Holistic Self Care
A Presentation for
School Nurses
Methods for Self Improvement, Stress Relief, and Well Being
Paul Nathenson, RN, ND, HN-BC
Creating a Healthy Lifestyle
• Step 1: Increase your activity
• Step 2: Adopt a Healthy Diet
• Step 3: Control stress
Health vs. Wellness
1.
Definition of health – the general condition of the body or mind,
especially in terms of the presence or absence of illnesses, injuries, or
impairments.
2.
Definition of wellness – “Wellness is a multidimensional state of being
describing the existence of positive health in an individual as
exemplified by quality of life and a sense of well-being.” Wellness is
an active process of becoming aware of and making choices toward a
more successful existence.
Henning, S., & Cilliers, F. (2012). Constructing a systems psychodynamic
wellness model. SA Journal of Industrial Psychology, 38(2), 107-116.
The Six Dimensions of Wellness Model
Developed by Dr. Bill Hettler, co-founder of the National Wellness Institute (NWI)
(Used by permission)
Physical Dimension
Create an Exercise Routine
Increase Activity
Get regular check ups
Fasting blood sugars
Cholesterol testing
Pap smears
Colonoscopies
Mammography's
Huang,
Prostate exams
J. H., Huang, S. L., Li, R. H., Wang, L. H., Chen, Y. L., & Tang, F. C.
(2014). Effects of Nutrition and Exercise Health Behaviors on Predicted
Risk of Cardiovascular Disease among Workers with Different Body Mass
Index Levels. International journal of environmental research and public
health, 11(5), 4664-4675.
Social Dimension
Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A., & Updegraff,
J. A. (2000). Biobehavioral responses to stress in females: tend-and-befriend, not
fight-or-flight. Psychological review, 107(3), 411.
Intellectual Dimension
Never Stop Learning
Stern, Y. (2012). Cognitive reserve in ageing and Alzheimer's disease. The
Lancet Neurology, 11(11), 1006-1012.
Spiritual Dimension
Pattison, S. (2013). Religion, Spirituality and Health Care:
Confusions, Tensions, Opportunities. Health Care Analysis, 21(3),
193-207.
Emotional Dimension
“The subset of social intelligence
that involves the ability to monitor
one’s own and others feelings and
emotions and to use this
information to guide one’s thinking
and actions”
Mayer, J. D., Salovey, P., & Caruso, D. R. (2008). Emotional intelligence: new ability or
eclectic traits?. American Psychologist, 63(6), 503.
Occupational Dimension
Steger, M. F., Dik, B. J., & Duffy, R. D. (2012). Measuring Meaningful
Work The Work and Meaning Inventory (WAMI). Journal of Career
Assessment, 20(3), 322-337.
What is Self Care and
Why is it Important?
Weaver, C. (2013). How I Practice Holistic Nursing. Oncology Times, 35(19),
1-2.
Leading Causes of Death in the U.S.
Heart disease
 Cancer
 Stroke (cerebrovascular diseases)
 Chronic lower respiratory diseases
 Accidents (unintentional injuries)
 Diabetes
5 out of the top 6 leading causes of death have
preventable factors
Jemal, A., Ward, E., Hao, Y., & Thun, M. (2005). Trends in the leading causes of death
in the United States, 1970-2002. Jama, 294(10), 1255-1259.
Leading causative factors
Stress
Smoking
Poor diet
Lack of exercise
Reis, J. P., Loria, C. M., Sorlie, P. D., Park, Y., Hollenbeck, A., & Schatzkin, A.
(2011). Lifestyle Factors and Risk for New-Onset Diabetes A Population-Based
Cohort Study. Annals of internal medicine, 155(5), 292-299.
CHILDHOOD OBESITY
Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood
and adult obesity in the United States, 2011-2012. JAMA, 311(8), 806-814.
Correlation between
Obesity and Development of Diabetes
• 44 million Americans are considered obese
• 17 million Americans have diabetes
• Obesity increased 74% since 1991
• Diabetes increased 61% since 1991
This demonstrates a strong correlation between
obesity and development of diabetes.
Nguyen, N. T., Nguyen, X. M. T., Lane, J., & Wang, P. (2011). Relationship
between obesity and diabetes in a US adult population: findings from the
National Health and Nutrition Examination Survey, 1999–2006. Obesity surgery,
21(3), 351-355.
Body mass index (BMI)
• Body mass index (BMI) is a tool for
indicating weight status in adults. It
is a measure of weight for height.
• Centers for Disease Control and
Prevention (CDC). BMI Calculator.
16 May 2006. www.cdc.gov
BMI
Weight Status
Below 18.5
Underweight
18.5 - 24.9
Normal
25.0 - 29.9
Overweight
30.0 and Above
Obese
• Me at 210 lbs =BMI of 30
Game Changer - Nutrition
• Changing your diet can be the
most difficult.
• Comfort food is called “comfort
food” for a reason
• Most often comfort foods are the
foods that are the worst for you
nutritionally and give only a short
term boost in mood leaving you
wanting more and/or feeling let
down
Processed Foods
Ingredients in processed foods such as
nitrates, nitrites, BHA, BHT sulfur dioxide,
monosodium glutamate (MSG), Propylene
glycol, sulfites, saccharine, and aspartame
have been shown by evidence based
research to cause or contribute to the
following deadly diseases:
•Cancer
•Autoimmune disease
•Subclinical sensitivity reactions such as
muscle soreness, muscle fatigue, muscle
twitching
•Diabetes
•Obesity
Stuckler, D., & Nestle, M. (2012). Big food, food systems, and global health.
PLoS medicine, 9(6), e1001242.
Processed Meats Declared Too Dangerous for Human
Consumption
The World Cancer Research Fund (WCRF)
Wiseman, M. (2008). The second World Cancer Research Fund/American
Institute for Cancer Research expert report. Food, nutrition, physical activity,
and the prevention of cancer: a global perspective. Proceedings of the
Nutrition Society, 67(03), 253-256.
2 pieces of pizza (just 2?)
Twenty Years ago 500 calories
Today’s Pizza 850 calories
Those extra 350 calories, if eaten a two times a month, would put on two
extra pounds a year, or forty pounds in the next two decades.
The Diet Should Contain Whole Foods:
Organic Vegetables, Healthy Fats and Whole Grains
Okarter, N., & Liu, R. H. (2010). Health
benefits of whole grain phytochemicals.
Critical reviews in food science and
nutrition, 50(3), 193-208.
Drink plenty of fluids…..
Mostly water
AND
Don’t eat TOO much!
Freed, C., Fawcett, S., Weber-Dewitt, D., & Melby, C. (2012). Effects of a Novel
Dietary Portion Control Program on Energy Intake, Energy Density, and Weight
Loss. The FASEB Journal, 26, 820-4.
10 Ways to Lose 20 Pounds
Slim down with simple tweaks to your diet and Fitness Routine
Internet Post 1/02/2013 from Men’s Health
1.Snooze—and Lose (Harvard Study)
2.Portion Control ( Cornell Study): use smaller bowls
3.10 minute workout break (Southern Illinois University Study)
4.Work your legs (Syracuse University Study)
5.Exercise (Harvard Study)
6.Whey Protein (Canadian Study)
7.Brush your teeth (Japanese Study)
8.Decrease carbohydrate intake (United Arab Emirates Study)
9.Cut out Soft Drinks (Penn State Study)
10. Plan for hunger if/then (Dutch Researchers)
Eat slowly and enjoy your food
(the dog study)
76.7 pounds
Sugar Metabolism
Insulin Resistance
Olefsky, J. M., & Glass, C. K. (2010). Macrophages, inflammation, and
insulin resistance. Annual review of physiology, 72, 219-246.
Having metabolic syndrome
increases risk for heart
disease, diabetes, and stroke
based on the number of
metabolic risk factors you
have.
Increased blood pressure (140/90 mmHg)
Increased blood sugar (100 mg/DL or greater)
A large waistline or apple shape
Increased triglycerides(150 mg/dL
Abnormal cholesterol with low HDL and high
LDL
Best Predictor of Heart Attack
• A. Cholesterol
• B. Homocysteine
• C. Triglycerides
• D. C-Reactive Protein
• E. A & C
• F. B & D
Harvard Women’s Health Study
Yale Physician’s Health Study
Lopez-Garcia, E., Schulze, M. B., Meigs, J. B., Manson, J. E., Rifai, N.,
Stampfer, M. J., ... & Hu, F. B. (2005). Consumption of trans fatty acids is
related to plasma biomarkers of inflammation and endothelial dysfunction.
The Journal of nutrition, 135(3), 562-566.
Glycemic Index and Glycemic Load
Glycemic Index: Food is rated on
a scale of 0-100, with pure sugar
topping the charts as the highest
GI food.
The Glycemic Load of a food is
calculated by multiplying the
glycemic index by the amount of
carbohydrate in grams and
dividing the total by 100. The
Glycemic Load gives you a more
complete picture as it takes into
account the quality of a
carbohydrate in a meal.
Artificial Sweeteners/Aspartame
NSAIDS: (Advil, Acetaminophen Aleve, ibuprofen, naproxen):
The biggest known risk of NSAIDs is from gastrointestinal ulcers and bleeding. Roughly 16,685 people die each
year from NSAID related complications making them just as dangerous as AIDS.
Cryer, B. (2005). NSAID-associated deaths: the rise and fall of NSAIDassociated GI mortality. Am J Gastroenterol, 100(8), 1694-1695.
TURMERIC
Anti-inflammatory
possesses only
COX-1 inhibition
without CO-2
inhibitory
consequences
Nieman, D. C., Cialdella-Kam, L., Knab, A. M., & Shanely, R. A. (2012).
Influence of red pepper spice and turmeric on inflammation and oxidative
stress biomarkers in overweight females: A metabolomics approach. Plant
foods for human nutrition, 67(4), 415-421.
Omega 3 Fatty Acids
Marroon JC. Bost, JW, “Omega-3 fatty acids
(fish oil) as an anti-inflammatory: an
alternative to nonsteroidal antiinflammatory drugs for discogenic pain.
Surgical Neurology. 2006 Apr;65(4):326-31.
PRO-BIOTICS
Beneficial bacteria
• Lactobacillus acidophilus.
Lactobacillus bulgaricus.
Bifidobacterium bifidum
• Improves the immune system
• Important for women to guard
against yeast infections caused by
opportunistic organisms.
• Keep the normal flora in the gut
preventing gas and indigestion
Rijkers, G. T., De Vos, W. M., Brummer, R. J., Morelli, L., Corthier, G., &
Marteau, P. (2011). Health benefits and health claims of probiotics: bridging
science and marketing. British Journal of Nutrition, 106(09), 1291-1296.
NERVOUS
SYSTEM
Stress Cycle
Stress Level
(Cortisol)
Time
•Slow deep breathing
can activate the
parasympathetic system
•Practice slow deep
breaths
•Talk slower
•Drink a glass of water
Breathing
Take a moment
to center yourself
Magnesium
Orchard, T. S., Larson, J. C., Alghothani, N., Bout-Tabaku, S.,
Cauley, J. A., Chen, Z., ... & Jackson, R. D. (2014). Magnesium
intake, bone mineral density, and fractures: results from the
Women's Health Initiative Observational Study. The American
journal of clinical nutrition, 99(4), 926-933.
Integrative medicine combines
standard medicine with CAM practices
that have been shown to be effective
Witt, C. M., Chesney, M., Gliklich, R., Green, L., Lewith, G., Luce, B., ... & Berman,
B. M. (2012). Building a strategic framework for comparative effectiveness
research in complementary and integrative medicine. Evidence-Based
Complementary and Alternative Medicine, 2012.
Holistic Health Care Reform
means taking personal accountability for your
health
Components of Self-Care
☺Exercise
☺Nutrition
☺Relaxation
☺Sleep
☺Safety
US Department of Health and Human Services. (2011). Healthy People 2020.
Massage
Hymel, G. M., & Rich, G. J. (2013). Health psychology as a context for
massage therapy: A conceptual model with CAM as mediator. Journal of
Bodywork and Movement Therapies.
Ambient Music for Relaxation
• Beta waves (13-38 hz) actively thinking,
problem-solving
• Alpha waves (8-13 hz) relaxed and calm
• Theta waves (4-7 hz) sleep, deep
relaxation
• Delta waves (below 4 hz) occur during
sleep
• Brainwaves synch with the music bringing
them to a relaxed state.
Colgin, L. L. (2013). Mechanisms and functions of theta rhythms. Annual review
of neuroscience, 36, 295-312.
Aromatherapy
Lee, M. S., Choi, J., Posadzki, P., & Ernst, E. (2012). Aromatherapy for health
care: An overview of systematic reviews. Maturitas, 71(3), 257-260.
Letting go of thoughts
Be conscious of negative thinking, let go of anger and perceived
insults, refute irrational thoughts
Brewer, J. A., Worhunsky, P. D., Gray, J. R., Tang, Y. Y., Weber, J., & Kober, H. (2011).
Meditation experience is associated with differences in default mode network activity and
connectivity. Proceedings of the National Academy of Sciences, 108(50), 20254-20259.
Get plenty of rest
García-García, F., Juárez-Aguilar, E., Santiago-García, J., & Cardinali, D. P.
(2014). Ghrelin and its interactions with growth hormone, leptin and orexins:
Implications for the sleep–wake cycle and metabolism. Sleep medicine
reviews, 18(1), 89-97.
AND
be sure to buckle up
Laughing
Laughter gives us distance.
It allows us to step back
From an event, deal with it
And then move on.
---Bob Newhart
My Personal Wellness Plan
Priority
Wellness Goal
high
I will eliminate processed
foods from my diet
high
high
medium
medium
Step One
I will eliminate drive
through fast foods from my
diet
I will exercise at the gym 4 I will walk 30 minutes a day
days per week
3 days per week
I will become a certified
I will go once a week to a
yoga teacher
yoga class
I will get 8 hours of restful
I will get started to bed by
sleep per night
10PM
I will practice gratitude daily I will acknowledge 3 things
I am grateful for in my
morning meditation
Thank You for Coming!
To make the most of this session, make a contract with yourself
to set aside a specific time
dedicated to relaxation.
Be committed to take time for yourself . . . You deserve it!