Clinical "Pearls" for Transforming Lives
Eating Scripts - Mindless Eating Better
Understood
Assertiveness: An Essential Part of
Wellness - Lisa Hinz, PhD
Stress Relief through Guided Imagery - Steve Wood, MA, MFT,
Behavioral Therapist
Rev Up Your Metabolism – Russ Melgar, CPT, FT Fitness Coordinator
VO2Max testing now available at ONE - Lisa Hellie,
MA, Experience Relationship Manager
FEATURED RECIPES – TOP 10 POWER FOOD SELECTIONS
Whole Wheat Rigatoni with Spring Spinach, Walnuts and Ricotta
Spicy Grilled Chicken Skewers
To help friends learn more about One: The Napa Valley Personal
Health Experience™, simply pass on this link:
www.onenapavalley.com or call 1-877-596-0664 or email
onehealth@ah.org .
Clinical “Pearls” for Transforming Lives
- Heather Peña M.D., Medical Director, St. Helena Center for
Health
As a graduate of Harvard Medical School I was particularly delighted
to have been invited to participate as a featured presenter in a
pioneering initiative launched by Harvard Medical School and The
Culinary Institute of America this past April: “Healthy Kitchens,
Healthy Lives: A Leadership Conference Bridging Nutrition Science,
Health Care, and the Culinary Arts.”
The conference, held at the Culinary Institute of American at
Greystone in St. Helena, brought together health professionals from
43 states to participate in seminars – and hands-on cooking
workshops – as they enthusiastically explored the delicious
possibilities of healthful food, its preparation, and the
implications on patients’ long term health. The energy and
excitement at this event was palpable. People were extremely
interested in what we are doing at the Center for Health. And in
this setting, while the presenters from Harvard updated the crowd on
the latest scientific findings about diet and nutrition – and the
CIA chefs demonstrated healthful cooking skills, ideas and
inspiration – I was able to provide a glimpse into the clinical
aspect of putting the science, and healthy food preparations, to
work with exciting results from the Center for Health’s
Transformations program.
We utilize much of the research that was presented during the
conference and have seen some dramatic changes in our clients.
During my presentation at the closing plenary session, “Clinical
Pearls for Transforming Lives,” I introduced many of the elements
that we have put into practice with our clients that are making
quite a difference – and we now have the numbers to back up our
initial results. We not only see the beginning of significant weight
loss while they are participating in our medically-based, 11-day
residential program, we also see many important changes in labs,
blood pressure, body composition, etc. With some very simple changes
in what we eat, how we eat, along with learning the other facets of
a healthy lifestyle, lives can literally be transformed. We
incorporate these suggestions into the nutritional element of the
One program as well.
The “Pearls”
#1 Eat More Plants – Populations that eat five or more
servings of fruits and vegetables per day live longer lives, have
less heart disease, stroke and cancer. A plant based diet doesn’t
necessarily mean vegetarian, it just means that we need to emphasize
vegetables and fruits each day.
#2 The 4 S’s – Soups, Salads, Smoothies and Stir Fries are
great ways to increase your plant intake.
#3 Eat more Phytonutrients – This is the “berries and
broccoli” message. These foods contain powerful chemicals known to
help prevent heart disease and cancer. And colorful vegetables and
fruits usually indicate more phytochemicals. If you don’t have a
copy of my 10 “power foods”, please ask and we will send you one.
#4 Good vs. Bad Fat – To keep your arteries healthy, minimize
saturated fats in whole milk, cheese, butter, cream, fatty meats,
baked goods and highly processed foods. And, eliminate trans-fats.
If there is less than .5g. of trans fat per serving, it is legal to
say “no trans fat “ on the label. Don’t be deceived by this. And if
the ingredients say “hydrogenated oils”, that’s a trans fat . . .
don’t buy that product.
#5 Good vs. Bad Carb – Minimize refined sugar and white flour
products. Instead, eat whole grain breads, oats, barley, brown rice,
quinoa and other grains and cereals. When working to lose weight,
minimize “dry” carbs such as bread, crackers and cereals, since they
are more calorically dense and have a higher glycemic load. Wet
carbs, such as cooked grains, take on water which has no calories
and makes you feel fuller.
#6 Don’t Worry about Protein – Most people get about 15-20%
of their calories from protein. We almost never see low protein
intake. It’s actually the hardest food group to eliminate since many
foods contain protein – yes, even spinach and broccoli are good
sources.
#7 5, 4, 3, 2, 1 – This is a simple formula by which to
construct your own food “pyramid.” Choose “5” whole grains, “4”
vegetables, “3” fruits, “2” servings of non-fat milk, “1” serving of
animal protein (4 oz.), and a few nuts. That will give you much of
the vitamins and nutrients you need daily and keep the calories in
check. It also contains 70 grams of protein, plenty for a 175 lb man
and more than enough for a woman.
#8 Beware of liquid calories – It’s often better to eat the
whole fruit rather than consume just its juice. In regard to sugared
sodas, they make no sense when making an effort to control weight.
For those lovers of the coffee drink, take a reality check. Your
daily mocha frappé may end up being half your daily allotment of
calories. (A breve latte venti is 800 calories). And in regard to
wine consumption, we encourage you to be mindful. A 5 ounce pour has
about 100 calories.
#9 Focus on Health, Not Weight Loss – By eliminating a food
group as many fad diets will direct you to do, you might experience
quick weight loss but certainly not optimal health. And how long
does it take for the deprivation to send you running back? Balance
and persistence still wins the race when it comes to health and
optimal nutrition. And a focus on health, instead of weight loss,
often removes the emotional barriers associated with the weight.
#10 Tools not Rules – Don’t try to be perfect. Do make the
best choices most of the time and follow a “bad day” with a good
day, avoiding the snowball effect. Tools are like metaphors: if you
push them too far, they break. A fad diet often takes a “tool” that
might otherwise be helpful and pushes it too far.
#11 Beyond the Usual Labs – Make sure your physician
considers measuring values for Vitamin D, Insulin, Hs-CRP and
provides advanced lipid analysis. These few areas, which are often
beyond the usual labs ordered for a physical, can tell a physician a
lot.
#12 Exercise is the Fountain of Youth – Yes, we can all find
a way to incorporate exercise we enjoy even into the busiest
schedule. And the benefits are manifold. Among them are the ability
to decrease your chances of getting a cold, cancer, heart disease, a
stroke, dementia and it will help control your weight and improve
your mood and energy. Quite a panacea! And you may even find you
will recover that “lost athlete” from younger years or it may even
help you to establish a “new identity”. And as to the commitment, we
have found that for weight loss, 5x a week for 30 minutes is
realistic. For weight maintenance, 3x a week for 30 minutes is
sufficient.
#13 Set Small Achievable Goals – Small steps will result in
improved health for the long term. We have found that even a 10%
weight loss results in dramatic reductions in health risks.
#14 Eating Out – I can’t say enough about strategies here. If
you have a strategy set ahead of time, eating out doesn’t have to
turn into a diet disaster. Order an appetizer as an entrée; Order
soup and salad as an entrée; avoid bread (just ask the waiter to
remove the bread basket), desserts (opt out or opt for fruit
instead) and caloric drinks if you are watching your weight; avoid
butter and cheese if cholesterol is an issue; and you can split a
main dish with someone else. These are but a few. I encourage you to
come up with some of your own before you walk through the
restaurant’s door. And my favorite: pick your poison carefully and
ENJOY it!
#15 Menu Planning – In order not to become overwhelmed,
recognize that most families eat around 10 dinners repeatedly; just
make these a good 10. Cross reference the foods you like with a list
of healthy foods. Where do they overlap? And at times consider
frozen foods. They can be nutritious (read labels carefully) and
time saving. And please eat breakfast. Most people fail to realize
that people who don’t generally eat breakfast actually weigh more.
#16 Listening Trumps Telling – Emotional eating is all too
common. Begin to take stock in why you eat when you eat. Perhaps
hunger isn’t the only cue. For the medical professional, empathetic
listening is the best tool to uncover emotional needs. Be honest
with your physician.
#17 Ancillary supports – Support from many directions is
extremely helpful in supporting new, healthful behaviors. Identify
saboteurs and supporters in family and friends. Tell those around
you how they can best support you – and nobody needs the “food
police.” If the going becomes too difficult, seek out a
comprehensive residential program, like Transformations, which takes
you away from the daily stressors and allows you to concentrate on
building healthy habits in a supportive environment.
#18 I had one last Pearl for the medical professionals who were the
audience for my presentation: Practice What You Preach. The
physician is healthier and so then becomes the patient. Think about
when physicians began to quit smoking in the 70’s, it encouraged
patients to follow suit. By encouraging physicians to be role models
for diet and exercise, we hope to generate a similar positive change
in society.
NUTRITION AND LIFESTYLE
Eating
Scripts – Mindless Eating Better Understood
– Vicki Saunders, MS, RD
People overeat for a variety of reasons, which may have nothing to
do with either being hungry or with the good taste of the food. One
reason, as described by Brain Wansink, Ph.D. of Cornell University
in the new book, Mindless Eating, is our individual “eating script”.
Everyone has an eating script, or several scripts, that they may or
may not be aware of. Dr. Wansink proposes that eating scripts drive
how, when and how much we eat.
One example of differing scripts that men or women have can readily
be seen in his example of how a man and a woman might differ in
their eating scripts while on a date: If a woman is paying attention
to what she eats on a date, she eats less. If a man is paying
attention to what he eats on a date, he eats more. They conducted a
study in which they wrote a date scenario for a hypothetical Brad
and Barbara with lots of details about their activities, which
included going to a movie and eating popcorn. In one version of the
scenario, Brad ate a lot of popcorn. In another scenario, all
details of the date were the same except that Brad ate only a few
handfuls of popcorn. They gave a copy of each scenario to 70
different college men to read and asked them evaluate the manliness
of Brad, and then asked how much weight they thought he could bench
press. Interestingly enough, the Brad who ate more popcorn was
presumed to be more manly and could bench press an average of 28
pounds more than the Brad who only ate a few handfuls of popcorn.
Men associate a higher food intake with more strength and manliness.
Women perceive that it is more feminine to eat less, however, when
given the same two date scenarios, discerned no difference between
the two versions of Brad.
Other studies by Dr. Wansink, demonstrated that eating with other
people influences both our pace of eating and the amount we eat. A
light eater, eating with a group of four to eight will eat more. A
heavy eater will eat less when eating with a group. When we eat with
people we like, we linger at the table longer. The longer we stay at
the table, the more we eat. On average, if we eat with another
person, we will consume 35% more than we would alone. If we eat with
seven or more people, we consume an average of 96% more—almost
double. When we eat with others, we tend to modify our speed of
eating based on whether they are a fast or slow eater.
A script that many of us are familiar with is that of “cleaning our
plate.” As long as there is something still on the plate, or in the
glass, we still have work to do. When I was a college student, if
food was free, I ate it. To a poor college student, the cost of the
food was a bigger motivator than the its caloric or nutritional
content. I recently had an overweight client who told me that she
and her husband had very different scripts when it came to eating.
In her family, they never felt that they had a fabulous meal unless
they had eaten until they were painfully stuffed. Her husband hated
to feel that overfull feeling and based his idea of a fabulous meal
on other criteria.
In the Napa valley, people in the wine business are often immersed
in the eating scripts that go with special events organized around
food and wine. Such a meal has multiple courses and each course is
paired with a different wine. The chefs and caterers are often
competing to outdo each other in the number of courses and the
delectability of each one. Once a person arrives at such an event,
the script is already pre-determined that they will eat and drink
their way to the end of it.
All of us have eating scripts, some of them are fairly universal,
some of them may be part of our occupation, and some are more
specific to us and to our family of origin. If your eating scripts
are not serving you well, the good news is that it is indeed
possible to revise our eating scripts. Dr. Wansink recommends:
- Rescript your diet danger zones. The most common danger zones are
dinners, snacks, parties, restaurants, desks/dashboards. For a fast
eater, one way to rescript is to be the last to start eating, pace
yourself with another slow eater, and take extra helpings of the
healthy foods, and smaller helpings of the meat and potatoes.
- Distract yourself before snacking. If you are not actually
hungry, you may forget about it. Try limiting your snacking to only
one place in the house such as the dining room or kitchen.
- Plate your food before you eat. Whether it is a meal or snack,
you can portion your food and stick with it. Eating directly from a
package or serving bowl, will lead to intake of unknown
quantities—Mindless eating.
A little mindfulness can go a long way toward making eating both
enjoyable – as well it should be – and a pleasant part of a healthy
lifestyle.
Assertiveness: An Essential Part of Wellness
- Lisa Hinz, PhD
People who are uncomfortable expressing feelings, setting
boundaries, or asking for their needs to be met often are the ones
who abuse substances to fill the void. Food, alcohol and tobacco may
take the place of the feeling or confidence that they really desire.
Being able to be assertive eludes many individuals. And the lack
thereof may be the source of great discomfort.
At some point in our past, we may have learned not to stand up for
our own feelings for fear of rejection, embarrassment, or any other
feeling or situation that might cause unease. Assertiveness training
teaches that it is your perfect right to express your feelings and
needs – and to set interpersonal boundaries that are comfortable. In
assertive communication, preferences and desires are stated directly
and matter-of-factly. The message is sent effectively using erect
posture while maintaining positive eye contact; no one gets hurt or
is offended in the process. The foundations of assertive
communication are maturity, equality, and mutual respect.
Assertiveness also includes expressing encouragement and positively
affirming those around us.
Take some time to assess your obstacles to assertiveness: what
situations, skills, or attitudes give you trouble? With practice,
any obstacles can be overcome. The book
Your Perfect Right by
Alberti and Emmons is a valuable resource.
Wellness begins with WE and includes healthy relationships.
Assertiveness is a communication skill that can promote optimally
healthy relationships today and in the years to come.
Stress Relief Through Guided Imagery
- Steve Wood, MA, MFT, Behavioral Therapist
Guided imagery is a gentle but powerful technique that focuses and
directs the imagination toward a positive physical, and even
physiological, outcome. It can enhance athletic performance,
stimulate immune cell activity, reduce headaches and pain, relieve
depression, improve pre-and post-surgical experiences and, among the
positive results it can have on a myriad of other maladies, it can
also be quite an effective stress reliever.
The impact that guided imagery can have easing stress and promoting
a sense of peace and tranquility is significant. Most of us struggle
with stress in our lives, at times more intense and prolonged. When
the stress becomes unbearable, it can greatly interfere with many
areas of our lives. You may feel overwhelmed, experience poor memory
and lack of ability to concentrate. Difficulty with sleep and
increased fatigue can also be due to increased stress, as can
feelings of anxiety, anger and tenseness. At its worst, the abuse of
alcohol, drugs and even food can be used to generate a temporary
“fix.” With the help of guided imagery, many of these symptoms can
be lessened or even alleviated before they cause more complex
issues.
Over the past 25 years, the effectiveness of guided imagery has been
increasingly established by research findings that demonstrate its
positive impact on health, creativity and performance. In regard to
stress in particular, it has been clinically proven to decrease
stress by up to 65%.
"Visualization" and "mental imagery” have been terms associated with
guided imagery and may actually be a bit misleading. When guided
imagery has the greatest impact, it actually involves the whole
body: the emotions and all the senses. Because it is a right-brained
activity, engaging in it will often be accompanied by other
functions that reside in that vicinity: emotion, laughter,
sensitivity to music, openness to spirituality, intuition, abstract
thinking and empathy. And because it mobilizes unconscious and
pre-conscious processes to assist with conscious goals, it can bring
to bear much more of a person's strength and motivation to
accomplish a desired end. So, subtle and gentle as this technique
is, it can be very powerful, and more and more so over time.
There are many options when pursuing a path of guided imagery. In a
clinical setting, a therapist’s voice guides you to images that
promote a sense of ease and wellness. Outside of that setting, you
can effectively invent your own imagery, or you can listen to
imagery that's been created for you. Either way, you own imagination
will sooner or later take over, because, even when listening to
imagery that's been created in advance, the mind will automatically
edit, skip, change or substitute what's being offered for what is
needed. So even a tape, CD or written script will become a kind of
internal launching pad for the brilliance of each person's unique
imagination.
The good news is that this technique requires less time and
discipline to develop a high level of skill than more traditional
meditation which can boast some of the same healthful achievements.
This is because it engages the mind with appealing sensory images
that have their own natural pull. And, best of all, just about
anyone can do this.
Sources for guided imagery abound. Probably the most well-researched
source for CD’s is produced by Diane Tusek, R.N., a surgical nurse
who has really brought this approach to mainstream audiences. Her
products can be found at
www.guidedimagery.com.
Additionally, you can also create your own guided imagery. There is
a website created and supported by a physician in Europe (Dr. J.L.
Mommaerts, M.D.) which allows you to choose different themes and
music and customize your therapeutic experience. His website is
www.aurelis.org.
The tools are available if we choose to use them!
Abraham Lincoln’s 5 Keys to Happiness
Free your heart from hatred
Free your mind from worries
Live simply
Give more
Expect less
- Let your mind wander. Pick a sport -- such as biking, running or
swimming -- in which your mind can wander. Great insights aren't
likely to come from activities such as alpine skiing or rock
climbing, where a mistake could break bones.
- Be patient. Don't expect instant results, especially if you're a
beginner. Jumping too quickly into a rigorous regimen may leave you
too tired for expansive thinking.
- Carve out ample time. Exercise long enough for both your mind and
body to relax.
- Make it a habit. Weekend warriors may not get much benefit. Rats
learn mazes better with every-other-day exercise than with
twice-weekly workouts.
- Unplug yourself. Creative juices are unlikely to flow if you need
the TV or an iPod to distract you. If you do use music, pick
something that allows you to hear your own thoughts.
- Go solo. A chatty running partner may stymie creative insights.
Possible Link Between Oral Health and Heart Health
For many of us, the thought of preventing plaque buildup and gum
disease isn't always sufficient incentive to floss regularly. But
how about adding "preventing heart disease" to the list of possible
benefits? At first, the notion may seem a bit unorthodox. Although
we don't yet have hard proof that good dental health means heart
health, there is now reason to believe that caring for your teeth
and gums can also help you care for your cardiovascular system.
The latest issue of the Harvard Heart Letter takes a look at the
impact of dental health on heart health. It is well known that the
billions of bacteria and other microscopic entities that live in the
mouth influence the health of teeth and gums. And now, researchers
say, they may also cause problems for the heart and blood vessels.
The notion that problems in the mouth cause diseases elsewhere in
the body makes sense but has been difficult to prove, explains the
Harvard Heart Letter. Scientists are exploring several mechanisms
that may connect the two processes. In people with periodontitis
(erosion of tissue and bone that support the teeth), chewing and
tooth brushing release bacteria into the bloodstream. Several
species of bacteria that cause periodontitis have been found in the
atherosclerotic plaque in arteries in the heart and elsewhere; this
plaque can lead to a heart attack.
Oral bacteria could also harm blood vessels or cause blood clots by
releasing toxins that resemble proteins found in artery walls or the
bloodstream. The immune system's response to these toxins could harm
vessel walls or make blood clot more easily. It is also possible
that inflammation in the mouth revs up inflammation throughout the
body, including in the arteries, where it can lead to heart attack
and stroke.
Although we still have a lot to learn about whether, and how,
periodontitis and other oral problems are linked to heart disease,
the Harvard Heart Letter notes that it still makes good sense to
take care of your teeth. Brush and floss every day, and see your
dentist at least twice a year for regular cleanings and oral exams.
This will pay off for your oral health, and just may benefit your
heart as well.
Benefits and Risks of Vitamins and Minerals
From Harvard Healthbeat comes some good advice about reassessing
your need for vitamins and minerals. . .
Apparently, about two out of five Americans take a multivitamin or
mineral supplement regularly. But understanding your body's
requirements can be undeniably confusing. Is it enough to take a
daily multivitamin, or should you consider adding certain vitamins
or minerals and perhaps cutting down on others? And is there a
difference in the amount required based on age and gender? It looks
like you could be in trouble if you get too little – or too much –
of certain nutrients. Working your way through the sea of available
supplements can be quite daunting – and even overwhelming.
Whether taking a multivitamin or not, it seems that many people
still lack sufficient levels of certain vitamins and minerals. Over
time, this can contribute to chronic illnesses such as heart
disease, osteoporosis, and even cancer. At the opposite end of the
spectrum, entirely avoidable illnesses are cropping up in some
health-conscious people who take dietary supplements in excess.
In taking look at some of our most basic needs, some people,
particularly older adults, are deficient in vitamin B12 because as
they age they have increasingly more trouble absorbing this vitamin
from food. Many are surprised to learn that a lack of B12 can cause
memory loss, dementia, and numbness of the arms and legs. And
conversely, large amounts of supplemental vitamin A can actually be
harmful to bones and increase the risk of hip fracture. The
recommended allowance of vitamin D – which we have paid particular
attention to here at the St. Helena Center for Health – is often
higher than many realize; the Vitamin D requirement for an
individual 71 years of age is triple the amount recommended for a
person at age 50. Even many at a younger age are not getting enough.
Sources such as newly published data from long-term studies and new
recommendations from the Institute of Medicine can help shed some
light on the subject. It's clear though that our knowledge of
nutritional needs is evolving, not definitive. New studies can bring
into question what researchers once thought was a healthy choice.
For example, at one time research indicated that taking vitamin E
supplements might boost your brainpower, reduce your risk of heart
disease, and protect you against cancer. However, the results from
recently published clinical trials have not been able to provide the
definitive results to back up these claims. The most recent studies
have concluded that taking vitamin E supplements probably won't
hurt, but don't expect much benefit. On the other hand, there is
greater evidence for the benefit of vitamin D supplementation, yet
people may not be getting as much of this vitamin as they need. It
takes some effort to stay on top of the latest nutrition science,
but the payoff can be better health.
At the St. Helena Center for Health, it is our job to help you
negotiate your way through the barrage of information available
about supplements and newly published research. And as a part of
your participation in the One program, we provide personalized
supplement recommendations that are geared toward optimizing your
health potential for the years to come.
Getting the most nutrients from foods
Whether you're a gourmet chef or a novice in the kitchen, you can
learn to squeeze the most nutritional benefit from the foods you
eat. How you choose and prepare foods can make a big difference.
Start by selecting a varied, multicolor diet. Not only is it
pleasing to the eye and palate, it also is good for you.
To preserve the nutritional content of foods, try the following
tips:
- Use it before you lose it. Refrigeration usually helps slow the
loss of nutrients. But even in the refrigerator, fresh produce can
lose half or more of certain vitamins in a week or two.
- Steam vegetables. Use small amounts of water to steam vegetables
or cook them in a microwave to retain nutrients that might otherwise
be lost.
- Wrap it up. Cover any cut fruits or vegetables with airtight
wrapping and cap juice bottles. Refrigerate unused portions.
- If you use the water that vegetables were cooked in, you won't
lose those nutrients; e.g. saving it for soup, sauces etc.
