A Healthy Lifestyle - Where should you focus your efforts?
This article is to serve as an overview of what people should prioritize in terms of their overall health and wellness. People are bombarded endlessly on social media or within their social circle with information (often wrong information) about a new diet, supplement or exercise they should or shouldn’t be doing. This can become overwhelming and do more harm than good. More often than not, people should adhere to very broad health promoting habits and behaviours rather than being caught up in the minutia of very specific interventions that do very little to impact longevity and quality of life.
To begin we will start with what the word “health” actually means. According to Huber et al (2011) health can be defined as “the ability to adapt and self-manage in the face of social, physical, and emotional challenges.” Notice the lack of specific foods, diets, supplements? The emphasis of self-management is important as well, as the ability to develop and execute adaptable health-promoting skills and strategies over a long period of time (read: no quick fixes) is the key to living a long and healthy life.
So what follows are what I (and the greater body of literature) think has the greatest return on investment for health. Focus on these areas before worrying about super specific elements, and I am confident that if you do, you won’t need to worry about all the silliness being peddled by the fitness industry...what a relieving thought!
Priorities for achieving a Healthy Lifestyle
1. Regularly participate in Physical Activity that meet or exceeds current recommendations
2. Maintain a Healthy Body Weight and Body Composition
3. Adhere to a Health Promoting diet
4. Aim to get sufficient durations of high-quality sleep
5. Avoid smoking/drug use and heavy alcohol use
6. Learn and apply self-management strategies for pain
7. Learn to manage work/life stress, maintain a healthy social life, and engage in meaningful/fulfilling work/activities
8. Routine and appropriate medical care and screenings
1. Regularly participate in Physical Activity that meet or exceeds current recommendations
Being physically inactive is a worldwide problem and is the 4th biggest global factor for death (WHO, 2009), being responsible for 6% of deaths worldwide. It increases your risk for developing chronic diseases like heart disease or cancer. Regular aerobic exercise can strengthen the heart, decrease fat accumulation, and maintain blood sugars. As you age, you will lose muscle mass (termed Sarcopenia) which increases your risk for a number of long-term health issues. Resistance Training (RT) is a powerful way to combat this. However, you get the most health benefits when you do both aerobic and resistance exercise (Bennie, 2020). For more information on the health benefits of resistance training, read this article.
The minimum weekly amounts required to elicit a wide array of health benefits are (ACSM, 2017):
1. 150 minutes of Moderate Aerobic Activity OR 75 minutes of Vigorous Aerobic Activity
2. AND; 2-3 days per week of RT (Note - the Canadian guidelines include strengthening activities in the 150 minutes)
Around 52% of Americans achieve the physical activity guidelines for aerobic exercise, but only about 22% achieve both the aerobic and RT guidelines (CDC, 2017). Canadians fare worse, with only 16% of adults between 18-79 years of age achieving the minimum threshold of 150 minutes of activity per week (link). Achieving these minimums will go a long way in preventing chronic diseases as people age while maintaining vigor and independence through the lifespan. The type of exercise here doesn’t really matter, the key is finding enjoyable ways to achieve these minimums on a consistent basis. Many roads lead to Rome...but that road should get you a bit sweaty.
2. Maintain a Healthy Body Weight and Body Composition
Nearly ⅔ of Canadians are classified as overweight or obese (Vogel, 2017). Carrying excess adipose tissue, especially visceral or belly fat, can lead to the development of many diseases. Combined with low muscle mass, this is a scenario that should be reversed to maintain good health for years to come. Fat tissue releases hormones (adipokines) that are pro-inflammatory and wreak havoc on the body, while muscle tissue releases hormones (myokines) that are anti-inflammatory and are health promoting. The ideal body composition is one low in body fat and high in muscle mass (read: that doesn’t mean be a bodybuilder).
It is generally recommended that in combination with your bodyweight and body mass index (BMI) that you measure your waist circumference to quickly determine if you are carrying excess visceral fat. Elevated waist circumference measurements have been associated with increased health risks so a priority should be getting this number under control (see table).
Excess body fat is ultimately an imbalance between the calories you consume and the calories you burn. Meeting or exceeding the weekly activity guidelines (above) and adhering to a health promoting diet (next) to achieve a calorie deficit is a powerful way to decrease excess body fat, gain muscle mass, and prevent obesity related chronic diseases. You don’t need to look like a fitness model to be healthy, but you should maintain a healthy weight, low waist circumference and a decent amount of muscle mass.
3. Adhere to a Health Promoting Diet
This is one of the most polarizing topics in health and wellness. But to be clear: there is NO one best diet. The key is finding a diet that achieves certain health promoting criteria (discussed below) while being a dietary strategy you like and will adhere to long term. Don’t focus on single food items or a pattern of eating that someone, somewhere told you you should be following. As long as it is flexible, adaptable, fueling your activity levels and is health promoting, you don’t need to obsess about it. That being said, a very health-promoting dietary pattern is the Mediterranean diet. There is good research showing it can reduce heart disease and other chronic diseases (Martinez-Lacoba, 2018). It is a great starting point for people to learn how to prepare healthy whole-food meals.
The following are the general dietary habits we recommend most clients to focus on. Note these are broad recommendations for healthy individuals, specific needs or medical conditions should be considered.
Characteristics of a Health Promoting Diet
1. Total Calories
o Consuming the appropriate amount of energy to fuel your activity levels and maintain an appropriate body weight and composition. Use the NIH calculator (link) as a starting point or use a qualified professional to help you.
2. Daily Protein
o Important to ensure development of lean body mass and prevent sarcopenia. Aim between 1.6-2.2 grams of protein per kilogram per day from a variety of sources. Don’t think too much about getting it at certain times, just try to hit your daily total each day.
3. Fiber
o Important for being regular, lowering cholesterol and feeling fuller for longer. Choose food sources high in fiber like whole grains, fruits and veggies (as opposed to fiber supplements). Women should aim for 25 grams per day, while men should get around 38 grams (Canadians get about half of that!).
o High Intake of Fruits, Veggies & Whole Grains
§ Besides fibre, more fruits and veggies in your diet will lower your overall caloric intake and provide lots of vitamins and minerals to prevent chronic diseases. If we consider a serving ½ cup (1 cup for leafy greens) adults should get between 7-10 servings per day for maximum health benefit.
§ Not to be confused with processed carbs, whole grains are high in fibre and other health promoting nutrients that have been shown to decrease cancer, heart disease and diabetes risk. Aim for 2-3 servings per day (1 serving = 30g).
4. Good Fats
o Depending on your preferences and goals, fat intake can be anywhere between 20-35% of daily calories. Prioritize unsaturated fats (fish or plant sources) while keeping saturated fats (junk food or butter) under 10% of total calories.
5. Prioritize whole foods and limit processed foods
o Make foods that consist of one ingredient (i.e., rice or salmon) the bulk of your diet. Anything that is pre-packaged or consists of many different ingredients (i.e., store bought sauces) generally are high in calories and are low in fiber and other nutrients.
4. Aim to get sufficient durations of high-quality sleep
Sleep is important for mental health, brain function, recovery from exercise and a host of other reasons. However, due to today's society, most people do not get enough sleep, or too much poor-quality sleep, with only ⅔ of Canadians getting the recommended amount. Chronic sleep deprivation (<6 hours) has been linked to increased inflammation, infections, obesity and mortality. Most people should aim for 7-9 hours per night with athletes being at the upper end. To improve your duration and quality you should follow good sleep habits (aka “Sleep Hygiene”).
1. Avoid alcohol and caffeine at least 4-6 hours before bed
2. Maintain a regular bedtime/waketime
3. Practice relaxation and mindfulness-based stress reduction techniques
4. Reduce noise and distracting light in the sleeping environment
5. Maintain a cool bedroom temperature
6. Use ambient or “white noise” (e.g., a fan)
7. Avoid electronics before bed or use blue-blocking lenses
8. Exercise regularly
5. Avoid smoking/drug use and heavy alcohol use
Fairly straightforward with smoking and drug use, however quitting can be difficult and multiple attempts and substantial external support is likely necessary. There are many public resources available and there are medications that can help via your family doctor.
No amount of alcohol can be considered healthy, though it is true some data suggests moderate use can be correlated with better health. However, this is unlikely to be from the alcohol itself and other factors like social interaction etc. Current recommendations in Canada for women are no more than 2 standard drinks* per day (3 on a special occasion) and no more than 10 drinks in a week, and more men no more than 3 drinks per day (4 on a special occasion) with no more than 15 drinks in a week. With ~20% of Canadians over 12 years of age (yes...12!) being considered heavy drinkers, understanding that alcohol consumption above these levels can have short- and long-term negative effects on your health should be recognized. Besides attempting to adhere to those recommendations, you can also build the habit of having 1-2 days of no drinking in between days of drinking.
*One standard drink includes: 1 can of beer, 5oz glass of wine or 1.5oz of hard alcohol
6. Learn and apply self-management strategies for pain
Pain is a normal part of the human experience, for example, 80% of people will have an episode of back pain in their lifetime (Rubin, 2007). However, short term and chronic pain can be devastating to individuals. It can lead to decreased physical activity and poor dietary choices, fear of movement and overall decreased quality of life. Rather than having one specific cause, pain sensation is highly complex and consists of a multitude of biological, psychological, and social inputs (termed the Biopsychosocial Model of Pain).
Physical activity and having a healthy body weight have been strongly linked to decreased pain sensitivity, though many people have the perception that exercise will make their symptoms worse and avoid all perceived threatening movements. Learning how to self-manage aches, pain and injuries is an invaluable skill that can reduce unnecessary fear, disability, and over prescription of drugs.
Some good resources to learn how to deal with pain include:
· Back pain - separating fact from fiction
· Pain Science - Guiding the Path
7. Learn to manage work/life stress, maintain a healthy social life, and engage in meaningful/fulfilling work & activities
Life and work stress can be devastating on your physical and mental health. It can lead to chronic health issues in the future and put a strain on social relationships. Feeling alone or cut off from peers can create an environment that is very difficult to maintain good health. This does not mean you should feel “blissful” all the time but engaging in work that is meaningful (subjective to each person) and building a strong and healthy support network can aid in managing stressful times of your life while supporting a healthy lifestyle. Ensuring you partake in enjoyable pursuits or hobbies outside of work is important as well. Meditating and reading can improve stress levels. If you suspect you are depressed or suffering from undue emotional stress, we highly recommend seeking out the appropriate medical care. Health isn’t just about food and looking good, the mental side of overall well-being is just as important.
8. Routine and appropriate medical care and screenings
Since we are not medical providers, we will not recommend specific tests or screens. However, it is generally not recommended to seek out specific tests or screens (e.g., specific vitamin or hormone tests, gut health etc.) unless you have specific symptoms, a family history of disease, or are in a certain age category or demographic warranting a specific screening. This can be costly and create unnecessary anxiety, as well may result in unnecessary treatment plans that do little to actually improve overall health. Especially if you are achieving the previously discussed areas, you do not need to focus on the minutia beyond routine screening or what your doctor/specialist recommends.
That being said, some routine screens that people should get regularly are blood pressure, cholesterol and depression as those can have a significant impact on health and well-being and should be addressed sooner rather than later. Similarly, immunizations can be very helpful for reducing the risk of disease and certain types of cancers. For more information on the recommended vaccine schedule please go here (Advisory Committee on Immunization Practices).
Some screening resources:
· Age/Gender Specific Screening Recommendation (discuss with your doctor if you have any questions or concerns)
· Recommended Screens for particular groups (again, this is for information purposes, please discuss with your doctor if you have questions about particular screen)
We hope the above overview of where you should focus your efforts in the pursuit of a healthy lifestyle proved useful. If you can work towards maximizing each one, you will notice a drastic improvement in your overall health. Notice the lack of specific nutrients, diets, exercises and routines. These areas are not overly strict or specific (aka you MUST do this, or you MUST avoid this), allowing you some flexibility to adapt it to your lifestyle and preferences. Please pass this along to people in your social network that are in need of guidance, struggling with their own health, or can’t make sense of all the information the fitness industry is pushing out.
In health,
Coach Gies