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Take Care of Yourself By Not Doing Things

Self-Care Series Avoiding Unhealthy Activities

Take Care of Yourself By Not Doing Things is the second post in the self-care series. In the last post, Making Healthy Lifestyle Choices, we talked about choosing to do activities that were healthy.  In this post, we will explore how to avoid some things that are unhealthy.

Let’s first define when something is a problem with your health.  Misuse of a substance to the extent that it causes harm is unhealthy.  First, ask if there are harmful consequences.  Second, possessing a compulsive drive that you cannot control.  This usually includes a loss of control over the use of substances.  “I had one drink and I just could not stop.”  Lastly, when your perceptions and denial over the consequences of your addiction are distorted.  

I’ll use caffeine as an example now.  Most of us can consume caffeine in the amount the FDA considers not harmful (400 milligrams a day—that’s about four or five cups).  However, when your doctor tells you you will have a heart attack unless you reduce your intake or you are using energy drinks to stay up for hours without sleep; then continuing to consume high levels would be unhealthy.

Three common unhealthy behaviors are smoking, excessive alcohol consumption, and

substance use disorder.

The choice is up to you, of course, to Take Care of Yourself By Not Doing Things.

The Health Belief Model

I want to explain a bit about the Health Belief Model.   This model describes how people get ready to decide to change. This model proposes that we think about health threats in terms of how susceptible and how serious the consequences are.  It also says that we assess health behavior in terms of the benefits and whether we think it will work (be effective) for us. Finally, it says we consider the barriers like how difficult it will be for us to implement the change.  Then we logically decide based on the threat and the behavior.

Health Belief Model by Earnest Action Health Coaching 2022

The choice is up to you.  You can choose to believe you are not helpless or destined to continue.

What is needed?

To be successful a person needs some help.

  • Extra Support To Cope with Withdrawal Symptoms and cravings.   
  • Identification of Behavior Chains.  Do you crave a smoke after every meal?  Does a stressful day at work cause you to be soothed with alcohol?  Health coaches can help you identify and talk through a plan to react differently.  
  • Acknowledge the shame and stigma surrounding unhealthy behavior.  

Smoking

The CDC says smoking has declined from 20% in 2005 to about 12.9% today.  As a former smoker, I can testify that it was one of the most challenging unhealthy habits to stop.  I believed I needed tobacco to deal with stress. At age 47 I believed too much damage had been done.  I was convinced I was destined to fail. Even after trips to emergency care for bronchitis several times, I still smoked.  

How did I quit?  I stared in the mirror and asked myself for three days straight, “Why do you want to die (faced the threat)?  After three days, I committed to stopping.  I also got some help understanding that the frequency of quitting was important. There was no shame in smoking as long as I quit without delay.  The more often you try in a short period meant better success.  A trainer helped me understand that I needed a strategy to break the mechanical habit of moving my hand to my mouth.  I carried a fake cigarette and used it for two years.  For two months I explained to my friends who smoked that I would not be around.  I met them in smoke-free places for several years afterward.  

If you are ready or considering quitting Visit smokefree.gov for more ideas.

Excessive Alcohol Consumption and Substance Use Disorder.

Alcohol Use disorder is a “chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social occupational or health consequences.  About 6% of people.  About 10% of people admit to using illegal drugs. The good news is most people who drink too much alcohol or have substance use disorder can change their behavior. 

Why am I addressing these two at the same time?  The health consequences are similar and treatment is often beyond the scope of a Health Coach.   While health coaches can help support clients with exploring values and building confidence, in most cases a coach will ask the client’s permission to refer to a medical professional when a client expresses concerns about their alcohol or drug use. The health coach may assist clients with modest means to find an appropriate 12-step program.  

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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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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How Do You Want To Talk About Being Large?

As a Personal Trainer, I discuss weight differently than I do as a Health Coach. In this installment, I want to discuss how these professions and our society are evolving regarding weight, obesity, and body-shaming. Are you wondering why I decided to talk about this subject? I have three reasons. I read about Queen Latifah’s reaction when her trainer called her obese; I completed Tasha Edwards, MS course on Breaking Body Barriers. Finally, I read Kellie Walters, Ph.D. recent article in IDEA Fitness Journal, Weight Biases: How Do They Influence Our Industry.

I want to know how do you want to talk about your body size? I invite everyone to share their comments below as we explore this topic. The material provoked a lot of reflection about how I think and talk about weight.  

Health Coaching and Personal Training Approaches.

First the approaches of both of these professions are starting to converge. Remember that I recently was certified as a Health Coach and have had my Personal Training certifications for over ten years. The Health Coach perspective asks coaches to address their weight bias first. We are taught to see our clients as a whole and resourceful people who can change their lives. As a coach, we collaborate with our clients to help them find their best selves. We are immediately instructed to ask permission to discuss a client’s weight. We candidly discuss what words will be used during that discussion. What resonated strongly with me was when I watched Tasha Edwards’ say that 95.8% of women 40-50 years old have negative emotions about their weight. I have always been stocky. I did not take action to improve my health earlier because I thought it was of no use.  

My Personal Training instruction and experience were quite different. While we were taught about the many causes of obesity (environmental including medications, stress, genetics, hormonal, sleep, energy balance), we were encouraged to use strong labels like obesity or overweight. As a new trainer, senior trainers often told me people need to have a wake-up call to become motivated. That their life depended on this change. No wonder 50% of women avoid gyms and fitness classes. However, the practice is changing with people like Tasha Edwards and Kellie Walters speaking out.

Walters gives fitness professionals five steps to reducing weight bias.

  1. Start with yourself. 
  2. Solicit feedback.
  3. Expand your worldview.
  4. Think through your actions.
  5. Continue Your Education.  

Using these five steps I started to think of my biases. First, there was a thread in each of these items. That anti-fat bias was a colonial idea used by white men to justify enslavement. At first, I shied away from this idea. Then as I reflected, I realized it has merit. As a trainer, I seldom saw large Black women in the gym. I did always assume thick people wanted to lose weight. I have to admit I have a bias here, and Tasha and Kellie helped me realize it. I will use the fourth step to ensure that I think through how I use images and how to be more inclusive of people with different body sizes.  

Stating Measurement Results in Language Our Clients Find Offensive.

Queen Latifa recently related a story about a discussion with her trainer. The trainer spoke to her about her BMI and called her obese based on the result. In Adreon Patterson’s Cinemablend article, the trainer, Jeanette Jenkins, states she based her comments on two other tests: bio-electrical impedance and calipers. As I read the two descriptions of events, I thought, what if the trainer had the discussion about how the client wanted to talk about her weight. I wonder if then the anger could have been avoided. This would have enabled a deeper discussion of the client’s values and motivation for training. Would it have been better to skip the characterization and focus on the higher rates of high blood pressure, heart attack, and diabetes for Black, Indigenous, and People of Color (BIPOC).

Assessments help estimate the risk to your health. However, only you can tell your health coach or trainer what words do not cause you shame. Sharing words like large or thick that are not shaming to you will help your coach engage you in further discussion about your health concerns. What is important is that you understand the more significant health risk of a higher body fat percentage. The tests your doctor does on a routine physical like Cholesterol, Triglyceride levels, and blood pressure are all necessary measures.  

For more information about why health coaching is about you, please ready my blog post, It’s All About You.

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

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Slumber Your Way To Better Health 

Donna Wurster

Slumber your way to better health.  This is the first of a series of articles I will present.  In this post, I will describe what health concerns can improve with better sleep and its purpose for your body.  I hope you will use this information to jump-start progress in your health areas of focus.   In the second post of the series, I invite you to participate in Sleep Homework for one week.  I will participate along with you.  In the final post of the series, I’ll share my results and I will provide some additional evidence about the longer-term effects of a sleep hygiene program.

What Health Concerns Improve With Sleep?

For many of us, weight gain is an area of concern.  Lack of adequate and poor quality sleep affects hormone levels that cause you to be hungrier.    In addition, when you have low energy and feel fatigued you are less likely to adhere to your exercise program.  So you end up with More Calories in and Fewer Calories out and that equals more weight gain.  Weight gain could contribute to even more health issues.

Increased risk of heart attack and stroke.  How much do you ask?  Studies estimate that people over the age of 45 who get less than six hours of sleep per night are twice as likely to have heart disease (National Sleep Foundation,2018).   Blood sugar regulation is often degraded, possibly leading to diabetes.

Sleep problems interfere with your immune system’s function.  Immune system signaling molecules (cytokines) can lead to chronic inflammation.  This is not the good inflammation that helps us heal from wounds and injuries, but excess inflammation.    Chronic inflammation contributes to artery disease leading to cardiovascular disease.  The list goes on to include type 2 diabetes, arthritis, and depression.  Finally, at a time when we are all concerned about COVID, Irwin 2015, indicates that sleep deprivation may lower the effectiveness of vaccines and increase susceptibility to disease.

Poor sleep is associated with anxiety and depression.   Some people sleep too much and others too little.   Disturbed sleep can contribute to emotional health issues causing us to be more fragile.  Who has not had a bad night’s sleep and not felt that we could deal with the challenges of our days.  There have been times when I have been brought to tears after a poor night’s sleep by the routine challenges at work.  Too much time is spent in fight or flight response so both the brain and the body are affected.  

The fogginess in our minds from fatigue results in a higher rate of accidents.  You may experience poor work performance.  

Many studies have linked inadequate sleep with Alzheimer’s disease. Later in the article, we will see that poor sleep can result in the buildup of amyloid proteins that are linked to the disease.

About 50 to 70 million adults have a sleep disorder.  For many of us it is not insomnia, but poor or inadequate sleep.  Some of the symptoms include:

  • day time fatigue.
  • trouble falling asleep
  • waking too early in the morning
  • unable to fall back to sleep once you wake up.

What is restorative sleep?

Of course, the standard answer we hear is that adults should get 7 to 8 hours of sleep and teenagers should get one more hour.  As many of you already know, being in bed does not mean we get quality sleep.  For people like me who suffer pain from injuries or arthritis during the night, losing an hour or two of sleep each night is not unusual.  A new study out of the University of California (Adams, Heather) has identified “efficient sleepers”  that have Familial Natural Short Sleep (FNSS).  These people can feel perky and energized after 5-6 hours of sleep.   The author refers to  this new study as proof that the quality of sleep is more important than quantity. However, most of the assessments of quality are made subjectively by how a person feels.  

Drake, Christopher L et al. in a Jul 14 journal of clinical sleep medicine article examines how difficult it is to validate the measures of adequate sleep.  They developed and tested a Restorative Sleep Questionnaire (RSQ).  Tools to evaluate   sleep onset or initiation, sleep interruptions, alertness on waking and length of sleep are common.  By using focus groups a nine item questionnaire was developed in two versions.  One version was administered daily and the other weekly.  Both tests were found to have internal consistency reliability (> 0.90).  In the focus group good sleep was described as :

  • falling to sleep easily,
  • sleeping without waking,
  • feeling rested when waking up.

Still, we don’t have an objective measure.  I have read that 20-25 % of the time during sleep spent in REM is one measure frequently.  I use a fitness tracker.  I track total hours slept, amount of time awake, and % of the time in REM.  Normally, when I feel rested is consistent with these measures falling into a certain range.  More about that next time.

How Does Sleep Benefit Your Body?

During the day your brain is busy processing the visual cues it receives.  We speed through our days reacting to events.  Often these activities are taking place automatically without much mindfulness.  During the night our brain cleans itself and removes waste products.  Our brains may shrink by as much as 60% which allows the cerebrospinal fluid to mix with the interstitial fluid.  This mixing washes away wastes like amyloid proteins that accumulate during the day.  The meditative state allows memories to be consolidated.  Some believe our creativity is sparked by the cleaning process resulting in dreams.

Sleep Cycle

Sleep affects several hormones.  The first is melatonin, the sleep hormone. To understand more let’s talk about the hormones involved in the sleep cycle.  We fall to sleep because GABA  (a neurotransmitter gamma-aminobutyric acid) is activated.  When we are awake, acetylcholine is secreted by the hypothalamus, which dampens the effect of GABA.  When you are active during the day another chemical , adenosine, builds up and hinders acetylcholine.  As the day ends the blue light from the sun causes melatonin to begin to rise.  Adenosine breaks the wall of acetylcholine and GABA takes over.   As you sleep your melatonin levels peak causing deep sleep.  As your temperature bottoms out and cortisol, the stress hormone rises, then you dream.  When the sun rises melatonin begins to fall and cortisol reaches its peak.   Since cortisol triggers many other hormones, when the cycle is disrupted then fragmented sleep may result.  Also, electronic devices can delay melatonin production causing the onset of sleep to be delayed.

Hormones

The final hormones we will discuss are human growth, hunger hormones (leptin, ghrelin, and insulin), and estrogen and progesterone hormones.  Not only does human growth hormone govern your body’s ability to repair itself, but it also affects how you metabolize sugar.  When HGH is disrupted, then pre-diabetes or diabetes can be complicated.  Poor sleep can mean that not enough leptin is produced leaving the hormone that makes you hungry, ghrelin to run wild.  Ever have a day that you just could not get enough to eat – ghrelin.  Finally, estrogen and progesterone are two of the hormones triggered by cortisol.   In both men and women, these hormones affect thyroid function and can slow metabolism.

Next time we’ll talk about sleep hygiene and make a plan to do some homework.  Sharpen those pencils.   

Please leave a comment.  Let me know what you think or share your story about how sleep is working for you. Contact me to suggest other topics.

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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Why Should I Invest in a Health Coach

I asked myself this question before.

My time and money are valuable. How will a coach help? After all everyday thousands of personal trainers, physical therapists, registered dietitians publish videos and posts everyday. Many of you have tried using this information with some success. Has that success been lasting? I have worked as a personal trainer. People came to me because I was an expert. They spent time and money on me to get the answers. At that time I thought I was a good trainer because I spent some time asking what the persons goals were. I had great success with helping them meet their goals. I rejoiced when one older client arrived one day and shared that he had been able to walk to his grandson’s soccer field and watch his game. This was a big achievement for him as he had watched from the seat of the car before. Ask me how many of my client maintained their fitness or weight loss five years after they stopped working with me. Zero not a one. But I had taught them the exercises, instructed them to spend a certain amount of time, designed a program based on their goals. Why didn’t this work?

Enter the Health Coach.

This person partners with you to find lasting change. This may include helping you to learn new strategies to plan for and cope with lapses. First, this person believes you are the expert in your like and has the skills to help you sort out what you want to change. Second the results, in the Durham VA Healthcare System study HbA1C, physical activity change, and BMI had a statistically significant change when health coaching was used. What’s different here is that a Health Coach is on your side. We are your mirror so that you can see yourself in new ways that enable change. Finally, your Coach is skilled at listening and has many different approaches you can use to plan the steps you want to take. Like a guide on a trip, the coach can help smooth the way and add color on your wellness journey.

Want more information? This Blog was based on some of the information below.

Billie Frances, 4 Benefits of Working With A Health Coach, February 19,2015, https://www.acefitness.org/education-and-resources/lifestyle/blog/5303/4-benefits-of-working-with-a-health-coach/

Melinda Huffman, Traditional Health Teaching is Out.. Evidence-based Coaching is IN! , 2015, https://www.ahihealth.org/wp-content/uploads/2015/12/Health-based-coaching.pdf

Durham VA Healthcare System, John W. Williams Jr., MD , MHSc, Director, The Effectiveness of Health Coaching, April 2017, https://www.hsrd.research.va.gov/publications/esp/health-coaching-REPORT.pdf

Perter Grinspoon, MD, Health coaching is effective. Should you try it? , Published in the Harvard Business Review, April 8, 2020, https://www.health.harvard.edu/blog/health-coaching-is-effective-should-you-try-it-2020040819444