As a health and nutrition educator I work with people who are attempting to achieve optimal health and wellness. I often present the components of health and wellness using the three legged stool model. A wooden three legged stool balances well on all three legs. If one of the legs is shorter or longer than the others, the stool lacks stability and “wobbles.” If one of the legs breaks, the instability becomes a crisis.
I recognize the importance of the mind and the spirit. However, I cannot adequately discuss every aspect of health and wellness in one post and the focus of this discussion is the body. More specifically, I describe my introduction to the work of Katy Bowman. Bowman’s views have me reimagining the “three legged stool” models that I use in my workshops. (Clearly, I need help from someone with better design skills.)
Many of the people that I know are working to improve the health of their bodies through increased exercise. They will find Bowman’s focus on movement to have immediate practical applications. I have not, as yet, been successful in breaking her work down into easily understood bytes for them. They need to confront Bowman’s work for themselves and I strongly recommend that they do so.
I was introduced to the work of Katy Bowman through a video tour of her home.Watch “Tour of Katy’s House” on YouTube https://youtu.be/E-sROj4QrPI
I am reading and thinking about two of her books. The books are quite popular and well written reviews are easy find.
I visit her Nutritious Movement Website. I read her blogs. I listen to her podcast. I am using her full body mechanics programs to increase my strength and mobility.
Perhaps the most important thing that Bowman says is the simplest. Exercise is only one form of much larger movement options.
I found this idea enticing because, while I enjoy movement, I have less appreciation for counting “sets and reps.”
My attempts to explain even Bowman’s simplest ideas come out sounding like nonsense because I have fallen into the deep end of the pool. For years I have been studying how food creates biochemical cascades that alter physiological states. I have never paid as much attention to how movement also creates biochemical cascades that alter physiological states. Bowman pushed me to change that with her definition and explanation.
MECHANOTRANSDUCTION The process by which cells sense and then translate mechanical signals (compression, tension, fluid shear) created by their physical environment into biochemical signals, allowing cells to adjust their structure and function accordingly.
I immediately wanted to learn more and attempted to audit advanced courses in biophysics. The professors quickly sent me back to the “kiddie pool” of introductory human physiology. I have been here before. However, I know that I will benefit from the review, the integration of newly discovered knowledge, and approaching the course from a new perspective.
The learning goal of the course that I am taking has been set by the professors.
At the end of this course, learners will be able to recognize how the basic organ systems of the body work and apply the basic concepts that govern integrated body function as an intact organism in the body’s nine organ systems.
The learning goal does not indicate the minutia of the detail involved in this study. I plan to enjoy spending time studying human physiology while thinking about mechanotransduction. In other words, when I go for my morning walk and when I do Bowman’s programs, I am going to think about, talk about, and write about them from a physiological perspective. I am compelled to explore the idea of nutrious movement. This is definitely my lane.
I have not given up on nutritious food. I am still working on autoimmune protocol meal plans that do not exceed 1200 calories per day. I am thinking about how a person with extreme oral allergies can design nutritious meals for themselves.
I have not forgotten about the importance of sleep, or the mind, or the spirit. But those discussions will have to wait until I finish this. I think my current workload is more than sufficient.
TALK TO ME ABOUT BOWMAN’S WORK! TALK TO ME ABOUT HOW MOVEMENT IS ALTERING YOUR PHYSIOLOGICAL STATE.
Skin is the largest organ of the human body. It is the first line of protection against outside invaders. That includes the skin of the scalp which is covered with hair. Pediatricians, social workers, teachers, family members, and even complete strangers will notice and judge how a child is being cared for based on the health of their skin and hair.
The hair and skin of children with African Ancestry can often present special challenges to their physical and emotional well being. Dealing with these challenges is no longer the sole responsibility of the mother. The fathers of children of African descent (at least some of them) have been stepping up to share the responsibility for this important area of HEALTH CARE. And as a health educator, health always comes first with me.
If you are person of either sex who is responsible for the care and well being of a child with African ancestry: Read, Watch, and then DO.
Hair and Skin Care for African American and Biracial Children. Written and Created by Nicole M. Hewitt, MSW for the Pennsylvania Child Welfare Training Program.
Remember that skin color is not a skin type. In order to give your children the best skin care you will need to learn what skin type they have. One of the most common problems that I see results from believing that all dark skin is oily. It results in the needs of dark skinned children with dry skin going unmet and their skin being damaged by cleaning regimens that are much to harsh.
When Alexis Ohanian tried to join closed Black Hair Groups created for women, they turned him away. They empathized with his desire to learn how to care for his daughter’s hair. They pointed out that he did not need to join a group created for women to learn. They told him to go to YouTube. This is a brief compilation from 2018.
Dad’s are helping their daughters have healthy hair and boosting their self esteem.
If the fathers in the compilation are above your skill level, don’t despair. Everyone had a first time.
Step Up Dads! Real men care for the total wellbeing of their children, including skin and hair. This is not vanity, this is HEALTH.
We need to identify the foods to which we have a negative reaction, allergy or intolerance (1), and eliminate them from our diet while making sure that we are still providing our bodies (and our families) with adequate nutrition. Elimination diets are an important tool in this process. I have a few food allergies and I am intolerant of many. The elimination diet (2) that works best for me is the autoimmune protocol (AIP).
Getting Help with the AIP
For a long list of reasons, I NEED A FULL AIP RESET. Changing from any dietary lifestyle to another requires planning. Even though I am not an AIP newbie (3), I decided to use the work of Jaime Hartman, a nutritional therapy practitioner, to help with the planning. (4)
I am using Hartman’s meal prep method to organize my own AIP compliant recipes and meal plans. However, I have accelerated my move into the AIP by using Hartman’s “AIP Done-For-You Prep Plan.” The recipes in this plan are compliant with a the full elimination phase of the AIP. The recipes are free of all major allergens. They are also free of legumes, nuts, seeds, and nightshades.
While it is commonplace for people to focus on what foods elimination diets require them to relinquish, I have found it useful to look at what I am allowed to eat during the full elimination phase. I shopped, using Hartman’s list. I prepped using her method. Then I cooked and enjoyed the fruits and vegetables pictured, as well as chicken, turkey, beef, and tuna.
I never once felt deprived. Through the shopping, the washing, chopping, slicing, and dicing, I felt as though I was providing myself with the type of self care that I deserve. My only regret is that I did not treat myself this well decades ago. Thank goodness it is never too late to love yourself more.
To live with a food allergy is to live with the fear that the accidental ingestion of the wrong food could lead to immediate death. To live ignoring food intolerances is to live a potentially long life feeling miserable from of any of a long list of chronic inflammatory diseases. I sometimes refer to this as, “the I been eating this my entire life syndrome,” as in, maybe you would be better off if you had not. But habits are a nutrition educators worse enemy and best friend. It’s about changing one habit for another.
“Some of the symptoms of food intolerance and food allergy are similar, but the differences between the two are very important. Eating a food you are intolerant to can leave you feeling miserable. However, if you have a true food allergy, your body’s reaction to this food could be life-threatening.
2. Recently, I experienced some digestive symptoms after eating the small triangles of mass produced bread used to create cucumber sandwiches (I adore cucumber sandwiches). Some members of an online support group to which I belong to suggested that I needed to try a “Low FODMAP” Diet.
My sincere condolences to those who loved Kelly Mason.
You need to lose some weight.
After a polite Texas greeting, Dr. Nowzaradan gets straight to the point.
Tell me about your eating habits.
Dr. Nowzaradan’s patients are seldom able to describe their eating habits with specificity. They are unable to accurately report what they eat, how much they eat, and when they eat. During their first meeting with Dr. Nowzaradan, they tend to talk about why they overeat. I keep waiting for someone on the program to mention food journals.
Nutrition consultants usually ask their clients to log meals. Keeping a food diary allows eating habits to be described in terms of what foods are eaten, when they are eaten, and how much of them are eaten. They can also help track the “why” of overeating.
Food journals are powerful tools in the attempt to change eating habits. Don’t reject the idea without trying.
There are so many ways of logging meals that I need to discuss the “how to” in a separate post. If someone can commit to logging meals for a specified period of time, there is a method for them.
The Diet Plans
Dr. Nowzaradan does not offer a singular diet plan. At the first office visit Dr. Nowzaradan provides his patients with customized dietary plans based on their current eating habits, weight, how much they need to lose, age, and gender.
Some patients return for their second visit claiming that they followed Dr. Nowzaradan’s diet instructions yet did not lose weight. He adopts an empirical approach that relies on the scale. He calls these patients liars. He tells them how many calories per day they must be eating in order to achieve their current weight. Sometimes they are eating 6000-7000 calories per day.
This is the type of information that I must look up. I use the calorie calculator at calculator.net.
I empathize with Dr. Nowzaradan’s patients because they cannot weigh themselves. Weighing on a more frequent basis would help them stay on track. I think these patients, like other overweight people including me, would benefit from keeping a food journal. They would benefit from measuring their food intake. Then they would know how far their eating habits are from Dr. Nowzaradan’s prescription.
When I see one of the patients using food measuring tools, I applaud. When dealing with a surgeon you too must adopt an empirical empirical.
That which is measured improves. That which is measured and reported improves exponentially.” – Karl Pearson.
You are delusional!
Some of Dr. Nowzaradan’s patients suggest that their dietary intake has little to do with their weight. He refers to these patients as delusional. The television program has featured people who appeared to be out of touch with reality.
These patients are also the most likely to question Dr. Nowzaradan’s recommendations and conclusions. They say, “It’s just his opinion.” That always makes me laugh. Professionals get paid for their opinions.
Other patients seem to engage in common forms of distorted thinking. I am sharing a list of cognitive distortions from a website devoted to eating disorders.
I want to emphasize that you don’t have to weigh more than 600-lbs or have an eating disorder in order to engage in distorted thinking about food. Human beings use distorted thinking to get through the day. Help is available.
Making longterm changes in lifestyle is a complex and difficult process. The person who wants to be healthier is the person who must put in the effort. The surgeon, the therapist, the nutrition educator do not have a magic weight loss wand. These professionals make recommendations and offer their opinions. Then they wait for the person hiring their services to put in some work.
Every professional has protocols and processes. Sometimes the people they serve must step out on the belief that the professional really does have the required expertise. Patients leave Dr. Nowzaradan’s office the first time swearing that the weight loss goal he gave them is impossible. Those who take his instruction are pleasantly surprised with the results. Sometimes patients refuse to take the advise that Dr. Nowzaradan offers and they must be dismissed from the program.
I think that calling patients liars and saying that they are delusional is confrontational. I tend to believe that Dr. Now uses these confrontational tactics because the extreme morbid obesity of his patients is an imminent threat to their lives.
It definitely makes for dramatic television. It also provides a learning opportunity for those who are watching even if they are not as overweight as the participants on My 600-lb Life. Don’t waste a professional’s time. Take their advise or stop talking to them about the problem.
Dr. Nowzaradan has started to introduce the need for therapy earlier in his relationship with patients. I applaud that decision. People who come to him benefit when he explains, early in the game, that they need both therapy and surgery. They need to know that he does surgery and not therapy.
Many people who want to lose weight, even if they are not as heavy as Dr. Nowzaradan’s patients, might also benefit from psychological intervention. This does not mean that they are “crazy.” It simply means that there are psychological skills that can help them achieve their health and wellness goals. They can be taught, for example, to counter disordered thinking. They can learn strategies for coping with stress that don’t cause weight gain.
The idea that anyone can benefit from coaching, group support, increased clarity of thought, and improved coping skills lead me to Noom. I am currently engaged in the two week trial of the app. I recommend that others give it chance. If Noom seems expensive consider the general pricing structure of one on one health coaching.
One on One Coaching Pricing Structure
Most coaches offer two sessions per month, and the session time ranges from 45 – 60 minutes.
New coaches that are just starting out charge around $50 – $75 per session.
More experienced coaches charge $100 – $200 per session.
There are also coaches that charge by the package ($1,200 – $2,400) so there is quite a range.
The more concierge services you require, the greater the cost.
As 2018 came to an end, I realized that I needed to become more physically active. So, I took an online class. Yes, I see the irony in that decision. I need to move, so I sat and read and took exams. Yet, when the course was over I had reviewed the recommendations for physical activity, set a few SMART goals, and purchased a very simple step counter (1).
During January of 2019, I counted steps and I counted calories. I also made the arrangements for the trial of a spinal cord stimulator (scs). A psychiatrist completed the psychological evaluation required before the trial. My pain management specialist agreed to conduct the trial and we set a date. Everything was going along smoothly. Then a set of new but familiar symptoms flipped my script.
On January 30, 2019 these symptoms sent me to Patient First, an urgent care facility. Laboratory tests indicated that I had a urinary tract infection. The need for antibiotics required that my spinal cord stimulator trial be postponed. The infection was a reminder of a kidney birth defect, another surgery, and a very dark period in my life. I felt deflated. When I returned home, I climbed into bed and went to sleep.
I awoke to a voice describing a life of full body pain and limited mobility. I immediately identified with the speaker and continued to listen. When I opened my eyes, I had a very up-close-and-personal view of a human being who was obese in the extreme. The auto-play function of Hulu had taken me to My 600-lb Life – https://g.co/kgs/YxKGV. When the scene shifted to Dr. Nowzaradan’s consulting room, I knew that this could be a meaningful viewing experience.
“How Y’all Doing?’
Watching Dr. Nowzaradan and his patients reinforced my commitment to resist the barriers to physical activity. I needed this reinforcement because my brain and my mind hold two very dissonant cognitions about movement. My brain is constantly receiving the message that movement is both painful AND dangerous. This is not a message that I can ignore because it is true. I have the falls, the fractures, the concussions, and the surgical scars to prove that this is the reality in which I live. The pain signals that reach my brain are not delusions.
The compression of nerve roots in my lumbar spine produces pain, weakness, and numbness in my lower back, buttocks, thighs, legs and feet. Since my last surgery, my right leg no longer collapses unexpectedly. However, it has not fully recovered and my brain, wisely, does not trust it. I cannot walk and chew bubble gum at the same time. Every step, every foot placement requires the active participation of a brain that has been traumatized on multiple occasions. Unfortunately, the brain, my brain, now insists that the proper course of action is to find a comfortable position and stay in it. My brain is a strong advocate for a sedentary lifestyle.
I am not naïve enough to consider being sedentary as a long term solution. I have 62 years of personal experience in coping with chronic pain. I know that my brain can exaggerate and sometimes lie to me. I have a master’s degree in health and nutrition education. I am a lifelong learner and continuing education is something about which I am passionate. I also have a mind that tends toward the rational. That mind, my mind, knows that physical activity is essential to life. At this point, my logical mind believed that if I did not move more, I would become sicker and die sooner than expected. I needed a specific type of push to break free of the uncomfortable dissonance produced by the contradictory cognitions held by my brain and my mind.
Dr. Nowzaradan and his patients provided the inspiration that I needed. Dr. Nowzaradan encourages movement using a rational approach that resonates with me. When his patients explain that movement causes pain, Dr. Nowzaradan’s response is “So what?” I have been adopting that approach to negotiate an amicable agreement between my brain and my mind.
When I first bought my step counter I was taking between 200 and 1200 steps per day. Two weeks of binge watching My 600-lb Life and my average was up to 3000 steps per day. Occasionally, I reach 6000-7000 steps in a day. This is acceptable progress for a 72 year old woman coping with multiple autoimmune diseases, lumbar radiculopathy, and a problematic kidney.
The bargaining starts every time that I stand up. My brain is uncertain that my legs will support me. It anticipates a fall with every step. My mind fights the prediction of catastrophe. I can only reach about 2000 steps before the peace talks between my brain and my mind break down. At that point I must sit and recover before moving again or the brain will make its prophecy self fulfilling. If you don’t understand how that works, I can’t help you.
Taking steps then resting several times throughout the day, requires a commitment to time and planning. It also requires that I give up some of those activities that promote a sedentary lifestyle. I just don’t have time for them.
I have an appointment for a CT Scan and a consultation with my kidney surgeon in late March. In the weeks leading up to that appointment, I need to move. As a 72 year old adult with chronic illnesses, I need to be as physically active as my abilities and conditions allow. I have definitely been inspired by Dr. Nowzaradan and his patients.
Over the past 6 months I have become increasingly sedentary. I was also gaining weight. Stopping this weight gain became my first priority. The simplest approach to stopping weight gain is reducing caloric intake. I knew that if I cut daily caloric intake to no more than 1200 calories I would lose weight. This is true for most women. I tried preparing three meals per day that were each under 400 calories. I soon discovered, however, that I don’t have enough stamina for that much washing up.
In order to reduce both caloric and kitchen cleaning loads, I needed to cook fewer meals. I examined the potential of frozen meals labeled as “healthy” choices to meet my needs. I found some that met the calorie count requirement and which were relatively tasty. Some even had a relatively decent micronutrient profile, EXCEPT for an excessive amount of sodium. I keep one or two of these in my freezer for unexpected situations, but they are not suitable for daily consumption.
Because I am trying to manage my weight, improve my health, and simplify my lifestyle, I switched to the two meal per day version of intermittent fasting (IF). I generally have lunch at noon and supper at six, then fast for the next 18 hours. In order to limit clean up, I find it helpful to cook both meals at the same time. Some days I find one meal sufficient.
I deeply appreciate the opportunity to eat a variety of foods. When I eat just a few foods day after day, I soon find myself overeating. I think of it as “palate fatigue.” In addition to keeping the palate alert, eating a wide variety of foods is good for nutrition. I relish “eating the rainbow.”
Recently I decided to try a meal preparation kit. I went with Home Chef because of a great offer through Groupon. I received the ingredients required to prepare three meals for two people, which translates to six meals for me, at a cost of $24. I enjoyed the three recipes tremendously.
Since I used the Home Chef offer, other companies have been pursuing my business aggressively. I have substantially discounted meals lined up for the next five weeks (Hello Fresh, Blue Apron, Green Chef). I am pleased that I get to cook a variety of new dishes, at a discount, without a trip to the supermarket. When I am only eating one meal per day not relying on my standard recipes increases the pleasure of the meal.
My neurologist/pain management physician suggested that I combine Keto with IF. I have not experienced ketosis since I tried the Atkins diet after the birth of my second child some decades ago. I plan to conduct a trial using meal preparation kits that support ketosis.
The participants in this reality series inspired me as a person, a sociologist, and a health and nutrition educator. I plan to share some of things that I learned or relearned while watching this program. These things can have import for anyone struggling to maintain a health weight.