Tag Archives: healthy-living

The five pillars of good health

What does it really take to live a healthy lifestyle? This is the topic of me Health & Fitness column in the Aiken Standard this week.


Confusing and conflicting information can make improving your health especially challenging. Some advice is straightforward—quit smoking, for example. But other recommendations, especially those regarding nutrition and exercise, are less clear. In an effort to stay focused on the “big picture” I have created what I call the Five Pillars of Good Health. These are five habits that are the basis for achieving and maintaining good health.

Don’t Smoke.

Smoking doubles your risk of heart attack and stroke and is the leading cause of lung cancer. Second-hand smoke can affect the health of others, so these risks are not limited to the smoker.

If you smoke, quit now…no excuses! Newer prescription medications and over-the-counter nicotine replacement products can help, but quitting will require dedication, effort, and support.

Eat Smart.

Good nutrition is essential for preventing and treating most chronic diseases including obesity, diabetes, and heart disease. Perhaps the best way to cut through the conflicting nutrition information and diet claims is to simplify healthy eating to it’s most basic form: Eat real food, not processed “food.”

This isn’t easy, of course. One sure way to make better choices is to limit added sugars and salt, which are almost always present in processed foods. Strive to eat more whole fruits and fruit juices, vegetables, whole grains, legumes (like beans), lean meat, dairy, and nuts. If weight loss is a goal for you, reducing portion sizes will absolutely help you cut calories.

Move More.

This is a three-step process. First, sit less. Limit sedentary time at work and home and make opportunities to get up and move. The health effects of prolonged sitting are similar to not exercising. If you find yourself in stuck a chair for an hour, at least get up and stretch for a minute.

Second, move more. Look for ways to add activity to your everyday routine. This can include yard work and house work as well as using the stairs and parking further away in parking lots. Every additional step counts!

Third, dedicate time to be active every day. This can include activity such as taking the dog for walk as well as more structured exercise that includes endurance, resistance, and flexibility training. Strive for 30 minutes per day, but know that more is better.

Chill Out.

Chronic stress can have a powerful effect on your health. While it is not possible to eliminate all stress from your life, you should dedicate yourself to identifying and modifying sources of stress at work and home and learning to control your stress response.

Much of the stress of life comes down to not having enough time. Good time management, planning carefully, and setting priorities will certainly help reduce both long and short-term stress. You should also know that inadequate sleep adds to the health effects of stress, so strive to get enough sleep.

Make It Work For You.

This is the tricky part—how to actually make these changes. The first step is to make good health a priority and dedicate time and energy to your efforts. No doubt you have tried some of these changes before, you probably have an idea of what does and doesn’t work for you. Try something different this time around. The support of others is essential, so don’t be afraid to ask for help. Get your friends and family involved, too. They will certainly benefit from joining you on your journey toward better health.

 

 

 

Not sure where to begin to improve your health? A guide to taking the first step

If you are thinking about losing weight, becoming more active, or quitting smoking you are not alone. These are three of the most common health-related New Year’s resolutions. Considering that two-thirds of American adults are overweight, about half don’t meet minimum recommendations for physical activity, and one in five smoke, there are many people who need to change more than one of these behaviors.

Quitting smoking and changing eating and exercise habits to lose weight or improve fitness are among the most difficult behavior changes to make, especially at the same time. Some people focus on one change to begin with.

Obviously, changing all three of these behaviors is ideal, but if you are only willing to change one, which should you take on first to have the biggest impact on your overall health? This is the topic of my Health & Fitness column in the Aiken Standard this week.

You might think that quitting smoking would be the most important change to make initially. Smoking is the primary cause of lung cancer and other respiratory diseases such as emphysema and chronic bronchitis. Smoking also increases the risk of most other cancers and is a major contributor to heart attacks and strokes. Quitting smoking greatly reduces these risks with beneficial changes that begin within days of quitting. Despite this, if you only want to change one behavior, smoking isn’t the place to start.

Being overweight is a leading cause of diabetes, high blood pressure, heart disease, and some cancers. If you are overweight, losing just 10% of your body weight (20 lbs. for a 200 lb. person) can significantly reduce the severity of these conditions. Maintaining a healthy body weight can prevent many of these health problems. However, losing weight is not the first change you should make.

It turns out that becoming physically active is the most important change you can make to improve your overall health. Decades of research show that regular physical activity reduces the risk of most chronic diseases including diabetes, heart disease, and some cancers and can extend the lifespan by up to five years. In fact, the health risks of inactivity are equal to or greater than that of obesity or smoking. Regular activity also improves muscular strength, aerobic fitness, bone density, cognitive function, and memory. There is no other single intervention—drugs included—that has as many health benefits.

Research also shows that the negative health effects of being overweight and obesity are, in part, caused by inactivity and poor fitness. If you are overweight but physically fit, your risk of death is lower than if you are at a “healthy” weight but unfit. Regular exercise can reduce the risk of diabetes in people who are overweight, whether they lose weight or not. Furthermore, studies of “successful losers” show that daily exercise is a requirement for long-term weight loss, so becoming active now can help you lose weight later.

You should change all three of these behaviors to achieve optimal health. But if you are looking for an initial step that will have the biggest impact, start by becoming more active. A good initial goal is to reduce the time you spend being sedentary (sitting) and to get a minimum of 30 minutes of moderate-intensity activity, such as a brisk walk, each day. You can get greater benefits by participating in more intense exercise, including strength training, three or more days per week. And once you have established a routine of regular activity you will be ready to make other health changes.

Advice for staying healthy for the holidays

Now that Thanksgiving is behind us, the holiday season is in full swing. At the same time, though, we are in the midst of cold and flu season. In addition to the natural spread of cold and flu viruses at this time of year, the holiday season itself, with hectic schedules, stress, and lack of sleep, can weaken your immune system making you more susceptible to getting sick.

The good news is that there is much you can do to keep yourself healthy for the holidays. This is the topic of my Health & Fitness column in the Aiken Standard this week.

For starters, getting a flu vaccine is the most sensible thing you can do to prevent seasonal influenza (flu). If you haven’t gotten your flu shot yet, it’s not too late. I have written about flu previously, including the fact that exercise may make your flu vaccine even more effective!

Another basic step in preventing sickness is to wash your hands regularly. Soap and water is best, and there is no additional benefit in using an antibacterial soap. If you can’t wash your hands, an alcohol-based hand sanitizer is an acceptable alternative. Keep in mind that hand sanitizers don’t actually clean your hands and aren’t as effective if your hands are dirty.

Cold and flu viruses are spread through the air when an infected person coughs or sneezes, so avoiding close contact with people who are sick is important. If you are sick, you should stay away from others as much as you can. Cover your mouth and nose with a tissue or cough or sneeze onto your sleeve to help keep the germs from spreading through the air or on your hands.

You can also be exposed to cold and flu viruses by touching something with virus on it (a doorknob, for example) and then touching your nose, mouth, or eyes. You can protect yourself by not touching your face and by washing your hands frequently.

People who participate in moderate exercise on a daily basis have fewer and less severe colds than people who aren’t regularly active. This is because exercise has the effect of stimulating the immune system, making it better able to respond when you are exposed to cold or flu viruses.

More exercise isn’t always better, though. Research shows that immune function is depressed in the weeks after running a marathon, leading to an increased risk of becoming sick. Athletes who engage in vigorous and prolonged training also tend to be more susceptible to upper respiratory infections. The bottom line is that regular exercise improves your immune system, but very vigorous exercise may not.

Good nutrition is also essential for optimal immune system function. Deficiencies of certain nutrients can have a negative effect on immune function, so eating a balanced diet is essential. That said, there is no support for “boosting” the immune system by taking high doses of vitamins, minerals, or other supplements, despite the claims made by supplement companies.

You can get benefits from two more common-sense recommendations: getting adequate sleep and reducing stress. Poor sleep habits are associated with suppressed immunity and more frequent illness. High levels of stress increase susceptibility to colds and flu and can lead to more sick days from work or school. Stress and poor sleep habits tend to occur together, creating a double negative effect on the immune system.

By taking these steps, you can improve your chances of celebrating the holidays in good health. As a bonus, eating a healthy diet, exercising every day, managing your stress, and getting enough sleep will give you a head start on what are likely to be New Year’s resolutions.

 

 

Why turning off your phone is so hard, and what it means for losing weight

I had an interesting conversation with one of my students recently about making a behavior change. It brought up a good point. So good, I wrote about it in my Health & Fitness column in the Aiken Standard this week.


One of the courses I am teaching right now is Health & Behavior Change. In it we identify the major factors that contribute to chronic disease and discuss how to modify them to improve health. Throughout the course, the emphasis is on health behaviors and how to change them for the better.

For example, smoking is among the most difficult health-related behaviors to change. Obviously, there is the addictive nature of nicotine that makes smoking cessation challenging. Beyond the drug effect, smoking also has a behavioral component. This includes what a smoker does first thing in the morning, after a meal, or on a work break as well as the act of holding a cigarette in his or her hand. Add to that the social aspects of smoking, including the influence of friends and family members, and it is easy to understand why it is a difficult habit to break.

This same principle applies to other health behaviors, including eating and activity. Like smoking, what we eat and our activity level are complex behaviors that are difficult to change. Because of this, losing weight can be as difficult as quitting smoking for similar biological and behavioral reasons. We think of weight loss as being about a diet or exercise program, but it’s really about changing behaviors and habits.

his is a difficult concept to teach, so I have my students learn through experience. Since almost all of my students are non-smokers and most are active and at a healthy body weight, I have them complete a project in which they change some other behavior. They are responsible for identifying a behavior that has a negative effect on their life, coming up with a plan to change it, and embarking on a four-week behavior change experience.

One student wanted to change her social media habits. As a compulsive social media user, she spent more hours than she realized checking, posting, and commenting on Facebook, Twitter, and other sites. Her goal was to limit her social media time so that it didn’t interfere with classes or studying. One of the steps she took was to turn off the notifications that alerted her to new activity. This was helpful, but she still found the habit of checking her phone hard to break.

In a conversation, she noted that the one thing that would help more than anything else would be to switch her phone off during the day. This way she would have her phone if she needed it, but it wouldn’t be so easy, or tempting, to use it. Despite knowing the most effective strategy—the one thing—that would help her, she never did it.

I thought this was an excellent example of something that is common in making health behavior changes. In many cases, people probably know the one thing they need to do to be successful but for a host of reasons, they don’t do it. This may lead people to make other changes that aren’t nearly as helpful. While even the smallest behavior modifications can help, successfully losing weight or quitting smoking really does require making big changes.

This goes a long way in explaining why quitting smoking, losing weight, and changing eating and activity behaviors can be so difficult, even when people know what they need to do. There is no easy solution for this problem, but finding someone to hold you accountable for making the necessary changes and sticking to them is a good start.

When it comes to your health, don’t take the high road.

When faced with challenging moral or ethical situations we are advised to do what is right, even if it is more difficult. “Taking the high road” is often synonymous with living a better life. When it comes to your health, though, taking the high road may lead you on a path to chronic disease, disability, and early death.

The high road I am referring to in this case has nothing to do with ethical decisions. It has to do with test results, specifically measurements your doctor makes of your weight and blood pressure as well as blood tests of cholesterol and glucose. This is the topic of my Health & Fitness column in the Aiken Standard this week.

These tests are indicators of your current health as well as risks to your health in the future. The results of these measures are used to classify you as having “normal” or “high” blood pressure, blood glucose, and blood cholesterol. For example, a fasting blood glucose between 70–100 mg/dl is normal but you are considered to have diabetes if your result is 126 mg/dl or higher.

Even if your blood glucose is above normal (100–125 mg/dl) but isn’t high enough for you to be classified as diabetic, it may still be too high. This condition is called prediabetes because without intervention most people in this category will eventually develop diabetes.

Considering that diabetes is a leading cause of heart attacks, blindness, and amputations, preventing your blood glucose from increasing should be a high priority.

The same is true for other measurements including blood pressure and body mass index (BMI), the most common assessment of obesity. Even if you aren’t considered obese or don’t have hypertension, the higher your BMI or blood pressure becomes puts you at increased risk of the condition getting worse over time or leading to other more serious health problems.

In fact, even within the normal range, a higher value is associated with increased health risks. Take blood cholesterol for example, where the risk of heart disease increases at total cholesterol levels above 150 mg/dl, well within the “normal” range of less than 200 mg/dl. At even higher levels, total cholesterol is associated with a much greater risk.

Clearly, having a high BMI, blood pressure, blood glucose, or cholesterol is concerning. But it is important not to be fooled into thinking that a value that is technically below the diagnostic criteria for “abnormal” is necessarily “normal.” For many, even slightly elevated levels of these variables now are likely to get worse over time.

The good news is that modest lifestyle changes including weight loss, regular moderate physical activity, and changes to what you eat can prevent conditions like prediabetes and prehypertension from getting worse. This can be achieved through losing as little as 10 pounds, walking or doing other activity for 30 minutes per day, and adding more fruits and vegetables to your diet.

To be sure, taking the “high road” with BMI, blood pressure, cholesterol, and glucose, even if your test results are within the normal range, can put you at increased health risk. For these conditions, you are far better off taking the low road and making the necessary lifestyle changes to stay there.

The diet wars continue

If you are confused or frustrated by the conflicting claims about whether a low-fat or low-carbohydrate diet is the best, you are forgiven. First we were told that eating a low-fat diet was the best way to lose weight and improve heart health. Then, research suggested that low-carbohydrate diets were better. And back and forth it has gone for years.

During this time, the prevailing recommendations have suggested that a diet low in fat and high in carbohydrates was best. But more and more research has supported the notion that cutting carbohydrates, not fat, would lead to greater weight loss. Although this has been supported by some research, critics pointed out that eating more fat would raise blood cholesterol and other risks for heart disease.

According to a recent study, though, low-carbohydrate diets seem to have benefits for promoting weight loss and improving some indicators of heart health over low-fat diets. But you should hold off on shunning fruits and vegetables in favor of cheeseburgers! Here is a practical interpretation of the research and some common sense recommendations, taken from my Health & Fitness column in the Aiken Standard this week.

The study, published last week in the Annals of Internal Medicine, reported on 150 men and women who either restricted the amount of carbohydrates or fat they ate. After one year, the group that ate a low carbohydrate diet lost over 7 pounds more than the subjects on the low-fat diet. Additionally, the low-carbohydrate diet promoted greater improvements in blood lipids than the low-fat diet.

This is important for two reasons. First, this wasn’t a weight loss study; the researchers were simply following the subjects to see what would happen as they followed either diet. The fact that the low-carbohydrate group lost more weight suggests that it is relatively easier to cut calories following this type of diet.

This is consistent with other research showing that eating more carbohydrates, especially refined carbohydrates and sugar, can actually make people feel hungrier and eat more. Indeed, other studies have shown low-carbohydrate diets to be more effective for weight loss than low-fat diets (although a more recent study suggests there isn’t such a difference).

Second, the greater decrease in triglycerides and “bad” LDL cholesterol and increase in “good” HDL cholesterol in the low-carbohydrate group were different from what might be expected. Conventional wisdom holds that a low-fat diet should have a greater effect on blood lipids. Since weight loss can have a big effect on blood lipids, the improvement in the low-carbohydrate group may be due to losing more weight, not a direct effect of the diet.

It is important to note that the low-fat diet also led to weight loss in this and numerous other studies. The critical component of any weight loss diet is that it is relatively low in calories, regardless of what nutrients supply those calories. Really, almost any diet will lead to weight loss as long as it contains less energy than what is expended, but a low-carbohydrate diet may be more effective for weight loss than the traditional low-fat diet.

The bottom line is that the best diet is one that emphasizes eating wholesome foods, not on cutting carbohydrates or fat. That said, limiting carbohydrates in the form of refined grains and added sugar is an excellent way to reduce calorie intake and improve the overall nutritional value of what you eat. And shifting toward more monounsaturated fats (think olive oil and nuts) rather than worrying about the total amount of fat you eat is also a good idea.

Mindfulness matters for health.

According to a TIME magazine cover article from earlier this year, we are in the midst of a “mindful revolution.” Beyond being a trendy topic, mindfulness is important for making meaningful and lasting health behavior changes. This is the topic of my Health & Fitness column in the Aiken Standard this week. 


Mindfulness can be described as an awareness of thoughts, feelings, bodily sensations, and the surrounding environment. This is most commonly explored through mindful meditation, a practice that is credited with improving physical and mental health. Beyond meditation, being mindful can help to improve attention and focus in nearly every aspect of life.

 

Thinking about your actions and the effect they have on your health and the health of others can be good for you and those around you. It turns out that we engage in many health behaviors that are driven more by habit than conscious decision-making. This includes what, when, and how much we eat as well as how active we are, two of the most important determinants of health.

 

When was the last time you thought about what you were eating? Not just which restaurant to go to or what time to eat, but really thought about what and how much you ate? Chances are, at least some of the time you eat when you aren’t hungry or keep eating even when you are full. You probably also eat foods you know you shouldn’t or don’t intend to, sometimes without even realizing it.

 

This concept was explored in depth by Brian Wansink in the 2006 book, Mindless Eating. Based on his research, this book helped to explain the hidden reasons behind what, why, and how much we eat, often without being aware of it. This includes marketing tricks as well as environmental factors, many of which operate outside of our consciousness, that drive our food choices and prompt us to eat. 

 

This is where mindfulness comes in. By making an effort to be cognizant about your own thoughts and sensations as well as the environment you are in, you can prevent overeating and poor food choices.

 

Furthermore, we should be aware of how our food choices influence others around us. Research shows that children of parents who eat more fruits and vegetables tend to eat more of these foods than kids without such influence. Mindful eating includes accounting for how our actions and choices can influence the decisions of other family members and friends.

 

 

The same is true for how active or sedentary we are. Being active is a choice, sometimes a difficult one, that is influenced by other people and the environment. Most people spend the majority of the day sitting at work and at home, often without thinking about it. This sedentary lifestyle has been linked to an increased risk of obesity and heart disease, so it is relevant.

 

 

Sure, it feels good to sit on the couch to watch television. Think about it: is that really the best way to spend your time? At work, taking short breaks to get up from your desk and move can make you feel more alert and energized. Isn’t that worth it?

 

 

Similar to eating, our activity choices can influence the actions of those around us. A suggestion to walk to lunch can increase your own activity and that of your friends. Planning to go for a walk or bike ride with your family after dinner is a great way to share the benefits of activity.

 

 

When it comes to health, mindfulness matters. Being mindful about what you eat and make a choice to be more active allows you to have a positive effect on your health and the health of those around you.