Dr. Ian Smith: Staying Fit and Losing Weight

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Dr. Ian Smith
Diet and Fitness Expert
Thursday, July 16, 2009; 12:00 PM

Dr. Ian Smith, diet expert on VH1's "Celebrity Fit Club," gave advice about losing weight and staying fit on Thursday, July 16 at 12 p.m. ET.

Smith is the creator of the national weight loss initiative The 50 Million Pound Challenge and bestselling author of "The 4 Day Diet," "The Fat Smash Diet" and "The Extreme Fat Smash Diet." He also hosts "HealthWatch" on American Urban Radio Networks and was a former medical correspondent for NBC News.

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Inquiring minds want to know..: Dr Ian: I've been doing weight training 3x/wk with a personal trainer since January. While I have lost about 6-7 inches total, I thought at this point that i would be much leaner. I realize that a large part of the equation is my diet and I have not been as strict as i need to be..I feel confident in my trainer and am committed to continuing through the end of the yr. Am I on the right track? Also, will celebrity fit club be back on the air anytime soon? I loved that show.

Dr. Ian Smith: This is a common issue. Your workout seems great, but it's all in the food. People don't get this and they get frustrated. That's why I wrote my book, The 4 Day Diet. It gives you the right balance of protein, fat, and carbs as well as gives you foods low in glycemic index. You should really check it out. People lose on average 12 pounds in a month. Yes, Celebrity Fit Club is slated to be back the first of next year. Thanks for watching.

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Woodbridge, Va.: My exercise routine tends to be a lot more cardo than weights. I enjoy working out on one or two cardio machines at the gym than jumping around on the weights. I also run a little and do rowing. I have a goal to lose some weight but just want to 'get into shape' as well. What is your suggestions for a balanced weekly workout routine for someone who doesn't like weight training that much?

Dr. Ian Smith: This will vary depending on who you ask. However, let me suggest that you do cardio at least 3 times a week for 40 minutes of more with moderate intensity. You should do strength training two times a week for at least 30 minutes. Focus when you're doing the training, then get out of there. That routine should do well by you.

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Washington, D.C: Is there any way for a person in their late 30s to tone/tighten loose skin like in the abdominal and arm areas?

Dr. Ian Smith: It really depends on how much tightening is wanted. If you're someone who has been very overweight or overweight for a long time, it's difficult for the skin to tighten back. Skin is like and elastic band. If you stretch it too much, then it won't go back to its original tightness. That's when you might need the help of a surgeon.

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Wokingham, U.K.: How are we getting on with the swine flu problem?

Dr. Ian Smith: There really is no problem at the moment. I think this will be taken care of with public health awareness and the new vaccine coming in the fall.

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Confused: Crunches or sit-ups? Intervals or jogging? Squats -- good or bad?

Dr. Ian Smith: Crunches and sit-ups, but crunches better to define the abs.

Intervals give a better workout.

NO squats. BAD BAD BAD.

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T for Texas (yes, and it's T for Timbuktu): Any advice for a middle-aged man who isn't overweight according to most charts, but has developed an unsightly bulge in the middle? I've lost 5-10lbs on past diets, but my shape hasn't changed.

Dr. Ian Smith: Unfortunately, you can't just lose weight in one spot. You have to lose weight all over. You should increase your protein, lower your glycemic index of foods, NO alcohol, NO soda. Check out the phases in The 4 Day Diet.

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Evanston, Ill.: Dr. Smith,

I was training for a half marathon Aug. 1, when last week I fell from my horse, broke 4 ribs and had a pneumothorax (which has since resolved). How can I keep from gaining weight and losing cardiovascular fitness while the ribs knit? I am so frustrated. I'm a 55-year-old female, and work hard to keep my weight down. Thanks!

Dr. Ian Smith: Don't do anything that will impact your recovery. Exercise only with doctor's approval as you don't want to make the situation worse. Diet is going to be REALLY important for you. You need to really lower you calories and avoid high Glycemic Index foods. Diet will be key until you can start exercising again. You should also check out The 4 Day Diet.

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Losing a few points, D.C.: Hi Dr., I work out 3-5 days a week and feel like I'm in pretty good shape but I'm struggling to lose a few pounds. My problem is I get so hungry in the middle of the day. Any ways to curb that hunger? I'm eating healthier but as a result eating a lot more (almonds for example) than I know I should. Thoughts? Thank you!

Dr. Ian Smith: You should eating every 3-4 hours, small to moderate meals. You can have snacks in between. The type of snack really matters. Check out the snacks in The 4 Day Diet on page 139. They are low in calories, but will fill you up.

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Washington, D.C.: How can I lose the last layer of fat, about 15 lbs.? I already exercise and eat like a bird.

Dr. Ian Smith: The last 15 are always the hardest. ALWAYS! You have to really work out like a machine, pushing yourself harder than you ever have. You also have to eat different foods. Keep the calories low, but change up the types of food you eat so that your body doesn't grow accustomed to the same food.

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NYC: I have recently come across diets which, although promoted as healthy, are highly restricted, with as little as 800 calories per day. Is there any health advantage, or disadvantage, to diets that restricted?

Dr. Ian Smith: I don't believe in restricted diets at all. They don't work for the long term. 800 calories is WAY too low. Try to land somewhere between 1100-1400 calories based on the amount of energy you expend.

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Reston, Va.: I try to keep in shape by avoiding fats. But sometimes the "let's get a pizza" frenzy gets to me. And once I have a slice or two of pizza, then the next day the craving is too much to resist. And begins the semi-annual high fat ritual.

When these things happen, I put on an extra ten pounds or so. But I can take it off within a week by eating nothing but grape nuts and raisins, and exercising like crazy.

Now I hear that dropping weight fast could cause organ damage. So, in loosing ten pounds quickly about twice a year, do I really have to worry about that kind of damage?

Dr. Ian Smith: What is quickly? You can lose 3 pounds a week and be fine. It's when you lose 30 or more pound too quickly, many times that there is a problem.

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Baltimore, Md.: If squats are bad, what exercises do you recommend for leg strength/toning?

Dr. Ian Smith: Machines. Hamstring, quad machines. They are the best. Also, try lunges. The are great!

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Washington, D.C.: Ian,

I hope you are well. After 33 years of really taking my metabolism for granted and generally just made sure was reasonable with what I ate, I have noticed the male spare tire growing. I decided about a month ago that it was time to act. I don't smoke or drink, but I also almost never exercised. I am 190 and 6' 2' so I am still in ok shape, but want to get better.

I have two questions: 1) I bought an iPhone app to count calories, but I don't really have guidance on "what to eat" Do you have any recommendations? I generally eat salads for lunch, and pasta or chicken and canned vegetables for dinner. I also have a sweet tooth and have maybe a scoop of ice cream or Italian ice for dessert. If I want to lose the spare tire, am I doing the right thing.

2) I bought a Wii fit. I know that isn't vigorous, but will it do any good just to get the basic exercises in squats, push ups, lunges, and running in place?

Dr. Ian Smith: 1) I have to be honest, you need to take a look at The 4 Day Diet. My philosophy on the right foods in the right amounts is spelled out so simply in it.

2) Wii fit is fine, but you really need to kick up the intensity for at least 35-45 minutes a session. Sometimes do 2 sessions in one day. One in the morning and one in the evening. It's called a twofer. Pro athletes do this.

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Arlington, Va.: Until this past year, I've regularly (5 times per week) worked out, using weights and cycling. Since our son was born, I've been struggling to get enough sleep and my workout schedule has suffered. Now that he's sleeping through the night, I'm getting back into my fitness routine. Any tips on how I can best lose the extra 10-15 pounds I put on during my hiatus?

Dr. Ian Smith: Nothing you haven't heard before. Great diet, regular exercise. I'm not trying to promote my own work, but I absolutely assure you that with The 4 Day Diet, people lose 12 pounds in a month. They lose 4 pounds on the first phase which is a detox. Check it out. If you don't want to buy it, get it from your local library.

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Lake Ridge, Va.: How can you treat blisters on your hands and still keep exercise? I started rowing this year and lately I've gotten a few blisters on my hands. I practice three times a week so there really isn't a 'rest' period to let them heal. I've tried Band-Aids but they just fall off. Any suggestions or products out there that could help?

Dr. Ian Smith: How about gloves? You need to wait until the blisters are in some healing stage, then you can also try the mole skin along with the gloves. Also, try changing your grip.

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Upper Marlboro, Md.: I have lost 84 lbs following your 50 million and 4 days program. I am worried about keeping it off. I have been ridiculed by people over the years. I am 20 years old. I used to weigh 268 lbs.I wore a size 44 pants in the waist, and now I wear a size 34 pants in the waist. I am majoring in exercise science in college. I really need to keep this weight off. Please let me know what I need to do to keep my weight off.

Dr. Ian Smith: CONGRATS!!!! This is so AWESOME!!! I want to have someone from my team contact you. Can you send me an e-mail at 4daydiet@gmail.com. We can talk through that e-mail. WAY to go. What an inspiration. Everyone else should join this FREE program at www.50millionpounds.com.

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Anonymous: I am a 44-year-old woman who currently weights 138 and for the past 4 months I have been trying to lose 8 pounds and can't do it. I am physically fit and run a 9-minute mile. Just ran 13 miles last weekend just under 2 hours. I work out 5 days a week and am not overeating.... I finally gave up and called for the food from Nutrisystem for a quick way to lose the 8 pounds I have gained since March. What are your thoughts? I gained the weight because I was sick and lost my energy (flu?) Did not do any running or working out for about 7 weeks and I think I totally messed up my metabolism... Your thoughts? Frustrated and still trying to lose...

Dr. Ian Smith: Nutrisystem? Good luck. Are you going to eat that for the rest of your life. If you're serious about losing this weight--and it's not a lot--I will tell you right now that The 4 Day Diet will take it off in no time. If it doesn't, e-mail me and I will work with you on it. But I'm absolutely sure you will find quick and lasting success on the plan.

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D.C.: Easy one for ya -- how do frozen fruits and vegetables compare in terms of nutritional value to their fresh counterparts?

Dr. Ian Smith: Very close. They get a bad rap and it's not fair. They are seriously a close second, especially the organic frozens.

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Richmond, Va.: I'm a 47-year-old male. Obviously I have to work harder than I used to to keep the tire away. I have always been thin and wouldn't mind a little more muscle mass. Is this still possible at my age without adding a tire?

Thanks.

Dr. Ian Smith: YES! YES! YES!

You need a 4 day a week program of lifting light weights and doing cardio. You're still young. Your body will respond. If you stay with the program, you'll see results in about 2 months.

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Virginia: Hello. Does having low blood pressure (I have about 80/56) impact physical activity in any way? I ask because, while I'm in decent shape, I cannot run for the life of me. The fastest I can go is a bit under a 12 minute mile, and I struggle all the way. Or, are some people just not runners?

Dr. Ian Smith: You must be very careful with a low blood pressure. Seriously. You don't want it to bottom out on you while exercising. Please check with your doctor to make sure this is fine. This is a VERY low bp. VERY low!!!!

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Herndon, Va.: Hi Dr. Ian, I lost about 45 lbs back in 2000 by exercise and eating right ( I am 5'5, medium frame and weigh 125 lbs). I have managed to keep the weight off but have noticed that I am slowly gaining weight, I exercise but am concerned that now that I am in my mid thirties does metabolism have anything to do with the slow weight gain(about 5lbs per year) and should I increase exercise or watch calories

Dr. Ian Smith: Yes. This is the time when everyone's metabolism starts to slow. Well, at least 95 percent of the population. Increase your exercise by 20 percent and really watch your calories. Try to keep it between 1200-1300 a day.

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Washington, D.C.: Why are squats bad? I have never heard that?

Dr. Ian Smith: Because of your lower back and your knees. You don't feel any problems now, but over the long term this is too much pressure on your joints. Believe me on this. Many football teams don't allow their players to even do squats. There's a reason.

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Pittsburgh, Pa.: Hi Dr. Ian! I'm almost 9 weeks pregnant, and I know I need to exercise. I didn't have a regular exercise routine before becoming pregnant and I'm slightly overweight. Any tips or suggestions as to how I can get moving (and safely) so I can make a healthy environment for my baby?

Dr. Ian Smith: Because you're pregnant I really want you to talk to your doctor. This is really something that should be discussed as an individual. Exercise is usually good for most pregnant mothers, but only under doctor's approval.

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Staten Island, N.Y.: When doing cardio, if I end up in the cardiovascular or endurance training heart rate zones, am I not burning as much fat as in the "fat burning zone?" Basically, if I want to lose weight, what heart rate zone should I be shooting for?

Dr. Ian Smith: The fat burning zone is the optimal zone, but not the only zone in which you can lose weight. The zone I like is take 220 subtract your age. Multiply that number by 55% and 75%. Those numbers are your range.

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D.C.: I'm a young (early 20s) guy who's in pretty good shape, but I eat ALL day long at the office. Can't stop. And while it doesn't seem to be a problem, I was hoping you could give me a couple suggestions as to good snacks to keep around. I was thinking Cheerios because they're small, low in calories, and if eaten one by one, I could probably munch on them all day and only add a couple hundred calories. Any thoughts?

Dr. Ian Smith: I have the best snacks for you. There's a list on page 139 of The 4 Day Diet. Almost 75 snacks for you. Yes, Cheerios is a good start. But there are so many more that are easy, tasty, and inexpensive.

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How far to push: My boyfriend and I are both in our mid 40s. I recently lost about 30 lbs through a moderate exercise program and healthy eating. My boyfriend tells me almost daily that he wants to lose weight (he really does need to lose about 30lbs). But, when I encourage him to take a walk with me he says I'm nagging. When I make him a healthy meal of lean protein (fish, chicken, or beef) and a vegetable, he'll say, "is this all you're feeding me?" He likes the food, he just wants to more, a lot more than he probably needs. Do I just throw up my hands and forget it? Should I persist?

Dr. Ian Smith: Persist softly and take control of the eating and activity environment. But at the end of the day he has to want it for himself. If he doesn't want it, it won't work! Let him know that.

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Washington, D.C.: Question about interval training. I'm 30, in average shape. I go to the track at my local high school and sprint 100m (1/4 length of track), slowdown for 200m (half length of track), then sprint 100m, slowdown 200m, etc. Is this enough or should I push myself harder? Should I sprint 200m and do slowdown of 200m? I feel like i should be tiring myself out more even though it is a little hard for me to finish the 100m sprinting. Thanks.

Dr. Ian Smith: You should be EXHAUSTED at the end of interval training. That's how you know you're doing it right. Try to push yourself harder and do the 200m sprint followed by the 200m slowdown. Exhaust yourself!

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Bethesda, Md.: I have purchased both the 4-Day Diet and the Extreme Fat Smash Diet books. I have had some success with the 4-Day Diet, but I find the beginning phase extremely difficult to stick to (I am not a big fan of rice, which is basically all you get to eat for dinner along with veggies).

I am trying to drop about 2 pounds next week before I hit the beach. Any other suggestions?

Dr. Ian Smith: But it's ONLY 4 days. Can't you suck it up for 4 days. It's not like you're eating grass only for 4 days. There's lots of good stuff you still eat. If you want 2 pounds off, the detox will do it. The Vigorous module of the diet will do it also.

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Philadelphia, Pa.: I have almost no cartilage in one knee so biking, extensive walking, treadmill, stair-climber, etc., are painful and I end up hobbling for days after using them. I've lost 20 lbs. recently and there is definitely less pressure on the knee, which is great. Can you suggest any forms of exercise for me that will really reduce fat and build muscle but won't irritate my knee?

Dr. Ian Smith: Because you have a medical condition, I really don't want to touch this one as you need someone with real knowledge of your complete condition. Let me suggest that you meet with a physical therapist. They can give you everything you need to know.

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Arlington, Va.: I am a fit 27-year-old and am working on getting back down to a weight that I used to be 2 years ago. I am exercising just as much as I used to then, if not more often, but I don't want to half-starve myself like I did at that time (it was before my wedding). Is it possible to lose weight by just running and eating a healthy diet under 2,000 calories a day?

Dr. Ian Smith: Absolutely. However, let me suggest that you really try to keep it to 1800 calories or less. That will really work.

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Hello from a Fellow Danburian...: I want to start swimming again for fitness, but I am way out of shape. Any suggestions on easing into it?

Dr. Ian Smith: Hey fellow Danburian. I'll be there next weekend speaking at the New Hope Baptist Church at the 11 AM service. Come by. Swimming is one of the absolute best exercises. Try to swim one lap at a time and take breaks in between. Go slow and build up your endurance. Your goal should be 10 consecutive laps without stopping.

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Leesburg, Va.: Dr. Ian,

What's the difference between the "4-Day Diet," the "Fat Smash Diet," and the "Extreme Fat Smash Diet?" For instance, why would I want to read the "Fat Smash Diet" If I know there's an extreme version of it that's even better?

Thanks!

Dr. Ian Smith: Very simple. Each program will bring great weight loss but...

4 Day Diet..easiest of the 3 and more fun.

Fat Smash..second easiest, faster results in the first 9 days.

Extreme Fat Smash Diet..GREAT results. FAST. Lots of work.

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Midwest: No squats? Why not? Is there a different type of exercise you recommend instead? Thanks!

Dr. Ian Smith: Read my earlier answer. BAD for the back and joints down the road. Injuries. Injuries. Injuries.

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4-Day Diet for non-weight loss?: Hi Dr. Smith -- I was curious if your book The 4 Day Diet would be helpful for someone who doesn't need to lose weight, but simply wants a plan/guide for eating better/healthier. Would it work or would it result in weight loss?

Dr. Ian Smith: YES! YES! YES! The book isn't just about weight loss, but maintaining your weight and health. Let me suggest that if you follow the plan, increase the portion sizes by 15% percent.

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Baltimore, Md.: Hello Dr. Smith,

In your book (4 Day) you stated the first two phases should be followed consecutively. How do you know when to move from one phase to the next?

Dr. Ian Smith: Each phase only lasts 4 days. You move to the next phase on the 5th day. It's meant to be a very simple and straightforward program.

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Washington, D.C.: I am 36 and currently weigh around 138 (I am only 5'3" so this is kinda a lot). I have lost about 10 pounds using the 4-day diet but the loss has been VERY slow. It took me 3 months to lose the 10 pounds, with lots of cardio and eating very carefully. I would like to lose 10 more pounds, but I seem stuck. Any advice?

Dr. Ian Smith: This is NOT a bad weight for your height. Your body could also be telling you that it's comfortable around this weight. You might want to try to go down another 5 pounds, but 10 might be too much for your body. Try doing the Induction module, followed by PUSH, followed by VIGOROUS, then TRANSITION.

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41 mile day hike: Dr. Smith,

This Saturday four friends and I are doing the Maryland Challenge which consists of hiking the entire Maryland portion of the Appalachian Trail in one day. My question, is what, if any, special foods should I be eating today and tomorrow?

Thanks

Dr. Ian Smith: LOTS of carbs. Fruits, veggies, and pasta.

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Edgewater, Md.: Almost inexplicably, my running times have become longer. For example, three years ago, when I was carrying 5 more pounds, I could run a 10-minute mile, now it's more like 11.5-minute. I try doing intervals, but my muscles ache and scream a lot when I pick up the pace. Mid-40s female with about 15 pounds to lose. Run/jog 4x/week, weight lift 2x/week; ride horse vigorously 5x/week. Help! Thanks.

Dr. Ian Smith: You MUST push yourself. No pain no gain..to some degree. If you don't force your body at times, it will choose the path of least resistance. Don't settle for this dropping performance. Train regularly and be focused on improving.

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Richmond, Va.: In 6 months I went from 170 to 139 with sensible eating and exercising on my elliptical. Now I'm at 144 and can't get back down to 139. 48 female, 5'7".

Dr. Ian Smith: First of all, congrats! That's great. What have you done differently that has caused the 5 lb increase? It must be something. I don't know what else to say as you didn't give me enough info about your food choices and exercise. Try the modules of The 4 Day Diet.

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Richmond, Va.: Dr. Smith:

LOVE LOVE your commercials! I have a reoccurring problem. After I work out (Curves program) sometimes I get a sharp pain under my left breast (I don't know exactly what muscle that is) and forces me to my feet. I try to stretch it out and eventually it goes away but how do I keep it from coming back? The Curves program has a series of stretches to perform afterwards but sometimes I skimp. And because I've done the program so long, I really don't follow the 30-seconds per machine -- sometimes tending to spend more times on legs or arms, depending on the day. BTW -- I'm 45, about 5'3" and 214 lbs. Thanks for any help you can provide.

Sincerely.

Dr. Ian Smith: You really need to see a physical therapist and make sure that there's isn't an underlying problem. I can't really diagnose what's happening based on the info you presented. But pain is not a good thing in this situation, so something's not right. It's probably nothing big, but get it checked out to be safe.

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Washington, D.C.: I work out about 5 days a week -- usually a combination of cardio and weights. I have lost weight but I'm starting to feel like my cardio workout isn't hard anymore. I choose interval and random on the elliptical machine but are there any other ways for me to step it up? How can I push myself to really work during my 30 minutes of cardio?

Dr. Ian Smith: Cardio becomes easier the more you do it. It's supposed to. So you have to keep challenging yourself. Every 10-14 days you should be increasing your workout by 10 percent. Whether it's duration or intensity, 10 percent increase is the number.

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Catonsville, Md.: I am confused or can't read. I have read your 4 day book. Is it 4 days on 3 days off then next phase or is move to the next phase every 4 days?

Dr. Ian Smith: Move to the next phase after you complete the 4 days. So it's 4 days, then the 5th day is the first day of the next phase. You go back to back to back with the phases.

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Icing: Is there such a thing as icing an injury too long (i.e., more than 20 minutes)? Can that cause damage?

Dr. Ian Smith: YES! For sure. The general rule is that you should ice 15 minutes on, 15 minutes off.

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Washington, D.C.: I haven't read the book yet (want to!), but is there any way for a non-meat eater to follow the 4 Day Diet? I always run into problems with pre-prescribed diets because I don't eat beef, chicken or pork. I do eat fish, and supplement my protein with lots of beans and soy, but if I supplement, will the program still work?

Dr. Ian Smith: Yes, lots of vegetarians and vegans have found success on the 4 Day Diet. Simply choose the options or make the substitutions that work for your eating style. Thousands have said it worked for them.

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Dr. Ian Smith: Thanks for joining me in the chat today. I hope I have been able to help. Come and join me for free at 50millionpounds.com. If you have any questions about The 4 Day Diet, feel free to reach me through the contact us link on the site. Stay healthy. Stay focused. Have a great rest of the summer. And Carpe Diem!!!

Dr. Ian

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What have you done differently that has caused the 5 lb increase?: I know, I know. I relaxed a little on my food regimen, let myself have dessert... Stopped calorie counting.

Dr. Ian Smith: then you know what it will take to fix it. Sometime we know our answers, but just need others to prod us to accept them! Take care everyone.

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For more wellness news, tools and information, visit http://www.washingtonpost.com/wellness.

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