By Carla MillsCarla Mills is a licensed and accredited Nurse Practitioner who has been a practicing clinician for more than 20 years. She is the author of A Nurse Practitioner’s Guide to Smart Health Choices, an easy to understand, medical reference guide for patients with no prior medical knowledge. Read her blog at maverickhealth.com.
The following article is adapted from Carla Mills’ blog, which is available at www.maverickhealth.com/blog. Carla has updated the content from the original posting. It is offered to NPs for personal use and enjoyment and/or to share with patients.
A diabetic patient of mine expressed worry about an upcoming trip to Disney World with his granddaughter. He knew he would have to walk more than he was accustomed to doing. I asked him if he ever exercised. He held up his hand in a “stop right there” gesture and said, “Don’t speak to me about exercise. I follow the religion of comfort, and exercise is uncomfortable.” His statement left me completely speechless (and if you knew me you would appreciate how uncharacteristic that is).
More than two-thirds of us are overweight,1 and that percentage is predicted to keep growing, along with our waistlines. Only about one-third of us exercise regularly.2 Is it any surprise that diabetes is an epidemic and preventable heart disease is disabling and/or killing us? Yet in spite of these dire health outcomes, the majority of us still cling to my patient’s “religion of comfort.” Why?
Maybe it’s the big screen TV, the recliner chair with the cup holder, and a remote control that gives us easy access to 200 channels without ever getting up. Or maybe it’s the computer and the Internet. With the virtual world sitting in our laps, why bother to go outside and explore the real one? In order to find the motivation to exercise, we must find a way to get out of our chairs and off of our keisters and unleash our inner Olympian!
Nurse practioners (NPs) can lead the way. Because an NP’s scope of practice is holistic, we take care of the whole person across all domains of his/her life. We teach as well as treat; we coach as much as we counsel. We can teach patients by telling them about their health risks, but we coach by being role models ourselves. What do your patients see in you? Are you a couch potato or an Olympian?
Everyone, patients and providers alike, knows that poor diet, excess weight, and lack of exercise are responsible for the blight of chronic disease. While chronic disease is sickening and killing millions of us, it is also bankrupting our healthcare system and our national economy. Yet, knowing this hasn’t changed our behaviors. We continue to slouch on toward years of illness and debilitation that lead us to early graves.
Diabetes and heart disease are only two outcomes of our poor lifestyle habits. Certain cancers (endometrial, breast, and colon among others); hypertension; lipid disorders; stroke; gallbladder and liver disease; respiratory problems, including sleep apnea; osteoarthritis; and gynecological problems3 (such as polycystic ovarian syndrome) can all be tied to poor lifestyle choices.
In January of 2010 the American Heart Association released seven criteria (they call them “The Simple Seven”) in an attempt to reach a goal of reducing heart disease by 20% by 2020. The simple seven
1. Don’t smoke (and good for you if you quit more than a year ago!)
2. Maintain a body mass index of <25.0
3. Engage in physical activity for at least 150 minutes (2.5 hours) at moderate intensity or 75 minutes (1.25 hours) of vigorous activity per week
4. Eat a healthy diet consisting of:
• Fruits and vegetables: ≥4.5 cups/day
• Fish: ≥ two 3.5-oz servings/week (preferably oily fish)
• Fiber-rich whole grains (≥1.1 g of fiber per 10 g of carbohydrate): ≥three 1-oz-equivalent servings/day
• Sodium: <1500 mg/day
• Sugar-sweetened beverages: ≤450calories (36 oz)/week
5. Control total cholesterol <200 mg/dL
6. Control blood pressure <120/80 mm Hg
7. Have a fasting blood glucose<100 mg/dL
One year later, in February 2011, a study done by the University of Pittsburgh found that only one out of nearly 1,933 middle-aged Americans met all seven criteria for heart health5—that’s right, in a random sample, only one out of 1,933 middle-aged Americans had all seven good heart health habits.
Think back for a minute, and remember some of the high points and special moments your life. I bet not a single one occurred in front of the TV or computer. Not that those aren’t entertaining pastimes; they just don’t ask anything of you. Unless you are creating something, you are just sitting there, passively consuming whatever you are fed.
Life’s adventures are active—active means you move—you try something new, you travel somewhere, you meet someone new, you practice something to get better at it. These are ultimate 3D experiences because life is happening in, around, and through you, in full color, tickling all of your senses.
Whether it’s running a marathon, climbing a mountain, or just walking to the mailbox and back without getting short of breath, it’s the spirit you bring to things that creates adventure. When you connect with your inner Olympian, exercise becomes a pleasurable necessity in your life rather than a dreaded chore. That is what you want to happen for yourself and for your patients.
When you think “Olympian,” maybe you think of famous athletes like Michael Phelps or Shaun Johnson who become rich and famous. But they are the exception, not the rule. Most Olympians never become famous, and they go home from the Olympic Games to live lives just like yours. No, Olympians aren’t driven by fame and money—it’s something else. To understand what I’m talking about, think about the Special Olympians, people with handicaps who choose to reach outside themselves to find out what they can achieve against great odds…and to have fun.
Seeking health and fitness through a nutritious diet and exercise (and weight reduction, if necessary) should be a fun adventure. It should bring you pleasure and a chance to bring out the very best in yourself. Whatever physical activity you choose—and it doesn’t matter what it is—just enjoy it. Physical activities that give you pleasure will be the ones you want to return to again and again.
Set some goals for yourself. It doesn’t matter what they are as long as they matter to you. Then, as the ad says, “Just do it!” Be consistent. Keep showing up. If you are faithful to your goals, the simple passage of time will bring results that may surprise and astound you.Once you’ve achieved one goal, raise the bar a little and go for another goal. Before long, you will realize that setting and achieving goals that are important and meaningful to you keep you well. Your inner Olympian will be unleashed.