Saturday, April 1, 2023

Life with Chronic Conditions: The Big Three (Diet, Exercise & Sleep)


In compiling the monthly Journal Watch, which is posted the third Saturday of the month, I continue to notice how many studies are finding that better health and longevity can be obtained by what we eat, if we exercise (both physical and mental) and get sufficient sleep. 

Many different groups have compiled their “lists” of “to do.” For example the Blue Zones Project has the “Power Nine,” while the American Heart Association has the Life Essential 8Even Phil Stutz, a psychiatrist who has gained a lot of publicity recently for the documentary “Stutz,” points out that these three factors are critical in treating psychiatric conditions such as depression. Interestingly, more and more medical groups are encouraging life style modifications before placing people on medications.

 

 In August 2022, the Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce were published in the World Journal of Biological Psychiatry. They came up with nine recommendations. The recommendations with the highest ratings to improve MDD [Major Depressive Disorder] were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies.

 

AHA’s Life’s Essential 8 includes: Not smoking; regular physical activity; healthy weight; healthy diet; Healthy sleep (defined as an average of 7-9 hours nightly); Blood pressure, glucose and non-HDL cholesterol all in a healthy range. Basically, with the exception of smoking, the big three, help to control weight and the other markers. 

 

Before launching into the “big three,” it’s important to note two things: 

-       Talk to your medical provider to assist you in making changes. They are in the best position of what will work best in your situation. 

-       There is a role for medications and if your provider things that the right approach for you, please take that seriously. 

 

THE BIG THREE


DIET:
 There are lots of diet trends out there, but the research continues to support that the best diet is plant slant with the Mediterranean diet leading the pack in helping with depression, heart health, dementia and a reduction in factors that can lead to heart disease, diabetes, cancer etc. 

 

With lots of options for fruits, nuts, whole grains, vegetables (yes to potatoes), and fish, there are lots of nutritious yet enjoyable foods to choose from. If you aren’t familiar with the diet, check out Cleveland Clinic’s Mediterranean Diet.

 







EXERCISE:
 The Physical Activity Guidelines for Americans from the Office of Disease Prevention and Health Promotion Health states the following:

 

Key Guidelines for Adults 

• Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits. 

 

• For substantial health benefits, adults should do at least 150 minutes least (2hour sand 30minutes)to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week. 

 

• Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week. 

 

• Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits. 

 

Key Guideline for Older Adults The key guidelines for adults also apply to older adults. In addition, the following key guidelines are just for older adults: 

• As part of their weekly physical activity, older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. 

 

• Older adults should determine their level of effort for physical activity relative to their level of fitness. 


• Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely. 

 

• When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow. 

 

Key Guidelines for Adults With Chronic Health Conditions and Adults With Disabilities Adults with chronic conditions or disabilities, who are able, should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week. 

 

• Adults with chronic conditions or disabilities, who are able, should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits. 

 

• When adults with chronic conditions or disabilities are not able to meet the above key guidelines, they should engage in regular physical activity according to their abilities and should avoid inactivity. 

 

• Adults with chronic conditions or symptoms should be under the care of a health care provider. People with chronic conditions can consult a health care professional or physical activity specialist about the types and amounts of activity appropriate for their abilities and chronic conditions. 

 

Exercises for the Mind

• Use relaxation techniques-such as guided breathing. Check out Cyclic Breathing & Sighing Improves Mood from a few weeks ago

• Mindfulness and meditation 

• Activities like yoga, Qigong and Tai Chi can exercise mind, body and spirit 

 

SLEEP: In a study presented Feb. 23 at an annual meeting of the American College of Cardiology, researchers identified five healthy sleep habits: getting seven to eight hours of sleep each night; falling asleep easily most nights; staying asleep most nights; waking up rested most mornings; and not using any sleep medications. To learn more about getting better sleep, check out the Sleep Foundation.  

 

 

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