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When I was sixteen I noticed the early signs of a six pack. I'm not talking about beer but this has some of that too. I attributed the creases and striations that had suddenly appeared below my pecs and alongside my navel to my new-found sit-up habit. On the floor at the foot of my bed, knees elevated to a 90 degree angle, elbows touching knees was one rep. Three sets of 35, three times a week was my work-out. 

But I'd later learn that sit-ups do little to lean-up the torso or for that matter strengthen the lower back. In fact abdominal exercises can actually cause back problems by tightening the hip flexors (groin muscles) which then put excessive strain on the back. Sit-ups hardly qualify as a good core work-out. Really any full-body exercise - pull-ups, push-ups, squats, shoulder presses - activates and strengthens the abdominals while also building beach muscles. In a recent poll published by GQ girls voted biceps as their favorite constrictor. I have always been partial to shoulders, chest and triceps. I'd say penis, but it isn't a muscle. I'm here to tell you that the trick to achieving and maintaining a six-pack lies in proper diet with or without cardiovascular exercise. It has nothing to do with sit-ups. Just ask Mick Jagger, who hasn't done one. It's no coincidence that my six-pack appeared when I started playing soccer.

When I was in my medical residency a colleague asked for my definition of success. I said it was always having a ripped stomach. The moment I developed a gut I'd consider myself a failure. Since the age of sixteen I have maintained my six-pack. Even when my diet was not proper, when I was drinking and smoking and eating meat and processed carbohydrates, even when I wasn't exercising. Though sometimes it has been reduced to a two-pack, the slightest hint of muscles at the mid-line right below the sternum. Once those go there is no coming back. 

Why this response? Was it vanity? No. I could have said keeping my hair or not going gray or being wrinkle free. But these are less under a person's control than belly flab, although too much testosterone in the diet can induce pattern baldness. I just felt that a successful life is one whose lifestyle is clean and pure, and a trim mid-riff is evidence of this. I could make a lot of money, or save a lot of lives, but if my lifestyle went to shit, and my linea semilunaris with it, none of it would matter to me. My health is a greater sacrifice than I'm willing to give to anything or anybody.

Now, though I haven't done a sit-up in a half a dozen years my six-pack is more pronounced than ever. At an age when most fathers are developing their unique brand of "dad bod," I am as lean as I've ever been. But I am not a father, which may have something to do with it. The only dads I know of who remain razor-sharp well into middle age are those for whom diet, exercise, image or some combination of these is their livelihood. And being an actor alone does not suffice, as Brendan can attest. You gotta move some.

Take a guy like ultra runner Dean Karnazes, who has completed 50 marathons in 50 states in 50 days. He's a father of two and happily married to boot. Probably because he's never home. Marathon champion Meb Keflezighi is practically my age and has the body of a teenager with testosterone at its peak. He's also a dad. But many professional athletes look like schlubs. Not just NFL quarterbacks, but practically all baseball players look like they spend way too much time at Mickey Ds. As a former varsity infielder myself I am ashamed. The baggy clothes these dudes wear don't help.
It makes a former fan long for the days of Ozzie Smith, even the steroid era with its bash brothers, Canseco and McQwire, whose physiques rivaled bodybuilders. Now the average person is heavier and this includes many individuals who are active for a living, though soccer players and basketball players are famously trim, at least in their playing days. But David Beckham, one of the greatest soccer players of all time, has been retired for a couple years and still looks tight. He's a father of three and during interviews often eats burgers and drinks Guinness. The lucky bastard. But I've done the same. Enjoyed burgers and beers and managed to maintain skin thin enough to expose the underlying musculature. Because really, we all have six-packs underneath that flab. The stomach muscles, rectus abdominus, transversus, obliques and serrati, are among the most frequently used of all the body parts. So exposing what you already have is merely a matter of clearing the weeds so the tulips can crown your garden, or of removing the "junk in your front." 

There have been periods in my life when I don't exercise for months at a time. This is usually when I'm injured, but sometimes I just get lazy. When I was in my mid-twenties I did nothing for a couple months. It was a particularly hot summer and all I really wanted to do, other than write my novel, was drink beer. I also drank about a bottle of wine a night, often with some combination of sushi, KFC or McDonald's - that is when we were out of frozen pizza. I held on to my sculpted torso, but only barely. 

In medical school I was on a budget and the store was miles away. So it was easy to fall into the habit of eating Skippy peanut butter sandwiches on Wonder bread, grilled cheese sandwiches, and as many Rice Crispy treats as I could find in the cupboard. And there were a lot, since my roommate's parents sent him a suitcase filled with these goodies every semester. I filled out, to be sure. I stopped running because it hurt too much to move at any appreciable speed. I was just too heavy. My thighs would rub against each other and chafe, and the sweat would make my skin sting. My joints hurt from all that pounding. And did I mention it was hot? So I cut out the processed foods and substituted banana berry smoothies for eggs and cheese and it was back to the endurance habit. 

Really, the biggest threat to my flat tummy has been romantic relationships. With girlfriends I'd eat out more, and even health food prepared by another is drenched in hidden fats and sodium. Though healthy snacks weren't on my mind when a sweetheart and I would visit a Jerry's Deli or Chaya on Venice. In general couples order in more, enjoy big meals in bed, and for physical exertion choose sex. I almost lost my six-pack when with Isabella I'd spend Friday nights eating chocolate covered raisins and laughing out loud to buddy comedies. Beatriz and I liked to patronize McDonald's before and sometimes also after movies at the mall. Shannon and I favored Pizza Hut and El Pollo Loco, with Baskin Robbins for dessert. After about a year of this she commented that my pecs were turning into tits. But I blame the weed. It was only with Kerstin that eating in took the place of ordering out (for the most part) and cooking together became a shared pleasure. Our trim tummies were grateful, but clean-up is a bitch. It is the case that many lovers simply lose the incentive to be fit and look trim once they've found the one. Once you are in a stable relationship with someone who loves you for who you are, whether rotund or V-shaped, if diet and exercise aren't ingrained, they can easily give way to Sizzler and more sex. I appreciate this point of view but I do not share it. I don't consider myself very lovable when I am soft and flabby. Guys are visual creatures, and gazing at cellulite-ridden thighs is not my idea of an aphrodisiac. I don't love you for your perky breasts but your perky breasts are part of you that I happen to find really hot, so let's do what we can that ours don't sag, shall we?

More recently injuries have put me out of commission twice in as many years. By this time I had become a vegan. After being hit by a car I was bed-ridden for a couple months. And though my diet was sharp I was still enjoying beer and wine every night, usually two glasses of each. But despite forced inactivity and low-grade insobriety, I was still shredded. "Cindys" sure helped. This exercise consists of 5 pullups, 10 pushups and 15 squats, as many rounds as you can manage in 15 minutes. When I broke my leg biking, I was unable to even do Cindys. By this time I had given up alcohol, and even though I was eating chocolate and peanut butter and granola bars more often than I care to admit, the "sixer" was in full effect.

My experience tells me that if you want a six-pack, start early, and don't lose it, because it's hard to get back. Also, drink moderately if at all, and avoid processed foods. Work out but don't let this take the place of a clean diet. And drink water. I cannot stress this enough. Even when my diet is perfect and includes a lot of juicy fruit, even when I run tons and lift a lot, I notice that if I don't drink at least 6 cups of water a day, I put on weight around my mid-section. The reason for this is two-fold. First, it is easy to confuse thirst with hunger. In other words, dehydration can lead you to reach for food you'd shun if you weren't so thirsty. Food does provide some water, but you probably don't need the extra calories. Also, the body seems to store fat more easily when it is dehydrated, so even if you exercise and eat clean and moderately you may carry more weight than you would otherwise if only you treated yourself to a little more H20, which is free in more ways than one.

Mrs. Obama got a lot of flack when she recommended that kids simply drink more water. Not just in place of soda but just because. It's unfortunate, because she was definitely onto something. We as a country, maybe even as a species, are walking around in a persistently dehydrated state, and the results can be catastrophic. Not just weight gain, food cravings and energy lulls, but even depression and cancer, if you believe Dr. "Batman." 

Some may smirk at your catering to your appearance and call you vain, but if vanity leads you to do what is necessary to maintain your flat tummy and this includes drinking more water, then you are serving your health. And without health, there is no wealth or happiness. There is no success. That is why being healthy is a form of success. Which the IRS cannot take from you, or sweethearts who break your heart. No matter how much money you make or fame you have, you can't enjoy it unless your insides are right. We are told not to judge a book by its cover, and appearances aren't everything, but a car that looks cherry on the outside is often just as peachy under the hood. Because the owner cares. So, care. Attend to both your outside and your insides and the best way to do this is by hydrating.

Whether you are single or spoken for, make staying in shape a priority. Your six-pack may brand you as a dandy. It may not make you millions, unless you're a David Gandy. But the fact that he is barely holding onto a two-pack hasn't hurt his income. Ah the good life. It's what happens with too many six-packs, of beer that is.


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