My 90-day health improvement plan

A few days ago, I Tweeted a message about how I've lost weight, dropped my blood pressure, and reduced my resting pulse rate over the last few months:

Sep 8 vs Dec 8: Blood pressure, 140/95 -> 115/75; resting pulse, 73 -> 48; Weight, 218 -> 185. Amazing what's possible in three months.

I had a few people ask (on Twitter) me how I made these changes. My response required more than 140 characters, so I thought I'd expand on it in a blog posting here.

Warning, this is a long blog entry, mainly because I've not written this down anywhere before, and I wanted to get it all in text. The executive summary version is simply that cutting sodium, watching calories, and running every single day possible are the three main factors behind the changes in my weight and blood pressure.

Read on for the highly-detailed version of the above...

Background: Back in early September, I found myself frustrated by a continuing battle with mild high blood pressure—my doctor had tried three or four medicines over the course of a year, and none seemed to be making much difference. So I decided to try some stuff on my own. We eat out a lot, and I knew there was quite a bit of salt in restaurant foods, as well as in certain processed food I ate at home (lunch meats, cheeses, crackers). I also knew that high salt intake can elevate blood pressure, so I thought I'd try reducing that first.

To help track my sodium intake, I downloaded Lose It!, a free food and exercise tracking app for the iPhone. My interest at this point was merely to track sodium consumption, not calories.

But as I looked at the app, I thought I might as well try losing some weight, too, to help with the blood pressure. So I established a somewhat arbitrary goal (40 pounds off), and gave myself six months to achieve it.

With Lose It! helping me out, I officially started my program on September 8th. (I'd been walking for exercise before this, but it didn't seem to be doing much for blood pressure or weight.) So how have I made the progress I've made? Here are some of the keys...

• Ramped up the exercise Instead of walking, I started running again—years ago, I used to run a lot, but with kids in the house, I'd let it lapse. While there are any number of exercise options, I chose running because it can be done nearly anywhere, requires almost no investment, and burns the most calories per hour of activity of any of the major activities (according to this table, at least). In short, I'm a lazy person, and want the greatest return for each hour of exercise.

  In the beginning, running was slow and painful—very painful. Back in September, I could barely run two miles (at just under 10 minutes per mile). I stuck with it, though, running nearly every single day, regardless of weather. (And in Oregon in the fall/winter, that means I've run in everything from sunny blue skies to blustery winds to snow flurries to pouring rain.)

  An ex-boss of mine used to say "what gets measured gets done," so I created a simple Excel spreadsheet to record my runs. It shows that I've run on 81 of the 92 days (totalling 325ish miles) between September 8th and December 8th. Of the 11 days I missed, six were required non-active days due to a medical procedure, so I've only actually missed five days.

  As I felt more comfortable with the two-mile run, I started doing some longer runs—a 3.5 mile loop was run many days in a row. When I grew comfortable with that distance, I stretched it out to 4.5 miles, and did that for quite a while. Now I'm running 6.2 miles (10K) most days, with shorter-distance days thrown in here and there. I'm still not the world's fastest runner, but the pace has improved greatly, as I can average around 8:15s for the six miles.

  For me, the key was really just devoting myself to get out every single day, regardless of weather, appointments, my feelings about running that day, or whatever other excuse I could come up with. Given I work from home and can mostly set my own schedule, this was easier for me than for many who must commute to/from an office each day.

  There are days I certainly don't feel like going for a run, but I force myself to go, knowing that when I get back, I'll feel better for having done so. I often run with an iPod Shuffle, but with the rainy season here, I'm mostly going music-free now.

• Cut the sodium This was probably the toughest change for me to make, because it turns out that sodium is everywhere. I've never been a big user of added salt—I never add it to anything I eat, but it turns out that's pretty much irrelevant to your salt intake. After starting this process, I discovered that my diet was simply loaded with hidden sodium, and I was blowing through any sort of recommended target by huge amounts on a regular basis.

  As reference points, the recommended daily allowance (RDA) of sodium is 2400mg; for those with high blood pressure, the target is 2000mg. After looking at what I was eating, I figure I was probably averaging closer to 5000mg than 2400mg. Yikes! So I decided to target 1500mg, knowing there'd be days I would go over, and wanting to keep myself under 2000mg. I'll go into how I did this in more detail in a future blog post, but here's one example of a before-and-after change with lunch.

  In my 'old' diet, I'd eat a ham or turkey sandwich—bread, two slices of meat, mayo, and mustard—for lunch. I knew processed meats had some salt, but hadn't really paid attention to just how much. That one sandwich has 917mg of sodium (260mg in the bread, 480mg in the meat, 120mg in the mayo, and 57mg in the mustard). Toss in some potato chips and a beverage, and I was probably close to busting my 1500mg target with lunch alone.

  Now I bake (with spices, but no salts) my own fresh turkey or chicken breast once a week, and then slice and refrigerate it. I then use those slices on "thinwich" sandwich bread, cut the amount of mayo in half, and leave off the mustard. My sandwich now has only about 200mg of sodium, instead of nearly 1000mg (and it's lower in calories, too).

  The other real big sodium challenge is that we eat out a fair bit, and as it turns out, many (most?) restaurant foods are just loaded with sodium. One of our fave haunts is Baja Fresh; the food is relatively good tasting, the kids like it, it's inexpensive, and you can get in and out quickly. My usual entre there was a bean and cheese burrito with black beans and chicken.

  I'd never even though about the sodium level of that burrito until I started this program. A quick look at Baja's nutrition table, though, was eye-opening—and shocking. My favorite burrito comes in with a whopping 2230mg of salt! That's nearly a full-day's RDA of sodium in one burrito, and it blows right through my 1500mg target. (That's not even close to the worst thing on Baja's menu, either—order the Carnitas Fajita on a flour tortilla, and you'll be ingesting 3450mg of sodium!)

  What about Subway, purveyor of healthier eating alternatives? Not much better—their foot-long Veggie Delight (no meat at all!) comes in at 810mg of sodium (it's in the bread). Order something with meat, and you're right there at Baja-esque levels: the foot-long Black Forest Ham at 2400mg, for example. Ouch.

  Needless to say, I had to do some adjusting, and I did. After some menu research, I've found lower-sodium alternatives at most of our usual haunts that still taste good. I'll cover some of the alternatives I discovered in my follow-up sodium-specific post.

  Since focusing on sodium reduction, my worst daily average for a given week has been 1950mg; my best, 1188mg. The effect of the sodium reduction was immediate, too—my blood pressure dropped 10 to 15 points on both scales within a few days of cutting back.

• Watched the calories Lose It! makes it amazingly easy to track calories (and other nutritional information). You can enter your own foods and recipes, and it includes a huge database of restaurant and grocery store items. With a few taps each day, you can see and track your calorie consumption. It also tracks exercise, which are netted against your calorie intake to come up with a "calories remaining" figure each day. In three months, I've gone over the target only a few times, and never by more than a few hundred calories.

  Lose It! also keeps track of consumption over time, lets you enter your own foods and full recipes, and lets you input a prior meal for the currently-chosen meal. In short, it's a great tool to use if you're trying to cut your caloric intake.

Wrapping it all up

It seems the combination of lower sodium intake, watching the calories, and a regular running regime has solved my high blood pressure issues. I'm still above my target weight, but undeniably in better shape than I was in three months ago—having my blood pressure back down to the normal range is a great relief, and I've been just stunned by the drop in my resting pulse rate.

I won't lie and say that it's always fun to head out for a run, or that it's easy and enjoyable to change my diet. However, every time I see my kids' smiling faces, all the work seems worth it—I'm doing this as much for them as I am for me, so that I'll be around for them as long as possible.