Ringing In a Healthier New You

Jan. 1, 2009 — -- Change was the campaign theme of Barack Obama's successful presidential bid in 2008 and it might be the mantra for your health behaviors as 2009 rolls in. But, unlike Obama, many Americans will not succeed in achieving the often unrealistic goals that accompany a New Year's resolution.

So should we be lowering our expectations?

The first day of the new year represents a natural transition point in life that presents an opportunity to look back on the past year and look forward, said Mark Reinecke, chief psychologist at Northwestern Memorial Hospital in Chicago.

People make New Year's resolutions to give themselves a sense of focus and a hopeful vision that's different and better than the way they perceive themselves now, he said. But where they run into trouble is when they set the bar for their resolutions too high to be attainable.

If you want a better shot at making resolutions stick, set modest, reasonable goals to begin with. In addition, have a plan in mind for how you will accomplish them, and anticipate obstacles along the way, such as bad weather and scheduling conflicts, and determine in advance how to handle them. "A goal without a strategy is unattainable," Reinecke said.

Be sure you have social support in place to encourage a new behavior, so you're not attempting difficult lifestyle changes on your own and will remain accountable for your actions.

"Look for ways to make simple changes in your life that make healthier choices easier to pursue," Reinecke said.

To give you a head start, here are some tips from the experts in four common categories for resolutions: weight loss, exercise, smoking cessation and better diet.

Getting or Staying in Shape

Many a couch potato or on-again, off-again exerciser resolves to be more physically active at the start of a new year. And they're gung-ho and motivated at first, only to wind up with sore, aching muscles after a workout or two. They try to jump back into their fitness program where they last left off, rather than starting off slowly and easing back into it.

"People haven't gotten away from the 'no pain, no gain' mentality," said David Williams, a staff psychologist at Miriam Hospital and an assistant professor of psychiatry and human behavior at the Alpert Medical School of Brown University in Providence, R.I.

Another reason people might set the fitness bar too high is that they are so crunched for time during the day that if they're going to exercise, they want to do something intense to "make it count," Williams said.

Often, he said, this causes people to end up dreading their workout: "They feel good to be done with it, not to be doing it."

Instead of dreading the experience, Williams recommended that you find a mode, intensity and setting so you're not averse to exercise.

For a person who has been a couch potato or somewhat sedentary (which is the category into which 60 percent of Americans fall), find a starting point for exercise that's doable -- even if it's a five-minute walk on your lunch hour, three times a week. Start small, do it regularly, and build from there.

Instead of feeling like you need to walk at a particular pace, just get out there and put one foot in front of the other. In other words, do something active rather than nothing at all. Focus less on the intensity of the effort, when you're just starting out or getting back in shape again.

Focus instead on being consistent and being active, no matter how small the effort. Over time, you'll increase your fitness by virtue of doing something and your level of intensity might naturally increase as well, Williams said.

Be Realistic About Exercise

For the yo-yo exerciser, who jumps on and off the fitness bandwagon, aim to find an activity that's realistic for you to do so you can slip into a routine. And if you get sick or take a vacation for a week or two, you get back into it without feeling as though all of your previous efforts are wasted or your progress is gone.

If you've just enrolled in a health club, commit to going twice a week at first rather than shooting for five days a week. Once you've been regularly sticking to your twice a week goal and feeling good about yourself as a result, see if you can work a third visit into your schedule.

And for those who are avid gym-goers or regular exercisers, keeping things fresh will likely help keep you at it. Whether that means dabbling with a new activity, adding some strength training to your aerobic workouts, or setting a performance-oriented goal, this will help keep your motivation alive, not to mention all the mood-boosting, calorie-burning benefits you're already getting from your regular workouts.

Shedding Unwanted Pounds

It's not unusual for Dr. Robert Kushner, medical director for the Center for Lifestyle Medicine at Northwestern Memorial Hospital in Chicago, to hear the lofty, grandiose "I need to lose 50 pounds" resolution.

But these kinds of goals are too broad and too long-ranging to be successful, he said. Although it's fine to have a long-term view, what's important is targeting short-term, practical, and manageable sub-goals to help you get there, Kushner added.

Kushner encourages his weight-loss patients to "focus on what you need to do today, tomorrow and next week to reach your sub-goals."

And be specific. If your ultimate goal is losing a particular number of pounds, spell out the actions you'll take to get you there. This could mean clearing out the house of any foods you tend to overeat, like candy earmarked for "the grandkids." Or it could mean committing yourself to walking three times a week after dinner.

Kushner recommended taking an inventory of your current eating and exercising habits, and also noting the stressors that might cause you to overdo it. Then he said to ask yourself the question, "What do I want to accomplish?" Depending on your habits, your responses might be "I need to start eating breakfast," or "I need to get more physical activity."

Circle a few items that appeared on your list, so you have a place to start. Then engage in those lifestyle changes.

To enhance your success, monitor and track your diet and exercise changes with pencil and paper or via the Internet and also by weighing yourself once or twice a week. Another way to elevate your enthusiasm is by joining a commercial weight-loss program at your work site, or a local church or community center.

No matter which route you choose, "know yourself and set yourself up for success," Kushner said.

"Shape your environment so that it's easier for you to make behavior changes, don't just depend on willpower," he said.

Have healthy foods and snacks readily available at home and at work, so you can control what you consume. When dining out, although you can't control the restaurant, you can control what and how much you eat when you're there.

Tracking is another important component of successful weight loss, Kushner explained. "When people fall off the weight-loss wagon, it's often because they stopped tracking what they were doing and stopped weighing themselves."

Making Smarter Food Choices

Because people often feel bad about overdoing it in December, they may feel guilty when January 1 comes along and seek to aggressively change their eating habits, said Keith Ayoob, an associate professor at Albert Einstein College of Medicine in New York. "But they get too ambitious and don't realize that making permanent changes are hard."

Don't Punish Yourself

Another common mistake he sees is that people focus on what they will eat less of and not on what they will eat more of or what is missing in their diet. Changing eating habits then feels like punishment if people are giving up their favorite foods.

This ultimately ends up in the dieter feeling deprived and resentful of a new style of eating so "all hell breaks loose."

A better approach is building in small amounts of a favorite food to keep you on track.

"Ban the concept of forbidden foods," Ayoob said. Think instead, "all foods are okay, but not all the time and not in all amounts."

Another weight loss pitfall is that people want instant results and make goals that are too general and lofty, like "I want to eat better."

Ayoob will try instead to pin the person down to a small gradual goal and suggests giving yourself simple things you can do for a month to achieve that result.

"Slow and steady wins the race" is Ayoob's philosophy for lasting lifestyle changes. For example, most people, he says, need to eat more fruits and vegetables each day. He advises patients that they don't have to get to this end point all at once, do one thing at a time. Add an extra piece of favorite fruit each day, for starters. Make sure there's at least one vegetable at dinner -- every night.

Ayoob also suggests getting organized about food shopping and chopping, and working to ensure food preparation is fun and meals involve the family.

Kicking the Habit in '09

With the holidays behind you, the new year is a great time to quit smoking, and millions of Americans will attempt to do just that.

"There's a psychological benefit to starting off a year fresh, and a little more of a commitment on people's part -- at least for the first week or two," said Dr. John Spangler, director of tobacco-intervention programs and a professor of family medicine at Wake Forest University School of Medicine in Winston-Salem, N.C.

Successful quitting entails both a motivation and a desire to break the habit.

"When I talk to patients about why they want to quit or whether they're ready to do so, I often hear comments, such as 'I want to, but I'll miss it' or that 'smoking is my best friend,'" Spangler said. "For many people, smoking has been a companion when they're bored or stressed, so quitting means ending a long-term relationship they've had their entire adult life."

If you're not ready to give it up entirely, Spangler says you can take some small steps to move you closer to quitting. These might include delaying that first cigarette of the day, or cutting down on the number smoked or not smoking immediately after a meal.

To have your best bet of succeeding, you need to have a plan for how you will quit. To create such a plan, Spangler recommends writing down all the reasons you want to quit. Next, write down your trigger times or those situations when you might automatically reach for a cigarette.

A third step is to think through a solution or strategy for what you can do instead of smoking when faced with a trigger situation.

As Spangler puts it, not smoking is like a war on two fronts. On the one hand you have the addiction center in your brain screaming, "I want a cigarette." And on the other hand, you have the environmental cues, in which smoking becomes the automatic response.

"It's easier to deal with the trigger situations, if you have the addiction center under control," Spangler said.

Medication can help treat the addiction, while coping strategies help tackle the triggers, he suggests. "You need to develop new habits for every single trigger."

This might mean reaching for a breath mint instead of a cigarette, drinking tea in the morning rather than coffee, or counting to 10 when feeling stressed or angry.

Of course, you need to set a quit date within the next week but on day eight, if you're using either of the prescription medications, Chantix or Zyban, that helps trick the brain into not wanting to smoke.

He also suggests telling friends and family for support, and finding one person with whom you'll feel accountable to go to when times are tough. "It's better to find a cheerleader rather than a drill sergeant," he said. "You want someone who will not shame or scold you, if you slip up."

Another key step is buying nicotine replacement products, whether it's a patch, gum, inhaler, nose spray or lozenges. Such products, according to Spangler, double your success rate.

There are toll-free quit lines available both nationally through the National Cancer Institute (1-877-44U-QUIT) and at the state level (1-800-QUITNOW) with counselors who can offer advice to help you problem-solve and strategize.

And change your environment as much as possible to avoid temptations and triggers. If you had a favorite chair you smoked in, rearrange the furniture. Ask friends not to smoke around you or offer you cigarettes.

Throw away all of your cigarettes, ash trays and lighters. Toss out all of your visual reminders of smoking.

People have to learn the skills to be nonsmokers and that takes time and practice, Spangler said. "The best way to learn how to be a nonsmoker is to keep trying," he said.

What Resolutions Are the Experts Making?

The experts interviewed for this article struggle with the same lifestyle changes that all of us do, and many have resolved to make a few tweaks in their own habits in 2009.

Spangler plans to exercise more, and will enlist the help of his daughter to take a walk with him after dinner. As a father of six, he needs to get the support of his wife and also recognize how this will impact other members of his family.

Kushner said that although he's good at fitting in his aerobic workouts, he wants to increase his resistance training. His goal is to do 10 to 15 minutes of strength training at least two nights a week.

Williams, who describes himself as a yo-yo exerciser, said he hopes to start back up again. He'll shoot for simply 10 minutes a night on his home elliptical machine, at least five times a week.

Ayoob admits he has to work on staying motivated to be physically active, but said his greyhounds' need for regular walks prevent him from being too lazy.

And, like millions, Reinecke wants to lose a little weight and stick with his exercise program. Reinecke prefers to run outdoors, but he has made some simple changes in his indoor fitness program: Instead of running on his treadmill, he said he has slowed it down and steepened the incline. That way his knees don't hurt him and he still gets a good workout.

Armed with their knowledge of setting small attainable goals, here's hoping that these experts achieve their health resolutions in 2009. And that you do, too.