Category Archives: Healthier Together

Healthier Together Series: 7C. Relaxation & Sleep – Allow Sleep with Sleep Training

Posted on May 8, 2020 | 1 comment

Bud Winter was one of the greatest Track and Field coaches who developed world class sprinters who competed globally and broke world records. How does a coach produce 37 world record holders, 27 Olympians, facilitate 3 NCAA championships and produce 49 NCAA records? Among with his athletic coaching skills, he helped his athletes master meaningful relaxation and sleep.

It all started in World War II, when he developed a relaxation and sleep training technique that allowed naval pilot cadets to be able to fall asleep within 2 minutes, in broad daylight, sitting upright wherever they landed, surrounded by the sounds of war. After 6 weeks of training, the relaxation and sleep training program demonstrated success in 96% of the cadets.

For those who have heard me speak or who are patients of mine, you know about this and you may have already begun your training. Here’s what you need to know.

  • Every human has the ability to learn how to completely relax the mind and body. However, you may find it takes regular practice before you can appreciate how effective this is.
  • True barriers to sleep:
    • If you believe you can’t or won’t sleep, you won’t.
    • If you move or think about activities or negative thoughts, you will need to settle down to sleep.
    • Certain medications, supplements, drugs, and alcohol can interfere with your mind’s ability to get restful sleep.
    • Untreated sleep apnea.
  • When you can completely relax your body and then clear your mind for 10 seconds, you will automatically drift off to sleep if you need it.
  • Steps to learning to completely relax your body:
    1. Get in a comfortable position, seated or laying down and begin deep belly breathing. Slow down your breathing.
    2. Begin progressive relaxation from your forehead and scalp. Begin by relaxing the muscles so that all the forehead wrinkles release. Breathe slow and steady.
    3. Move down to releasing your jaw muscles, the muscles around your eyebrows and eyes. Let your eyes get limp.
    4. Continue releasing the face, lips and mouth muscles.
    5. Breathe slow and steady as you work your way down your body, progressively relaxing each part of your body until you have relaxed down to your toes.
  • If you want to sleep, after you are completely relaxed, you will then train your mind to be blank for 10 seconds. Bud winter recommends multiple ways to do this like visualizing laying in a canoe on a still lake, staring up at the sky or repeating simple words.

What’s so wonderful about this is, to know what’s possible. It’s possible for almost anyone to learn to completely relax the body AND to be able to fall asleep within a few minutes, no matter how stressful the awake hours might be.

We know the importance of relaxation and sleep on overall health and well-being, but also on performance. The world’s best athletes have learned how to relax completely between moments of competitive, intense focus, and they know how to get restful sleep. In the past, this training was available only to some. Now, we can all learn and benefit. Anyone who wants to, who practices, can and will be able to master this. I have seen the this work for children, adolescents and adults of all ages, for those who are already high achievers, those who are struggling and those who are just looking to acquire more tools for self care.

Allow yourself time for rest and sleep. Then, use that opportunity to master the ability to completely relax your body and be able to drift off to sleep whenever you need it. After you have mastered relaxation and sleep, you can tap into your best self. Think about the possibilities.

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Posted in Habits & Behavior Change, Healthier Together, relaxation, sleep

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Healthier Together Series: 7A. Nutrition – The importance of calories in

Posted on July 21, 2019 | Leave a comment

hessam-hojati-M4hazNIyTsk-unsplashWe’ve heard that weight is all about the calories we consume. In fact, someone recently shared with me that she felt betrayed. She had been successfully losing weight eating very low carb, and had not been counting or restricting calories. She had been feeling so happy about her progress and how easy it was and how she had so much more energy that she had now been regularly working out for over 2 years. However, she recently heard that eating very low carb or “keto” was effective for weight loss because it cuts calories. This whole time, she thought it was being low carb that worked, not the calorie restriction. She felt “tricked.” Have you heard this too?

Allow me to clarify. If you are eating carbohydrates and your waistline is enlarging or you are gaining excess weight or you have prediabetes or diabetes or PCOS or metabolic syndrome, you have insulin resistance. Insulin resistance means that your body produces excessive amounts of insulin for the same amount of carbohydrates you consume. So, if you eat carbs, your body dumps too much insulin into your blood stream.

High levels of insulin prevent your body from being able to access your back up fuel source – your fat cells. You will not be able to get fuel from your fat cells. This means that when you need fuel, you will need to provide fuel, to run your body, by eating or drinking it. You know the feeling- you will be hungry or get the munchies when your fuel in your blood stream starts dropping low. Again, you have to eat or drink calories the have the fuel to continue to run your body. If you don’t eat and your insulin level is high, you don’t have access to your back up fuel source, so your cells begin to panic. You get hungry, ravenous and feel your blood sugar dropping and feel very unwell. Eating or drinking carbs (including sugars) is the fastest way to “feel better” in this scenario.

Now, let’s go on the “common” diet of cutting calories or portion size. If you started out eating a standard American diet with lots of carbohydrates and then begin calorie restriction, or cutting calories or eating smaller portions, it usually means you cut back on the fats and eat mostly carbohydrates. Carbs spike insulin. This means you keep insulin pretty high and as a result, you starve those poor cells in your body. Your body doesn’t like starving, so it adapts and starts to cut back on its activities and slows your metabolism to “conserve” your limited energy. With this method of weight loss, weight loss is very difficult to maintain unless you continue to add more exercise and/or continue to cut calories. There’s a limit to how far you can go with this.

When someone pursues a very low carb or ketogenic diet, your body adapts to running on the ketones produced from burning your fat stores (it continues to make glucose too). Good news, ketones act as a natural appetite suppressant- so you don’t need to eat as much or as often. You just aren’t that hungry because with this method, your insulin levels stay lower. When insulin is lower, your body can burn fat for fuel when it needs fuel (burning fat for fuel instead of requiring eating for chronic re-fueling). Also, by eating a very low carb or ketogenic diet, your brain and gut can receive the signals that you are “full” when you eat fat and protein.

Ultimately, by keeping insulin levels in the naturally lower range, when you need fuel, you can easily burn fat for fuel, your appetite is decreased overall, and your brain and gut can receive signals and know when to stop eating. Voila! Less calories in, but it is because you don’t need or want them- NOT because you artificially put your body into a starving panic mode. VERY different reason for less calories in. VERY different body response to less calories in. Long term weight loss and weight loss maintenance is achievable. Pretty cool, right?

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Healthier Together Series: 6D. Putting it all together – Organizing Your Day For Productivity & Success

Posted on July 12, 2019 | Leave a comment

hannah-olinger-NXiIVnzBwZ8-unsplashToday, we are finishing up our 6th series. You have all the tools and knowledge to make the choices to optimize your health. How do you make it all happen? Here’s how to set yourself up for success. Make adaptations to make it your own. Here’s the basics.

Once a week:

  1. Review what happened last week. Make notes about what you learned, what you need to do, what has to be carried over from last week. Are you making decisions that align with your mission statement and your values?
  2. Brain Dump. Make a list of everything on your mind, everything you need to do, everything you are worried about, anything that is taking up mental space. Empty the brain of distracting thoughts.
  3. Prioritize your goals for the week. What do you need to accomplish this week? Include your goals for nutrition, physical activity, sleep and relaxation as well as any social goals.
  4. Develop action items, or next steps towards achieving those goals. Prioritize them or mark the most important ones so you work on those first. Also, it helps to have  a list of action items that are take less than 10 minutes to complete so that you can easily complete those tasks when you have sudden open moments like when a meeting ends early or you find yourself waiting for an appointment.
  5. Next to each action item, it helps make some notation or color code it to indicate a location. For example, some actions require you to be at your computer (sending an email or creating a powerpoint or editing a document) or at home (pack for trip).
  6. Review your calendar for the week ahead and fill in any of the necessary appointments or usual activities and block out those times. Account for every hour of every day. Remember to include your commute times, food prep, eating, shower, workouts, relaxation times, sleep times, etc. There are 24 hours in a day and remember that you cannot be in 2 places at the same time.
  7. Now you see how much of your week is open for discretionary time. Find the largest blocks of time and block those for your most important projects or creative activities so you can do a dive deep into them. Fill in the smaller chunks of time with errands and To Do’s that don’t require much thought or creativity but take up some of your time.

At this time, you likely have a brain dump list, a prioritized list of goals, a prioritized list of action items with locations and a prioritized list of “10 minutes or less” tasks.

Daily:

  1. At the end of your day, review your day (see #10 below) and then review the weekly calendar for tomorrow. Make sure you have carved out enough time for a bedtime routine and sleep and personal hygiene. Review your list of remaining action items and “10 minutes or less” tasks. Determine which of those items and tasks need to make it onto your calendar- pick the most important ones first. Print out or write your schedule for the day with action items and tasks.
  2. Figure out your foods and drinks for tomorrow and prepare or plan for optimal nutrition. If you are going to eat out, make a plan for what you will have. If you are monitoring or logging your foods, you could enter in what you plan to eat or drink and review the nutrients and macros of your planned foods and drinks. This allows you to make modifications.
  3. Confirm your physical activity plan for tomorrow based on your body state, your schedule and time available. If you drank alcohol, your body will benefit by some exercise tomorrow morning.
  4. Identify a pocket of time for self care and self reflection – whatever will be best for you. Some days, your physical activity plan may also include self care and self reflection.
  5. In the morning, follow your healthy morning routine and check in with your personal mission statement, your goals and your day calendar. Avoid checking email or social media when you wake up. This is to prevent other people or outside demands from taking control of your mind and mood so early in the morning.
  6. Start your day in control and do what’s best for you.
  7. Use your calendar and lists to help you maximize your accomplishments during the day. This will save you from spending time trying to figure out what to do with your time.
  8. If you happen to have an unexpected time that’s open, make a choice to move around, listen to music, draw, sit in nature, meditate or work on your “10 minutes or less” tasks.
  9. Cross off the items or tasks as you accomplish them throughout the day. It feels so good to do that! Write in anything extra you complete or any alterations to your schedule so that you have a log of how you spent your time.
  10. At the end of the day, review your day. Look for patterns and learn from your day. Over time, you may identify patterns of your best, most productive times of the day, or that some things take longer than others, or that other items on your calendar are constantly skipped and may not be a true priority for you.

***Share your wisdom in the comments below.***

Photo by Hannah Olinger on Unsplash

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Healthier Together Series: Cycle 6C. Relaxation & Sleep – Focus your mind, Relax your body

Posted on July 1, 2019 | Leave a comment

camilo-jimenez-mUCnQpBZzXA-unsplashWant to learn how to immediately relax your body and focus your mind when your fight or flight response has been triggered – Naturally- without drugs or medications?

Let me introduce you to the Quieting Reflex, developed by Charles F. Strobel.

  1. Breathe in deeply so that your belly rises first when you breathe in (breathing from your diaphragm) and say to yourself, “Alert, amused mind.”
  2.  Breathe out through your mouth, saying to yourself, “Calm body, ” as you release the tension in your jaw.
  3. Let the tension flow out through your arms and smile inwardly to yourself.

If you practice this now, your mind can learn to respond automatically and become alert, while your body will relax. Then, you will be able to use this when you really need it – when you are overwhelmed, stressed or anxious and you need your mind to be sharp and focused.

Stroebel, Charles F., MD. QT – The Quieting Reflex. NY: Berkley Books, 1967, pp 110-112

Photo by camilo jimenez on Unsplash

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Posted in Healthier Together, performance, relaxation

Healthier Together Series: Cycle 6B. Physical Activity – 3 Steps to Developing a Daily Exercise Habit

Posted on July 29, 2018 | Leave a comment

You know you should exercise. You want to exercise. You have a gym membership. You have cute workout clothes. But…You haven’t slept well, so you need to get that extra half hour of sleep in the morning, so your workout doesn’t happen in the morning…You plan to work out later that day but then traffic was bad/work was brutal and you are exhausted/you still have work to do at home/you are tired/your kids need your help with homework/you have a million errands you want to do/you are hungry and have to cook dinner/you just blow it off…You will catch up tomorrow…

Does this sound familiar? Here are 3 steps to improving the odds that daily exercise will become a routine.

  1. Link one part of your exercise prep to something you do every day. For example, you always brush your teeth every day (I hope so). You always wear a sports bra to exercise or you always wear a certain pair of shoes when you exercise. Then link the two activities. Put on your sports bra or shoes when you brush your teeth. Do that every day. You don’t have to work out if you don’t want to, but just link the 2 activities together.
  2. Have a variety of methods of achieving your goal of daily exercise. Have them different enough that they fit different scenarios. For example, if you are tired or have not time, you need an effective workout you can do at home – try body weight high intensity interval training (HIIT) where you don’t even need any equipment and you can complete the workout in under 5 minutes. If it is a lovely day out and you want to spend time with a friend or loved one, have a walking route that allows you to enjoy each other’s company while walking. Take a bike ride. Dance to music. You can use an app like 8Fit or Sworkit. If you want to take a class, you can go to an exercise class or follow an exercise YouTube or DVD or app. You can always go to the gym if you have time and want to get a complete workout with weights or cardio equipment or take a class or with the help of a personal trainer.
  3. Log what you do and keep track of your progress. My bullet journal is where I write out the plan for my workout 2 weeks in advance. Then, as I complete my workouts, I jot down notes about my day and always end with a positive note to myself, “Feeling great! Went up on the number of crunches! Yeah!” I use my apple watch to monitor my overall activity and aim to close my activity rings every day. Then, I see how many days in a row I can complete all of my rings and I check it out on my phone. This is tremendously motivating since I love the 3 colors of the rings. image1

Basically, you want to lower barriers and make it easy to get started on any single day. Have various options on how you can achieve your goal to work out daily. Track it and celebrate each day’s success. Aim to do something physical every day and it will become a habit much faster. Then watch. Other areas of your life improve too. Sleep gets better, mood improves, eating improves, confidence improves, work improves…you get it. With the inevitable ripple effect of daily workouts, you may find that the rest of your life starts to fall into place and you become more and more successful in more and more areas of your life. Try it.

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Posted in Exercise, Habits & Behavior Change, Healthier Together

Healthier Together Series: Cycle 6A. Nutrition – If Food is Medicine, “What should I eat?”

Posted on July 14, 2018 | Leave a comment

lily-banse--YHSwy6uqvk-unsplashKeep it simple.

INCLUDE  What Your Body NEEDS:

  1. Water
  2. Protein
  3. Colorful and non-starchy Vegetables
  4. Fats

Whole grains and whole fruit may be beneficial in specific doses depending on your weight, exercise routine and other health conditions.

AVOID  What May HARM Your Body:

  1. Sugars of any kind including high fructose corn syrup, agave, natural sugar, etc.
  2. Processed foods including enriched wheat flour, white flour, corn meal, etc.
  3. Sweet beverages & Juice including 100% fruit juice.

 

Photo by Lily Banse on Unsplash

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Posted in Habits & Behavior Change, Healthier Together, nutrition

Healthier Together Series: Cycle 5D. Putting It All Together – Words Matter: 7 Steps to Self-Compassion.

Posted on July 1, 2018 | Leave a comment

tim-mossholder-SR8ByN6xY3k-unsplashWords are powerful. I can see this when I am talking with patients, my children, my spouse and my friends and colleagues. In this post, I am thinking about how powerful words can be to someone who is scared, feeling out of control, or uncertain of what is going on. This situation is common in a doctor’s office and in the hospital where people seek help when something unpleasant is happening that seems to be out of the control of the individual seeking care.

Studies have shown that patient outcomes are often impacted by what they hear from healthcare providers even when they hear something indirectly- if they believe it is about them. Consider this: What happens to a patient in the ER, frightened and waiting for a test result, hearing someone outside of the room saying, “Yeah…he’s a train wreck. It’s not looking good. There’s not much we will be able to do. He will have to follow up with his primary care doctor…”? Later (feels like HOURS to the patient), the provider comes into the patient’s room and says, “Thank you for waiting. Your labs were unremarkable and your chest x-ray came back and you do not have pneumonia. It’s probably just a viral upper respiratory infection. We recommend you follow up with your primary care provider…” Might this person be reassured by this visit?

People can be scared, feeling out of control, or uncertain of what is going on outside of the doctor’s office or hospital.  There are times when our senses hyper-sensitized, when we are on high alert, and what we hear, enters deep into our subconscious mind and begins to influence our feelings, thinking and behaviors. This hyper-alert state is usually when we are feeling strong emotions, when our mind is “wide open.” Words at these times are very powerful. They may be accurate and rational, but they may not be. Sometimes, we are aware of these influences and many times we are not.

In my practice, I see that there is much suffering related to the hostile and negative words we have absorbed at various vulnerable times in our lives. Maybe a parent, family member, teacher, partner, close friend, colleague said something hostile or we misinterpreted some comments which were deeply painful and our brain absorbed it and was altered by it. When I hear hostile and negative words being used against oneself, “I was bad,” “I failed,” “I have no discipline,” “I just can’t do it,” “I’m not strong enough,” “I’m hopeless,” “I’m no good,” “I’m stupid,” “I can’t help it,” “I’m just out of control,” I recognize one of the keys to healing and success will be to develop a capacity for self-compassion.

We have mentioned self-compassion before. When we develop the capacity for self-compassion, healing begins. When we practice self-compassion, success follows. If you use hostile and negative words to describe yourself or your character, stop now. It seeps in unexpectedly and it has no purpose. It blocks your ability to progress and limits your success. Good news! This negative self talk can be phased out and left behind. Replace it with a healthy practice of self-compassion. Here’s how:

  1. Become aware of it if you hear yourself saying something judgmental and negative about yourself. “I was bad (this implies a character flaw), I ate that cake even though I knew I shouldn’t. (a routine character flaw)”
  2. Identify it and label it. “That was my negative self talk and it’s not true.”
  3. Reframe it. “I feel bad (this implies a temporary feeling). I ate that cake even though I knew it would interfere with my weight loss goals. (a simple mistake)”
  4. Reflect. “I have been very stressed and bought the cake to “treat” myself. I don’t actually feel better after eating the cake. My stress is not improved after eating the cake.”
  5. Learn. “Taking a walk outside, listening to music, dancing, calling a friend, drawing, or journaling DOES relieve my stress and also would be distracting me from the desire to eat cake.”
  6. Empower yourself. “Next time, I can try some or all of my other stress relieving activities. If I still want the cake, then I can still choose to eat a smaller piece of cake, but maybe I won’t have it. If I do, I will own it and move on. I will know that I am doing the best that I can, at that moment.”
  7. Reaffirm. “I am doing the best that I can, right now.” If you then hear yourself responding, “Well…actually, I COULD do better…” then smile to yourself and say, “I know you can… And, you will when you are ready.”

Given the power of words, imagine what might happen if you protected yourself from negative self talk. Imagine what your day would be like if you heard warm, loving, supportive comments all day and accepted you are human and humans make mistakes and allowed yourself to regularly reflect and learn how to get better and better. Can you appreciate how much you’d flourish and achieve? When you practice self-compassion, you open yourself to your incredible capacity for success and joyful living.

Let me know how you have conquered negative self-talk or how you practice self-compassion.

Photo by Tim Mossholder on Unsplash

 

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Posted in Habits & Behavior Change, Healthier Together, performance

Healthier Together Series: Cycle 5C. Relaxation & Sleep — 7 Steps to Using Traffic and Commuting for Self-Care

Posted on June 16, 2018 | Leave a comment

aditya-chinchure-ghbepAO7BCs-unsplashAfter residency, I decided I wanted to live within 10 minutes from my practice so I would not have to spend my precious time commuting to and from work. I moved within a 7 minute drive from my work, no traffic. I loved the extra time I had on either end of my work day. First, I was exercising more, cooking more dinners, and having time for grocery shopping. It was great! As time went on, I was able to fit other activities into that extra time and I could spend more time doing work-related activities. I could run a few more errands each day and I began taking on more work duties that could be accomplished in the extra time I now had.

As a result of my increased number of activities, the exercise routine became more sporadic. Instead of working out before work, I could “get more stuff done” and then plan to workout in the evenings. Of course, EVEN IF my clinic didn’t run late with last minute add-on patients and phone calls or EVEN IF I wasn’t too fatigued or hungry after a full clinic day missing lunch, my family members needed my focused attention and my workouts would be further “postponed.” I now didn’t have time to workout. Basically, the “saved” time started out as more time for self-care, but ultimately was squeezed out with with more time spent on activities and obligations that I didn’t need to do BEFORE I eliminated my commute and less self-care. Poor planning…Lots of reflection and learning…

Fast forward to my current job that I love but that is far from home. (We can discuss in the future about how to grow into the job you love.) When considering this job, I had to accept that I would have a total daily commute of potentially up to 2.5-3 hours with the common severe traffic. I considered taking the train in. The hospital even offers a free shuttle to drive people to and from the train station. However, I do not live close to the train station, so it would still take me about 2-2.5 hours door to door to take the train, and without the flexibility of coming and going as I wanted. It was clear. With this new job, I would have a long commute to and from work, 5 days a week.

I began investigating how to optimize my commute time. After trial and error and rapid “quality improvement,” my commute is part of my self-care time. If you have a long commute, here are my 7 steps to achieving a Self Care Commute:

  1. Figure out when you HAVE to be in your office.
    • Can you work from home on some days?
    • Does it matter the exact time you get to work or leave work?
    • Can you adjust your work day start and end times? If no, move to #4.
  2. Figure out your transportation options that agree with your work hours.
    • Do you need personal space and time without other people during your commute? Do you have a car? If yes, move to #3.
    • Are there ride share or public transportation options for you to get to and from your work that you would consider? For example: Uber, Lyft, Train, Subway, Bus, Carpool with neighbor. List them.
    • How long does it take to get from your front door, to your office door for each of those options? Add to your list next to each option.
    • Is your schedule predictable enough that your schedule can match a ride share, bus or train schedule? If no, move to #3.
    • Will you need to travel from one site to another during the day? If so, will it be easier if you have your own car? If yes, move to #3. If no, list your options for travel during your workday. Include the door-to-door travel times and costs associated with each option.
  3. If commuting by car or truck, review the various driving routes to work and traffic patterns. 
    • Waze, ETA and other apps offer anticipated travel times to destinations at various hours of the day. Make a list.
    • Can you find the range of travel times for the times you could drive to and from work for the hours you need to be there. Circle those travel times.
  4. Make a list of the categories of activities you can do during your various commuting options that you would like more time for. For example, Train: knitting, reading, listening to music, audiobooks, podcasts, writing, closing eyes and visualizing. Car: listening to music, audiobooks, podcasts, sitting in silence, connecting and talking to family/friends hands-free, driving through scenic route.
  5. Figure out the options for your activities on the way TO work which may be different than the way FROM work to home. For example, I am focused and my brain is eager to learn early in the morning, so I listen to non-fiction educational audiobooks on the way TO work. At the end of my day, my brain needs to relax. I may process my day by listening to music or thinking in silence or I may connect with others by calling my family or friends or I may want to be entertained and eagerly listen to the next chapter in the current detective series.
  6. Organize your commute times to optimize your commute and productivity. For example, my commute is cut in half if I drive in extra early before my scheduled meetings or clinic. This works great for me since that is when my brain is most productive so I can use that early quiet time in the office to achieve more. On my ride home, my commute is not optimized and is longer (by choice). I love that the longer drive home allows me more protected time to “squeeze” in a chapter or two of a fiction audiobook (which I wouldn’t read otherwise), process my day and connect with family and friends.
  7. Try it out and adjust your daily routines to optimize your commute times. After adapting my schedule and travel times, my commute time is not as long as I anticipated. I am more productive, my time is spent more efficiently and I have protected self care time daily. Despite the long commute, I have better integration of my work life and personal life.
    • Maybe you will have more time to connect with more of your family and friends with hands free phone calls.
    • Maybe you will find a new podcast or book series that make that unexpected traffic delay enjoyable.
    • Maybe you will learn new skills with personal development audiobooks or a recorded lecture series.
    • Maybe you will use the time to process your day, think about your family, consider your future.
    • Maybe you will learn a new language and take that trip abroad or meet new people.
    • Maybe you will work out at the gym near work in the evening before you drive home so that your commute time will be shorter and you will achieve your daily workout goals.

Once you recognize your commute time can be protected time to fit in the enjoyable activities you currently don’t make time for, you will find it is a luxurious time. While sitting in traffic on my ride home, I am forced to slow down. There is no checking emails or texts or getting online. I am in control of and I choose which activity I engage in. I appreciate the extra time I have for those fun activities that I otherwise would not make time for. The traffic ensures that I dedicate more time to self-care.  It’s now my Self-Care Commute.

Photo by Aditya Chinchure on Unsplash

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Posted in Healthier Together, performance, relaxation, Travel

Healthier Together Series: Cycle 5B. Physical Activity – Exercise and Fitness and Sedentary Jobs

Posted on August 20, 2017 | Leave a comment

arek-adeoye-ljoCgjs63SM-unsplashRecently, after presenting at Grand Rounds about exercise, it became clear that there are many physicians who appreciate the value of exercise and recommend it to their patients. It is impressive- the number of very busy physicians who are fitting exercise into their own lives, on a daily basis. We see what many people don’t see, the variety of ways we can get older and the consequences of our lifestyle choices. It is with this wisdom that they are living what they preach- “Exercise- however you can fit it in.” Physicians who regularly see patients aging, prioritize exercise.

Exercise and physical fitness is one thing that has the greatest impact on all areas of health and cannot be replaced by pills or medical procedures. Yet, according to CDC, only 20 % of adults get “enough” aerobic and muscle strengthening exercise. This amounts to 150 total minutes of moderate intensity activity (or 75 minutes of vigorous activity) divided throughout the week plus 2 days per week of muscle-strengthening activities per week.

Many people state that they have no time (such as “small children and childcare concerns” or “long work day” or “care-taking/traveling sports duties” or “homework”) and/or that they have a “very sedentary job.” They sit for much of the day and it’s hard to find the chunk of time to prepare for exercise (clothing, determine appropriate and effective exercise plan for the day), work out, and then deal with the sweat (shower, change clothes, makeup/hair), never mind the time to get to and from the gym if that’s the exercise zone. It is easy to get discouraged.

However, the great news is that 15 minutes a day of walking UNIVERSALLY improved health in a study of over 400,000 male and female adults of all ages despite other lifestyle choices. The study demonstrated that a minimum of 15 minutes of walking a day, decreased all cause deaths by 14% and extended lifespan by 3 years compared to people who were sedentary. Every additional 15 minutes daily decreased death from any cause another 4% and from cancer another 1%. In fact, the researchers noted that 1 in 9 cancer deaths may be avoided with that 15 minute walk. Maybe 15 minutes of walking daily is possible for an added 3 years of life or a chance to avoid a death from cancer.

And about that sedentary job, many people would choose to be more active at their otherwise sedentary job if given a choice. Sometimes, we might not recognize some of the options. See if you can get up from your chair at regular intervals or consider moving the printer or trash farther from your desk so you have to get up for access. Take the long way to the restroom or the stairs. Many people appreciate the reminders and step tracking from various fitness trackers.

What helps me? It is the stand up desk that I am a fan of. My stand up desk keeps me moving more throughout the day. Treadmill desks (cons: higher risk of serious injury and difficult to use a keyboard or write due to the movement) and cycling desks (cons: non-weight-bearing) are also available but are more expensive, take up more space and often go unused. It is the stand up desk that I am a fan of. And when colleagues see my at my stand up desk, they often end up getting one and using it too.

Find ways to incorporate that 15 minute walk every day. See if you can set up your sedentary job to be less sedentary. Please share your methods of increasing your physical fitness even when you have a sedentary job.

 

Photo by Arek Adeoye on Unsplash

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Posted in Exercise, Habits & Behavior Change, Healthier Together

Healthier Together Series: Cycle 5A. Nutrition – How To Manage Your Hunger – 10 Things to Know

Posted on February 22, 2015 | Leave a comment

melissa-walker-horn-lo_udD1o_lk-unsplashHunger can be a natural physiologic signal from the body requesting more fluids or nutrients or it can be cravings (learned habitual behaviors) and pathologic symptoms of a mismanaged metabolism. We sometimes forget to check in and determine why we might be hungry.

NATURAL & HEALTHY HUNGER SIGNS:
1. Dehydration. In most cases, this can be managed by drinking water.

2. Need to replenish nutrient supply.  For most people, eating a variety of colors of vegetables and supplementing with protein, will meet all the body’s nutritional needs. Make a list of easy naturally nutrient rich snacks that you can have readily available – then you can make healthy choices when you are hungry and need to replenish.

HUNGER SIGNS TO BEWARE OF:
3. Insulin resistance. If your waist line has grown since after highschool and you are not pregnant, you are developing or have developed insulin resistance. As we age, we also naturally become more insulin resistant. This means that our body over-reacts to sugars and carbohydrates in the diet which leads to a roller coaster ride of high and low blood sugar levels which lead to fatigue, mental fog & “the munchies.” Solution: Drink water, Eat protein or leafy vegetables when hungry and avoid sweetened or carbohydrate heavy foods.

4. Poor food choices earlier (ie. starting your day with sugar or processed carbs). Eating sugar will cause you to crave more sugar later in the day. Sugar can trigger the same area in the brain as heroin. It IS addictive. Solution: Avoiding it is the best way to manage being losing control. Make smart food choices. Start your day with protein instead of sugars or starchy processed carbohydrates. Choose whole foods.

5. Some medication and illicit substances (ie. marijuana). Some medications and illicit substances make people hungry and eat more, usually poor quality foods like most fast food. Solution: If your meds are making you want more broccoli, that’s great, but if it makes you get “the munchies” or you notice weight gain, have that important discussion with your doctor to see if you can find a way to manage it. Also, when you get “the munchies” or are hungry, drink water, eat veggies, nuts, or a cheese stick or have a light soup.

6. Boredom. Solution: Find something to do that is NOT related to food. Do something physical – take a walk, stretch, dance, move. Connect with family or a friend. Journal, garden, read, play solitaire, play a musical instrument, work on a hobby or create something artistic, etc.

7. Emotional unrest. Solution: If you are an emotional eater, it will be important to find new ways to soothe yourself. Consider finding a counsellor to help you process and learn better ways to cope. Find other healthy outlets – take a walk, spend time in nature, contact a friend or family member who nourishes you, spend time with you pet, listen to soothing music, learn meditation, go to a religious/spiritual place.

8. Habit (ie. before bedtime or while watching TV/movie). If you link certain activities or times of the day with eating/drinking, this is a habit and can be challenging. Solution: The best way to change that habit, it to create a NEW (more desirable) habit to replace the old, undesirable habit. For example, instead of having hot cocoa after being out in the cold or at bedtime, have some hot rooibos tea which is caffeine free and deliciously different. Instead of buttered popcorn with a movie at home, try berries or baby carrots. Keep healthy snack options easily available for “break time” at work- have salty, crunchy and “creamy” options available.

9. Seeing or thinking about food/drink you like. Having a variety of options to eat actually has been shown to increase the amount of food we eat. The larger the plate, the more options of different foods at any time, we eat more and sample more. Solution: Use a smaller plate. If you are sampling, think of the size of your stomach when not-too-full (the size of your fist), and look at the total volume of food you have on your (smaller) plate. STOP adding to your plate when it exceeds the size of your stomach. If you have more foods to sample, take less of each item so that you are not OVER-stuffing your stomach as it would not feel good anyways. Really, if you look at your plate and wonder how that would fit in your body, it’s too much. It’s ok to leave food on your plate. Note: Raw leafy greens shrink dramatically when chewed up, so you can be liberal with raw leafy greens!

10. Worry that later you won’t have time/opportunity to eat (ie. busy schedule). How many of you are “go-go-go” all day long and time for eating is a luxury? As a physician who may be running behind because of an earlier unexpected patient emergency, I hear you. Solution: Keep that stash of quick, healthy food/drink readily available, ALWAYS. Nuts, cheese stick, baby carrots and hummus, celery sticks and almond butter, whatever. Remember, IF you are unable to eat, as long as you are drinking, you are going to be fine for several hours. In fact, if you do not eat, but you maintain proper hydration, worse case, you will have to eat later than desired. However, your body starts to draw energy from your personal fat stores. Unless you are medically underweight, you should be ok to be burning extra fat on your body until you can eat later in the day.

Do you have other times you “hunger” triggers? How do you manage your hunger? What are some of your snacks you keep on hand?

Photo by Tim Mossholder on Unsplash

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Posted in Habits & Behavior Change, Healthier Together, Metabolism, nutrition, relaxation