paul nathenson , rn, nd, hn-bc
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Holistic Self Care A Presentation for
School NursesMethods for Self Improvement, Stress Relief, and Well Being
Paul Nathenson, RN, ND, HN-BC
Creating a Healthy Lifestyle
• Step 1: Increase your activity• Step 2: Adopt a Healthy Diet • Step 3: Control stress
Health vs. Wellness1. Definition of health – the general condition of the body or mind,
especially in terms of the presence or absence of illnesses, injuries, or impairments.
2. Definition of wellness – “Wellness is a multidimensional state of being describing the existence of positive health in an individual as exemplified by quality of life and a sense of well-being.” Wellness is an active process of becoming aware of and making choices toward a more successful existence.
Henning, S., & Cilliers, F. (2012). Constructing a systems psychodynamic wellness model. SA Journal of Industrial Psychology, 38(2), 107-116.
The Six Dimensions of Wellness Model
Developed by Dr. Bill Hettler, co-founder of the National Wellness Institute (NWI)(Used by permission)
Physical Dimension
Create an Exercise RoutineIncrease ActivityGet regular check upsFasting blood sugarsCholesterol testingPap smearsColonoscopiesMammography'sProstate exams Huang, J. H., Huang, S. L., Li, R. H., Wang, L. H., Chen, Y. L., & Tang, F. C.
(2014). Effects of Nutrition and Exercise Health Behaviors on Predicted Risk of Cardiovascular Disease among Workers with Different Body Mass Index Levels. International journal of environmental research and public health, 11(5), 4664-4675.
Social Dimension
Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A., & Updegraff, J. A. (2000). Biobehavioral responses to stress in females: tend-and-befriend, not fight-or-flight. Psychological review, 107(3), 411.
Intellectual DimensionNever Stop Learning
Stern, Y. (2012). Cognitive reserve in ageing and Alzheimer's disease. The Lancet Neurology, 11(11), 1006-1012.
Spiritual Dimension
Pattison, S. (2013). Religion, Spirituality and Health Care: Confusions, Tensions, Opportunities. Health Care Analysis, 21(3), 193-207.
Emotional Dimension
“The subset of social intelligence that involves the ability to monitor one’s own and others feelings and emotions and to use this information to guide one’s thinking and actions”
Mayer, J. D., Salovey, P., & Caruso, D. R. (2008). Emotional intelligence: new ability or eclectic traits?. American Psychologist, 63(6), 503.
Occupational Dimension
Steger, M. F., Dik, B. J., & Duffy, R. D. (2012). Measuring Meaningful Work The Work and Meaning Inventory (WAMI). Journal of Career Assessment, 20(3), 322-337.
What is Self Care and Why is it Important?
Weaver, C. (2013). How I Practice Holistic Nursing. Oncology Times, 35(19), 1-2.
Leading Causes of Death in the U.S.
Heart disease Cancer Stroke (cerebrovascular diseases) Chronic lower respiratory diseases Accidents (unintentional injuries) Diabetes
5 out of the top 6 leading causes of death have preventable factors
Jemal, A., Ward, E., Hao, Y., & Thun, M. (2005). Trends in the leading causes of death in the United States, 1970-2002. Jama, 294(10), 1255-1259.
Leading causative factors
StressSmokingPoor dietLack of exercise
Reis, J. P., Loria, C. M., Sorlie, P. D., Park, Y., Hollenbeck, A., & Schatzkin, A. (2011). Lifestyle Factors and Risk for New-Onset Diabetes A Population-Based Cohort Study. Annals of internal medicine, 155(5), 292-299.
CHILDHOOD OBESITY
Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA, 311(8), 806-814.
Correlation between Obesity and Development of Diabetes
• 44 million Americans are considered obese• 17 million Americans have diabetes
• Obesity increased 74% since 1991• Diabetes increased 61% since 1991
This demonstrates a strong correlation between obesity and development of diabetes.
Nguyen, N. T., Nguyen, X. M. T., Lane, J., & Wang, P. (2011). Relationship between obesity and diabetes in a US adult population: findings from the National Health and Nutrition Examination Survey, 1999–2006. Obesity surgery, 21(3), 351-355.
Body mass index (BMI)
• Body mass index (BMI) is a tool for indicating weight status in adults. It is a measure of weight for height.
• Centers for Disease Control and Prevention (CDC). BMI Calculator. 16 May 2006. www.cdc.gov
• Me at 210 lbs =BMI of 30
BMI Weight Status
Below 18.5 Underweight
18.5 - 24.9 Normal
25.0 - 29.9 Overweight
30.0 and Above Obese
Game Changer - Nutrition
• Changing your diet can be the most difficult.
• Comfort food is called “comfort food” for a reason
• Most often comfort foods are the foods that are the worst for you nutritionally and give only a short term boost in mood leaving you wanting more and/or feeling let down
Processed Foods
Ingredients in processed foods such as nitrates, nitrites, BHA, BHT sulfur dioxide, monosodium glutamate (MSG), Propylene glycol, sulfites, saccharine, and aspartame have been shown by evidence based research to cause or contribute to the following deadly diseases: •Cancer •Autoimmune disease•Subclinical sensitivity reactions such as muscle soreness, muscle fatigue, muscle twitching•Diabetes•Obesity
Stuckler, D., & Nestle, M. (2012). Big food, food systems, and global health. PLoS medicine, 9(6), e1001242.
Processed Meats Declared Too Dangerous for Human ConsumptionThe World Cancer Research Fund (WCRF)
Wiseman, M. (2008). The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proceedings of the Nutrition Society, 67(03), 253-256.
2 pieces of pizza (just 2?)
Twenty Years ago 500 calories Today’s Pizza 850 calories
Those extra 350 calories, if eaten a two times a month, would put on two extra pounds a year, or forty pounds in the next two decades.
The Diet Should Contain Whole Foods:Organic Vegetables, Healthy Fats and Whole Grains
Okarter, N., & Liu, R. H. (2010). Health benefits of whole grain phytochemicals. Critical reviews in food science and nutrition, 50(3), 193-208.
Drink plenty of fluids…..
Mostly water
AND Don’t eat TOO much!
Freed, C., Fawcett, S., Weber-Dewitt, D., & Melby, C. (2012). Effects of a Novel Dietary Portion Control Program on Energy Intake, Energy Density, and Weight Loss. The FASEB Journal, 26, 820-4.
10 Ways to Lose 20 PoundsSlim down with simple tweaks to your diet and Fitness RoutineInternet Post 1/02/2013 from Men’s Health
1.Snooze—and Lose (Harvard Study)2.Portion Control ( Cornell Study): use smaller bowls3.10 minute workout break (Southern Illinois University Study)4.Work your legs (Syracuse University Study)5.Exercise (Harvard Study)6.Whey Protein (Canadian Study)7.Brush your teeth (Japanese Study)8.Decrease carbohydrate intake (United Arab Emirates Study) 9.Cut out Soft Drinks (Penn State Study)10. Plan for hunger if/then (Dutch Researchers)
Eat slowly and enjoy your food(the dog study)
76.7 pounds
Sugar Metabolism
Insulin Resistance
Olefsky, J. M., & Glass, C. K. (2010). Macrophages, inflammation, and insulin resistance. Annual review of physiology, 72, 219-246.
Increased blood pressure (140/90 mmHg)Increased blood sugar (100 mg/DL or greater)A large waistline or apple shape Increased triglycerides(150 mg/dLAbnormal cholesterol with low HDL and high LDL
Having metabolic syndrome increases risk for heart disease, diabetes, and stroke based on the number of metabolic risk factors you have.
Best Predictor of Heart Attack
• A. Cholesterol• B. Homocysteine • C. Triglycerides• D. C-Reactive Protein• E. A & C• F. B & D
Harvard Women’s Health Study Yale Physician’s Health Study
Lopez-Garcia, E., Schulze, M. B., Meigs, J. B., Manson, J. E., Rifai, N., Stampfer, M. J., ... & Hu, F. B. (2005). Consumption of trans fatty acids is related to plasma biomarkers of inflammation and endothelial dysfunction. The Journal of nutrition, 135(3), 562-566.
Glycemic Index and Glycemic Load
Glycemic Index: Food is rated on a scale of 0-100, with pure sugar topping the charts as the highest GI food. The Glycemic Load of a food is calculated by multiplying the glycemic index by the amount of carbohydrate in grams and dividing the total by 100. The Glycemic Load gives you a more complete picture as it takes into account the quality of a carbohydrate in a meal.
Artificial Sweeteners/Aspartame
NSAIDS: (Advil, Acetaminophen Aleve, ibuprofen, naproxen): The biggest known risk of NSAIDs is from gastrointestinal ulcers and bleeding. Roughly 16,685 people die each year from NSAID related complications making them just as dangerous as AIDS.
Cryer, B. (2005). NSAID-associated deaths: the rise and fall of NSAID-associated GI mortality. Am J Gastroenterol, 100(8), 1694-1695.
TURMERIC
Nieman, D. C., Cialdella-Kam, L., Knab, A. M., & Shanely, R. A. (2012). Influence of red pepper spice and turmeric on inflammation and oxidative stress biomarkers in overweight females: A metabolomics approach. Plant foods for human nutrition, 67(4), 415-421.
Anti-inflammatory possesses only COX-1 inhibition without CO-2 inhibitory consequences
Omega 3 Fatty Acids
Marroon JC. Bost, JW, “Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surgical Neurology. 2006 Apr;65(4):326-31.
PRO-BIOTICS
Beneficial bacteria• Lactobacillus acidophilus.
Lactobacillus bulgaricus. Bifidobacterium bifidum
• Improves the immune system • Important for women to guard
against yeast infections caused by opportunistic organisms.
• Keep the normal flora in the gut preventing gas and indigestion
Rijkers, G. T., De Vos, W. M., Brummer, R. J., Morelli, L., Corthier, G., & Marteau, P. (2011). Health benefits and health claims of probiotics: bridging science and marketing. British Journal of Nutrition, 106(09), 1291-1296.
NERVOUS
SYSTEM
Stress Cycle
Time
Stress Level
(Cortisol)
•Slow deep breathing can activate the parasympathetic system•Practice slow deep breaths•Talk slower•Drink a glass of water
Breathing
Take a moment to center yourself
Magnesium
Orchard, T. S., Larson, J. C., Alghothani, N., Bout-Tabaku, S., Cauley, J. A., Chen, Z., ... & Jackson, R. D. (2014). Magnesium intake, bone mineral density, and fractures: results from the Women's Health Initiative Observational Study. The American journal of clinical nutrition, 99(4), 926-933.
Integrative medicine combines standard medicine with CAM practices that have been shown to be effective
Witt, C. M., Chesney, M., Gliklich, R., Green, L., Lewith, G., Luce, B., ... & Berman, B. M. (2012). Building a strategic framework for comparative effectiveness research in complementary and integrative medicine. Evidence-Based Complementary and Alternative Medicine, 2012.
Holistic Health Care Reform means taking personal accountability for your health
Components of Self-Care
☺Exercise☺Nutrition☺Relaxation☺Sleep☺Safety
US Department of Health and Human Services. (2011). Healthy People 2020.
Massage
Hymel, G. M., & Rich, G. J. (2013). Health psychology as a context for massage therapy: A conceptual model with CAM as mediator. Journal of Bodywork and Movement Therapies.
Ambient Music for Relaxation
• Beta waves (13-38 hz) actively thinking, problem-solving
• Alpha waves (8-13 hz) relaxed and calm• Theta waves (4-7 hz) sleep, deep
relaxation• Delta waves (below 4 hz) occur during
sleep• Brainwaves synch with the music bringing
them to a relaxed state.
Colgin, L. L. (2013). Mechanisms and functions of theta rhythms. Annual review of neuroscience, 36, 295-312.
Aromatherapy
Lee, M. S., Choi, J., Posadzki, P., & Ernst, E. (2012). Aromatherapy for health care: An overview of systematic reviews. Maturitas, 71(3), 257-260.
Letting go of thoughts
Be conscious of negative thinking, let go of anger and perceived insults, refute irrational thoughts
Brewer, J. A., Worhunsky, P. D., Gray, J. R., Tang, Y. Y., Weber, J., & Kober, H. (2011). Meditation experience is associated with differences in default mode network activity and connectivity. Proceedings of the National Academy of Sciences, 108(50), 20254-20259.
Get plenty of rest
García-García, F., Juárez-Aguilar, E., Santiago-García, J., & Cardinali, D. P. (2014). Ghrelin and its interactions with growth hormone, leptin and orexins: Implications for the sleep–wake cycle and metabolism. Sleep medicine reviews, 18(1), 89-97.
Be safe
be sure to buckle up
AND
LaughingLaughter gives us distance.It allows us to step backFrom an event, deal with itAnd then move on. ---Bob Newhart
My Personal Wellness Plan
Priority Wellness Goal Step One
high I will eliminate processed foods from my diet
I will eliminate drive through fast foods from my diet
high I will exercise at the gym 4 days per week
I will walk 30 minutes a day 3 days per week
high I will become a certified yoga teacher
I will go once a week to a yoga class
medium I will get 8 hours of restful sleep per night
I will get started to bed by 10PM
medium I will practice gratitude daily I will acknowledge 3 things I am grateful for in my morning meditation
Thank You for Coming!
To make the most of this session, make a contract with yourselfto set aside a specific time
dedicated to relaxation.
Be committed to take time for yourself . . . You deserve it!
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