Thursday, November 23, 2017

10 Tips for Healthy Hedonism During the Holidays

Balancing a healthy lifestyle while honoring family holiday traditions can often lead to frustration, anxiety, and dread — and result in a hiatus from your healthy routines.

Phoebe Lapine knows this all too well. After being diagnosed with an autoimmune disease in her 20s, Lapine spent a year revamping her lifestyle and diet. She was determined to lead a fulfilling, healthy life in spite of her illness. Lapine chronicles that year in her book, The Wellness Project: How I Learned to Do Right by My Body, Without Giving Up My Life, which is filled with practical and insightful tips for anyone seeking a healthy balance — including at the holidays.

We hope her tips (and Gluten-Free Buckwheat Blinis recipe!) below help take the stress out of balancing health — and fun — this season. —Casie Leigh Lukes

  1. Don’t consume holiday punch on an empty stomach. A small bite of fiber-rich food (even a handful of peanuts off the bar!) can slow absorption and limit the negative effects sugary drinks have on your blood sugar and hormone levels.
  2. Embrace the potluck. If you come from a big family, holiday meals are likely a massive undertaking. Offer to bring a dish to the party, and make sure it’s something that you will feel good about eating. Especially for those of us with food allergies, it’s important that there’s at least one option on the table that’s safe (and delicious!). Try my recipe for Gluten-Free Buckwheat Blinis With All the Fixings below.
  3. Alternate your alcoholic drinks with water. Even if you’re drinking in moderation, alcohol causes dehydration. Having a glass of water after every drink can help lessen the blow to your liver and slow down your total consumption by giving you something else to sip on between eggnogs.
  4. Choose a sacred night to refuel. Picking and choosing social plans so you can get eight hours of sleep will make you a better friend to others and yourself. Especially during the holiday season, when cocktail parties abound, it’s important to block off parts of your calendar for some downtime and detox.
  5. Start the day with an anti-inflammatory latte. When we wake up after an imperfect night’s sleep, the first thing we crave the next morning is a cup of the antidote: caffeine. The holidays can turn into a vicious vice cycle if we’re not careful. Instead of depending on coffee to add pep back in your step, try something like a Golden Milk Latte with turmeric, which can help limit inflammation and won’t set you up for another crash by lunchtime.
  6. Brown bag your lunch. Since the evenings might be more out of your control than usual during the holiday party marathon, try to make more of an effort to set yourself up for success at lunchtime. Set aside one weekend afternoon to make a few healthful options for the week ahead.
  7. Add fermented foods to your diet. One of the consequences of too many cocktails and puff-pastry canapes is that it throws off your gut bacteria. Eating lacto-fermented foods with your meals can help mitigate some of that damage. Kefir is great in smoothies or dressings, kraut and kimchi can be used to top homemade sausage or grain bowls, and organic white miso can be whisked into soups.
  8. Put a pitcher of water or reusable water bottle on your desk. This will give you a visual reminder to drink water during the day, which can help ease a hangover headache or prevent one in the first place.
  9. Sweat it out. The end of the year tends to add more stress to our days as we try to finish up all those nagging tasks before the new year. Getting in 30 minutes of movement in the morning can help our minds unwind and shed excess toxins through our pores.
  10.  Host your own holiday party! The good news about opening up your home to friends and family is that you have control over the menu and can make sure there are sufficient options for the dietary challenged, or those looking for some whole-food options beyond pigs in a blanket.

Gluten-Free Buckwheat Blinis With All the Fixings

These gluten-free blinis use a mix of buckwheat and paleo flour, but you can easily substitute any all-purpose gluten-free flour you have on hand, and even white-rice flour. If you aren’t concerned about dairy, you can stick with traditional buttermilk instead of the coconut milk–lemon juice combo, though you can barely taste the difference!

The blinis taste great at room temperature, but you can also reheat them for five to 10 minutes in a 350-degree oven. They are a great option to make a few days before your holiday party. Or simply pre-prep the batter.

As for the fixings, I used Greek yogurt instead of sour cream or crème fraîche, and I even mixed in a little curry powder or turmeric to make it more colorful. Diced roasted beets, smoked salmon, fresh dill or chives, and chopped kimchi are other favorites. And, of course, to get really festive, you can serve them with caviar.

Prep Time: 20 minutes
Cook Time: 10 minutes
Total Time: 30 minutes


  • One 13.5 ounce can coconut milk
  • 2 tbs. lemon juice
  • 3/4 cup paleo baking flour or all-purpose gluten-free flour
  • 1/2 cup buckwheat flour
  • 2 large eggs
  • 2 tbs. unsalted butter or ghee, melted
  • 2 tsp. honey
  • 1 tsp. sea salt
  • 1/2 tsp. baking powder
  • 1/4 tsp. baking soda
  • Olive oil, for brushing


  • In a food processor or blender, combine all the ingredients except the olive oil. Scrape the batter into a large bowl and let stand for 15 minutes.
  • Heat a large nonstick skillet or griddle over medium heat until very hot. Brush lightly with the olive oil. Spoon scant tablespoon-size amounts of batter into the hot skillet to form 2 1/2-inch rounds (you’ll make six to eight pancakes at a time, depending on the size of your skillet). Cook until bubbles form on the surface and the blinis are browned on the bottom, about one minute. Flip the blini and cook for 30 seconds longer. Transfer the blini to a baking sheet. Brush the skillet with oil as needed and repeat with the remaining batter, layering the cooked blini on the baking sheet.
  • Serve alongside sour cream, crème fraîche, or Greek yogurt (you can mix in a little curry powder or turmeric to make it more colorful), diced beets, smoked salmon, fresh dill or chives, chopped kimchi, caviar, or any other creative toppings you fancy.

If you make this, tag @phoebelapine and #feedmephoebe — I’d love to see it!

Recipe printed with permission from Phoebe Lapine.

Excerpt from

Monday, November 20, 2017

Acne and eczema symptoms? SIX ways to ease skin conditions in winter weather REVEALED

ACNE and eczema are two common skin conditions whose symptoms can be exacerbated during winter. Here are six ways to ease them.

Reporting from

Friday, November 10, 2017

12 Strategies for Safe Detox

Anyone who’s been stuck behind a city bus inhaling big gulps of diesel exhaust or noticed a funny plastic taste in bottled water has probably wondered how to help their body unload those extra toxins.

The instinct to detox is a great one: We’re exposed to an unprecedented number of toxins in the modern environment. Each year, 2,000 new chemicals are registered for everyday use in the United States, notes functional-medicine doctor Robert Rountree, MD, adding that, “humans have become rent-free storage systems for synthetic chemicals.”

With a wealth of research showing that toxic exposures can contribute to weight-loss resistance, fuel chronic conditions like cancer and diabetes, and both trigger and aggravate autoimmune conditions, engaging in a strategic detox protocol can be a worthwhile practice.

Detoxing too quickly

 But detoxing must be done carefully. Just as toxins can cause problems as they enter and stay in the body, they can cause similar problems on their way out. If we detox too fast, or without the right support, we run the risk of reabsorbing some of the dangerous chemicals as they try to make their way out of the body.

When the toxins being released from the body’s tissues outpace the body’s ability to eliminate them, they stay in the bloodstream, triggering an inflammatory response, and causing people to feel, in the official parlance, crappy.

“There are two phases of liver detoxification. The first phase liberates the toxin, and the second phase deactivates it. Many people have difficulty with phase two,” writes Eileen Laird, author of A Simple Guide to the Paleo Autoimmune Protocol. “If you feel sick on a detox protocol, there’s a reason. You are essentially getting poisoned with your own released toxins.”

Symptoms tend to mimic the flu. People can experience fatigue, nausea, headaches, dizziness, bloating, digestive issues, chills, elevated heart rate, brain fog, and increased joint and muscle pain. Taken together, these symptoms are known as the Jarisch-Herxheimer Reaction, or “herxing” or “retoxing” for short.

Some health practitioners call this detox reaction a “healing crisis,” saying that if you feel bad during the detox process, then you know it’s working — toxins are on the move. But there’s a broader consensus among practitioners that having a pronounced Herxheimer reaction is not healthy.

Feeling bad during a detox is “not necessarily good or OK,” says functional-medicine practitioner Jill Carnahan, MD. “People shouldn’t say, ‘Oh, this is herxing; I should just push through it.’ It’s a sign that they should slow things down or take an alternative approach because they’re overwhelming their detox pathways.”

That’s a long way to say that, when it comes to detoxing, the best advice is to listen to your body. “Our bodies speak to us all the time,” says Laird. “It’s risky to override those signals of what our body is telling us is true.”

Safe detox

The first step in any safe, effective detox is to work with a qualified practitioner. Look for someone who has experience with strategic detox protocols and ask them how they work with patients who have a detox reaction.

After that, there are strategies you can use to support and protect yourself during a detox. These strategies will help you live a lifestyle that supports ongoing detoxification long after the targeted detox phase is over.

1. Make sure your symptoms aren’t related to something else. If you’re having an allergic reaction to something in your environment, you will feel consistently crummy. If you’re truly experiencing a Herxheimer reaction, you should feel better in a couple of days, says Carnahan. No matter what, you should consult your practitioner. If you’re having an allergy or other issue, you’ll want to determine the root cause. If you’re having a detox reaction, you’ll want to slow down your detox protocol.

Sometimes people experience a couple of days of flu-like symptoms from simply cutting out certain foods and doing nothing else. This is often talked about as a detox reaction, but it’s more likely withdrawal, says Carnahan. For example, dairy contains opioid peptides called casomorphins, and gluten contains opioid peptides called exorphins — both substances can have a mild opioid-like effect on the body. When these foods disappear from the table, mild withdrawal can follow. If symptoms last more than a couple of days, consult your practitioner.

When someone eliminates sugar, she or he may experience a die-off of intestinal yeast (yeast loves sugar) and a similar set of symptoms. Taking a natural binder, like activated charcoal, can help absorb the yeast and hasten it out of the body.

2. Keep new toxins off your plate. Try to eat organic fruits and vegetables and clean, pastured-animal proteins. Otherwise, you’re taking in toxins at the same time that you’re eliminating them — and never getting ahead.

3. Keep toxins off your body. Make sure your health- and body-care products aren’t introducing new synthetic chemicals into your system. Their effect on the body is no different than food. “If you’re putting it on your skin, it’s like you’re eating it,” says Rountree.

4. Continue with strategies no. 2 and no. 3 after you finish your targeted detox protocol. “Being mindful of toxins all the time can be overwhelming,” says Laird. “People are drawn to detox because they think they can burn the candle at both ends and then just detox seasonally.” The better strategy is to keep those toxins at arm’s length every day. Once you make the switch to clean foods and clean body-care products, the feeling of being overwhelmed by all the new choices will dissipate in time.

5. Make sure you’re getting your minerals. Minerals are critical for optimizing the detox pathways in the body. Two easy mineral-boosting strategies? Take Epsom salts baths (for the magnesium) and drink mineral water, says Carnahan.

6. Eat your (brassica) veggies. The brassica family of vegetables — including broccoli, cauliflower, watercress, Brussels sprouts, kale, and collard greens — contain sulforaphane, which can increase the enzymes in the liver that break down certain toxins.

7. Eat the rainbow. The health-promoting compounds in vegetables and fruits are also usually responsible for their bright colors. The more colors you eat in a day, the more phytonutrients you’re exposed to — and phytonutrients powerfully assist the detox process and help protect the body against more toxin-related damage. Try to eat one food from each color of the rainbow every day (red, orange, yellow, green, blue, purple).

8. Load up on fiber. Toxins leave our bodies in one of three ways: through urine, sweat, and elimination via the GI tract. Keep your digestion humming along by eating foods high in fiber, like beans, avocados, berries, peas, squash, and flax and chia seeds.

9. Stay hydrated. The more clean, filtered water you drink, the more you urinate — and the faster toxins leave your system.

10. Sweat. Move toxins out through your skin by getting in a heart-pumping workout or sitting in an infrared sauna.

11. Consider herbal and supplement support. There are some great herbal blends for helping optimize liver and kidney function. Consult with your practitioner about what might be best for your unique situation. The antioxidant glutathione is incredibly important for detox. One of the best ways to supplement with glutathione is to take N-acetylcysteine, or NAC, a glutathione precursor.

12. Rest. “Sleep is powerfully regenerative,” reminds Laird. Getting high-quality rest can optimize all your body’s functions, including its ability to detox.

Excerpt from

Thursday, November 9, 2017

Christina Peters’s Success Story

I’ve spent most of my life at war with my body. For years, I thrived on being thin, and I managed my weight closely with extreme exercise and dietary restrictions. I had a distorted body image and no self-esteem.

I was just 11 years old when it all began. At the time, a lot of things in my life felt uncertain — my mother was recovering from some health issues and my father was considering moving our family to Cincinnati from our home in Fort Wayne, Ind., where I’d lived my whole life. Tracking my meals and workouts offered a sense of control that I felt I desperately needed.

I wore a belt to bed to keep my stomach flat, and I exercised at all hours — doing sit-ups in my bedroom and running on the treadmill at night while my family slept. I was adept at hiding my behavior, and, for a while, my parents thought the changes in my body were a natural part of preadolescence. But later that year, I became so malnourished that my hair began falling out. That’s when they took me to the doctor, who diagnosed me with anorexia nervosa.

Tough Transitions

I spent a few weeks receiving outpatient medical treatment so doctors could treat my malnutrition. Once I was released, my parents sought additional help. They arranged personal therapy sessions for me, and we went through family counseling together. My symptoms improved somewhat, and there were even times when I was able to maintain a healthier weight.

But those improvements were always short-lived. Once I put on some pounds, I would start to feel out of control, and my old habits would creep up again. My disordered behaviors grew especially intense during times of change, like when

I started high school or when I moved away from home to begin my freshman year at Purdue University.

At home, my parents helped me stay the course with my recovery, but college was a whole new ballgame. None of my new friends knew my history. I could make excuses for skipping meals, and no one would question it; they just thought I was naturally thin.

My diet was all low-calorie convenience foods, including diet frozen meals and fat-free snacks. I was hitting the treadmill at the gym to burn off what little I did eat — but since I was so malnourished, running hurt my joints. Ironically, I was studying to be a nurse — I wanted to help others take care of themselves, but I neglected my own health.

The first three years of my nursing program were rigorous, and the stress made me more obsessive. Because I worked out so much during the day, I’d have to stay up all night to study, and that lack of sleep distorted my thinking even further. Still, as much as I began to dread exercising, I felt like I couldn’t stop.

The Other Side of Unhealthy

The final year of my nursing program was less regimented than the first three, and I finally felt I could relax a bit. Like most of my friends, I had just turned 21 and wanted to spend my time the way a lot of 21-year-olds do. Before I knew it, I was out drinking three or four nights every week and making a lot of late-night, deep-fried decisions.

After years of obsessing over everything I ate, it felt good to give myself a break. But my behavior had swung too far in the opposite direction. Despite my healthier BMI, I felt bloated and self-conscious because my weight gain was all pizza and beer.

As the end of my senior year approached, I began to feel intensely anxious about the next phase of my life. I was so tired of living in extremes, and I was determined to make this transition a good one.

After graduation, I moved to Indianapolis to begin work as a registered nurse. Seeing patients every day, I became even more motivated to get healthy. I wanted to feel good about advising and helping others do the same.

My roommate and I joined the Life Time near our apartment shortly after we moved, and I was intrigued by the group fitness classes. In the past, I’d only exercised alone, but I felt open to trying something different. That’s how I ended up in my first yoga class.

I’d always eschewed yoga because it doesn’t burn a lot of calories. But the first time I stepped onto my mat, I felt a sense of calm unlike anything I’d ever felt before. For so long, I’d been feeling pressure — to look perfect, to get perfect grades, to keep everything perfectly under control. I’d never experienced a physical activity that wasn’t about pushing myself.

Yoga is so much about listening to yourself: You go into a posture and stop when your body tells you to stop. Ultimately, that’s how you make progress; yoga is about practice, not perfection. The breathing exercises helped me appreciate the powerful connection between mind and body. I learned that when I slowed my breath, I could steady my thoughts.

I was getting to know my inner self. I realized that I’d never really tried to honor my body’s wisdom. That’s when my practice began to improve my life off my mat.

A Fresh Start

I wanted to feel good during class, so I started eating more whole foods; I was craving veggies and fruits, and cutting out the processed junk. In the evening, I found myself enjoying hot tea instead of a glass of wine.

Every time I stepped onto my mat was a little different from the time before, which taught me to be more forgiving with myself. I had to accept that I couldn’t always get into every pose. That sense of patience has influenced other parts of my life: I’m a more empathetic listener, which makes me a better nurse — and a better friend and family member, too.

After practicing yoga for four years, I went to Costa Rica in the fall of 2016 to complete my yoga-teaching certification. It was a challenging and intense program, but it helped me discover more of my inner strength and gain a deeper respect for what my body can do.

The practice of yoga — like recovery, and like life — is far from perfect, and that’s OK. It’s a beautiful thing to stumble and fall, because then you have the chance to begin anew.

Excerpt from

Tuesday, November 7, 2017

Why Your Fitness Mindset Matters

You read the articles and listened to the podcasts. You bought the shoes, consulted the trainer, set the goals. But try as you might, something keeps sabotaging your best intentions to exercise regularly.

I’m too busy, you tell yourself, rattling off a list of legitimate obligations and responsibilities. Who has the time? 

Or you berate yourself: Why bother? I’ve tried getting fit before. It never sticks. You clearly lack the willpower, you convince yourself as you stand on the precipice of abandoning exercise for good.

But what if your problem wasn’t time management, your distaste for sweating, or lack of follow-through?

There’s a good chance, in fact, that all these obstacles have a single cause: your mindset.

In a culture saturated with pop psychology, the term “mindset” takes on many meanings. But ultimately, says Brian Grasso, author of Mindset Matters Most and cofounder with Carrie Campbell of the Achieve the Goals You Set coaching program, those two syllables refer to “the stories you tell yourself, about yourself.”

The study of the mind — and how it both limits us and sets us free — began thousands of years ago. “Any serious Asian martial-arts training is primarily a study of the mind,” says Jeremy Hunter, PhD, director of the Executive Mind Leadership Institute at Claremont Graduate University. “A student learns to turn fear into focus.”

Coupled with current research on behavior change, modern mindset-shifting techniques have helped people cope with addiction, depression, anxiety, and other crippling conditions. But can they also help us conquer our fears and doubts about taking up — and staying with — regular workouts?


The Phases of Change

Before discussing mindset, it’s important to understand the transtheoretical model of change (TTM), a system of behavioral modification developed by psychologists James Prochaska, PhD, John Norcross, PhD, and Carlo DiClemente, PhD. The name may be a mouthful, but its guiding principle is simple: If you’ve had trouble starting (or restarting, or re-restarting) an exercise program in the past, the first step is to figure out where your head is.

Self-help books often suggest that change is instantaneous. Overnight, they promise, you can throw out old behaviors (obsessing over social media, eating sweets) and adopt new ones (jogging, eating more -vegetables).

TTM asserts that it’s a multistage process. “The key is always to use the right strategy at the right time,” Prochaska, Norcross, and DiClemente explain in Changing for Good.

Their model identifies six stages of behavior change:

  • Precontemplation: You don’t recognize the need to change — and may resist it.
  • Contemplation: You understand that you need to change.
  • Preparation: You’re ready to take action and begin planning.
  • Action: You implement your plan.
  • Maintenance: You consolidate the gains you’ve made.
  • Termination: Your new behavior is habitual.

Though the process appears linear, you might skip from one phase to another and back again several times before making it to the termination phase. You may resolve to start working out, even attend a few classes, only to skip exercising for a month or more.

Many people interpret this as a failure of willpower — and perhaps further evidence that they aren’t cut out for exercise. But “falling off the wagon” is part of the model: not a relapse, but a recycle through the phases and another opportunity to learn what works for you.

Conceptual shifts like these may seem simple, or even pointless, but how you think about your behavior plays a vital role in your capacity to make change (see “Change Your Words, Change Your Mindset,”below).

“When you tell someone how to do something and it doesn’t work, they feel like they’ve failed. That implants a new story and a deeper belief that they won’t be able to do it,” says Campbell, who’s also a clinical counselor. If, however, you see setbacks as a part of the process, you’re more likely to return to, and stick with, the new program.

In other words, expect your progress to be nonlinear. Expect that you may take two steps forward and one step back.

A step back might seem like a failure, but every one is an opportunity to learn and take that next step forward. As Zen Buddhist monk and author Pema Chödrön advises, “Fail, fail again, fail better.”

TTM also suggests that people who have trouble exercising may be taking the wrong type of action at the wrong time: They draw up plans they aren’t ready to implement; they stop budgeting time for workouts before they’ve established the habit. This helps explain why so many New Year’s resolutions — more than 90 percent, by some estimates — fall by the wayside.

So, be kind to yourself as you set new fitness goals, begin to examine your own long-held truths and personal stories, and sense a mindset shift. Be patient. Stumbling is part of the process. If you feel lost or frustrated, identify the TTM phase you’re experiencing and remember that change at the intersection of body and mind is not always a smooth, linear flow forward.

Taking Inventory

Before you take action, consider your exercise mindset: Are you excited by the prospect of working out? Feeling overwhelmed? Guilty? Annoyed? Are you ready to start tomorrow — or would you rather not think about it at all?

Try writing down your feelings about working out in a quick, five-minute, stream-of-consciousness burst. This can help indicate your current phase of change.

Focused writing can also reveal what Campbell and Grasso call the “stories” that might be hindering you. You might discover, for example, that you think you’re smart but not athletic, or funny but physically hopeless. Such inner sound bites may seem innocuous, but over time they can start to feel like inescapable facts.

With practice, Campbell and Grasso say, you can change the stories you tell yourself — and, ultimately, change your life.

Like any worthwhile change, shifting your perspective on exercise takes time. “Mindset is often mistaken for getting amped up, like all those messages on social media about your ‘one shot’ and how ‘now is the time.’ But that’s not sustainable,” Grasso says. Just as a single workout won’t transform your body, he explains, a single motivational workshop or visualization session won’t change your mind. “Changing your mindset is about consistency plus simplicity.”

If you discover you’re not ready to begin exercising regularly, consider what exercise might do for you. Could it make you feel better about yourself? Give you the energy to play with your kids or the courage to speak publicly? Enable you to take more risks, spend more time in nature, pursue an activity that’s always intrigued you? Could it support you through any health issues you might be facing?

At some point, you’ll hit on a reason that fires you up. No single motivation works for everyone — which is why it’s important to search your soul until you find reasons that resonate.

Cat Thompson, founder of the coaching company Emotional Technologies, calls this getting in touch with your why. “What’s the life you envision after you’ve made your transformation?” she asks. “What does success look and feel like, and what will you do in your stronger body?”

Think beyond rational reasons like lowering your blood pressure or relieving your back pain. Though important, they aren’t usually enough to spur action. “You may have all the concrete reasons in the world to exercise,” says Thompson. “But unless you’re emotionally engaged in the process, you’ll sabotage yourself every time.”

Move deliberately through these initial steps, especially if you’ve had painful experiences with exercise in the past. Like a Zen warrior, you’re battling inner demons, laying the psychological groundwork for a life-changing breakthrough. Don’t shortchange this important stage of your personal hero’s journey.

The more you can frame exercise as a positive, active step toward greater fulfillment (more confidence and enjoyment) rather than a way to avoid a negative outcome (illness, weight gain), the more likely you are to succeed.

Ready, Set, Plan

At some point, you’ll need to specify your intentions, making plans for how you’ll integrate exercise into your life and clarifying your goals. Many people aim too high, setting unrealistic expectations (I’ll go to the gym six days a week!) and unattainable goals (I’ll lose 20 pounds before the end of the month!). But this approach seldom works, and it can lead to feelings of hopelessness.

“It’s easy to get intimidated or overwhelmed,” says Campbell. If you’ve had success setting goals in other areas of your life — such as work or finances — feel free to set some around exercise and fitness, too. But if not, don’t: “Better that than falling short of a big goal and reinforcing an old, negative story,” she says.

For now, stick with shorter-term goals involving habits you’re trying to establish (I want to get to the gym twice a week for a month) rather than outcomes you’re trying to achieve (I want to bench press 300 pounds). That way, each workout becomes a victory.

Many adults, perhaps remembering coaches who had punished them with laps or pushups, see exercise as a form of penance. We may assume the drill-sergeant role ourselves, undertaking demanding exercise routines and Spartan diets as a way of disciplining ourselves for what we consider slip-ups or bad behavior.

This is not an effective — or sustainable — strategy. “Humans are pleasure-driven creatures,” says Thompson. “Think back to a physical activity you enjoyed as a child. Was it hiking? Cycling? Climbing trees?” You might be able to base your entire fitness routine on that one, enjoyable activity. If not, she advises, “include at least some activities you enjoy.”

Many of these choices come down to personal preference, so it’s essential to stay flexible as you plan your approach. Consider all your options: Do you enjoy working out after work? At night? On weekends? Weekdays?  “If you hate getting up early,” says Thompson, “your plan to get up five days a week at 6 a.m. won’t last long.”

The goal is to craft a strategy that creates new, positive associations with exercise and overrides older, negative ones. In essence, you’re rewriting your exercise story.

Jumping In

Armed with a new outlook on fitness, and a plan designed to maximize your enjoyment, you’re ready to dive in. As you head to the gym, pool, trail, or park, go easy on yourself.

An exercise program has lots of moving parts, and you may need to change your diet or sleep habits. Some days you’ll forget your shoes or miss the early class; your enthusiasm for working out may wax and wane as your body adjusts to your new routine. When setbacks happen, don’t despair. Simply steer yourself gently back to your workouts.

If your efforts to get started stall repeatedly, adjust your strategy so it’s more in keeping with your preferences. “Resistance often crops up because you’re not being flexible enough,” says Thompson. Maybe cycling isn’t all you thought it would be. Maybe your workout buddy is holding you back. Change the elements of the plan that aren’t working and stick with the ones that are. “There’s a lot of power in letting things happen instead of making them happen,” she explains.

Hunter teaches a course for industry leaders at the Executive Mind Leadership Institute on focusing the mind during stressful periods. The key strategy? “The students observe themselves in stressful situations,” he says. They quickly notice harmful, intrusive thoughts, which drive destructive, negative behavior. Once aware of these thoughts, they learn to step away from them and take a new direction to make better decisions.

So, notice what stories run through your head during your workouts and write them down. How do these thoughts translate into actions and results? Documenting these things can help you track how you respond to your new program over time.

Through a combination of nudging the script a little (shifting your inner monologue from I’ll never get through this to This is hard, but I can do it) and altering your behavior (using a lighter weight, taking an easier class, exercising at lunchtime instead of in the morning), you will find an approach that’s challenging, rewarding, and sustainable in just the right combination.

Staying The Course

Establishing a beneficial habit is a little like tending a garden: lots of work early on, and less as you progress — but never no work at all. Unlike dropping a bad habit, “exercise requires modifying your behavior until it becomes such a significant part of your life that you miss it when you can’t do it,” says DiClemente. The trick, he notes, is to keep the number of pros high and the cons low.

Many of the pros will quickly become obvious. After just a few weeks of working out regularly, maybe you’ll notice more vitality, sharper focus, and increased muscle mass accompanied by less stress, body fat, anxiety, and depression. All of this will motivate you to keep it up.

But some days, says Thompson, life will get in the way. The key is to take the long view. “It’s like the stock market: One day might be great, the next terrible. Instead of worrying about day-to-day fluctuations, think of your exercise program as an investment for five or 10 years in the future.”

Journaling remains a valuable tool during this phase, she notes. On days when you might get discouraged, “it gives you tangible evidence of your accomplishments.”

Finally, she says, build variety into your program to stave off boredom, perhaps changing the focus of your workouts with the seasons. You might swim in the summer, lift weights in the fall, ski in the winter, and hike in the spring. This strategy helps prevent repetitive-use injury, respects your body’s need for change, and parallels the behavioral patterns of humans through history.

As you reach higher levels of fitness, minigoals — perhaps completing a 5K or competing in a mud run — can add structure to your workouts and provide additional short-term motivation to stick with your program.

Despite all the hardcore “no pain, no gain” cheerleading that surrounds exercise, it’s most important to simply stay flexible and go easy on yourself as you move forward. Celebrate the victories, let yourself off the hook for the missteps, and keep progressing, one step at a time.

“Too often we fall for the promise of an easy fix,” says Thompson. “Like four weeks to six-pack abs. Forget that. Look at your actions over time. Exercise is part of a wellness plan — and that’s a plan that you work forever.”

This originally appeared as “Get Your Head in the Game” in the November 2017 print issue of Experience Life.

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Monday, November 6, 2017

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PUMPING IRONY: Too Weak for Surgery?

Aunt Lois is 93 years old, lives independently in her own home and, last I heard, was still driving to her hospital volunteer gig once a week. So, I was taken aback the other day when My Lovely Wife mentioned that Lois had recently undergone surgery to implant a pacemaker.

“It’s risky business for someone that old,” I noted, more fretfully than I had intended. “I mean, surgery at that age can often be the beginning of the end.”

MLW glanced up from her newspaper, eyes narrowed.

“Oh, I’m sure nobody would’ve talked her into it if she didn’t want to do it,” I offered, backpedaling. “If her heart was really getting to be too weak, I suppose it would make some sense.”

The operation was successful, MLW reported, and Lois seemed to be doing fine. “Her doctor came in to discuss when she would be released from the hospital and Lois told him, ‘Go to your room.’”

Lois may be an outlier among the multitudes of elderly Americans who end up in operating rooms each year despite a level of frailty that makes survival — not to mention recovery — a dicey affair. As Paula Span reports in the New York Times, patients over the age of 65 account for more than a third of all inpatient surgical procedures in the United States. And about 15 percent of that group — plus a full third of those over 85 — are probably too weak to risk even routine surgical procedures.

“Researchers have shown that after major operations — including cardiac and colon cancer surgery and kidney transplants — frail older patients are more prone than others to longer hospital stays, being readmitted within a month of a procedure and winding up in nursing homes after they’re discharged,” Span writes. “They’re also more likely to die.”

If the anesthesia and inflammation don’t get you, University of California, San Francisco, surgeon Carolyn Seib, MD, tells Span, there’s always blood clots, infection, and muscle weakness to contend with. “The more frail a patient is, the higher the risk of complications.”

Some surgeons have responded by devising various methods to determine a patient’s level of frailty before deciding whether to operate. “We have to take frailty into account for any operation, big or small,” says Seib, though she admits that it’s not a widely accepted practice. “I wouldn’t say it’s routine yet.”

Part of the challenge, I suspect, lies in distinguishing the weak from the strong(er). Some doctors test their patients by measuring the time it takes for them to get out of a chair, walk 10 feet, and return to the chair. Others rely on tests of grip strength and walking speed, while still others look more generally at the presence of chronic illnesses and cognitive issues.

Span describes the case of an 86-year-old man with a troublesome gall bladder who failed the chair test. After discussing the risks of surgery, the patient decided to forgo the knife and try to avoid the foods that tend to cause his symptoms. It’s part of what’s called a “prehabilitation” program, which often includes lifestyle changes. Recent studies in Poland and Singapore, which suggest physical training and dietary changes can actually reverse frailty in the elderly, support this strategy.

“Surgical decision-making is not a binary choice between patients agreeing to the standard operation or doing nothing,” Span explains. “Alerted to frailty, a surgeon might opt for a less aggressive approach or a different kind of anesthesia. A patient, understanding that she may be looking at an altered future even if the surgery fixes the physical problem, will have her own priorities to weigh.”

Aunt Lois has never been shy about asserting her priorities. At her 90th birthday party, someone asked her what she wanted for her birthday. Nursing a cocktail, she smiled as she surveyed the room. “I’m just looking for a date,” she replied. I suspect, frail as she may be, the old girl was going to get her pacemaker no matter what anyone else said. Here’s hoping it’ll come in handy if she finds a fellow who manages to quicken her heartbeat.

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