Health–by any other name

Definitions:

Per Google Search:

The state of being free from illness or injury

A person’s mental or physical condition

Used to express friendly feelings towards ones companions before drinking

Per World Health Organization:

A state of complete physical, mental, and social well-being beyond and not merely the absence of disease or infirmity

I’ve been thinking a lot lately about health, and what exactly in means currently (in a popular culture sense). Questions have come to mind: what does it really mean to be healthy? How do we know when we are healthy? Do we reach an end point of healthiness that we just maintain? Is it about fitness or about more than just exercising and eating right? Is it about balance?

Reflecting my evolution in that area, I’ve been interested in health since I was about fourteen when I first started endurance running. My own personal health journey could be broken down like this (please note this breakdown is especially simplified): increase exercise start to feel good, step on scale realize body does not fit “health standard of appropriate BMI” and begin changing diet, see results, but begin to believe that BMI of 20 would be “healthier” than BMI of 24, spend youth obsessively dieting. But things go downhill and begin to realize perhaps this is not healthy anymore, change tactics, beliefs still centered around idea that health is mostly about fitness, eating well, and he body but do not use scale as measuring stick, gain a boost in health, self-confidence, self- esteem etc.. Get older, some life changes happen, leading to a return of some unhealthy thoughts and habits, light bulb moment where suddenly know that actually mental health, relationships, and everything else counts too, shift focus again….

As I grew into someone working professionally in the health field, I’ve come to realize health is a continuous journey. It isn’t about “achieving” something like an “after” photo or even about perfect lab values that then remain perfect forever. It’s about a myriad of different things, and for most of us it is constantly in flux. This was at one point hard for me (and I imagine many others) to really accept or understand; as culturally we look at health as an “end point” where we get healthy and stay healthy. But that health constantly changes, as parts of our life change and habits we created needed to change again.

I rarely meet people who are satisfied with their health, but a lot of these people I meet really should be okay with where they are. I’ve noticed that we have a hard time with the idea of satisfaction and acceptance (in this case how they relate to health). We seem to believe being satisfied with our health and accepting where we are means we will become stagnant. I don’t believe this is true, I haven’t seen it to be true. In fact when health is truly suffering there is usually no acceptance going on: no acceptance that parts of life are out of balance for us. Is being happy with where your health is at really bad? I don’t think so – but there’s enough pressure out there to make it a really hard thing to do.

In the popular culture of health I see (blogs, books, etc. etc.) health is something we consider to be an individual responsibility. Not only should you be disease free (or managing your illness or physical health or mental health) you should be striving to do it better than you do now (or perhaps your neighbour). So with the pressure to constantly improve our health, how do we accept it when life changes mean we have to take a few steps back? Suddenly we fail – and we no longer consider ourselves healthy.

I hope that many people can start to see their health as a continuous, often circular journey. Not simple a moment of achieving a certain desired health characteristic. I hope people can accept that sometimes aspects of health might not be perfect, as other areas need attention.

I still have lots more thoughts on health, but I’ll leave it there for now. I’m sure you’ll see a part two somewhere on the horizon.

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But are you still living?

I see it all the time; people making “lifestyle changes”. Usually lifestyle changes are relegated to one part of our lives: diet and exercise (Which irks me to no end – but that is not the topic of this post) but unwittingly this can affect our lives in other, more subtle ways.

Sometimes this is for the good of our life. We start finding ways to integrate food and exercise in a way that helps us feel better physically, or fills our time with healthy activities, or even builds and improves friendships and relationships in our lives.

But sometimes it can take a less positive turn and can take away some things in our life we really enjoy. There’s a popular misconception about healthy eating and exercise that they are unpleasant, drudgery and chore like. So if this is to be believed then the opposite must be true: if you’re living your life happily, you can’t be healthy.

This just isn’t the case.

For instance perhaps you’ve really started to “clean up your diet” (for lack of a better term) and things are going well; you’re focused, you haven’t “cheated” and things are showing progress. In your “old life” you go out every week for drinks with friends (you’re young and single, this is your social life!). Now because you’re so focused you either skip these evenings with your friends or you deny yourself your favourite meal every time because you are only allowed to eat salads and lean proteins. (But you love burgers and fries! And the occasional adult beverage. )

I bet you start to feel resentful.

And that good habit you’ve started starts to become a chore and something you hate doing because it deprives you of something you used to really enjoy.

Sometimes you have to find the middle ground… In the example above you could order what you wanted one of the nights out (one meal that doesn’t fit the healthy meal plan du jour won’t hurt your progress). Or a happy medium every time; a burger with salad or the lean protein salad but your favourite caloric-heavy beverage.

Then (and this is the important part) let yourself enjoy every second of it.

I do believe a lot of these instances are when diet or exercise changes become extreme in nature – and thanks to our perpetually perfectionist society we often have these extreme swings in habit. But the best way to truly change your lifestyle is to find a happy middle place where you still do what you enjoy, but slowly change the habits that might not be serving you.

Have you ever gone through experiences like this in the name of getting healthy? How did you find middle ground?

This Girl Can (and Does)

There’s been a lot of buzz this week about a campaign out of England to get more women involved in physical activity. The ads show women of all ages, shapes and sizes getting their sweat on in all sorts of ways. These women jiggle, they have cellulite, they’re anything but perfect.

And it’s awesome.

I read this Huffpost article on the new campaign, and this line stood out for me:

So what has been stopping us from doing so thus far? Unlike the gender pay gap, this was one area where we weren’t being held back, where we were actively choosing to not participate in something. “We did lots of research,” says Executive Director Tanya Joseph, “and there was one single unifying theme – fear of judgement.”

I have been active for most of my life. My family really emphasized the importance of sport and being active.

But I’ve never looked like an athlete; I’m chubby, I jiggle, I get super red in the face (I’m already very pink to begin with). I’ve also never been the best at any sport; I’ve never been the worst either though. I’ve felt self consciousness around both these issues (how I look and my abilities) when being active or considering trying a new sport.

In the past few years a number of friends and acquaintances have confessed to me a similar discomfort at trying new things. Either fear of judgement around their performance because they’ll be a beginner, or fear of how they’ll look. What makes me sad is that these friends of mine aren’t talking about their self-consciousness filled teenage years either; they are talking specifically about being an adult and getting active. I’ll admit that my history of being active since a young age has helped me with the confidence in my athletic ability as an adult, but still I thought I’d share a few of my mind tricks to help get me out the door for a run, or trying a new sport.

1. Be a role model: this is the biggest one for me. A lot of my self-consciousness came because I’d never see someone that looked like me doing such and such sport. A lot of the time I think about that young girl (aka me) who wanted to try dance but who believed she wasn’t flexible enough and so she shied away from trying it. I want her to know it’s okay to dance anyway, so now I try it. I figure if no one else will be the fool, I will, because the me that was ten and sees someone just like her dancing, gives her permission to go out and dance to her hearts content too.

2. Remember everyone was a beginner once too: if you think about how you work with someone completely new to something you’re really good at, you’ll realize you probably don’t judge them. Sure you may get the odd moment of being impatient, but mostly you know you started somewhere like that once too. Sometimes you will get a coach or trainer or teacher who is judgemental, but try to keep in mind that’s their stuff not yours. There are probably a number of things that you might look foolish doing, but if say it’s a beginner dance class, everyone will be in the same boat. If it’s a yoga class with newbies to advance practitioners, remember that you have no idea how long the other people have been practicing (so drop the comparing which brings me to…).

3. Change that self talk: this is honestly the hardest and probably the one I’ve been working on the most recently. Negative talk surrounds us on a daily basis; we are constantly bombarded with messages telling us we are not good enough; either through advertisements or other pieces of media (I think health related issues can be particularly damning). I used to use pretty negative self talk to motivate myself; a la Jillian Michaels, I would basically yell at myself in my head, it was not pretty. This past year I thought what if I just told myself I’m doing awesome? What if I simply started saying I can instead of I can’t or will never be able to? So now in the gym I often consciously focus on what I’m thinking. Honestly as silly as it sounds it’s been working. Strength things I never thought I’d be able to do I’ve been doing with much less effort (hello longer planks!) and I’ve made much better strength gains. And I acknowledge how far I’ve come with those. Being positive about what I do, instead of negative, has made a world of difference in my performance. I think it could for you too.

So those are a few of the tricks that work for me.

Have you seen the campaign? What do you do to get yourself out there?

Thanksgiving

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This past weekend was the Canadian Thanksgiving.

It’s always a great weekend. I can honestly say I have a lot to be thankful for in my life.

I was sitting and journaling last month when I realized I had one month until my birthday. This year has been a crazy adventure for me on many different levels. I always find myself retreating into a very introspective place in the fall, just before my birthday (and that’s saying something because I’m always pretty introspective).

According to Brené Brown and many others, happiness (or joy rather) is actually something you can cultivate. One of the ways of doing this is to keep a gratitude journal. Seriously, practicing gratitude can increase your everyday joy in life. It goes back to that old saying “it’s not having what you want, it’s wanting what you’ve got”. I have a tendency to focus pretty strongly on what I don’t have, or what I think is missing from my life. And considering all I do have, this can make me feel guilty on top of feeling a little put out about what I supposedly feel is lacking in my life. So I decided on that day to challenge myself to focus instead on everything I am grateful for in my life as I approach my birthday.

So I started a 30 day gratitude challenge for myself. My rules were this:

1. Write what I’m grateful for every day for the next 30 days.
2. Each day add something, starting from one to thirty (so today I will be writing down 23 things I’m grateful for)
3. No repeats: exceptions include specifics (like I can be grateful for my parents one day, but can’t say that again for the rest of the challenge, but I can be grateful for a phone conversation with my parents on a different day).

The no-repeats part was a little intimidating for me. After all, it is easy to fall back on being grateful for my loving family and my cat (#haveyouseenmyinstagramaccount?). But I wanted to stretch my gratitude muscle and really try to find different things every day. And surprisingly I’ve been able to do just that. A lot of my grateful for things focus around friends, family, nature, and that sort of thing. But random ones will pop into my head every now and then. I mean yesterday I even wrote that I was grateful for my mom making me keep a journal when I was 12, without which I wouldn’t have cultivated a practice to journal EVERYTHING and have journals from my teen years until now (seriously got a lot of journals filled almost to the last page).

Can I say if it’s increased my happiness levels? I’m not sure. I definitely actually try to notice things throughout my day, or I’ll think oooooh that’s something I can be grateful for (which I promptly forget about and can’t remember when I sit down to write my list…). I’m not sure if I was in a more positive place mentally and started the gratitude journal or if it really has helped me focus on what I got instead of what I want-but-don’t-have. Either way it’s been a great challenge to date, and I’m excited to see how the last week of it goes.

Have you ever kept a gratitude journal? Or even just tried focusing more on what you’re grateful for?

Boxes

I’ve been thinking a lot about boxes lately. Not physical boxes, but the metaphorical ones we fit ourselves into. Call them labels, call them boxes, call them descriptors, whatever you like; same deal, it’s about fitting to the implied meaning of a descriptive word/noun and fitting all it’s implied attributes.

This post came to mind earlier this week, or rather last week, when I joined some friends for board game night, or rather nerd night as it’s being affectionately called.

The guy who organizes the nights asked me at one point what I thought of the new Hobbit movie.

“It’s long,” I replied, because it was.

“Oh,” he said shaking his head regretfully, “I almost gave you nerd cred there.”

It had happened, someone called me out on my lack of true nerdiness – but wait let me explain just what I mean a little bit more.

This comment is part of a series in my life recently, which at first glance might not seem to connect. I had a friend comment early in January when we were skiing that I was obviously a really good athlete. The comment made me really uncomfortable, and I couldn’t figure out why (after all shouldn’t that be a compliment?).

Back in November at brunch with friends, another friend commented, “But you’ve always been really healthy” (on the topic of me being a dietitian). Again I felt really uncomfortable (and bit my tongue from curtly asking, “And what does it mean to be “really healthy”?).

Mostly these comments made me feel like a fraud, because despite the fact that yes I am “really healthy” and I am “a really good athlete” these descriptors have never been ones I’ve considered myself to be belong to. These are not boxes I felt I truly fit in; I was neither born an athlete, nor the most crazy health zealot I knew.

My athletic abilities came from being born to a family who valued sports and had the means to provide me skiing and skating lessons. My healthy habits were also learned and self taught, and often include chocolate on a daily basis (which in my mind negated all the other healthy habits I had). And I am nerd in that I enjoy sci-fi and fantasy, but I don’t necessarily go so far as to read anime, comics, or really play video games.

But mostly I always thought; I’m not enough of a nerd/an athlete/a healthy person  to really fit myself into the boxes. And this means someone will call me out on it (such as at nerd night) if I do call myself a nerd, or athlete or whatever, eventually someone who epitomizes the box (the stereotypes) of these will call me out on it; well you’re not a real nerd or athlete or whatever. This is of course perfectionist thinking at it’s finest; I’m not good enough to be the stereotype, so I can’t actually be part of the box, to use to describe myself.

But on the flip side it bothered me when my friends put me into those boxes, as though they are stationary things, as though I just showed up on this planet and fit into the boxes of being an athlete or being healthy. And it all comes down to me being more athletic or more health conscious than they consider themselves.

Maybe I should just accept the compliment. Or maybe I should not worry about it. But I’m not sure I will be able to stop feeling uncomfortable when someone stamps a label on me as a compliment, nor will I ever fully enjoy self-imposed labels either. After all does it really matter if I’m a nerd, an athlete, or someone who is health conscious? Do these definitions become the be-all end-all?

I really think that while these labels do come from my actions, they aren’t necessarily what should be important in life; after all they reduce me a couple characteristics that don’t allow much wiggle room. Even self-labeling is really about how others see you or how you want others to see you. I kinda just like being me, no boxes, no perfectly-fitting-into-the-stereotype. Just me, and my random collection of interests.

What have you experienced with labels or boxes? Self-imposed (or restricted) or otherwise?

It’s Not A Diet, it’s a Lifestyle

Heard this one before, have you?

I’ll admit I like this phrase. I used to really love it; yesssss, I would think when I read it; it is all about the lifestyle.

Sadly like many trends, it is now everywhere, and most stunningly (though not surprisingly) it is attached to a large number of what should be called diets.

A while ago I was eschewing diets with all the long term bad side effects that can happen (regaining the weight, increasing some medical problems substantial, poor quality of life, loss of connection to hunger signals, the list could go on) to a friend on facebook. She was a little surprised:

Me: love busting diet myths for people… did you know you end up eating more if you are “dieting” than if you are not?
Friend: huh, how does that happen? if you are dieting aren’t you watching what you are eating so therefore wouldn’t you be eating less?
Me: well that is the thing, how do you define dieting? and what does “watching what you eat” really mean?
Friend: i dunno eating no junk food, less fruits, more veggies and meat….less carbs
Me: and if you are going to define dieting then what is not dieting?
Friend: eating some of the other stuff occasionally once u are at the weight u want? lol i dunno

My friend’s definition of dieting is innocuous enough, and really this (somewhat vague) description might be what most people consider a diet. There are hundreds of different definitions of diet, and if so, what is the “real dieting” that leads to the studied negative (and somewhat ironic) outcomes?

Truthfully it’s the diets that cut out entire food groups. Or that have you eating very very few calories. Or has you eating all their packaged foods (as a nutritionist, all I can say is for optimal health real food is where it’s at; our body knows what real food is, it doesn’t recognize those unpronounceable words on the ingredient list either). I would go so far as to say if they are charging you money to attend their meetings/weigh in/lose weight it’s a diet.

I personally completely agree with Health At Every Size. I am glad to see that provinces in Canada, like New Brunswick and British Columbia are starting to focus on wellness rather than on weight loss being a goal of prevention initiatives. Even the Canadian Obesity Network believes that obesity management should be about attaining the Best Weight possible while living the healthiest lifestyle a person can maintain with enjoyment.

Still, wanting to lose weight is not always a bad thing, but sometimes focusing solely on the number on the scale, and focusing on it’s downward spiral at any cost is more detrimental to your health than simply allowing that number to get where it will with reasonable healthy eating and living.

I was thinking about giving a list of how to recognize if the “lifestyle” you’re looking at is actually a diet. But I figure there are a lot of those lists out there. There are many many different ways to eat healthy. And eating can change more than your weight, and it should be about more than your weight, especially if you are considering a “lifestyle change” (lifestyle does imply something beyond eating food, doesn’t it?).

I think I will draw this post to a close before it gets even more rambly than it already is.

One question I think you should ask yourself should be (before you start your next lifestyle change): if  this diet/lifestyle/health challenge/detox/cleanse didn’t promise me weight loss, would I eat like that?

The Danger of a Single {Medical} Story

Have you guys seen the Ted Talk, The Danger of a Single Story?

No? Well it’s awesome. Go watch it now.

A few weeks ago I was teaching a diabetes class, the topic was creating reasonable health goals. As an example I mentioned adding a couple pieces of fruit as a snack a day.

A rather outspoken woman looked towards me and said, “And why are you telling diabetics to eat fruit?” Her words were sharp and her eyes concentrated on me, “Diabetics can’t eat fruit.”

This was news to me and my colleague. We’d never heard that diabetics can’t eat fruit.

It turned out as the conversation progressed that when her husband (the diabetic in this case) ate fruit his blood sugars would shoot to 23 (very high for you who don’t know.). This is not the case for everyone. Diabetics can eat fruit. But for this gentleman, fruit might not be a good idea.

But for his wife, after being told fruit was probably not a good idea if his sugars went to 23, she assumed ALL diabetics could not eat fruit.

Assumptions. Stereotypes. Simply reading between the lines of our client’s diagnosis and assuming we then know their life. Yes, the woman in the the diabetes group is a client, but do we as health professionals really behave differently?

After all many health care professionals have personal experience with diseases, chronic or otherwise. Either ourselves, or a close loved one, or even a friend may have been diagnosed with x, y, z and beat it through careful monitoring of this or a lifestyle change of that.

The danger comes because sometimes the patient we’re seeing doesn’t need to change what your aunt changed to get her weight down, or her blood sugars in order. But because the patient fits, in looks, in diagnosis, with your aunt’s story of diabetes, you assume that’s what her problem is.

But all health conditions are made of myriad of factors. No two people live the exact same lives with the exact same results.

So it’s important to ask them the questions, even if you predict the answers correctly, about their life and their lifestyle, because simply basing your answers on your assumptions isn’t going to help them.

And really you might be surprised at how many times their answers surprise you. And getting the full story of their life outside of their diagnosis is the best way for you both to work together to help them get to the healthiest place they can.