Month: November 2022

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Making Healthy Lifestyle Choices

Self-care Series

Making Health Lifestyle Choices daily is the hardest thing we do.  For me the current events of the day; the war in Ukraine, the pandemic, gun violence, and intolerance drive me to seek out activities that make me feel better. My choices are only sometimes good.  I eat ice cream, have two too many adult beverages, and hit the snooze alarm causing me to miss my exercise time.  Fortunately, I learned not to beat myself up about these choices.  Since I track the activities, I can face the choices I made and take small actions to make better ones.  

This is the second installment of my Self-care series.  We will focus on Making Healthy Lifestyle Choices in healthy eating, physical activity, and emotional health.  These three areas are most important because they address two key risk factors for chronic disease; poor nutrition and lack of physical activity.  Poor emotional health can prevent improvement in the other areas because one feels they can not succeed or lacks the motivation to move or eat well.  I see these three areas as interlocking.  Higher physical activity has been proven to improve mood and self-efficacy.  Good food can elevate joy and help us feel wonderful.

Healthy Eating

The Dietary Guidelines for Americans have five key guidelines.  You can find information on how to build a healthy routine here (Spanish).  First is to follow a healthy eating pattern throughout your life.  This includes:

  • Variety of vegetables
  • Fruit
  • Grains, primarily whole grains.
  • Fat-free or low-fat dairy.
  • Foods rich in protein like legumes, nuts, soy products, lean meats, poultry, and eggs.

More information can be found at MyPlate Nutrition .  What I really like about the MyPlate site is that it has advice for people during special stages of their life like pregnancy, teens, and older adults.  Many of us struggle with the affordability of food.  The Shop Simple With My Plate app provides information on budget-friendly foods and lists of local savings by zip code.  Some stores even accept SNAP EBT.

I suggest starting with one meal a day that you know you eat.  Does this meal currently include a vegetable?  Could you add fruit as a dessert?  Could you substitute a bean dish sometimes?  I recently attended a continuing education presented by Monica Reinagel where she presented her Nutrition GPA app and the science behind it. This app has really helped me be more aware of simple changes I could make to improve my eating grade.  

When you are ready for more.

Physical Activity 

An earlier blog post provided information on activity levels .  People with health conditions or impairments have special considerations for activity.  For you a visit to your physician and/or fitness professional is a great idea.  

Think first about where you are now. 

Think first about where you are now.

Are you moderately active for 150 minutes each week (25 minutes each day?).  What is holding you back?  

  • Motivation.  Most importantly Start.  Small improvements will accumulate.  Add 10 minutes to where you are now.  Find an activity you like. Walk, Cycle, and lift some water bottles. I have even climbed my stairs in a pinch.   Once you are moving for a couple of weeks, then think about how to avoid setbacks and add another 10 minutes.  In a few weeks you’ll feel great. 
  • Affordability.  A gym membership may never be needed.  Is walking possible for you?  A decent pair of shoes is what you need.  12 oz water bottles or gallon water jugs make great weights to lift.  Does your city have a community center with a gym?  Does someone you know have fitness equipment gathering dust?  
  • Time.  Family, work commitments, friends, TV! Well TV, stand up and walk in place.  For many people early morning is the best time.  I have a teacher friend who started working out at 5:30 am.  She gives herself the first hour of the day as a gift.  Track what you are doing hour by hour for a week.  Review the results.  Are there 30 minutes for you?  

Physical Activity LevelModerate Intensity Minutes Per WeekSummary of Overall Health BenefitsLifestyle Application
InactiveNo activity beyond baselineNoneBeing inactive is unhealthy
Insufficiently ActiveAbove baseline and less than 150 minutes per weekNoneLower levels of activity are preferable to inactive lifestyle.
Active150 – 300 minutes per weekSubstantialMore benefits at higher level
Highly Activegreater than 300 minutes per weekAdditionalNo identifiable upper limit of activity above which there are no additional benefits.
Table of activity levels.
Emotional Health

Emotional wellness is the expression and management of one’s feelings to cope and thrive in relationships and pursue acceptance of your emotions.  I am not a mental health professional so I cannot give specific advice for your situation.  If you are having thoughts of self-harm, call 998 Suicide & Crisis Lifeline to get help.  One of the tools I suggest clients complete is a PHQ-9, Patient Health Questionnaire.  This tool is designed to be used with a healthcare professional.  If you feel concerned about your mood, there are resources that can help.  I know as a veteran, I have problems hiding my emotions.   Stress can be good and bad.  If you are interested in knowing more visit my blog post.

Happy always?

Notice the definition of emotional wellness does not mean that we are always happy.  All people have a range of emotions.  When you look at the Feelings Wheel, are you able to accept the emotions you are experiencing?  Are you taking the time to reflect on your feelings?  Would mindfulness training help you relax and be less judgemental? Does deep breathing help you feel more centered?  

Feelings Wheel, https://feelingswheel.com/feelings-wheel.jpg

Disclaimer.  The information provided in this article may not be appropriate for all people.  If you are not currently exercising or have or suspect you have conditions like cardiovascular, metabolic or renal disease, then you should consult your physician before considering making any changes suggested.  

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Are There Benefits to Brisk Walking?

Are there benefits to brisk walking?  I recently read an article published on IDEAfit.com by  Shirley Archer, JD, MA, Benefits of Brisk Walking for the Brain .  She mentions a Colorado State University study  of 180 adults aged 60-69 who participated in a 6 month study comparing aerobic walking, social dance, and a control group.  The study shows an increase in white matter integrity in the brain with better signaling between the brain regions.  While this was very informative, I still had questions. 

Did I want to know how fast is aerobic walking? How fast would I need to walk to get the benefit? What is the difference between gray and white matter in the brain? How does reduced signaling between the brain regions affect me as I age? What if I started an aerobic walking program at 40 years of age, would it help me preserve my brain better as I age? In this article, I am going to find out how much evidence I can find.

How fast would I need to walk to get the benefit of aerobic walking?

First, walking at any speed is better than not walking at all.  In fact, a May 2012 study found as little as 4,400 steps results in lower mortality and reduction in development of diabetes and high blood pressure.  Keep in mind more is better.  Even if some studies may say benefits level off at 7,500,  there’s no reason not to do more if you are able.  Here are some links to evidence-based walking programs.  Consider starting where you are and tracking your SPM (steps per minute),

Arthritis Foundation, Walk With Ease

American Heart Association, Six Week Beginner Walking Plan  

Now back to the speed question. When you are looking to speed up, then 80–112 steps per minute is a good range to work up to. Generally speaking, 3 miles per hour is considered brisk. If you do not have a fitness tracker, time yourself for one minute and count your steps. One hundred (100) steps is about three miles per hour for most people. That being said, I am in fairly good shape at 62 years of age and I need to push to get to this speed. An October 2022 CNBC Make It article summarized two recent studies published in JAMA Neurology and JAMA Internal Medicine by stating that people who walked at least 80 steps reduced their rate of heart disease, cancer, and premature death more than other groups who walked less than 40 SPM (Steps per minute) and 41–79. 

What is the difference between gray and white matter in the brain?

  

picture of a brain's gray and white matter
From Reading and White Matter in the Brain, by Joan Sedita | 1 September 29, 2015, https://keystoliteracy.com/blog/reading-and-white-matter-in-the-brain/

When we picture the brain, we normally see the cerebellum with its wrinkly appearance.  The edges of the folded brain are like the rind of a melon, but flexible.  This rind layer is the gray matter.  It contains the synapses and related structures. The gray matter controls the senses and muscular movements.  Diseases of gray matter are called neurodegenerative (Alzheimers). 

The gray matter needs help communicating with other parts of the brain and spinal cord to execute that control. The white matter contains the axons that allow communication to and from different gray matter areas making fast communication to control functions that we are not aware of. Things like maintaining body temperature, blood pressure, and heart rate, dispensing hormones, food, and emotions. Diseases of the white matter are those that interfere with the signaling of the nerves like Multiple Sclerosis and the hardening of white matter that causes a stroke.

Finally, when the author tells us episodic memory is preserved this means our long term memory used to recall experiences in detail (time, place, and emotions).  We all want to be able to remember the best times of our lives as we age.

How does reduced signaling between the brain regions affect me as I age?

Generally, white-matter lesions tend to appear around 60 years of age.  The Alzheimer’s Association says 1 in 10 people will develop the disease.  The National Institute of Neurological Disorders and Stroke,  estimates the chance of a stroke for those 60-65 is 11%.  This gives us a general idea of the occurrence of severely reduced signaling between brain regions as white matter lesions normally increase with these conditions.

As you might expect most of us can expect trouble remembering things, slowed thinking, leaking urine (one of those activities we are not aware of), problems walking, and balance issues.  As the signals move slower this can be expected.

Not all people who have lesions are impaired in activities of daily life.  A March 24, 2003 study published in the American Psychological Association described a study of 327 people.  Of the people with hypertension a small but statistically significant number of people had higher lesions.  This is consistent with other recent research that seems to indicate better circulation results in fewer white matter lesions.  This is the link between faster walking and lower rates of cardiovascular disease and lower blood pressure.  

In conclusion, when we walk faster (80-112 steps per minute), we have reduced cardiovascular disease and normally better circulation, and lower blood pressure.  Recent studies indicate that better circulation leads to fewer white matter lesions.  

Disclaimer.  The information provided in this article may not be appropriate for all people.  If you are not currently exercising or have or suspect you have conditions like cardiovascular, metabolic or renal disease, then you should consult your physician before considering making any changes suggested.  

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Self-Care Information Series

Self-Care information Series picture of small blue butterfly landing on a person's hands.

Self-Care Information Series. The World Health Organization(WHO) defines self-care as, “Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker.”  For most people in the wellness and health professions we view self-care through the lens as those activities we engage in to preserve our ability to serve others by avoiding burnout.  In this post and those to follow I’ll be exploring self-care interventions any person can consider to enhance one’s physical, mental, emotional, and spiritual well being.    The objectives today are:

  • To explain why self-care is important.
  • Provide a little information about self-care interventions.

If you are interested, let’s get started.

Why Is Self-Care Important?
Costs

The cost of healthcare in the United States continues to grow.  The Centers for Medicare % Medicaid National Health Expenditure Fact Sheet states that expenditures have risen 9.7% in 2020, 19.7 % of Gross Domestic Product.   Self-Care are evidenced-based actions people can take to prevent disease and maintain health.  For the most part the more we do to take care of ourselves the lower our costs will be.  Of course, genetics and age are factors we cannot change.  You may not be able to completely prevent a condition, however, using self monitoring like regular breast self-examinations can result in early detection.  

Access to Essential health service

While costs are increasing, according to WHO 3.6 billion people in the world lack access to health services.  In addition, by 2030 it is estimated that the shortage of health workers may grow to 15 million workers.  On July 28, 2022 a US News article stated that the number of health care workers was down 1.1%.   Think about how many hours a year you spend with your doctor?  One hour or  maybe 12 hours? The ability to research and implement self-care interventions can mean the difference between wellness and illness.  

Reducing the Risk of Serious Conditions

Reducing risk factors of physical inactivity and tobacco use can prevent up to 81% of cardiovascular disease.  Self-sampling for (human papilloma virus which causes cervical cancer) has reduced mortality from cervical cancer.   Self monitoring of blood pressure earlier in life can bring awareness of the need for a physician’s intervention and motivate a person to make better lifestyle choices. 

Overcoming Stigma.

In conclusion, as we all know the COVID 19 pandemic has increased the awareness of the need for mental health care.  In many places a woman’s access to reproductive care is restricted.  Annually access to self-injectable contraceptives can reduce 74 million women and girls living in low and middle income countries.  Also HIV self-tests allow people to monitor for the virus in areas where going to a clinic for testing can open a person up to ridicule.

What are Self-Care Interventions?

In this section, I will describe some examples of interventions. First interventions are evidence-based actions a non-medical person can implement.  We all know how difficult it is to discern a fad from fact.  Quality and results must be proven.  Since many of the evidence based initiatives target reproductive and sexual health and I feel those are out of scope of my practice, then I will not be addressing any of those topics. I will in coming posts discuss topics that align with the Global Self-Care Federation’s grouping. In the Self-Care Information Series we will discuss some of the following intervention groups.

  • Making healthy lifestyle choices – physical activity and healthy eating, like the Mediterranean Diet, and emotional health
  • Avoiding unhealthy activities – smoking and excessive alcohol and substance abuse.
  • Self-recognition of symptoms – in collaboration with your physician track symptoms
  • Self-monitoring – checking for deterioration.  We’ll discuss topics like blood pressure monitoring and fitness trackers.
  • Self-management- managing symptoms of diseases in partnership with physicians and others who may have the same condition.  Diabetes management, prescription adherence, cardiovascular health. 

Disclaimer.  The information provided in this article may not be appropriate for all people.  If you are not currently exercising or have or suspect you have conditions like cardiovascular, metabolic or renal disease, then you should consult your physician before considering making any changes suggested.