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opinion

Peter Singer, director of the McLaughlin-Rotman Centre for Global Health

Today is my 50th birthday. A year ago, I set a goal to lose 50 pounds by today: My slogan was "50 by 50." I never would've believed I could do it, but I did. I learned some lessons that may be helpful to you; those lessons also may have public policy implications.

How did I do it? I used three interlocking strategies: healthy eating, fitness and motivation. With respect to healthy eating, I kept a diary of what I ate (using a website), limited quantities and learned how many calories my body needed. I cut out starches and simple sugars - no bread, no potatoes, no beer, no sweets. I increased lean protein - eating egg whites for breakfast, for example, and discovering Greek yogurt. I ate more whole vegetables, and limited fruit. I shifted more food earlier in the day - recalling the saying "eat your breakfast yourself, share your lunch with your friend, and give your dinner to your enemy" - so as not to drive up insulin, which deposits fat, while I was asleep and inactive.

Regarding fitness, I learned that cardiovascular fitness is not enough - strength training is needed to keep the metabolic rate high beyond the time of exercise. I spent an hour a day doing exercise six days a week. On at least three of these days, I went to the gym and lifted weights; on other days, I did cardiovascular on an elliptical. I started slow, built core strength first to prevent injury, and lifted weights under supervision.

On motivation, I learned to set a goal and stick to it. I treated eating as an addiction, and kept things I shouldn't eat out of the home. I thought of going on the elliptical not as exercise but as watching Jon Stewart or Fareed Zakaria. And I learned the critical importance of a personal trainer: He always asked me about my eating habits, and provided expert guidance on exercise so I got the most out of my time and didn't injure myself. There were days I wouldn't have gone to the gym had he not been there waiting.

What questions are raised for public policy from my experience? Does Canada's Food Guide - which emphasizes grains, treats fruits and vegetables together, and may not adequately message the importance of protein - need to be revisited? Why is it that, for many Canadians, breakfast is almost all grains and sugar and little protein - and, since some of these choices may be driven by affordability, should we be looking at how our agricultural subsidies and regulatory regimes align with our national nutritional goals?

How can we get Canadians to combine cardiovascular fitness with strength training? Why can Canadians get a massage reimbursed under their extended health benefit plans but not a personal trainer? Should we extend the recently introduced Children's Fitness Tax Credit to personal training for adults (which could also be delivered in groups to increase affordability)?

Finally, should we encourage people to set more realistic goals? My body mass index (the standard measure of weight for height) is still around 29, more than the recommended 25 (although recent Canadian evidence shows that a BMI of 28 to 30 is associated with the lowest mortality). BMI is probably too complicated, anyway; waist size may be a better measure (mine went from 42 to 32 inches).

I couldn't be having a happier birthday today, because I'm now more likely to live to see my children grow up. And the best 50th birthday present I could get would be for these lessons to help others.

Peter A. Singer is professor of medicine, Sun Life Financial Chair in Bioethics, and director of the McLaughlin-Rotman Centre for Global Health, University Health Network and University of Toronto.

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