SHAVE

YOUR BALLS
& 100 Other Things Your Mother Should
Have Told You

The GoodDoc, BadDoc Guide To Men’s

Health and Grooming

By
Valerie Eckard, M.D.
Donald Eckard, M.D.
 THIS IS A GOODDOC BADDOC, LLC BOOK
PUBLISHED BY KINDLE DIRECT PUBLISHING

First Edition
Copyright © 2012 by Valerie Eckard, M.D. and Donald Eckard M.D.

ALL RIGHTS RESERVED. No part of this e-book may be reproduced or transmitted in any form
whatsoever, electronic, or mechanical, including photocopying, recording, or by any informational storage
or retrieval system without the expressed written, dated and signed permission from the author.

LIMITS OF LIABILITY / DISCLAIMER OF WARRANTY:

The authors and publisher of this book have used their best efforts in preparing this material. The
authors and publisher make no representation or warranties with respect to the accuracy, applicability,
fitness, or completeness of the contents of this program. They disclaim any warranties (expressed or
implied), merchantability, or fitness for any particular purpose. The authors and publisher shall in no event
be held liable for any loss or other damages, including but not limited to special, incidental, consequential,
or other damages.

This manual contains material protected under International and Federal Copyright laws and Treaties. Any
unauthorized reprint or use of this material is prohibited.

Manufactured in the United States of America

Library of Congress Control Number: 2012948170
ISBN 9780988234307 (kindle book)
DISCLAIMERS
1. Please don’t be stupid and kill yourself. It would make us both quite unhappy. Consult a doctor before
doing anything in this book.

2. The material in this book is for informational purposes only. As each individual situation is unique, you
should use proper discretion, in consultation with a health care practitioner before undertaking the diet,
exercises, and techniques described in this book. The authors and publisher expressly disclaim
responsibility for any adverse effects that may result from the use or application of the information
contained in this book.

3. The information presented in this work is by no way intended as medical advice or as a substitute for
medical counseling. The information should be used in conjunction with the guidance and care of your
physician. Consult your physician before beginning this program as you would with any exercise and
nutrition program. If you choose not to obtain the consent of your physician and/or work with your
physician throughout the duration of your time using the recommendations in the program, you are
agreeing to accept full responsibility for your actions.

By continuing with the program you recognize that despite all precautions on the part of Val and Don
Eckard and GoodDoc BadDoc, LLC, there are potential risks of injury or illness which can occur because
of your use of the aforementioned information and you expressly assume such risks and waive, relinquish
and release any claim which you may have against Val and Don Eckard and GoodDoc BadDoc, LLC, or its
affiliates as a result of any future physical injury or illness incurred in connection with, or as a result of, the
use or misuse of the program.


CONTENTS

INTRODUCTION

CHAPTER 1
LIVE LONG AND PROSPER — YOU ONLY GO AROUND ONCE

CHAPTER 2
WHAT’S IN IT FOR ME? - WHY YOU NEED THIS BOOK

CHAPTER 3
NUT UP - BE A MAN

CHAPTER 4
ENJOY LIFE - ANYTHING AND EVERYTHING IN MODERATION

CHAPTER 5
FIT OR FAT - THE SKINNY ON FAT

CHAPTER 6
VITAL INFORMATION - LETS RUN THE NUMBERS

CHAPTER 7
DIET – IT’S NOT JUST FOR BREAKFAST ANYMORE - AND IT’S NOT
ANOTHER FOUR LETTER WORD

CHAPTER 8
I’LL SLEEP WHEN I’M DEAD - SWEET DREAMS

CHAPTER 9
RUN FOR YOUR LIFE - REAL MEN SWEAT

CHAPTER 10
AN APPLE A DAY - THIS WON’T HURT A BIT
CHAPTER 11
SHAVE YOUR BALLS - I’M JUDGING YOU

CHAPTER 12
SOMBODY’S GONNA LOSE AN EYE - IT’S ALWAYS FUN UNTIL
SOMEBODY GETS HURT

CHAPTER 13
IN CONCLUSION - LIVE LIFE + LONG TIME


This is book about health, fitness and grooming. It is based on the way that we
live our lives. There is a boatload of conflicting information on what is healthy
and what is not healthy. Utilizing our extensive medical background, we have
sorted through the information and the bullshit, to come up with advice on
health, fitness, diet and everyday living. You may not agree with everything in
this book, but we believe if you follow the guidelines that we set forth, you will
live a healthier, longer and better life, while still having fun and enjoying
yourself.

So, cheers! To life! To YOU!


LIVE LONG AND PROSPER — YOU ONLY GO
AROUND ONCE

INTERVENTION SUNDAY!! What the hell is that?

With the great weather we have in San Diego, many of the bars and clubs have
come up with a Sunday afternoon party, held out by the pool at many of the
hotels. The one at the Hard Rock Hotel goes by the name Intervention Sunday.
Hot girls in bikinis, ripped guys and, of course, plenty of adult beverages (in
moderation of course). Are we advocating this? HELL YES! This book is
about living healthy, looking good at any age and having fun.

So why am I, Dr. Don starting off with a story about Intervention Sunday? It is
because when I go to the door to enter the party, the bouncer asks for my ID. Of
course he knows I am over 21, but it is a requirement to check everyone. When
he looks at my ID, he looks at me and then back down at my ID and says, “No
way! I want to look like you when I am your age.” Not only that, but I see him
later as he patrols the party and he high fives me and tells me several times,
“Dude, I want to be you when I grow up!” Well, we want you all to be healthy,
look good and feel good and we want to help you do it.

The Docs Party On!

Do you want to be the guy that people say “seriously? YOU are 55? You look
15 years younger!” Or the guy behind whose back people say, “he’s a heart
attack waiting to happen!” If you are not concerned about this now, you will be
someday. It is never too late to learn and implement the things we are going to
tell you, but the younger you start the better.

So who are we, and what makes us qualified to tell you anything?

GoodDoc and BadDoc, in order of appearance

As two physicians in active practice, we have long had an interest in health,

fitness and grooming. Because of our interests, we have spent a great deal of
time researching health, wellness and longevity. We are not just sitting on our
asses behind a desk telling you how you should live – we are in the gym, in the
kitchen and living fantastic lives by putting into practice what we preach. The
results speak for themselves. This information needs to be shared. We want you
to be able to benefit from our knowledge and experience so that you will feel
better, look better and get more out of life.

Dr. Don is the conservative doc, also known as the GOODDOC. Would he
normally go to a wild and crazy party on a Sunday afternoon? No.

That is where Dr. Val comes into the picture. She is the wild and crazy doc, also
known as the BADDOC. She would not only be at the party, but she would be
one of the “bad girls” at the party.

Between the two of us, we have found a happy medium where we not only
practice a healthy lifestyle but we also have tons of fun. We want to share with
you how you can be healthy, look good, feel good and still have a blast. It is the
best of both worlds. IT IS POSSIBLE, and we want to show you how to do it.

Living healthy pays off.

The Docs in a pace line in New Zealand.

What make us uniquely qualified? We are living proof.

You want to see our pedigrees? Really? Then go to our website at

www.GDBD.com and you can bore yourself with our CVs. First – we are actual
doctors. Not people who call themselves doctors, people with a mail-order
degree from the West Indies or even people with a medical degree who’ve never
practiced medicine in their lives. After receiving Bachelor’s degrees in college,
we both went to 4-year medical schools to receive our MDs. Dr. Val followed
this up with a 4-year radiology residency. Dr. Don completed a yearlong
internship, 4-year radiology residency, and then spent 2 additional years in
fellowship for neuroradiology and endovascular neurosurgery. Show off.

This book is about the way we try to live our lives. Healthy and fun! Eat well,
exercise and don’t do stupid shit. Then be active and enjoy! We have run
marathons, done multiple century bike rides, white water rafted and hiked on
multiple continents, done mountain climbing, skydiving and have recently gotten
into fitness competitions. In fact, Val has placed several times in INBA and NPC
bikini competitions. The point is we want you to be able to participate in life
and enjoy life. To do that you need to be fit and healthy. This book is your
guide!
 Dr. Val in the Tournament of Champions, Los Angeles.

By reading this book, you’ll learn how to:

· Get into the best shape of your life
· Lose the weight you’ve been wanting to lose
· Look younger
· Feel younger
· Live longer
· Be more attractive and get more attention
· Have more fun
· Understand string theory and quantum physics*
· Achieve things you never thought possible

*Ok, so maybe you won’t understand string theory. We just always wanted to
use “string theory” in our book. And who doesn’t love quantum physics?

WHAT’S IN IT FOR ME? - WHY YOU NEED THIS
BOOK

Ever since medical school, Dr. Don has wanted to write a book on how to take
better care of yourself. Of course that is easier said than done. Life seems to get
in the way.

There are so many things that people can do to be healthier, feel better, live
longer and enjoy life more, but they just don’t seem to know how to do it. We
want this book to be your guide.

DR. DON SAYS:

When I told Val about my idea, she said: “That will be boring as hell.” Her goal
is to not only impart valuable information, but to spice up the book to make it
interesting to read.

She is also appalled and occasionally revolted at the way men look after their
personal hygiene and wanted to add that to the book. She is shocked to this day
by the poor hygiene of some physicians in particular. Certainly you would
expect physicians to know how to bathe, brush their teeth and dress
appropriately, right?
 Is that a swimsuit or a diaper?

DR. VAL SAYS:

Before I came into the picture, Don didn’t think that how he dressed mattered.

First of all, and I hope most importantly, it matters to me. I like it when we go
out and other women (and men) notice him. I want to be seen with a guy who is
confident, stylish and successful – just like guys want a hot date on their arm
when they roll into a room.

DR. DON SAYS:

The guys always notice Val!!!!!

I’M OK, YOU’RE NOT OK*

*At least if you do not take care of yourself

 GoodDoc? BadDoc?
How about HotDoc?

Sorry, but we disagree head-on with the touchy-feely trend that it is ok to be fat,
to be unhealthy, or to let your personal appearance slide. It is NOT okay.
Accepting yourself for the dazzling individual you are is one thing, but using it
as an excuse for being overweight and unhealthy is something else. In fact, like
it or not, you are being judged on all of these criteria, all the time… by potential
mates, by the boss eyeing you for a promotion, by everyone you meet.

Quite frankly, we get tired of seeing one fat ass after another. At the extreme,
these people are gross. They aren’t healthy, they have yeast growing in their
creases and they smell bad. Dr. Don has even found coins and food items
underneath the rolls of fat in some patients. They are not able to enjoy life the
way that it should be lived.

But even if you are only a little overweight, you are not as healthy as you should
be. We want to help you get back on the right track.

Do you want a long life? To feel good? To have rock star sex? Then you need
to worry about your health, fitness and grooming. Paying attention to these
things will give you a lifestyle improvement. You get to do stuff. Try new
things. People will even wish they were you!

THE CARROT – WHAT YOU GET FOR TAKING CARE OF

YOURSELF
 Motivation is in the eye of the beer holder.

When you think of all you stand to lose, it just makes sense to take care of
yourself.

Take care of yourself, and…

· People will treat you differently.
· You will feel better about yourself and be more confident.
· You will be more likely to get promoted and get a higher salary.
· You will live longer.
· You will spend less time in the doctor’s office or hospital.
· You will have less aches and pains.
· You will spend less money on health related issues.

The list, of course, goes on.


NUT UP - BE A MAN

DR. VAL SAYS:

Ever seen South Park?

Cartman comes home from school, upset about being teased for being fat. “Hey
mom…all the kids at school say I’m fat.” His mother tells him “Don’t worry –
you’re not fat! You’re big-boned.”

That’s bullshit. Cartman isn’t big boned… he’s fat. Let’s be real!

First and foremost – YOU ARE RESPONSIBLE

Do you smoke?
Do you have high blood pressure?
Are you overweight?
Do you have high cholesterol?
Do you wear your seatbelt?
Do you do stupid shit?

These are all things you can control and for which you need to nut up!

There are both genetic factors and environmental factors that account for the
way you look and feel. Some people are luckier than others and are born with
bodies like a Lamborghini. Others feel like maybe they drew the short straw and
got the VW bus. Genetic factors can be difficult to overcome or modify.
Therefore we need to make the most of the environmental factors that you can
control. Plus, with proper care and attention, you can even the playing field.
You can do well with either type of body.

STOP BLAMING OTHERS, STOP BLAMING YOUR

GENETICS AND STOP MAKING EXCUSES.
 Don’t do stupid shit!

Many people smoke cigarettes, have high blood pressure, high cholesterol or
diabetes secondary to being overweight. All of these things are extremely
detrimental to your health. They are also all factors that you can control with
lifestyle modification, proper diet and sometimes medications.

Dr. Val recently saw a 38-year-old patient with diabetes, high blood pressure and
high cholesterol. The guy was too “busy” or too irresponsible or too lazy to take
his medications. It had been documented again and again by his primary care
doc that this patient refused to take his meds and to be responsible, EVEN
THOUGH he had been warned about the consequences! By the time Dr. Val
saw him it was too late. He had suffered a brain stem stroke. Devastating. No
messages could travel from his brain to the rest of his body creating what we call
a “locked-in syndrome”. He is awake and aware of his surroundings, but he is
totally unable to move his arms or his legs or to speak. He can move his eyes,
but that is it. This is an extreme example, but it is also something that did not
need to happen to him had he only taken care of himself.

THERE IS NO EXCUSE!

Sadly most of the diseases we see are preventable. Many people just don’t know
how to take care of themselves or have given up. Of course some people just
don’t give a rat’s ass (even though they should). Why live a wretched existence
when you don’t really need to live that way?
Unfortunately there are a large number of people who DO care but get the wrong
information. The amount of misinformation available in diet books and on the
Internet is abhorrent. There are scammers everywhere you look, trying to profit
from your insecurities. How would you know what to believe?

WE CAN HELP

There is tons of information out there. It is hard to know what to believe even
for us. We have sorted through the information and come up with what we think
is the best possible plan. Not everybody will agree with everything we say, but
overall, if you live your life the way that we suggest, you will be much better
off.

We have found that there are a few things that matter lots, and lots of things that
don’t really matter that much. Often times the media will get hold of a story and
it will get blown way out of proportion. For example, there has been some
controversy over whether cell phones cause cancer. The media reports the story
– BREAKING NEWS! CELL PHONES LINKED TO CANCER. However,
frequently these stories are based on one small clinical study that may not even
be correct. The latest, and largest study to date on cell phones actually reports
that they DO NOT cause cancer. Naturally, as this news won’t make people run
shrieking and leave them shivering in a corner, it doesn’t get much airtime.
What should you believe? Who knows? The bottom line is that even if cell
phones do cause cancer, it is probably very, very rare. There are a hell of a lot
of things that are more likely to kill you, so keep reading.

We have found that this is true with much of the information reported by the
media and on the Internet. So we try to emphasize the things we think are
important. There are lots of little things that get a lot of attention, but in
actuality aren’t significant and you don’t need to waste your time and energy
worrying about them.

We can help, but you are going to need to meet us halfway. Make no mistake,
your health and wellness is your responsibility.

IT’S YOUR RESPONSIBILITY – not that of your mother, your therapist, your
trainer or McDonald’s – to monitor your health and make changes in your
diet/lifestyle to prevent or help alleviate potential health problems. Stop blaming
other people for your situation and take charge.
Studies have shown that being overweight compromises your ability to get a
better job or a better salary. Do you really want your worth to be based on your
waistline instead of your education or experience?

By the way, being attractive to the opposite sex doesn’t just apply to the single
crowd. Why should you look like shit and be unhealthy just because you are
married? This especially applies to the married crowd because people get
complacent. You’ve seen it – your buddy gets married or his girl moves in and
BAM! He puts on 20 pounds. We want you to see your grandkids grow up.
Not be six feet under in a pine box.

Being responsible also means using some common sense and not doing stupid
shit. And if you do, be sure and own up to it. If not to your coworkers, at least
to your doctor.

Take for example the guy who came into the ER with vague abdominal pain.
His first CT scan was read as normal. A week later, he had another one – we
thought maaaaybe there was something in his colon. Plastic, as it happens, is
translucent and difficult to see with CT scan. The surgeon later confirmed that it
was, in fact, a glitter pen. In his colon. And the patient had NO IDEA how it
might have gotten there. But if he had fessed up initially, it would have saved
him a week in the hospital and a lot of trouble.
 Notice that the sign doesn’t specifically tell you not to do this.
You can if you want to. Use your head to think with, not to land on.

ENJOY LIFE - ANYTHING AND EVERYTHING IN
MODERATION

OK. Now you know you have some work to do and we are going to help you
get there. But, we don’t want you to be some freak. You are going to do healthy
things but still be normal.

A few years back, we briefly subscribed to a meal delivery service. They

provided pre-made, fresh, calorie-controlled meals daily. As an aside, this is a
good thing to do if because of your schedule you are not able to have healthy
meals at work or home. We personally think it is better to learn to make your
own meals or eat properly at a restaurant because subscribing to a service will
not actually teach you how to eat well

As part of the service, there was a weekly newsletter suggesting ways you could
improve your health and fitness and to stay on track. One week the newsletter
discussed the topic of eating away from home. The suggestion was to take your
meals with you.

WTF? Part of traveling is interacting with colleagues or friends over dinner.

Toting around your own oatmeal and brown rice is not how real people live. We
have to hand it to the author though. At least he was honest.

He describes a road trip to Las Vegas -- a bachelor party. He made his meals
before he left (!) and packed them in the trunk of his car in a small cooler. It
consisted mostly of chicken, brown rice and fresh vegetables. However, he made
one big mistake. He neglected to refresh his cooler with ice. By the time he got
to Vegas, his meals were no longer refrigerated. But he ate them anyway, rather
than “risk” ordering at a restaurant. So by the third day, you guessed it, food
poisoning. Stomach cramping, vomiting, diarrhea. Seriously. Who does that?
To be that obsessive about eating your perfectly measured chicken that you
would risk food poisoning rather than making a smart choice at a restaurant?

We are going to say this again, WE WANT YOU TO BE NORMAL.

The key is MODERATION.

As long as you eat well most of the time, you can break the rules some of the
time. While we don’t advocate going hog wild, it is ok to go out and eat stuff
that you would not normally eat and that you may not think is healthy. Just don’t
do it all of the time.

There are some things that are obviously not ok in moderation – like shoving a
glitter pen up your ass, smoking and doing stupid things.

Likewise, if something is good for you, don’t go overboard with it. You can
certainly take diet and exercise too far. Diets too low in calories can cause
damage to your bodies – even lead to death. Even too much water can be bad
for you – extreme over hydration can result in water intoxication. Betcha didn’t
know that.

Dr. Don overhydrates in Cambodia.

Our advice is to follow the plan outlined in this book 80 to 90% of the time.
Eating right, exercising and enjoying life on our plan is easy. However,
occasionally (like when we travel or have a big night out), we don’t worry as
much about the plan. We may party a little harder or not worry about the
details. Remember everything in moderation. Don’t go totally overboard,
nobody likes feeling like shit.
Having your cake and eating it too.

FIT OR FAT - THE SKINNY ON FAT

One of the most confusing and frustrating things is trying to determine your
ideal weight.

The Skinny on Fat

So what if you’re fat? You’ve got a great personality, right? It’s all about who
you are on the inside…. blah blah blah. While that may be true, fat isn’t just
about vanity.

There are many health risks related to obesity including, but not limited to, type
2 diabetes, high blood pressure, high cholesterol and triglycerides (elevated
levels are linked to hardening of the arteries, heart disease and strokes), coronary
artery disease and heart attack, stroke, sleep apnea, gallstones, liver disease,
gastroesophageal reflux (heartburn), infertility, and musculoskeletal problems
like arthritis. Additionally, it increases your risk of many types of cancer. These
diseases cannot only make your life miserable, cost you money in health care
and lost time at work, but they can kill you. On the average, obesity reduces life
expectancy by 6 to 7 years. Severe obesity decreases life expectancy by a decade
or more.

Obesity and being overweight also limits your quality of life. You want to live
well right up until the end – to be the octogenarian running marathons, or at least
the guy with all the ladies following him around the retirement village.

So, what’s your target?

Maybe the right question to ask is, “what is your ideal body composition?”

Body fat percentage is the percentage of your body composed of fat. Duh.

Fat storage was key in the hunter/gatherer period, where you could go for days
or weeks without a good meal. Without food sources, you could rely on energy
produced from fat stores. It’s not so helpful today, when there is a fast food
restaurant on every corner and you’re trying to tame a raging beer belly.

Lest you think all fat is bad, you need to remember that fat also has important
functions with regard to cushioning your organs, insulating you from the cold,
and more importantly, has many hormonal functions. Therefore you need
SOME fat, but not too much.

It goes along with our philosophy of everything in moderation. We know that

too much fat is bad for you, but we know too little fat is bad as well.

Better health has been associated with 10 – 18% body fat in men and 18-25% in
women.

JUST SO YA KNOW: What’s up with the difference between men and women?
There is a certain level at which body fat gets too low for the organs of the body
to continue to function. This set point – known as essential fat – is different for
men (3-5%) and for women (10-12%). Women have a higher set point because
it is believed that they need a higher fat percentage for reproductive purposes.

Rather than concentrating on your weight, you should be concentrating on your

body fat percentage. We give you some options to roughly calculate or measure
your body fat percent below.

You often hear that muscle is a calorie burner. A pound of muscle can burn about
6 calories/day at rest compared to 2 calories/day for fat. Plus, muscle takes up
less space and therefore looks better than fat.

Dr. Don adding some muscle with an incline shoulder press.

DR. VAL SAYS: BS ALERT!
Beauty and fitness magazines, personal trainers, and even TV physicians repeat
so much misinformation! Makes me CRAZY! Sure muscle burns more than fat
- but only about 3 times as much. Not the 50 times as much (as Dr. Oz would
have you believe in his presentation to the National Cosmetology Association in
07 – as reported in an article from the LA Times in May 2011). And certainly
not 50 calories per pound – another figure we see repeatedly, including in the
San Diego paper recently! Do the people who write this shit even THINK about
what they are saying? In training for my bikini contests over the past year, I
have put on about 8-10 pounds of muscle. That would amount to an extra 400-
500 calories/day that I could eat. Wow. If I eat that much more per day, I’ll be
adding 10 MORE pounds, and it won’t be muscle!

Dr. Val ripping out some chin-ups in Point Loma, California.

Every tidbit that appears on the Internet gets propagated as fact by the
uneducated and the lazy. After a while, it is repeated in so many places that
people accept it as fact. Look into the scholarly articles and journals to find the
real information.

For a real-life example Don, weighing in at 165 pounds has a body fat of 11
percent. If he were to work his ass off to get down to 8% while maintaining his
weight, that would mean an increase in about 5 pounds of muscle. So at 6
calories/day/pound for muscle compared to 2 calories/day/pound for fat, that’s
going to buy him 20 calories. That’s about a Starburst candy.
So, be realistic – adding muscle isn’t going to make you into a calorie-burning
machine like the fitness magazines would have you believe. But don’t be
discouraged, muscle is lean and sleek – it looks better. Someone with more lean
muscle mass and lower body fat will look thinner than someone who weighs
less, but has higher body fat. And as we said before, it’s the excess fat that leads
to disease and even death.

Biking in New Zealand (where they drive on the left side of the road).

Remember, don’t obsess over the scale. Body fat percentage is much more
important than what you weigh. Men should be in the range of 10 to 18% body
fat and women should be in the range of 18 to 25% for ideal health.

MEASURING UP

There are multiple ways to evaluate your level of fat-ness. They all give
estimates and are not completely accurate, which is something to keep in mind.

CHECK YO SELF BEFORE YOU WRECK YO SELF*

(* from the song by ICE CUBE – Check Yo Self)

The Bathroom Scale

The bathroom scale is a good way to track your weight, but it tells you nothing
about body fat percentage that we think is more important.

Mirror or photo test:

Take a look in the mirror. You may already have a pretty good idea that you need
to lose some weight. Photographs are another good measurement. Have you
been shocked at how you looked at your friend’s party after she posted the
pictures online? Did you think – “that photo makes me look fat.”? Maybe the
camera doesn’t lie.

DR. VAL SAYS:

You want 6-pack abs? It’s not about the crunches; it’s about the diet. Guys will
need to get down to about 10% body fat and women will need to get down to
about 15% body fat.

DR. DON SAYS:

A number of years ago, I thought I was pretty buff (and so did everyone else
thanks to my loose-fitting scrubs that I wore to work everyday). I remember
coming back from a beach vacation in Mexico and showing my coworkers the
photos. One of the technologists said, “Eeeew!” She didn’t realize how fat I was.
And apparently neither did I.

Clearly a “before” picture.

Circumference Measurements

Another useful way to check yourself is by using waist circumference

measurements. Men tend to store fat in the abdomen, not only under the skin but
also deep in the abdomen around the organs. Women tend to deposit it in the hips
and thighs. Abdominal fat around the organs (called visceral fat) is especially
unhealthy and is associated with higher risk of disease and death.

Our trainer Joe Lenihan (www.nextlevelpersonaltrainer.com) correctly measures Val’s waist.

The World Health Organization has established criteria for waist circumference
(at the level of the belly button) with level of risk for disease such as diabetes,
stroke and heart attack

If you fall into the latter two categories, you definitely need to get off your ass
and get started.

Body Fat Estimation

We feel that knowing your body fat percentage is the best way to evaluate if you
need to lose weight or can just maintain. Body fat measurements are estimates.
In the following paragraphs, we’ll show you some ways to estimate and then
give you our recommendations.
 YMCA – Not Just a Song By The Village People:

Probably the easiest way to get an estimate of your body fat percentage is to use
a simple equation like the YMCA Formula. It is not perfect, but it is a place to
start. All you need to know to use the equation is your weight and your waist
circumference measured at the belly button.

Male body fat % = ((-98.42 + (4.15 waist circumference in inches) – (.082

weight in lbs))/weight in lbs =

Female body fat % = ((-76.76 + (4.15 waist circumference in inches) – (.082

weight in lbs))/weight in lbs =

Go to our web site www.GDBD.com/succeed to easily calculate your body fat

% using this formula by plugging in your weight and waist circumference.

Calipers

Calipers measure the thickness of skin folds. Someone who has been properly
trained, such as many personal trainers or dieticians, measures the skin fold
thickness in several different spots. Those measurements are then plugged into a
formula (and there are over 100 to choose from) that yields an estimated body fat
percentage. The accuracy depends on the person measuring and results can vary
widely.

Here is Joe using calipers to measure belly fat (or lack thereof).

Our recommendation is to find someone who knows what they are doing and
have them measure you consistently. It’s a cheap, easy, and effective way to
track your progress.

BIA – Bioelectrical Impedance Analysis

With BIA, electrodes can be attached to your hands and feet, or you can stand or
hold electrode pads. You can buy a scale or hand-held device with the pads too.

Small electrical impulses are sent through your body to measure how fast they
travel. Unfortunately, this can vary based on your level of hydration. So if you
were on a bender the day before, had a few glasses of wine, or even have a full
bladder, it can alter the results. These scales can be wildly inaccurate, but CAN
be used as a way to track your progress, if you measure yourself consistently on
the same scale under similar conditions (time of day, last meal, etc) and consider
the hydration factors discussed above.

Air Displacement or BOD POD/Hydrostatic Testing – Underwater

measurement

Both of these methods use displacement methods to estimate body fat. They both
require a facility with the proper equipment and can cost anywhere from $20 -
$100 for testing.

DEXA – Dual X-ray Absorptiometry

DEXA is the most accurate way to measure body fat and is the gold standard.
It’s a full-body x-ray at very low-level radiation. It’s safe and only takes a few
minutes, but can cost between $65 to a couple of hundred dollars depending on
the facility. While we like this for accuracy, it’s too inconvenient and costly to
use to track your progress.

BMI

Body mass index (BMI) gets a lot of press these days, so we will talk about it for
completeness’ sake. BMI was developed as a way to study large populations so
that the statistics evened out over large numbers of people. For individuals, the
number is not as valuable. It gives a rough indication of body fat percentage,
but grossly overestimates fat in athletic individuals and underestimates in very
obese people.
To determine your BMI, you can plug in the numbers to the equation:

BMI = (mass in pounds x 703)/(height in inches) squared

You can go to our web site www.GDBD.com/succeed to more easily
calculate your BMI.

· Underweight less than 18.5
· Normal 18.5-24.9
· Overweight 25 – 30
· Obese over 30

It will give you a little bit better insight into your body composition, but can
often times be misleading. It’s really just a weight to height ratio. It doesn’t take
into account whether the weight is because of fat, muscle or dense bone.

For purposes of calculating body composition, the body is comprised of fat and
lean body mass (LBM). LBM is everything else – bones, muscle, organs, etc.
Unlike Cartman, if you are African American or Pacific Islander you might have
denser than average bones, which will give you a high BMI. Similarly,
weightlifters and other athletes will have a higher BMI because of muscle mass.
Take for example a man, 5’ 10” tall who weighs 175. He is overweight by BMI
standards, regardless of whether he is a muscle-bound meathead with a 6-pack or
a doughy, sedentary blogger with a 6-pack. Of Milwaukee’s Best.

SO NOW WHAT?

If you are athletic or relatively lean, keep up the good work. We advise getting a
body fat measurement using one of the methods above to establish a baseline
and make sure that your really are fit. We know lots of guys who think they are
fit but are not. Remember too that as your life changes (like getting married)
and as you age you tend to put on more body fat. Therefore you need to
continue to monitor by using the mirror, the bathroom scale (we recommend
weighing a few times a week) and how well your clothes fit with occasional
body fat checks. When you follow your weight, try to weigh at the same time
each day since your weight fluctuates throughout the day. It is usually lowest
first thing in the morning and then increases throughout the day.

If you are slightly overweight or need to get into better shape, keep reading.
Determine your body fat percent using one of the methods above and follow our
plans for diet and fitness.

If you have significant weight to lose, it’s even more critical that you get started
today. Don’t wait until you have irreversible health issues to realize that it’s a
problem! We still advise a baseline body fat measurement with occasional
follow up measurements to track your progress. Plus, your lean body mass is
going to be used later to determine your calorie and nutrient intake.

Our advice? Get started right now by using the YMCA formula (because it’s
easily done at home in only a couple of minutes.)

We also like the DEXA scanning method, as it is believed to be the most

accurate.

Dr. Val is a fan of measuring with calipers, as long as you have someone who
knows what they are doing. It’s more affordable, and for people who are trying
to track progress over many weeks and months, it’s easy to check it frequently.

Our main message here is not to get obsessed with the number on the scale.
Body fat percentage is more important. Plus, there can be stalls or plateaus with
weight loss. We talk in more detail about weight loss plateaus in our book on
dieting – The GoodDoc BadDoc Guide to Healthy Eating. Don’t throw in the
towel!

Look for other signs that your fitness regimen is working for you, like loss of
inches, clothes fitting better, visible gain of muscle, and of course the attention
you are getting when you run into old friends. Remember, muscle weighs more
than fat. Therefore, if you are working out hard with weights and putting on
muscle you may not be losing weight, but rather replacing some of the fat with
muscle, but you are still becoming healthier.

VITAL INFORMATION - LETS RUN THE
NUMBERS

Your vital signs are your heart rate, blood pressure and respiratory rate. They are
critically important in seriously ill or injured patients. But they are also
important in normal healthy people and can give you a snapshot of your health.

Heart Rate

Your resting heart rate is an excellent way to monitor the state of your health.
Your resting heart rate can be obtained by finding your pulse, measuring how
many times it beats in 15 seconds, and then multiplying by 4. This gives you the
number of times your heart beats in a minute.

The average resting heart rate in a male is approximately 70 beats per minute
(bpm). A better than average heart rate is in the 60s and even better is a resting
heart rate in the 50s. A well-conditioned athlete may have a heart rate in the low
50s or even in the 40s.

Another way to measure heart health is by determining your recovery rate or

how quickly your heart rate drops after intense exercise. To determine your
recovery heart rate, take your pulse immediately after intense exercise and then
take it again 1 minute later. The faster your heart rate slows down, the better.
Studies have shown that if your heart rate slows down at a rate of less than 12
beats per minute, you are at a definite increased risk of death.

Heart rate monitors are an excellent way to monitor your heart rate while
working out. You may want to consider one. There are also pretty accurate
heart rate monitor apps available for smart phones.
 It’s ridiculously easy to get your heart rate using a smart phone app.

Blood Pressure

Blood pressure is the force exerted upon the walls of the arteries by the
circulating blood. The higher the blood pressure, the harder your heart needs to
work to pump the blood and the harder it is on your arteries. The blood pressure
varies during the cardiac cycle. The measurements usually provided are the
maximum blood pressure during the cycle (systolic) and the lowest pressure
during the cycle (diastolic).

A sphygmomanometer is used to measure blood pressure.

The risk of cardiovascular disease increases progressively for values above

115/75. As a general guideline, make sure your pressure is under 130/85, but the
lower the better. Your blood pressure is measured with a device called a
sphygmomanometer. It is best to have somebody that knows what they are
doing check your blood pressure. The machines found in malls or drug stores
are not always accurate. If your blood pressure is normal, then you should check
it at least once every year. If your blood pressure is elevated, you should see
your physician for treatment.

OTHER IMPORTANT NUMBERS YOU SHOULD KNOW

Cholesterol

Cholesterol is an important steroid-like substance that is used to produce

hormones and is important in the structure of cell membranes. The body
manufactures most of the cholesterol that it needs in the liver and intestines and
absorbs a smaller percentage through the foods you eat. High levels of
cholesterol in the blood are strongly associated with atherosclerosis (hardening
of the arteries) and heart disease. As a general rule, try to get your total
cholesterol under 180 mg/dl. It is very hard if not impossible to control your
cholesterol levels through your diet since if you eat less, your liver tends to make
more. Therefore, if you have a genetic predisposition to high cholesterol (which
many people do have), you may need medication to control it.

Cholesterol is transported through the blood via substances called lipoproteins.

The lipoproteins you hear the most about are very low-density lipoprotein
(VLDL), low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

VLDL and LDL carry cholesterol from the liver to cells in your body. HDL
carries cholesterol from cells in your body back to the liver. In general, high
levels of LDL are considered bad and high levels of HDL are considered good.
The American Heart Association recommends that LDL be below 100 mg/dl or
less than 70 mg/dl if you are a person at risk for heart disease.

If that last part read like, “blah blah blah cholesterol” to you, just remember
this: You will need a blood test that you can obtain at your doctor’s office to
measure your cholesterol.

HALL PASS:

We have a friend who thinks that being on a cholesterol lowering medication

gives him a pass to eat like crap. This guy thinks sausage is the new black.
News flash!! Having low cholesterol is important, but being overweight and
eating unhealthy foods is still bad for you. Sorry, no hall pass on this one.

C Reactive Protein

Inflammation is the basic way the body reacts to irritants, injury or other harmful
stimuli. If you stub your toe for example, white blood cells and other chemicals
rush to the site of injury to begin repairing and protecting the site of injury. The
toe becomes red, painful and swollen as a result of these inflammatory changes.
This type of reaction is known as an acute inflammatory response and is a part of
the body’s natural healing process.

There is also another type of inflammation known as chronic inflammation. In

chronic inflammation, the body’s immune system is turned on and silently and
slowly damages the body by attacking itself. Smoking, obesity, chronic gum
disease and repeated or prolonged infections can all cause a chronic
inflammatory state. It is likely inflammation has an important role in heart
disease, stroke, diabetes, cancer, cognitive decline and all of the diseases of
aging.

In an inflammatory state, the body releases many biochemicals including one

known as C-reactive protein (CRP). In an acute inflammatory response, levels
of CRP become markedly elevated and are easy to measure. However, in
chronic inflammation, the levels are not nearly so high. A test we recommend
which will give you an idea of your state of inflammation is a high sensitivity
CRP (hs-CRP). Ideally, you should have 2 tests done 2 weeks apart since your C
reactive protein could be elevated from a benign reason such as a minor injury.
Studies have shown that hs-CRP levels correlate with your risk of cardiovascular
disease.

· hs-CRP less than 1.0 mg/L = low risk of cardiovascular disease
· hs-CRP between 1.0 and 3.0 mg/L = average risk of cardiovascular
disease
· hs-CRP greater than 3.0 mg/L= high risk of developing cardiovascular
disease

If your levels of CRP are high, you will definitely want to adhere to the
principles in this book to help lower your level of chronic inflammation. You
may want to start on a statin type cholesterol-lowering drug even if your
cholesterol levels are not elevated as there is strong evidence that this will
prevent much of the damage caused by inflammation.

You can have your doctor draw your CRP.

Glucose and Insulin

When you eat a candy bar or an apple or many other foods, you are eating types
of carbohydrates. Your body breaks all of these carbohydrates down into
glucose (blood sugar), which is the type of sugar that the body uses for fuel.
Glucose gets removed from the blood by a hormone called insulin. Persistent
high circulating levels of glucose or insulin are bad for you. If you have high
blood glucose, it means that your pancreas is either not producing enough insulin
(type 1 diabetes) or more commonly that your cells are not responding to the
insulin appropriately (type 2 diabetes). Insulin resistance, a term you may have
heard, refers to this inability of your cells to respond appropriately to the
insulin. Measuring your fasting glucose levels and your fasting insulin levels
will tell you if your insulin is adequately removing glucose from your blood. If
not, there are lifestyle and diet modifications that you will definitely need to
make. If these things do not control the glucose levels, then you may need to
take medication to help keep the glucose levels in your blood under control.

The bottom line - Too much circulating glucose and insulin in the bloodstream is
bad for you, as it results in damage to your organs and your blood vessels. You
want to keep your fasting glucose level between 70-100 mg/dl. Ideally your
fasting insulin level should be less than 10 mIU/ml. Again, these tests will
require a blood test from your doctor. Don’t worry – all of these things can be
done at once, and won’t require multiple visits (or multiple needles!)

Vitamin D

It turns out that many people are deficient in vitamin D. Vitamin D can either be
consumed or made in the skin when the skin is exposed to UV light.
 Dr. Val loads up on Vitamin D.

People that do not get much sun exposure or people with darker skin are at
increased risk of deficiency. Many experts believe that levels of vitamin D
should be at least 50ng/ml or greater. If you use this number, approximately
90% of people are deficient in vitamin D. Therefore, we recommend getting
your vitamin D level checked and supplementing with a vitamin if necessary.

DIET – IT’S NOT JUST FOR BREAKFAST
ANYMORE - AND IT’S NOT ANOTHER FOUR
LETTER WORD

DR. VAL SAYS:

Like a whole lot of America, I have spent countless hours slogging it out on the
treadmill and in the kitchen counting calories, trying to lose weight. And like a
lot of people, I figured that if eating less and working out wasn’t getting me the
results I wanted, I had better eat even LESS and work out MORE, right? And if
you don’t get the results you want…you get the idea. But this doesn’t always
seem to work in the real world. Your body adapts and when faced with famine-
like or stress conditions, it hangs on to all that it can. (over time, if you stayed in
a caloric deficit you would gradually lose weight of course, but people tend to
either give up or give in – even if just for a vacation – which puts you back to
where you started) Plus, you end up making yourself AND those around you
miserable.

So how did I get into the best shape of my life at 42 years old? Eating more and
exercising less. Seriously!

Eating more, exercising less—really!

The answer lies in knowing exactly how many calories and what types of
macronutrients you need. This should be based on your body weight, your level
of exercise and your fitness goals (NOT on your blood type, your astrological
sign, or whatever Gwyneth Paltrow is eating).

Diet is an incredibly complicated and controversial subject – so much so, that

our chapter on it really took on a life of it’s own. So to keep this book
manageable, we’ve boiled it down to just the basics. For more detailed
information on our recommended diet plan, see The GoodDoc BadDoc Guide to
Healthy Eating.

Eating/dieting really is about calories in vs. calories out. Whatever you eat is
either used to keep your body functioning or stored for future use. We go into
much greater detail on this in our Healthy Eating book.

For maintenance calories in an active individual, you should aim for 14 – 16

calories per pound of body weight. For an average 175-pound man, this would
be around 2,600 calories per day. If you need to lose weight, start at 10 - 12
calories per pound of body weight. Give yourself 2 – 3 weeks adhering to this.
If you are losing weight at roughly 1 – 2 pounds per week, you are probably
right on track. No weight loss and you might have to adjust down a little bit.
Many folks give up too early, so give it some time. We will give some
suggestions on super easy ways to track calories shortly.

Don’t forget – when you jump into a diet, you may initially see a dramatic drop
in the scale. This is usually due to water weight (particularly if you are
decreasing the amount of sodium or carbohydrates you’re consuming). This is
the basis of many rapid weight loss diets – but it was not fat that was lost. After
this, the weight loss will slow a bit to a more reasonable one or two pounds a
week. To lose a pound, you need to cut 3500 calories from your diet. For a 5-
pound weight loss this amounts to 17500 calories. That is why your goal should
be 1 or 2 pounds of real weight loss/week.

Be warned, after you initially lose some weight, you may go for a while without
seeing results and then suddenly * poof * the scale will show a dramatic change.
This frequently has to do with water shifts, but can be frustrating whey you are
trying hard but not “seeing” results.
People often fail when dieting because they underestimate the amount of food
they are eating, the caloric value of the food, or they don’t account for it at all.
Studies consistently show that overweight and obese people underestimate their
food intake by 30 to 50%. The handful of M&Ms you snagged from your
coworker’s desk on the way to the copier might have 75 – 100 calories or more.
That stuff adds up. Believe us.

This handful of peanut M&Ms has a whopping 250 calories!

DR. VAL SAYS:

Pull your head out of your ass. We have a friend who wants to shed a few
pounds prior to his next birthday. He’s in pretty good shape and spends enough
time working out and thinking about what he is eating to make it happen. But in
talking with him the other day, he mentioned that he eats a lot of almonds and
walnuts. Yeah, they are healthy – good fats! But one handful (particularly for
our buddy, who is a big guy with big hands) is close to 200 calories. He
admitted he probably eats 4 or more servings a day --- so that’s an additional 800
calories. In a week, that is 5600 calories – over a pound and a half. Wow. That
kind of thing goes a long way to understanding WHY you might not be losing
weight and WHY you have to record everything and be accountable.

You need to track what you eat. In fact, this is the key to being fit while not
being a freak.

We have a friend who has been phenomenally successful with her diet and
workout – she has lost 40 pounds over the last 9 months! Recently, she was
invited to tailgate before the Chargers game and her date suggested they bring
bratwurst. She told him that was fine, but could he bring a piece of chicken to
grill for her instead? He just didn’t get it – but a brat has about 21 grams of fat
in just one serving, and 260 calories. That’s almost her whole day’s allotment of
fat! But if you are tracking what you are eating you can make a choice – if you
really crave the brat, have the brat! But you will know you have to eat lean the
rest of the day. OR, you could have half the brat, or you could choose chicken or
low fat chicken sausage and save your fat and calories for something that really
rocks your world!

Tracking what you eat has actually become ridiculously easy and fun. Gone are
the days of tallying all that crap in your head or writing it down on a piece of
paper. There are tons of smart phone apps and online programs to help you track
calories and macronutrients. A tracking program that we especially like and use
is available as a smart phone app – it is called Lose It! and we highly
recommend that you Use It. It is super quick and easy. It even has a bar code
scanner so that you can scan foods you like into your food log. MyFitnessPal is
another excellent app that we recommend for tracking.

Lose It! Tracking app for the iPhone

When you cook at home, we recommend that you weigh your food or measure
your food using measuring cups or spoons. This only takes a few seconds and
will give you a much better idea of what you are eating.
 Lose It! also helps you track macronutrient data!

When you eat at restaurants, you will need to estimate roughly what you are
eating and then check for similar foods online or on your tracking app so that
you can get fairly accurate caloric data. Don’t worry, after you do this a few
times it gets really easy. We give you some tricks on ways to track your foods
on our website www.GDBD.com/succeed.

WHAT THE HELL IS A MACRO?

Nutrients are chemical compounds used by any organism to sustain life and
growth. Macronutrients are the three types that humans consume in significant
quantities.

Macronutrients are protein, carbohydrates (abbreviated as CHO or carbs) and

fats. You need all three of them for a healthy, balanced diet.

Protein is necessary for building muscle and tissue repair. Second to total caloric
intake, the amount of protein is the most important part of your diet. After you
determine your daily caloric requirement, we believe you should start with
calculating how much protein you should have each day. A good rule of thumb
for most individuals is to estimate your protein requirement based on your lean
body mass. Go back to the section on body fat for ideas on how to calculate
your body fat percentage. If you weigh 170 pounds with 20% body fat, that
means that 80% of 170 pounds is your lean body mass. So your LBM is 136
pounds.

Protein is necessary for building new muscle of course, but when you are trying
to burn fat, it’s also essential to preserve the muscle that you have. Your body
would preferentially breakdown your existing muscle to use for energy rather
than your fat stores because muscle tissue is easier to mobilize for fuel. So
having adequate protein in your diet will help prevent muscle loss. In addition,
protein helps to keep you full longer giving you more bang for your buck.

We recommend 1.0 – 1.5 grams/protein per pound of lean body mass per day.

The amount should be toward the lower end (1.0 g/lb) if you are female or
significantly overweight. Aim for the mid to higher range if you are lifting and
trying to add muscle mass. So again, for our 170-pound guy with a LBM of 136
pounds, he should get 136 - 204 grams of protein per day. Somewhere in the
middle of that range would be about right for most people. Protein has 4 calories
per gram, so that’s around 540 – 800 calories from protein.

Too Much Protein?

The belief that too much dietary protein can cause kidney failure is another
example of the media propagating incorrect information. Recent studies have
shown that if you have normal kidney function, high protein diets do not damage
the kidneys. In fact, they have also shown that even very high protein diets
(greater than 1.5 g/lb) do not appear to impact kidney function in healthy
individuals. However, if you have impaired kidney function, you should consult
a physician and/or nutritionist who can help you with your diet, as a high protein
diet may not be appropriate for you.

The best sources of protein are lean animal meats like turkey, chicken, pork or
lean beef; fish; eggs or egg whites; and low-fat dairy products like Greek
yogurt. If you are vegetarian, soy products like tofu, beans and lentils are
amongst the best sources of protein, but do not contain nearly as much protein as
animal based products.
 Sushi is a great option for lean protein.
Even Don has learned to eat the raw fish!

We actually find it can be challenging to get enough protein per day just eating
whole foods. Therefore, we also recommend taking a protein supplement. A
protein supplement can be especially good as an addition to a quick breakfast,
can be used to make great tasting shakes, can be incorporated into various
recipes and can also be convenient pre or post workout.

Protein supplements are derived from a variety of whole foods including milk,
eggs, soy and even foods such as peas, hemp and rice. In general, we
recommend a protein supplement derived from milk. The 2 major proteins in
milk are whey (20%) and casein (80%). The milk based protein supplements are
also high in calcium.

Whey is a good pre-workout protein since it is digested rapidly and does not
leave you feeling full. It also mixes very easily. The disadvantage of whey
protein is that some people experience digestive issues such as gas and bloating
after eating it. If you have a problem with this, using a whey protein isolate (a
more purified form of the protein) may help with this problem. If not, make sure
your spouse or roommate is understanding and/or has a bad sense of smell.

Casein is a protein that is more slowly absorbed. Because it is more slowly

absorbed it keeps you feeling full longer which makes it especially good for
people who are trying to lose weight. The main disadvantage of casein protein is
that it does not mix as well.

We like best the mixed whey and casein supplements. Watch out for the
shysters. All you need is a basic supplement. Many of the supplements are
over-hyped as to their benefits. Don’t believe them. You just want a basic
protein supplement. At the end of the day, it’s just protein, not jet fuel.

Does this fat make my ass look fat?

Gone are the days (we called them the 80s) when fat was evil. You need fat in
your diet! Rejoice! Does this mean Ben & Jerry’s for everyone? No…but still
ok in moderation!

There are 4 basic types of fats:

· Monounsaturated Fats
· Polyunsaturated Fats
· Saturated Fats
· Trans fats

Monounsaturated fats are liquids at room temperature, and they are considered a
relatively healthy fat. The best examples are olive oil, canola oil, nuts and
avocados. The people in the Mediterranean consume a fairly high quantity of
olive oil, which is probably partially responsible for their excellent health.

Avocados are a great source of healthy fats.

Polyunsaturated fats are liquid at room temperature and are found in nuts, seeds,
leafy greens, krill, fish and algae. They are broken down into two major types of
fat – omega-3 and omega-6 fatty acids. Both of these types of fats are
considered essential fats. In other words, your body needs them but you cannot
make them. Therefore you need to eat these types of fats. We all get plenty of
omega-6 fats in our diets. However, most people do not get enough omega-3
fatty acids.

The omega-3 fatty acids have been shown to be beneficial to human health in
multiple studies. In fact, it is one of the few topics that we discuss in this section
on which there is very little debate. Suggested benefits include reduced
depression, improved blood lipid levels (cholesterol and triglycerides), reduction
in cardiovascular diseases such as heart attack and stroke, improvement in joint
pain and arthritis, and improvement in overall inflammation within the body and
in various inflammatory diseases.

You probably need to be eating (or supplementing) to increase your intake. The
best sources of omega-3s are cold-water fatty fish such as salmon, herring,
mackerel, anchovies and sardines. Since most people don’t eat large amounts of
these fish, supplementation is required for optimal health. Free-range meats are
another potential source – although the amounts are small compared to cold-
water fish.

Saturated fats are solid at room temperature and are found mainly in animal
products, palm oil and coconut oil. There are a variety of different types of
saturated fats including stearic acid, lauric acid, palmitic acid and capric acid to
name a few. Some of these saturated fats have very negative effects and others
probably do not. There is quite a bit of controversy regarding saturated fats and
their effects on your health. Our advice is to limit saturated fats by mainly
eating lean cuts of meat and low fat dairy products as much as possible but not
totally stressing out about them.

Trans fats are composed of fats (usually vegetable) that have been altered by a
process called hydrogenation. They are semisolid and favored by food
companies because they are stable and less likely to spoil which gives them a
long shelf life. There is no debate, however, that trans fats are bad for you.
Trans fats increase LDL, decrease HDL and increase heart disease. Since it is
becoming widely known that these fats are bad, the food industry (sometimes
because of laws or fear of laws) has been eliminating them in many foods. You
may find trans fats in commercially baked products like cookies, doughnuts,
pizza crust and hamburger buns; stick margarine and vegetable shortening; fried
foods like French fries, chicken and breaded fish; candy bars; potato, corn and
tortilla chips; microwave popcorn; cake mixes and pancake mixes. Check the
food labels before you buy and avoid foods with trans fats OR that list
hydrogenated or partially hydrogenated vegetable oils in their ingredients. Be
aware though, that if a food has less than 0.5gms of trans fat per serving, it does
not need to be listed on the label, and they can STILL claim 0 trans fats.

We recommend that you get 25 – 35% of your daily calories from fat. So for the
average guy on maintenance at 2600 calories, that’s about 780 calories. To find
the amount of fat in grams that you can consume, divide by 9 (there are 9
calories in each gram of fat). So roughly 87 grams of fat. You want to try and
eat the good fats, like those in olive oil, nuts, fish and avocado. These foods
contain healthy mono-and polyunsaturated fats. Eat saturated fats in moderation,
like those found in full-fat dairy products like ice cream and butter and in fattier
cuts of red meat. The American Heart Association recommends that you limit
your saturated fat intake to no more than 7% of your daily caloric intake, which
would equate to no more than 20 gms for a person consuming 2600
calories/day.

Stay away from trans fats/hydrogenated fats altogether.

A SPOONFUL OF SUGAR

So what’s left? Carbs, baby! Subtract the calories from fat and protein, and
everything else you should consume in carbs.

Carbohydrates are sugars or chains of sugar molecules. Their main function is to

provide energy to the body, but excess carbohydrates can be turned to fat.

Carbohydrates can be divided into 4 main types.

· Monosaccharides
· Disaccharides
· Oligosaccharides
· Polysaccharides

Monosaccharides and disaccharides are smaller molecules and are also referred
to as “sugars”. The common monosaccharides are glucose (blood sugar),
fructose (fruit sugar) and galactose (milk sugar). Common disaccharides are
sucrose (glucose + fructose), which you know as common table sugar, lactose
(glucose + galactose) that is found in dairy products, and maltose (glucose +
glucose) found in malt beverages.

Oligosaccharides and polysaccharides are longer chains of sugar molecules.

Polysaccharides are sometimes referred to as starches and can contain 1000’s of
sugar molecules strung together. (In the body, these long chains of sugars are
called glycogen – which is the way the body stores sugar for breakdown at a
later date).

Fiber is another type of polysaccharide that for purposes of nutrition gets divided
into soluble or insoluble. Soluble fibers go into solution in a liquid and insoluble
fibers do not. Common sources of soluble fibers are oats, peas, beans, apples,
citrus fruits, carrots, barley and psyllium. Common sources of insoluble fibers
are whole-wheat flour, wheat bran, nuts and many vegetables. Some fibers are
also fermentable which means they can be fermented into other things like short
chain fatty acids, CO2 and methane. Therefore, they can cause gas. Methane is
one of the things that give farts their wonderful smell! If you have not been
eating lots of fiber, increase the amount slowly which will help to alleviate the
gas problem.

In spite of the gas problem, there are many reasons to consume an adequate
amount of fiber. Although fiber is not digested by your body and is passed
relatively intact it is still a very important nutrient.

The role you hear about most often is that it helps with constipation. If your
stool is hard and dry (making you constipated), fiber pulls water into the stool
making it softer and bulkier which helps you to go. If you stools are loose,
gooey or sticky, the fiber may help to solidify the stool.

Fiber is also a great help if you are trying to lose weight. Fiber makes you feel
full longer, decreases calorie absorption from other food that you eat at the same
time and helps to stabilize glucose levels. Fiber has also been shown to decrease
cholesterol and likely helps to prevent colon cancer. Shoot for 30 to 60
gms/day, which you should get by eating whole grains, fruits and vegetables.
Again, this is one of the things that you can easily track with your smart phone
app.

Like protein, carbs weigh in at 4 calories per gram.

There are all kinds of great tasting carbs – pasta, cereals, rice, breads and candies
are what we always think of – and those are great if you don’t overindulge.
Keep in mind though that the calories can add up pretty fast – a plate of pasta at
an Italian restaurant can have upwards of 1000 calories!

DR. VAL SAYS:

Wait! Who said we were limiting sugary carbs? WTF? I want my Hot Tamales,
man. Ok, so refined sugars aren’t going to help you add muscle, and high sugar
foods can have a big impact on people with diabetes or insulin resistance.
However, if your weight is under control and as long as you keep an eye on your
total caloric intake and ratio of macronutrients, you’ll probably be ok. Skittles,
anyone?

DR. DON SAYS:

Keep in mind, however, that it is very easy to overindulge in carbs. Many

processed foods have tons of carbs and tons of calories and you need to exercise
caution when eating these types of foods. In fact, if you have elevated levels of
fasting glucose or insulin, pre-diabetes or diabetes, you may want to cut back on
carbs. This is something you should discuss with your physician.

Fruits and vegetables are ideal sources of carbohydrates. Fruits and vegetables
are loaded with phytochemicals and other nutrients that are believed to play a
role in good health.

Try to get 9 servings of fruits and vegetables per day.

Therefore, you want to try to emphasize fruits and vegetables in your diet. Go
for at least 9 servings of fruits and vegetables/day. Each serving is
approximately ½ cup.

Phytochemicals – why do I care?

Phytochemicals are biologically active compounds that are found in plants.

There are estimated to be over 10,000 different phytochemicals. The
phytochemicals play different roles, but many are felt to be important in
reducing inflammation and others are felt to be important in various metabolic
pathways. Salicin is the chemical from which aspirin is derived and was
extracted originally from the white willow bark tree. Phytochemicals likely play
a strong role in reducing cancer and vascular diseases such as stroke and heart
disease.

Low-fat dairy products like milk and yogurt are also good sources of carbs, in
addition to being good sources of protein.

RECOMMENDED FOODS:

Healthy Fish – especially fish like salmon because it is high in the omega 3
fatty acids that have been shown to be really good for you.

Lean Proteins – help maintain muscle and help to keep you feeling full.

Vegetables – great low calorie, high fiber food with healthy phytochemicals.

Fruits – another great food source that is packed with fiber and phytochemicals.

Green Tea – contains a group of phytochemicals known as polyphenols that are

felt to be beneficial in reducing inflammation and promoting health.

Dark Chocolate (greater than 60% cacao) - packed with antioxidants and is
believed to contribute to cardiovascular health. It is high in calories and has
saturated fat though so beware. We usually have 20 or 30 gms/night.

Avocados – contain healthy monounsaturated fats, high in fiber and potassium

and have been shown to lower levels of LDL cholesterol and triglycerides.
Olive Oil – is high in healthy monounsaturated fats and antioxidants. Go for the
extra virgin type that contains the highest levels of antioxidants.

Nuts – are an excellent source of healthy fat, plus they are rich in
phytochemicals, fiber and antioxidants such as vitamin E and selenium. Don’t
overdo it though. Nuts are packed with calories.

FOODS TO AVOID (or at least to eat only in limited quantities)

Fried Foods – high in unhealthy fats (often trans fats) and high in calories

Foods containing trans fats and hydrogenated fats

Sugary Sodas and Drinks including most fruit juices – these drinks are packed
with calories.

Canned Soup – too much sodium

Processed Foods and Prepackaged Meals – processed foods are frequently

high in sodium and preservatives and the processing of the foods often robs them
of their nutrients and important phytochemicals. Whenever possible eat whole
foods to get the healthiest food. Eating whole foods that you cook yourself
doesn’t take all that much more time than eating shit out of a box or can and it’s
a whole lot healthier.

DR. VAL SAYS:

Why is drinking bad for your diet? IS drinking bad for your diet? The whole
topic of alcohol consumption, what it does to metabolism and diet, and what you
should do about it is enormous in scope. You could write a whole thesis on it –
we don’t want you to get bogged down in the details either. Alcohol is fun,
dammit! Plus, it has been shown to be beneficial (particularly red wine) in
moderation. This is all about being a normal, real person, right? So our
recommendation is to drink one or 2 servings, preferably red wine, a night.

Can you have a beer? Hells to the yeah. Moderation, baby (one or 2). Just
watch the calories – sure, a Bud Light has 110 calories for a 12 oz. serving. But
a Sierra Nevada Bigfoot packs in 330! Knock back a few of those while you’re
watching the game and you’ve added a ton of calories.

One or two servings of red wine per day has been linked to better health. Don't overdo it though, as there is
a law of diminishing returns!

While a little alcohol is a good thing, and a little more than that might sound like
an excellent idea sometimes, there is no argument that too much can be
detrimental to your health. In the short term, it can cause impairment in your
coordination, judgment and thinking. While this CAN be amusing when it
involves public pantslessness or dance floor disasters, driving while intoxicated
is always the wrong decision. Plus, we frequently see injuries and fractures as a
result of bar fights and drunken assaults. In the long term it can lead to
addiction, liver disease, pancreatic disease, cardiovascular disease, neurologic
impairment, cancer and other diseases.)

Dr. Don enjoys a cold one after cycling through southern Utah.

And speaking of DRINKING –

DR. DON SAYS:

What about water? You often hear that you should drink 8 glasses of water/day.
I don’t know many people that do that. Quite frankly, drinking tons of water
makes me nauseated. Well, I have some good news. Every non-alcoholic drink
that you consume counts. Your goal is to have 5 relatively clear urinations per
day. Drink a diet coke, low calorie beverages, coffee or tea or whatever you
want. Every magazine article that you read saying that sodas, etc., don’t
contribute toward hydration is pure bullshit. Read the back of a can of coke.
First ingredient? Water.

Alcohol does not count in this category though since it is a mild diuretic and will
make you a little dehydrated.

DR. DON recalls being at Scout Camp with his kids several years ago. It was
hot and humid. I remember the Scoutmaster and Camp Directors telling the
kids: “No soda or juice. You need to stay hydrated.” The message came out
over the loudspeakers: HEAT ALERT. STAY HYDRATED. NO SODA.
DRINK ONLY WATER!!! ” WTF. This was wrong advice and your goal is to
drink enough to have clear urinations. (Sugar free/low or no calorie beverages
preferred).

DR. VAL SAYS:

Another myth I see propagated again and again (and sometimes by doctors) is
that diet soda or the artificial sweeter sucralose somehow impairs fat
metabolism. There have been NO studies that show this! There have been
epidemiologic studies that have linked diet soda to type 2 diabetes and metabolic
syndrome (which is a catchy moniker for the constellation of risk factors for
vascular disease that include high blood pressure, central obesity, high
triglycerides and blood sugar among other things). But there has been nothing
established that shows a causative link. In other words, people who have these
risk factors tend to drink diet soda, but there is no evidence that supports diet
soda resulting in these problems. Instead, experts believe the “link” may be
because these individuals overcompensate for the calories “saved” with diet soda
and think they can eat more of something else, or that these individuals drink
more diet soda as part of an attempt to control weight.
Similarly, studies have shown that drinking an artificially sweetened soda
doesn’t cause a significant change in insulin levels as compared with carbonated
water.

Will you find someone who ADAMANTLY disagrees with us on this? Of

course. Someone who SWEARS their (mother, great aunt, guy at the club) had
something adverse happen to them. There are also people who swear that Elvis
is alive and people who think Britney can sing. You have to know your source.

SUPPLEMENTS

We are not going to go into detail on supplements in this book. Check out our
web site and our Guide to Healthy Eating for more advice.

However, there is one supplement that has been shown to have so many positive
benefits, that almost EVERYBODY should be taking it. If you could take a
supplement that helped reduce inflammation throughout the body, helped reduce
heart disease, lower cholesterol and triglycerides, helped to prevent some kinds
of cancer, helped reduce the risk of depression and gave you healthier skin,
WHY WOULD YOU NOT?

You need to be taking fish oil supplements. Fish oil contains the omega-3 fatty
acids eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) which are
precursors of the eicosanoids that are known to reduce inflammation throughout
the body.

We recommend a dose of between 1.8 to 3 gms/day of the active ingredients

EPA and DHA. You will usually need to look at the back of the bottle to figure
out how much EPA and DPA is within the supplement, since the front of the
bottle will list the total amount of fish oil per dose and not the amount of EPA
and DHA.
 Fish oil capsules. They may be big, but they're worth the trouble.

FYI – if you have issues with the giant fish oil capsules, you can also get it in a
liquid form.

MICRONUTRIENTS

Micronutrients are nutrients required for a range of functions in your body that
you cannot yourself produce. Vitamins and minerals fall under this category.
While most people in developed countries probably get enough vitamins and
minerals through the food they eat, many people do not. Therefore we also
recommend a multivitamin every day as a way to make sure that you are not
deficient in the micronutrients.

VITAMIN D

Many people are deficient in vitamin D, and therefore, we recommend that you
have your blood level checked. If you are low in vitamin D, then you need to
take a supplement.

MYTHS

Things that get repeated enough, even when wrong, have a way of seeping into
the conventional wisdom of society. Flat Earth ring a bell?

· 6 meals a day myth – There is a common belief that you need to eat
 frequent small meals to keep your metabolism revved up. Not true. Your
metabolism does not slow down in a matter of hours. You can eat when
you want to eat. It comes down to the number of calories consumed, not
how frequently you eat during the day.

· Protein damages your kidneys – Not true.

· Eating fat makes you fat. Not true. Eating too many total calories
makes you fat.

· If I exercise, I can eat what I want. Exercise does increase the number
of calories you burn, but not nearly as much as most people think. A 30-
minute workout does not equal a cheeseburger.

· Late Night Snacks cause weight gain. Nope. Count and track. If you
are eating 2100 calories a day, it’s 9pm and you have 400 left? Eat up.

· Diet soda impairs fat metabolism. No link. See above.

· If you cross your eyes, they’ll get stuck.

YOU CAN DO IT

This may all sound difficult, but it is actually very easy once you start to do it. If
you want to eat healthy but still enjoy eating out and doing normal things, you
need to keep track of what you eat.

A great way to stay motivated is to find a friend or family member to participate

in the plan with you. You can make a wager out of it with your friend. A
workout and diet buddy provides motivation and moral support. Forty-five
minutes on the stair climber goes much faster when you’ve got someone hanging
out with you. And when everyone else is telling you, “oh c’mon man, just order
the fries,” they will be there to say, “nah – we’re both gonna stick with the
vegetables instead.” You can share ideas and recipes as well as sharing your
success.

CALCULATE YOUR NUTRITIONAL REQUIREMENTS

For a printable worksheet to help you calculate your calories and macros go to
our website www.GDBD.com/succeed.

A. Calculate your maintenance calories.

· 14 – 16 calories/day/ multiplied by your weight (lbs.) to maintain your
current weight

· 10 – 12 calories/day/ multiplied by your weight (lbs.) if you want to
lose weight.

B. Calculate your protein requirements.

1). Get a rough estimate of your body fat percentage using the YMCA
formula:

§ Male body fat % = (-98.42 + (4.15 waist circumference in inches) –
(.082 weight in lbs.)/weight in lbs. =

§ Female body fat % = (-76.76 + (4.15 waist circumference in inches) –
(.082 weight in lbs.)/weight in lbs. =

2). Lean Body Mass = Multiply your weight by (1 – body fat %)

3). Grams of protein to eat/day = Multiply your lean body mass by 1.2
(you can go slightly higher or lower on this number depending upon your
goals as discussed in the main chapter.)

4). # of calories from protein/day = # of grams of protein/day x 4.

C. Determine Fat Calories

1). Fat calories = Total calories/day multiplied by 0.3

2). # of grams fat to eat/day = Fat calories/9 =

D. To determine carbohydrate intake:

1). Calories from carbs = Total calories – calories from protein –
calories from fat

2). # of grams carbs to eat/day = calories from carbs/4
E. Track to make sure that the number of calories/day that you are actually
consuming is allowing you to meet your goals. If you are on a maintenance diet
and you are either gaining or losing weight, adjust your calories down or up
respectively to maintain your weight. Similarly, if you are trying to lose weight,
make sure that the number of calories you are consuming/day is allowing you to
lose weight. You may see a quick drop initially, but the goal is 1 to 2
pounds/week after that.

F. Recalculate monthly if you are on a weight loss program as the numbers will
change as you lose weight.

G. Track your calories and macronutrients with your smart phone app to see
where you are.

H. The most important things to track are the total calories and the amount of
protein/day. Make sure to track these things and try to come close to your total
calorie and protein requirements. Fats and carbs are less important to track, but
it is very easy to track them as well.

I’LL SLEEP WHEN I’M DEAD - SWEET DREAMS

Many studies have shown that too much or too little sleep is detrimental to
health and longevity. Most studies show that sleeping about 7 hours per day is
ideal. It is our recommendation to sleep about 6 ½ to 8 hours per day for ideal
health. Naps count.

If you nap, it is best to nap for a period of only 10 to 45 minutes. Otherwise, you
are too groggy when you try to get back up and a longer nap can also interfere
with sleeping at night. If you are feeling tired during the day though, a short nap
can help you to feel better and give you more energy.

Plus, some studies have correlated adequate sleep with increased leptin (a
hormone that suppresses your appetite) and decreased ghrelin (a hormone that
makes you hungry).

Occasional problems sleeping are normal and nothing to worry about.

If you suffer from chronic insomnia (trouble falling asleep, staying asleep, or
waking up too early and not being able to fall back asleep) there are some things
you can do to try to help.

First of all, analyze the problem. Why do you think you are having problems
sleeping? Are you stressed? Are you depressed? Do you have poor sleep
habits? Are you overweight? Do you have pain or discomfort at night? Are you
on medications that might interfere with sleep? In other words try to figure out
why you are not sleeping. If you can pinpoint a particular problem perhaps you
can fix the issue.

If you have trouble sleeping, we have some recommendations listed below that
may help. If these things do not help, and you continue to have ongoing sleep
problems, it may be advisable to see your physician.

· Make sure your room is dark, quiet and cool. Blackout shades, eye
masks and white noise machines can help to block out light and background
 noise if necessary.

· Avoid large meals late in the day.

· Avoid caffeine after lunchtime.

· Avoid alcohol late in the day. While alcohol can make you feel sleepy,
it interferes with the quality of your sleep.

· Do not smoke.

· Avoid stimulating activity and stressful situations before bedtime. We
recommend not working out vigorously at least 4 hours before bedtime. It
may help to avoid TV, video games and computer use just prior to bed.

· Read a book before bed.

· Relaxation techniques such as deep breathing exercises or progressive
muscle relaxation may help if you are stressed.

· Many people find a warm bath relaxing and find that it helps them to
sleep. Dr. Don hates warm baths before bed – I like a nice cold bed. If I
am hot, I can’t sleep.

· Turn clocks so that you cannot see the time or the glow from the
digital display while you are in bed. We have found this to be a common
problem in hotel rooms.

· Get rid of the ticking alarm clock.

· Let your natural biological clock work for you.

· Establish a routine. Support your biological clock by going to bed at
the same time every night and waking up at the same time every morning.

· Melatonin is a hormone produced in your brain that helps to regulate
the sleep wake cycle. Melatonin is controlled by light exposure. Not
enough light during the day can make you feel sleepy at the wrong time and
too much light at night can suppress melatonin and make it harder to sleep.
Increase light exposure during the day (Take breaks outside during the day
and open blinds and curtains during the day) and decrease light exposure at
night (use low wattage bulbs, avoid bright TV and computer screens at least
one hour before bed and make your bedroom dark).

· Avoid naps if you have chronic sleep problems. If you nap (especially
for too long) you will not be sleepy when it is time to go to bed.

· Use the bed only for sleeping or sex.

· Don’t get stressed if you are having trouble falling asleep. If you
don’t sleep so well one night you can make up for it the next night. In fact,
as physicians in our old jobs, we were often up for over 36 hours at a time.
Nothing feels better than being super tired and finally letting your head hit
the pillow.

· Maintain an ideal weight. Being overweight is a common cause of
sleep apnea, a condition characterized by abnormal pauses in breathing
during sleep. It can cause insomnia or cause sleepiness during the day.
See your doctor if you have snoring loud enough to disturb others or
yourself, shortness of breath that awakens you from sleep, intermittent
pauses in your breathing during sleep or if you have excessive daytime
drowsiness.

· Work out every day. It will help your sleep.

Melatonin, as we discussed above, is produced by the body to help with the sleep
cycle. It can also be purchased in pill form over the counter and used as a sleep
supplement. Studies have not been done to determine the ideal dose. Ranges we
have seen reported as being beneficial range from 0.1mg up to 10mg. If you
want to try melatonin as a sleep aid – start with a low dose like 1mg for a few
nights and see if it helps. If not, go up a bit on the dose until you decide if it is
worth taking or not.

We are generally against prescription sleeping pills, but if used sparingly for
short-term situations they can be helpful. For example, they may be helpful
when traveling across multiple time zones or after surgical procedures. Make
sure you have enough time to get a full 7 to 8 hours of sleep after you take them
though. Also be aware that there may be side effects.

DR. DON SAYS:

I once took a sleeping pill on the airplane while traveling to Thailand. I slept
well on the plane (at least as well as one can sleep sitting up on an airplane), but
was still super drowsy when I arrived – mainly from the lingering effects of the
sleeping pill. The sad part though is that I don’t even remember the first 2 days
of the trip as one of the side effects can be amnesia. DR. VAL SAYS we had
fun.

RUN FOR YOUR LIFE - REAL MEN SWEAT

It was a race to the top of the hill. But it was not just any hill. It was an 11-mile
long hill to the top of Mount Figueroa just outside of St. Ynez in the Central
California wine country. It is the same hill that we were told Lance Armstrong
had trained on before some of his big races. It was ridiculously steep in parts.
Nothing for the faint of heart.

The Docs conquer Mt. Fig.

But we did it. It took standing up on the bike in places – pushing as hard as you
could just to get the wheel to turn, but we did it. And it was fun! And the reason
we could do it and it was fun is because we are fit. We work out almost every
day. HABIT. Like brushing your teeth. It is something you need to try to do
every day.

YOU NEED TO BE FIT. You will feel better, look better and you will have
more fun. It is part of being healthy, living longer and staying active until you
are old. You will have a lower heart rate, lower blood pressure, lower
cholesterol level and decreased inflammatory cells. Who knows, the girls may
even come on to you!
 Sadly, as many people age they lose the ability to adequately take care of themselves.

The goal is to function at a high level throughout life.

If you are young and healthy, you want to stay healthy and functional. One of
the keys is fitness.

If you are older and not as healthy – you can make things better.
 Even if you are not in great shape now, you can make things better. Get started today.

What does it take to be fit?

To be the best at any sport, it takes sport-specific training and years of practice.
But we are not talking about that – the scouts aren’t looking for you, sorry. We
are talking about general all-around fitness. You can be good at a lot of different
sports if you are fit. You can play some pick-up with your friends, try out
surfing when you are in Hawaii or climb a volcano in Costa Rica and not have to
worry that you aren’t gonna make it. We think this is a healthier, and certainly a
more realistic approach.

The Docs' first time surfing

Of course, if you are really into a specific sport – and want to be really good at
it, you need to train for that sport.

We think the best overall fitness requires:

· CARDIO TRAINING to include INTERVAL TRAINING
· STRENGTH TRAINING
· FLEXIBILITY
· BALANCE

Our recommendations for most people are:

§ 30 – 60 minutes of cardio 3 or 4x/week
§ depending on your level of fitness the above cardio might include
interval training 1-2x/week
§ 30 – 60 minutes of strength training 2 or 3x/week.
 § Stretching is incorporated into the pre and post workout.
§ Balance is incorporated into the other movements.

We understand it may be difficult to find time to work out this much. Do the
best that you can. Trust us, it’s worth finding the time.

CARDIO TRAINING

You absolutely need cardio training. The major benefits are better heart health
and longevity. You will feel better and live longer.

You need to tailor it to your ability. If you are overweight or in poor health –
start slow. Walk. Obviously if you are young and healthy, you can do much
more.

You can double check that you are exercising at an appropriate level of exertion
by monitoring your heart rate. You can check your pulse or use a heart rate
monitor.

The traditional formula used to monitor your heart rate is 220 minus your age.
However, this is only a rough estimate and your maximum heart rate could be as
much as 20 beats per minute faster or slower than what the formula tells you.
The formulas to calculate maximum heart rate are only estimates, so you need to
keep this in mind. For example, if you are 40 years old, your maximum heart
rate would be approximately 180 and the 70 to 85% zone would be 126 to 153
(plus or minus 20 beats per minute).

There are different levels of cardio:

· Light cardio is an exercise that can be performed for a long time at a
slow pace (up to about 65% of your maximum heart rate). It is good for
endurance, burning fat, and overall health and peace of mind. Who doesn’t
love a walk along the beach, a hike to a favorite lake or a nice bike ride
through the country. We live about 3 miles from the San Diego zoo and
like to walk up there once or twice a month. Dr. Don is especially fond of
this because he loves the soft ice cream at the zoo and uses that as his
reward!! If you are not fit, this is definitely the way to start. It is the kind
of exercise you can keep up for hours at a time.

 · Moderate cardio is more intense exercise. It is the type of exercise
you usually think about when you think cardio or aerobic exercise. You
want to aim for 70 to 85% of your maximum heart rate to see the best
benefits. We recommend this range for most of your cardio. It will make
you stronger, faster, more energetic and you will feel much better. (At least
after you are done.) You should aim for 2 or 3x/week.

Add cardio to your routine 2-4 times/week.

High intensity cardio takes the intensity up another notch. It’s also known as
anaerobic exercise because you deplete the oxygen in your muscles and use non-
oxygen dependent pathways to generate energy. You can only perform this type
of exercise in very brief spurts – maybe a few seconds up to 2 minutes max. It‘s
a fantastic way to get into peak shape. We recommend this type of activity
occasionally – ideally, one of your weekly cardio sessions should be high
intensity. Sprints or intervals on the stairs are good ways to get intense in a
hurry.
 What goes up…must come down.

INTERVAL TRAINING

Interval training is a type of cardiovascular workout that mixes bursts of high

intensity work with rest periods.

You often read about High-Intensity Interval Training (HIIT) in the fitness
magazines these days. Unfortunately, a lot of what they offer up as HIIT, doesn’t
really fit the bill. True HIIT should be 30 – 60 seconds of intense exercise (think
75 – 100% of your maximum intensity) followed by 30 – 90 seconds of rest, or
of low intensity exercise.

The magazines also tell you what a great calorie burner interval training is – but
surprise, it’s not that simple! Ok – if you are only going to do 15 to 20 minutes
of cardio, you might actually burn more calories with intervals. But, as we
mentioned above, you have to do it right with maximum effort. You can get
more bang for your buck in a shorter time period. But, we aren’t talking about
melting away the calories – it’s the difference in just a handful of calories. Plus,
done right, it’s a hell of a lot harder!

For longer periods of exercise, (45 to 60 minutes) you will actually burn more
overall calories doing steady-state cardio. So why drag your ass up the stairs 10
times? The benefit of interval training is that helps to increase fat oxidation (i.e.
fat burning), it’s a good conditioning exercise and it can break up the monotony
of your other cardio sessions. You really have to push yourself to see a true
benefit from interval training. If you’re going to half-ass it, stick to half-assing
steady-state cardio. You’ll see a greater overall calorie burn.
Many researchers have shown that this type of exercise may be equivalent in
cardiovascular benefit to more prolonged but less strenuous training.

Examples:

· 5 minute warm up
· 30 to 60 second interval of high intensity pedaling on the stationary
bike, at the highest level that you can maintain, followed by a 60 second
low intensity rest period, bringing the resistance back down to a more
gentle speed (repeated 6 to 10 times)
· 5 minute cool down

Even more extreme is High Intensity Interval Training (HIIT) that might consist
of :

· Warm up with stretches and ½ to ¾ speed sprints
· 10 to 20 second all out sprints followed by a walk back to the starting
line with a brief rest. (repeat 5 to 8 times)
· Cool down

We love to go down to the San Diego Convention Center and run the stairs –
about 80 stairs in total. We warm up by vigorously walking or jogging down to
the Convention Center and then run up the stairs as fast as we can, walking
down, and repeating about 10 times. FANTASTIC!! What’s really impressive is
when we see the firemen come and run the stairs – with their tanks on their
backs. Rock on, guys!
 Dr. Don using stairs for HIIT

We like to use interval training for one of our workouts each week. At a
maximum, intervals should only be done twice a week. Like everything –
moderation is key! More isn’t better. It’s just more.

If you can’t get formal workouts in every day, do what you can. It all helps.
Start taking the stairs instead of the elevator. (It always really annoys us when
some out-of-shape slob gets on the elevator and then goes up 1 floor). Don’t use
the elevator if you only need to go up a couple of floors. TAKE THE STAIRS.
If all you can manage is a Saturday morning Zumba class, DO IT!! It’s a start.

Quit being a lazy ass and looking for the parking spot closest to the door. PARK
IT AND WALK.

DR. VAL SAYS:

At the hospital where I used to work, there was a woman I saw every morning in
the gym. She came 5 days a week to walk briskly around the track for about an
hour. And then she would get in her car, drive to a handicap spot 10 feet from
the entrance of the hospital and go to work. Now, before you go accusing me of
being insensitive to people with physical handicaps, I overheard her saying that
she had a disabled permit because of her chronic lung disease and difficulty
breathing. WTF? She didn’t seem to have much difficulty during her workout.
Save the spot for someone who needs it.
Unless you are training for a specific event, mix it up. You want to do different
things so that you are not constantly pounding the same joints. We love running,
but it is not something that most people can do day in and day out for their entire
lives. Good exercises include incline walking (walking on an inclined
treadmill), stair machines, cycling, swimming or the elliptical.

We recommend warming up by starting slow and building up gradually to full

speed. Simple.

Ideally, the cool down is the time to stretch because your muscles are warmed
up. You will want to do some stretches for the muscles you worked.

Rectus femoris stretch after running the stairs.

GO HEAVY OR GO HOME!

Strength Training!!! The benefit – being able to do what you want to do at any
age. The older you get the more you need this. It helps prevent osteoporosis,
helps to keep muscles toned and protects your joints.

Hmmm, maybe younger guys really need this too. How many people do you
know, young people, who have had knee surgery? No guarantees, but it will
help. Plus if you really want to look good – RIPPED - you need strength
training.

Hit the gym 2 or 3 x/week.

The primary goal of strength training is obviously to get stronger. The benefits
are numerous if done correctly. Stronger bones, stronger ligaments and tendons,
healthier joints, (yes this will help you if you have arthritis), less chance of
injury to your joints/knees/shoulders, etc., better tone, better posture and
therefore less back problems.

Dr. Don doing curls. Strength training is critical.

Strength training can also mean body sculpting. Can you spot reduce the fat off
your abs or the back of your arms? NO! Can you try and build better deltoids to
increase the size and definition of your shoulders or pecs to increase the size of
your chest? Absolutely. Plus with improved muscle tone you will look way
better.

If you look pretty while lifting, you aren't working hard enough.

The myth of bulking:

I hear people, mostly women, say they don’t want to lift weights because they
don’t want to “bulk up.” Give me a break. First, show me a woman that
“bulked up” and I’ll show you a woman who put on fat and thought it was
muscle. Testosterone is the hormone that allows men to build muscle. Women
have a small amount, but lack the necessary amount of testosterone to really add
significant size. If you need proof, look at any of the professional figure
athletes who try to build muscle. They work at it like a full-time job, some of
them lifting weights over 20 hrs a week, and choking down protein powder like
it’s going out of style. And they still end up looking lean, not bulky. End of
story.

Bulky? You be the judge.

You need to do it correctly. If you don’t have the right form, you aren’t working
the right muscle and can actually be doing more damage than good. The best
way to do this is to get a good trainer. Somebody who can show you how to do
it properly, tailor your workout and correct your mistakes. You think you know
your way around the gym? Even Phil Mickelson needs a golf coach, so you can
probably use a trainer.

DR. VAL SAYS:

If you are paying a trainer and his idea of training is watching you on the step
mill or bicycle for 30 minutes, find another trainer. I see this ALL THE TIME at
my gym and it blows my mind. You can handle it on your own after your
session. Also, if your trainer isn’t buff and in absolutely fantastic shape, find
another one. It would be like going to a dermatologist with zits.

Technique is incredibly important for several reasons.

1. You want to avoid injury.

2. You want to train the proper muscle or muscle group.

3. You want to achieve the proper balance. While most guys concentrate on
the glamour muscles -- chest and biceps -- you also need to work even
harder on the less glamorous muscles such as the rhomboids (muscles in the
upper back) and serratus anterior (muscles along your sides). These
muscles help not only with strength, but stability and will contribute to your
overall health and athleticism.

4. Your posture will improve, you will be less prone to injury and you will
feel much better.

Most adults have back pain. Many times, the problem is muscle imbalance.
Proper training can alleviate back pain in many, many people. Learn to do it
right.

Sadly, even a lot of physicians don’t understand that back pain is frequently a
result of muscle imbalance, strain or spasm. The problem with this is twofold.
First, they aren’t going to get you the right kind of help or treatment that you
need to alleviate your problem. Second, people with back pain often get
imaging such as CT scans or MRIs as part of their initial workup. However,
there are a lot of things that we as physicians can find as incidental findings
(things that are seen on a CT or MRI that have nothing to do with your current
complaint) that could be erroneously interpreted as the offending agent. For
example – you might have a bulging disk in your spine that isn’t actually causing
you any problems at all. But you have back pain. 2 + 2 = 4. You get treatment
for a disk, just because it was there.

Another great example, Dr. Val’s mom was recently complaining about leg pain.
An MRI of the lumbar spine, hip and knee were ordered by her physician for
evaluation. The studies revealed a small tear in the cartilage in the hip joint of
the OPPOSITE leg. This incidental finding led her doctor to believe maybe
because of the tear, she was favoring the other leg causing it to hurt. He then
referred her to an orthopedic surgeon. In the meantime, she sent Val the films
and told her about her pain. Dr. Val thought it highly unlikely that the hip was
the problem – her symptoms sounded more like Iliotibial Band Syndrome (a
common complaint) and instead suggested she see a physical therapist. Voila!
After 4 weeks of PT, the pain was gone.

The moral of this story? Many abnormalities visualized on imaging tests are
asymptomatic and not causing you a problem. Before undertaking radical
procedures to fix musculoskeletal problems like this, you may want to get a
second opinion.

GUESS WHAT

You will not be fit in 10 minutes a day. You will not get rock-hard abs while
watching TV. If someone tells you that, they are lying. If you believe that,
you’re an idiot. You need to work hard and consistently to get fit, especially
early on.

Warm up – to loosen up the joints so that you are flexible enough to use proper
technique. Also start with a light set before going heavier.

Cool down – stretch the muscles you have been working.

FLEXIBILITY

Flexibility is Dr. Don’s least favorite component. Like a lot of guys, he is really
tight. Women are naturally more flexible. We incorporate stretches into our
warm-ups and cool downs. If you have spare time or really have a problem with
your flexibility, it might be worth it to devote a little more time to stretching.

BALANCE

We try to incorporate balance into the flexibility training and weight training.
Dr. Val works on balancing her margarita glass so that she doesn’t spill.

NUTRITION
Peri-workout nutrition (nutritional requirements before, during and after the
workout) is an important topic that we will discuss in our GDBD Guide to
Healthy Eating chapter.

Rocks with salt, please

POSTURE

Posture may seem out of place in this chapter, but it has more to do with fitness
than you might think. Bad posture isn’t just bad manners or laziness. It can
reflect a muscle imbalance.

You hear you should sit up straight, keep your spine aligned and your shoulders
back. Sounds good in theory, but guess what, how often do you see people do
it. RARE. It is because in most people, front muscles are dominant. Our back
muscles are weak. If you want to look better, have better posture and have less
chance of developing back pain or if you need to improve your back pain, you
need to strengthen your posterior muscle bundles. DO IT. You need it. You will
feel better, trust us.

At a recent body building competition in LA, we noticed that a lot of the male
competitors in the physique category had phenomenal bodies but horrendous
posture. Heads down, shoulders slumped, rounded backs – essentially hiding
the pecs and abs! So why bust your ass in the gym and not really show off the
fantastic body that you’ve built? Stand up and get noticed!

A WORD OF CAUTION
We sincerely hope that this book lights a fire under your ass to get you out of
your La-z-boy and into the gym. But understand your limitations.

Recently, while Val was lifting at our gym, someone ran in asking if anyone was
a doctor. A man was unconscious on the leg press. Other members lifted him
onto the floor where she then checked for breathing and a pulse. She started
CPR and used the gym’s AED (Automated external defibrillator). To make a
long story short – he died, likely of a heart attack. As it turns out, he was a
tourist, visiting from Arizona, just stopping to get in a workout. He was older,
around 60, overweight and obviously a smoker. The take home message from
this is NOT “hey I’m gonna die anyway, so leave me alone,” but rather if you are
overweight, older, and/or have other risk factors for cardiovascular disease, be
sure to check with your physician prior to starting ANY exercise program.

AN APPLE A DAY - THIS WON’T HURT A BIT

What you don’t tell the doctor, the doctor doesn’t know.

Take 2 and call us in the morning.

Should you see the doctor?

It is a good idea to see the doctor occasionally even if you are healthy. The
doctor can:

· Screen for diseases or problems such as high blood pressure or high
cholesterol
· Update vaccinations
· Get to know you so that when you really need him/her you have a
doctor you know and trust to care for you.
· Advise you on additional preventative measures you could be taking

Age Specific Guidelines

Age 18 – 45

· Testicular self-exam monthly. Seriously. Feel your nuts for lumps or
 masses. Do one side at a time preferably after a hot shower. We
recommended this for men 18 – 35, anyone with history of testicular
cancer or family history of testicular cancer, or anyone with a previously
undescended testicle (one in the groin, not in the scrotal sac). Most
lumps or masses are benign, but if you find one, you should see your
physician as soon as possible. Additionally, if you have a sudden onset
of severe pain in your testicle, you should see a doctor immediately as
this can be a sign of a medical emergency. Unless of course it was
preceded by a swift kick to the crotch, in which case you’ll probably be
ok. In about 15 minutes.

· Flu shot yearly. (The CDC recommends that everyone over 6 months of
age with rare exceptions get a yearly flu shot.) They are usually
available in the fall.

Visit your doc for:

· Height and Weight
· Physical exam every 2 or 3 years
· BP Screening every 2 years if healthy
· Cholesterol Screening every 5 years if at normal levels
· Immunizations – tetanus-diphtheria booster every 10 years
· Eye Exam every 2 years if you have vision problems or wear
corrective lenses
· Yearly dental checkup with cleaning 2x/year. Our dentist advocates
cleaning 3 – 4 times a year. Most people don’t realize that the health of
your teeth and gums can be directly related to the health of the rest of your
body. Inflamed teeth or gums result in an inflammatory state, as discussed
previously, that can affect the heart, blood vessels and your entire body.

Age 45 – 65

Visit your doc for:

· Height and Weight
· Physical Examination every 1 or 2 years
· BP – Yearly
· Cholesterol screening every 1 or 2 years if within a normal range.
· Colon cancer screening with colonoscopy beginning at age 45 to 50
· Prostate Exam yearly beginning at 45 to 50
 · Osteoporosis Screening depending on risk factors
· Immunizations –
· Flu Vaccine yearly
· Pneumococcal Vaccine – discuss with doctor
· Tetanus-Diphtheria booster every 10 years
· Shingles/herpes zoster vaccine once after age 60
· Eye exam every one or 2 years even if you do not have eye problems.
Need to have exams done to check for glaucoma, which should be part of
any routine eye exam
· Dental exam once/year and cleaning at least twice/year

DR. VAL SAYS:

Dr. Don was less than enthusiastic about having a prostate exam at age 45. At
his yearly physical, his physician (also a friend of mine) said, “ well, do you
want me to do a prostate exam?” Don said, “No, but Val will kill me if you
don’t. “ To which the doctor replied, “yeah, and she’ll kill me too.”

Dr. Don’s fear of prostate exams is not entirely unfounded. However… When
he was a medical student, he was told by the resident to go into the exam room
and perform a comprehensive exam, including a prostate exam. Don gloved up
and asked the patient to assume the position. Man, did he have trouble trying to
insert his finger into the guy’s anus! The patient was yelling (Don specifically
remembers the little hairs getting stuck on the glove and pulling…) but finally,
mission accomplished! He went back to the resident and recounted the story and
told him about the difficulty he had. The resident physician said, “You used
lube, right?” Right???

Age 65 and older:

Visit your doc for:

· Height and Weight
· Physical exam yearly
· BP yearly
· Cholesterol every 1 or 2 years
· Colon cancer screening
· Abdominal aortic aneurysm screening at least once
 · Prostate screening
· Osteoporosis screening with a DEXA exam at least once over age 70
· Immunizations:
o Pneumococcal vaccine
o Flu shot yearly
o Tetanus-diphtheria booster every 10 years
o Shingles/herpes zoster vaccine if you have not had one
· Eye exam yearly with glaucoma checks
· Hearing exam yearly
· Dental exams yearly and cleaning at least 2x/year

LALALALA – I CAN’T HEAR YOU…

SYMPTOMS AND SIGNS NOT TO IGNORE

Symptoms that may require immediate attention (Go to the ER):

· Chest Pain
· Shortness of Breath
· Weakness, dizziness, vision changes, confusion
· Severe sudden headache
· Severe abdominal pain
· Severe trauma and burns

Symptoms that need fairly prompt evaluation:

· Persistent high fever
· Unexplained weight loss
· Blood in your stool
· New lumps or bumps
· Dark colored or pigmented skin lesions that are new or growing

If you think something is wrong, trust your gut and get it checked.

SHAVE YOUR BALLS - I’M JUDGING YOU

DR. VAL SAYS:

I’m judging you.

That’s right. I probably shouldn’t be, but I am. If you just walked into the bar or
the meeting and you are unkempt, scruffy or wearing clothing that doesn’t fit,
some people have already disregarded you as a potential date or hook up. This
applies to boardrooms and job interviews as well. I know a lot of men who
believe that their CV speaks for itself, but you need to trust me on this one. It
doesn’t.

Women and men alike are making a judgment call on your intelligence, your
income and your education based on your appearance. This is the old “you
never get a second chance to make a first impression” argument comes into
play.

But its worse than you think – you could even have rolled up in your Mercedes
SLK, but if you get out of your car wearing dad-jeans, the ladies are going to
assume that you are neither very hip nor very fun.

So, does this mean you need to drop a small fortune on your wardrobe and show
up in your Armani jacket? Not necessarily….

Start with clothing that fits. Sounds basic, but you’d be surprised how many
men are wearing stuff that’s not suited for them.

Most egregious offenders? Pants that are too short. Kills us every time… For
the under-informed (if you aren’t a clothes horse or don’t follow Fashion Week,
this probably means you), a medium break is probably the best choice for you.
That’s all you need to tell the tailor. This will have your pants hitting mid way
between the top of your dress shoe and the top of your sole.

Shirts that are too big, usually but not limited to T-shirts. No – you probably
aren’t an XL. If you are, go back to the chapter on diet and read it again. Buy a
shirt that fits. Your shoulder seam should be ON your shoulder, not 2 inches
below it or halfway to your elbow.

Here’s the before…

Note Dr. Don's XL shirt and Dad-pants.

…and here’s the after.

Now THAT'S what I'm talking about

Hopefully you have at least one nice sports jacket in your arsenal. If not, invest
in one that you can dress up or dress down with jeans. Spend the extra cash and
get someone who knows what they are doing to tailor it to fit you. You don’t
want to look like a kid borrowing his dad’s jacket, nor do you want to look like
you are stuffed into a sausage casing.

Which brings us to another point…. If you have a really nice jacket or suit that
you’ve been carting around for years because you spent a lot of money on it, turn
a critical eye to it. Does it still fit? Is it still in style? Probably neither. Donate
it and come to terms with the fact that you no longer fit into the suit you bought
for medical school interviews (We meant law school. Or business school. Dr.
Don wouldn’t be guilty of that, right?)

Lastly, if you are wearing running shoes outside of the gym, think again. If you
are doing something active like playing Frisbee in the park or taking a long walk
or hike, you are forgiven. If you are drinking beers and watching the game,
pushing a shopping cart at Costco or touring Paris by foot, find a more suitable
alternative that proves you don’t have your head up your ass. Even a pair of
Converse sneakers or slip-on Tom’s would be a big improvement. Nothing says
suburbia like a guy in dad-jeans with running shoes. It’s like proclaiming to the
world that you only have sex once a week. If you’re lucky.

If you think this describes you, or worse still, if you DON’T think it describes
you, but someone else might…ask for some guidance. Swallow your pride and
ASK a female friend or coworker (or gay guy) to serve as an ad-hoc appearance
coach. Preferably, this individual would represent the age group and
demographic profile you are trying to, uh, penetrate. The reality is, a lot of guys
have no clue when it comes to style and appearance and could probably benefit
from a woman’s perspective.

FACE IT

There is a huge industry based on skin care. Although women are the primary
target, you guys should pay attention too. Use a moisturizer on your face daily,
preferably one with SPF. It will help keep you looking younger longer, not only
from the moisture but also by protecting your skin from harmful UV light that
will age you prematurely.

Speaking of the sun, if you really want to look good when you get older, try to
avoid the sun and always use a broad-spectrum sunscreen. While we’re at it,
don’t forget your shades. It’s not just a fashion statement. Protect your eyes
from the UV rays and prevent crow’s feet formation from squinting.

We don’t expect any man reading this to go get a facial, although it’s not a bad
idea. But, DO pay attention to zits and blackheads. We notice them on sales
clerks, wait staff and on plenty of patients, so believe us – your date sees it too.
We are here to encourage you to do it, particularly if you are going to be sitting
across from us at dinner.

Similarly, a lot of men suffer from folliculitis in their stubble. Pustules (zits)
form from an infection of the hair follicle from normal skin bacteria or more
uncommonly a fungus. You can also have pseudo-folliculitis from ingrown
hairs. This can be remedied by using an electric razor rather than a blade, or by
massaging your skin with a warm washcloth prior to shaving. This usually will
go away on it’s own, but can require antibiotics or antifungal medications. If you
have a persistent problem with any of these things, go see a dermatologist.

Lastly, exfoliation isn’t just for women. Get some facial exfoliator and keep it in
the shower. You don’t need to tell anyone. Little bits of dry skin are pretty
gnarly. Dr. Val used to work with a guy who always dressed to the nines, but
had dry skin and little flaky bits all over his forehead. Yuck.

BACK TO BASICS

We shouldn’t even have to tell you this, but for God’s sake, brush and floss. We
knew a physician who was so scatterbrained he had to tie his toothbrush to the
doorframe so that he would run into it on his way out the door. Halitosis can
make the best looking man or woman downright unfuckable. It may be as a
result of negligent brushing or flossing, but it might also be due to bacteria
growing on the base of your tongue. If you know you have bad breath and can’t
seem to cure it with brushing, consider a tongue-scraper. If you aren’t sure ASK
someone. You’ve got a buddy you can ask, right? Even your best friend’s girl,
or your sister. Your dentist or hygienist can also help you out, and may have
other recommendations.

Speaking of, if you aren’t seeing your dentist regularly, you need to be. You
should have your teeth cleaned at least 2 times a year. Personally, we hate going
to the dentist and can think of better things on which to spend the money. But
dental health (including your gums, etc) is paramount to the health of the rest of
your body. The inflammation from chromic dental disease or periodontal
disease contributes to inflammation that contributes to heart disease, stroke, and
cancer. Additionally, if you have smoldering dental infections, the bacteria can
spread to your heart, your spine or your brain.
Finally, yellow teeth are not cool. There are plenty of good teeth whiteners
on the market. If you need to whiten your teeth see your dentist or use one of
the commercially available products.
IT’S GETTING HAIRY

Ok – we promised and we will deliver.

Excess hair is a problem. This goes back to looking like you don’t care, or
worse still, looking like you aren’t clean.

The dreaded unibrow. Nobody, and we mean NOBODY rocks this look. Either
tweeze or get it waxed.

Additionally, as you get older, your eyebrows (along with a lot of other hair) will
grow to unfathomable lengths. Think Walter Matthau. They need to be
trimmed. One day you’re going to look in the mirror and see your granddad if
you don’t pay attention to this stuff. And if your date wakes up next to Walter
Matthau, that’s going to be a problem.

You need to be conscious of and trim your ear hair (this means inside and along
the pinna – which is the big cartilaginous disk part) and your nose hair.
Whoever cuts your hair should trim/shave the hair on the back of your neck and
on your ears. If they don’t, ask them to. Nose hair is distracting – if someone is
talking to you and you have protruding nose hair, we guarantee they aren’t
thinking about what you are saying. They are looking at your nose hair. Buy a
trimmer. Use it once a month, minimum.

DR. VAL SAYS:

Body hair is controversial. I myself like a guy with some body hair – it means
virility, maturity, etc. I don’t want to sleep with Justin Bieber. But like
anything, you gotta keep it under control. Groomers are available with variable
attachments so that you can choose your length.

And as for the balls? Yes, shave them. It’s not just for the gays. First, shaving
your nuts and trimming your pubic hair and particularly the hair at the base of
the shaft makes your penis look longer. Bonus! Plus, if you get lucky enough
to have a wife/GF/hook up who likes to give you oral, it’s a complete deal
breaker to get down there and find a forest. It’s just like cleaning up your living
room before she comes over – make it look nice and smell good, K? Hair traps
odor, which won’t help your cause. Plus, trying to pick hair out of the back of
your throat doesn’t make us want to come back for seconds.

Phallic symbols are common in rural Bhutan.

They could use some man-scaping.

DR. DON SAYS:

Insider Tip:

If you are going to be doing anything where you get a little sweaty, remember
the anti-chafing powder or cream. You don’t want your balls sticking to your leg
like a bare ass on hot vinyl.

SWEET SMELL OF SUCCESS

It seems like a no-brainer (Ms Max had to talk to our 7th grade class about it, but
I thought by now we’d all have it figured out) but for God’s sake – shower and
wear deodorant. We worked with a physician whose funk was so funky, there
was actually dialog about who was going to have to confront him about it.

Of course, the other side of the coin can be just as bad. Another physician at the
same hospital wore so much cologne that you could walk down an empty
hallway and know that he’d been there.

KEEP IT UNDER WRAPS

This is a public service announcement. If you are sporting man-boobs, love

handles, muffin top, bad tattoos, bad skin or excess body hair alone or in any
combination, think twice before taking off your shirt. There are really very few
venues that are appropriate for shirtlessness, and those usually involve water or
sex. If you are walking your dog, moving a sofa, riding your bike or lifting at
the gym, just keep it on. Again – unless you are really sporting a great
physique, taking off your shirt is only going to detract points from your overall
score.

A manicure doesn’t make you a princess, but if the tiara fits….

If you can’t adequately trim and shape your nails (or remember to do so) pay
someone else to do it. It’s really not a bad experience. Well-groomed nails may
not get you noticed, but snaggle-toothed toenails in your flip-flops sure as hell
will. And if you scratch a chick with your machete-shaped big toenail while in
bed, she’s gonna remember it. And like I said, we’re all judging you.

SOMBODY’S GONNA LOSE AN EYE - IT’S
ALWAYS FUN UNTIL SOMEBODY GETS HURT

All lightness and frivolity aside, this is a book written to address some really
important topics that we feel don’t receive enough attention. One topic that
really gets ignored is safety. There are certain things that seem fraught with risk
– hang-gliding, chain saws, diving into the shallow end of the pool. In fact,
you’d be surprised by the amount of stupid shit that we see in our jobs on a day-
to-day basis. Like the guy who shoved a rubber ball up his ass. And that wasn’t
the problem, really. It was that he tried to use a metal coat hanger to get it out.
But there are less inventive ways to get yourself in trouble.

Dumbshits happen.

In emergency radiology, there are repeat offenders – auto and motorcycle

accidents, bar fights, firearms, and anything involving drugs/alcohol and motor
vehicles or other things with moving parts. The inherent danger in these is
fairly self-explanatory.

Our trifecta of things to avoid that you might not think about? Horses, ladders
and ATVs… In our practice, we see an astounding number of serious injuries as
a result of ATVs and ladders in particular. ATVs are hazardous because people
don’t seem to have an appropriate level of respect for the damage that can be
done. They seem safe and stable because they are on 4 wheels and low to the
ground.
Dr. Don once had a patient who was thrown from his ATV. He landed on a sharp
stick, which penetrated his neck exiting out the other side. Luckily for him the
stick missed all of the important arteries and the patient survived.

DR. VAL SAYS:

It’s beyond me why people think ATVs are safe for small children. So thinking
about safety also means thinking about the safety of your kids or kids around
you. It’s not a teeny little car – it’s a motorized vehicle and a 3 year old
shouldn’t be riding one.

Ladders on the other hand are so simple and commonplace, people don’t think
twice about cleaning the gutters or changing a light bulb. We see loads of spinal
injuries and head injuries with both of these.

Creative ladder stacking in Peru.

We didn't watch to see how it ended.

Dr. Don was working late one evening just before Christmas. A 40-year-old man
had been on a ladder hanging Christmas lights from the roof. Unfortunately he
slipped off the ladder and hit his head on the cement driveway. He developed a
large hemorrhage in his brain and never recovered.

While injuries involving horses aren’t as common, horses can be unpredictable

even with the most skilled riders. Look at Christopher Reeve. The results can
be devastating.

Our advice – stay away from these if you can or at the very least, exercise a
modicum of caution. A dead squirrel in the gutter isn’t worth a lifetime in a
wheelchair.

DR. VAL SAYS:

A few years ago, I met another radiologist who had a fantastic tale about male
stupidity. When he was in medical school, a guy came into the Emergency
Department wearing a trench coat over his shoulders, accompanied by his
brother, who could barely stand up. Because he was laughing so hard.

Seems that the man in question had been cleaning the engine on his motorcycle.
While doing so, he exposed an opening that was, well, penis-sized. So clearly,
he had to see what it might be like. What he didn’t count on, was the increase in
blood flow and increase in size to his penis while, uh, servicing his engine. His
dick got stuck in the engine. He called his brother who drove him to the ER.
Under the trench coat he had both arms carrying the engine block, still firmly
affixed to his member. Clever boy!

Avoid confrontation/bar fights. It is absolutely amazing how many people we

see every night we work that were involved in bar fights. Lots of pain and
broken bones. You don’t need it. Edward Norton and Brad Pitt bounce back
pretty readily, but real people end up with real damage.

We like active sports. However, you need to make sure to follow proper safety
precautions. When biking, rollerblading or skiing be sure to wear a helmet. If
you participate in an activity – be sure to take proper safety precautions.
 A friend involved in a ski accident with a head injury in 2002.

The Docs wear ski helmets.

Wear your seatbelt. We mean it.

Speaking of automobiles and driving, DO NOT DRINK AND DRIVE. You

know that. Take a cab.

Avoid distractions while driving. That would include not talking and certainly
not texting on your cell phone.

If you smoke, we don’t expect this book to change your mind. Similarly, if you
use cocaine, meth or heroin. You know this shit is bad for you. However, the
book would not be complete if we don’t at least mention this kind of stuff. Our
only advice is: DON”T.

OK. We want you to enjoy life. That includes sex!! However, if you are not
monogamous, you need to use a condom. You don’t want an STD. In fact one
of our friends sent us a CT scan for review on a patient the other night that had
multiple genital warts that were so big they looked like broccoli florets growing
off of his penis.

One last thing, since this is a book about health, fitness and living longer, if you
are depressed get help. Suicide is one of the leading causes of death. It is
preventable.

Highway sign in the foothills of the Himalayas in Bhutan.


IN CONCLUSION - LIVE LIFE + LONG TIME

You can do this! It isn’t that hard. You can have the body and the life that you
want, without totally giving up the things that you enjoy.

We hope that we’ve shown you that maintaining an ideal weight and being fit
isn’t just about vanity. It is the key to health, longevity and being able to
participate in life. And being hot is pretty cool too.

You need to take responsibility for you own health, and you need to do it NOW,
before any problems arise.

Almost everything in this book (nut shaving and prostate exams aside) applies to
BOTH men and women. So if you are a guy reading this book, share these tips
with your wife or girlfriends. If you’re a chick, hoping that you can talk your
man into shaving his balls or buying some pants that fit, think about how you
can apply this to your own life. So…raise a glass – preferably of red wine,
loaded with antioxidants – to your health, to your life, and to the new, better
YOU!

THE GOODDOC BADDOC TOP TEN

1. Be responsible
2. Don’t smoke
3. Eat right
4. Be fit, get off your ass and exercise regularly.
5. Monitor blood pressure and cholesterol
6. Everything in moderation
7. Take your fish oil
8. Get some sleep - 6 ½ to 8 hours/night
9. Drink up - 1 or 2 glasses of alcohol/day
10. Wear your effen seatbelt

 WANT MORE?
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