My Plan For Health

From Shelly Dembe's Web site, A Healthier Balance

Happy Thanksgiving, everyone!

This blog has given me a lot to be thankful for. I’ve learned that I can make changes in my life at age 39 that make me feel better and help me enjoy life more. I’ve discovered that there are many resources at Ohio State to help me accomplish my goals.  I’ve had the chance to write about health and fitness for the first time in years. And I’ve enjoyed the support of so many people across campus — including those who notice when I don’t post updates for a while. For that I am thankful indeed!

But this year, the thing that I am most thankful for is dancing.

I’ve been studying belly dance at Habeeba’s in Grandview, and yoga dance at Ohio State through Lunch & Learn. The classes are very different — Habeeba’s technique is very controlled, while yoga dance is about moving however your spirit takes you.

Habeeba's dancers at the Upper Arlington Labor Day Arts Festival 2009

Yoga dance teacher Shelly Dembe, RN, tells us to “move like no one is watching.” There is just something about Shelly. She can get a roomful of self-conscious people to open up and dance as if we’ve been doing so all our lives. Her class is the most fun I’ve had since kindergarten.

“Think about how you felt when you got here,” she said to me after class, “and how you feel now. That’s what it’s all about.” She’s right — I always arrive tense from the office, and leave relaxed and buoyant.

Belly dancing has been a different experience. The class has been difficult, and I must have quit and unquit dozens of times early on. Now I love it and can’t imagine not doing it.

Me dancing on stage after the show. It's the shades that make the look.

I worked backstage at a Habeeba’s performance at the Upper Arlington Labor Day Arts Festival, and one of my teachers even pulled me onto the stage afterwards. More recently, after we’d just finished learning a new move in class, teacher Sharon Buhrts got me to think about how far I’ve come. “When you got here, you were afraid to move your arms,” she said, “and now look at you!”

I turned to Susan Van Pelt Petry, professor and chair of the Department of Dance at Ohio State, for an academic perspective on all this fun I’ve been having. The following text is from our email Q&A.

Enjoy, everyone, and have a healthy and happy Thanksgiving. Dance with those you love — to burn some holiday calories, and let your spirit soar.

PFG: Do you have any advice for people who are pursuing dance for fitness, such as myself?

Susan Van Pelt Petry

SVPP: Find a teacher who has some dance credentials - either a degree in dance, professional experience, membership in a professional dance organization, etc. Notice if the teacher communicates instruction about movement with clarity and anatomical awareness. They should be able to address things such as how to protect knee joints, how to develop core strength so the back is not at risk of injury, and how to pace a class for appropriate levels of muscle fatigue, stamina building, warmth, and flexibility.

A dance class should have an aesthetic component – it is an art form and one of the reasons it can be an attractive way to “exercise” is that it has that very quality of the mind that makes moving a pleasurable, engaging activity, and not just something to check off your list. Seek an experience where you feel the quality of your body and moving changes, where there are sensations of lightness, resistance, speed, etc. and not just the making of exterior “shape.”

PFG: I am taking two dance classes right now — belly dancing and yoga dance. The form of belly dance I’m studying is Habeeba’s, which is largely based on ballet, and thus very structured and controlled (and up on our toes!). The yoga dance is unstructured, freeform. I enjoy both very much! Can you tell me — what different benefits might I gain from the structured dance versus the unstructured?

SVPP: More structured classes teach dance “vocabulary” and instruct in the building blocks of a style. Often the style will have a cultural or historical context and that can be a very interesting and satisfying experience. In a more structured class one might be able to assess one’s progress quite clearly, as skills get added as you progress through movement sequences. In a less structured class, such as an improvisation group, or some forms of modern dance, or hybrid styles such as “yoga dance,” you have the advantage of learning more perhaps about yourself and you learn how to observe your movement from inside and not from outside instruction. In a less structured class there is often a higher degree of creativity, and that can be very fun. There might be less physical rigor as it is more self-driven.

PFG: Dancing is uplifting, psychologically. For instance, I’m more confident and I don’t mind wearing more revealing clothing (especially while I’m belly dancing — it helps me see my moves in the mirror, right?). The yoga dance is uplifting because it’s just wild and crazy and fun. Would you have any comment about how dance has been uplifting for you personally? Do you find that many people (dilettantes such as myself) get this kind of emotional boost from dancing?

SVPP: Absolutely! Very uplifting. Dancers even joke they get addicted to it…. And there are studies that show there is real brain chemistry that changes as exercise, music, and expression conjoin for powerful rise of seratonin levels. I am at my desk a lot more these days, and I do feel fundamentally somewhat diminished without dancing as much as I used to.

I've updated my data page.

It’s the start of a new quarter, so I wanted to post an update on how my health is evolving. You’ll see a review of summer quarter on my data page.

The good news is, I’ve lost 17 pounds so far this year.

The (bad? neutral? other?) news is that I lied about how much I weighed when I started this venture.

Well, maybe not lied in the strictest sense. If I may reveal my Catholic upbringing for a moment, I would tell you that it wasn’t a lie of commission so much as a lie of omission.

The truth is, I didn’t know exactly how much I weighed when I started, because I didn’t want to know. I guessed 240 lbs. as a ballpark figure.

So when I weighed in at 231 lbs. at a checkup last month, I thought I’d lost 9 lbs. in total. Not bad, but not as much as I wanted for 9 months work. Then my doctor congratulated me on losing 17 lbs. and asked me how I did it. I didn’t believe her at first, so she turned her computer monitor to me and showed me my chart. I weighed 248 lbs. in January (a weigh-in in which I distinctly remember looking away from the scale and sort of humming to myself, while asking the nurse not to tell me the number) and 231 lbs. in September.

So then I had the conundrum of wanting to brag about losing 17 lbs., but having to admit that I was 248 lbs. at the start.

Here it is, out on the table. I lied. Lied lied lied. There you have it.

Other changes are afoot… Though my weight has stayed the same since last month, my clothes are still getting looser, so I think (hope) that maybe my body composition is changing. People keep telling me that I look slimmer, but I’m not certain whether they are just saying that. This morning my husband told me I look “more hourglass-y,” which is a good thing.

I know that I would probably get healthier faster if I changed my eating habits, which I have not done at all this year. I’ve just been working out a lot and hoping for the best. Steven Devor, associate professor of exercise science, offered to give me a little nutritional counseling some time ago — and I’m aware of formal nutritional counseling programs at Ohio State — but I’m having trouble getting past the “I don’t want to” hurdle.

C’est la vie.

This week, New York Times science writer Tara Parker Pope announced that she is going to keep a decades-long promise to herself, and run the New York City Marathon. As a former runner who is trying to get back into the sport, she’s worried about injuries. The lessons that she’s learning along the way are valuable for anyone who’s starting an exercise routine.

Her Tuesday post offered some words of advice from Olympian and marathon trainer Jeff Galloway:

The key to injury prevention is to start slow and continue to take frequent walk breaks during the weeks of training and the marathon itself… The first step for any new runner, he says, is to just get out there two or three days a week for about 30 minutes. Don’t try to run the whole time — that’s how new runners get injured. Decide what run-walk combination works for you.

But for me, the words that resonated the most came from Olympian and marathoner Kara Goucher in yesterday’s post:

Q: What can someone planning to run a first marathon learn from an elite runner like you?
A: I’m going to train at a different level than an average runner because I have the time to and the resources to, and that’s my job. But I can relate to your average runner absolutely. You just have to scale everything and put it in perspective of what you’re trying to accomplish. You’re asking a lot of your body no matter how fast or far you’re going. Running is something that hurts. It’s a wonderful thing. It’s a gift in my life. But it’s painful, and it hurts and takes a lot of time. Have patience. Stick with it and don’t expect results overnight.

Since I broke a foot while jogging two years ago, I’ve been terrified of it happening again. I do not jog, and the hardest surface I will walk on for exercise is blacktop. I wear cushy shoes and cushy socks and tape up my feet and — for the most part — stick to the elliptical machine. But there are other things I can do to avoid injury, as Galloway suggests:

Q: One of the big worries of new runners is getting injured. How do you deal with injury concerns?
A: I’ve had lots of injuries, stress fractures, shin splints, compartment syndrome, I banged up my knee. I know what it’s like to be hurt. In my running I’ve incorporated a lot more weight lifting and drills that give my body overall more athleticism. I think that helps prevent injuries. If you only have 30 minutes to work out, sometimes it’s more important to run 20 minutes and take 10 minutes to stretch and do weights and build your overall athleticism. I think that will keep you healthy.

This is very similar to the advice that my trainers have been giving me in the Faculty and Staff Fitness Program. To balance out my fitness routine, I’ve scaled back some calorie-burning activities to make room for ones that build muscle, flexibility, and endurance.

Justin Dials of PAES puts me in the BOD POD.

As it turns out, my earlier body composition testing was a little wonky. In March, Rebecca Nguyen, manager of the Faculty and Staff Fitness Program, measured the amount of fat on my body with calipers, warning me all the while that calipers are, in fact, one of the least accurate tools for doing so.

That test determined my body fat percentage to be 39.9 percent and my lean weight — the weight of the non fat portion of my body (my bones, muscles, and organs) — to be 144 pounds.

Now, I may be 5′8″ tall, but 144 pounds is a heck of a lean weight. Either I was truly dense as I had been joking all along, or something was a little off.

This week, I had a chance to go back to the Exercise Science Laboratory in the School of Physical Activity and Educational Services and sit in the BOD POD — one of the most accurate devices available for measuring body composition. It was a high-tech and fun experience, and I had my results instantly.

The BOD POD works by measuring a person’s weight and volume, explained graduate student Justin Dials. Then a computer uses that information to calculate body composition.

"Yes, I see... Mmm-hm."

I stood on an electronic scale for the weighing part, and then sat in a cool space-egg pod contraption for the volume part. Special electronics inside the egg measured how much air my body displaced to obtain my volume. This involved some air pressure changes inside the pod, and my ears popped a little. It kind of felt like being on an airplane. Kind of loud like being on an airplane, too.

Seconds later, I had my results: 50.3 percent fat, 122.6 pounds lean weight. That, sadly, makes much more sense.

I will also say that the supposedly highly accurate electronic scale weighed me many pounds heavier than my scale at home. Therefore I will completely disregard my weight as measured by the BOD POD and pretend that it doesn’t exist.

Rebecca agreed with me that what’s important is to always weigh yourself on the same scale, and look at the change in weight, not the specific number. So I’m going to stick with my scale at home, which currently shows that I’ve lost five pounds.

Let’s try that again:

I LOST FIVE POUNDS!

Yeah, that looks better.

And if you check out my new data page, you’ll see that I received some other good news, as Rebecca re-measured me: I’ve lost nearly two inches around my hips. Woo-hoo!

My fitness evaluation from the Faculty and Staff Fitness Program.

I got the results from my comprehensive fitness evaluation from the Faculty and Staff Fitness Program (FSFP)!

Matthew Garver, a doctoral student in health and exercise science, explained my results in detail, and gave me an “exercise prescription” that will help me lose weight and meet my goals.

Not surprisingly, I earned a rating of “below average” in all categories, except one: flexibility. For that, I rated “average.”

Let us pause for a minute and appreciate the fact that I am, in one sense at least, average. Yay!

Now, onto the things I need to improve.

VO2max: This is a measure of endurance, and it’s why I took the stress test on the treadmill. Specifically, VO2max measures how well my body utilizes oxygen in milliliters of oxygen per kilogram of my body weight per minute (ml/kg/min). Professional athletes can use as much as 70 ml/kg/min; a young woman with no athletic training who is otherwise healthy might might use 38. (For men, the corresponding number would be 45.)

VO2max decreases with age, and since I’m 38 years old, I wouldn’t expect to have the same VO2 max as a young woman. But I did rate a lot lower than I’d hoped: 24.5. Matthew explained that, as I lost weight, this number would increase, since I’d be dividing my milliliters of oxygen by a smaller number of kilograms.

As to body composition, this was a measure of my percentage body fat. For women, a body comp over 32 percent is considered obese. (For men, the corresponding number would be 25 percent). I scored 39.9.

All I can say is that I’d rather have a body comp of 39.9 than a body decomp of 39.9. (Those of you who watch Law and Order or CSI know what I’m talking about.) But I need to bring that number down. As Matthew explained, I am at a higher risk for chronic diseases such as cancer, coronary artery disease, hypertension, and diabetes if things stay as they are. He suggested that I work toward a percentage of 20-25.

I was surprised by his estimate of my “lean weight,” however. This is a measure of the non-fat portions of my body, i.e. if it were possible to remove all fat from my body, how much would the leftover bone, muscle, and organs weigh? My lean weight was 144 pounds.

I’m 5′8″ tall, so I guess this makes sense. But if I had a 25 percent body fat on top of a 144 pound frame, I would weigh 192 pounds! Not so long ago, after my initial major weight loss, I weighed 180. And I felt huge! I felt like I needed to lose at least 20 more pounds. But if I did weigh 160, that would give me a body fat percentage of 10 percent, which is normally something only professional athletes attain. Bizarre.

So I guess if I could get back to 180 pounds (which would mean 20 percent body fat), I should be really happy.

See, I told you. I’m just really, really dense.

Lastly, Matthew explained my muscle strength, which is the force I was able to generate during the arm press and leg press. It’s given as a ratio of pounds I could press divided by my weight. I was able to press 80 lbs with my arms, and 130 lbs with my legs. That means my upper body strength ratio was 33 percent, and my lower body strength ratio was 54 percent.

I really had no idea what those numbers meant, but I was able to badger Matthew until he conceded that the average person off the street who’d never lifted weights in their life would probably score about the same as me. “I mean, it’s not like I’m some kind of weakling or something, right?” I asked. He kindly agreed with me.

The FSFP gym.

He suggested that I aim toward at least doubling those numbers, so my upper body strength goal is 60-70 percent, and my lower body goal is greater than 100 percent.

I won’t be weight training right away, though. For now, I’m supposed to focus on aerobic exercise. Matthew pointed me toward the elliptical trainer, stationary bike, and rowing machine in the FSFP gym as good places to get started. He recommended that I try for 30-40 minutes of aerobic work, most days per week. That’s about what I’m doing now, so I’m feeling pretty good about that.

Nowhere to go from here — but up.

My PHA score

Today I took the YP4H Personal Health Assessment (PHA) test online. The results were not entirely what I expected, but I give a “thumbs up” to the new test, as administered by WebMD. I took the original test when it first became available in 2007, and the WebMD system is certainly snazzier, complete with colorful graphs and animations.

After that initial PHA test, I never went back to the old YP4H Web site.  Ideally, we should all take the test at least once a year, in order to update it with our most current health data (weight, cholesterol, etc.). I’ve heard that I’m not the only one to slack off, and that fewer Ohio State faculty and staff have taken the test every year since it was first offered.

This is sad news, for several reasons. YP4H is, after all, an incentive program, meaning that by participating we earn a discount of $15/month on our health insurance premiums for the year. Who doesn’t want a discount? The healthier we are, the lower the healthcare costs for the university and for ourselves. So everybody wins. Plus, we get to enjoy better health, which, as my colleague Emily Caldwell said to me the other day, is “kind of a gift in itself.”

Gretchen Feldmann is the communications director for YP4H, and when I first started this blog she offered to help me with any info I needed. So I’ve asked Gretchen to give me the stats on how many employees have taken advantage of the PHA test each year. I’ll let you know what I find out.

Now that I’ve taken it again, I am impressed with the test’s ease of use, and the clarity with which it explained my results.

After a few pages of simple health questions (some of which I had to leave blank, because I just didn’t have the data, such as my most recent cholesterol numbers), an animated box displayed my PHA health score: 65. My peers (women aged 30-39) had an average score of 80, it read.

Below that were a set of sliding controls, where I could adjust the key risk factors that affect my health, and see how those adjustments would change my score in the future. Apparently the test indicated that I was highly stressed ["Who you callin' stressed?!?! Grrrr!!!"] and overweight. So it recommended that I reduce both stress and weight. I saw that by dialing down both of those factors, I could raise my PHA score to something as good as — or better than — my peers.

My risk factors, in an adjustable graph

It also showed me how health changes could reduce my risk of developing certain health conditions. As I dialed my weight up or down, animated graphs showed how the risks changed. For instance, here is my risk for developing a musculoskeletal condition now:

…And here it is after I’ve reduced both my stress and weight to the lowest levels possible on the graph:

I suppose a livable reality is somewhere in the middle.

I wasn’t surprised to see that stress affected my chance of developing a musculoskeletal disorder. I’d already learned from working with Bill Marras, director of the university’s Biodynamics Laboratories and our newest member of the National Academy of Engineering, that stress can lead to back injury. When we’re stressed, we use our muscles differently than when we’re relaxed — and we inadvertently increase the forces on our spine.

I was a little surprised to see that one year of messing around with cigarettes in my youth [Hey, I was a good kid, and just wanted to do something "bad" before I was too old to be stupid.] apparently means that I am at high risk for developing lung cancer for the rest of my life:

There appeared to be no way to adjust my risk factors to reduce my lung cancer risk. Ever. That doesn’t seem right to me.

I get lots of exercise. Ha! Take that, peers!

The test also offered “condition reports” and “risk reports” which detailed my results in plain language. Much appreciated! For instance, I read:

Congratulations, Pamela! Your exercise and strength training routine currently meets national health standards for the recommended total minutes of exercise in a week.

Woo-hoo! I had told it that I do aerobic exercise for 30 minutes, six days a week. This is a bit of an underestimate, since water aerobics takes up most of an hour, and I do that three times a week. So I get lots of cardio. The one thing I don’t do is strength training, e.g. weight lifting. ‘Cause, really, who needs strength training, right? I kept reading…

However, national guidelines say that the best exercise routine is a combination of both aerobic and strength-training activities.

Uh, oh.

You reported that you currently do aerobic exercise 180 minutes a week and strength train 0 minutes per week… To optimize your health, you should aim to meet the requirements for both aerobic and strength training in your routine.

Sigh. Ah well. I have joined the Faculty and Staff Fitness Program, and will have my first physical assessment next week. After that, PAES faculty and staff will give me advice on how to design an exercise program that will most benefit me. Why do I think they’re going to mention strength training?

Thanks to everybody who has offered such kind words of encouragement since my first post appeared in onCampus two weeks ago. I knew I wasn’t alone in my desire to live healthier lifestyle, and your emails and comments have confirmed it.

The word everyone keeps using is “brave” — as in “You’re so brave to do this.” What everyone seems to find brave is the public admission that I am overweight, which is a little perplexing. I’ve only admitted the obvious. The fact that I reported my actual weight seems to have astounded people as well. Didn’t Joy Behar say on “The View” that she’d have to be water boarded before she would admit her weight? And yet she appears to be quite fit. So what’s the big deal? It’s as if we fear the numbers themselves. We don’t know exactly what anyone else weighs, so we’re not going to admit our own weight, just in case we’re heavier. Our fear keeps us ignorant of how fit we are, and how fit we can be.

So this is what 240 pounds looks like. To those of you who’ve said that I don’t look like I weigh that much, you’ve discovered my secret: I do, in fact, contain an infinitely dense singularity that warps time and space. But really, I still need to lose a few pounds.

So please don’t call me brave. My friend in the Army who’s guarding the Demilitarized Zone in Korea is brave. I’m just a chick who’s trying to lose weight, so let’s keep some perspective. I happen to have a job that gives me access to the research and the experts I need to form a healthy life plan, and I happen to be in a position to write about it. Writing is what motivates me, so I’m taking advantage of writing to achieve my goals. It’s all self-serving, really.

Yet your comments and emails have shown me that I’m not alone. Many of you have shared your personal struggles, and your desire to find answers. I encourage you to not only read this blog, but leave comments and questions. Tell me what you want to know, and I’ll do my best to find out.

On the Saturday after Christmas, I leaned on my cart in the Kroger checkout line in a post-holiday stupor. Then the January issue of O, the Oprah Magazine caught my eye.

There on the cover was Oprah, weighing 200 pounds. She stood next to an image of herself from four years ago, when she weighed 160. The pain shone in her eyes. “How did I let this happen again?” she asked.

I bought that issue — my first ever — because I have been asking myself the same question.

Only I didn’t lose 40 pounds and then gain it back, like Oprah. I lost 100, and gained back 60.

Don’t feel sorry for me. I’m not sad. I’m angry.

Back in 2004, when I weighed 280 pounds (yep, do the math: I’m currently at 240), I decided to try to lose weight in a new way. I’d played around with diets before, but this time I took advantage of university resources and utilized my science writing skills. I approached weight loss the same way I approach writing a story: I read the scientific literature (journal articles on weight loss, nutrition and motivation), I consulted experts (my doctor and a personal trainer, both here at Ohio State) and I formulated a plan.

Two years later and 100 pounds lost, I thought I’d won.

Now, as I face the task of doing it all again, I’m feeling a lot of things — anger, guilt, determination … and just a tiny bit of relief. Because this time I have a tool that I didn’t have before: Your Plan for Health (YP4H).

For me, YP4H couldn’t have come at a better time. Now I will have a host of professionals to help me develop a comprehensive healthy life plan that will stick.

I’m going to follow YP4H. And as I learn new things and make healthy changes, I’ll report them in a personal journal, which I’ll open for the world to see.

So why am I doing this? Oprah is publicly chronicling her own efforts to lose weight, but I’m no Oprah. The idea of trying to lose weight in such a public way scares the bejeezus out of me.

Then again, I’m counting on it to scare the bejeezus out of me. Because I can’t let myself fail if it means failing in front of all of you.

My promise to you:

• I will follow YP4H to the best of my ability for the next year, with the understanding that I am only human, and there will be setbacks. I will report the good times and bad.
• will get out there and try as many of the fitness facilities, wellness programs and classes as I can, and review them honestly. If I see something I like, you’ll know it. If I see something I don’t like, you’ll know that, too.
• I will apply the same standards to this journal as I do to my research stories. I will talk to Ohio State researchers about their latest findings, and I will discuss how those findings apply to real life.
• I will eat real food. No fad diets! I will not eat a bowl of twigs for dinner with dressing on the side. There will be pizza. Oh, yes, there will be pizza.

Wish me luck.