t start by running marathons, they start by walking around the block, then gradually increase their distance and duration until several months later they are going the distance.

With discipline, patience, and consistency, you can take control and balance the calories.

This blog is intended for information purposes only and should not be considered Medical Advice. Discuss with your doctor any personal medical conditions, dietary changes or exercise programs before making any lifestyle changes.
©2016 Guy A. Crawford

Taking Control of Your Health

Most everyone wants to live better and healthier. Like many things in life, wants and wishes do not make things come true.

Doctors and other health professionals can help by giving advice and guidance, but they can’t make the changes that you need to make a difference. Only you can do that, one day at a time, one meal at a time, one walk at a time. No excuses, no put offs, no delays. If you are going to change, then change. As my mother used to say, “If wishes were horses, then beggars would ride.” Only putting in the time and effort will show results.

What does taking control really mean? It means that you have to control the variables in your life rather than letting those variables control you. It means that each day you have to do the things that you need to do, moving toward good health rather than doing the same things you have done for years. The AA definition of insanity is “doing the same thing over and over while expecting a different result”. It doesn’t work.

Taking control means acknowledging that you are harming yourself by your own actions or inaction then making the changes to improve the situation. I’m sure that most of you know someone who says things like, “I know I need to eat better and get some exercise” but they never really start doing it. Maybe you say that to yourself.

Taking control takes effort! Taking control means getting out of your comfort zone and developing new routines, new habits. Sometimes taking control means making new friends, associating with different people. Your old friends like you the way you are, and may try to keep you from becoming the new you.

Taking control takes time. Changes won’t come overnight. In an earlier post I mentioned that establishing new habits takes 66 days to become routine. Sixty-six days seems like a long time, but that 66 days will pass whether you stay the same or change.

It’s all up to you. Stay where you are or take control and make the change to a healthier lifestyle.

Hazards of Obesity

Why all the worry about obesity? In years past Overweight or obese people were considered healthy. But many health problems are associated with being overweight, and the more overweight, the greater the health risk.

Obesity is now classified as a disease by the American Medical Association. The cost of obesity and related illness to the health care system is about $3.5 BILLION annually. Let’s look at some of the health problems associated with obesity.

Heart disease – Most people who are overweight also have poor physical conditioning. The foods that makes us overweight or obese contribute to high cholesterol and triglycerides (fat) in the blood. The cholesterol and fat are deposited on the walls of the arteries resulting in plaque that limits blood flow to the heart muscle. Eventually the artery becomes completely blocked preventing blood from flowing to the muscle down stream. Without adequate blood flow, the muscle starts to die. If the blockage occurs in a small artery of the heart it’s a warning that bigger things are yet to come. If the blockage is in one of the major coronary arteries the results are catastrophic, frequently with sudden death.

Type 2 Diabetes – The greatest cause of Type 2 Diabetes is obesity. At one time Type 2 Diabetes was called Adult Onset Diabetes, but now, with the increase in childhood obesity, more children are being diagnosed with Type 2 Diabetes. Forty years ago when I was a student, one of our instructors, an endocrinologist, told us that if we could get our “adult onset” diabetics down to ideal body weight no medication would be needed to control the blood sugar. At that time we didn’t know why, but now we do. With obesity comes insulin resistance. The islet cells of the pancreas secrete insulin, the hormone that moves sugar from the blood into the cells. Obese persons, develop a resistance to the insulin blocking the movement of sugar from the blood into the cells. Over time the pancreas wears out and can no longer make insulin. Then insulin shots are required. The first and preferred treatment for Type 2 Diabetes is weight loss to ideal body weight through diet control and exercise. If this is done early enough insulin injections can be prevented.

Obstructive Sleep Apnea – Obstructive Sleep Apnea (OSA) is frequent pauses in breathing while sleeping. This causes micro awakenings during the night preventing adequate rest, resulting in excessive daytime sleepiness. OSA is much more common in obese and overweight persons, and can in turn lead to greater weight gain and obesity.

Osteoarthritis – The greatest risk for degenerative or Osteoarthritis is living long enough to get it. It’s a disease of aging. There are a couple of things that can increase your chances of developing, or having a more severe case of osteoarthritis. One is something we can’t do much about, getting older. The other is how much we weigh.  Being overweight puts more stress on the weight bearing joints.

Cancer – Risk for colon, pancreatic, breast, and gallbladder cancer raises with obesity, sedentary lifestyle, and diabetes, all of which are common in patients who live an unhealthy lifestyle.

Liver disease – NASH (Non Alcoholic Steatohepatitis) or fatty liver disease is now recognized as the second leading cause of liver cirrhosis, behind excessive alcohol intake, and can lead to liver cancer.

Through changes to a healthier lifestyle you can decrease your risk of disability and early death.

This blog is intended for information purposes only and should not be considered Medical Advice. Discuss with your doctor any personal medical conditions, dietary changes or exercise programs before making any lifestyle changes.

©2015 Guy A. Crawford





One Pound a Week

One pound a week is a good weight loss goal. By strict dieting you can lose more than that, but losing more than one pound a week has some drawbacks. Sudden drastic changes and too rapid weight loss can make it difficult to continue your program, lead to loss of muscle or lean tissue rather than fat, and increase the risk of developing gallstones.

What is one pound a week? One pound a week is 500 calories a day. If you take in just 500 calories a day more than you burn you will gain one pound a week. The opposite of that is true, if you burn 500 calories a day more than you take in you will lose 1 pound a week.

What is 500 calories? 500 calories is three pieces of candy each hour from a bowl on your desk during an eight hour day. That would be 500 calories that you probably wouldn’t even remember eating.

Burning calories takes a lot more time and effort than eating them. The average piece of pie, a nine inch pie cut into 8 equal slices, is about 400 calories. Eating the piece of pie takes about 3-4 minutes depending on how much talking you are doing at the time. To burn off those 400 calories takes walking 4 miles in one hour, or 15 minutes per mile. Most people can’t walk 4 miles in an hour, so they would have to walk twice as long.

Add those extra calories to your meals and you can see where you could easily gain a pound a week. It’s what I call a creeping weight gain. You don’t feel like you are eating much, but you notice your clothes fitting tighter, or you step on a scale and see a weight gain and ask yourself, “Why am I gaining weight? I don’t eat anything!”

Save the high calorie desserts and snacks for special occasions. Regularly eat high volume low calorie foods such as lean mean, low starch vegetables rather than low volume, high calorie foods like fast foods and desserts. Exercise regularly to increase the efficiency of you metabolism. Aim for a weight loss goal of 1 pound each week. By doing that you will make changes that you can stay with.

Make changes slowly. If you change too much all at once, you and your body will rebel against the changes and you probably won’t stick with them. Know what you are taking in by educating yourself on proper nutrition and exercise. Always see your health care provider to discuss diet and exercise changes.

It takes time, thought and commitment to change your lifestyle, but 500 calories a day, one pound a week can make a big difference in your life.

This blog is intended for information purposes only and should not be considered Medical Advice. Discuss with your doctor any personal medical conditions, dietary changes or exercise programs before making any lifestyle changes.

©2014 – Guy A. Crawford – All Rights Reserved

Your Lying Mind

Why do you think that it’s so hard to stick to the changes that we want to make in our lives? In my last post I said that it takes an average of 66 days for a change in lifestyle to become ingrained in our daily lives. I tell my patients it’s because your mind will lie to you.

When you begin a lifestyle change whether it be quitting smoking, eating healthy, or starting an exercise program, you have to change the lifestyle routines that are comfortable to your mind. You want to give up cigarettes, snacks, or fast food meals but your mind rebels against these changes. Your mind whispers to you, “Just buy another pack of cigarettes today and quit tomorrow,” or, “Just super size the meal today and start eating healthy tomorrow.” Sound familiar? It happens to all of us.

These are the blocks you must overcome to change your life. As long as you allow your lying mind a voice, you will not make the needed changes in your life. Change comes with recognition of what is going on and taking control. Every day that you have control the closer you get to your goal. Some people are strong enough to take control on their on, others need help from a support group, or medical intervention. But whether you go it alone, or with the help of others, you must overcome — your lying mind.

This blog is intended for information purposes only and should not be considered Medical Advice. Discuss with your doctor any personal medical conditions, dietary changes or exercise programs before making any lifestyle changes.

©2014 – Guy A. Crawford – All Rights Reserved

Making the Change to Healthy Living

Living a healthy lifestyle is fairly easy. Making the change to living healthy is the hard part. That’s why so many New Year’s resolutions fail, the resolver doesn’t make the full commitment of time to changing behaviors. Changing is a difficult thing for all of us to do. We are accustomed to doing certain things in our daily routine, and changing means becoming comfortable with a new routine.

When I was growing up there was a country comedian named Brother Dave Gardner. In one of his routines he said, “We do something once, twice, and the third time is addiction.” That is true in some cases, particularly bad habits. But, in a study conducted by Phillippa Lally and others for the European Journal of Social Psychology in 2010, it was shown that it takes an average of 66 days for new habits to become routine.

How many times do we actually give ourselves 66 days of changing eating, exercise and getting rid of other unhealthy behaviors before we slide back in to our old, comfortable routines. It takes time for new routines and habits to take hold and become the norm. The trick is to hang in there and become dedicated to making the change for the better.

There are many programs and aids to help you make the change. Some are good, some not so good. The important thing, though, is to set your mind and be diligent about following YOUR plan. Any plan can work if you work the plan.

This blog is intended for information purposes only and should not be considered Medical Advice. Discuss with your doctor any personal medical conditions, dietary changes or exercise programs before making any lifestyle changes.

©2014 – Guy A. Crawford – All Rights Reserved

Hello world!

Welcome to Healthy Lifestyles 101. I hope you find the information here interesting and relevant to your life and health. I have been thinking about this website/blog for several years, trying to decide just how I wanted to present the material. I finally decided to take my own advice and just do what I need to do, jump in and see where this takes me.I invite you to go along for the ride.

For the readers who don’t know me, let me give you some of my background, and why I am so interested in the subject of Healthy Lifestyles.

I am a retired physician assistant, graduating with the second class of PAs at Emory University in Atlanta in 1974. I have worked in emergency medicine, family practice in rural Alabama, the Federal Prison System providing health care to inmates, and organ procurement with the University of Florida Transplant program. The last 18 years of my career were spent in family practice and urgent care.

During these years I worked with many patients with health problems directly related to their lifestyle such as obesity, metabolic syndrome, alcohol and tobacco use. I have to admit that I indulged in some of these same unhealthy behaviors; however, I learned over the years that in order to get the most out of life I have to moderate the unhealthy aspects of living. I am not a “Health Nut,” but I believe that eating healthy, avoiding tobacco, limiting alcohol, and regular exercise will help keep me healthy and limit my risk for early death or disability.

Life is risky enough. After all, the number one cause of death is being conceived. Why increase the risk with unhealthy behaviors?

Over the next few weeks and months, I will address these subjects in detail with suggestions for how you can live healthy with some changes in your habits.

This blog is intended for information purposes only and should not be considered Medical Advice. Changes in diet and exercise routine should be made only after consultation with your primary health care provider.

© 2014 Guy A. Crawford – All rights reserved.