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Interview: Author Dr. Pamela Peeke Discusses Fit To Live

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From the New York Times Best-Selling author of Body For Life For Women and the book and PBS Special – Fight Fat After Forty: The Stress Connection, comes Fit to Live: The 5-Point Plan to Become Lean, Strong & Fearless for LIFE by Pamela Peeke MD, MPH, FACP.

Dr. Peeke has been a Pew Scholar, the recipient of the National Research Science Award Fellowship, is an advisor to the Clinton Foundation Alliance for Healthier Generations, a member of the Maryland Governor's Council on Fitness, and is Chief Medical Correspondent for Nutrition and Fitness for the Discovery Health Channel.

Dr. Peeke – Where did Fit To Live originate?

Fit To Live is the third book in my series. First, I published Fight Fat After Forty – it is the bible of the stress-fat connection. In it, I helped women understand how fighting stress works by explaining the “menopot.” The National Institute of Health worked on this with me. We studied the science of fighting stress.

In my second book, Body-For-LIFE for Women, I covered women’s health – womb to tomb. This included every decade, divided by each hormonal milestone: pregnancy, PMS, menopause, etc.. A woman’s body changes physiologically as she ages. I give an explanation to women about what happens, introducing them to Vitamin I – “I” for intensity.

In Fit To Live, I go to an interesting place, and I blow it out a little further. You can’t keep turning yourself into a science fair project. I use an integrated approach involving the Mind, the Mouth, and the Muscle (covered in my first two books), but add the Money, and the Macrocosm. The Macrocosm is a nature deficiency. In other words, you haven’t seen enough green outside; go hug a tree. Have you had a bad day? Take a walk, just go out there and do it. When was the last time you had a bad experience? Walking outside reduces cortisol and the appetite and increases endorphins. It’s a win-win.

Women are hardwired to ruminate, to be perfectionists, and care-givers. We do this by dropping ourselves off our own radar screen.

Using a pair of sneakers as a metaphor, I’ll explain:

Mind – get a woman’s head wrapped around her own hard-wiring. Put on a pedometer and walk. Walk 10,000 steps a day. Movement ends the mind-body dissociation.
Pamela Peeke,MD,MPH,FACP
Mouth – how do you nourish yourself? Now that you’re walking, what does your body need?
At any age, what is the template? You need proper nourishment to keep walking.

Muscle – how do you walk? “How many calories should I burn?” you ask. Burn 400 calories a day with aerobic activity. Do as much as you can or even more. Challenge yourself. Use an elliptical machine, walk outside, or bike. Do what’s best for “me” as a woman.

Money – if there’s no money, you ain’t getting those sneakers. You must have saved to have the financial wherewithal to buy them. If I stand as a physician ranting and raving at you about you needing to live long and well, that’s great. But you need money for a gym; even the Y is $30 a month. You’ll need health insurance, and LTC (long term care). Do you know what these things are? Statistics are strong– you’ll need these things.

You will also need dollars for produce: it’s the health and wealth connection. Today a bag of organic carrots costs more than a bag of Cheetoes.

Recently, Prudential approached me – boy, I had an eye-opener!

Macrocosm – is environmental. (I’m having an Al Gore moment.) In all my years dealing with women, I have found that there are elements in the lifestyle which will work for or against them. To walk outside, a pair of sneakers is absolutely essential. Sneakers represent self-care. If you can’t find your sneakers, you won’t be wearing them. What about that cluttered mess in your house? How do people get out the door? Where are the exercise clothes? Disorganization is an issue. If you can’t find the bill for the sneakers, you’re in trouble. We have to change it all up!

Dr. Peeke, what is the most successful point of your life?

Professionally – when I am touching the largest number of lives out there. Whether on Oprah, on the board of Prevention Magazine, when I’m able to teach (“Teach” is a Latin derivation of doctor.), or when I’m reaching the largest number of people or women out there–giving them a gift of my wisdom and insight. Or, when I’m receiving their feedback.

Are we, as Americans, deluding ourselves that we are fit?

Absolutely, most Americans are not Fit To Live the life they deserve. They live in denial and disassociation.

Could you run for your life? How fast could you get up, if you were by yourself and fell? You could? Do it now.

Do you think you eat ok? Do you eat fruits, vegetables, take a multivitamin and fish oil every single day, religiously?

What about that estate plan? How’s your Roth IRA? Do you have Long Term Disability insurance? Do you want to die in your own bed or in a warehouse?

Are you alert and vertical? Does your house look like a bomb went off in it?

We are unfit as a society today. What has changed us? How have we “morphed?”

The change began with the Industrial Revolution. Inadvertently, we built a society, that puts low quality food on every block in America, in large quantities. Because we drive everywhere, we have a lack of physical activity.

9/11 did not exist 100 years ago. We didn’t have that stuff. The worst crime was being burglarized. Terrorism – we didn’t have that crap!

Weather is bad. Today, there’s crowding. On top of it, the entire family structure is changing.

I’m 51. When I was a kid, there was one fat kid and one kid from a divorced home in the whole school. Now it’s an option. If things don’t work out, “Dump ‘em,” they say.

Here’s the real deal: we’ve created a society with very strange stresses. We have sophisticated ways of killing ourselves slowly, ie. micromanaging bosses. Our bodies are ill-equipped to handle this. We are made for physical activity.

What is Toxic Body Fat? What causes it and how does it affect the body?

The bottom line is: if you’re looking for a way to play with all this — prescriptive view — rein in the two kinds of fat – menopot fat, which is under the skin against the abdominal muscle wall and the deep fat.

The fat deep inside, the visceral intradominal fat, if excessive, is highly toxic and leads to cancer and cardiovascular disease.

After age 40, a woman is perimenopausal. She is at a point when she’s looking at decreasing good lifestyle habits, becoming sedentary, making poor lifestyle choices, and having hormonal change — estrogen withdrawal. Stress — helplessness and defeat, is associated with this fat and it becomes ten times easier to put on weight deep inside. I hope you’re below 35 inches across the bellybutton. This is very important. Most women are absolutely astounded to find out they are 38 or 39 inches across.

First, you must adapt and adjust to stress, devote your life, become mentally fluid and flex. Or none of it works.

Second, after age 40, pay attention to your nutrition. What goes into your mouth? There are bad things going on inside the mouth. One of most important things to do, rein in total calories. Quality makes the difference. In Quantity, most women get and F-. The body is not as efficient in breaking down calories. Eat less but eat better, enjoy and eat slower, add value to your food.

After crossing the age 40 threshold, I stopped eating rows of oreos. When I want a cookie I eat one hazelnut biscotti with my tea or skim latte. My third point – eat every three to four hours. With smaller, higher quality meals, you’re not hungry at all. You’re satiated and can call it a day. We’re eating too much. We’re packing on toxic fat.

Helping to bring in the waistline, in addition to aerobic exercise, is lifting weights two times a week. It is very important for women to concentrate from the pelvis on up.
One day exercise the chest, shoulders and triceps. The second day work the back and biceps.

If women are heavy, I do not like to see them doing lunges or steps. This hurts the knees. Low impact aerobics, or the elliptical machine burns more calories.

Unlike my childhood, today’s children state that they are ‘stressed out.’ How can we change this?

We need to first help ourselves. They’re taking their cues from us. We have to stop treating our kids like science projects. What are they learning from you? It is usually a significant factor. This is a family issue. The family should be taking itself to a healthy lifestyle.

Dr. Peeke, how is your book, Fit to Live, different and more up-to-date than any other book out?

No one has gone there before. I’m so far out there. In Fight Fat After Forty, the bible of the stress-fat connection, every science study borne me out. No one has included all five elements. There’s the exercise book, or maybe the financial book. I put it all together. I tend to be an integrationist. It works.

The main prerogative is womb to tomb.

Fit To Live. Work it all your life. Once it’s going – it gets easier. It is never too late. One of my most successful patients is a 70-year old woman. She was amazed when she dropped four inches from her waistline.

Fit To Live is an integrated approach to life. Just do enough to say I’m Fit To Live to enjoy each category.

Ramp it up – Fit To Live to challenge: Walk the 5K challenge!

Nutritionally – try new recipes, experiment with unusual veggies, new fruits. Have some fun.

In every category: Survive! Enjoy! Challenge!

Dr. Peeke, thank you for your perspective on how to be Fit To Live!

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