Good news about great health
Tackling one short list of lifestyle factors impacts health on many fronts. Start small. Start anywhere – just start
EAT RIGHT. Go to the gym. Stop smoking. Blah, blah, blah.
Unless you’ve been living under a rock, you’ve been inundated with these healthy-living messages. You might even be feeling a bit guilty about your own habits, what with all those fit folks trotting off to yoga, eating salads and eschewing cigarettes.
And you’re not alone. Clearly there’s a sizeable chunk of the population that’s not on board with healthy living. But why?
Could it be because the time pressures of modern life — too busy for the gym, too busy to cook a proper meal — have made our bad habits so ingrained that they seem impossible to change? Or are the changes we’re being told to make just too big and too hard?
Inundated as we are by the sledgehammer of dire health warnings — whether it’s childhood obesity or the high risks of cancer and stroke as we age — it’s little wonder we’re tempted to put our collective heads in the sand.
Now for the good news.
Many common health problems come down to the same set of “modifiable” lifestyle factors. And experts agree that changes to even one of the big four — smoking, physical inactivity, obesity and poor diet — can reduce the risk of illnesses on many fronts.
Even better, a lifestyle change doesn’t have to be a complete about-face. Every great journey starts with a single step, as they say.
“What a lot of people don’t realize is that even small, incremental changes over time can be positive,” says Scott Leatherdale, Cancer Care Ontario research chair and associate professor at the University of Waterloo’s School of Public Health and Health Systems.
“These behaviours develop over time. People don’t become long-term committed smokers, inactive or obese overnight, so it makes sense that it takes just as long and just as much effort to reduce those behaviours. The problem is, people tend to look at these things as either white or black. But there are a lot of grey areas. “When they want to change, they try to change everything at once and that makes it more difficult. That makes it more complicated.” Take smoking, for example. Smokers have seen and heard the dire warnings. They know cigarettes are bad news.
But smoking is not a matter of intellect. And knowing about all the bad stuff isn’t enough. As bad as it is for us, it still feels good.
“We have nicotine receptors in our brains, and they’re there always, and they are very smart. They’re brilliant,” explains Suzy Young, a nurse practitioner in respirology at St. Mary’s General Hospital.
“They will make smart people believe we need to smoke even though truly we know we shouldn’t. They wake us up, they’re part of a reward pathway — kind of like eating when we’re hungry. There’s memory attached to it, too. We remember that it made us feel good. It’s like exercise. It makes us feel invigorated, we’re more attentive, our memory may be better. It’s conditioning, and it’s quite amazing. That’s why people 20 years down the road say, ‘I could pick up a cigarette right now and smoke it.’ ”
Comforting as it is to know that science
can explain why it’s so hard to quit, most smokers have felt crushing guilt at one time or another. Knowing on one hand that cigarettes might kill us, but on the other hand not being able to quit, is the toughest kind of guilt to stomach. Young has an answer for that — and it’s more than a little encouraging.
Just because you’ve tried and failed, she says, doesn’t mean you’re going to fail next time. The key, she says, is truly being ready to quit.
Knowing what lies ahead — the cravings, the irritability, the fear of failure — makes it possibly the toughest thing in the world.
“The tobacco companies are brilliant,” Young says. “They have made the best drug-delivery system in the whole world. You can’t mainline heroin better than you can smoke a cigarette. >>
>> “But we need to learn as we quit smoking to calm those nicotine receptors down and say, ‘These things aren’t going to control our lives.’ ’’
She says that boredom and inactivity get in the way of quitting — that, and not having a plan. “Even if it takes 10 times, 15 times, 20 times — there’s so many options out there right now. Nicotine isn’t the harmful part of smoking, but it’s the extremely addictive part of smoking. However, it can be replaced — the patch, gum, non-medical things like exercise or getting a new hobby — whatever works for that person.”
And don’t beat yourself up about it. “It’s something in your brain so if you do go back to it, realize that — and next time you try, have a plan ready. ‘Just keep trying’ is really the take-home message,” Young says. “The worst thing to do is not to try.”
It’s a sentiment that applies not just to quitting smoking but to all the tough-to-break lifestyle habits, including bad eating.
Janice Holley, a clinical dietitian in the cardiology and cardiac rehab program at St. Mary’s General Hospital, says that past failures to eat well don’t mean you shouldn’t try again. “A lot of it has to do with how busy we are,” Holley says. “We all get caught up in it. It’s difficult for people to plan and organize. Meal planning and preparing foods can be very simple, but a lot of people have this mentality of ‘all or nothing’. They might think: ‘Unless I’m super-structured on this low-cal meal plan, what’s the point?’ But that’s not what healthy eating is all about. It doesn’t have to be complex.” The key is not to give up. “I would say not to see yourself as a failure but rather to look at your past experiences and learn from them,” Holley adds. “Ask yourself: ‘What was the barrier?’ If it was making the time to put the right food in the grocery cart, if you truly value your health, you will set aside that time.”
Holley points to excessive salt and fat intake as among the worst culprits. Blood pressure increases as we age, she says, regardless of sodium intake. But when you put a high-sodium diet into the mix, high blood pressure is associated with everything from kidney and heart disease to diabetes and stroke.
“We tend to have that habit-forming love for salt and we just go for the quick and easy: the highly processed convenient food,” Holley says. “Manufacturers discovered that decades ago and started adding tremendous amounts of salt to food. But when all the health-related issues started popping up, we realized the sodium we eat is 10 to 20 times more than our body actually needs.
“It’s hard for people to change, including the food industry. It’s going to boil down to all stakeholders — government, industry, health care, the individual — looking to get foods on the market that don’t have so much sodium. It’s not needed anymore for preservation.”
Excessive fat intake is also a problem – and typically the foods that tend to have a lot of salt also tend to be high in calories and saturated fats. Then there’s the issue of a lot of sugar, which can cause weight gain. And portion control is “huge,” Holly says.
‘‘People do not have to diet,” she explains. “Rather look at what you’re doing and try to go 50 per cent less — if it is an area of excessive intake, say alcohol, sodium or sweets, try the 50 per cent less option so you’re still enjoying that particular food but you’re being prudent and mindful.”
In other words, small changes are better than no changes.
“People often look for the easiest way to change,” adds Leatherdale, of the University of Waterloo. “Ideally, people want a pill to help them lose weight or quit smoking. But behaviour change is hard. It’s a function of the individual and the environment.”
Leatherdale says the big four modifiable lifestyle factors contribute not only to 60 per cent of the cancer burden but to a host of other illnesses. And, yes, it’s hard, but at least we can do something about it.
“If you can get the population to smoke less, eat better, be more active and lower their fat percentage, that has a huge impact on reducing cancer rates in the future,” Leatherdale says. “Those modifiable lifestyle factors are also key determinants for cardiovascular disease and for diabetes. They’re all intertwined.”