Weight control is absolutely essential for controlling high blood pressure. About 30 percent of all people with high blood pressure can cure themselves by simply losing weight.

Each extra pound of fat, though it appears inert, requires about 5 miles of extra blood capillaries. To push blood through all those minuscule passages requires somewhat higher blood pressure.

But a more common cause of high blood pressure in overweight people is excess insulin. Because fat cells are less sensitive to insulin in some overweight people, their bodies produce more insulin, and extra insulin signals the kidneys to increase blood pressure.

Excess weight has nothing in its favor, and young overweight people have a shorter life expectancy because they are at greater risk for heart disease, cancer, and stroke.

If the excess weight is complicated by high blood pressure and bad habits like drinking or smoking, the risk of an early death increases and the quality of life declines even more.

The basal metabolic rate (BMR) represents the number of calories the body needs daily to maintain temperature, blood flow, and urine production, to breathe, and even to think. A calorie is the amount of energy required to increase the temperature of 1 gram of water 1 degree.

Scientists express calories in increments of 1,000, or as kilocalories (kilo means “one thousand”). The calories that the body burns or are in food are really kilocalories. However, kilo is dropped and the word calorie is capitalized.

But remember most of the time you see the word calorie, capitalized or not, it usually means kilocalories. Think of BMR as the energy you’d burn if you just lay in bed all day. Interestingly, your brain uses a large block of energy.

You can easily calculate your BMR using a pocket calculator. For example, the following formula has been used to determine the BMR of a five-foot, four-inch, thirty-five-year-old woman weighing 120 pounds.

Basic level:	655
4.36 x weight in pounds	4.36 x 120 = 523.2
4.32 x height in inches	4.32 x 64 = 276.5
Total	1454.7
Subtract 4.7 x age (35)	– 164.5
Calories	1,290.2
BMR is 1,290 calories per day.

The basic level (655) is a factor that applies to all women; it was derived by measuring thousands, if not millions, of women. The factor 4.36 accounts for the calories necessary to keep all your organs working, based on your weight.

The next factor (4.32) times height accounts for body surface area and the calories lost to either keep the body warm or cool, as the case may be. The factor 4.7 times age accounts for the decline in BMR as an individual ages.

The formula below has been used to determine the BMR for a six-foot, twenty-six-year-old man who weighs 180 pounds. The basic level for all men is 66 with a weight factor of 6.22 and a height factor of 12.7. The age factor is 6.8.

Basic level:	66.0
6.22 x weight in pounds	6.22 x 180 = 1,119.6
12.7 x height in inches	12.7 x 72 = 914.4
Total	= 2,100.0
Subtract 6.8 x age (26)	– 176.8
Calories	1,923.2
BMR is 1,923 calories per day.

How many calories do you use in a typical day? Table 14.1 below shows how many calories our 120-pound woman and 180-pound man burn up daily at varying levels of activity.

Activity Level	Multiplier*	Calories (Woman)	Calories (Man)
Mostly inactive (sedentary, sits most of the day)	1.3	x BMR = 1,677	x BMR = 2,500
Moderately active (exercises three to four times weekly; 30 minutes per session)	1.4	x BMR = 1,806	x BMR = 2,692
Very active (exercises more than four times weekly; 30 to 40 minutes per session)	1.6	x BMR = 2,064	x BMR = 3,077
Exceptionally active (exercises six times weekly; 40 minutes per session)	1.8	x BMR = 2,322	x BMR = 3,461
*The multiplier is derived by extensive research on people who are active to various levels. These are quite accurate if a person is honest about her level of activity.

How would an overweight five-foot, four-inch, thirty-six-year- old woman, who weighs 140 pounds, achieve 125 pounds?

Her BMR is (rounded to the nearest whole number): 655 + (4.36 x 140) + (4.32 x 64) – (4.7 x 36) = 1,373 calories.

If she is moderately active, her daily calorie use is: 1.4 x BMR = 1,922

A 1,000-calorie diet would create a daily deficit of 922 calories.

If her target is 125 pounds, her goal is clear: 15 pounds x 3,500 = 52,500 calories ÷ 922 = 57 days.

It would take about two months of a 1,000-calorie daily diet, while maintaining a moderately active life, to achieve her target weight.

This is a very realistic objective. When she achieves her 125- pound goal, her eating pattern should fit the following level: BMR: 655 + (4.36 x 125) + (4.32 x 64) – (4.7 x 36) = 1,307 calories.

Maintain a moderately active lifestyle: 1.4 x BMR = 1,830 calories.

If she maintains a modest exercise program and eats sensibly, she will easily maintain 125 pounds.

At 1,830 calories, it is difficult even for a dietitian to eat a balanced diet, so it is important to supplement with a multiple vitamin-mineral supplement, calcium, fiber, and—to manage arthritis—EPA and flax oil.

How would a six-foot, thirty-six-year-old man, who weighs 210 pounds, achieve 185 pounds? I meet many men in this predicament. You can usually spot them by their bulging waistlines.

His BMR is (rounded up): 66 + (6.22 x 210) + (12.7 x 72) – (6.8 x 36) = 2,042.

If he is moderately active, his daily calorie use is: 1.4 x BMR = 2,858.8.

This man now has a clear target for a healthy weight.

Exercise is an excellent way to control weight. Exercise burns calories, so it helps get rid of extra pounds. Even at rest a fit body has more muscle, which burns more basal metabolic energy than fat. So a fit person sleeping uses more calories than a fat person does.

A little arithmetic tells you that if you exercise at about 300 calories per day and watch your diet, you’ll control about one pound every twelve days. That means that if you burn an additional 300 calories through exercise daily, five days a week, and cut out an equal number of food calories, you could lose a pound or more every week.

So a 10-pound target loss would take ten weeks. However, if you exercise regularly, your 10-pound target will realistically reduce to 8 pounds because you’ll be building muscle and eliminating body fat, and muscle is heavier than fat.

Muscle looks better, however, takes up less space, and improves body size and shape. As the body ages, BMR declines. A twenty-five-year-old expends 14 percent more calories daily than a sixty-five-year-old.

But because people tend to become less active as they get older, the difference is probably more like 30 percent. A recent study of two major nationally franchised diet programs gave some startling results.

Of the people who lost over 50 pounds, two years later, less than 10 percent had kept it off. Over 60 percent had gained it back, and about 10 more pounds besides. In fact, the dieters proved the programs work well for weight loss.

However, the weight losers proved they have a problem, and that is keeping it off ! Dieting for weight loss is simple in principle: All you’ve got to do is reduce your caloric intake, carry out a normal routine, get about 200 to 250 calories of exercise, and you’ve done it.

Start by following some rules that are a proven aid to dieting. These guidelines will also help you develop new eating habits, which will help you keep the weight off.

These rules, identified by experts over many years, have been refined by people who have lost weight using them.

1. Food Diary - Keep an accurate food diary and write a critique of what you ate at the end of each day. Don’t omit a single morsel. Record your blood pressure also.

2. Bulk at Each Meal - Salads, fruits, cereals, grains, and vegetables can be used in unlimited amounts. Every meal should include a vegetable, grain, or salad. Eating bulky low-calorie foods is more satisfying and will slow your eating.

Compare a 1-ounce pat of butter, which contains 250 calories, to a head of lettuce or a large apple, which contains about 150 calories. Throw in a large carrot for another 100 calories.

You can swallow an ounce of butter in an instant without chewing but not the apple, lettuce, or carrot. That’s what bulk is all about.

3. Avoid Red Meat - Don’t eat red meat; eat fish and poultry (skin removed) barbecued or broiled.

4. Eat Starchy Foods - Eat rice, baked potato (no butter or sour cream), or pasta (plain tomato sauce). Always eat a single serving. Snack on popcorn with no butter or salt.

5. Eat Green Vegetables - Eat all the green salad you want; snack on raw vegetables.

6. Fruit for Dessert - If you must eat dessert, make it fresh fruit—an apple, pear, orange, or grapefruit.

7. Alcohol - No alcoholic beverages!

8. Purchase a Book That Gives Calories, Sodium, and Potassium - I strongly urge you to obtain Bowes & Church’s Food Values of Portions Commonly Used, by Jean A. T. Pennington, Anna De Planter Bowes, and Helen Church (Philadelphia: Lippincott, 1998).

9. Fat Bag - Every time you lose a pound of weight, put a pound of sand in a cloth bag. Put the bag in a prominent place. If you regain a pound, remove it from the bag. Start a new bag every 10 pounds.

10. K-Factor - Limit each meal to 200 milligrams of sodium; be sure to get 3,000 milligrams of potassium daily. Strive for a K-factor of 3 or more. If in doubt, use a little salt substitute (preferably not potassium chloride) at mealtime.

Basal metabolism holds the secret to losing weight easily. Diets work because basal metabolism usually burns over 1,000 calories. On a low-calorie diet of less than 1,000 calories, you’d lose weight even if you stayed in bed.

Rather than decrease caloric intake, some people try to take a shortcut by artificially boosting their metabolic rates through diet pills and other stimulants.

Although these diet aids may work in the short term, they are not practical or advisable for long-term use, and some pose serious health consequences. Following are some common diet aids.

• Smoking elevates metabolism by about 10 percent, and on average, smokers weigh about 10 percent less than nonsmokers. Conversely, smokers who quit usually gain weight even if they don’t eat more. However, the adverse effects of smoking far outweigh any metabolic advantage it gives.

• Amphetamines, or “uppers” (drugs that stimulate the nervous system), are still prescribed by some doctors to help people lose and control their weight.

Although uppers stimulate the metabolic rate, they are not safe because they’re addictive and can cause serious mental health problems, and sooner or later you have to stop taking them.

• The herb ephedra (which provides ephedrine) stimulates metabolism and is also used as a weight-loss aid. However, ephedra doesn’t work for everyone, and when it does, the body adjusts; so its effect is transient.

Still, ephedrine will speed weight loss in a low-calorie diet; you can use it to get started and then stick with the diet alone.

All these examples simply prove that pills or other quick fixes can’t help you maintain a healthy weight. Even if a drug or herb accelerates weight loss, people can’t be on either one permanently. Ultimately, you must manage your own caloric intake by controlling what and how much you eat and how much exercise you get.