Conquer Your Weight

Dr. Sarah Stombaugh: This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight podcast. Announcer: Welcome to the Conquer Your Weight podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh. Dr. Sarah Stombaugh: Hello everyone and welcome to today's episode. We are talking about some tips and lessons that I wanted to share with you. My husband and I recently took a 10 year anniversary trip to Europe. We were there for almost two weeks, and there were a lot of things that I was thinking about over there that I really wanted to stop and share with you because it's very common for vacation in general, but especially these longer trips that are specifically for vacation, especially when people are going to Europe. There's a lot of walking. There's things about the trip that are just a lot different from being certainly in our normal day to day life, but even different than if we took a vacation for a long weekend or something that was a little bit more local or even just somewhere domestic. So I wanted to talk a little bit about our trip to Europe and share with you a little bit about what that looked like and how you can apply some of these principles maybe just in general in your life, certainly if you're going on vacation, but especially if you're having one of these longer trips, things you can do to plan and make sure that you can stay in line with your health goals. One of the things I want to invite you before we get into today's episode is join me over on my website. We have a newsletter that goes out twice every week. We share recipes that are easy, things that you can throw together, maybe making large portions so you can eat them throughout the week, things that are healthy and just delicious. So check that out. You can also see our podcast updates over there. Any other updates from the practice, like recently, we hired a health coach named Caryn. You're going to be hearing from her eventually as well and talking about how things are changing, growing, and evolving at Sarah Stombaugh personalized weight loss. So I am so excited to share all that information. If you are interested in getting some of these updates, come on over to www.sarahstombaughmd.com. You'll find that link in the show notes, and I would love to have you on our email list. You can see all these updates, get those great recipes and learn what's going on with our practice. So let's tell you a bit, let's dive into this episode about lessons from my trip to Europe. So the first thing that I want to start with is thinking about steps. One of the conversations that I have with patients all the time is I went to Europe and I got 18,000, 20,000, 25,000, 30,000 steps per day, and a lot of my patients come back from their trips to Europe and actually find that they've lost weight, which is really exciting for everybody. So I want to talk a little bit about step count, certainly why it's so high while we're in Europe, how we can bring that into our everyday lives here, but then what that means in terms of food choices, maybe the amount of food that you're eating. So let's think about this a little bit. So we hear recommendations about getting 10,000 steps per day. Some people are very regimented about tracking their steps, other people are not. The reality is I think it can be valuable to track from time to time to get an idea of how active you are or are not, and that can be a good way if you're looking for a measurable way to increase the steps that you get per day can be a good way to understand what you're doing. Maybe set a new goal for yourself and start growing upon that. But measuring, I don't know, sometimes we like measuring all these things, measuring steps, measuring calories, measuring our sleep, and if that's helpful for you, excellent. I don't know that that needs to be part of everyone's journey. The interesting thing is that with smartphones, with which almost all of us have now, there're actually counting your steps for you in the background. So certainly that assumes that your phone is on your person, so it's in your pocket. Maybe you have a smartwatch, even if it's on your purse actually, it'll be tracking your steps as well. So even if you don't realize that your tracking steps, if you do have your smartphone on you, it is tracking your steps while you have that on you. So a lot of times if that's not something you've done before, I encourage you to take a peek at your phone and just see what it says. I have an iPhone, so that is listed under the Health app. It's a little white icon that has a heart on it, and if you click on that, there'll be a couple of different indicators, but typically you can scroll down and see step counts from the past even if you weren't aware that that was being something or that was something that was being tracked. So there's recommendations about getting 10,000 steps per day. The interesting thing is that the data that supports those numbers is a little bit arbitrary. However, we do know that being routinely active is an important part of making sure that we have good over our all cardiovascular health and that we're staying active. It helps to reduce weight, it helps us to improve our heart health and certainly many other benefits to exercise. We know that many people, especially in America, are pretty sedentary, often getting less than 2,000 or 4,000 steps per day, and that there are probably pretty few people who are getting 15, 20, 25, 30,000 steps per day. So when we look at why that is the case, a lot of times we think about exercise, we're thinking about intentionally going out for a walk or a run or a bike ride or something like that that's going to make us be more active. But a lot of it is actually just our basal movement. So our movement throughout the day when we are walking, do we walk to work versus do we commute to work? Are we walking up the stairs versus are we taking the elevator? Do we park at the far end of the parking lot versus do we park at the closest spot that we can find? Are we using public transportation and therefore maybe walking a little bit more? What do these different things look like for us? And then how does that add up for us over time, especially in America, a lot of people commute by car. I know that I certainly do now that we live in Virginia and therefore my step count is quite a bit lower, especially compared to when I was in the Chicagoland area and I commuted by train. There was the walk to the train station, then to the office and back, and there was a lot just different flow of what the day looked like. And so you find that just your basal metabolic or your basal exercise rate is quite a bit lower. Then we look at going to Europe. A lot of European cities are old. They are designed for people who live really in the city center. A lot of cities have great public transportation, whether that's trains or buses, and so people are utilizing a combination of walking and maybe taking public transport in order to see those cities. And so especially when we go over as tourists, it's common that people spend really the entire day walking because they're walking from this site to that site, exploring all of these different things and finding that while it might be punctuated by stopping to see a site or stopping to have a meal, that really from when they wake up in the morning until the end of the day, there's pretty consistent moving that's happening. And what ends up happening there is we burn a lot more energy. So we talk about calories in calories out, and I think for any of us who practice in medical weight loss and support patients with that, it can be really frustrating because the calories out versus or calories in versus calories out equation is both true. I mean calories in versus calories out is thermodynamics that cannot be argued, and weight loss is not as simple as that. Weight loss is not just exercise more, eat less. We know that there are all these other hormonal factors and psychological factors and environmental factors that drive the fact that it is not just as simple as calories in versus calories out. But that being said, when we are more active, there is a higher calorie expenditure happening. You're burning more energy. So what a lot of my patients find, and what I certainly found as well is that if you're routinely getting 20 or 25,000 steps per day, which even for me is quite a bit more than I get on a day-to-day basis, that means you're simply more hungry. So let's think about just some general numbers so you can put this into context. On average, obviously this will depend on how big your stride is, how big your steps are, but about 2,000 steps equals a mile. When we think about 10,000 steps per day, that's about five miles. If you're getting 20,000 steps per day, that's about 10 miles and 30,000 steps per day would be about 15 miles. Now again, if you think about the amount of energy that our body burns, the amount of calories that we burn when we walk a mile, that is also going to depend on factors like your body size, how much of your body is muscle versus fat, what is your fitness level? All of these things impact how much energy does it take to move your body a mile? But a good estimate is often about 100 calories per mile. So if you imagine let's say on a day-to-day basis, you're walking 5,000 steps. You're walking about two and a half miles in an average day. Now if you go to Europe and you're walking 25,000 steps, that extra 20,000 steps that you're getting is the equivalent of about 10 extra miles of walking. And if that's a hundred calories burned per mile, about an extra 1000 calories available for you to consume. Now that doesn't mean that you should just go and eat everything in sight, but it's very common that you'll find that you are more hungry. Your body is telling you that it needs more fuel because you've been walking more, you've been burning a lot more energy. A lot of my patients too talk about the amount of bread or pastries or other desserts that they consume in Europe. And part of the reason why we may be able to do that and not gain weight during that time is because when we are walking so much, our body is using that carbohydrate for fuel. We think about the different macronutrients, we think about carbohydrates, we think about protein, we think about fat. Each of those things serves a very important role in our body. And the thing about carbohydrates that both get demonized but is really important is that they are a very easy and really the preferential fuel source for our body. So when our body is active, when our muscles need fuel, it is very easy for our body to use carbohydrates for energy. So whether that's simple carbohydrates like breads and sugars, for example, or more complex carbohydrates like fruits, vegetables, and whole grains, our body can utilize these very readily for energy. And when we're walking pretty consistently simply put, our body is able to utilize those in the bloodstream in our muscles before we're storing them away as energy for fat because they're being burned up before they need to be stored. And so a lot of people find that they're eating more of these type of foods and it's because they're more active. And so one of the things I encourage my patients to do all of the time, but especially in times like this where you're a lot more active, your hunger may be different coming back to something like the hunger scale where you can assess, okay, how hungry am I right now? Am I a negative six? Am I feeling like, wow, I've really built up an appetite because I've been walking around so much today compared to a typical day? And if that's the case, you might find that it takes more food to fuel your body compared to a typical day. So you might find that there's a snack that happens, or you might find that at mealtime you're consuming a bit more food, and that is okay, if your body is moving more, your hunger, your body is asking for more food, then we get to, and we should acknowledge that by providing it with more food. Another thing is that sometimes with that, we know that the food choices that we're making or the food choices that are available to us may look very different depending on where we are. I think one of the things that I was very struck by is just how much real food, normal real whole food is available in Europe compared to America. And I didn't really expect that or wasn't surprised by that at restaurants per se, but the thing that really caught me was our very first traveling in on the airplane. We stopped in Munich, actually in Germany, and I was so surprised every single airport food stall had real delicious normal looking food as opposed to an American airport. It's like, here's some hot dogs, here's some cheeseburgers, here's some popcorn, maybe here's a Starbucks. Foods that are really processed and just don't feel like you're eating a real food as opposed to something that's been a little bit more heavily processed. So we are eating foods that are based in whole grains. There's fruits, there's vegetables, there's proteins, there's fats with those. You're eating breads that are not these highly processed breads that would last on the shelf for a month or two, that bread that would go moldy in a couple of days because it's a fresh baked bread. These type of things when we're eating them, eating whole foods, natural foods, foods that have been less processed are going to help our body to have natural satiety signals to those foods that have more fiber, have less preservatives, foods that are rich in protein, have a little bit of fats. When we have these well-balanced and complex meals that helps our bodies to achieve satiety initially and then to feel that there is some staying power from that because that food will stick with us for hours compared to something that is more processed. The problem with processing is just that it's already been sort of processed, so when your body eats it, it's really easy for your body to absorb that energy and it moves you more quickly. It doesn't have the same sustenance as sustaining power compared to something that is a more whole food. Those things were the things that stood out to me the most. But I wanted to share some other observations, some tips, things I wanted to share that will be applicable both for a European trip or really any travel that you have. One of the things that's really important when you travel any distance where there's going to be an adjustment with jet lag, your circadian rhythm is going to be off, is that it's going to take a couple of days for your body to sort of feel normal. You may be awake during times. You would typically be sleeping, you're going to be eating at different times than you typically would. And so encouraging you to listen to your body and just recognizing that things are going to be out of whack for a couple of days. So you may not be able to eat fully based on what the clock is telling you. You might look at the clock and it might say noon. You might say, great, this is time to eat lunch. But if your body is feeling maybe a little bit nauseated or just not hungry at that time, making sure that you're not forcing yourself to eat or eating just because this is a good opportunity. Similarly with that, when our eating is out of whack, we may as we sit down for a meal, not have our normal hunger, rather maybe not feel like we need to eat as big of a meal. And I think one of the biggest things that comes up during travel is this fear of, okay, this is my opportunity to eat. I don't know, an hour or two, three hours from now, is there going to be food readily available for me? So with any travel, making sure to have food available if it's needed. So whether that's a protein bar, whether that's beef jerky, I'm a huge fan of those little tuna packets, for example, maybe a whole piece of fruit, although you can't travel internationally with that. Making sure to have things that are available to you that maybe you throw in your purse, things that you keep in your suitcase so that when that hunger strikes, you do feel like, Hey, there's an option available to me. And that during mealtime, you don't feel like I absolutely have to force myself to eat if quantity of food that doesn't feel good just because this is the time that I'm eating. So especially with our circadian rhythm being thrown off, just being really cognizant that we're paying attention to and maybe utilizing the hunger scale, but recognizing if some of that scarcity comes up, some of that, oh gosh, what if I don't have an opportunity to later? How can you plan for that and build around that? So absolutely that planning ahead piece is always important. Another thing, and this is such a simple thing in the world of weight loss, is drinking plenty of water. Now, especially the reason I mentioned it here is thinking if you're walking so much, we traveled in the middle of July, so it was hot out, making sure that you have water available, making sure that you're drinking consistently, making sure you have some extra money and coins with you because it does cost money to use the bathroom while you're in Europe. Making sure to have that plan so that you can make sure to stay well hydrated throughout the day. In general, that helps our body to feel good, reduce the risk of headache, feel a little bit more energized and fueled and not feeling so bled, which can certainly happen when we get dehydrated. But the role that hydration plays in hunger is really important. So making sure that we've adequately addressed hydration so that we don't overeat in order to compensate for our hydration, which can certainly happen. Another thing, just some general travel stuff When we're traveling, it's very common to get constipated, and so if you are someone to whom this happens, my recommendation is just have a plan for that in advance, even if you don't necessarily need to use those medications or anything. Having a couple of laxative type medications available with you will help your body to stay more regular if it needs to, and then keep you from feeling that kind of bloated and bli feeling. That can happen when you get constipated, which is super, super common during travel. My favorite two travel medications for constipation are Senna. Senna is available in a lot of different formulas, but I really like the tablets for travel just because they're so easy. You can buy a bottle of those easily over the counter at CVS, Walgreens or any pharmacy. The other option I really like is MiraLax. The giant bottle of it a lot of times does not feel like a great option for travel, but they sell individual packets of it. And so those are nice. You can throw a couple of those into your bag, into your suitcase and feel like, especially if you like MiraLax on a regular basis, it's a nice gentle laxative. You have those sort of single serving packets available to you. But addressing constipation while you're traveling is a nice way to feel like your body is not getting bloated, feeling kind of heavy and weighed down as we can often feel if we're getting constipated. Another thing that's really common with airplane general and travel or airplane travel in general, but especially some of those longer trips, is making sure that your body's not getting too swollen. So I don't know about you, but I get swollen along flights. My ankles get puffy and I'll blame pregnancy. I don't remember that ever happening before I had kids, but at this point, whenever I travel, I get a little bit of swelling in my legs. And for one, we went to reduce the risk of vein disease, any of those venous diseases, and making sure to reduce things like blood clots, for example, and then even reducing risk of things like varicose veins, that wearing compression stockings can really be a good way in order to reduce that risk. But honestly, just reducing that swelling can make you feel a lot better, and it can also make the number on a scale look better. A lot of times when we travel, if we get that swelling, that fluid retention can stick with us for a few days. I've seen patients who weigh themselves consistently find that it sticks with them for up to a week, which feels really crazy, but it's absolutely true. And so when you have that swelling that happens, making sure that you're doing something preemptively to reduce that risk, and then it makes your legs feel better, it makes your body feel better, helps prevent venous disease. And then it also is not going to derive the number on the scale up just because you're retaining fluid. And another thing that I wanted to share is potentially even bringing a travel scale. So this is a little bit controversial, and it will depend on what your relationship is with the scale, how you're utilizing your scale in your weight loss journey. But I have patients who maybe gone for a two or three week trip occasionally, I have patients who take six or eight weeks, sometimes these prolonged trips. And being away from a scale for that period of time, if it's part of your consistent weight loss routine can be really challenging because you feel like, oh gosh, is it good? Is it bad? I don't even know. And so we might overly restrict ourselves. We might decide it doesn't really care because I'm not going to know the number for eight weeks anyway. So bringing a travel scale can be a good way just to keep up your routine with weighing yourself if that is part of your weight loss journey. The reason I wanted to mention that is that there are travel scales available if you go online, or I don't know if I've ever seen one in the store, but if you go online on Amazon and you start to travel scale, there's a lot that weigh about half of a pound. So they're pretty small. They're pretty compact. My recommendation is if you do something like that, weigh yourself on your regular scale and your travel scale back to back just to see is there any difference there? Make sure that those numbers are pretty equally calibrated. There can be sometimes half a pound to a pound difference. So it can be important to know that, especially if your weight loss journey is slow, or if you're further into your weight loss journey where weight isn't moving as quickly, knowing that half a pound or pound difference is really important, but a travel scale, having that in your suitcase, having that option to check in can be a really nice way to say, okay, yep, I'm totally on track. Everything that I'm doing. Maybe I have been a little bit more active and therefore I've been eating a little bit more and I feel maybe a little psychologically uncomfortable because the food choices that I'm making are more compared to what I would make on an average day. So having that scale can be a great reassurance to say, okay, yep, things are moving exactly according to plan, or if they're not, that you have that opportunity to address it before 2, 3, 8 weeks depending how long your trip is. So these are some of the things that came to mind while I was traveling. If you have other travel tips that you would like to share, I'd love to hear those. We can share those with our audience. Please reach out. I love to connect with you all. Thank you so much for joining me. I will see you all for next week's episode. bye-bye.