My Plan For Health

Have you taken the RealAge quiz online, which supposedly tells you your “biological age” based on your health?

Science writer Tara Parker-Pope of the New York Times takes issue with RealAge, and points readers to a better quiz:

My problem with the RealAge quiz is its lack of scientific validity. The notion that health behaviors can translate into a meaningful “biological age” is just marketing hype, not real science.

A better health quiz is Your Disease Risk, a useful set of questions to help you determine your risk for diabetes, several cancers, heart disease, osteoporosis and stroke.

It might be worth taking the Your Disease Risk quiz, to compare the results to the Your Plan for Health PHA.

YP4H welcome screen

Gretchen Feldmann, YP4H Communications Manager, gave me lots of great information about the PHA test. Here’s what I learned:

Since the YP4H program was launched in 2006, approximately half of the 25,000 Ohio State faculty and staff have taken the PHA. In 2008, 37 percent took it. Those are good numbers! When I think of all my fellow employees and how busy we all are, the fact that half of us made the time to take the test is wonderful.

Based on those numbers, I gather that I was among the 13 percent (or so) of people who took the test in prior years, but didn’t take it in 2008. I can’t speak for the others (most of us probably just forgot, right?) but I just didn’t want to look at the numbers, you know?

Here’s why the PHA is the best place to start your YP4H experience, according to Feldmann:

…[W]e have designed the PHA so that it serves as a “gateway” into the YP4H initiative. In other words, employees need to complete their PHA in order to participate in the Incentive Program and to take advantage of the health coaching services. Additionally, by completing the PHA, their yourplanforhealth.com experience will be much more robust because the platform is designed to give an employee a truly customized experience (i.e. the more information they enter, the more customized the site will be for them).

I can testify to that; since I took the PHA, the Web site has started offering me specific health information based on my goals and my family medical history. My next steps, including biometric screening and health coaching, are clearly spelled out for me.

Here’s what she said about how often we should take the test:

Re: when employees should take their PHA, we communicate to employees that they should complete their PHA (the online questionnaire – some employees are still confused in thinking that the “PHA” means the biometric screening) once a year. The reason is two-fold: 1) to get an annual pulse on their health condition (i.e. Did their health improve? Are there other health indicators to be concerned about?, etc.); and 2) to lock in their premium reduction for the following benefit year. Completing the PHA is not a one-time event – it’s an annual event. Employees can certainly log in and update their PHA throughout the year as they lose weight, get off medications, etc. in order to generate a new personal summary report.

That’s my plan. If knowledge is power, I can’t avoid looking at the numbers any more.

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?

Hi — sorry I didn’t have time to post this yesterday, but RPAC is offering all its fitness classes for free this week (finals week, 3/16-3/20).

I called the RPAC welcome desk to ask whether you have to be a member of RPAC before you can attend the “free classes,” and the answer is yes — you have to be a member first. You cannot simply buy a day pass to attend a class. It seems unreasonable to me that you would have to commit to a full membership before you could even see whether you liked any of the classes.

RPAC offers indoor cycle classes

But if you are already an RPAC member or want to join right now, feel free to check out the classes this week. For faculty and staff, the cost is $115/quarter, $437/year.

Given my interest in water aerobics, FSFP water aerobics instructor Ya-Ting suggested that I try RPAC’s H2O Challenge class Thursday evening. She describes it as more intense than her class. Here’s the RPAC description:

Looking for a challenging cardiovascular workout minus the impact of a floor?  Stop looking! H2O Challenge is a mixed intensity workout designed for all levels. Within varying depths (4ft to 9ft), the participant is instructed through a range of movements that create resistance work with a cardio focus.  Noodles, water belts, water dumbbells, and water paddles give the participant an extra challenge, as well as extra comfort, when working in the water. No swimming experience is necessary, but very welcome! The option to remain in shallow water the duration of the class is certainly encouraged to those who do not feel comfortable in deeper water.

As it turns out, Thursday night I’m otherwise engaged (book club — hey, I’ve got priorities).

I’m still waffling on whether to join RPAC. I already have a membership at the Center for Wellness and Prevention, and I have also signed up for FSFP. But I’ve worked out at RPAC practically every day for the last three weeks (via a short-term membership), and I’m starting to really like it.

I’m also starting to feel a little stronger and a little more energetic — when I’m not curled up in a little ball moaning about how sore I am.

Liquid courage?

Last night, I headed to RPAC to try the cardio equipment for the first time. I was just a wee bit intimidated about exercising amongst the students. For some reason, after changing into my workout clothes and tennis shoes, I felt the need to don lip gloss. Must have been some kind of self-defense mechanism.

RPAC offers cardio equipment in several areas of the building, including “Cardio Canyon.” [As I left the office, Jeff Grabmeier asked me if I was headed to Cardiac Canyon. All I could say was, "Only if things go horribly wrong."]

An elliptical trainer similar to those at RPAC

Once at RPAC, I climbed to the balcony in the hopes that the high ground would give me an advantage à la Obi-Wan Kenobi. I found myself surrounded almost entirely by female students, which felt less intimidating. Though it was 5:00 p.m. by this point, there were still several cardio machines available.

The elliptical trainer was similar to others I’ve used. The experience is like pedaling a bicycle, only standing up. It’s a heck of a workout. I was a little out of practice, and at one point I nearly dropped my water bottle when I tried to take a drink while still pedaling. I managed to catch the bottle, only to send my iPod and headphones bouncing across the floor. The nice young ladies around me pretended not to notice.

The half hour went something like this:

1-10 min: Warming up. Lots of energy.
11-20 min: Working hard, hitting a groove.
21 min: Feeling a little tired.
22 min: Feeling a lot tired.
23 min: Looking around for a place to lie down after.
24 min: Second wind. Woo-hoo!
25 min: Second wind? What second wind?
26-30 min: [Expletives deleted]
30 min: Cool down! Whew!

No problem. No problem at all… According to the machine, I burned almost exactly 300 calories.

The other day after a swim, I ducked into the RPAC sauna… a girl who had been lounging there squinted at my new swim shoes. I figured she was just jealous, because these shoes are absolutely adorable. Only then did I read the sign on the door: shoes prohibited. Her flip-flops were sitting demurely outside.

Adorable, no?

Aghast, I scanned the tile floor in vain for any visible sign of athletes’ foot fungus. Could it really be safe to walk barefoot here? I walked barefoot in a gym once. Once.

Yet all around me at RPAC, people were barefoot. Exiting the locker rooms, crossing the hallway, emerging from the pool. All oblivious to the itchy danger that might lurk beneath them.

My mind raced. Could the RPAC floor be made from magic fungus-resistant tile? Could these people have acquired some kind of fungal immunity? Could I stop asking these questions and just take off my shoes already?

No, I couldn’t. I left them on.

No one arrested me.

I’m a little flummoxed about the shoe policy. I can see why RPAC wouldn’t allow street shoes in the saunas — it’s a cleanliness issue. But why not allow shower shoes or swim shoes? Does anybody know? Send me an email, or leave a comment below. And let me know whether you’ve walked barefoot in RPAC and emerged fungus free.

I heard that saunas are good for you, because the heat raises your metabolism temporarily. Time spent in a sauna is supposed to offer the same health benefits as light exercise — say, taking a brisk walk.

Well, it turns out that the sauna doesn’t offer those benefits. But I really liked it anyway.

You won't see this at RPAC!

Saunas were invented 2,000 years ago by the Finns, who according to legend get naked, drink vodka, and beat each other with birch branches to enhance the experience. I don’t know what advantage the birch branches offer, but given that saunas dehydrate the body, vodka is just about the worst thing you could drink at that moment. In the least, you’d be in for a major hangover.

Before I could review the saunas at RPAC, I needed something to compare them to. So I ventured to a private gym in Pickerington, on a day pass courtesy of my office mate Barb Withem.

A quick word about the fitness equipment at this private gym: We sampled the treadmill, the elliptical, and the stationary bike, then toured the weight training machines. Now that I’ve tried them, I say that you can find machines of equal or better quality at any of the fitness facilities on campus.

More like this -- a modern sauna

Satisfied that we’d earned the sauna, we set off for the ladies’ locker room. This, really, was the only moment when I thought the private club had any advantage over RPAC. The locker room was carpeted, and lined with private changing rooms. It also featured wall-mounted TVs and piped-in music. The lockers had polished wood doors.

So I relaxed in spa-like luxury. I had to. After all, this was research.

The sauna was… amazing. The walls and benches were constructed entirely of cedar, and when we opened the door, the warmth and the smell of the wood instantly combined to relax my body and lift my spirits. My first instinct was to lie back and go to sleep, a definite no-no. It’s dangerous to sleep in the sauna, and now I understand why. The heat felt a lot like strong sunlight, only without the sunburn. Maybe this is what it’s like to be a potato in the microwave.

I turned bright red, and while I didn’t feel like I was sweating, I definitely felt like something was happening metabolically.

Here’s what was happening, according to Steven Devor, associate professor of exercise science:

Your heart rate increases in a sauna, due to the need to cool the body, so more blood is shunted toward the skin away from your core, and thus your skin becomes flushed… You will get a sweat response as well, as your body tries to perform evaporative cooling… The same thing happens when you are outside lounging on a very hot summer day.

This was all by way of telling me that there was no exercise benefit. There’s more to exercise than boosting your heart rate, Devor said, and there is little clinical evidence that saunas provide any benefit beyond relaxation. Of course, after a few moments in the sauna, I was too relaxed to care.

One drawback: my shower afterward felt shockingly cold. By the time I switched off the water, I was shivering. But, by golly, I was awake! The sleepiness of the sauna was banished, and I felt rejuvenated.

To be honest, at this point I wasn’t certain that the RPAC saunas would stack up. But they did. I stopped by after a swim, and found the same floor-to-ceiling cedar panels as the private gym, and even what appeared to be the same hot rock stove in the corner of each one.

The stove heats the sauna to around 182°F. Sounds impossibly hot, I know. But it’s comfortable because it’s a dry heat. Steam saunas are run at cooler temperatures, because the moisture in the air conducts heat to the skin, and could cause a burn. In dry saunas like the ones at RPAC, sweat evaporates quickly, so dehydration is a danger. Bring a bottle of water.

My only complaint is that I couldn’t see a clock to tell me how long I’d been in. Sauna visits should be limited to around 15 minutes, and I didn’t want to risk staying in too long. But in general, I found the RPAC saunas to be just as enjoyable as the private sauna.

Since I returned to exercise last summer, the activity I have stuck with most faithfully is water aerobics. Normally, I attend classes at the Center for Wellness and Prevention (CWP). This week, I tried the class offered by the Faculty and Staff Fitness Program (FSFP), and I’m glad I did. (Thanks to John Beacom for the tip to check out FSFP, and to program manager Rebecca Nguyen for letting me check it out!)

An outdoor water aerobics class

The CWP offers 17 “water movement” classes throughout the week, mornings and evenings. Class is held in a therapy pool, which is heated for the comfort of people who are recovering from musculoskeletal injuries or dealing with conditions such as obesity. The temperature hovers around 90°F — like bath water.

The warmth is pleasant but raises the heart rate (much as a whirlpool does) so you shouldn’t stay in it for more than an hour. Nor should you exercise as intensely as you might in a cooler pool. But if your current activity level is zero, as mine was last year, the therapy pool is a great way to get started with fitness.

The instructor, Vicky, recommends the class for “anyone who wants to feel alive again,” and that’s certainly the effect the class had on me.

In early 2007, when I weighed 180 lbs., I jogged. Sure, I jogged about as fast as other people walked, but I loved it. Then I broke my foot. I had surgery in September, and gradually got back to walking normally over the winter. By spring of 2008, I had gained a lot of weight, and jogging was out of the question.

The RPAC lap pool (front) and instructional pool (back)

In the water, I can jog again. Water provides buoyancy, so I feel like I weigh a lot less. And that means I can do other things that I wouldn’t attempt even when I weighed 180, like plyometrics (a fancy word for “jumping”). I first learned about plyometrics in 2004, when my then-colleague Holly Wagner wrote this Ohio State research story. The idea is to jump in a controlled way in order to strengthen particular leg muscles. The advanced water movement class at the CWP includes water jogging and “bunny-hopping,” which I find gets my heart rate up and makes me feel good.

The FSFP offers water aerobics Mondays, Wednesdays, and Fridays at 12:30 p.m. Classes are held in the RPAC instructional pool, which is kept at a comparatively chilly 83°F. But as the instructor Ya-Ting explained during my visit, the lower temperature meant that I could push myself harder and stay in the water longer than I could at CWP.

The workout was indeed more intense, and featured more jumping. We did “Mario jumps,” which you can easily picture if you ever played Nintendo, and “straddle jumps,” where we hopped up and kicked our legs out to the side and back before landing. This last jump kicked my soggy butt.

After class, I felt energized… until about two hours later, when I felt like I’d run into a brick wall. And the next day, I was sore! That doesn’t normally happen to me with the CWP water aerobics. Hmm…

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.