Even though muscle is heavier than fat, and exercise greatly stimulates appetite, no health improvement or weight loss program will ultimately succeed without focused toning. This is because muscle is hugely metabolically active tissue and uses up close to 80% of our glucose requirements. In general, I favor low carb (and no refined carb) diets, especially for blood type O and B. A’s should ideally be pesco-ovo vegetarians. But we all like to have a “treat” now and then — right? So, save your brownie (organic dark chocolate, gluten free of course) or gingersnap or bagel for a little carb load 60-90 minutes before a big workout. Sugar that doesn’t get burned quickly (within 2 hours of consumption) gets stored as that special type of “sugar-fat” called triglycerides. This lipid is actually three glycerol molecules hooked together and gets stored in our favorite fat-holding area: the mid section. When a patient walks into my office with muffin top, I know they have high triglycerides. In fact, if you take your total triglyceride level (from a blood test) and divide it by your so-called “good” cholesterol HDL (all cholesterol is good but that’s another topic) and if that number is 4 or more — you have “metabolic syndrome.” Google that because I’m going to talk about exercise now.

The basic weekly exercise prescription I give most patients is a combination of strength, flexibility, balance and cardio:

Aerobic: 3 hours (six 30 minute sessions such as brisk walks, or 4 x 45 minutes or 3 x one hour)

Strength: 1 hour (2 x 30 minutes or 3 x 20 minutes)

Flexibility: 10 minutes every other day. Basic yoga stretches: 8 sun salutes for example

Balance: 30 minutes weekly; ideally 5 minutes 6 days a week such as standing on one leg while brushing teeth or washing dishes

If you are committed to optimal health you must schedule exercise into your week and keep the appointment. Meaningful exercise tends to not happen spontaneously in our gadget-filled realities. If you are lucky and get to work outside or work in a physical profession, you will probably still need to round out with aerobic and flexibility training.

Let’s drill down a bit on the strength component. That generally involves weight lifting. If you want to build muscles, you have to stress them. I urge you to work with a trainer for the first few weeks to get a weight lifting program going. If you have access to a gym — great. But you can create a simple home gym using only your own body weight (think: push-ups). There are many options out there. The basic idea is that you need to regularly stress your muscles and force them to develop. In general, we have stronger legs than upper bodies so in a 20 minute weight routine (that you would commit to 3 times weekly) you will probably have just enough time for 5 different exercises with 3 sets, and from 8 to 12 reps per set. Four of the five exercises should be for arms, and one for lower body, particularly if you walk a fair amount or live on stairs. Keep track of your weights and reps and try to increase either the weight or the number of reps each time you engage in this resistance training. An example of a leg exercise would be deep squats with a bar (which generally weighs 45 pounds) balanced right on your collar bone and the upper arm flesh. An example of an arm exercise would be a bench press lying down or an overhead press, standing, with free weights in each hand. Try to keep the rest between sets below 60 seconds. If you can easily perform 12 reps in the first set of a given exercise, increase the weight slightly for the second and third sets. If you can barely perform 8 reps, stay at the same weight and work towards 12 reps before increasing the weight.

One inexpensive, quickly effective tool I recommend to help stimulate muscle development, and also curb carb cravings, is branched chain amino acids. Very high doses tend to be cited in research studies (15 grams or more) but I think somewhere between 2 and 4 grams twice daily, say in a morning smoothie on weight-training days, are quite adequate. Ideally one dose before exercise and one dose after. There are three amino acids in the BCAA group: L-Isoleucine (50%), L-Leucine (25%) and L-Valine (25%). This amino acid combo has a somewhat bitter taste and doesn’t dissolve readily in water, but mixes well into a shake that has a thicker texture. You can also find the powder encapsulated, but caps are always more expensive than powder. Vitamin C and B6 are synergistic nutrients for the absorption of BCAAs and daily intake would optimally be 1 to 3 grams of Vit C (ideally not just plain ascorbic acid, but complexed with bioflavonoids for the anti-inflammatory and vasculature-healing properties of those amazing yellow and orange pigments) and 50-150 mg of pyridoxine (B6). The way the BCAAs work is by minimizing or even preventing the body’s need to catabolize (break down) endogenous BCAAs from muscles during exercise by providing an alternate source of BCAAs for the body to convert into fuel. Many professional athletes use BCAAs and I also give them to patients who are recovering from an injury or illness that required prolonged disuse of a a body part. For example, when someone breaks their leg and is in a cast for 6 weeks, the healing leg tends to atrophy, which means lose a lot of muscle mass. Taking BCAAs during the recovery, including the physical therapy rehab, allows for much quicker success.

If you are making a pre and post work-out smoothie, experiment by adding some super-green food, some frozen berries, maybe a splash of flax oil or bee pollen or aloe vera juice. My favorite current super-green food is “Synergy.” For blood type Os or Bs a banana adds thick, creamy deliciousness. Blood type As should avoid bananas so pineapple or nicely ripened pear would be good fruit choices. Extra protein powder will help turn the smoothie into a mini-meal and also round out the amino acid profile of your power tonic. Whey protein, one of the better performance products, is about 24% BCAAs. Whey protein is generally not a problem for lactose intolerants, but if you have a true dairy allergy and can’t handle cassein either, pea protein might be better. If you choose soy-based protein powder, be absolutely sure it is organic soy, because if not, it is guaranteed to be GMO soy.

If you don’t exercise according to my minimal prescription, do yourself a big favor right now and prioritize fitting regular work outs into your week.