Gain the Holiday Spirit not the Holiday Weight

Can a little too much holiday cheer add to holiday weight gain?  Holiday weight gain is a relative myth, it’s not the 5-10 pounds like we often hear.  The average American only gains 1 pound over the holiday season, but that does not mean it is nothing to worry about.  Studies have shown that when we follow individuals after their 1 pound holiday weight gain, they typically don’t lose that pound over the next year leading into the next holiday season.  So do this over the next 20 years and you’ll find yourself carrying an extra 20 pounds around and some negative health risks that go with that weight gain.

Another concern is that overweight people tend to put on an average of 5 pounds for the holidays.  So if you are overweight to start with, you are more likely to put on more weight then an individual that is not.  Not a good thing if you already have weight to lose, because you will end up with those 20 extra pounds in just 4 years.

While eating all of those Christmas cookies and treats on top of our normal calorie intake is usually the thing blamed for the added weight gain, don’t forget that added alcohol consumption with holiday parties can be partially to blame.  An average alcoholic beverage contains between 100-150 calories and if you are having only one drink per day that is not a problem.  But remember that alcohol calories come primarily from sugar.  We should take in only 5-15% of our calories from solid fats or added sugars.  So if you are at the average calorie intake for most women, which is just over 1900 calories or for men it is 2550; you can see how you can easily exceed this amount with a couple drinks and then throw in some food with extra sugars added to them.  Plus alcohol does impair our thinking and our willpower to say no to an extra cookie and some fudge.  This can create a double whammy with the added calories of the alcohol along with decreased willpower to say no to over eating. 

Unfortunately the added stress of the holidays can be to blame as well.  A short acute stress response from our body is helpful when we have a true emergency that should last a few minutes.  Long chronic stress is not good, which is what many of us live with daily and especially over the holidays.  When we get into a chronic stressed state we often tend to use poor strategies to relieve that stress such as drinking and eating compared to good strategies like meditation, prayer and exercise.  Also our willpower is decreased in a stressed state, just like it is under the influence of alcohol.  A time of acute stress is not a time to worry about your waist line in upcoming years; it is a time of survival to get through to the next day. But when that acute stress becomes chronic daily stress you can start to see how that can derail us and our future health needs.

So control your eating over the holidays, it is okay to have a few tasty holiday treats, but remember to try and do it with some moderation.  Also be careful with your alcohol intake, as it can lead to extra calories and decreasing your willpower.  Also try to meditate on the “reason for the season” to help decrease a little stress.  Get away from the TV and watching reruns of “It’s a Wonderful Life” and get out for a walk and some exercise to make it a wonderful life.  And after the New Year begins, start working to take off any weight that you might have put on so you start next holiday season where you began this one or a little less if needed.

Is your present self working for your future self?

Everyday we make decisions about choices we have that will have good or bad consequences for our present and future self. Often times we make decisions that benefit our “present self” with great expense to our “future self”, especially when these choices are repeated. Many of our decisions are emotionally based and taking care of our immediate emotional state of present self, this often time trumps future self potential needs.

Let’s look at a few simple examples in regards to health that many of us can relate to.

• I go to the fridge for a bed time snack. I can choose an apple or some chocolate cake with ice cream. Present self will be much more satisfied with the decedent taste of the cake and ice cream over the apple. Future self will appreciate the apple as it provides many valuable nutrients to assist in keeping your self healthy long term.
• I get home from work and make dinner, after dinner the decision of what to do comes up. I can go for a walk and get my daily cardiovascular exercise in or begin watching “The Office” on TV. Present self sees the importance and simplicity of sitting and watching the TV program (it is the last season of “The Office”, can you imagine missing an episode during its last season!). Future self would much more appreciate the walk and all the health benefits it provides.

Present self likes to consume things and looks for immediate pleasure and gratification at the least amount of effort. Future self on the other hand is more concerned with health and safety and willing to forgo some instant gratification to ensure that it can enjoy long term health even at the expense of some increased effort. Present self many times will neglect future self due to beliefs that may be inaccurate or rationalize that one time doing it doesn’t make a difference to future self. One piece of chocolate cake while watching the office just this once isn’t really going to make me obese and won’t make me get a serious disease latter in life. While present self is correct that doing something once most often will not have a significant affect on future self, but if present self repeats daily this choice then future self is in trouble. When present self repeats habits that are not good for future self, it walks us down a path of obesity and increasing risk for significant diseases. Pretty soon cake and ice cream is our bed time snack as we watch 4 hours of TV every night, and future self is doomed.

Next week we will look at commitment devices, tools to help future self overcome present self. Also at the potential pitfalls and concerns with commitment devices.

Superman's cape vs. Batman's utility belt

Another guest post on my blog.  Today's post comes from John Rounds, SPT.  John currently is doing one of his eight week clinical rotations with me as part of his final year of Doctor of Physical Therapy schooling through the University of South Dakota.  As with any guest post I want writers to write what they think, not what they think I want them to think, think about that!!!  Enjoy, I like his thinking...

A common theme being displayed among health gurus and marketing agencies is the term "superfood." But what are we really getting with these that we aren't with everyday "regular" healthy foods? Many media outlets have been filling our minds with ideas that by consuming "these 7 foods regularly, you can reduce your look of aging or lose 10 pounds in 10 days." Unfortunately, what holds true for most things that sound too good to be true, so are a lot of these.

Now don't get me wrong, if you are researching "superfood" lists (which I have) you will find apples, oranges, broccoli, avocados, nuts, salmon, etc. But you will also find other items like acai berries, raspberry ketones, mangosteen and noni berries, and supplements such as fish oil. A lot of these foods and supplements also claim to have scientific research backing them. However, the validity behind this research is lacking in practical use.

According to a study published in the Hawaii journal of medicine and public health, it looked at the research backing these "superfoods" and supplements, and discovered that much of the research done was comparing their product to a placebo group, and not revealing the side effects noted by the participants in these studies. Most side effects were minor, with the occasional headache, dizziness, or fatigue being noted; however, one study found in a follow up study, that the amount of the supplement needed to produce the beneficial effects in these commercialized products was leading to hepatotoxicity in some people taking them. This would be reason enough for me to avoid these foods, let alone I can eat an apple for lunch and feel more energized rather than fatigued and not have to worry about getting a headache.

Additionally, on a recent Dr. Oz episode they were pushing raspberry ketones as a "miracle" fat loss supplement. Fortunately, a member of the audience asked why they can't just eat fresh raspberries, and we're answered with, “it will take 90 pounds of raspberry to get the same amount of ketones that you will get in this one small supplemental pill." As far as I know, if it is going to take me 90 pounds of raspberries to get the amount of ketones in these pills, there may be a reason for that. Potentially, that amount of the supplement at one given time may not be healthy.

Thus, if you are looking for that new miracle pill to make you look younger or thinner, it's simple, EAT HEALTHY! Remember the old adage, "an apple a day, keeps the doctor away"? Well, that may be true, but it has been shown to give you just as much if not more energy than a cup of coffee, not to mention, that apples along with most fruits and vegetables actually have negative calories, meaning that you burn more calories eating them, than they actually contain.

Therefore, I return to how I began, "Superman's cape" or "Batman's utility belt." As hard as it is for me to say, as I prefer Superman, in this case I'd go with the "regular" utility belt. Just because these foods have been dubbed "super," there still isn't sufficient scientific evidence that show they are better than a "regular" apple or celery stalk. Essentially, the choice is yours; however, know your choices.

Macronutrient extreme diets may not be healthy.

How our bodies use and store the energy of the calories of the macronutrients (carbohydrates, proteins and fats) we put into it is a complex process. The diet industry has been pretty good at confusing most of us by its use of these complexities to justify their method. We have every end of the spectrum when it comes to diets touting specific diet ratios of these macronutrients to help us lose weight: low-fat/high carbohydrate, low carbohydrate/high protein, low carbohydrate/high fat, etc. They all claim they work and show scientific research they work, how can that be?

With calorie control, most diets will work to lose weight, for a short time. Also some people, no matter what macro nutrient ratio they use can lose weight (hint: it’s not the diet, but the genetics their mom and dad gave them that is working for them). Also remember when most people talk about diet success, they are referring to weight loss. Weight loss is healthy for us, if it is the excess body fat above a healthy range we carry around. But what if I just lost muscle mass? I would be losing weight, but do you see where this is not healthy. So a diet successful in losing weight may not always be healthy for us. Also understand even if we do lose some of the excess storage fat with our diet, it may still not be healthy for us due to increase in other health risk factors.

A recent study in the June 27, 2012 issue of the Journal of Medical Association demonstrated some of the ill health effects of these restriction type diets. Those people on these restriction diets have been found to have increase in heart disease risk factors, chronic inflammatory markers and stress hormone production (none of those are good things if you want to live a long healthy life). Senior author Dr David S Ludwig (New Balance Foundation, Obesity Prevention Center) told heartwire in an interview (this may be some of the best suggestions about diet in just a few sentences I have ever read):

"Extreme restriction of fat or carbs can have bad effects. The best long-term approach will be to avoid restriction of any major nutrient--either fat or carbohydrate--and instead focus on the quality of nutrients. This is not to say that the number of calories isn't important, but it's now saying we should also pay attention to the quality of those calories. So the argument that the food industry likes to make--that all foods can be part of a healthful diet as long as you watch calories--is really misleading at best. Relatively unprocessed, low-glycemic-index foods are best, things that our grandmother would recognize. Choose relatively unprocessed foods whenever you can and cut back on white bread, white rice, potato products, prepared breakfast cereals, and, of course, concentrated sugars."

So as we can see that restriction diets may help us lose weight, but they may be making us unhealthier. What is the proper ratio of macronutrients one should be using? This is going to vary for all of us (again due to that genetic thing mom and dad passed on to you). Typically a general range to start with is 50% carbohydrates, 30% proteins, and 20% fats. But remember each calorie of the macronutrient is not the same. Carbohydrates should come from low glycemic index foods (think the natural stuff not the processed stuff that comes in a box or a bag). Proteins should be from lean sources and from multiple sources (think fish, chicken, turkey, and some red meat). Fats need to be of the monounsaturated, polyunsaturated and Omega 3 fatty acid type, while avoiding the saturated and trans fat types. Then you can play with the ratios “a little” to see if it helps you feel better and get a little better weight control. When we say “a little”, we mean probably no more the 5-10% any one direction with any one macronutrient. Extremes of anything usually are never healthy for us and a diet pushing the macronutrient ratios to extremes are no exception to this simple healthy rule to follow.

Understanding calcium supplementation for bones

Bone health is important to all of us and it gets lots of press and publicity on how to maintain it throughout our life span. Sometimes this info can be confusing to say the least. We know that bones need calcium to stay strong and healthy, as this is one of the primary building blocks to build bones. Bone is a living tissue just like all of your other tissues, so it needs a constant supply of nutrients and activity to keep rebuilding. When we lack these nutrients (such as calcium) and activity we can develop osteoporosis, where your bone mineral density decreases and increases your risk for fractures. Calcium supplementation is a common treatment for this, but it has come under some scrutiny lately because of potential side effects from it. Let’s try to separate the fact from the fiction with some of the reporting that has gone on.

New research has shown potential increased heart attack risk with calcium supplementation. Don’t panic and stop your supplementation just yet, but do read on to understand pro’s and con’s. First lets clarify what you may have read or heard from the press or others. Some reports have gone so far as to say calcium supplementation increases heart attack risk by 50%. While this is true, it is a stretch, realize that heart attack risk in the study went from just over 1% for those that didn’t supplement, to a little over 2% if you do. So the risk is 50% more, but still very small overall. But don’t be fooled in thinking that if you take calcium it will solve all your problems with osteoporosis and fall risk. Some studies show that supplementation only reduces your fall risk by 10%. So taking a calcium supplement helps, just don’t fool yourself to thinking you are out of the woods when it comes to fall risk. Research has been pretty consistent to show that if you get your calcium naturally (milk based products, broccoli, cabbage to name a few good sources) through diet you will get greater benefits and no side effects as to if you get it through supplementation. Another thing research has shown that if you hit your later years low on calcium and bone density it is hard if not almost impossible to catch up. You might slow the decline of bone density loss with improved diet or supplementation, but you are better off getting enough in your younger years then trying to play catch up.

So what’s the take home? If you supplement calcium, do it under a physician’s care to look at benefits and risks for you. Better yet, get enough calcium through a proper diet and start early in life to limit risks of osteoporosis throughout your life. Also don’t forget other things that can help: exercise, don’t smoke, avoid excessive alcohol, have an overall healthy diet and maintain proper weight control. Sounds like good advice for lots of health issues your bones included.

Dark chocolate has benefits, but be careful

A new study shows potential that consumption of dark chocolate could be an effective strategy for prevention of cardiovascular events in high risk patients, due to it’s blood pressure lowering and lipid effects. How cool is that you might be thinking, let’s run out and overload on dark chocolate to prevent a heart attack or stroke. Hold on not so fast my friend!

Just as with any research we need to look at it critically and in context of other research of what we already know. First this study only was found effective for high risk patients, those with metabolic syndrome that were not diabetic. Obviously if you have diabetes you need to control your sugar/carbohydrate intake appropriately and taking extra dark chocolate will probably not help that. Also if you are not a high risk cardiovascular person, the extra dark chocolate will not reduce your risk, so you get no added benefit. Additionally we know that frequent chocolate consumption can lead to increased BMI. That increased BMI has lots of bad health risks involved with it, as you are probably well aware of. This means if you are not a high risk patient then you are getting no added benefit from cardiovascular risk reduction, but you are gaining increased obesity risks. That’s not a good trade off.

Where does this lead us to understand the research better and how to use it? If you are a high risk patient with metabolic syndrome and no diabetes, adding some dark chocolate to your diet may be beneficial. Talk to your doctor about this as a potential strategy to assist your current medical intervention. But remember this study also showed the benefits of dark chocolate were not as profound as drug interventions, so it will not be a substitute for your current treatment. Be aware that you could see increased BMI, so adjust your total diet to make sure you are not adding additional calories with the added dark chocolate. If you are not a high risk patient, enjoying some occasional chocolate is okay, but don’t think it is giving you any added health benefits just some added taste benefits. Remember just as in almost all food choices, enjoy in appropriate moderation for the best health benefits.

Obesity is a chronic inflammatory disease: An evolving paradigm

The following is my first guest post.  Dr. Joseph Gentzel is a recent graduate from USD tDPT program that I do adjunct faculty work for.  He has done extensive study in the area of obesity and chronic diseases, especially related to diet and exercise (you can see why I thought he would have some great insights to share on this blog).  He graciously offered to do a post (after a little begging and pleading with him).  Here it is and you can follow more of his post at his blog Senior Physical Therapist's Blog.

Obesity is a chronic inflammatory disease:
An evolving paradigm

Dr. Joseph B. Gentzel, PT, DPT

With the most recent announcement that by 2030 forty-two percent of us will be obese¹ that translates to 9 out of ten ² of us being overweight or obese by 2030; it is imperative that we dismiss the information cascades that have failed so completely these past 40-50 years. There are many information cascades, but none bigger than the notion that obesity is caused by consuming too many calories in relation to the calories we burn; thus resulting in the deposition of fat stores in our body. Science has documented for us sufficiently that the weight reduction benefits of exercise is not restricted to calories burned³, but to other dramatic physiological changes made to the body’s physiology by a diet low in advanced glycation end products ( AGE poor diet)⁴  and exercise^5,6.

In 2001 Das asked the rhetorical question: Is obesity an inflammatory condition? ⁷ Ronca & Folco⁸ plus many others have indicated via their works how science supports obesity as an inflammatory condition. Calder et all⁴ describe many dietary factors associated with chronic disease inflammation that includes obesity. Roncal-Jimenez et all drive one of the many nails in coffin of the calories in calories out paradigm.⁹ May it rest in peace to never return again. By employing a model that fails so completely, we insure failure in addressing this mammoth public health problem. Failure, by any rational measure, has occurred in dramatic fashion with this paradigm.

Rayssiguier¹⁰ et all note that “studies have been published that implicate subclinical chronic inflammation as an important pathogenic factor in the development of metabolic syndrome”.  With multiple components comprising metabolic syndrome, this is an important point. Metabolic syndrome is comprised of combinations of visceral obesity, dyslipidaemia, hyperglycaemia, and hypertension.¹¹

So what? The clinical picture over these past 10 plus years seems to be clearing up to support that obesity is at least associated with and potentially caused by systemic inflammation. This is inflammation that we can measure with inflammatory markers such a C reactive protein, interleukin 6, possibly tumor necrosis factor, and many others. Being able to quantify the systemic inflammation offers objective measures of the condition and our interventions with same.¹²

This presents some novel approaches to addressing the disease that somehow we always knew worked but never understood how/why and too often got sidetracked by the clutter and noise that has bombarded the scene these past 40-50 years. The Centers for Disease Control and Prevention (CDC) appear to have little understanding of this and continue to apply invalid models. Nowhere is this more glaring that the USDA food pyramid that misses the point as illustrated by its continued advocacy of the toxin sugar¹³ and other nutritional areas that have ignored the science of the past 10 years.¹⁴ The Harvard School of Public Health agrees.¹⁵ The science is in and piling up to lead us away from the old information cascades. Information cascades that need to take their place alongside bloodletting and the like.

Sugar creates inflammation.⁴ Sugar causes injury to kidneys¹⁶, liver⁹, pancreas¹⁷, GI system^4,18,19, and virtually every system in the body. We should therefore not be surprised to find that obesity induced chronic inflammation damages the brain circuits that are involved with reward and feeding behaviors.²⁰

References

1.         Finkelstein EA, Khavjou OA, Thompson H, Trogdon JG, Pan L, Sherry B. Obesity and severe obesity forecasts through 2030. Am J Prev  Med. June 2012;42(6).

2.         Melville K. 9 out of 10 americans obese or overweight by 2030. [ONLINE]. 2008; 29 July, 2008:http://www.scienceagogo.com/news/20080629010344data_trunc_sys.shtml. Accessed May 7, 2012.

3.         Cannon B, Nedergaard J. Thermogenesis challenges the adipostat hypothesis for body-weight control. Proc Nutr Soc. Nov 2009;68(4):401-407.

4.         Calder P, Ahluwalia N, Brouns F, et al. Dietary factors and low-grade inflammation in relation to overweight and obesity. Br J Nutr. Dec 2011;106(Suppl 3):s5-s78.

5.         Kawanishi N, Yano H, Yokogawa Y, Suzuki K. Exercise training inhibits inflammation in adipose tissue via both suppression of macrophage infiltration and acceleration of phenotypic switching from M1 to M2 macrophages in high-fat -diet-induced obese mice. Exerc Immunol Rev. 2010;16:105-118.

6.         Petersen A, Pedersen B. The. anti-inflammatory effect of exercise. J Appl Physiol. Apr 2005;98(4):1154-1162.

7.         Das U. Is obesity an inflammatory condition? Nutrition. Nov-Dec 2001;17(11-12):953-966.

8.         Rocha V, Folco E. Inflammatory concepts of obesity. Int J Inflam. 2011 2011;2011:529061.

9.         Roncal-Jimenez C, Lanaspa M, Rivard C, et al. Sucrose induces fatty liver and pancreatic inflammation in male breeder rats independent of excess energy intake. Metabolism. Sep 2011;60(9):1259-1270.

10.       Rayssiguier Y, Gueux E, Nowacki W, Rock E, Mazur A. High fructose consumption combined iwth low dietary magnesium intake may increase the incidence of the metabolic syndrome by inducing inflammation. Magnes Res. Dec 2006;19(4):237-243.

11.       Alberti K, Zimmet P, Shaw J, IDF_Epidemiology_Task_Force-Consensus_Group. The metabolic syndrome--a new worldwide definition. Lancet. Sep 24-30 2005;366(9491):1059-1062.

12.       Ploeger H, Takken T, Greef Md, Timmons B. The effects of acute and chronic exercise on inflammatory markers in children and adults with a chronic inflammatory disease: a systematic review. Exerc Immunol Rev. 2009;15:6-41.

13.       Johnson R, Sanchez-Lozada L, Nakagawa T. The effect of fructose on renal biology and disease. J am Soc Nephrol. Dec 2010;21(12):2036-2039.

14.       Chiuve S, Willett W. The 2005 food Guide Pyramid: an opportunity lost? Nat Clin Pract Cardiovasc Med. Nov 2007;4(11):610-620.

15.       Willett W, McCullough M. Dietary pattern analysis for the evaluation of dietary guidelines. Asia Pac J Clin Nutr. 2008;17(Suppl 1):75-78.

16.       Nakayama T, Kosugi T, Gersch M, et al. Dietary fructose causes tubulointerstitial injury in the normal rat kidney. Am J Physiol Renal Physiol. Mar 2010;298(12-20).

17.       Ryu S, Ornoy A, Samuni A, Zangen S, Kohen R. Oxidative stress in Cohen diabetic rat model by high-sucrose, low copper diet: inducing pancreatic damage and diabetes. Metabolism. Sep 2008;57(9):1253-1261.

18.       Ding S, Lund P. Role of intestinal inflammation as an early event in obesity and insulin resistance. Curr Opin Clin nutr Metab Care. Jul 2011;14(4):328-333.

19.       Kawada M, Anihiro A, Mizpguchi E. Insights from advances in research of chemically induced experimental models of human inflammatory bowel disease. World J Gastroenterol. 2007;13(42):5581-5593.

20.       Cazettes F, Cohen J, Yau P, Talbot H, Convit A. Obesity-mediated inflammation may damage the brain circuit that regulates food intake. Brain Res. 2011;Feb 10(1373):101-109.

Fast Food done better

Doesn’t it seem like we have less time in a day then when we were younger. Well obviously there is still 24 hours in a day now as there was 30-40 years ago, but how much we try to pack into that time seems to increase as we get older. With more and more responsibilities, obligations and demands onto our day, cooking a healthy meal at home is often not high on the old priority list. Welcome the time saver for this problem – Mr. McDonald’s or Miss Wendy’s or what ever fast food chain we want to throw into the mix to become a staple of many of our diets.

Let’s be honest about the truth of the fast food diet. They are not as healthy or nutritious as the home cooked meal. They have more salt, more calories and are made up of more processed foods with added preservative and flavor enhancers. None of that is good. We all know that it is not the best for us, but what to do when we have the stress of everything else bearing down on us and we need something fast. Well here are some ideas. 

Try to preplan your meals. You know what nights you have a meeting and when the kids have to be at soccer practice or dance. So prepare a home cooked meal ahead of time at home that you can grab and go from home; instead of grabbing and going through the fast food drive-through. Make your own sack meal not one from the fast food joint. When to do this? How about the night before instead of watching “The Biggest Loser” on TV, help yourself to become a biggest loser and make your meals (maybe even with your family help to create some family time together) the night before.

Another thought is just because you are having to drive through to get the meal, doesn’t mean you have to pick the worst item on the board and then supersize it. We can make wise choices; most restaurants have a nutritional guide to help you know how to make the better choice. You might be a little surprised at how many calories and what is in some of your choices. Also some fast food restaurants will be better then others when it comes to nutritional value of what you are taking in.

Another thing, just because the super extra large soda is only a dollar, doesn’t mean that it is the best value for your health. Save the dollar, get some water and add some better nutritional value to your life. And if you just have to have that Coke, maybe you can survive with only a medium size.

Probiotics a good thing?

Over the last few years we are seeing the term “probiotics” being placed on various foods and being touted with many health benefits.  Probiotics refers to live micro-organisms that interact with your existing bacteria in your digestive lining to produce a positive effect on your health, primarily your immune system.

The general research has been very promising that these probiotics can help reduce the length of an illness in people compared to placebo interactions. Those taking the probiotics also showed increase in biological markers for improved immune function. While the results from these early studies are very encouraging, the problem is that every individual strain of probiotic strain has different effects. Currently there is no consensus on which the best are and how much of any of them we need to be the most beneficial. So don’t believe the hype on why you need to buy one type over another. And realize the probiotic effects may be limited, so don’t think overdosing on them is protecting you extra from other poor diet and health practices.  And just taking them in supplement form may do you no good, so it is best to get it in real foods so you at least get the other benefits from a healthy food.

So even though the research is not yet fully complete, it still might be beneficial to incorporate foods like yogurt with live bacterial cultures into your diet. Even if the probiotics don’t do anything for you, you still have eaten a nutritious food that has lots of other good benefits.

Switch part III - Shape the path

We have our riders directed and our elephants motivated; now it is time to shape the path. 

First thing is to tweak the environment. When the situation changes, the behavior changes. So change the situation. The best way to eat more fruits and vegetables is to only have fruits and vegetables in the house to eat. If there are no potato chips in the cupboard you are less likely to eat them at night when you go looking for a snack. Use a smaller plate if portion control is a problem. After making your bed place your bible on top so you have to pick it up before going to bed at night and you’re more likely to spend some time reading it. Don’t have clothes drying on the treadmill so it is easier to get on.

Next step is build habits. Look for ways to encourage habits. Place your work out clothes out on the floor, so when you wake up you step into them and get your daily walk done before the TV goes on. Pre-make healthy lunches and diners; so when you are rushed for time you have a healthy option instead of eating fast food. Use checklists to make sure you have walked 30 minutes at least 5 times each week. While recording your 5 fruits and vegetable servings, have a spot to write down one thing your thankful for each day. Find ways to encourage those habits, workout with a spouse or friend. Post on Facebook everyday what your exercise was or something that you are grateful for. Fill your grocery cart up with fruits and vegetables first then go down the processed food isle.

Last thing is to rally the herd. Behavior is contagious. Help it spread. Get the whole family involved. Get your work unit doing an exercise challenge like Live Healthy Iowa or 10,000 steps per day challenge. Start a healthy recipe exchange with friends on Facebook. Start a small group of friends doing a bible study once a week to help develop an attitude of gratitude.

For things to change, somebody somewhere has to start acting differently. When it comes to your health that somebody is you. Direct the rider, motivate the elephant and shape the path to help you switch into the healthier you.

Switch Part II - Motivate the elephant

Last time we started looking at Chip and Dan Heath’s book entitled “Switch: How to Change Things When Change is Hard” and how it applies to improving our health.

Directing the rider as we talked about last week, usually isn’t hard as most rational people will agree that exercise, a good diet and stress reduction are staples to improving our health. The problem usually arises in motivating the elephant, the emotional side. No matter how smart our rider is, if the elephant doesn’t want to give up potato chips and sitting in front of the TV we are going to have a hard time making a change.

First step to motivate the elephant is finding the feeling. Knowing something is never going to be enough to cause change. You have to feel something for it to stick. How does it feel when it is difficult to get up from a chair? Not be able to climb a flight of stairs without stopping half way to catch your breath? Having to sit and watch your grandkids play and not be able to join in? What did it feel like when you could run a mile? What was it like to not be on 4 or 5 different medications because of health issues you have going on? How much fun would it be to play tag with your grandchildren in the yard? You have to find the feeling of why getting healthier is important to you, knowing you need to get healthier is never going to be enough.

The next thing is to shrink the change. Our emotional elephant can get spooked very easily when the task looks like it is too big to accomplish. We need to break down the change until it no longer spooks the elephant. Walking for 30 minutes seems impossible when you currently can’t walk more then 5 minutes without needing a break. But I can probably walk 6 minutes by the end of next week if I add 10 seconds every day. If I did that every week, in 6 months I would be walking for 30 minutes. Adding six helpings of fruits and vegetables is a lot when I’m lucky to get in one. But I can go from one to two for a month, keeping adding one per month and in less then 6 months I am where I want to be.

The last thing is to grow your people. This means to cultivate a sense of identity and instill a growth mind-set. People with a growth mind-set see their abilities are like muscles that can grow and change, fixed mind-set people passively accept status quo and don’t challenge it. A growth mind-set individual recognizes that failure is a natural part of the change process not a sign of overall defeat. The challenges now are the price for the pay off later as time goes by working toward success. A growth mind-set can be taught and practice is the key because everything is hard before it becomes easy.

The last thing we will discuss next week is shaping the path for the rider and elephant.

Switch - Getting to a healthier you

Chip and Dan Heath wrote a wonderful book entitled “Switch: How to Change Things When Change is Hard”. It looks at ways to try and help us make changes. And most of us will agree change can be hard.  Many of us can improve our health with some changes to our lifestyle and habits, but often times these changes may be hard. Let’s look at applying principles of the book to improving health.

They point out that each us has an emotional side and a rational side. These two parts of our brains thinking are sometimes referred to the rider (rational) and the elephant (emotional). The rider can steer the elephant, but if the elephant wants to go somewhere else it can always overpower the rider. In order to be successful in changing things you have to reach both and clear a path for them to succeed. In short you have to “Direct the Rider”, “Motivate the Elephant” and “Shape the Path”.

Directing the rider isn’t to difficult because most rational people know that better eating, more exercise and controlling our stress is healthy for us. But here are a few things to help the rider.

First when it comes to directing the rider look for bright spots. Investigate times in your past that you may have been a little healthier with better diet, exercise and stress reduction. What was going on then and then clone it. Did you eat better because you ate home cooked meals instead of fast food? But now as the kids got older and you are taxing them to and from places it is easier to drive through for dinner? Maybe make your meals ahead of time so you can do the drive through at your own house. Did you exercise more because it seemed like you had more time? With the business of life, finding time is often times difficult. Maybe create a half hour of time by cutting out a half hour of TV each night.
Another technique to direct the rider is by scripting the critical moves. Don’t think in terms of the big picture (eat healthier, get more exercise, reduce my stress), think in terms of specific behaviors. Think eat one fruit for breakfast each day, two vegetables for lunch and half of my plate at dinner should be fruits and vegetables. Think no more chips and cookies for snacks only fruits and vegetables. Think walk 30 minutes every night with my spouse instead of TV. Think lift some weights on Tuesday and Thursday. Think spend 10 minutes each night before bed doing some meditation and relaxation breathing.

The last point for directing the rider is point to the destination. Change is easier when you know where you are going and why it’s worth it. I will be eating 4-5 servings of fruits and vegetables every day and my cholesterol will be under 200 in 6 months, so I can get off cholesterol medication. I will be walking for 30 minutes each night, so I have energy and endurance to play with my grandchildren.

Next time will discuss motivating the elephant.

Water or Sports Drinks?

When we are exercising or doing physical activity there is much debate and confusion over how much hydration we need.

The sports drink industry has gradually convinced us over the recent years that we need to replace all of the fluids, carbohydrates and salts that we are depleting with exercise. Much of the research that these claims are built off was done on people that were depleted of these things prior to starting their exercise and then exercised at maximum levels. Most of us don’t deplete our stores of fluids, carbohydrates and salts before exercise. We drink fluids through out the day, we eat foods that keep us loaded with a reserve of carbohydrates and the American diet usually is never lacking for salts. On top of that, when we are at the gym or home doing some exercise or activity we are not at top high level athlete intensity and trying to run the Boston Marathon or racing the Tour de France.

So what and how much do I need to drink when exercising? If you are an average person working out at the gym for an hour or less, there is no need to drink anything other than water. And that is only if you feel thirsty. If you like the sports drinks because they taste better, then choose one with a small amount of carbohydrates (3% or less). Drinking those extra calories can lead to weight gain if not controlled properly. All the other high tech additives that claim to perk you up, metabolize your energy, improve your focus and enhance your immune system that are added will do none of what they claim, so don’t waist your money based on the claims.

If you are a high intensity exerciser and your event lasts longer then an hour or two then consuming some carbohydrates (no more then 6%) and electrolytes may be needed. It is important to drink to thirst and not force yourself to drink if you are not thirsty as drinking to much can lead to low sodium balance called hyponatremia. No more then 8 ounces every 20 minutes is the current recommendation again that is only if you are thirsty.

Healthy eating can help make a happier you

Having a bag of potato chips or large bowl of ice cream to help us cope with stress may not be as beneficial as we often think. For many people when they feel depressed or anxious out by life events they often turn to comfort foods such as candy, potato chips or other junk foods. These foods may give an impression of comfort initially, but new research is showing that they are actually leading to more mental health issues such as anxiety and depression.

Felice Jacka, PhD and colleagues from Deakin University and the University of Melbourne in Australia found that better diet quality is associated with better mental health. Those individuals with better diet associated with better mental health in those that they studied. Also when following them over a two year period they noticed that those that improved their diet also saw improvements in their mental health, while those whose diet worsened saw their mental health get worse as well.

This better diet as recognized by this study included 2 or more servings of fruits and 4 or more servings of vegetables whole grains and high-quality meat and fish, along with general avoidance of processed foods including chips, fried foods, chocolate, sweets and ice cream. They found individuals with better quality diets were less likely to be depressed, whereas a higher intake of processed and unhealthy foods was associated with increased anxiety.

Depression and anxiety are very complicated disorders and research has not shown specifically that they can be solved with simple diet changes alone. But an improvement in your diet might help you on your road to improved mental health.