Embracing Prevention: More than a Crash Diet

Dr. Lisa Fitzgerald | 12/14/2010, 10:19 p.m.

Earlier this year, a 62-year-old woman came to my clinic for an evaluation. It was my first time seeing her. She had high blood pressure, AIDS and chronic lung disease. After the introductions, I reviewed her laboratory results and noticed that AIDS was the least of her worries because she had been taking her medication and it was working well. However, I was alarmed by her cholesterol level. A normal level is less than 200 and hers was 361. In addition, her triglyceride level, a fatty substance floating in the blood stream, was also elevated. We started to talk about her lifestyle and habits. I became even more concerned when we discussed her diet.

"I eat the same thing every morning," she said.

Her daily breakfast consisted of two eggs over easy, grits with butter and on alternating days either two bacon strips or two sausage links. That was just breakfast! The look of shock and disbelief on my face must have betrayed my intent to appear non-judgmental about her food choices because she immediately asked, "Why? Is that bad?" So, instead of discussing HIV/AIDS, we discussed chronic disease prevention and solutions for her to adopt a healthier lifestyle. It proved to be a teachable moment.
This teachable moment has broad application to Americans, particularly Black Americans. Despite being inundated with health-related information, marketing and proposed remedies for every possible ailment, we are as unhealthy as ever. According to the Centers for Disease Control and Prevention, Black Americans have the highest rates of preventable diseases and conditions like obesity, heart disease, stroke, HIV, diabetes and cancer. Furthermore, the leading causes of death among Black Americans are all attributable to preventable conditions.

If these diseases are preventable, why are we so unhealthy? The answer to this question is complex yet simple. The simple explanation is that our lifestyles require an overhaul. Regardless of income, class or social circumstances, we each have the power to make improvements in our health. In the same way we obsess about the type of gas that fuels our cars and the quality of the polish that shines our rims or how often we meet the barber or beautician, we must obsess equally about the choices we make that impact our health and longevity.

In our culture of immediate gratification, people generally don't have the discipline required to make a sacrifice now in hopes of achieving an unknown outcome later. And herein lies the burden of prevention. How many times have you heard about a person who suffers a sudden heart attack and upon recovery loses weight and gives up cherished foods after decades of dismissing health warnings and health information?

The human body is a resilient and miraculous machine with a remarkable ability and potential to adapt to its environment. However, the body has limits. Imagine a small car attempting to tow a mini-van. The car can successfully move the van but only at a snail's pace until the motor burns out. This is just like strain placed on the heart of a person with an unhealthy body weight. Similarly, a cholesterol-laden artery is like a traffic jam building at rush hour. It is only a matter of time before the congestion forces every vehicle to a crawl and eventually to a standstill. I see people taking their health for granted all the time--thinking that because they feel fine, they are fine. This is a slight form of self-delusion that likely affects each of us. However, we also have the power to change it by embracing prevention.

Often suggested solutions for implementing lifestyle changes are impractical and don't lead to sustainable behavior change. Here are few suggestions that may help avoid common pitfalls on your journey to wellness and a healthy lifestyle. Reflect on them and consider adopting the ones that are realistic and aligned with your lifestyle and health goals.

Decide, identify and commit. Decide you want to make lifestyle changes, identify your challenges and commit to addressing them. Spend time thinking about what it will take to achieve the changes. If you have attempted lifestyle change before, what obstacles did you encounter and how will you address them this time? Achieving a state of wellness and balance in life does not only mean selecting the salad when you eat out but also ensuring you make time for stress-reducing activities like exercise, quiet time to rest your brain and using every day of your vacation to escape from your mobile devices and other demands.

Establish realistic goals and make changes incrementally. One of the biggest mistakes people make in pursuing a healthier lifestyle is establishing unrealistic goals. Don't set a goal that involves immediate and complete elimination of a food you love. This will make you resentful and equate your new goals with negative feelings like punishment. If you love pizza and eat it four times a week, decide you will indulge only twice a week. If you eat fried foods nearly every day, consider eating fried foods once or twice a week or as part of your Sunday meal. Start slowly. The long-term benefit will far outweigh the mad dash to the finish line that often ends in disappointment and discouragement.

Tell someone about your intentions. Telling a friend or loved one about your intentions ensures that someone can hold you accountable and encourage you to reach your goals. Children are great at this because their honesty will certainly help keep you on track. Tell other close friends and loved ones about your goal(s). Identify a buddy who has similar goals. The support will lift you up and help keep you encouraged and motivated to reach your goals.

Increase your activity. Increasing your activity will boost your metabolism which leads to faster weight loss. Even if you don't enjoy exercise, find a way to increase your activity throughout the day everyday. Set realistic goals for activity. If you never exercise, a goal that involves buying a gym membership and working out everyday is unrealistic. There are opportunities to increase your activity all around you. Take a flight of stairs. Park your car further away from your destination than normal. Speed clean the house. Walk around your block once every day. Turn on your favorite high tempo song and dance the entire duration of the song. Getting started is the biggest challenge. Be creative in finding ways to move. Once you start, the momentum will carry you.

Rewire your mind and educate yourself about food. Rewire your mind to develop a new attitude about food. Our relationship with food is often a root cause for disproportionate rates of diabetes, obesity and heart disease. Be mindful about the foods you eat. Being mindful means thinking about your food choices. Read labels. The ingredients may surprise you. Do you recognize all the ingredients? Don't rely on product marketing to tell you what you need to know about food. Ignore the fancy packaging and study labels to be certain you are aware of the content before consuming food. If you tend to overeat, don't eat alone. Eat with your buddy and monitor each other's portion sizes. Use a small plate and return for seconds rather than starting with a big plate which may cause you to overeat. Eat slowly and enjoy the taste of your food.

Prevention is the road to good health. Stepping onto the prevention pathway and adopting healthier lifestyle behaviors is more effective than any health policy, media or marketing campaign. Remember, regardless of income, class or social circumstances, we each have the power to change our lifestyle by embracing prevention. Decide, commit, educate yourself and enlist support from friends and family. The prevention tipping point and sense of urgency are different for each person. For those of you who are ready to embrace the lifestyle changes, move ahead with determination. For those of you who are not yet ready to make these changes, save this article and return to it whenever you decide. Prevention will be here waiting for you.