Public heath in this country has been likened to two freight trains headed directly at each other. One is loaded with epidemic cases of obesity, diabetes, and other preventable chronic diseases.  The other is freighting the rising costs of medical care and lost productivity because of the illnesses. This is the metaphor used by Reed Tuckson of the not-for-profit United Health Foundation. He was quoted in an article in USA Today published on December 11, 2012. The following quote was my motivation for writing this article.

“There's no way that this country can possibly afford the medical care costs and consequences of these preventable chronic illnesses," says Tuckson. "We have two freight trains headed directly into each other unless we take action now."

"People have to be successful at taking accountability for their own health-related decisions."

Tuckson is right.  Each of us needs some hope of success if we are to take accountability for our decisions that lead to preventable chronic illnesses. Call them what you will; we need goals, targets, objectives, aspirations, wishes, desires, or resolutions, it all comes down to thoughts of making improvements in our health.

I’ve observed that many people say that they no longer make resolutions, because they don’t like the way that they feel when they don’t succeed. So I was thinking that maybe I could jot down a few ideas, and then maybe some of you would share your ideas – the possibility is then born, that together we can move forward. Forward and away from the public health lifestyles that are buying us longer and sicker lives. This link takes you to the USA Today article where I found the quote.

Tuckson calls these chronic illnesses preventable. He is referring to obesity and overweigh and their consequences. These are the leading controllable causes of risk for type 2 diabetes. Diabetes is a very serious disease; two out of three people with diabetes die from heart disease or stroke. I think the two freight trains headed directly into each other is a great metaphor. I know that many of us want to avoid the train wreck; we realize that we can’t let our health be our doctor’s problem. Doctors are generally most involved when we get sick enough to seek them out. Taking steps toward better health, prevention, is about decreasing our chances of sick lives – poor health.

When I write this blog each week, it frequently crosses my mind that I am preaching to the proverbial choir.  If you are reading this Dr. Grandma’s Blog about nutrition, exercise and your part in public health, I expect you already know quite a bit about health. But applying the knowledge and changing behaviors is definitely more challenging than learning facts.

Goethe said: “Knowing is not enough; we must apply. Willing is not enough; we must do.” This great thinker died in 1832, but his aphorism probably fits the situation today even more than in his day. It fits with our need to apply and do those health behaviors and resolutions we know call out for the best in us.

1.  There’s a plethora of research that shows health habits can keep each of us living longer and better. Let’s move past knowing and into a stage of doing. Let’s make up our minds to implement true change – this is the first step.

2.  It is best, to be successful, not to attempt giant leaps and fall short. Consider making goals that lend themselves to gradual, more readily sustainable, life-long behaviors. For example, today I’m going to have a certain number of servings of fruits and vegetables; I’m going to keep a record of how many I actually eat. Next week, I look at that record and see what the average is each day. Do I decide that there’re further opportunities for more fruit and vegetable servings? If yes, bump the goal up one; or if it was a struggle, keep the same goal and recommit. Or if, you’re satisfied, then keep striving to maintain the same goal. You can use that system with any goal you decide upon.

3.  Not eating too much is one of the more popular goals. Unfortunately, people want to take giant steps and cause themselves great discomfort. Friends have told me that they cut back and they were so hungry. Maybe this year you could try a different method. Just try eating about 200 calories per day less. Some of the easiest places to cut back are with the starchy and fatty foods. You might check out an old article that I wrote in May 10, 2010 – Making a Difference in the Mindless Margin which was motivated by Brian Wansink’s book. The following is a paragraph from that article:

“This is the really splendid news. If you were used to eating 2000 calories a day and ate only 1800, your body wouldn’t send out strong hunger signals and you wouldn’t feel deprived. So he (Wansink) calls the 100 or 200 calories more or less the ‘mindless margin.’ Taking advantage of the body’s insensitivity at the low range (100 – 200 calories) and helping you not to feel strong hunger pangs and feel deprived is really a great boon to comfortable weight loss/management. It’s turning mindless eating around in a way that helps you eat better. He says that we can reengineer our mindless margin. I am delighted by these simple, workable ideas.”

The point is too cut back a little; get used to that level and then take the next step. It is a process – not a giant uncomfortable leap, followed by a depressing, demotivating failure.

4.  As I mentioned above, cutting fatty foods is one of the easy ways to cut calories. A good place to start, if you’ve not already done so is to choose nonfat or 1 percent milk, in place of whole or 2 percent. If you have difficulty with grey milk, then do it gradually. Mix the milk and keep decreasing the proportion of fatty to nonfat. It’s an amazingly easy way to reduce saturated fat. Also in the dairy aisle, is yogurt; the nonfat Greek yogurt is so think and creamy it’s hard for me to imagine anyone missing the fat.

5.  Choose fish, chicken and very lean cuts of meat more often. This is another good place to start. Use meat as a flavoring instead of the main item (Think stir-fry, soups, casseroles.) This is another relatively painless place to start in cutting calories/fat from meat. Just like any of the steps, a gradual process is better than a larger step that punishes you with the body’s hunger pangs.  The body will mobilize its resources to get you to avoid any approach toward starvation. If you’ve been a big meat-eater, you can try cutting a chunk from your serving piece and keeping it for lunch or another meal. You may want to consider keeping the volume of the meal the same by adding extra vegetables, salad or fruit.

6.  Use more whole grains – they are filling and keep your body away from those hunger pangs longer than the highly processed grains. Substitute oatmeal for cream of wheat; brown rice for white; whole-wheat bread for white bread; and popcorn for chips. If you get started you may find that this is one of the easiest places to start.

7.  Move your body more. This idea lends itself very well to the gradual long-term process-type of change. A nice side effect of making it a gradual goal is that you avoid the injuries that might result at the first of the year when people dedicate themselves to go back to their exercise program – starting from where they used to be. Over-worked muscles are not a great motivator. Start – just start! Move from where you are and keep increasing the duration and intensity, until you’re getting a great workout six days a week.

8.  Gradually shift your diet toward plant-based foods, away from animal foods. Plant-based diets have long been associated with healthy weight and longevity, and the research to prove it is compelling. How about just a meatless day or two a week? Consider starting with a certain number of meatless meals and eventually put them into a day. By having a meatless day, we are more likely to remember this is one of the ways that we can move toward health. For example, we might say; “It’s Monday we don’t need so much animal-base food products. About 33% of Americans are now considered Flexitarians and eat vegetarian meals a significant amount of the time, but also eat meat, just in smaller proportions. In addition, 2 to 8% of the US population are vegetarians.

Above are eight ideas – places to start. The train wreck involves many people, many forms of chronic but preventable illness, and many ways to run up health care costs and lose productive and happy days from our lives. We all have to help if our country is to avoid the train wreck. I feel confident that you too, have many ideas of things that you’ve done or plan to do.  Maybe you’ll take a moment and share an idea in our comment section.