Losing and keeping off 100 pounds is hard. Having done it, Sal wants to convince you that you too can gain control of your weight. No drugs, no surgery, just new habits patiently created and reinforced. Sal’s daughter Grace Daher conducted this frank interview.
Highlights:
Here’s the Story of How Sal Daher Lost 100 Pounds with No Drugs and No Surgery – You Can Do It Too
Sal Introduces His Daughter Grace Daher Who Is Asking the Questions
When Sal Was First Told He Needed to Lose Weight
A Big 13-Year-Old on a 1,300 Calorie Diet – Misery!
Early On It Was Evident that Sal Was Triggered by Food but His Brother William Was Not
Sal Became More Active in College but Bad Diet Caused Weight Gain
Lost Weight During Summer Break in Brazil – Less Eating More Moving
Sal Was Fit in College, But Still Overweight – Did Not Realize the Burden He Was Carrying Around
Sal Got Down to His Ideal Body Weight in His Mid 30s Out of Concern for His Blood Pressure
Lost the Weight on the HMR Program – No Hunger – More Is Better
How the Weight Came Back On – Grace Remembers Sal’s Struggles
HMR Program Turns Down Chance to Coach Oprah Winfrey Individually Because They Did Not Have Data to Support that Approach
Attending Weekly Support Group Is Essential for Success Long Term – Alcoholics Anonymous Example
Grace Was Shocked to See Sal’s Weight Loss After the Isolation from COVID
Sal Was Proud to Be Fat but Fit – His Doctor’s Warnings Were Not for Fit People Like Him
Being Overweight Has a Lot to Do with Genetics – We Have to Fight Our Genes
A Painful Health Event Motivated Sal to Take the Weight Off for Good
How the HMR Program Works
The First Three Weeks Were Hard – Plenity Helped
Maintaining Your Weight Loss Means Acquiring a Whole New Set of Habits
The Multiple and Marvelous Benefits of Exercise
There are No Magic Pills – Except Exercise
The Importance of Human Connectedness in Weight Control
Sal’s Regrets for Not Having Taken Off the Weight Earlier
Sal Is a Big Supporter of Statins
“How are you managing to keep off those 100 pounds?”
Committed to a Baseline of 10,000 Steps Per Day
Highly Structured Eating
Cool Facts About Coffee
“Why Is getting sleep so important?”
“…you need the support of a coach to help you work out those particulars…”
ANGEL INVEST BOSTON IS SPONSORED BY:
Transcript of “Losing 100 Pounds”
Guest: Sal Daher, Host: Grace Daher
Sal Daher: I'm really proud to say that the Angel Invest Boston Podcast is sponsored by Purdue University Entrepreneurship and Peter Fasse, patent attorney at Fish and Richardson.
Purdue is exceptional in its support of its faculty of its top five engineering school in helping them get their technology from the lab out to the market, out to industry, out to the clinic.
Peter Fasse is also a great support to entrepreneurs. He is a patent attorney specializing in micropolitics and has been tremendously helpful to some of the startups, which I'm involved, including a startup, came out of Purdue, Savran Technologies. I'm proud to have these two sponsors for my podcast.
Here’s the Story of How Sal Daher Lost 100 Pounds with No Drugs and No Surgery – You Can Do It Too
This podcast is about my taking off and keeping off 100 pounds of body weight for more than a year. It's not a brag. It took me more than 30 years of failure to finally get it right and I regret that I only achieved the weight control in my seventh decade of life. I hope some of the things that I learned with all the mistakes that I made over the past decades are useful to you. I hope it inspires you to make a really strong effort to get to ideal body weight.
Controlling your weight is a highly individualized thing. Every person is going to do it slightly different ways, but I think there might be some lessons here that would help you along that difficult but achievable journey.
Sal Introduces His Daughter Grace Daher Who Is Asking the Questions
Hi, this is Sal Daher, I'm an angel investor in Cambridge, Massachusetts who works with early-stage biotech companies. I host a weekly podcast, the Angel Invest Boston podcast, in which I interview angels, founders, and other people interested in building technology startups. This is why I chose to tell the story in the podcast. Now with respect to the format of the program, I invited my daughter Grace Daher to interview me. Grace studied biology at Cornell then pivoted to software development. She grew up witnessing my struggles with weight. She also coaches me regularly on my work as a podcast host. Welcome, Grace.
Grace Daher: Hi, happy to be here.
Sal Daher: Great. Take it away, Grace. You're the co-host so you get to ask questions instead of chastising me for talking too much.
When Sal Was First Told He Needed to Lose Weight
Grace Daher: [laughs] First question, why don't you tell us a bit about how your struggle with weight started?
Sal Daher: Oh, you remember my parents, so I was maybe eight years old and my parents went to the doctor and the doctor told them, "Mr. and Mrs. Daher, your son is overweight. He needs to lose weight." The solution prompted at that time was give me a soccer ball for Christmas. I was steamed, Grace. I was so steamed because, for me, the definition of a Christmas gift was a mechanical toy of some type, but a soccer ball. I wasn't really interested in sports. I was interested in gadgets and things and reading. I was a kid who liked to read and liked to play with things, with mechanical things. Playing soccer wasn't my thing. I hated that. I was about eight, and that's the first time I was told I was fat.
Grace Daher: Did it continue to be a problem?
A Big 13-Year-Old on a 1,300 Calorie Diet – Misery!
Sal Daher: This is Brazil in the early 1960s. Being overweight, today you’d call me pudgy, maybe a little bit zaftig. A little pudgy. I wasn't overweight. I put on a lot of weight when I came to the States in 1966, I was 11 years old then. The next couple of years was a procession of RingDings and Yodels, and Twinkies, and all these baked goods that were very expensive in Brazil but here were available. I put on quite a bit of weight and the doctor said to my parents, "Mr. and Mrs. Daher, your son is overweight. He needs to go on a diet." They put me in a 1300-calorie diet.
Oh, Grace, it was horrible. A 13-year-old boy eating 1300 calories. I would eat my meals, I would still be hungry because it was stupid. They didn't pay any attention to eating style. I loved eating vegetables. Instead of loading me up on vegetables, they gave me these tiny little portions, two spoons of rice, one spoon of vegetable, three ounces of meat and I would scarf that down and I'd be starving.
Grace Daher: Sounds terrible.
Sal Daher: They wouldn't load me down with water stuff like that. It was just like brute force, stupid dieting. Children shouldn't diet it, it's just a disaster. After that I was like, oh, horrified by the idea of dieting to me. Then I grew up and I was always chunky. Now, I must say that after that experience, the Twinkies, the Yodels, the Hohos or whatever those things, all the Drakes-- Let me put it this way, Drake's Cakes had less revenue from our household because my parents just made those things disappear. But still, I found stuff, junk to eat somewhere else.
Early On It Was Evident that Sal Was Triggered by Food but His Brother William Was Not
I had a hint that everything wasn't the same because way back in Brazil, Uncle William, your uncle William, Aunt Elizabeth [aka Tia], and I, maybe I was six and Uncle William was five and Tia was four, we used to get this tiny little chocolate from our dad on Sunday. Why a tiny? Because that's all you could afford. It was a very expensive chocolate, very expensive in Brazil. Tia and I would immediately scarf our chocolate, and Uncle William who wasn't triggered by food would leave it for later. Then when Uncle William unwrap his chocolate, Tia and I would turn up and say, "Can we have a piece of yours?" Then he got very mad because we have to share his.
Sal Became More Active in College but Bad Diet Caused Weight Gain
Anyway, that told us, it gave me a hint, I'm different from my brother, my brother is not triggered by food, I am. I grew up being kind of overweight. I wasn't obese, but I was a chubby teenager. I started becoming more active, and in college, I discovered physical activity. I started running, I did judo, I started playing squash, and I was pretty fit, but still chunky. Why was I chunky? The midnight chocolate shakes in the snack bar at Baker House. The double cheeseburgers at 20 Chimneys in the Student Center at MIT. I could outeat the calories that I burned exercising. I was pretty, pretty active, but my mouth was more active, shall we say.
Grace Daher: Did you have problems then with the weight?
Lost Weight During Summer Break in Brazil – Less Eating More Moving
Sal Daher: No. When you're young, you don't have any problems. Well, I didn't know it. Perhaps I did, I just didn't know it. Now one thing that was interesting, when I went home from Brazil for the summers, there were a couple of summers I went home from Brazil, and when I was there, I was doing competitive swimming. I was in this league and it wasn't major competition, but we're really pushing it, so I swam several hours a day. I wasn't eating American diet, I was away from all the junk, the chocolate chip cookies, and all that stuff. I would lose 20 pounds, 25 pounds. I’d come back my clothes were loose in the fall when I came back to MIT, but then, of course, put it right back on over the term with my healthy diet of milkshakes and double cheeseburgers and stuff.
Sal Was Fit in College, But Still Overweight – Did Not Realize the Burden He Was Carrying Around
I was overweight. I was in great shape, but not as great of shape as I could have been because years later, when I did get down to ideal body weight, this is circa, my 36, 37 years of age. Grace, when I ran, the wind would rush by my face as if I were on a bike. I never ran so fast in my life when I sprinted. Really, I didn't know it when I was in college, but I was compromising my health by being overweight, if only by maybe 30 pounds or something. I was carrying around 30 pounds I didn't need to be carrying.
Grace Daher: When did you start to realize that it might possibly be a problem?
Sal Got Down to His Ideal Body Weight in His Mid 30s Out of Concern for His Blood Pressure
Sal Daher: Well, I was in my mid 30s, 35, 36. My blood pressure is always unstable because I'm a highly a very emotional person, so my blood…systolic pressure goes up, but then it comes right down. I said, "Well, maybe I should do something about this." I joined HMR Program and I got down to ideal body weight. This is just before we went to Singapore, and so maybe you remember skinny dad then. [laughs]
Grace Daher: I do.
Lost the Weight on the HMR Program – No Hunger – More Is Better
Sal Daher: You were four, around that age. The HMR Program is a highly structured program, it's very well supported by data. In those days it was just shakes, You’d take a certain number of protein shakes. They already had the concept of “more is better”, so I could take as many protein shakes as I wanted throughout the day, and those protein shakes are 110 calories. You could get pretty full. Well, if you take 10 of those things, you're sloshing, you're so full, so there's no hunger.
This is a completely in contrast with my horrible experience at age 13 being told the diet. It was just night and day. I used to think that it must be something in the shakes at HMR. No, it's just that they've studied, they've understood that people have different eating styles, and certain people like to eat large volumes of food, so like me, and I'm a fast eater, all sorts of things about eating styles. Basically, what they would recommend is just space out your shakes, and if you're hungry, take a shake. If you're still hungry, take another shake. You're still hungry, I go woof for another shake.
They also have like a chicken soup. Oh, to vary, a chicken soup. I got down to ideal body weight. I was feeling great. My numbers were perfect. My blood pressure just perfect. I didn't have piles of blood lipids in those days, blood lipids like low-density lipoproteins in the blood, the LDL, that kind of thing. When you're young, everything looks fine, but I was probably depositing plaque in my arteries in those days. Not that I have severe cardiovascular disease, but I have some plaque in my arteries. If I'd been watching it then, I probably would be in much, much better shape today.
How the Weight Came Back On – Grace Remembers Sal’s Struggles
Grace Daher: Then what happened? You didn't manage to keep it off, I think, after that, because I think I remember you struggling quite a lot with weight, and on and off, HMR, throughout my childhood, I remember. It was really difficult.
Sal Daher: Yes, yes. Well, in Singapore, those days HMR had a maintenance program. They understood the importance of…after you lose a weight, you have to change your ongoing lifestyle, and they had a program to support you to do that, but it entailed being in class. They were so rigid. The founder, Dr. Larry Stifler, he's PhD in Psychology was very data-driven and they had tons and tons of data, that if you attend a class, and you did this, and you did that, 2,000 calories of exercise every week, you took so many shakes, you manage to lose weight, manage to keep your weight off, and all that stuff.
HMR Program Turns Down Chance to Coach Oprah Winfrey Individually Because They Did Not Have Data to Support that Approach
They believed in this so much that Oprah Winfrey at one point wanted Dr. Stifler to send a health educator, a diet coach to her house to coach her in the HMR Program, so she could use the HMR Program for weight loss. It would have been a huge boon to be the weight loss program of Oprah Winfrey, but Dr. Stifler said, "Well, we can't do it because we don't data to support it. I'm sorry." Of course, Oprah Winfrey's people were like, "Well, it's not possible for her to attend a class." Imagine, a celebrity of that stature showing up [laughs] in one of HMR centers. There'll be photographers, every day will be a zoo. It would be impossible. They have a lot of integrity, very serious program.
Grace Daher: Is that group setting, that was so helpful?
Attending Weekly Support Group Is Essential for Success Long Term – Alcoholics Anonymous Example
Sal Daher: That is very important. The most successful program for recovering alcoholics is AA, which entails having a sponsor, like a buddy that you talk to all things, having attending group recognizing that you are a recovering alcoholic, and then having regular support groups. This is crucial to maintaining weight, to losing weight.
Grace Was Shocked to See Sal’s Weight Loss After the Isolation from COVID
Grace Daher: After having found HMR, what finally prompted you to lose all the weight, and then finally keep it off? When I saw you, I think in 2022, it's been a while because COVID times and whatnot, I was avoiding heading over to your place because I didn't want to get you guys sick. You are overweight. I was concerned about your health, and about what might happen if you got COVID, but when all of these things simmered down, I come back, and I hardly recognized you. You've changed so much.
Sal Daher: Shape-shifter dad.
Grace Daher: Yes. What prompted that change?
Sal Daher: Well, Grace, let me just wrap up the story of Singapore. When we went to Singapore…because HMR was so particular set in their ways, I couldn't do the maintenance program long distance. E-mails existed and all that stuff but they wouldn't do it by e-mail. You have to actually physically attend the class. It wasn't possible to do phone calls from Singapore. It might have worked with phone calls but still-- so it wasn't possible, and I managed to keep most of it off for a long time, But it slowly crept back on. Interesting thing, after that, I always used the shakes. Those shakes have served me really well in a sense that because they are high in calcium, I have incredibly dense bones. I do not have a problem with osteoporosis.
Sal Was Proud to Be Fat but Fit – His Doctor’s Warnings Were Not for Fit People Like Him
Anyway, what prompted me to lose weight and keep it off this time? Well, let's go back to my early 60s. I'm 67 now as we're doing this interview. In my early 60s, my primary care physician who is really an excellent doctor, very concerned said, "Mr. Daher, you must take off the extra weight because being overweight is really very unhealthy. Look around you, you don't see a lot of obese 80-year-olds running around, do you? If you're going to see your grandchildren grow up, you've got to lose the weight."
I was like, I didn't say this to him, but I said, "Doctor, yes, that's for other people. I'm fat but fit." I had a resting pulse of 58. …squash and all the stuff that I did. I was very active. I flattered myself. One of my comings and goings at MGH, they enrolled me in a program for fat but fit people, if you can call it that. I had this Fitbit, they tracked my physical activity because they wanted to see why some people became diabetic, and why others didn't, and if physical activity had something to do with it.
It's probably genetics and physical activity, a bunch of…it's multifactorial I'm sure but being active is probably a key to that. However, I was deluding myself. Yes, I'm fit, but imagine how fit I would be if I weren't carrying around 90 extra pounds, 100 extra pounds of body weight. It's not just the body weight, it's the reaction your body has to having too many calories. It does stuff that's not healthy for you. A long, long ago when we're trying to survive famine, it probably had survival value. Now it's really destructive. Depositing plaque inside your arteries like making you become insulin resistant.
Grace Daher: An evolution's not going to get rid of it because all the problems of being overweight happen mostly after childbearing years after you've had your children.
Sal Daher: There are no evolutionary pressures for you to be alive at 90 and in good health. Nature's not going to help you. You have to fight against nature. It's a reality. Being overweight is highly genetically determined. I should mention Peter Attia MD has a podcast called The Drive. I listen to his podcast a lot, and I love his approach to health, his idea of health span, idea of controlling blood lipids early on so that you don't end up with heart disease.
Heart disease is what kills everybody. Eventually, if they dodge cancer, they're going to die of heart disease, sad to say. Your great-grandmother just passed away at 104. Basically, her heart gives out at 104. Dodge cancer, dodged all kinds of all the horrible things. You want that last 10 years of life to still be time when you can do it. You can do stuff about it. I'm going to mention people like Andrew Huberman, the Huberman Lab podcast that I listen to and I got some stuff from there. Another person I'll mention is James Clear and Atomic Habits. It's been really helpful.
Being Overweight Has a Lot to Do with Genetics – We Have to Fight Our Genes
Anyway, a conversation that Peter Attia MD was having with Stephan Guyenet, PhD, who's a researcher in this whole area of people being overweight and what causes it and so forth. They said that one of the most heavily studied connections…they did a lot of identical twin studies over decades and decades. The concordance in weight between identical twins raised apart is in the 80s, 90%. It's astonishing. It's highly genetically loaded meaning your genes are your destiny. However, because of that, you need to fight against it. You've got evolution and you've got this set of genes.
Some people like my brother when I was a kid doesn't have a weight problem. Uncle Mauricio doesn't have a weight problem. I do. Tia does. It's a genetic thing. It's not simple. It's lots and lots of genes involved. It's very complex, but you got to fight against it. If you have a propensity to put on weight you have to fight against it. The answer here is that I can do it. If I can do it after all the mistakes that I made, after all the crazy things, you can figure it out. This is why I'm doing this podcast.
A Painful Health Event Motivated Sal to Take the Weight Off for Good
Now, in particular, so what happened? My doctor says, Mr. Daher, you don't see a lot of obese 80-year-olds running around, blah, blah, blah. You’ve got to lose weight. Then I suffered a debilitating, embarrassing injury when I was in my mid-60s, not life-threatening. I don't want to go to the details of it but it had to do with being overweight and it laid me up for weeks. I'm never sick. I'm always up and around. I was on my back. That's why you got that sitting desk that you're using right now is from that episode. When I recovered from that I was so, so motivated to take off the weight once and for all. I don't do anything halfway. If I do something I go full tilt.
Sal Returns to the HMR Program for the Sixth Time
I had gotten, at that point, to 294 pounds in body weight on the home scale. I went back to HMR the sixth time. I've been to HMR several times since that first time. I went back to HMR the sixth time. When I went into HMR I was at 288. I was at home 294. Between going into HMR and the day that I decided I was going to do it, I managed to lose six pounds just on my own because I was so psyched because HMR says no. They make a big fuss about, there's a certain date that's your start date, they're going to plan for that. They're going to get everything ready and so forth. I was like, because I knew the plan, so I was revved up. I was ahead of the game.
My official weight starting at HMR was 288 and I got down to 173. I'm around 186, 187 fluctuating around there. I probably want to take off a couple of pounds right now since my lowest body weight, I've put on 13, 14 pounds, but most of that is muscle.
Grace Daher: Did you face any struggles or problems along the way? It was almost a whole year, I think, that it took you to—
How the HMR Program Works
Sal Daher: 10 months. 10 months during the weight loss phase. Then you go into a transition. They slowly get you back. Let me describe the diet as it is now that I did. There's different versions of it. I did what they call the Decision-Free Diet. That mean is they have something called The Box, which is like your tools that you have that you can use. You reach in that box and you use those tools. You don't reach for anything else outside The Box.
The tools I had were shakes, 110 calories. I'm lactose intolerant so I can't have whole milk, pure milk. I can eat cheese and yogurt and things like that, but not milk. They have a lactose-free shake which is HMR, 70 Plus. I was having 8 to 10 of those a day. They're very high in protein. They're tasty. You can prepare them in many different ways. You can make them cold, hot.
In that box of tools, there was also these packaged meals. They called them entrées. They're a couple hundred calories each. They're designed to be very filling, very healthy, and it provides you the opportunity to chew on something. Also, there's a cereal, delicious cereal, which I love eating every day still. The point here is that you create this box that you live in. Now I was absolutely punctilious about being in The Box, Grace. I didn't have one grape, I didn't have one grain of rice outside of that box. Everything I ate was in that box and I ended up…1,400 calories a day and so forth. I had some difficulties, yes, especially the first two weeks. I'm not going to lie to you. Because you're changing your habits, it's extremely uncomfortable.
The First Three Weeks Were Hard – Plenity Helped
The first two or three weeks it was difficult. At that time I reached out-- As I say, I didn't use any drugs. I didn't have surgery, but I did take this-- It's actually classified as a medical device by the FDA and it's called Plenity. You take with water. What it is, is natural fibers that swell up in the gut in the presence of water to 100 times its size and then it passes. It doesn't act systemically in your body. It just makes you feel fuller and slows the progress of food through your digestive tract and therefore helps… I just felt fuller because just having shakes and then an occasional entrée wasn't doing it for me so this really helped. The first three, four weeks I was using Plenity.
It's basically celluloid [cellulose] held by citric bond acids. It doesn't act in a systemic way. It's not a drug. It's classified by the FDA. It's cleared with the FDA as a medical device actually because it just acts physically in the gut and it passes completely from the gut. That was a big help. That and lots of water, what they call more is better at HMR, Coach, in weight loss, Jina Klapisch, was very supportive, and being in a class with other people who are struggling with the same thing.
Once I was on a diet, Grace, I was just cruising. It was like chunk, chunk, 3 pounds off, 4 pounds off, 2 pounds off, 3 pounds off, every single week. You get almost used to it. If you don't lose 3 pounds, you're like, "Oh, what happened?" That was the biggest challenge that I had. I had hernia surgery in the middle of this, but I stayed on the diet. That week, I didn't lose weight because you swell up with fluids, your abdomen is disturbed, but the next week I had a big drop. That's the difficulty that I had in weight loss.
Grace Daher: What advice would you have to give to people who are thinking about losing weight or are currently doing so?
Maintaining Your Weight Loss Means Acquiring a Whole New Set of Habits
Sal Daher: First thing you need to realize about weight loss that I've discovered all these years is that what drives your weight is the habits you have and if you got to change your weight, you need to change your habits. People have this idea that they go on a diet, they get overweight. "Oh, I'm overweight. I need to go on a diet." They go on a diet, lose the weight, and then they go back to the exact habits that got them to that weight. If you go back to your habits before, you will eventually get to that original weight. It's physics because your set of habits is leading you to consume a certain number of calories on average and to burn a certain number of calories on average, so you need to change your habits permanently. Hard to do, but it can be done if you focus on it. It's not going to be done on the cheap, on the easy. You got to want it. You've got to focus on it.
The Multiple and Marvelous Benefits of Exercise
Another thing that's important to think about is exercise has a mysterious connection to weight control. If I stopped exercising, I would gain weight but if I start exercising somehow you don't take the weight off as easily. I don't know what it is. I think it has to do with the fact that it's so much easier to eat your calories than it is to burn off your calories with exercise. A hot fudge sundae is 1500 calories and the average 150-pound person would have to walk 10 miles to burn off a hot fudge sundae so it's not practical to just burn off your calories with exercise.
Grace Daher: Do you find yourself feeling less hungry after you've exercised? I found that.
Sal Daher: Oh, yes. Not just exercise, other things. Sometimes if I've had my shake and I think I shouldn't be hungry, but I'm hungry, sometimes you're hungry just because it's in your head. You can do all kinds of things. Do a couple of chin-ups, the pushups, go for a walk, have a glass of water, breathing exercises. It resets your mood. We get these signals to eat, and sometimes they are real because you really are hungry. Sometimes it's just because you're bored or whatever. The best thing when you're getting the munchies is go out for a 10-minute walk. I guarantee you, even if you get soaking wet when you come back, you're like, I didn't regret that. I'm soaking wet, but still, it was worthwhile. I guarantee you.
Grace Daher: Or maybe just take an umbrella on your walk.
There are No Magic Pills – Except Exercise
Sal Daher: Yes, well, take an umbrella but the downside of going out for a 10-minute walk is zero. Exercise is magical. I don't believe in magic pills. I don't think Ozempic, Wegovy, well, injected to-- There are no magic drugs. Mounjaro, the big-- everybody's, "Oh, Mounjaro, it's going to cause weight--" I think they're very great for people who have Type 2 diabetes. It's wonderful. People can go on those and lose tons of weight but when they get off the drug, what happens? Indication that we've seen so far is they lose an unusual amount of lean mass, muscle and other things, tendons and things like that, which are hard to build again.
Point is, there are no magic solutions. The closest there is to that is exercise. Lifts your mood. Oh, here's another one helps your freaking blood pressure! Can you answer that? Helps regulate your blood sugar. It does great things for your joints. Walking actually helps with arthritis
Grace Daher: And your brain.
Sal Daher: Huge. When we're walking outside, most of what's going on in our brain is processing this, what's going by and navigating in space, and so forth. It keeps you sharp. The best way to stay sharp is to go out for a walk.
“There's a lot of research to support exercises being helpful to cognitive functioning.”
Grace Daher: There's a lot of research to support exercises being helpful to cognitive functioning. For me, it's actually the main reason why I exercise.
[laughter]
Sal Daher: On the African plains over eons as hunter-gatherers and what the hunter-gatherers do all the time, they walk, sometimes they find a few berries here. They find a few nuts there. Then once in a while, a sabertooth feline chases after them and they run off so they get a little sprinting in, and then they get away, [heavy breathing sound] and then they resume their walk and then they chase after the gazelle.
Walking, sprinting once in a while, and then eating a few nuts and berries, and once in a while, some meat, that's how we evolved. That's how we're built to do, so sitting around is very destructive for us.
Grace Daher: We have “change your habits”. We have “exercise”. Is there anything else?
The Importance of Human Connectedness in Weight Control
Sal Daher: Grace, let's go back to the group thing. Support. Human connectedness is extremely important. I did an interview with Jacquie Olds, a psychiatrist who wrote The Lonely American. She's our neighbor. You've met Jacquie. She and her husband, Richard Schwartz wrote that book and she talks about connectedness and how human beings need to be interacting with other humans. We lose our power of speech if we're by ourselves in a desert island for 40 years. We can't utter sounds. It would become incomprehensible.
Human beings are immensely social and we need each other and we signal to each other, all kinds of things. Being in a support group of people who are doing something similar to what you're doing is extremely important. James Clear in Atomic Habits, which is a really, really powerful book, talks about you have to build an identity as someone who is doing this new thing. In this case, someone who is managing her weight or his weight and being in a group helps to do that.
Now let's go back to the Peter Attia podcast. Professor Sapolsky from Stanford University studies stress. He’s studied stress for decades and decades. Started out as a graduate student studying stress in bands of great apes in the Serengeti. He knows tons and tons about it. He tells a story in the podcast with Peter Attia about this discovery in the mid-'80s that people who attended cancer support groups had significantly better results on cancer treatment. The stress researchers all thought, so what's the mechanism of action here? The mechanism of action must be that by attending support groups, they're reducing the stress, and that has some physiological impact in the body, and they can fight cancer off better. Now, they said decades after that discussion and so forth.
Finally, they concluded that the mechanism of action was adherence to chemotherapy, which is extremely unpleasant. By attending a support group, people were able to tolerate this horrible treatment, which makes you nauseous, makes you lose your hair, it's like taking a poison, controlled poisoning of yourself to get rid of the cancer, to kill the cancer. When I listened to it, I said, jeez, that is a very strong argument for how powerful groups are, because changing your habits around eating is really, really difficult. It's a fundamental human thing. If it can help people doing something horrible, like taking chemotherapy, help them adhere to their plan, how much more can it help doing something far less onerous, which is adhering to your weight control plan?
Also, family, also having the support of friends and people who recognize that you are someone who has this problem, so they don't, "Oh, here's your favorite cheesecake," every morning. That they help you by keeping that stuff out of your environment. It's called environmental control. I would say exercise is essential, but not enough. Weight control is a result of our habits. We have to build new habits and maintain them. Building new habits for long-term success is really hard. You have to work at it long-term, but it can be done. It can be done, and you need the support of other people, which makes the whole thing much easier.
Grace Daher: One last question that I have. What are your regrets?
Sal’s Regrets for Not Having Taken Off the Weight Earlier
Sal Daher: My regret is not having started earlier. All those stupid days of, "Oh, I'm fat but fit." If I started in my early 60s, I'd be so far ahead of where I am now. If I had done a maintenance program in my 30s, I'd be way ahead. When I was in my 20s, I did these all-meat diets, I lost a lot of weight, but then you couldn't stay on that. I mean, how can you just eat only meat? We're omnivores, we're meant to eat everything.
A word about Peter Attia and Andrew Huberman, they are unbelievably brilliant young researchers and professionals. Peter Attia is a practicing MD. He has a concierge practice in Austin, Texas, and he also has a national program and all this stuff. He's highly sought after, and his thing is longevity, but longevity of a particular kind, he calls it health span, meaning not only do you get to live long, but most of that life is going to be healthy. I recommend that you listen to his podcast. You've got to pay to get the full podcast, and it's well worth $150 a year. It could save your life. Peter Attia's big thing because he's done tons and tons of studies. He's also a practicing physician. He sees this firsthand with his patients. Is that you have to start early managing your blood lipids. Okay?
He emphasizes checking your ApoB, which is an early indicator of whether you're building plaque in your arteries or not. If your ApoB level is high, get on it like a ton of bricks with statins to control your blood lipids so that you don't build plaque in your arteries, so when you're my age, you don't—
I have a little bit of plaque in my arteries, but it's not to the point where it's debilitating. I can do any type of exercise. I had heart surgery because of a birth defect. One of my heart valves had to be replaced with animal valve, and there were some scans and they showed some plaque in my arteries, but my cardiologist tells me I have no restrictions. I can do all the exercise I want to do. I'm on a regimen to really control my blood lipids. Every time my cardiologist, my primary care physician, they see my number's perfect.
I wish that I had paid attention to that in my 20s because that's when atherosclerosis and all these other things start, people start…also from a Peter Attia podcast. I remember the guest they're talking about people having glucose intolerance in their teens, teenagers displaying glucose intolerance, lean teenagers because they're inactive, because of their diet, and so forth. Their bodies are becoming glucose intolerant, which is what leads to eventually diabetes, Type 2 diabetes, which is your muscles can't process the sugar. You can die if you have too much sugar in your blood. Distinct from Type 1 diabetes, which is where your body can't produce insulin as an autoimmune disease, is nothing to do with lifestyle.
Type 2 diabetes is very, very linked to lifestyle, and so I urge people, this is not an old person's problem. This is an every person's problem. Women have less problem with cardiovascular disease until change of life, menopause. But they have to pay a lot of attention about bone density and building bone density, which means exercise, which means good nutrition, and paying attention to those things and building muscle. Peter Attia is really big on this.
Where I part company with him, and also with Andrew Huberman, is I think they are too easily convinced to take supplements. Peter Attia, for example, rapamycin. Andrew Huberman, a whole bunch of things that are-- there's a science to support that, but I don't know that the science is that deep.
I think about your sister going to medical school up University of Vermont, where they did very early studies on X-rays, and the physicians who experimented on themselves with the X-rays all ended up having their hands amputated and so forth. Physicians are very dedicated. People like Peter Attia, I think, has tremendous integrity, very dedicated. My experience tells me, let's be very, very careful.
I fully support what he's doing about controlling lipids and all of that. Things like rapamycin, supposed to clear your body of mTOR, which is to reduce inflammation, and so forth. What else? Maybe in 30 years, they'll discover that, oh, remember all that mTOR we were throwing away was crucial for something else, and we didn't know about it because the human body is so unbelievably complex.
Grace Daher: There's so much that we don't know.
Sal Is a Big Supporter of Statins
Sal Daher: So much we don't know. However, let me put in a plug for statins. Lots of people are going to say, "Oh, well, statin they do this. Diabetes, joint pain." There's always a different statin you can take. When I had my heart valve replacement, I chose the best heart valve replacement person that I could find. Dr. Prem Shekar at Brigham and Women’s and he's a tremendous guy. He told me, Mr. Daher, "I used to do coronary artery bypass surgery, but I couldn't make a living doing that anymore." Coronary artery bypass surgery is when they would take a piece of a vein from a leg, and put it on the heart, because people would get blockages of their hearts from heart disease, from blocked arteries, and heart tissue would die. They would substitute that and then the person could go and live with that. He says the number of people having those heart attacks declined tremendously. Some of it is from people not smoking, but a lot of it it's statins, so statins killed that business. "I had to go into the valve transplant business, which is much better because valve transplants are when you get to your '80s, your valves start to give out anyway."
The great thing now is that those valve transplants are done minimally invasively. Anyway, the point is don't listen to all this baloney about statins, take your statins but make sure if you have a problem with one, there's a whole bunch. The armamentarium is full of weapons, so reach for the right weapon.
“How are you managing to keep off those 100 pounds?”
Grace Daher: How are you managing to keep off those 100 pounds?
Sal Daher: What am I doing now that I didn't do back in the early '90s when we moved to Singapore? What I'm doing now is number one, I'm attending class every week. My HMR maintenance class, they have what they call Phase 2, which is a maintenance class designed for people who are trying to maintain their weight as opposed to Phase 1, just people losing weight, so I attend. Every week, I have a midweek communication to my coach, Jina Klapisch. I send her my numbers. I keep track of my numbers. I use MyFitnessPal. I also use the HMR app to keep track of my food intake. Once you build that habit, Sal it becomes really easy.
Committed to a Baseline of 10,000 Steps Per Day
I have made an unshakable commitment to walking no fewer than 10,000 steps every single day. I'm at more than 530 days of 10,000 steps, no less, and sometimes significantly more. I use Fitbit to keep track of that. I also use a WHOOP band to tell me what's the ideal time for me to really push it, push my cardiovascular exercise, when I should lift, and do some-- Oh, by the way, I do weights, I do chin-ups, I do pushups.
Most of my exercise is tons and tons of walking, preferably early in the morning because exposure to sun at that time is much less harmful. Before 10 o'clock you really don't need sunscreen, and it's really beneficial. Early morning exposure. I wear lenses that don't block out blue light in the morning. Why? Because I need that blue light to signal my brain to sleep at the right time. Very important people have these blue light, filters in their glasses so they don't get the benefit of early morning light which is very strong in blue light.
Highly Structured Eating
What else do I do? My eating. Highly structured eating. I'm counting my calories, but I have help. Why? Because I'm eating pretty much the same things every day. There's some variations. Sometimes I go off the diet when there's an event or whatever, but I always try to keep a few elements of the diet to kind of cut off the tops of the high days because I know that later on I'm going to have to make up for the excess calories that I consume.
My normal everyday routine is I have an HMR cereal in the morning with a quarter cup of wheat bran. I eat a lot of fiber in my diet. As that HMR, I make it with the 70-plus shake to add protein. This is a podcast with Don Layman, Peter Attia's podcast about building muscle. I make a point of having about 40 grams of protein as early in the day as possible. This is animal protein because it's the easiest way to get all the amino acids that we need to build muscle. That's cereal. On top of it, I put a full cup of non-fat Greek yogurt. I love Greek yogurt. Yes. Fage or Skyr, like this Iceland yogurt, fat-free. Love it. I drink tons of coffee, no sugar, no milk, black.
Cool Facts About Coffee
Oh, there's a really interesting podcast with Andrew Huberman about the sort of, why we enjoy coffee so much. Listen to that. It'll blow your mind. How we have collaborated in the survival strategies of caffeine-bearing plants. It is the coolest podcast, but that brings me to sleep. It's really important to sleep enough. So all my coffee drinking is in the morning. I try not to drink coffee afternoon because the half-life of caffeine in your body is six hours from the Huberman podcast. The quarter-life is 12 hours. 8:00 in the morning. If you have 300 milligrams of caffeine in the morning, a quarter of that is 75 milligrams is still floating around in your body. The quarter-life is 12 hours. Keep that in mind. Same thing with drink, alcohol. Don't drink too close to bedtime. Argues for brushing your teeth in the morning with beer. No, I'm just joking.
“Why Is getting sleep so important?”
Grace Daher: Why is getting sleep so important?
Sal Daher: Because of stress. Cortisol levels because your body needs sleep. If you don't get enough sleep, your immune system gets depressed. You eat more. You can't control your-- Sleep is a lot like exercise. It's like the opposite. Sleep and exercise are mysterious. If you don't get enough of it, you can't control your weight. Your life just goes to hell. You have to work really hard. The WHOOP band helps me with sleep because it prompts me when I should go to bed, when I should be getting up, am I getting enough sleep? My Fitbit helps me with that as well.
Now getting back to the diet. The middle of the morning, I have two of the 70-plus shakes that's like 220 calories and that is very filling with water. That's like 16, 18 ounces. Then lots of water, lot of tea or coffee or whatever. For lunch, I have a cup of frozen peas microwaved with two cups of some vegetable like cauliflower or broccoli or okra, some vegetable that's lighter. Peas, one cup of peas is maybe 110 calories. One cup of broccoli is like 30-something calories. I try to balance that and then I chop up shallots. I put half an avocado in there and tomatoes. I have one of their prepared meals, the Chicken Enchilada all cut up. It's like my big dog food bowl. That's my lunch.
Then maybe I'll have an opal apple after that and maybe I'll leave it for the middle of the afternoon. Then I have an afternoon snack, which is another double shake. Maybe I'll eat that apple and the shake. Four o'clock is a difficult time, because that's people, you begin to get noshy at that time. So I try to leave calories at that time. Then supper, I try to eat supper early so I can sleep well. That's another trick I learned, not eating too close to-- especially as you get older, young people can do that, but just in general, it's a good idea not to eat within an hour and a half or two hours of going to sleep. You need to eat enough so that you're not hungry in the middle of the night, but not too much.
For supper, I have like a bag of a California blend vegetables, that's like four-something cups of vegetable microwaved with two of the HMR entrées. That's still under 600 calories. Then after that, I have two of the HMR shakes with made of the Creami ice cream machine with this fat-free jello pudding in it and some Ghirardelli cocoa powder and it is delicious. I use monk fruit sweetener. Thank you, Peter Attia, for putting me onto that. I also use a little bit of Truvia. I have a sweet tooth.
Then I finished the day with two little tubs of the 60-calorie Activia Thanks to a podcast of Peter Attia. As you get older, it helps to have some probiotics on top of the yogurt, because these things are just engineered to provide the appropriate bacteria for your guts. That ends up being somewhere around 2,800 calories, 2,900 calories, 2,700 calories, sometimes 3,000 if I eat a extra piece of fruit or something like that or nosh some cashew or whatever. Cashews are great but an ounce of cashew is 160 calories. By the way, I know all these calorie counts. That's a day and a typical day I will, on average walk burn off about 600 calories in exercise. 600, 700 calories. 600 calories take away from 2,900, 2,800. I'm at 2,300, 2,200, 2,400.
Those are my maintenance calories. If I were on just like not going on exercising every day, I would have to reduce my eating down to 2,200, 2,300 calories every day. Not to gain weight, but since I'm walking around all the time and moving, I can eat more. That's my maintenance program. It is really, really important to be in the presence of other people weekly, who are fighting the same fight.
Your mom, she manages her weight very easily. She's not triggered by food and she likes to eat, but she stops, when it's too much just stops. She doesn't have a weight problem but I do. People have eating styles. Some people like to nosh. Some people like to eat large meals. Some people like to eat food that is very dense in calories, very buttery, and so forth, but they don't eat a lot. Other people like to eat large volumes of food. I'm in that category. I like to eat big amounts of food, six meals a day. I have to figure out the calories to work at night. Other people can go hours and hours without eating. Everybody's different.
“…you need the support of a coach to help you work out those particulars…”
This is why you need the support of a coach to help you work out those particulars in your diet, in your routine. Now, there are times when I feast. When we have events, I love meat, I love all kinds of wonderful things. Oh, I do cook vegetables sometimes from scratch having the frozen stuff is just for convenience.
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Sal Daher: Well, Gracie, thanks a lot. Grace Daher, my daughter, Grace Daher, thanks for coming on and being a good support and interviewing your dad on his continuing fight to maintain his weight.
Grace Daher: It was a pleasure.
Sal Daher: This is the Angel Invest Boston podcast. I'm Sal Daher. Thanks for listening.
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Sal Daher: I am glad you were able to join us. Our engineer is Raul Rosa. Our theme was composed by John McKusick. Our graphic design is by Katharine Woodman Maynard. Our host is coached by Grace Daher.