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!