Darkness had already closed in on Lido Isle--with fog soon to follow--as Kae Ewing slipped on his hand weights and headed out the door just after 6 p.m. The street lights glowed soft and yellow in the mist, and the scent of burning wood from neighborhood fireplaces mixed in with the salt air. It seemed a perfect evening for locking the door and settling in with a warm meal and a good book.
But Ewing has made a promise to himself, and he says he intends to keep it, no matter what else he had rather be doing. Two weeks ago, the 56-year-old Newport Beach stockbroker was reminded of his own mortality when a routine treadmill test turned up some suspicious electrocardiogram tracings.
Although Ewing had experienced no symptoms of heart trouble, there was only a 20% to 30% chance that the reading was false, according to Dr. James Lindberg, medical director of the UC Irvine Executive Health Program, where Ewing was undergoing a complete screening.
After a couple of nervous days, Ewing went to UCI Medical Center in Orange for another, more complex test to determine if he indeed had blockage in his coronary arteries, as the first electrocardiogram suggested.
The second test was negative, fortunately, but in the interim, Ewing had time to think seriously about his diet and fitness program and whether it should have a higher priority in his life.
Ewing began the program last November, under the guidance of fitness consultant Joe Dillon of Body Accounting in Irvine. He agreed to allow Health & Fitness to follow his progress from the beginning.
He quickly adapted to the low-fat, low-complex-carbohydrate diet Dillon recommended, but he just couldn't seem to work regular exercise sessions into his schedule. Since his recent heart scare, however, Ewing has hit the streets every night without fail for an hour of brisk aerobic walking. Even during a weekend trip to San Francisco, Ewing and his wife, Louise, trooped around the city on foot.
"My legs were really sore from going up and down those hills," he said as he walked along the Lido bay front, his usual route.
Still, Ewing acknowledged that he isn't confident he'll be able to keep it up night after night.
"For the first 48 hours after the test, I was really motivated," he said. "But then when I found out I was OK, you know, it's easy to slip into being complacent again."
When Ewing, who is 6 feet, 3 1/2 inches tall, began the program, he weighed 258 pounds, 33% of which was fat, according to an immersion test in which Ewing was weighed in a tank of water. His weight dropped about 14 pounds during the first two months, but by the time he was weighed at UCI, he was back up to 256.
The good news is that his body fat on the most recent test was down to 26.7%, according to Lindberg. The second test was performed with skin fold calipers instead of immersion, so Lindberg cautions that although the number is definitely lower now, exact comparisons cannot be made.
"That change is probably from the exercise and diet changes he's made so far," Lindberg says.
With the test results, Lindberg and his staff created a customized "Health and Lifestyle Profile" for Ewing in a loose-leaf binder, detailing his current risk of heart disease, cancer and other problems--even death in an auto accident--and what he can do to improve his chances of staying alive and healthy.
According to the profile, Ewing now has a 9.7% risk of a fatal heart attack within the next 12 years, compared with a median, or average risk of 8.2%. The optimal risk level, Lindberg says, is 3.5%. "That means he can reduce his chances of a fatal heart attack by two-thirds." His blood pressure and cholesterol levels weren't excessively high, but Lindberg says that with regular exercise, Ewing will be able to increase his level of high-density lipoprotein (HDL) cholesterol, commonly known as "good" cholesterol because it transports excessive cholesterol from the tissues to the liver, where it is broken down and excreted.
When all those factors are taken together, Ewing has the "equivalent risk age" of 59. If he can lose just four pounds, that will drop to age 55, a year less than Ewing's chronological age, and his risk of a fatal heart attack will be reduced to 7%. By the time Ewing reaches his goal of 230 pounds his risk will be down to 2.4%, even below the optimal level. At that weight, Ewing's percentage of body fat would be 19.2%.
Since he has never smoked, Ewing is at low risk for lung cancer. His chances of most other forms of cancer are also relatively low, except for skin cancer. "He's at higher risk for that simply because he's Caucasian and lives in Southern California," Lindberg says.
And because Ewing uses his seat belt only about 30% of the time, he has about a 5.4% chance of being killed in an automobile accident. If he wore it all the time, those odds would drop to 4.9%.
Fortunately, Ewing doesn't drink--not since he began his diet. If he did, his chances would be much higher: 15.2% if he had 25 or more drinks a week and always wore his seat belt, 8% if he had 7 to 24 drinks a week, and 5.6% if he had 1 to 6.
Another risk factor for Ewing is stress. As a stockbroker (he's a senior vice president at Shearson Lehman Hutton in Irvine), he faces stressful, fast-paced days at the office, and Lindberg says he is definitely a "Type A" personality. "Type As" tend to have a strong sense of time urgency, low patience, frequently need to do two or more things at once, are sensitive to criticism and have difficulty relaxing.
Based on a brief questionnaire, Lindberg rated Ewing's stress level at 134%, or 34% higher than average. The optimal level is 50%.
Although Ewing isn't likely to change careers just to bring down his stress level, Lindberg says there are strategies he can use, such as listening to relaxation tapes, using time-management techniques, and even biofeedback.
Lindberg recommended that Ewing give himself six months to drop another 26 pounds. To help keep Ewing motivated, the doctor wrote two "exercise prescriptions"--one for walking, one for riding an exercise bike. If he follows them, Lindberg says, Ewing can bring his weight down about 15 pounds even without dietary changes. "That's a conservative estimate," Lindberg says. "With changes in his diet, he's going to lose more."
Although Ewing seems to be sticking to the right kinds of foods, Lindberg says, "What's sneaking up on Kae is that the portions are a little too much. If he works on that, I think he'll see more progress. It's just a matter of motivation and tenacity."