Category Archives: Coaching

Smoking Cessation

Positive Thinking: Negative for Habits and Smoking Cessation

Positive thinking is typical in our New Year’s Resolutions. Resolutions aren’t the only reason to change habits, but if they motivate you, great. The Scientific American magazine article (link below) is a short four paragraph summary of a study published a few years ago that might be relevant. The Northwestern University study demonstrated that a certain kind of belief (cognition), restraint bias, may put those with bad habits or addiction at risk.

The study may also have raised the possibility that it is fairly easy to influence this belief in research participants.

Smokers were randomly assigned to two groups, both of which took a self-control test. But one half was randomly told they had low self-control and the other half was told they had high self-control. Therefore, some of these individuals would have unrealistic positive thinking, i.e., his/her self-control is really low, but he/she was told it was high.

Then they watched a movie that included smoking. They were offered a choice to be paid to resist smoking during the film by keeping an unlit cigarette in their mouths, their hands, or on a desk in another room. The cash rewards were higher for the greater level of temptation.

Those smokers told they had high self-control were much more likely to take higher levels of temptation. But they ended up being more likely to light up and smoke during the film.

It appears that overestimating one’s level of self-control could lead to putting oneself at greater risk of temptation only to end up giving in to a habit one may be trying to resist. Having accurate beliefs about our capacities can be really important in behavior change. In this case, even positive thoughts, which are inaccurate or irrational, can be harmful. So telling ourselves positive things is not always good advice.

http://www.scientificamerican.com/article/why-we-return-to-bad-habits/

#habits #positivethinking #smoking

fasting

Intermittent Fasting – Lose Weight and Cheat Death?

Intermittent Fasting

Weight loss may be the reason you are reading this, but intermittent fasting advocates believe IF can offer health benefits beyond ripped abs.  Very low calorie diets (VLCs) have scientific support for extending life in animals and humans.  But have you ever seen the meals those folks eat?  Caloric restriction may the best way to live longer, but if you feel the way I do about food, you may not want to live longer if you have to eat like that.  You have probably heard people say, “You may not live longer, but it will sure feel like it.”  After all the quality of life needs to be considered in addition to quantity of years.

Intermittent fasting (IF) may be the answer.  There is evidence it has similar health benefits to caloric restriction, but still allows you to eat a lot some times, and many have an easier time adhering to this kind of diet.  Some biohackers do make it sound like a panacea.  If you have been in the blogosphere in the last few years, you have seen claims that intermittent fasting extends your life, prevents chronic disease, increases muscle mass, melts fat, improves concentration, and does your dishes (well it does decrease the number of dishes that you have to wash).  Let’s see how much that picture matches its current scientific status and what intermittent fasting protocols look like in practice. (Photo Credit © Pascu Gheorghe)

What is Intermittent fasting?

Intermittent fasting refers to a temporal pattern of eating and non-eating episodes.  Simply put, there are specific feeding windows, times during which you can eat, and fasting windows, times during which you do not eat- and yes, sleeping counts.  While some IF protocols specify how many calories you can have during a feeding window, most allow you to eat ad libitum, i.e., as much as you want during your feeding windows.  Yes, that is right, after fasting, you can eat as much as you want.  Many encourage you to eat high quality nutrient dense foods, but the amount is typically up to you.  Interestingly, and this surprised researchers, most people do not go crazy and make up for all of the calories they missed during the fast.  In addition in one study, it also appears that hunger levels decrease after two weeks and people get used to fasting, which makes compliance more likely.

If moving between fasting and feeding is what it is, what are the benefits?

What are the benefits of Intermittent Fasting?

If you are a rodent, this is definitely the way to go.  Similar to very low calorie diets, intermittent fasting extended the lives of some strains of mice, (effects varied by genetics and age at which IF was initiated).  Similarly, body weight significantly decreased as well, but the genetic strain of mouse and the age at which it received IF mattered for weight loss too- so not all mice lost weight and lived longer.  But IF has even more specific health benefits for mice than just weight loss and longer life expectancies.

Intermittent fasting appears to protect mice from developing certain cancers, e.g., lymphoma and liver cancer.  In one trial 33% of mice eating at regular times injected with a carcinogen developed cancer, while none of the mice on the intermittent fasting schedule developed cancer.  This is quite interesting, especially considering that the two groups ate roughly the same number of calories- just at different times.  So the timing was the critical component, not a reduction in calories.

Diabetes risk also appears to be diminished in animal studies and cardiovascular risk factors are reduced as well.  So if you want your hamster to live longer and look great, you know what to do.  But what about the rest of us?

Is Intermittent Fasting Healthy for Humans?

Intermittent fasting studies have been conducted in humans.  Both normal weight and obese populations have been studied, and studies have included men and women.  This is important because there have been some gender differences.  The majority of trials have lasted from two to 24 weeks and have involved a particular type of intermittent fasting called alternate day fasting (ADF).  ADF involves alternating a feed day with a day of fasting.  So basically you eat every other day.  That typically means there is a 36-hour fast.  On a feeding day (Monday) you may eat between 8:00 am and 8:00 pm, and then fast the entire next day (Tuesday) until 8:00 am two days later (Wednesday).  One study utilized an alternate day modified fasting (ADMF) protocol where the fast day allowed for one meal between the hours of 12 pm and 2 pm.  So the fasting window here would be shortened considerably.

Will Intermittent Fasting increase Life Expectancy?

In terms of living forever, we don’t have studies following subjects to the grave yet (for IF or extreme calorie restriction). But based on animal studies for calorie restriction, some advocates of the practice hope to live to be 120 years of age.  While some experts, believe 5% to be a more reasonable estimate of how much longer humans might live on caloric restriction.  ADF has shown to increase life expectancy in mice.  But I have not yet seen any computations extrapolating those findings to humans, but I am sure they are coming.  But there are plenty of findings for disease in humans.

Fasting is good for Heart Health

High-density Lipoproteins (HDL), the good cholesterol, was increased by intermittent fasting and triglycerides and Low-density lipoproteins (LDL) decreased in some studies.  Many physicians use these as predictors of cardiovascular disease.  So it appears that intermittent fasting may improve heart health.

Weight Loss from Intermittent Fasting

There is also evidence that overall fat oxidation is increased and the majority of people in studies lost significant weight in a short amount of time.  One study of normal weight men did not find weight loss, but the trial was only two weeks- and they were normal weight.  One trial of obese women that lasted 24 weeks had an overall weight loss of 7% of total body weight, a fat mass decrease of 13%, and a reduction of waist circumference of 6%.  Other studies had ranges of 4-9% weight loss from their initial weight.  Another important finding in one trial was that, unlike in caloric restriction (CR) diets where clients lose both fat and muscle, obese participants losing weight with intermittent fasting, lost fat while preserving muscle mass.  This may be one of the most important benefits of intermittent fasting and hopefully many other studies will replicate this finding in both obese and overweight populations.

Diabetes and Cancer Risk

Diabetes risk factors appear to significantly decrease for men, but it is less clear if there are benefits for women.  Some authors believe that conflicting studies don’t make it clear at this point, but longer trials will likely clarify what the effects might be- which will be positive if they are congruent with the animal studies.  While IF appears to protect mice from some forms of cancer, human studies have not yet been conducted.  Given that the majority of animal studies have found these effects, many scientists are hopeful that IF could be beneficial for humans regarding cancer, but further studies are certainly required to make those conclusions.

So, for humans – it does look like many people can expect intermittent fasting to result in weight loss (hopefully with preservation of muscle), reduced risks of heart disease, diabetes (if you are a male), and possible protection against carcinogens (the jury is still out, awaiting human trials).

Those are the benefits, what are the options?

As I mentioned earlier the majority of animal and human studies use the ADF version of intermittent fasting.  But, many health advocates recommend different IF protocols.  I will detail a few of the most popular.

IF Protocols

An infinite number of IF protocols could be implemented.  It is really as simple as picking specific feeding and fasting times.  What you think the optimal amount of time for a fast is balanced with the likelihood you can maintain that time should be what guides your plan selection.

Full Day Fast

Similar to the ADF protocol in the scientific studies, you have a full day of fasting, followed by a feeding day.  When there are only one or two fast days per week, this is often called Eat Stop Eat, a program promoted by Brad Pilon.  He does recommend eating normal amounts on the feeding days.

Alternate Day Fasting (ADF)

To recap, this is an entire day of eating as much as you want, followed by a day where you do not eat at all.  While ad libitum eating was allowed in the studies I cited, it is not typically recommended to overdo the amount or to eat unhealthy foods.  Instead listening to your hunger cues and eating healthy quality foods is your best bet.

Alternate day modified fasting (ADMF)

This is very similar to ADF, except you are allowed to eat one meal during the fast day.  The scientific trial that utilized this protocol specified the hours of 12 pm and 2 pm to be the feeding time.  It also specified the caloric amount of that meal to be 25% of baseline caloric needs, e.g., 500 calories.  The meals in that trial included an entrée, snack, and even a dessert, e.g., a cookie.

Intraday Fasting

This is a term I use to refer to protocols in which the fast and feeding windows occur on the same day.  In these protocols, the differences are simply how long each window is.  Some popular ones also recommend when to exercise, how much protein to consume, and whether you can have coffee, tea, creamers, butter, etc. during fasting windows.  I will list some of the most popular timings below.

Intraday Fasting-10

IF-10 refers to a 10-hour feeding window and a 14-hour fast.  This timing is promoted by Martin Berkhan in his Leangains program.  This ratio is what he recommends for women.

Intraday Fasting-8

IF-8 refers to an 8-hour feeding window and a 16-hour fast.  This timing is also promoted by Martin Berkhan in his Leangains program, but is recommended for men.

Intraday Fasting-4

IF-4 refers to a 4-hour feeding window and a 20-hour fast.  This timing is promoted in the Warrior Diet by Ori Hofmekler.

Those are the intermittent fasting protocols I have seen promoted the most in the blogosphere.  It is important to note that the scientific literature has not yet tested the majority of these.  ADF and ADMF have been evaluated the most.  There are countless anecdotes of those utilizing many IF protocols on the internet.  Many of those blogging about these report incredible weight loss stories with beneficial indicators in blood panels that result in physician’s amazement.  Based on the research findings, it seems very plausible that many of these reports are accurate.  While the mechanisms are still debatable (something I may tackle in a future blog) as to why or how intermittent fasting works, there are some pretty incredible findings in both animal and human studies in terms of health outcomes.  More studies need to be conducted.  And I would very much like to see not only a wider variety of human subjects used, but longer trials, and protocols other than ADF.

Thus far, I think the scientific findings are pretty remarkable and I am incredibly optimistic that future research may help determine precisely who can benefit from particular protocols the most.  But the research has demonstrated that IF can have significant impacts on various physiological indices without many side effects.  Not many medications have these kinds of effects without creating other health problems.

With that said, there are not many human trials yet, and they certainly have not tracked participants across years.  So it is unclear what the effects will be in the long-term.  My hope is that longer trials will result in an increase the intensity and number of health benefits.  But questions remain about potential adverse effects as well.  Some authors and professionals believe IF may be detrimental to women, diabetics, or those at risk for adrenal fatigue.  And I think given the lack of longer terms studies proceeding sensibly and cautiously makes sense.

I have educated a number of my patients about intermittent fasting.  I have always recommended that they speak to their physician before implementing any protocol.  I work to improve many lifestyle factors of my patients, but without question weight loss is a focus for many of my clients.  Intermittent fasting not my first tool when it comes to weight loss.  While IF may result in weight loss regardless of the types of food people eat, I make sure clients are making better food choices regarding macronutrients, micronutrients, and portions as well- and I typically emphasize food quality and quantity prior to IF protocols.  But, given the scientific support for weight loss and decreases in cardiovascular disease risk factors, I believe intermittent fasting is a promising strategy to consider as long as you are working closely with an informed medical professional that will closely monitor any potential adverse effects.

Overall it appears that for many people, IF could have enormous potential.  Fat loss, without losing muscle, reductions in heart disease risk, diabetes risk (at least for men), possibly protection against cancer and life extending benefits in animal studies, while being more palatable than caloric restriction make it an important strategy to consider.  It may not be right for everyone, but if more studies demonstrate it is safe in the long-term, I believe health care practitioners will be recommending it more frequently to help us lead long, lean lives.

Intermittent Fasting References

Freedland, S. J., Klink, J.C., Mavropoulos, J.C., Poulton, S.H., Demark-Wahnefried, W., Hursting, S.D., Cohen, P., Hwang, D., Johnson, T.L., & Freedland, S.J. Effect of intermittent fasting with or without caloric restriction on prostate cancer growth and survival in SCID mice. The Prostate, 1037-1043.
Howell, A. Effect Of Intermittent Versus Continuous Energy Restriction On Weight Loss And Breast Cancer Risk Biomarkers. Breast Cancer Research, P28.

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Information provided on this site is provided for the general public.  It is made available with the understanding that the author and publisher are not providing any medical, psychological, health, or other personal professional service.  Any information provided should not be considered complete and does not cover all diseases, disorders, syndromes, ailments, physical or mental conditions or their treatment.  This information should never be used in place of calling or visiting a medical health professional, mental health professional, or other appropriate competent health professional, who should be consulted prior to making any changes based on suggestions from this site or any inferences drawn from material presented on this site.  Any information about drugs that appears on this site is general in nature.  It does not include all possible uses, precautions, side effects, or interactions, nor is it intended as medical advice.  Anyone reading this information who is considering medication or drug changes should consult with his or her medical doctor.  J. Ryan Fuller, Ph.D. is a New York State licensed clinical psychologist.  He is not a medical doctor.  Anyone considering changes based on information provided on this site or inferred from that information should consult with his or her medical doctor.  The operator(s) of this site specifically disclaim all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any of the material on this site.

Employment and mental health

Which is worse- A Bad Job or No Job? – by Staff

Common wisdom says that being employed is much better for one’s mental health than being unemployed. Right? It makes sense that the former might lead to loss of self-esteem and self confidence and, in consequence, depression. However, according to the results of a national survey conducted regularly in Australia, it really depends a lot on the job.

Employment that is unfavorable in terms of important conditions and aspects may not improve one’s mental health at all; in fact, it might just be harmful to psychological and emotional health. In other words, if your new job provides little monetary compensation and few benefits, offers little control over what you have to do, and/or is very demanding, you may see a decline in your wellbeing. And if you stay in the poor quality job a long time, your mental health is more likely to continue deteriorating.

These findings seem to create a serious dilemma. Obviously, there are advantages of having a job, regardless of how bad it is, over not having one. Besides getting some measure of wages to at least help pay the bills, a job usually affords one the social benefits of companionship or friendships, as well as psychological benefits, such as structure, maintaining a work ethic, and feelings of accomplishment. What other benefits does a job potentially offer?

Nevertheless, if a poor job is worse than no job, as the research indicates, what does it mean we should do? Turn down a lousy job to avoid worsening our mental health? Or take the job, even though we know the working conditions may make us “sick?”

I can’t imagine with unemployment where it is, any of us plan to turn down the Plan B job offer if we get the call.

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Freshman Orientation Should It Prepare You for College or For Life Itself

New Fitness Program for Coker College Freshmen

A college in South Carolina is trying to initiate some positive changes in the lives of its students while chipping away at our nation’s growing obesity problem. The current president of Coker College is passionate about fitness and healthy living, having been 100 pounds heavier when he, himself, was in college than he is now. So he wants to make sure, starting with this year’s freshman class, that the students at Coker are offered programs in “fiscal and physical fitness.” The institution’s curriculum therefore will now include a ‘healthy’ serving of fitness.

Main Components of the Program

Entering freshmen, first of all, will be required to take a physical fitness test. Also, students are ensured that in the cafeterias and/or dining halls, there will be wholesome, nutritious food options at each meal. Finally, a full program of carefully selected intramural and other activities has been put in place, including many unique choices, such as yoga, Zumba, and tubing—definitely not limiting students’ options to team sports and competitive pursuits. Students may even choose discussions with a dietitian. And, starting with this class, at least four of these activities (over the course of their college experience) are mandatory. The good news is that students may take part in as many of these as they want.

Smart Move?

Now, on the one hand, the program represents a wise move on the part of the administration, reflecting compassion and concern for every student admitted to the college. Many of us would have appreciated the care that went into planning this program and would have liked the opportunity to attend free fitness classes of various types and individual dietary planning. It is actually somewhat of a return to university requirements of several decades ago when four semesters of active physical education courses were requisite for graduation. But it seems Coker College is choosing to make the whole experience a little more fun. Mandatory weigh-ins and even optional weigh stations on campus were considered but nixed in light of potential problems of eating disorders, known to be pronounced in the college-age population.  Program officials are making the focus of the program health and fitness—not weight, size, or appearance.

On the other hand, taking this step—be it in the right direction or not—is sure to anger or at least frustrate some freshman and is likely to keep a few prospective students from applying to or enrolling at Coker. How do you feel about Coker’s approach to improving student fitness levels? If a college you were considering implemented such a program, what kind of influence, if any, would it have on your decision? Is this sort of thing going to extend the college student’s time on campus? If so, would it mean extra hours or extra semesters?

A Similar Program

One university (a historically black institution) tried a program with similar goals in 2009 and received much criticism from different fronts for targeting African-Americans and even for “racial abuse.” The faculty planners made some programmatic adjustments (namely removing the requirement for graduation) but stuck to their guns on mandatory health risk appraisals. They are reporting positive results.

Do you think it is the responsibility of a college/university to include some sort of fitness assessment when students enroll? And, if so, how much do you believe colleges can add to a student’s already burgeoning schedule in terms of required PE courses or physical activities? Or . . . should they just mind their own business when it comes to student health and fitness?

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Hatha Yoga

Hatha Yoga- A Pain Management Tool for Fibromyalgia

How are your cortisol levels? If you are a yoga enthusiast (especially hatha yoga), you probably have at least above-average levels of the hormone cortisol surging through your body.

The purpose of a study just published in the Journal of Pain Research was to examine what effects, if any, the practice of yoga had on cortisol levels and, consequently, on such characteristics/symptoms of fibromyalgia as pain, fatigue, anxiety, muscle stiffness, depression, disordered sleep, and stomach problems. At least one benefit—decreased muscle stiffness—of yoga is a “no-brainer.” Some of the other findings, however, were quite remarkable.

Participants were females with fibromyalgia, who engaged in two hatha yoga sessions a week for eight weeks. They responded to questionnaires and provided the researchers with saliva samples, which were analyzed for cortisol.

Their cortisol levels did in fact rise, following this program. And here are some of the positive changes observed, which the York University researchers believe to be related to high levels of cortisol, in this case stemming from practicing yoga: Increases in mindfulness, ability to detach from the psychological experience of pain, and acceptance of their condition; decreases in feelings of helplessness, and tendency to “go off the deep end.”  All of these changes appear to be extremely helpful in pain management and to relieve stress.

If you have fibromyalgia or other condition that includes chronic pain, has yoga ever helped you to cope with psychological or physical problems, including pain? Would you try (or stick to) a program like this as an approach to treating pain, fatigue, and stress sensitivity?

Jobs

To work or not to work, is that really a question? -by Staff

Which is worse: A Bad Job or No Job? – by Staff

Common wisdom says that being employed is much better for one’s mental health than being unemployed. Right? It makes sense that the former might lead to loss of self-esteem and self confidence and, in consequence, depression. However, according to the results of a national survey conducted regularly in Australia, it really depends a lot on the job.

Employment that is unfavorable in terms of important conditions and aspects may not improve one’s mental health at all; in fact, it might just be harmful to psychological and emotional health. In other words, if your new job provides little monetary compensation and few benefits, offers little control over what you have to do, and/or is very demanding, you may see a decline in your wellbeing. And if you stay in the poor quality job a long time, your mental health is more likely to continue deteriorating.

These findings seem to create a serious dilemma. Obviously, there are advantages of having a job, regardless of how bad it is, over not having one. Besides getting some measure of wages to at least help pay the bills, a job usually affords one the social benefits of companionship or friendships, as well as psychological benefits, such as structure, maintaining a work ethic, and feelings of accomplishment. What other benefits does a job potentially offer?

Nevertheless, if a poor job is worse than no job, as the research indicates, what does it mean we should do? Turn down a lousy job to avoid worsening our mental health? Or take the job, even though we know the working conditions may make us “sick?”

I can’t imagine with unemployment where it is, any of us plan to turn down the Plan B job offer if we get the call.

For full article:

http://www.sciencedaily.com/releases/2011/03/110314184714.htm

Breakfast

Weight Loss Breakfast Helps-Challenged

Weight Loss Mantra or Myth?

You should “. . . eat breakfast like a king, lunch like a prince, and dinner like a pauper.” Right? A new study out of Munich is making us take another look at the breakfast question. Granted the importance of the first meal of the day, if we want to lose weight—should we eat a big breakfast? Or a skimpy one? Or should we skip it altogether?

Traditional thought says that a big breakfast gets us set for the rest of the day and we tend not to eat as much at the other meals. Not so, say the German researchers’ findings. Subjects in the study, whether of normal weight or obese, seemed to eat the same amount for lunch and dinner, regardless of the size of their breakfast. Asked to vary the amount of food they had for breakfast from no food at all to a large amount, they then kept track in a journal of everything they ate. The only difference noted was that a mid-morning snack was more likely skipped if the person ate a large breakfast. Bottom line: the common advice of experts still stands when you’re trying to lose weight: decrease the number of calories you take in, increase your physical activity, and work for a better balance in these two. (Of course, eating more healthful foods can’t hurt.)

Read the news article