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Finding the balance of physical and mental health through adventures and fitness

Wellness Refocused Education: Fat and the Ketogenic Diet

For a long time there was a war on fat, like over 30 years long. I’ve talked a lot about the importance of reading labels and understanding what you’re consuming. Not necessarily saying no to the processed food, but understanding or knowing what is in it. Well, taking that a step further – we need to also understand that the guidelines that back those labels up are created by governing bodies that may or may not benefit by creating certain guidelines or encouraging certain studies.

I’m not saying that the FDA or USDA or other regulatory groups are bad, but I am saying that the information can be misleading or a generalization in some cases.

A good example: the nutrition label you see on your boxed and canned goods is based off of a 2,000 calorie diet. This means the percentage listed as daily value is based off of 2,000 calories, but you may not be eating 2,000 calories – you may be consuming more or less.

Another example: the most recent guidelines by the USDA have a caloric recommendation for individuals based on gender, age and activity level with all numbers being whole, round numbers. These numbers are only below 1,400 daily calories for children under the age of 6, sedentary males peak at 2,600 calories for a 19/20 year old with sedentary females peaking at 2,000 calories for ages 19-25 – individuals who are more active peaked calories up to 3,200 daily.  The guidelines state that the sample bodies used to determine were an average height and a “healthy” weight (page 77-78).

“For adults, the reference man is 5 feet 10 inches tall and weighs 154 pounds. The reference woman is 5 feet 4 inches tall and weighs 126 pounds.”

I’m 5’4″ and I weight about 138 pounds. I’m roughly 17% body fat, which is lean and considered athletic for a female. My measurements are small. I don’t fit the sample body. I also don’t know many “healthy” men that would fit this sample body either.

The first dietary guidelines were rolled out in the 1980s and at the time, the biggest concern was heart disease and heart attacks. Ultimately, the first guidelines recommended against all fat and foods that had cholesterol like red meat.  However, more research has shown that not all fats are created equal and that dietary fat is necessary for bodily function. In the most recent guidelines for 2015-2020, it’s stated that saturated fat consumption should be 10% or less of overall calories consumed (page 15 footnotes). It’s also recommended that you replace saturated fats with unsaturated fats.

Before we get ahead of ourselves, let’s talk about fats. Have you ever heard about triglycerides? It’s possible that your doctor has mentioned this term before when discussing blood work and overall health. These are the most common dietary fat we eat. This is also the form that fat is stored in our bodies.

The science of triglycerides

Triglycerides are a molecule consisting of 3 fatty acids attached to a 3 carbon glycerol backbone (Thompson & Manore, 2015). They are classified by their chain length (how many carbons are attached), their level of saturation (how much hydrogen is attached to each carbon) and their shape.

The first way to classify – chain length. The first thing we learned in biology is that structure determines function – if you have a wheel it can move things forward, right? It can’t make things fly. There are three chain lengths: short (6 or fewer carbon), medium (6 to 12 carbon) and long (14 or more carbon). The lengths determine the method of fat digestion and absorption as well as how the fat works within your body. As you imagine, the shorter the chain, the faster the digestion and absorption (Thompson & Manore, 2015).

Now, saturation level. What’s the difference between these two kind of fats?

The simple answer – saturated fatty acids have closely packed molecules because they lack a double bond that would “space” them out. This means they can solidify at room temperature, example: a jar of coconut oil. unsaturated fatty acids do have a double bond, which prevent them from solidifying at room temperature, example: olive oil (Reece, Taylor, Simon, Dickey, & Hogan, 2015).

Lastly, shape – the carbon molecules impact the shape. The lack of the double bond in saturated fat allows the chain to be straight and pack tightly together. The double bond in unsaturated fat prevents the chain from being straight and actually adds kinks, which makes them liquid at room temperature.

But what about  bottles of coconut oil at the store, how are those liquids? Coconut oil that is liquid at room temperature is manipulated during manufacturing. The removal of natural fatty acids that solidify allow liquid coconut oil to be just that. Lauric acid, the fatty acid in coconut oil known for its health benefits like being a germ killer, is actually removed in this process. This is because it’s melting point is over 100 degrees Fahrenheit. To read more about the production, safety and use of liquid coconut oil check out this article.

Coconut oil isn’t the only thing that is manipulated on the market. Unsaturated fats can also be manipulated by food manufacturing in a process called hydrogenation, which started in the early 1900s (Thompson & Manore, 2015). This process adds hydrogen molecules, which in unsaturated fats causes the double bonds to be partially or totally removed allowing the fat to become solid and store more easily for a longer period of time.

This is also where we get trans-fats, which actually is describing the double bonds in the molecule. This kind of fat is found mostly in foods that are manipulated, although a small amount of natural trans fatty acids are found in cow’s milk and meat.

Now that I’ve confused you, triglycerides do contain essential fatty acids that are important for health (Thompson & Manore, 2015). Essential fatty acids (EFA) are obtained from the foods we consume – our bodies cannot produce them. There are two groups of them: Omega-6 and Omega-3.

Omega-6 Fatty Acids have a double bond 6 carbons from the end (omega = end of the chain, 6 = number of bonds away from the end). Linoleic acid is an omega-6 that is essential for human health. This is found in vegetable and nut oils like peanut oil, sunflower oil, corn oil and soy.

Omega-3 Fatty Acids have a double bond 3 carbons from the end. Alpha-linolenic acid is the most common in our diets and primarily comes from plants like leafy greens, walnuts, flaxseeds.

Why are EFAs important?

They’re precursors to biological compounds found in every cell in the body that regulate cell function.

Why is fat in general important?Fat provides energy; it has 9 calories per gram, which makes it the most dense energy source. Our bodies use fat when we’re at rest and during physical activity.

  • Fat helps transport vitamins A, D, E and K throughout the body, which help regulate functions like calcium absorption and utilization, cell membrane protection, blood clotting, bone health and vision.
  • Fat regulates our hormone production and cell function. *
  • Fat contributes to satiety, which means we stop eating sooner and helps us feel full longer.

Fat Importance on Cell Function and Hormone Production

This is something I talk a lot about with my clients. Fat is important because of the reasons listed, but as someone who works predominately with women this is something I want to drive home with them. There’s no reason to fear dietary fat, but we do need to moderate it. Phospholipids are a major component of our cells (Reece, Taylor, Simon, Dickey, & Hogan, 2015). These are similar to fats, except they contain two fatty acids attached at the glycerol, not three. Steroids are hormones produced in the adrenal cortex, cortisol is an example of a steroid hormone, which regulates carbohydrate metabolism and provides an anti-inflammatory effect on the body.

Fat -loving and the Ketogenic Diet

As the war on fat has started to settle, the rise of high fat diets like the ketogenic diet have started to become increasingly popular for fat loss; however, this style diet isn’t for everyone and should be monitored because of other potential health outcomes.

So what is the ketogenic diet?In simple terms it’s a high fat, very low carbohydrate (~20g or less daily), moderate protein diet that has been utilized to help with refractory epilepsy since the 1920s (Gupta, et al., 2017). It’s especially helpful for children with epilepsy, but according to the Epilepsy Society, adults may also benefit from it. The ketogenic diet has also been found to assist with fat loss in individuals who are obese lose as well as help manage other disorders like polycystic ovarian syndrome (Gupta, et al., 2017). However, be reminded that less extreme diets that moderate calories will also result in fat loss as long as the individual adheres to it and a diet that moderates carbohydrate intake may also assist with PCOS.

So how does the ketogenic diet work?

Our bodies utilize carbohydrates that have been broken down to glucose as a main source of energy (Thompson & Manore, 2015). While our bodies also use fat as fuel, glucose is favorited by red blood cells, some nervous tissue and our brains for energy.

When we don’t take in enough carbohydrates…. let me pause…enough carbohydrates doesn’t mean hundreds of grams daily. Enough carbohydrates could be 100g a day depending on the age, gender and activity levels of the person. Ok continuing…our bodies start looking for another fuel source. In the process of ketosis, the liver converts fat into fatty acids and creates ketone bodies or ketones that will be utilized as fuel. These ketones are a natural appetite suppressant that can help control nutritional intake (Thompson & Manore, 2015).

What about the keto diet is beneficial to different populations?

The effects on the “central nervous system, cellular metabolism and metabolic pathways, have shown promising results in a variety of neurological disorders, traumatic brain injury, acne, cancers, and metabolic disorders (Gupta, et al., 2017).” “The ketogenic diet alters the energy metabolism in the brain, therefore altering brain excitability,” which impacts  how cells communicate with each other and regulate the CNS (Lee, 2012).

Is there one way to practice keto?

This is a tricky question. The classical diet of keto that is utilized with epilepsy patients suggests strict ratios of fat, carbohydrates and protein at every meal. It also includes little protein and carbohydrate because of the body’s ability to be “knocked out” of ketosis by too many of either.

The medium chain triglyceride (MCT) diet allows for a little more carbohydrates and protein. This version provides some flexibility and allows MCT oil to be used a supplement. Nutrients are also calculated by the percentage of calories for each group, meaning it’s not a specific number of grams, but a percentage of overall calories.

If keto can be helpful, why shouldn’t everyone utilize it?

A true ketosis diet should be monitored because of higher risks for other health concerns like osteoporosis (weak and brittle bones), hyperlipidemia (abnormally high fat in the blood), nephrolithiasis (kidney stones). Some of these health concerns can onset as we age, but nutritional deficiencies can increase risk. This means that supplementation is necessarily because there is a lack of diversity by lowering carbohydrate intake. This would be a recommendation for many people seeking fat loss with any diet – supplement appropriately.

The use of carbohydrates in our diets isn’t just for daily function like walking, talking and sitting; they’re also used for fuel during prolonged period of activity and protect again the use of stored protein as a fuel source  i.e. muscle loss (Thompson & Manore, 2015). When our bodies don’t have enough carbohydrates our bodies continue to find fuel sources, and while in a perfect world we imagine the body will find stored fat to utilize, it will also find stored protein. Not only does this result in muscle mass loss, but it can weaken our immune systems and prevent optimal function. However, this kind of loss can be associated with too little calorie intake because a nutrient group has be drastically decreased or eliminated.  

If ketone levels are too high the blood can become very acidic and can lead to ketoacidosis. This actually prevents optimal body function and ultimately can lead to damaged tissue.

Why don’t I believe the ketogenic diet should be prescribed to everyone?

My personal belief is that the ketogenic diet should be utilized for clinical conditions like epilepsy and other cognitive or metabolic disorders. I do believe that some people feel better on lower carbohydrates, but lower is relative.

I had a client who recognized she felt physically better on higher fat, moderate carbohydrate and protein. Her macros were 75F/100C/147P or 1,663 calories. Her goal was fat loss and this was a deficit for her. On days that she would run long distances (over 4 miles) she would increase her carbohydrates between 20-40g because it helped in those runs.

Yes, I eat processed food and things with real and artificial sweeteners in them, but I also know that’s not for everyone. I know not everyone can moderate these foods and that’s completely ok. I do believe that one way to work towards creating a healthier food plan is to examine the carbohydrates that are you taking in and how they make you feel. I ask my clients to do this often by making a list or notes when they recognize they feel bloated, jittery, exhausted, fatigued, etc.

Carbohydrates breakdown to sugars like stated above so in many cases they feel these things because of 1. too much sugar (real or added) 2. too many overall carbohydrates 3. the kind of carbohydrates they’re consuming (simple versus complex). I don’t think extremes need to be implemented to see change or progress unless specified by a physician.

Mentally, I think elimination diets that pull full groups of foods can be harmful over time to the relationship that we have with food. Creating a balance lifestyle also means enjoying foods that tastes good, but isn’t necessarily the greatest for us, but understanding that moderation is key. Eating out, attending and participating in parties and functions is a part of life and experience. While many suffer from auto immune disorders or illnesses that force them to create alternative eating styles to manage their health, many don’t need extreme measures.

Health coaches, lifestyle coaches, personal trainers, wellness coaches, etc. people assisting others like I do, should be encouraging individuals to bring in all their resources to find what ultimately works for them in a reasonable and safe way.

We shouldn’t fear fat in our diet, but we also shouldn’t fear other nutritional groups either – we just need to better understand them.

References

Epilepsy Society. (2016, March). Ketogenic Diet. Retrieved from Epilepsy Society: https://www.epilepsysociety.org.uk/ketogenic-diet#.WkzL6TdG1PY

Gupta, L., Khandelwal, D., Kalra, S., Gupta, P., Dutta, D., & Aggarwal, S. (2017). Ketogenic diet in endocrine disorders: Current perspectives. Journal of Postgraduate Medicine, 242-251.

Lee, M. (2012). The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders. Korean Journal of Pediatrics, 316-321.

Reece, J. B., Taylor, M. R., Simon, E. J., Dickey, J. L., & Hogan, K. (2015). Campbell Biology: Concepts and Connections. New York: Pearson Education.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

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Recipe: Walnut Butter

Currently, there are 10 jars of nut butter sitting in my cabinet.

1. Cinnamon Raisin Swirl from Peanut Butter and Company

2. Mighty Maple from Peanut Butter and Company

3. Nutella – yes, that counts, hazelnuts!

4. Unsalted cashew butter, store brand

5. Pumpkin Spice from Peanut Butter and Company

6. Extra Crunchy Skippy

7. Smooth Jif

8. Brownie Batter from D’s Naturals

and now, chocolate protein walnut butter and plain walnut butter

It started with an email from The Peanut Principle telling me about their year of sale or coupon, regardless, I sighed because 1. I have a lot of jars in the cabinet and 2. I didn’t really need to spend the money on more right now. JP and I were getting dinner ready and I asked him if he thought we would have time to try to make our own this weekend.

He immediately turned to the cabinet and grabbed a full bag of whole shell walnuts and said “could we use this?” Yep. Yep, we could.

So I looked online so see if there was any magic to making nut butter and you know what, there’s not. So we played around and gave it a go.

Here’s What You’ll Need

  • Food processor
  • 1 to 2 cup of nuts, unsalted
  • optional – salt
  • optional – protein powder, we used Chocolate Cupcake from PEScience
  • optional – Hershey’s chocolate syrup
  • optional – vanilla extract

Directions

  1. Pick your nut! I know, I know, but you need to decide what butter you want. I chose walnuts.
  2. If your nuts are already shelled, you can add between 1 to 2 cups to your food processor. If they’re not shelled, shell them and make sure that all the piece of shell and inner skin are removed.
  3. Pulse your food processor on chop for a few minutes before switching to grind. If your food processor doesn’t have multiple settings or has numbered settings you will want to processor the nuts until they are smooth. Scraping the sides every now and then to ensure that all pieces of what may be meal now continue to be ground down.
  4. When ground to desired smoothness, pour into a jar and store in the fridge.

To make protein infused nut butter

  1. Make the recipe above and divide in half then add 1 teaspoon vanilla extract.
  2. Once vanilla is blended in, add a scoop of protein of your choice slowly. We used chocolate frosted cupcake by PEScience, which will cause the nut butter to dry out slightly. I believe all powders would cause the nut butter to dry out though, not just the whey casein blend.
  3. To combat the dryness of added protein, add a little bit of water. I added 1/2 a tablespoon of water at a time up to about 2 tablespoons of water.
  4. To enhance the chocolatey-ness of the nut butter or because I wanted to add chocolate sauce… I added 1 tablespoon of Hershey’s syrup and blended.

Nutrition for a 28g serving of protein walnut butter using 100g of blended nut butter: 12.5F/3.6C/7.1P

*Notes*

I would wait until the next day to put add-ins into the nut butter because this gives the mix time for the oils to separate, which may help with mixing in the protein. Since it is naturally and minimally made, we have had to mix both butters before every use so that oils are mixed thoroughly.

Day 1, Movie Quote 1:“To Making It Count”

I figure life’s a gift and I don’t intend on wasting it. You don’t know what hand you’re gonna get dealt next. You learn to take life as it comes at you… to make each day count. – Jack Dawson, Titanic

It’s kind of fitting that the new year starts on a Monday, right? I mean how many of you have said “never miss a Monday”? How many have said “I’ll start on Monday”?

I feel bad for Monday’s because there’s such high expectations for them, there’s also disappointment because the weekend is over.

But it’s also a new year and just like everyone else, I like a new day, a new week, a new month, a new year – a fresh start. I’ve been thinking a lot about last year…even though it was just yesterday that it ended. I’ve been thinking about what I wanted to accomplish and if I had really done that.

✔️ I wanted to compete and a I did that- three times. I wanted to come as close as I could to getting a National bid…I did that too. I could’ve gone to Junior Nationals.

✔️ I went back to school and made the merit list, which was the highest honor I could for the credits I was registered for. I was also inducted into two honor societies because of my academic achievements.

✔️ I wanted to grow coaching and make a direct impact on people’s lives. I knew and I still know that my style of coaching isn’t for everyone, but I’ve had the chance to work with almost 60 people in the first year and to me that’s pretty amazing.

By the middle of the year, I had added some other things added to my list.

✔️ I needed to find more emotional balance so I tried something new: I added regular hatha hot yoga and meditation to my routine. Since August, I’ve gone to about 45 yoga classes and finished 60 at-home mediation sessions through the Headspace app.

✔️ I wanted to run another 5K this fall. JP and I did that on Thanksgiving and I ran my fastest 5K: 25:58 with JP beating me by one second.

✔️ I wanted to run more. Perfect goal was working up to 10 miles a week, but that didn’t happen. What did happen: 13 weeks of more consistent running for a total of 78.02 miles. The last week slacked, but #holidays.

✔️ After getting used to my fall schedule, I wanted to find consistency with my added yoga and meditation. I found regularity with lifting, running, yoga and meditating. My routine fluctuates between 4-6 days of working out between 20-90 minutes because yoga is 90 minutes, but I won’t run longer than 20ish.

For this upcoming year, JP and I have talked about what we want to do together and separately. We’ve lived together for 15 months and we’re still working on doing things a part.

So together we want to:

  • Hike more starting in the spring
  • Run another organized race
  • Go on a weekend getaway that doesn’t include the gym or working on cars
  • Learn more cocktails than Moscow Mules…our bar cart is quite full, but we drink most things neat. A little adventure wouldn’t hurt.

On my own, I want to:

  • Continue to be consistent with my activity since I sit at higher ratio than I am mobile
  • Continue to run every week with the eventual goal to get up to 10 miles a week
  • Build my strength in my squat and deadlift and front squat
  • Continue to develop coaching to meet different populations where they need to be met to be successful in their health goals
  • Learn as much as I can during my internship
  • Write more often
  • Say ‘yes’ more often
  • Try more new things

I could probably add lost half an inch off my hips, but I also know that if I work towards the goals above, that I’ll be comfortable in my skin because I’ll be active in the ways I enjoy and I’ll be striving for balance – whatever that may be.

We didn’t make it to midnight, but in most ways, it was just another night where I got to make a fancy meal with my best friend that ended with a full bottle of wine and crawling into bed from exhaustion at 8:30. I was up at 6:50 and JP up shortly after. I’ve been reading and writing from bed and we’re going to start our day soon with breakfast and mimosas because we didn’t even bother to open the champagne last night.

Here are some of my photos to recap last year. I hope you go back through yours and then step forward.

❤ Cristina

Recipe: Broccoli Cheddar Soup

It’s single digits and with the wind, we’re hitting negative temperatures. I know, I know. I live in New England, I did it to myself. I like it here, but living here for about five years doesn’t make it easier dealing with the snow, the bitter cold or plastic wrapping my windows. Yes, for those in warm weather – plastic sealing your windows can help keep the draft out.

One thing that has been helping us this fall and into the winter has been making soup and chili. Our rotation has been ground turkey chili, white chicken breast chili and broccoli cheddar soup with the latter being added to the recipe collection this season.

We’ve buy a lot of vegetables in bulk from BJ’s whole sale, we also go to you-pick places in the summer and I’ve been trying to utilize as much of the veggies and fruit as possible. Broccoli cheddar soup is one of the recipes that allows me to use all the parts of broccoli without waste.

To me, at least, the stalk is usually a little bitter and needs to roast a lot longer than florets do, however, in this soup all parts continue to cook down and there’s no lack of flavor.

Back in the day, I could easily consume a bread with broccoli cheddar soup from Panera, however, that was before my diet changed and before my digestion system changed. If you’re someone like me who experiences lactose intolerance to things like cheesecake, soft serve ice-cream or heavy whipping cream, but can handle hard cheeses or goat products – this recipe will be for you.

Low Dairy Broccoli Cheddar Soup for Two

What You’ll Need

  • 1/4 cup red onion chopped
  • 200g of broccoli
  • 1 tablespoon of butter
  • 2 tablespoons of chopped carrot
  • 1 and 1/3 cups of almond milk or other milk alternative
  • 1 cup of water + 1 tsp of salt free chicken seasoning (you can also use 1 cup of chicken broth, I’ve made this recipe both ways)
  • 1 tablespoon of flour (you can skip this step if you don’t want your soup thicker)
  • 1/4 cup or more of shredded cheddar cheese
  • Baking sheet
  • Medium sized pot
  • Food processor

Directions

  1. Pre-heat oven to 375 degrees.
  2. Chop broccoli into 1 to 2 inch pieces include both florets and stalk in using a crown, if you using pre-cut florets cut florets into smaller pieces suitable for roasting.
  3. Spray a baking sheet with non-stick spray and spread out broccoli pieces so that they lay flat and aren’t piled on each other. Spray broccoli with cooking spray. If you prefer to cook with oil, use about a table spoon of olive oil to toss the broccoli in before laying it on the greased baking sheet.
  4. Bake broccoli for about 15 to 20 minutes (this is the longest part of this recipe).
  5. While broccoli is baking, peel and chop the red onion and dice the carrots. These pieces should be small
  6. In a medium pot, melt 1 tablespoon of butter and add chopped onion. If you want your carrots a little softer, you can add them with the onion at this step. Let vegetables simmer for a few minutes until onions become more translucent.
  7. Add 1 and 1/3 cup of milk alternative. I used almond milk, but I have used cashew milk before.
  8. Add 1 cup of water with 1 teaspoon of salt free chicken seasoning – I did this as a chicken broth alternative because I was out. I’ve made it with 1 cup of chicken broth, you could also use 1 cup of water with a bouillon cube. If you want this to be completely vegetarian, you can also use vegetable stock.
  9. With a whisk, mix ingredients well and top with a lid and let simmer on low heat until broccoli is finished roasting.
  10. Once broccoli is down roasting, you have two options – chop in a food processor and then add to the pot or add directly to the pot. I’ve done both. With the broccoli chopped fine, the soup become thicker on it’s own while with the whole broccoli it’s more soup and may need a thickening agent.
  11. If you prefer a more soupy broccoli cheddar soup you can skip this step: After you’ve added the broccoli to the pot, remove a little bit of the liquid into a small cup or bowl and then add 1 tablespoon of flour to create a paste. Mixing the flour in a small amount of liquid allows for it to be combined thoroughly and prevents clumping. Add the paste to the pot and whisk thoroughly.
  12. Lastly, add your cheese. I used a shredded cheddar jack and used about a 1/4 cup. You can use more, you could also use a different cheese blend.
nutrition label for broccoli cheddar soup on blog

Nutrition calculation in MyFitnessPal Recipe Creator

Macro Nutrients: Fat (cheese, milk alternative, butter) Carbohydrates (broccoli, onion, carrot, milk alternative, flour) Protein (cheese, milk alternative, broccoli)

Are you even ready?

Don’t doubt yourself. Try to not let the doubt of others fill you either. But, are you ready for the things you want to accomplish? I’m not just talking about your health, but in general, everything you want – do you really want to put your words into action or are they just words right now?

I talk about goals a lot because I feel better and more in control when I have a goal in mind – either continuous or deadline driven. I have a mostly Type A personality meaning I like structure, but I’ve also figured out how to go with the flow and be more fluid with my methods and goals. However, not everyone is like this and that’s completely okay.

Whether you realize it or not, as you think about tomorrow, next week, next month and next year you are going through The Stages of Change Model. I first learned about this model in my psychology course last fall, since then, it’s been discussed in five out of nine of my program’s classes.

Some background…

In 1979,  James O. Prochaska developed a transtheoretical model of change in a study that compared 18 different therapy systems and reviewed about 300 therapy outcomes. His model categorized the systems of therapy into five processes of change. “These processes are differentiated along two dimensions.”

1. verbal and behavior categorized the change process according to application – therapy that relies of verbal interaction or behavior manipulation.

examples: feedback and awareness of a problem like smoking, education about a problem like smoking

2. experiential and environmental categorized the change process by the individual’s experience or the individual’s surrounding environment

examples: finding new coping mechanisms instead of smoking, removing triggers like ashtrays and cigarettes

In 1982, Prochaska and Carlo C. DiClemente worked together using Prochaska’s model to examine self-change and therapy change in smoking behavior. Their study was titled: Self-Change and Therapy Change of Smoking Behavior: A Comparison of Processes of Change in Cessation and Maintenance. It was published in Addictive Behaviors volume 7 that year.

The sample was small, but there was a mix of gender (29 males to 34 females).  Smokers who quit on their own (n=29) were compared with two different groups of smokers: an aversion group (n=18) and a behavioral-management group (n= 16). The sample was random with self-quitting participants recruited through various methods like fliers, advertisements and newspaper – remember, this is 1982. Participants from the two therapy groups were recruited randomly as well through fliers handed out after meetings.

Within seven weeks of quitting all subjects were given a change-process questionnaire verbally with all responses recorded on tape. They also answered a variety of smoking history and demographic questions. They were told they would be interviewed a second time within six months.

From these responses, Prochaska and DiClemente looked six verbal and four behavior process of change, and three stages of change (decision to change, active change and maintenance).

Here’s what they found:

1. Attempts to quit among the three groups were similar, gender didn’t necessarily make a significant difference among the three groups either.

2. The group that did see signification differences (p < .01) were from the behavioral-management group. These participants were older with an average age of 42, the age range varying from 30.4 years to 53.6 years. They smoked for a longer time than the other two groups with a mean of 25 years and a years-as-a-smoker range from 14 years to 36 years. These participants were more invested in quitting this time.

When looking at the different processes of change they found:

1. Individuals who quit on their own rated feedback, stimulus control and social management as less important than the other two groups.

2. All three groups rates self-liberation as quite important, however, the aversion group said it was more important than the other two groups.

3. The behavioral-management group rated counterconditioning as more important than the other two groups.

During the follow up they found:

1. Two-thirds of all subjects remained abstainers.

2. There were no differences in proportion of successes and relapses for all groups. Looking at the variables such as age, education, occupation, years smoking, etc. didn’t have any significance.

When speaking to participants who relapsed:

1. They struggled to find other coping mechanisms to deal with personal problems like consistency with exercises or health-related physical activity.

2. Some said they believed the habit was under control even with the relapse.

3. Some said they missed the habit.

Prochaska and DiClemente conducted new study a few years later where they used a sample of 872 smokers. This study was an extension of the first.

This model of behavior change is taught in all areas of the health field from psychology to sociology to nursing and public health. While I don’t blatantly tell my clients they are going through this model when we have our screening, I assess them with this model.

Many who talk with me are usually past precontemplation and contemplation – they’re ready for action, however, some are still determining the right course of action. It’s not about how bad they want change, it’s about being ready for change and finding the right way to go about making changes to their lifestyle.

There are some cases where a client and I will discuss their goals and I’ll say, I think these are great, but be aware that it’s possible that they may change, that you may realize there are other things that will assist with these goals that may become more important for the time being. This isn’t too discourage them, but to let them know that I’m acknowledging that goals can change and that as their coach, I think it’s okay. An example may be the client who says they want to lose weight, but doesn’t realize that they have a poor relationship with food. The goal eventually will be weight loss, but for the moment it’s about working on building a better relationship with food so it’s not used as a coping mechanism or so that they don’t restrict themselves and feel incapable of adhering to their nutrition goals. We will work on stress management,  meal planning, meal creation and setting micro-goals that work towards a healthy lifestyle that assists weight loss for eventual weight loss over time.

It’s completely okay to not be ready for a goal, it’s also completely okay to change your immediate goals in order to work towards the bigger picture.

When we think about our goals and what we want out of life, what direction we want to take, we also need to look at the driving force behind it. I always ask my clients why their goals are their goals. The responses have ranged from “I want to be able to get on the floor with my kids” to “I want to be stronger”. There are also some who say they want to lose weight because they believe they will be happier or feel better when they have.  I have said to them that size doesn’t equate happiness, but if being a healthier smaller size means that they will be more outgoing and their mental well being will improve – then yes, it’s reasonable to say that you believe you may be happier when you’ve lost weight.

But for all clients, regardless of their reasoning behind their goals, I ask them to dig deeper to make sure that their goals are truly something they want.

Living a healthy lifestyle is more than the time that it takes to lose weight. It’s more than the time it takes to learn to allow freedom and flexibility. It’s about building lasting habits and truly implementing and learning positive behaviors.

Now, that’s not to say that you won’t ever “mess up”, you won’t ever not want to eat off plan,. It’s human to have set backs. It’s human to take a break. It’s crazy to think that every day has to be perfectly lived towards these goals. I don’t believe that’s realistic, but it’s about small behaviors that add up over time that make meaningful change.

I challenge myself often to remind myself why I’m back in school, why I’m coaching, what health means for me in this moment. I want you to think about your why’s, your life, your plan  – are you ready? Do you have the support around you? Do you truly support yourself to make the changes necessary to accomplish whatever it is you want to?

I hope you can see the greatness inside you. There’s nothing more rewarding than the light bulb going off when something finally clicks for a client or they start seeing the greatness I see in them.

I wish for you empowerment in the New Year. I wish for you that you allow yourself time as you start to figure out your next steps. Don’t rush – good things can come slowly, we just need to learn to be patient.

❤ Cristina

 

Catching Up

It’s been about a month since I’ve written on here, but let’s be honest, that was a recipe – that’s not real writing.

I’ve said it before on Facebook more recently, but here as well – I write when I feel compelled. I write when I feel it’s the most beneficial to me. I feel like this is something I always write when I’m coming back after a hiatus of not writing as well. But sometimes I need the reminder of why I blog or why I don’t, and I think you do to.

This year has been all over the place. I think it started with adventure and a new high. A new direction, a path that I was excited to take and discover. I felt that I was going to learn more about myself and the biological world that I had barely scratched the surface of. I’m sure some of you sat there and thought, well damn her life’s a mess – I’m pretty sure I said that a few times from my living room floor.

Academically, I have pushed myself well out of my comfort zone. This pursuit started so I could better meet my clients needs. I had been asked many times to help with weightloss and meal planning, I had been asked to coach people to help them create a healthier lifestyle, but people were asking based on my experience alone. For me, that’s not enough. I don’t think you can just have an education, and I don’t think you can just have experience. You need to blend the two and be open minded to learn more and learn often.

I’ve taken some classes that are straightforward like anatomy and physiology, and I’ve taken some that are more fluid like nutrition and sociology.

With finals I started to feel slightly burnt out, but that’s normal after writing thousands of words, reading through dozens of studies, studying for hundreds of hours and filling up multiple notebooks. It doesn’t matter if you take one course or five courses – it’s brain power. Along with my classmates, I had been saying I was ready for this semester to be over, but I’m also so excited and ready for next semester.

My courses: medical microbiology, chemistry and epidemiology. Eleven credit hours. All in person. All night classes. There are going to be some long days because I still work three days a week in a doctor’s office. I will also be starting an internship.

I start an internship for my program that should last for at least half the year. It’ll total roughly 300 hours at least. it combines my love of health and education along with serving specific populations – in this case, children. I think if we start the conversation while their young and the parents are involved, then positive habits can be created and in a fun way that doesn’t make them seem so tedious and boring.

On the more personal end of things- yoga, lifting and running have helped me get back to feeling like I did before with my activity. I’m feeling good about the ratio of ass sitting to mobility. I’m physically feeling more comfortable in my skin and have been working on getting my strength back up. I know the upcoming semester will be a little more unique as far as scheduling because I will have some long days shifting from work to internship to class to coaching, but that’s part of goal development. At different times, some routines make sense and others don’t. I’ve gotten better at not fighting it, and going more with the flow.

Since October 1st, I’ve run 76.62 miles. Nothing ground breaking, but a lot more than I had been running earlier this year because it wasn’t necessary to my training and I didn’t feel it in my heart to do so.

Eating has been normal. Indulging in a lot of cocoa and some treats that are only available at this time of the year. However, I’m creating a balance. I’m making the decision to indulge versus mindlessly doing so or feeling guilty about it. Stress hasn’t felt out of control, aside from the standard academic stress – I’ve been meditating a little less than I was before, but I also don’t think that’s a bad thing. My meditations have also changed, which wasn’t something I was expecting.

It’s been three months since I’ve been off birth control and hormonally, I’ve noticed a lot of change. My anxiety is different, reactions to similar situations are a little different – I feel less wiped out and that has been the biggest change.

Sitting down writing this out is weird because in my head I think I want to share what my next steps are, but then part of me goes who cares?  That’s the honest truth. I’ve always had both thoughts in my head, but the one always overpowered the other. I think about what is different, and I think I finally realized the answer.

I want to help people and that’s not a bad thing, but it also means that I forgot I can help someone indirectly by sharing my perspective.

On Facebook, I’ve started to share more about my interest in public health, my investment in organizations on campus, what I’m writing and talking about in class, but I’m going to start doing that here too. Writing has never been something I felt like I had to do, it wasn’t something that was an outlet for me. After talking with friends and doing a few too many videos on Facebook, I’ve been missing it.

My goal is to be more active in writing because I do enjoy it, but I need to protect it so that it doesn’t feel like an emotional burden. Some part of me also believes that there are people who click on my posts to actually read them, not just skim them to see if I’ve fallen on my face. So there’s that – the indirect way to help someone else.

I’m not putting a schedule out there for writing, but my promise to myself is that I’m going to sit down more often. I have a few recipes in my drafts folder I’ve been meaning to finish as well. So that’s on my to do list during break.

I have a list of things I want to do over the break before the spring semester starts. There’s no penalty if things don’t get crossed off, but I have a wish list, but that’s for another conversation.

❤ Cristina

 

Recipe: Stove-top Gingerbread Oats

Insert winter/holiday season pun/quote here.

I’ve probably consumed more pumpkin foods than I should’ve this fall, and now I’ve been turning to gingerbread and mint. As my adventure through my Pinterest pins continues, I’ve been trying to see how I can utilize my baking pantry in other ways that cookies and muffins.

I had found a few pins for gingerbread oats, but many had barely any oats and they were loaded with sugar. You can make good, sweet oats, without loading them with sugars or carbohydrates that won’t provide satisfaction.

So if you don’t mind stove top and you have about 5 minutes or so, this recipe may put you in a mood that satisfies the desire for gingerbread cookies  while leaving you’re stomach full.

What You’ll Need

  • Milk or milk alternative – I used unsweetened vanilla almond milk
  • Rolled oats
  • Molasses
  • Almond butter – I used crunchy
  • White chocolate chips (optional)

Directions

  1. Using a medium sized pot, you’ll want a little room, warm on low heat about 3/4 cup of milk.
  2. When the milk is slight hot to touch (not boiling), add half a cup of rolled oats. This is a serving for the store brand I used.
  3. Keep the burner on low heat, you don’t want these boil and burn on the bottom.
  4. Mix in 3/4 tablespoon of molasses.
  5. Mix in 1/2 tablespoon of almond butter, I used crunchy because I prefer it. You can use smooth or crunchy – you can even use peanut butter if you don’t like almond butter.
  6. Immediately remove pot from burner and either store in a tupperware for later or bowl for serving. Removing from the burner is important because even if you turn it off the heat will continue to cook the oats.
  7. Top off with a few white chocolate chips. This is completely optional.

As always, brands and portions impact nutritional value. These oats were 280 calories, 8.5F/46C/7P