Peter wrote:
Food is always a difficult topic, because people are extremely attached to theirs (it is a huge part of life for most, especially if you socialise around food… going “healthy” is rarely going to be appreciated at a dinner party) and most people who have heart issues and have had some surgical procedure (bypass or a stent) just treat it as a plumbing repair, go on statins, beta blockers, aspirin, anti platelet, etc and eat and smoke like they did before. Then they are back for another op a few years later… still in denial, saying heart disease is 99.9% genetic etc.
I think you are wrong to the extent that the majority of people actually find it very very difficult to substantially change their lifestyle and diet. There is also evidence that the body resists you doing so in many different ways – including a lower overall calorie burn rate when it thinks it is being starved – doubtless a very good strategy before supermarkets and the like.
That is not to say it isnt worth the effort and not very important, but I think it is easy to criticise or believe the solution is easy.
Chatting to my AME he can count on one hand the number of people over 50 who have lost a substantial amount of weight and remained at their reduced weight for more than 12 months. Not many more hands are required over 40. It gets progressively more difficult.
Smoking is much the same. As many times as people are told it stands a very good chance of killing you, they continue. Technically it may be habit forming not addictive but it is clealry extremely additictive and requires a huge amount of will power and committment to give up.
I am glad I have never smoked, and I have lost a significant amount fo weight, so I know how very difficult it is.
Fuji I totally accept that losing weight via eating less, and sustaining it, is really hard. The number of people I know who have done it I can count on exactly one finger, and she had an incentive in the form of some deaths or serious issues in the family due to diabetes. This is because if you eat less you get hungry 
The way to do it is to eat a plant based diet. Cut out meat and dairy, especially dairy. Cut out pasta and replace it with something like this. Cut out all the crap like choc bars cakes and croissants. Not fanatically, just almost entirely. Veg fills you up so you don’t go hungry, and you lose weight effortlessly. I lost 8kg in 3 months, 80 down to 72. There are various problems with this however:
Justine is a nutritionist but doesn’t practice anymore because the above issues made it almost impossible for most people (those who really needed to lose weight) to pull it off. The last point alone (i.e. one’s relationship situation) pretty well finished it off for most people.
I had an AME who almost got me to stop flying with his fanatism on that subject. Every time I had to go there, it was dieting for months before to little or no success at all for most of the reasons Peter mentions and it put a massive strain on me and my relationship because of my stress and foul mood during the time. Just in time I changed the AME and found a very pleasant and competent fellow who is a joy to go to.
I am overweight BUT healty with it. That means, neither do I have diabetes nor any sign of it, my cholesterol level is normal for my age and my blood pressure is bog standard (120/80). I don’t smoke and I don’t drink (out of professional necessity, they have a zero limit at the airport) . The Cardiogram is bog standard yet again.
I have lost two acquaintances to sudden heart death and I know a good dozen more who had heart attacks and strokes and lost their licenses because of it. ALL of them had BMI’s below 25 and two actually are competition runners doing stuff like Iron Man e.t.c. None of them was obese. On the other hand, I had one acquaintance who was massively obese but beat cancer for 10 years while a top fit guy I knew was gone in 2 months.
Go figure.
I am still trying to loose weight but not fanatically so and I have stopped totally setting unrealistic goals of like loosing 60 lb or more as the original AME demanded of me. So far, I am down 20 lb over 2 years and the tendency continues,but I am doubtful if I ever will become as I was as a youngster. Nor am I sure I should.
The optimal BMI if longlivety is your goal is between 25 and 27 btw, so slightly overweight. Anything more and your morbidity increases rapidly, anything less and one apparently has insufficient reserves to make it through critical illness like sepsis or cancer. It probably also has a lot to do with people in this BMI range being most at ease with themselves and enjoying their lives.
The longer I live (and I’m overweight, so it’s probably on borrowed time ), just like the old people used to say – “everything in moderation” is the way to go. My grandpa never touched any greens, ate meat and potatoes and gravy all his life for every meal died at 96. Genes only? Perhaps. But you have to admit – look into your family history you’ll probably find that many of the “old folks” often lived very long lives, despite not eating any of the stuff we today consider healthy. How is that possible? I think it’s very simple:
1. They ate home cooked. Not processed.
2. They ate in moderation. Because that was the generation that had experienced real poverty.
3. They were rarely overweight.
4. They ate real fats. Ever since the low fat fad started in the 80’s (replacing it with sugars), we’ve become fatter and heart disease has increased.
If I look at Swedes in general – they cook everything in butter (nobody in Sweden even knew olive oil existed before 1990), use lots of salt, cream, and eat potatoes to every meal. All the things that are supposed to kill you. What’s the average lifespan of Swedes? 9th highest in the world. Guess who has similar food – cream, potatoes, butter, meat – Switzerland: 2nd highest lifespan in the world. The Japanese eat more rice and salty soy sauce than anyone else – 1st in longevity. So, it’s obvious that there is no correlation between a long life and the things many of the nutritionists say is good for you. To paraphrase William Goldman: “Nobody knows anything”.
Eat and drink everything in moderation and try not to be overweight.
There will always be loads of exceptions, but I think your #3 is the biggest factor Adam. Another one is that – without cars – they walked a lot more. This translates to a better quality of life (less going wrong) in the 10-20 years before death. Today, people live longer and longer but often with a load of medical attention and a poor quality of life in the last decades. Pop into any hospital waiting room and it’s obvious. You can have a nation of 90 year olds whose last 20-30 years are achieved with a ton of medical care, which works OK in a high-tax country. You probably don’t want to be like that in the UK, nowadays…. Here, diabetes is likely to overtake Alzheimers and that will bankrupt the place because the former needs 20 years of medical care whereas the latter is only several (average care home stay is 2.5 years).
BTW it is very hard for a nutritionist to make a living, because clients don’t want to pay for the time it takes. The successful ones have either managed to write a book (which sells) or they sell a load of supplements on which they make commission 
It’s interesting that while some have mentioned moderation (they key in my eyes) – nobody mentions that you have to MOVE to stay healthy.
Of course you can force your body to lose weight by only eating less or only salads and fish – but you will lose not only fat but a lot of muscle mass too if you don’t move enough.
I am slightly overweight but it’s clear that this is a result of sitting too much. My strategy is to not eat two days a week (except fruit), to excercise (home trainer in front of TV, tennis, ski) and as a family we try to eat meat only once a week and a salad with every meal.
(I quit smoking on January 31st, 1993 – and to this day i know it was the one thing that took most willpower in my whole life. But i have never touched a cigarette again. In 1996, while drinking with friends, i challenged myself again – and i have never had an alcoholic drink again. I tried it, because I feared i could not do it – and after one year i did not want to go back.
Today i only drink coffee, maybe too much of it but i love coffee, and i do eat chocolate – sometimes too much aswell. There’s s limit to every character i fear … :-)
That’s what I said – the older generations were a lot less likely to be immobile in their old age.
As Peter says above ….. without cars-they walked a lot more….
My mother in law has never driven a car in her life, if she wants anything she has to walk to the shop and buy it and not having a freezer means she has to do that most days, This also avoids consuming the rubbish that’s generally put in freezers.
At 90 she is still as fit as a flea and in better overall shape than a lot of 60 year olds.
IMHO “walking” is not enough. You have to accelerate your heart rate and circulatory system to have a training effect. Of course walking a couple of thousand meters (recommended 10 km) every day is better than driving, but (other than in cities like Los Angeles where you can’t get anything done walking) it is part of our normal lifestyle in many European places anyway.
My wife takes that concept to an extreme: Although she has a nice car she almost never uses it (and I have to take it out of the garage every now and then to recharge the battery) … she does everything by bike in the city, rain or shine, summer and winter … most times witha a trailer behind her mountain bike for groceries. When we go on a bie ride together, like four days ago to the Stones concert at Olympic Stadium, the kids and I have almost no chance following her …
