T Nation

Nutrition and Workout for My Dad

hey all,

I’m trying to help my dad out, he needs to shed some fat but has a ton of medical problems.

his knees are ok but he has back pain from bone spurs on his spine, doesn’t have pain medication anymore either. He also has atrial fibrilation, aka a slight irregular heartbeat. He needs to lose weight before getting surgery to have it completely fixed.

He’s 6’4, 306 pounds, 52. His lean mass is probably around 230. He hasn’t done lifting but used to do basketball and construction work and has a good amount of muscle. The problem is he is very easily winded and can’t risk injuring himself

so, what would be a good type of light workout program to put him on, if anything? I mean really light, there’s no way he’s doing squats with his back, it hurts him to do CRUNCHES. Right now he just does some cardio, swimming and treadmill and biking, all pretty light.

the main issue is his diet. He weighs so much I’m not really sure what it should be. He actually doesn’t eat that much junk but eats a TON when he does. He’s been dropping a little but mostly maintaining for a couple months.

Maybe a diet with mostly meat, fish, and few starchy carbs and nothing sugar based? Anyone have any suggestions on anything?

thanks for reading

-Jeff

Replace the starchy carbs with veggies and some fruit. Add loads of healthy fat. He should keep intensity manageable. Whatever he can do is the best. He can always move on to bigger things when the time comes. It should be a progression, not a huge jump.

This sounds serious so you might want to get him to a registered dietician. That is my disclaimer.

For exercise, the big thing is to get him to move more. Morning and evening walks would be a great start.

Meals should consist of mainly green veggies, whole grains and a lean protein source. Cold water fish would be great,the Omega 3s might help with joint health. Almonds and other good sources of monounsaturated fats are always welcome. He should be eating fruits earlier in the day with his meals.

Oh, and make sure that he isn’t drinking any calories, that is usually a bad idea.

He needs to move more, eat less.

please don’t think like a doctor when it comes to squats.

of course he can do squats. how else does he go to the bathroom?
seriously though, he can squat, just not how most people think.

start him with bodyweight squats. have him start by sitting on a bench then raising up (this seems to be the easiest way for deconditioned people to learn the proper technique)

planks would be a good idea if he has the ability to do so. if regular ones are too tough, you can start him on his knees.

does he have access to a gym?

[quote]Peter Orban wrote:
Replace the starchy carbs with veggies and some fruit. Add loads of healthy fat. He should keep intensity manageable. Whatever he can do is the best. He can always move on to bigger things when the time comes. It should be a progression, not a huge jump.[/quote]

yeah, that’s what I figured for the diet. Slowely cut starchy carbs until its only postworkout maybe?

everything re: working out definitely has to be minor steps at a time

[quote]Zagman wrote:
This sounds serious so you might want to get him to a registered dietician. That is my disclaimer.

For exercise, the big thing is to get him to move more. Morning and evening walks would be a great start.

Meals should consist of mainly green veggies, whole grains and a lean protein source. Cold water fish would be great,the Omega 3s might help with joint health. Almonds and other good sources of monounsaturated fats are always welcome. He should be eating fruits earlier in the day with his meals.

Oh, and make sure that he isn’t drinking any calories, that is usually a bad idea.

He needs to move more, eat less.[/quote]

yeah you’re right, we should actually find a legitimate dietician. Most of them actually know their stuff and won’t just say “don’t eat fat and eat lots of carbs” though? That type of thing seems to be the concern

I don’t think he can take fish oil. He can’t take anti inflammatories because of the blood thinning properties. The medicine he takes for his heart and blood pressure makes it that way. However maybe he can take some in moderate doses. I will have him ask his doctor.

What do you think for calories? depending on his physical activity I guess

[quote]jehovasfitness wrote:
please don’t think like a doctor when it comes to squats.

of course he can do squats. how else does he go to the bathroom?
seriously though, he can squat, just not how most people think.

start him with bodyweight squats. have him start by sitting on a bench then raising up (this seems to be the easiest way for deconditioned people to learn the proper technique)

planks would be a good idea if he has the ability to do so. if regular ones are too tough, you can start him on his knees.

does he have access to a gym?[/quote]

I mean, his legs are pretty strong and his calves are enormous. One of the main issues for him is just mobility. He needs to be able to walk and be comfortable and have good posture, and he can’t always do that now

I’ll definitely get him to think about the bw squats. Should these be squats where his knees don’t move and he just sits back, or full 3rd world squats? Remember, his knees aren’t that bad, but he has had knee surgery and they do get inflammed from time to time…

we have access to a health club and I’m here a lot to help him so that isn’t a problem.

I don’t know if he can do planks

thanks for the advice so far guys!

[quote]Zagman wrote:
This sounds serious so you might want to get him to a registered dietician. That is my disclaimer.

For exercise, the big thing is to get him to move more. Morning and evening walks would be a great start.

Meals should consist of mainly green veggies, whole grains and a lean protein source. Cold water fish would be great,the Omega 3s might help with joint health. Almonds and other good sources of monounsaturated fats are always welcome. He should be eating fruits earlier in the day with his meals.

Oh, and make sure that he isn’t drinking any calories, that is usually a bad idea.

He needs to move more, eat less.[/quote]

Pretty good advice, but I would also add my two cents to get plenty of magnesium rich foods (magnesium is one of the best nutrients to correct heart abnormalities in conjunction with a potent source of CoEnzyme-Q10 which is another supplement I would highly suggest your dad add to his dietary equation, D-Ribose probably would be another great hearty)

Abstract
Clinical Review
Intravenous Magnesium for Prevention of Atrial Fibrillation After Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis

* Abdullah A. Alghamdi, M.D.**Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada,
* Osman O. Al-Radi, M.D., M.Sc.**Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada, and
* David A. Latter, M.D., F.R.C.S.C.**Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

* Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

Abstract Atrial fibrillation (AF) is one of the most common complications after coronary artery bypass surgery. The objective of this study was to assess the effectiveness of intravenous magnesium in preventing postoperative atrial fibrillation. A meta-analysis of eight identified randomized controlled trials, reporting comparisons between magnesium and control was undertaken. The primary outcome was incidence of postoperative atrial fibrillation. Our review revealed that use of intravenous magnesium is associated with a significant reduction in the incidence of atrial fibrillation after coronary artery bypass surgery, with a relative risk of 0.64 (95% confidence interval = 0.47, 0.87, and p = 0.004).

[quote]actionjeff wrote:
Zagman wrote:
This sounds serious so you might want to get him to a registered dietician. That is my disclaimer.

For exercise, the big thing is to get him to move more. Morning and evening walks would be a great start.

Meals should consist of mainly green veggies, whole grains and a lean protein source. Cold water fish would be great,the Omega 3s might help with joint health. Almonds and other good sources of monounsaturated fats are always welcome. He should be eating fruits earlier in the day with his meals.

Oh, and make sure that he isn’t drinking any calories, that is usually a bad idea.

He needs to move more, eat less.

yeah you’re right, we should actually find a legitimate dietician. Most of them actually know their stuff and won’t just say “don’t eat fat and eat lots of carbs” though? That type of thing seems to be the concern

I don’t think he can take fish oil. He can’t take anti inflammatories because of the blood thinning properties. The medicine he takes for his heart and blood pressure makes it that way. However maybe he can take some in moderate doses. I will have him ask his doctor.

What do you think for calories? depending on his physical activity I guess[/quote]

You might SERIOUSLY look into Seanol.
Heres the research (Over $30 million of research on this nutrient, over 7 double blind clinical studies currently performed so far)
http://www.jprenew.com/documents/app_A/SEANOL_APPLICATIONS_RESEARCH_OVERVIEW.pdf

[quote]actionjeff wrote:
jehovasfitness wrote:
please don’t think like a doctor when it comes to squats.

of course he can do squats. how else does he go to the bathroom?
seriously though, he can squat, just not how most people think.

start him with bodyweight squats. have him start by sitting on a bench then raising up (this seems to be the easiest way for deconditioned people to learn the proper technique)

planks would be a good idea if he has the ability to do so. if regular ones are too tough, you can start him on his knees.

does he have access to a gym?

I mean, his legs are pretty strong and his calves are enormous. One of the main issues for him is just mobility. He needs to be able to walk and be comfortable and have good posture, and he can’t always do that now

I’ll definitely get him to think about the bw squats. Should these be squats where his knees don’t move and he just sits back, or full 3rd world squats? Remember, his knees aren’t that bad, but he has had knee surgery and they do get inflammed from time to time…

we have access to a health club and I’m here a lot to help him so that isn’t a problem.

I don’t know if he can do planks

thanks for the advice so far guys!

[/quote]

what’s a full 3rd world squat?

[quote]BigKDawg wrote:
Pretty good advice, but I would also add my two cents to get plenty of magnesium rich foods (magnesium is one of the best nutrients to correct heart abnormalities in conjunction with a potent source of CoEnzyme-Q10 which is another supplement I would highly suggest your dad add to his dietary equation, D-Ribose probably would be another great hearty)
[/quote]

I was focusing on behaviors, that is why I recommended veggies. Usually when when protein and fat consumption come from decent sources, vegetables alone will round out any missing micronutrients. Magnesium is of course one of these.

As for whole grains, in this case we are requiring a significant fat loss. This is not required for providing micronutrients as they can be had in higher densities in other foods. If he chooses to consume whole grains, quinoa, steel-cut oats, buckwheat, amaranth and wild rice will have the highest fiber and micronutrients. These grains will also have more magnesium, potassium and trace minerals than other grains.

A dietician will most likely come back with a higher carb, restricted calorie diet. While I cannot comment on this particular case because I have not seen the medical records, in general, in these types of cases, this is not the dietary path to follow. This body is already showing the signs of severe metabolic issues, to simply drop the overall metabolism and hope for weight loss is silly.

There are numerous studies that support the use of lower carbohydrate and higher fat intakes in obese people when attempting fat-loss. It allows for a higher metabolic rate and the improvements seen in the blood lipid parameters are much greater.

You might also want to suggest swimming and/or running in water if his knees are an issue. I did that (and still do it) in place of cardio sometimes when my knee is bothering me and I don’t feel I’ll be able to go all out running.

full 3rd world squat is a full bw squat

I will have him ask his doctor about that, fish oil, and all of the other things recommended

lower carb sounds like the way to go. With his low activity and health issues what type of macro breakdown/total calories should we be doing? No way he is cycling or anything, just overall calories per day strict ish diet. And yes he still needs to go see a dietcian.

he thought the idea of running in water was silly but he likes low intensity swimming. He can only do low intensity stuff, walking and swimming. How does the running in water work? Can you further elaborate on that?