All that was a relief. The sigmoidoscopy was no more painful than some yoga poses, and the benefit of early cancer detection obviously outweighs a few minutes of discomfort. For someone like me, with low cholesterol, the EBT scan was probably overkill, especially since it gives you a dose of radiation roughly equivalent to spending a year at high altitude (and I had lived in Denver for 17 years when I was younger). Still, Kettles pointed out that an EBT had found an early pancreatic cancer in a patient in her 40s, who is doing great and might not otherwise have survived. The test is expensive, so it’s an individual decision best left up to you and your physician. (The total tab for the Cooper Clinic tests, I should note, is steep — $1,800 to $3,500 — and not covered under most health insurance plans.)
Fit, but (a Little) Fat
All was going well until, hooked up to electrodes, I got on the treadmill, which tracks how long you can fast-walk on an incline and how your heart reacts while resting, under stress, and recovering. My heart was strong, but I was gasping and exhausted at 18 minutes; 12 years ago, I made it to 21 minutes. Even adjusted for my age, I dropped a fitness category, from "superior" to "excellent."
Then I got weighed. As I suspected, this was bad for my mood. Very, very bad. I had gained eight pounds, and I’d been chubby to begin with. All that time, I thought that if size 12 jeans still fit, I was more or less the same weight, and I didn’t want to start obsessing by getting on the scale. But to be honest, I’d been searching far and wide for size 12s I could squeeze into, and the last ones were stretch fabric and had "tummy tuck" in the description. Reader, at five-foot-six-inches tall, I weighed 176. Please don’t tell my mother — her heart is not in as good shape as mine. To add insult to injury, my body fat percentage had crept up from 27 percent to 31 percent, which is higher than a rib eye steak’s.
Given that my overall health was "fabulous," as Kettles said, there was no urgent need to get my weight down. For many of her patients, excess weight is a marker for low fitness. Not only don’t they exercise, they also have sedentary lifestyles. They’re heart attacks waiting to happen or latent diabetics, but luckily, in their 40s, they still have time to turn around bad habits.
In my case, extra weight wasn’t affecting my health, because it’s a rare day when I don’t exercise. The Cooper Institute, the nonprofit group affiliated with the clinic, is famous for studies that prove you can be fit and fat. Steven Blair, an epidemiologist and former CEO of the institute — and fairly rotund for a runner — has done several long-term studies showing that fat people who are fit live longer than skinny couch potatoes. But it isn’t a good idea to gain weight steadily through the years, Kettles told me, particularly as you head toward menopause, when your metabolism takes a dive. And even if my weight wasn’t hurting my health, it was, as I mentioned, damaging my mood.
Before the checkup, I’d kept a three-day diary of everything I’d eaten (bear in mind that we’re all a little too good when we know we have to write things down, and perhaps we underreport the amount of dark chocolate we consume). The nutritionist, Jennifer Neily, analyzed my diet. I eat mainly fresh fruits and veggies, whole grains, lean meats, olive oil, and low-fat dairy products, along with the occasional bacon-Gorgonzola burger. Neily approved of my eating philosophy, which is that because I like to eat a lot, I have plenty of salads and other bulky foods that fill me up without being too caloric. The fattening treats I indulge in tend to be small amounts of pecorino cheese, olives, and dark chocolate. I take in more than 100 percent of most nutrients, including calcium (thank you, lattes), get plenty of fiber, and eat hardly any pound-packing simple carbohydrates, trans-fatty acids or saturated fat. Still, mysteriously, I was consuming too many calories.
Then Neily took her red pen and circled the culprit in my otherwise A+ food diary: wine.