The first episode of public backpedaling on vitamin supplementation probably occurred during Sanjay Gupta’s segment on CNN’s Situation Room.  Reporting on the results of a recent study that associated multivitamin use with an elevated risk of breast cancer, Gupta dared to venture that we should be cautious about vitamin use.  He spoke to the fact that the great majority of the many studies on vitamins do not show benefit.  He also said something that made me cheer:  removing a  vitamin from its food source and concentrating it many times may not work; may even be harmful.  Bravo for Sanjay.

But by later that day, the CNN website had thought better of Dr. Gupta’s comments.  http://pagingdrgupta.blogs.cnn.com/2010/03/31/can-your-multivitamin-give-you-cancer/   After warning readers about the shortcomings of this study (and there certainly are many), it carefully decided to cover all bases. 

First, it took one side: 

“The National Institutes of Health have said that ‘some of the roughly 75 million Americans who buy [multivitamins and supplements] may not need them.’" 

Then, the other:

"At the end of the day, it's always better to see someone taking a vitamin than not. The benefits outweigh the risks," advises Dr. Kent Holtorf, medical director of The Holtorf Medical Group, who was not affiliated with the study.

"The bottom line is a patient is not a population," says Holtorf. "It's better to take a vitamin than nothing but your best bet is to find out if you're deficient in anything and then treat those deficiencies in an individualized way."

This article equates information from the NIH with the opinion of Dr. Holtorf.   Since I had never heard of the Holtorf Medical Group, I Googled them.   They are a practice in California that deals in natural supplementation for a whole host of conditions from menopause to “adrenal fatigue”.  They also use supplements for anti-aging medicine.   This is not exactly an academically rigorous discussion of the issues raised by the study.   

But we shouldn’t be surprised.  The media does a generally poor job of covering complex issues like medical studies and treatment.  America is hooked on the idea that supplements are a magic wand that can erase our dietary indiscretions.    Very little science supports this view.   The AJCN study is challenging because it provides the springboard for discussion and for a re-evaluation of supplementation.  We should pick up that gauntlet rather than ignore it. 

It’s particularly interesting that the people who defend supplements most vigorously are those who believe in natural solutions to health.  There may be a basic misconception here.  Is supplementation with vitamins and minerals which are extracted from food sources natural? 

Even if vitamins are useless but harmless (they make very expensive urine, as a professor of mine used to say), there is potential damage from relying on them as a kind of magic feather that allows us to eat all kinds of bad stuff and assume we’ll be saved.  We use medicines like cholesterol lowering drugs and blood pressure pills the same way. 

In the meantime, I’m personally putting my money on original, whole foods from sources that (I hope) I can trust.  I remain suspiciously paranoid about ingesting anything made in a factory or deemed to be healthy be dubious experts.  We just don’t know enough about that stuff.  We do, on the other hand, know an overwhelming amount about the positive benefits of living clean.

May 9-15, 2010, is the 13th annual Food Allergy Awareness Week. This year, help those with food allergies “Respect Every Bite.” Food Allergy Awareness Week is devoted to educating others about food allergies, a potentially life threatening medical condition.

Food allergy occurs when the immune system mistakenly attacks a food protein. Ingestion of the offending food may trigger the sudden release of chemicals, including histamine, resulting in symptoms of an allergic reaction. The symptoms may be mild (rashes, hives, itching, swelling, etc.) or severe (trouble breathing, wheezing, loss of consciousness, etc.). A food allergy can be potentially fatal. Scientists estimate that approximately 12 million Americans suffer from food allergies.

Eight foods account for 90% of all food-allergic reactions. They are milk, egg, peanut, tree nuts, fish, shellfish, wheat, and soy.

At this time, no medication can be taken to prevent food allergies. Strict avoidance of the allergy-causing food is the only way to prevent a reaction. Medications are administered to control symptoms after a reaction occurs.

Sources:

http://www.nlm.nih.gov/medlineplus/foodallergy.html
http://www.foodallergy.org

Information

Food Allergy Information from MedlinePlus includes overviews, diagnosis/symptoms, prevention/screening, disease management, specific conditions, clinical trials, directories, and more.

Tools

Virtual Allergist Interactive Tutorial (American Academy of Allergy, Asthma, and Immunology)

Videos

Food Allergies: Reducing the Risks (Food and Drug Administration)
If I Had - A Child with a Food Allergy (Insidermedicine)
If I Had - A Food Allergy (Insidermedicine)
If I Had - An Allergic Reaction (Insidermedicine)

Latest News

Food-Allergic Kids Should Carry Two 'Epi' Doses

(03/22/2010, Reuters Health)

Rates of Food Sensitivity Vary by Country

(03/12/2010, Reuters Health)

Peanut Allergy Linked to Worse Asthma in Kids

(03/11/2010, Reuters Health)

Food Allergy-Related Disorder Linked to Master Allergy Gene

(03/08/2010, National Institute of Allergy and Infectious Diseases)

More Information:

American Academy of Allergy, Asthma, and Immunology
Food Allergy & Anaphylaxis Network
National Institute of Allergy and Infectious Diseases

If you would like more information, please contact a Lake Health Professional Librarian

Scientists are supposed to be curious.  Weren’t they once the little boys and girls who peppered their parents with a zillion questions about how the world worked?  Didn’t they once want to solve the riddles of the universe?  

But then the scientists grew up and like all the rest of us, they became less open minded.  Perhaps they were influenced by powerful figures.  Or perhaps they became so immersed in their own hypotheses that they stop looking at others. 

In no area has this been so true than in the reluctance of researchers to look at the negative role of sugars in our modern diet.   In 1980 (take note of this date), Ancel Keys, a professor of physiology from the University of Minnesota, published a study that would change science for decades.  The Seven Countries Study was a research project that looked at diet and heart disease throughout the world.  It concluded that there was a strong association between the amount of saturated fat people ate and their cholesterol levels and subsequent chance of developing heart disease. 

The Seven Countries study has arguably been one of the most influential forces on our modern American diet.  Keys was a big, loud voice in the scientific community.  Beginning in the late 60s, he had begun convincing much of America to start eating more polyunsaturated fats and fewer saturated ones.  It was around this time that my mother banned the Breakstone butter tub from our table and substituted that fabulously healthful product--- margarine---made completely from corn oil.    Americans stopped frying in lard and started consuming tons of vegetable oils instead.  With the advent of the Seven Countries Study, things got more confused.  All fat became the enemy and the fat-free craze was on with a vengeance.  Carbs good.  Fats bad.  Dutifully, I switched to a diet of vegetables, grains, pasta, and bread with fat-free Entenmanns cookies for dessert.   It was all completely fat free.  But, for the first time in my life, I started to gain weight as if it was going out of style.  I chalked it up to being 40.  My diet was obviously pristine.

But holes began to appear in the Seven Countries Study.  (For more on this, see Gary Taubes’ book, “Good Calories, Bad Calories.”) Critics noted that Keys had omitted data from countries in which results contradicted his preferred hypothesis. At the same time, Dr. Atkins popularized a diet which had pretty much no carbohydrates. Cholesterol levels fell on this diet.  How could that be if fat raised cholesterol? For years, people like Weston Price who studied the anthropology of diet had noted that the inclusion of large amounts of carbohydrate in native diets was linked to modern disease. Yet science refused to be swayed from its single-minded pursuit of fat as villain. Clinicians who spoke out against sugar and starch consumption, and those who wrote about it were sidelined as kooks. 

Despite the fact it is clinically obvious that cholesterol falls when patients are placed on low carbohydrate diets, other doctors still look at me as if I’m nuts if I suggest that sugar has anything to do with lipids. Even more importantly, we now know that our levels of total cholesterol are only one, much generalized, piece of the puzzle.  Equally, if not more important, are the types of lipids you have.   We’ve gone beyond just the “good” cholesterol and the “bad” one. We now know recognize vital subtleties.  Bad cholesterol turns out to exist in two forms:  a light, fluffy, innocuous form and an irritating, small, dense and dangerous form.  Dense LDL predisposes you to coronary disease.  Standard lipid tests do not say anything about the size of LDL particles, but doctors can tell if you have them by looking at levels of two other elements, triglycerides and HDL.   If the ratio of these two elements is above 3.8, it’s a strong indication that you have small, dense LDL.   We call this type of lipid profile “dyslipidemia” and it is highly correlated with vascular disease. 

Is this all about the fat we eat?  Absolutely not.

On April 21, 2010, with absolutely no fanfare, the Journal of the American Medical Association published an uber-important study. “Caloric Sweetener Consumption and Dyslipidemia Among US Adults.”

Here is how the authors introduced it:

            Dietary carbohydrates have been associated with dyslipidemia, a lipid profile known to increase cardiovascular disease risk.  Added sugars…are an increasing and potentially modifiable component in the US diet.  No known studies have examined the association between the consumption of added sugars and lipid measures.

 Isn’t it incredible that with all the research on diet and heart disease that has been going on for the past 30 years, this is the first study to even consider the possibility that sugars impact lipids??

 So here’s what the study showed. It looked at 8,495 US adults over the age of 18 who were part of our ongoing national nutritional survey (NHANES, 1999-2006).   Excluded from the study were those on cholesterol medicines or diabetics---so two of the populations that theoretically might have shown the greatest correlation of lipid levels with sugars were not considered. The study also looked only at the added sugars people consumed, in other words, the extra sugar, high fructose corn syrup or other sweeteners that were included in the foods they ate, not at the total carbohydrate composition of their diets. 

 Results:  Good Cholesterol levels, which should be high, fell as the consumption of added sweeteners increased.  Triglyceride levels rose significantly, meaning that the ratio between the two went up (suggesting more dense LDL) as sweetener use did.  In women,   total LDL (bad) cholesterol rose with increased sugars as well. 

 Interpretation:  Sweetening agents directly affect cholesterol and triglyceride levels (or at least are highly correlated with them).  If this study is correct, eating more sugars increases your risk of vascular disease. Finally, it’s not just about fat anymore.

 How much added sugar do we consume?  On average, about 16% of our calories are coming from this completely unnecessary source.  Recently, the American Heart Association jumped on the anti-sugar bandwagon with the recommendation that women consume no more than 100 calories in added sugar per day   (150 calories for men).   How likely is this to happen?   Well, one can of coke has 140 calories from sugar.   A Starbucks Blueberry scone has 460 calories, 96 of which come from added sugars and a small pack of M&Ms has about 130 calories of added sugars.  Eat any one of these and you are done with sugar for the day and that doesn’t factor in the hidden sweeteners that are added to restaurant foods, canned foods, and just about everything else.  How many sugars should we truly eat?  In my world, the answer would be:  just the sugars contained in natural foods.

 Finally, this study just skims the bare surface.  It opens the door to the thought that too many sugars can be just as dangerous for your heart as too many of the wrong fats.  But the name of the game is gestalt—or totality.  If we get bogged down in running after sugars as we’ve gotten bogged down in running after fats, we will find ourselves at the end of another blind alley.  Each and every one of these studies confirms the very same principle; the further we depart from the diet that was original to man, the more we mess things up.  Clumsy attempts to “correct” the problem only reveal our ignorance.  Remember that margarine my mother switched to?  Turned out that it was full of corn oil, which is high in omega 6—or pro-inflammatory—fats.  Also turned out that margarine was just a tub of trans-fat, one of the most dangerous substances for the heart.  And all of those Americans who switched to vegetable oil?  They vastly raised the ratio of omega 6 to omega 3 fats in their diet, putting them at risk for inflammatory problems. Is it such a fringe idea to suggest that we need to revamp our entire idea of diet to bring it back into line with what kept us healthy in the past?  I certainly don’t think so.

 But for today, I will celebrate the JAMA study and be glad that science has started to expand its view.  Maybe I’ll try re-reading it while eating the peculiar concoction that I’ve recently been enjoying for lunch:  some sardines mashed up with good mustard, a salad, and an avocado.  Lots of omega 3, completley Primarian, and not a sugar in sight.

Also called: IBS, Irritable colon

Irritable bowel syndrome (IBS) is a problem that affects the large intestine. It can cause abdominal cramping, bloating, and a change in bowel habits. Some people with the disorder also have constipation or diarrhea.  Although IBS can cause a great deal of discomfort, it does not harm the intestines.

IBS is a common disorder and happens more often in women than men. No one knows the exact cause of IBS. There is no specific test for IBS. However, your doctor may run tests to be sure you don't have other diseases. These tests may include stool sampling, blood tests and x-rays. Your doctor may also do a test called a sigmoidoscopy or colonoscopy. Most people diagnosed with IBS can control their symptoms with diet, stress management and medicine.

Source:  http://www.nlm.nih.gov/medlineplus/irritablebowelsyndrome.html

Information

Irritable Bowel Syndrome   Information from MedlinePlus including overviews, diagnosis/symptoms, treatment, alternative therapy, nutrition, clinical trials, directories, and more.

Tools

Interactive Health Tutorial

Latest News

Irritable Bowel Syndrome Patients' Families More Prone to Symptoms Too(03/30/2010, Reuters Health)

Shift Work Linked to Irritable Bowel Syndrome(03/26/2010, HealthDay)

Health Tip: Symptoms of Irritable Bowel Syndrome(03/19/2010, HealthDay)

More News on Irritable Bowel Syndrome

More Information:

American Gastroenterological Association
International Foundation for Functional Gastrointestinal Disorders
National Digestive Diseases Information Clearinghouse (NDDIC)

If you would like more information, please contact a Lake Health Professional Librarian

Diaphragmatic breathing is a process that helps people improve their ability to focus their attention on their bodies. It involves breathing from your diaphragm instead of your chest. Your diaphragm is the muscle located just below your ribs. Breathing from the diaphragm involves slow deep breaths where the diaphragm actually pulls and pushes air in and out of the lungs. Breathing from the diaphragm promotes relaxation in the body as opposed to the shallow, rapid and tense breathing that occurs in the chest when you are anxious.

Relaxation methods enable you to effectively reduce both your mental anxiety and its physical signs. As you become more relaxed, you will be able to listen better to important things you want to say to yourself regarding your health. Relaxation is a self-control technique; you are in control of your level of relaxation. Like any skill, the more you practice, the better able you will become to relax more fully and in less ideal places.

Not only does this type of breathing make relaxation on a physical level much easier to achieve, it is also more efficient and subsequently increases the oxygen supply to the heart, brain, and other organs. By using this type of breathing you can reduce your stress, reduce anxiety and improve your mental and physical well being. Practice the following exercise on a regular basis until you are able to effectively use this breathing technique as needed, particularly when you're under stressful circumstances.

1. To begin the exercise, find a comfortable chair in a quiet room.
2. Place your hand on your abdomen below your rib cage. This where your diaphragm is located.
3. Concentrate on your breathing, taking slow, deep breaths. Breathe through your nose, inhale, and hold it.
4. Exhale slowly. You should be able to feel your stomach moving out when you inhale and in when you exhale.
5. Focus on your belly as it expands like a balloon when you inhale and deflates when you exhale.
6. Repeat several deep breaths. After you inhale, hesitate for a moment, and then slowly exhale.
7. Remember to slowly but deeply inhale and slowly but evenly exhale.
8. Avoid rapid, quick breath. This can lead to hyperventilation.
9. As you slowly blow all of the air out of your lungs, image all of the tension leaving.
10. Pause, and repeat this deep breathing until it has become a slow comfortable rhythm.
11. As you concentrate on slowing down your breathing, let your body sink into your comfortable chair. Notice how relaxed your arms feel against the chair; so do your legs, your back, and your neck. Notice that your breathing is slow, deep and regular. With each breath, you are becoming more relaxed and the tension is slowly fading.
12. You may wish to combine some imagery and positive self-statements with the breathing exercises. For example, when you exhale, imagine letting all of the tension in your body go with the breath; imagine that when you inhale, you are taking in energy and feeling stronger with every breath.          

National Strength and Conditioning Association Position Statements

Health Aspects of Resistance Exercise and Training

http://www.nsca-lift.org/publications/health aspects of resistance training.pdf

Youth Resistance Training

 http://www.nsca-lift.org/youthpositionpaper/Youth_Pos_Paper_200902.pdf

Basic Guidelines for the Resistance Training of Athletes

http://www.nsca-lift.org/publications/Basic guidelines for the resistance training of athletes.pdf

Explosive/ Plyometric Exercises

http://www.nsca-lift.org/publications/PLYOforWeb.pdf

The Squat Exercise in Athletic Conditioning

http://www.nsca-lift.org/publications/SQTforWeb.pdf

Introduction:

This on-going blog will provide a basic understanding for anyone who is interested in developing a sound strength and conditioning program to enhance their athletic performance. It is my goal to provide information to all levels of athletic individuals. This blog will give you an edge to help you succeed in your athletic accomplishments.

Keep in mind, even if you have no experience working out in a gym or at home you can still develop an effective training program.  Age does play a role in performance ability, but performance can improve with a proper strength and conditioning program and dedication.

Remember, there are no shortcuts or magic supplements. Please don’t be mislead by companies who guarantee false health benefits, such as, "This advanced dietary-fat inhibitor helps block the absorption of fat calories" or "Take 3 capsules before bedtime. Watch the fat disappear!"  Products that are not FDA regulated are not supported by reliable scientific evidence. Visit the FDA website for a list of distributors receiving warning letters:  http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/ComplianceEnforcement/ucm188136.htm

More information to come……

The patient in front of me is Mr. C, a 308 pound man who has been sent by one of my favorite referring doctors.  This doctor truly cares about the health of his patients and it shows.  In fact, Mr. C’s physician is a triathlete, eats for health and practices what he preaches.  He’s never been overweight.   His clients are devoted to him and Mr. C is no exception.  But Mr. C. is worried.  He genuinely wants to lose weight but the doctor he so much wants to please has told him that he needs to reach 170 pounds: the white or “healthy” zone of the BMI chart.  “Doc,” he says earnestly, “Is that possible? I’ve never been that light, not even in high school.”

With the advent of the internet, interactive tools like BMI calculators have become familiar to dieters.  Twenty years ago, BMI was part of the foreign language of doctors.  The measurement was recorded on the chart and remained obscure for patients.   Today, nearly every dieter understands, (and sometimes obsesses about), his or her niche on the BMI chart. 

BMI, or Body Mass Index, is shorthand that describes the relationship between your body height and weight.  The measurement first saw the light of day in the mid 1800s, invented by a scientist named Adolphe Quetelet.  In order to compare people’s masses, Quetelet proposed a method which divided weight by height squared.   Current BMI figures are still based on the same equation:  weight in kilograms/ height in meters squared. Today, high BMIs denote overweight and obesity, with the cut-offs being as follows:  BMI of 25 or less =normal, BMI of 25 to 30=overweight, BMI of 30 to 35= obesity, BMI of 35 or greater= morbid obesity.  On many BMI charts, the obese weights are colored red, the overweight weights yellow and the normal weights white.   (You can find a typical BMI chart on my practice website at www.weightmp.com).

Because BMI looks at weight without distinguishing whether it is coming from fat, bone, or muscle, people with denser bone structure or those with large muscles masses can have high BMIs.   I am frequently asked by patients whether a weight that increases or fails to drop might be coming from a new muscle-building gym regimen.  Alas, the answer is generally no.  Unless you are built like Dwight Howard or Arnold Schwarzenegger, the amount of muscle you gain in the average gym is not causing your BMI to rise.  This is especially true for women, who can get great toning and definition from lifting, but are generally not capable of building large amounts of new muscle mass.

However, the major problem with BMI is not that it is inaccurate for the Greek gods among us.  The major problem is in its low end, where it sets the bar for “normal”. The BMI chart, with its white, yellow and red sections shouts unequivocally that certain weights are unhealthy. These arbitrary divisions are at odds with the advice that obesity societies routinely give patients:  that weight loss of 5-10% of current poundage can greatly reduce medical risk.  So which is it? Do we need to lose just a bit or do we need to get ourselves all the way to the Promised Land….the white zone???

In my book, Refuse to Regain, I reference the work of Dr. Walter Willett of Harvard’s School of Public Health. Dr. Willett has been in charge of the comprehensive Nurse’s Health Study for some years, a study which shows that the risk of diabetes, hypertension, gallbladder, and coronary artery disease starts to rise at BMIs that are far below the 25 we consider “just overweight.”  Dr. Willett has said that this data was known, but ignored when committees set the “normal” cutoff for BMI.  He believes that the reason is simple.  If normal BMI were lowered to somewhere around 22, the vast majority of America would be classified as overweight. 

While Dr. Willett is one my dietary and medical heroes, I have a somewhat different take on BMI.   Yes, we know that weight gain impacts our health negatively.  We know that even small amounts of weight gain put us at risk.  But what happens once the horse is out of the barn?  Once we have gained that weight, incurred that new risk, what then?  Are the rules for “healthy” BMI the same after gain has occurred?  This question brings us to a larger and more fascinating issue: is there some permanent change that occurs within us once we have been overweight that changes those rules?

I believe the answer is yes. What I call POWs (previously overweight people) seem to be quite different from NOWs (never overweight people).  As someone who was an NOW in my earlier years and is now a POW, I can attest to the fact that my physiology has changed. Can I prove this scientifically?  No. We have now crossed over into the area of observation and opinion.  Read on with that knowledge.

In my view, weight gain occurs when the normal mechanism that controls and stabilizes weight is damaged by over-exposure to elements of the SAD (standard American diet).  Once the damage is done, I believe that we remain prone to weight gain.  We can prevent this by avoiding the foods that caused the damage in the first place, but we must be extra careful.  Most POWs cannot eat “mindlessly” anymore. 

This tendency to weight regain may also have to do with fat cells which remain in the body, but which no longer contain fat.  No one knows if depleted, empty cells signal the brain or cause other kinds of hormonal havoc.

So what does this have to do with optimal BMI? When we gain weight, the body has to manufacture new fat cells to store the oily triglycerides which are being created. These cells are supported by a scaffolding of connective tissue and muscle.  After weight loss, the fat cells are emptied, but some of the tissue may remain. Many POWs find that they simply cannot lose enough weight to reach the white area of the BMI chart. This may well be because the BMI chart is based on the weights of those who have never been heavy, in other words, the weights of NOWs. Since they have never manufactured new fatty tissue, their baseline weights are lower. 

I love what I do, but I have written before about the one part of my job I don’t enjoy.  That would be the very last phase of a patient’s weight loss. Almost without exception, my patients are unhappy with their final weights. This happens even when they have lost 60, 80, or 150 pounds.  Each one longs to get down “just a little more!” Each one feels like a failure for not reaching the white zone.

This is the point at which BMI charts become tyrannical, and for no good reason. The rules for optimal BMI in the POW are different, just as pretty much everything else is different for POWs. Since there are no established guidelines for optimal weight in the POW, I can only offer my own take.

1. If you have been significantly overweight, a loss of 20% of your pounds is highly successful and is what I usually target. If you’ve lost more, great!!

2. Your optimal BMI should be the one at which you have eliminated or greatly minimized any weight related medical issues (especially blood pressure, diabetes, and lipids). In some people, remnants of the problem will remain, but the vast majority can expect significant improvement and decrease of medications.

3. Your optimal BMI should be one at which you can comfortably maintain.

Number three is probably the most important guideline, because weight loss is of no consequence if it ends in regain. POWs who push themselves to very low weights often do so at the expense of muscle tissue. If you start to look wasted, your vital muscle mass may be dissipating.  At such low weights, and without muscle to help out with calorie burning, you will have to make do with what I call “two peas and a bean”.  That’s not fun, that’s not life, and that’s not sustainable. 

Are BMI charts important at all?  Yes.  They remain vital for judging the weights of NOWs, like our kids, young adults and that minority who remains at normal weight.   If we can prevent them from converting to weight gainers, they will not have to deal with the permanent changes that dog the rest of us. As parents, educators, doctors and public citizens, this is a worthwhile goal and one that our health care system should be targeting.

But for the rest of us?  Shoot for maintenance, comfort, health, mobility.  These will stand you in good stead whatever your zone or color.

The Lake Health Carol DeJoy Resource Center offers access to electronic resources in addition to print resources. Health & Wellness Resource Center from Gale is a comprehensive resource that provides integrated access to medical, statistical, health, and related information. The Health & Wellness Resource Center features a fully updated, intuitive interface -- providing multiple pathways to key information.  You can browse the latest news, review a set of subject areas, review and select a particular resource, or search across the entire database.

Health & Wellness Resource Center delivers up-to-date reference material as well as full-text magazines, latest news topics, journals, and pamphlets from a wide variety of authoritative medical sources, including descriptions of and links to many pertinent websites, selected for their usefulness and appropriateness.

Health & Wellness Resource Center has partnered with Healthology, an industry leader in providing health and medical video content and physician-authored articles. You can access the Healthology content from the Health Highlights area of the home page. And whenever you perform a search using the search box or using the Advanced Search page, your results may include video content from Healthology as listed on the Video tab of your results list.

The Carol DeJoy Lake Health Resource Center also provides the add-on Alternative Health module which looks at health care from a holistic lens.

A single search brings together reference, periodical, pamphlets, news and multimedia content, organized into tabs that let you target the type of information you are seeking. Once you have linked to an article, pamphlet or multimedia resource, you will be able to print, e-mail and download the content.

In order to use this valuable resource, you must come to the Carol DeJoy Lake Health Resource Center.  The Resource Center is located in Suite 113 on the first floor in the Physician Pavilion adjacent to the TriPoint Medical Center.  Please call before visiting to ensure staff availability at (440) 639-4387 or (440) 375-8100, ext. 42019.

For more information, please contact a Lake Health Professional Librarian.

When presented with information about their health and the changes they need to make to their lifestyles, what exactly motivates people to make these changes? Well, the fear of death is a great motivator for change. Frequently, after patients suffer a heart attack for example, they begin to make changes in their life. They may quit smoking and improve their diets. However, it’s also not uncommon for people to lose their motivation to continue these changes. They may return to smoking or gradually return to their poor eating habits. Does this sound familiar?

Are there certain factors that help people stay committed to the changes they make? There are twenty-one commonly studied theories and models that explain how certain feelings and beliefs can contribute to healthy behaviors. The following basic themes and concepts of these theories will help you identify what motivates you and how you can stay committed to healthy behaviors.

Perceived Threat

This concept refers to whether or not you believe you’re going to get sick in the first place and if you accept your diagnosis. That is, what are your beliefs about your own susceptibility to developing an illness or disease?  Do you deny the impact of your behavior (smoking, weight, stress) on worsening or contributing to your illness?

• Obtain accurate and specific information from your doctor: Often patients will claim that the doctor never specifically said that their smoking or their diet can cause damage or disease. This miscommunication may be due in part to the patients not asking direct questions because then they can assume if it wasn’t directly stated, than it must not be that serious.
• Objectively evaluate the information you are given about changes in your lifestyle: We are often very comfortable giving advice to other people we care about. We can easily say, "You really shouldn’t smoke", or 'You need to better manage your stress." However, when it comes to us, the advice is often lost. Although you may be able to say to yourself, "I really should be exercising." You may also follow-up up with excuses that gives you permission to continue with the behavior. It is important that you listen objectively to what you are saying to yourself and then correct the self talk.

Beliefs about Immediate Benefits

We are unlikely to change our behavior unless we believe that there will be an immediate benefit to our health. Telling somebody to monitor the amount of saturated fats in their diet when they are not currently experiencing any medical concerns is unlikely to yield a change in behavior. Behavior change needs to be anchored to improvements that can be experienced now.

• Visualize yourself benefiting from the changes: If you are quitting smoking or improving your diet, visualize your arteries with blood flowing freely without the clogging effects from unhealthy behaviors. Imagine your heart pumping at a regular comfortable rate without having to work so hard.
• Remind yourself that you are making the right choices: For example, tell yourself as you exercise that you are lowering your cholesterol, keeping your weight down, and improving the overall functioning of your heart.

Beliefs about the Costs of Making a Change

When we are confronted with information about our health and the changes we need to make, a couple of thoughts usually come to mind. First, we begin to weigh the benefits of eating a healthy diet versus the loss of eating whatever you want. For example somebody who perceives that the benefits of eating a healthy diet includes marginally improving heart health but the cost of changing the diet that involves depriving oneself of "good foods," is "expensive" and "an inconvenience to family" is unlikely to stay motivated. The cost of the change clearly outweighs the benefits.

How do you view changes that you need to make in your life to improve your health? Try to do a cost-benefit analysis for yourself. Notice the language that you use and then honestly assess how real you believe the health risk of is for you and what cost you perceive yourself having to pay for your health.

Self Confidence

Do you listen to a health message and find yourself acknowledging that, while it makes sense, deep inside you’re thinking, "I could never really do that."

Confidence is built when we are able to have several small measures of success in high-risk situations. So if you notice that resisting high-fat foods is particularly difficult for you when you’re dining out with friends, then small improvements will be felt as success to be built upon. This will improve your confidence and commitment to sticking with your healthy behavior.

Environmental Cues

Many of the motivating factors we’ve talked about so far involve changes that you need to make inside yourself. There are also environmental changes you can make to support your efforts to change unhealthy behaviors. Surrounding yourself with cues to remind you of our commitment to change and help you sustain changes can be quite useful.

• Surround yourself with supportive people who share your commitment to a healthy lifestyle.
• Keep healthy foods readily available to you.
• Establish an exercise routine with a partner.
• Keep a list of your priorities and the amount time committed to each task as a reminder of your improve time management techniques.