I am a 76 year old man. My BMI is in the stated range at 22 though I’m not sure the calculations for BMI at my age are valid or whether the tables factor in the variable and progressive muscle wasting of old age.
I have very evident muscle wasting compared to my younger more active days which is normal and to be expected. I have also developed an early pot belly which is not good for my male ego.
My reason for wanting to lose weight is that I get moderately short of breath due to mild heart failure, in turn due to moderate tricuspid regurgitation and permanent atrial fibrillation.
My thinking behind my question is that even though I have a BMI in the stated range, if I could get my BMI down to 17/18 I might see an improvement in my breathlessness,
It’s important to me because I may have tricuspid valve surgery soon and it may influence the decision on surgery.
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This is my current food plan
7 am Filter coffee with 15 ml of single cream
Midday as above
7 pm only meal of day and only calories other then cream in coffee
Set on variety of salad leaves dressed with olive oil (the amount of which not yet measured)
TOPPING
Choice of
2 eggs, 30 gms of cheddar cheese, 2 medium tomatoes. salami or similar, tuna or tinned sardines.
Fresh meat twice a week, 6 oz steak or two salmon fillets.
Brazil nuts, walnuts and peanuts. Apples, blueberries and strawberries Occasional full fat unflavoured Greek yogurt.
Half a standard glass of wine daily, no beers or spirits. Total fluid intake 2.,3 litres daily typically
2 to 3 miles walking daily at moderate pace
WEIGHT DAY 1 68 KGS (MY USUAL)
DAY 14 69 KGS
I feel fine and don’t have much appetite on this once daily meal regime.
Good sleep 6 hours
MY QUESTIONS
Can rise in weight in early stages of ZERO CARB DIET be unremarkable?
Are there other things I could usefully do?
What level of fat intake is appropriate for a low carb diet? Should I be weighing my food and keeping a diary?
Let me first say that I am not medically qualified, or an expert, but my thoughts on this are:
My understanding of a low carb/ketogenic diet is that it will normalise your weight and as you are on the lower end of normal weight for your age, that could be the reason for the slight rise. You're unlikely to see any reduction unless you physically starve yourself, which is definitely not advisable.
Studies have shown that a slightly higher BMI for older adults leads to a lower all cause mortality rate. Here's one example ncbi.nlm.nih.gov/pmc/articl...
I suspect that the breathlessness you're experiencing is down to the problems you have with your heart and weight loss won't improve that.
Lack of muscle mass could probably be improved with strength exercises alongside your walking. nhs.uk/live-well/exercise/p... There are many videos online to help.
I honestly do not think you should be aiming for weight loss, but looking to improve your muscle mass with exercise appropriate to your abilities. I'm sure your cardiologist/cardiology team could guide you.
Hi Jim987. Moreless has given you a great reply. I just wanted to add to what she said by saying I recently watched an interesting netflix series ( you are what you eat, a twin experiment) and it demonstrated how the body will use its own muscle for energy, thus breaking down your muscles, if you don’t eat enough. If you’re also eating insufficient protein you won’t gain muscle however much you exercise. I don’t know anything about Atkins but it doesn’t look like you eat very much, so maybe have a rethink and look at a food plan which gives you three balanced meals a day. Might be more interesting too.
Thank you very much Frenchfields. You’ve made some good points.
Atkins is one of the low carb diets, based on evolutionary science. Until 15,000 years ago with the introduction of cereals, man ate only protein and fat, with minimal if any carbohydrate.
Carbohydrate restriction induces ketosis which causes fat to breakdown to supply energy. I usually find it very effective and easy both in the short and long term.
Loss in muscle mass (sarcopaenia) is normal with aging.
Thank you, interesting to know about Atkins, though I quickly looked him up and apparently his arteries were in a shocking state when he died! But I digress 😀. Yes I understand sarcopenia is common due to hormonal changes etc as we age but can be reduced with a good diet and strength training, as I think moreless suggested. Anyway, good luck with your regime.
Your cells can burn glucose or ketones (made from fat) for fuel but a mechanism intended to keep yur blood sugar down means that you can not burn off fat while your blood sugar is above a certain threshold so while you are consuming any ammount of carbohydrate e.g alcohol you will not loose weight and may put on weight until the resulting blood sugar has been burnt off. Try time restricted eating, commonly called intermittent fasting, where you extend the time between your last meal of one day and your first meal of the next day which allows more time for fat burning. I do that by not eating breakfast and having my evening meal before eight pm. There is no essential nutrition in carbs so you do not have to eat any at all as the body has a mechanism (gluconeogenesis) which makes any required glucose from protein. Are you identifying all sources of carbohydrate correctly e.g some root veg are surprisingly high in carbs?
A pot belly indicates inflammation possibly from the regular alcohol or possibly from wheat or refined seed oils (what's usually labeled 'Vegetable oil'), switch over to animal fats, olive oil, coconut oil or avocado oil.
Thanks. No I’ve never drunk more than my doctor and sugars never. Bread yes please and that’s why I need to go back on the Atkins which worked so well for me last time.
Interesting about fatty liver and a pot belly. How does that work?
p.s you'll find it very hard to over eat on a truly ketogenic diet as blood sugar affects your hormones meaning that you get more of the satieted feeling whenyou've eaten enough and you do not get strong hunger pangs driving ou to snack regularly. I've never counted a calorie in my life.
It’s great that you’re focusing on your health and looking for ways to improve your breathing. I know from experience that BMI can be a bit misleading, especially with the muscle loss that comes with age. My grandfather faced similar issues; he had a bit of a pot belly too and was dealing with some heart issues.
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