Mastering the Life Plan: The Essential Steps to Achieving Great Health and a Leaner, Stronger, and Sexier Body

CHAPTER 1

The Life Plan Philosophy

As a doctor, I know that the second half of your life can—and should—be the best half of your life. I’m confident saying that even though every day, we are aging. But the truth is, we don’t have to feel old. To me, getting “old” means the deterioration of your health accompanied by declining energy levels, loss of sexual function, and loss of your zest for life. I don’t want any part of that for myself or my patients, and I bet that you don’t, either.

It has now been fifteen years since I began my complete physical transformation. What’s so exciting to me is that what I accomplished in just a few months has lasted. Today, not only do I feel great, I’ve been able to maintain my physique and my good health over all these years. In fact, in many ways, I’m stronger, healthier, and more fit than I was when I first got into shape.

I’ve been able to stay strong and lean, reduce my cholesterol levels, reduce internal or “silent” inflammation, reduce blood sugar levels, eliminate biomarkers for heart attack and stroke, and avoid diabetes. I have actually stopped the progression of heart disease that, unknown to me, had started when I was in my twenties. I have the mental focus, clarity, and sharpness necessary to keep me more productive and creative than ever. At 74 I’m in love with my wife, working every day building my medical practice, writing best-selling books, training with elite athletes, riding my Harley, playing with my grandkids, and learning more about exercise, nutrition, and preventive medicine. I love my life!

But back in 1998, my future did not look as bright. When I discovered that my own hormone levels were deficient, traditional medicine said that andropause, or declining testosterone, is not a disease but a fact of life, so it shouldn’t be treated. When I was losing muscle tissue and strength to sarcopenia, conventional doctors once again said to just accept that I was getting older, and basically, just get over it. But even 15 years ago, I knew that they were wrong. The sad part is, most men continue to hear this same message from their doctors even today.

What most docs still don’t get is that aging is not the enemy, and it’s not a disease. In fact, by its very definition, aging is a gradual change in your body that doesn’t result from disease. Disease is the deviation or interruption of the normal function of any part or system of your body. Each of us has a unique set of inherited predispositions for certain health issues: That’s your DNA code. On top of that, your lifestyle choices contribute to whether these tendencies will materialize. Lifestyle can definitely trump genetics. So instead of accepting disease or waiting for it to appear, you can learn how to use my health strategies to keep your body metabolically and physiologically in balance. That’s the Life Plan.

The Philosophy Behind the Medicine

I do not accept as fact traditional medicine’s proclamation that there’s nothing we can do about “natural declines” that occur as we get older, when in fact there’s everything we can do about them. When I was on The Doctors Show in 2012, the producers cleverly built the segment not only around my book, but around my name. I think the acronym they created really sums up my philosophy (and I wish I’d thought of it myself). This book teaches you how to master these four core areas as we age:

¦ L—Levels of hormones: Reversing hormone deficiencies keeps you energized, vibrant, and healthy. Declining hormone levels are the result of a disease process, not aging, and should be treated. In my opinion it’s malpractice for doctors to ignore declining hormone levels and write them off as an acceptable part of aging. Study after study has shown that increasing testosterone and other critical hormone levels in deficient adults greatly affects health in many positive ways, from improving bone mineral density, sexual function, libido, and body composition to reducing risk for heart disease, diabetes, cancer, stroke, and Alzheimer’s disease. An optimal level of testosterone can actually decrease or eliminate Metabolic Syndrome, obesity, diabetes, and high blood pressure and cholesterol. And testosterone is not the only hormone you need to be concerned with: Later in the book you’ll learn about all of the hormones that you need to be tested for, and how to enhance existing levels if necessary.

¦ I—Insulin control: Maintaining low insulin levels keeps you from getting fat and cascading into poor health, so it’s critical to learn how to manage it through diet. Many researchers believe that high levels of insulin cause the other components of Metabolic Syndrome to develop—obesity, high triglycerides, elevated blood pressures, and inflammation. Excess levels of insulin are also thought to be the single most important factor that accelerates the aging process. High insulin levels affect your percent body fat, blood lipid levels, glucose tolerance, aerobic capacity, muscle mass, strength, and immune function. However, when you structure a nutrition program around keeping blood sugars and insulin levels in check as I have, you will get a huge benefit beyond improved health—increased muscle size. In just four to seven days of eating “clean” you can move your blood sugar and insulin levels toward their ideal range, and by two weeks you will no longer be plagued by feelings of hunger, depravation, and cravings. You’ll experience a marked improvement in your mental focus, exercise endurance, strength, optimal health, muscularity, and leanness. These are the reasons why my diet plans are all structured to lower insulin levels.

¦ F—Food as fuel: The foods we eat can change our lives by providing constant energy and promoting good health. Your current diet may be filled with processed foods, unhealthy proteins, and sugar-laden simple carbohydrates that all taste great but really accelerate aging. All these bad foods are quickly stored as body fat and arterial plaque. They also suck the energy right out of you, add weight, and create the perfect conditions for stroke, diabetes, heart disease, and Alzheimer’s disease. Always remember, what you put into your mouth can either hurt you or help you. I’ll teach you how to change the way you eat so that you can begin to lose weight and reverse your potential for illness.

¦ E—Exercise: A comprehensive exercise program can not only transform our bodies, but improve our thinking and even our sex lives with just one hour of working out a day. One goal of the Life Plan is preserving bone density and enhancing muscle tissue growth. Without it, the average American male can expect to gain approximately one pound of body fat every year between ages 30 and 60 and lose about a half pound of muscle mass each year over the same period. At age 60 and onward it gets even worse as the rise in body fat replaces muscle mass. The largest loss of muscle mass occurs between ages 50 and 75, averaging 25 to 30 percent.

The 10 Biggest Myths Surrounding Men’s Health

Healthy aging specialists like me are dedicated to the science of healthy aging. We emphasize the enhancement of health over the treatment of illness, focusing on disease prevention, wellness, and quality of life. This approach is based on the fact that today, the majority of men already possess a genetic makeup that will allow us to live well beyond age 85. The key is to make the best of the genes we have so that we can live better, longer. By incorporating these practices into our daily lives we can reverse illness and compress the time we are sick. As I like to tell my patients, we can’t stop the aging process, but we can definitely manage it.

Even still, there are many misconceptions that surround men’s health, and particularly healthy aging. These myths do nothing but hold men back, and frankly, we need to get rid of them. Another aspect of my philosophy is being completely up to date with the medical literature and backing up all my recommendations with peer-reviewed, evidence-based research studies.

1. Growth hormone therapy and testosterone therapy are the same as steroid abuse by athletes: Completely false. Bodybuilders and athletes who use testosterone replacement therapy to enhance their performance are illegally (and dangerously) using hormone therapy in a manner not intended, because they are taking too much and are most probably not deficient. In fact, I’ll bet the illegal users aren’t getting tested for hormonal deficiencies, but are merely using the drug to ramp up their testosterone levels to as much as 10 to 20 times higher than the upper limits of the healthy range.

Testosterone replacement therapy needs clinical supervision. Because illegal users’ levels aren’t monitored via periodic blood work, the concentration of testosterone in their system can reach hazardous levels. However, clinically supervised testosterone replacement therapy for the purpose of counteracting hormone deficiencies and promoting good health is safe and effective, with minimal side effects.

It’s also important to remember that growth hormone and testosterone therapies are prescribed to prevent disease and reverse disease; they will not help you grow muscles and get ripped. I look the way I do because I spend hours at the gym each week working out. This is the most common misconception: that by taking these hormones men can build muscle and get rid of body fat. However, I will say that what hormone replacement therapy has done for me typifies what it has done for my patients. It has helped me create an optimal environment within my body, a healthy environment of hormones that are at healthy levels, which has enabled me to maximize all the training that I do, all the cardio and resistance training and flexibility training, so that I can look like I do at age 74. If I just did all the training and had low hormone levels, I wouldn’t look anything like I do now. If I did no training and just took hormones, I wouldn’t look anything like I do now.

It is very likely that the same young, professional athletes who are abusing hormone therapies are also working out at elite levels every day. These guys train at such intense levels that to some extent it’s questionable whether their athletic performance really benefits from growth hormone or testosterone replacement therapy. I do believe that these therapies make them feel psychologically better and probably allow them to train harder and have fewer injuries. At the same time I know that they are putting themselves at great risk for potentially serious medical problems.

One of the big complaints my patients share with me is that when they start the program, and are going to the gym after not working out for a very long while, it takes them a few days just to recover from just one workout session. Once I correct their hormone deficiencies, that all goes away and they can recover more rapidly, which allows them to work out more often and at a higher level.

2. Testosterone therapy causes cancer of the prostate and testicles, and other serious health concerns: Simply wrong! In fact, reversing testosterone deficiencies is one of the key ways to prevent these and other types of cancers. This unfortunate myth has steered the medical community in the wrong direction for 70 years. It started with a 1941 journal article that reported that testosterone injections increased the rate of prostate cancer growth, and that castration decreased it. Yet the problem wasn’t with testosterone, it was with the study: It was based on only one patient! Subsequent studies have failed to link elevated testosterone levels with increased risk of prostate cancer. In fact, one large longitudinal study found just the opposite to be true—low testosterone levels were a risk factor for prostate cancer.

Another frequently repeated myth is that testosterone replacement therapy increases the risk for cardiovascular disease. Not so. Again, it’s just the opposite. The heart has the highest concentration of testosterone receptors in the body, so testosterone has a huge impact on heart health. Men with healthy testosterone levels have fewer cardiovascular issues and lower mortality rates than those with deficiencies. Other studies link optimal levels of testosterone to reduced risk of coronary artery disease and hypertension, as well as improved cardiac function for those with preexisting heart disease. Older men who undergo testosterone replacement therapy typically see a decrease in LDL and overall cholesterol levels. On the flip side, low testosterone levels have been associated with increased atherosclerosis.

3. Men don’t experience anything like menopause: While men don’t experience a precipitous fall in hormone levels that causes noticeable symptoms as women do, they absolutely do lose hormones as they age, and the results can be just as devastating. The male version of menopause, known as andropause or late-onset hypogonadism, is not yet universally recognized by the medical community, but its effects are all too real. Men begin to experience a gradual decline in testosterone and other hormones starting in our thirties. By our forties, we may start to feel the effects: decreased libido, erectile dysfunction, decreased bone density, fatigue, weight gain, loss of muscle mass and strength, even anxiety or depression.

A traditional doctor may shrug off these complaints as the “normal” signs and symptoms of aging and leave it at that. Such medical practices are what perpetuate the myth that andropause isn’t real.

Or they may check your testosterone level and—finding it to be in the “normal” range—allow the problem to go untreated. However, the problem lies in the definition of “normal.” The reference range is between 300 and 1,000 nanograms per deciliter (ng/dl). A testosterone “deficiency” is characterized by levels below 200 ng/dl. So if your tested levels are above 200, the traditional physician may think your testosterone levels are fine. The reality is that a low borderline-“normal” test result is equivalent to a D-minus on your report card. Raising your testosterone level to the upper normal range of 700–1,100 is what I look to achieve for my patients, and you shouldn’t settle for less either. By reversing hormone loss, you’ll reverse the symptoms of andropause and the diseases that accompany it.

4. Men cannot increase muscle mass and strength as they get older: Nothing could be further from the truth. I’ve gained 10 pounds of muscle in the last two years just by doing the right kind of exercise, eating clean, and making sure my hormone levels are at the top end of the normal range. The Life Plan is meant to make sure that we avoid losses of muscle tissue and strength as we age. You’ll first learn how to get back into exercise safely so that you can begin to build muscle and get stronger, which will help protect your health for years to come. Then, by following this program, you’ll quickly start to see results as you get leaner and more ripped, which will motivate you to make exercise an integral part of your life.

The truth is that men need to increase muscle mass in order to combat sarcopenia, a condition marked by muscle atrophy and loss that typically begins in your thirties and worsens as you age. If you don’t exercise properly, muscle loss will progress at the rate of 3 to 5 percent with each decade starting in your thirties and forties, then increase to 10 to 20 percent every decade after that.

5. Declining sexual function or interest (libido) is a normal part of aging: If you want to use this as your excuse, go ahead. But I’ll show you how to have a vibrant sex life and enjoy every minute of it. Having sex three times a week serves as a key benchmark that you’re healthy and physically fit. Yet an estimated 34 percent of all American men age 40 to 70 suffer from some level of erectile dysfunction. Before you fill your Viagra prescription, or talk to your doctor about getting one, there’s plenty you can do yourself to get your sex life back on track, beginning with exercise. I’m not talking about using your bed as a trampoline, either. Physically active men over 50 reported better erections—and had a 30 percent lower risk for impotence than their inactive cohorts. Another study of over 40,000 men became the largest study to demonstrate that the more exercise a man does, the less likely he’ll experience erectile dysfunction. So once you get with the program, you’ll find that your sexual health improves along with your physical health, and you may go back to having the sex life of a 20-year-old.

6. I’m not a candidate for heart disease because I exercise, my cholesterol is in normal range, and my last stress test was normal: I wish this one were true, but sadly, it’s not always the case. I believe, and the medical literature supports me, that the better care your heart gets—including the right exercise, nutrition, nutraceuticals, and healthy hormone levels—the easier it is to reduce your risk of heart disease. But it doesn’t give you a free pass. What’s more, over 90 percent of heart attack events in men with significantly diseased blood vessels happen at arterial sites undetectable by conventional diagnostics (that is, stress testing).

Since heart disease is the leading cause of death for men, every strategy in this book is designed to help you prevent or reverse cardiovascular problems. My approach is focused on protecting your endothelium, the thin, one-cell layer lining the interior of the heart and entire vascular tree. The endothelium forms a dynamic interface between your blood and your body. When not properly cared for, your endothelial cells can become dysfunctional and fall prey to numerous disease processes that may cause atherosclerosis, hypertension, inflammatory syndromes, heart disease, stroke, and even dementia. A 2003 Mayo Clinic paper defined endothelial dysfunction as the “ultimate risk” among all the cardiovascular risk factors. So even if you don’t have heart disease or a family history of risk, you must still work at improving the health of your endothelium.

7. Carrying a spare tire is another part of aging that I can’t do anything about: Not true! I used to have a huge belly, and now I’m incredibly lean. Belly fat is hard to get rid of, but not impossible. In fact, belly fat is the last area where you’ll see results as you get leaner, but getting rid of it has been a top priority in my life and is a major objective of my Life Plan. That’s because it’s a pretty clear sign of premature aging and also a huge health risk.

On this program you’ll learn how to get rid of the gut with the right exercises and foods you’ll actually enjoy eating. For example, a 2011 Harvard study that closely examined weight-loss patterns over 20 years has shown that a diet high in vegetables and whole grains like I prescribe is the best way to lose weight. We also know that certain foods actually increase metabolism and play a significant role in promoting fat loss, including belly fat. The study also found that there are only two foods proven to encourage weight loss: peanut butter and yogurt, both of which you can eat pretty frequently on this plan. On the flip side, the study confirmed what I’m sure you can guess: Every guy’s favorite foods—steak, potatoes, sweets, and beer—are literally guaranteed to add inches to your midsection.

I’ll show you why a strong cardiovascular exercise program is critical for tapping into belly fat and shrinking your waistline while you shed pounds all over and lower your percent body fat, so that eventually you’ll be impressed with your new six-pack.

8. Retirement is when I finally get to sit back and relax: If that’s your plan, then pick out a new rocking chair and plan to spend plenty of time in it. But that’s not what I’m looking forward to. When my dad retired at age 65 he was all about sitting in his La-Z-Boy. That’s what his whole generation thought: They were supposed to just stop doing everything. But in reality, the last thing they needed was to sit around and take it easy. By the time my dad was my age he was profoundly deconditioned and had lost much of his muscle mass and strength. Worse, his thinking was cloudy, and he had lost all appreciation for life, to the point that he actually dreaded getting up every morning.

At 74, I’m not at all ready to retire, but when I think about it, I’m hoping that retirement will give me more time to increase my exercise program and do more physical activity outdoors because I’ll have more time on my hands. I won’t miss workouts because of my hectic schedule. My new condominium has a magnificent indoor two-lane lap pool that’s hardly ever used, so I have gotten back into swimming in addition to everything else I do.

If you are new to retirement and out of shape, this is a perfect time to really focus on your own health and well-being. Take advantage of this well-structured program of exercise and nutrition, and use all the tools available to regain your vitality and energy, so that you can really enjoy your retirement and fully participate in whatever is in store for your future.

9. As you get older you need less sleep: Not true! As we get older we typically get less sleep because nighttime becomes more interrupted with more intermittent awakenings, but the truth is that you really need the same number of hours of sleep, and maybe even more. During sleep your body repairs itself: It’s the time when you produce most of your growth hormone. So sleep is extremely important, and men who are sleep deprived will be the first to tell you that every aspect of their life is affected, from health, to mental clarity, to energy levels, to progression of disease.

If I get less than seven hours of sleep, I’ll wake up fine and go to the gym and feel fine until the afternoon, and then I just really start dragging. I start getting aches and pains in my muscles and joints. I also notice that my performance in the gym is not as good: I can’t lift as much. But if I get eight hours of sleep, even if I have to get up to use the bathroom, I can go through the day with high energy right up until it’s time to go to bed. I never think about taking a nap.

Getting good sleep is vital for better thinking and your overall health. It’s also a necessity when it comes to losing weight and keeping it off for good. According to an American Heart Association Conference in 2011, Columbia University researchers have demonstrated that people who get less sleep consume significantly more calories. A good eating and exercise program, like mine, is a key ingredient in increasing your energy, which can then keep you alert and awake throughout the day and help you sleep better at night. You’ll also see how an eating plan centered on small, frequent meals throughout the day will provide much more energy than three larger meals.

10. Memory lapses and brain fog have nothing to do with my overall health: Not true! Your brain’s performance is one of the best indicators of how the rest of your body is functioning. The brain is a delicate and sensitive organ that requires significant amounts of energy, oxygen, and nutrients. So if you believe that you’re not thinking as clearly as you used to, it’s not a sign of aging: It’s a wakeup call for you to take a good look at your health, and see how you can improve the way your internal systems are working.

Brain fog can include feeling spaced out, forgetful, confused, lost, tired, and having difficulty with concentration. If you’re not keeping up in the office or you’re slow to remember where you’re supposed to be, you may be experiencing the first signs of mild cognitive impairment, or MCI. Luckily, this book will show you how to reverse these symptoms by focusing on the right foods, engaging in smart, frequent exercise, and correcting hormone deficiencies so that you can avoid brain fog, dramatically improve your brain health, and think clearly for years to come.

FEEDBACK FROM MY FANS

NAME: Tyler S.

MESSAGE: I just bought your book at the local Books a Million here in Prattville, AL. I turn 50 in March. All I needed to see was the cover and realize my life is just an excuse. I am taking back control of my health and my desire to live life fully. There is much to do . . . let’s get started.

Getting Started

Tyler’s right: There’s no time like the present to get yourself into better shape. Now that you know where I’m coming from, let’s begin by getting your daily eating habits cleaned up. In the next chapter, you’ll learn how to master my program for optimal health and determine which of three simple diets you should follow. You can start immediately on any one of these new eating plans, depending on what your weight-loss goal is and your current health status.