“Chicken Soup” for Stress

Patrick H. Friedli, MD ABOMMedical Director Weight Management

ProgramsMunson Medical Center

Definition of Stress

Noun:

1. a state of mental tension or worry, caused by problems in your life, work, etc.

2. something that causes strong feelings of worry or anxiety.

3. physical force or pressure

Miriam-Webster Dictionary

Top 10 Causes for Stress

1. Childhood trauma

2. Death of a loved one

3. Divorce

4. Finances/poverty/debt

5. Job

6. Health/illness/disease

7. Personal relationships

8. Chronically ill child

9. Pregnancy

10. Danger

Depression

• Most common mood disorder

• Leads to one of the most common reason people go to their health care provider

• One of the major causes of fatigue

Depression and Stress

• Significant relationship between elevation of cortisol and increase in appetite and cravings for sugars/sweets

• High correlation with relapse after weight loss

• One of the most common causes of fatigue and weight gain

Winnie the Pooh and Friends

Mood Disorders

Tigger is Bipolar

Dealing with Stress

“The greatest weapon against stress is our ability to choose one thought over another.”

- William James

Chicken Soup for Stress

H

E

N

S

H = Humor

LAUGHTER is the best medicine. But if you’re laughing without any reason, you need medicine.

- Unknown

Humor

“The difference between genius and insanity is that genius has its limits”

Albert Einstein

H = Happiness

Happiness

• Hobby• Play time• Sports• Friendships• Learn something new• Volunteer • Vacation

E = Exercise

“I challenge you to a foot race”

Top 10 Reasons People Don’t Exercise

10. I’ve tried exercise in the past and failed

9. Exercise is boring

8. I don’t want to bulk up

7. I don’t know what to do

6. I‘m too lazy to exercise

5. I’m too tired to exercise after working all day

4. I don’t like to sweat

3. I get exercise at work, I’m SO active

2. I don’t have time

Top 10 Reasons People Don’t Exercise

1. Mike Hill looks better in spandex than we do

Lack of Exercise in Adults

• No physical activity during leisure time = 25.4%

• Completely inactive = 52%

• CDC BRFSS telephone survey data 2008

Successful Weight Loss MaintenanceThe National Weight Control Registry

• Established in 1994 by Rena Wing, PhD from Brown Medical School and James Hill, PhD from the University of Colorado

• NWCR is the largest observational study of individuals who have maintained a weight loss of at least 13.6 Kg (30 pounds) for at least 1 yr.

• Currently 10,000 individuals over 10 years

Graham T. Obesity 2011 Abstract Suppl. 2011

NWCR Facts

• 80% are women, 20% are men– Ave. woman 45 yrs, 145 pounds– Ave. man 49 yrs, 190 pounds

– Members lost an average of 66 pounds (30 Kg) and kept it off 5.5 yrs

– 45% lost weight on own, 55% lost with a program– Only 4% used medication to lose weight– 86% have maintained at least 10% weight lossNWCR. www.nwcr.ws.research. 2011

NWCR How They Kept the Weight Off

• Most report maintaining a low calorie, low fat diet and doing high levels of physical activity

• 75% weigh themselves once a week• 62% watch less than 10 hours of TV per week• 90% exercise on average 1 hour per day

burning 400 calories

NWCR. www.nwcr.ws.research. 2011

NWCRDietary Composition

• 98% modified their food intake in some way PORTION CONTROL:

– 24 % Kcal from fat– 19 % Kcal from protein– 56 % Kcal from CHO

78% eat breakfast dailyWomen: Ave 1306 Kcal/dayMen: Ave 1685 Kcal/day

NWCR. www.nwcr.ws.research. 2011

NWCRExercise

90 % exercise about 80 minutes/day

Exercise 400 Kcal/day (2800 Kcal/week)

How did you lose weight? “EXERCISE”

How do you keep it off? “EXERCISE”

What do you do if you gain? “EXERCISE!”

NWCR. www.nwcr.ws.research. 2011

NWCRTypes of Exercise

Walking 76.6%

Cycling 20.6%

Weight lifting 20.3%

Aerobics 17.8%

Running 10.5%

Stair Climbing 9.3%

Treadmill 6.3%

NWCR. www.nwcr.ws.research. 2011

Exercise Prescription

F = Frequency

I = Intensity

T = Time

Exercise

Intensity

• Target HR = (220 – age) x 75%

example 220 – 20 = 200

200 x 75% = 150 beats per min

Exercise

“Talk Test” as a measure of intensity

Goals of an Active Lifestyle

Take 2000 more steps or activity equivalent daily. Goal of 10,000 steps daily

Eat at least 100 fewer calories per day

“Motion is Potion”

N = Nutrition

Nutrition

• We are over-fueled as a society

• We can eat like it’s Thanksgiving daily

• Portion sizes have increased over time

• The push for “low fat” has led to “high sugar” ingredients in foods

Nutrition Quiz

1. According to consumer research, which factor tops nutrition as the number one reason why consumers buy one food over another?

a. Packaging

b. Preparation time

c. Taste

d. Cost

Answer

• C. Taste

Taste, aroma and touch (temperature and mouth feel) make up flavor, which is a priority for food choices. Eat foods with a variety of flavors including sweet, sour, bitter and salty.

Nutrition Quiz

2. With thousands of food items to choose from the supermarket, most Americans regularly consume a wide variety of foods. True or False?

Answer

2. False. Most Americans are in a food rut, and plan their meals around the same 10 to 15 core foods. Variety is the key to good nutrition and health, so expand your range of food.

Nutritional Facts

1. Added sugar/high fructose corn syrup leads to obesity

2. Avoid saturated fats/hydrogenated oils

3. Refined carbohydrates increase fat storage in the abdomen

4. Diets “die”. A lifestyle change is necessary.

Authoritynutrition.com

Eat the Rainbow

Have a variety of color in your diet and less white flour and white sugar foods

Pearls for Weight Loss

Limit or avoid “C” foods

Remember the Chicken?

• Humor

• Exercise

• Nutrition

• S

S = Sleep

Sleep

Sleep Facts

• Normal sleep is 7 – 8 hours per day

• Teenagers require more sleep

• Poor sleep habits are the most common reason that teens are tired.

• Inadequate sleep is a stress to the immune system

Sleep Hygiene

• Consistent wake up and bed times

• Avoid caffeine in the evening

• Use the bedroom for S/S

• Comfortable mattress and temperature

• Don’t eat within 2 hours of bedtime

• Relaxing bed time routine

The 4 T’s of Life

• Time

• Talk

• Trust

• Touch

TIME

Time heals wounds

Time is sometimes slow

Time for yourself

Time for your significant other

Time to help others

Time to sleep

TALK

Communication is critical

Lack of communication leads to problems

Learn how to communicate effectively

Anger and fear tend to disrupt good communication

Trust

• Trust in the people closest to you

• Sometimes lack of trust breaks up relationships

• Some people need trust in faith, religious beliefs, spiritual integrity

• Most important person to trust is yourself

Touch

• Touch can provide a sense of belonging

• Re-affirms commitment, closeness

• Helps to avoid sense of isolation

• Provides physical bond of teamwork

Summary

• Stress is a leading cause for depression which can affect our health

• Rely on Humor/Happiness, Exercise, Nutrition and Sleep for management

• The 4 T’s of Life help when faced with life stressors

Things turn out best for the people who make the best of the way things turn out.

John Wooden