Tuesday, January 5, 2016

Making New Year’s Resolutions that Stick

*Photo credit: blog.linkedin.com

All those grandiose goals—lose 30 pounds, cook all of my own healthy meals, etc.—may sound good after some champagne on New Year's Eve, but are they DOABLE?

Yes and no.

We’ve all been determined to improve ourselves in some way, but without setting specific, measureable, attainable, realistic, and timely (or S.M.A.R.T.) goals, there’s often not enough planning to make them stick.

The idea of SMART goals has been around for nearly 35 years. Isn’t time that we made use of them?

An example of a non-SMART goal is:

I will lose 30 pounds.

An example of this same goal transformed into a SMART goal is:

I will lose 1 pound per week for 30 weeks by cutting out 500 calories per day from my diet (3,500 calories=1 pound, 7 days/week x 500 calories=3,500). I will figure out how to do this by using an online calculator to figure out how many calories I need per day to maintain my weight and will then subtract 500 calories from that to come up with my total daily calories. I will make sure that I’m eating 500 calories less per day by using MyFitnessPal to track my calorie intake.

Specific—check
“I will lose 1 pound per week for 30 weeks by cutting out 500 calories per day from my diet.”

Measurable—check
“…using an online calculator to figure out how many calories I need per day to maintain my weight and will then subtract 500 calories from that to come up with my total daily calories. I will make sure that I’m eating 500 calories less per day by using MyFitnessPal* to track my calorie intake.”

Attainable—check
Except for those whose weight maintenance calorie level is very low (e.g. those of us who are vertically-challenged), most people can cut 500 calories per day.

Realistic—check
A healthy level of weight loss for most people is 1-2 pounds per week. More than that is not only not realistic, but can also set you up for a weight yo-yo where you gain back everything that you lose and more.

Timely—check
“…1 pound per week for 30 weeks”

In addition to SMART goals, I find it useful to take lessons from motivational interviewing, health coaching, and the Transtheoretical Model and plan for the following:

  • How will you stay accountable?

o   Solution: enlist a partner in your goal—either someone who also needs accountability in achieving their own goal or someone who cares about you and wants you to succeed.
  • Do you need help to achieve your goal? Identify the help you need and make a connection.

o   If you want to quit smoking, you may need help from a physician to get nicotine replacement and they can refer you to a support group of others trying to quit smoking.
o   If you want to eat healthier or exercise, you may benefit from the help of a wellness coach, personal trainer, or by taking healthy cooking classes. 
  •  What will keep you motivated?

o   Solution: create a list of the reasons you want to achieve your goal and look at it when tempted to go off-track, or post an inspirational picture or phrase where you’ll see it regularly.
  • Envision your life if you are successful at your goal. What will you gain and what will you lose?
  • Identify the things most likely to get you off-track. Plan ahead how you will deal with them.

o   Solution(s): if you snack on junk food, get all of the junk food out of the house. If exercise is part of your goal, get the workout gear for your next workout together immediately after you finish working out and put it in a place that you can’t miss it. This may help motivate you to exercise when your activation energy is low.
  • What will you do if you get “off track”?

o   Create a plan to get back “on track” before you even begin. Modify the plan, if needed, after your first bump in the road.
  • What if you discover that your goal is too difficult (e.g. 500 calories per day is too difficult to cut out)?  Make a “plan B.”

o   Example: Instead of cutting 500 calories from your diet, try cutting out 300 calories from your diet and walking briskly for 30 minutes (burns 150-200 calories) to add up to the 500 calories. Alternatively, just plan to cut fewer calories and stick with your plan longer than 30 weeks.
  • If your goal takes time, how will you make time?

o   We’re all busy, but I believe that whenever we want something bad enough, we can make time to achieve our goals. Stop making excuses and make a plan.

This post highlights the most common mistakes and frustration-prevention points I see with people trying to make positive changes. The above goal setting and achieving tips are not meant to be encyclopedic. The example solutions are meant only to illustrate the point, but many other solutions may be a better fit for you. These tips offer a place to start.

Now, go get started!   


*There are many other calorie and fitness trackers available for free out there. This post is not an endorsement of MyFitnessPal.

Saturday, December 5, 2015

Diabetes Type 2: Facts & Lifestyle-based Treatments and Prevention

*Photo credit www.reviewsmemos.com

The following information is about type 2 diabetes and describes how prevalent the problems is, who should get screened for the disease, and what you can do to prevent or treat it. 

The healthy lifestyle changes described here are healthy for everyone, not just those with or at risk of diabetes.

The great thing about healthy lifestyle changes is that they’re in your hands—no prescription needed! (Though, if you are diagnosed with diabetes and told to take a medication by your doctor, you should.)


Lifestyle changes can help those with diabetes cut down their need for many medications and are always a good idea unless you’ve been specifically told by a doctor not to make them.

I have also included a link to a patient handout that I created with the same information written below in case you’d like to print it out for you or someone you know. Any healthcare professionals reading this are welcome to print the handout and give to their patients free of charge and without asking permission. (If you do use it, please do send a message if you find it helpful!)

TYPE 2 DIABETES: Facts & Lifestyle-based Treatments

What IS diabetes: Diabetes refers to a group of diseases that cause your body to mishandle your blood sugar, resulting in high blood sugar. If left untreated, or not properly treated, high blood sugars can damage nearly all of the organs in your body.

Facts about Type 2 Diabetes:
  • Approximately 1 out of every 10 people in the US have diabetes,1 but
  • More than 1 in 4 people with diabetes (8 million people in the US) don’t know that they have the disease.2
  • Diabetes is the 7th leading cause of death in the US.2

The good news is that diabetes is treatable with a combination of lifestyle changes and other treatments prescribed by your doctor.

For some people diagnosed with diabetes early on, the disease can even be reversed with the lifestyle changes described below!

Who is at risk and should be screened for Type 2 Diabetes?3
  • 45 years old and older
  • Overweight or obese (Body Mass Index of 25 or greater)
  • Anyone with a first-degree relative who has diabetes
  • Those who do not exercise regularly
  • Women with a history of diabetes during pregnancy, who have delivered a baby weighing more than 9 pounds, or who have polycystic ovarian syndrome
  • High blood pressure
  • High cholesterol
  • Vascular or heart disease
  • Anyone with a history of elevated blood sugar or pre-diabetes
  • If you have excessive thirst, frequent urination, blurry vision, extreme hunger or unexplained weight loss. 

How do I get screened?
For most people, all that is required is a simple blood test—you don’t even have to be fasting.

Other conditions that people with Type 2 Diabetes are at risk of:

Depression
Heart disease
Stroke
Vascular disease
Kidney disease
Overweight
Obesity
High blood pressure
High cholesterol
Nerve disease (neuropathy)
Eye disease
Bone disease
Sleep apnea
Hearing trouble
Fatty liver disease
Gum disease
Memory problems
Cancer 

Reversing Type 2 Diabetes & Preventing Complications with Lifestyle Changes
The lifestyle changes recommended to treat diabetes and prevent complications are the same healthy lifestyle recommendations for everyone. Enlist those you care about to make healthy lifestyle changes with you—everyone wins!

1. Eat a Healthy Diet

o   Make ½ of your plate vegetables and fruits (white potatoes don’t count)
o   Make ¼ of your plate whole grains
o   Make ¼ of your plate healthy proteins including beans, fish, nuts, or poultry.
o   Use healthy oils (those liquid at room temperature) and avoid trans fat found in partially hydrogenated oils
o   Drink water, coffee, or tea; skip sugary drinks; limit dairy to 1-2 servings per day.

2. Maintain a Healthy Weight
  • This means that a tape measure around your waist, at the top of your hip bones, across your belly button measures less than 40 inches for men, or 35 inches for women.
  • Alternatively, you can measure your height and weight, then input that information into this online body mass index calculator http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm . A healthy body mass index is 18.5-24.9.

3. Engage in Regular Physical Activity
  • Minimum exercise recommendations are as follows, but you get more benefit by doing even more! 

o   150 minutes of moderate-intensity activity (e.g. brisk walking) per week —OR— 75 min. vigorous-intensity aerobic activity (e.g. running) per week
                                                   —PLUS—
o   Strength training of all major muscle groups 2+ days per week

4. Don’t smoke
  • If you smoke or use tobacco ask your doctor, go to www.smokefree.gov, or call 1-800-QUIT-NOW for help quitting. 
5. Moderate your alcohol intake
  • If you don’t drink, don’t start.
  • If you do drink, women should drink no more than 1, and men should drink no more than 2, standard-sized drinks per day (one 12 oz. can of beer, 5 oz. glass of wine, or 1.5 oz. “shot” of spirits).


1.  C Li, et al. Surveillance of certain health behaviors and conditions among states and selected local areas—Behavioral Risk Factor Surveillance System, United States, 2009. Centers for Disease Control. Surveill Summ. 2011 Aug;60(9):1-250.
 2. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.
3. DK McCulloch, et al. Screening for type 2 diabetes mellitus. Up-to-Date, Literature review current through Sept 2015. http://www.uptodate.com/contents/screening-for-type-2-diabetes-mellitus?source=search_result&search=screening+for+diabetes&selectedTitle=1%7E150#H18058884

Chef Michelle Hauser, MD, MPA © 2015