What comes to mind when you hear the words, “Physical Activity”? For some, it might conjure up a negative connotation while for others, they may already be a go getter for an active lifestyle. Believe it or not, physical activity and exercise are two different terms although used interchangeably. Physical activity is any movement of the body done through skeletal muscle contraction that causes the energy expenditure to go beyond its baseline. Simply stated, physical activity is movement, in any form.
Sadly, less than 5% of adults participate in 30 minutes of physical activity, and 28-34% of adults aged 65-74 are physically active in the United States. It is important to gather some perspective on the impact of a sedentary lifestyle and how it is more common than physical activity. According to the Center for Disease Control, physical inactivity is even more common among ethnic and racial groups in most states. The CDC’s January report from 2020 showed overall, Hispanics had the highest prevalence of physical inactivity (31.7%), followed by non-Hispanic blacks (30.3%) and non-Hispanic whites (23.4%).
We all have heard of vital signs. Part of that assessment should also involve the type of physical activity one engages in. As nurses, we are the largest body of the health care workforce, and studies show that we are not following healthy practices when it comes to our self-care and well-being. The American Nurse Association even launched a Healthy Nurse, Healthy Nation initiative to address the core elements that address nurse’s self-care and well-being, Activity, being one of them which goes to show that this is a pressing concern.
Some of the challenges posed as to why people do not take part in physical activity is location. The neighborhood in which people live may not have access to outdoor parks, paved streets, or recreation centers. Depending on your home environment, you may not have the space to exercise in.
The good news is just doing any activity, especially one in which you enjoy doing is acceptable in burning calories. Anything is better than being sedentary. The risks of sedentary behavior are universal and it is important for nurses to adopt a more active lifestyle. Physical inactivity is closely related to premature death, preventable disease, and health care costs.
Exercise is a subset of physical activity and is defined as an activity that is organized, planned, and reoccurring which is done with the intent of improving or maintaining one or more components of one’s health. Having said this, physical activity can involve any movement and does not have to involve a schedule or with an “all or nothing” attitude. For those who are trying to lose weight, exercise is not as important as much as your food intake. There needs to be a calorie deficit in order to lose weight. Nutrition and physical activity work in tandem but about 80% is based on nutrition and 20% should be focused on physical activity.
Physical activity come with benefits such as: heart health and prevention of diabetes, improved strength and mobility, release of dopamine, endorphins and serotonin (the “feel good” hormones), increased lifespan, and increased insulin sensitivity. Carrying on extra weight can contribute to joint pain. For every additional pound that you are overweight, an extra 5 pounds of pressure is exerted on your joints.
It cannot be argued that the majority of nurses are female and women tend to hold onto more fat than men; that is how nature intended us to be designed. As we age, we are also at risk for bone loss. For that reason, we do not want to lose weight too quickly because we also want to protect our bones, which is why muscle resistant training is so important. Half a pound per week of weight loss is the ideal; it is all very specific to how much weight the person needs to lose. Even a 5-10% weight loss can reap positive effects on overall health.
Nurses, especially those of other ethnicities can become role models and advocates for system changes at the workplace as well as at home. Even if nurse leaders are not fully on board, it is important to heighten awareness on the benefits of physical activity which would improve morale as well as productivity. Identifying barriers is the first step and serving as a role model would also provide an impetus for behavior change.
Just like with patients, we need to assess our readiness and meet ourselves where we are at. We need to give ourselves permission to work on our fitness regimen so it can be more sustainable. The best exercise to lose weight is the exercise you will do. If you have to ask yourself, “Should I work out today?” hopefully, the answer is yes. If you choose “No”; well, yes you should.
Nurses are integral in the care of patients and their health. Exploring a plant-based diet may be beneficial to patients so they can take back their health. It is time for health care disciplines to be aware of a plant-based diet and to dispel any myths that exist. In fact, a plant-based diet is not a diet—it can be viewed as a way of life. A plant-based diet are foods consumed that is devoid of animal ingredients, such as dairy and meats. A plant-based diet relies on foods that are grown from the ground such as fruits, vegetables, whole grains and nuts, and seeds.
People are living longer, but we are also living with more chronic diseases, with heart disease being at the top of the list. Heart disease, diabetes, and hypercholesterolemia are contributors to sickness where medicine is the answer. Health care providers tell patients to lose weight by restricting food intake. While patients may see results initially, they usually do not adhere to this long term as it is not sustainable for them for a variety of reasons. In addition to that, the medications with their side effects usually do not highlight many benefits. One-third of animal products in the American diet are very concentrated in calories and are deficient in antioxidants and vitamins. Needless to say, the vast majority of chronic illness is highly correlated to what we eat. There is a different biological effect of meat versus plant-based protein such as beans. The body can store these amino acids and complete them without overshooting the hormone, Insulin Growth Factor 1 (IGF 1). On the contrary, processed foods and meats produce a lot of IGF1 where insulin ends up storing a lot of fat. It is also attributable to cancer and inflammation.
People have long touted the benefits of a
plant-based diet. Brooklyn Borough President Eric Adams reversed his diabetes Type 2 due to a plant-based diet. He was already suffering from nerve damage as a result of his disease with a hemoglobin A1C of 17 (anything over 6.5% is considered diabetic), so his was very high and the doctor was surprised that he was not in a coma. Adams was placed on medications, but he also sought the help of Caldwell B. Esselstyn, Jr., the same doctor who treated Bill Clinton and author of the book, Prevent and Reverse Heart Disease. He was informed by doctors that he would be on insulin for the rest of his life. He was placed on medicine for his acid reflux, medicine for his high cholesterol, and medicine for his burning and tingling of his hands and feet. His family is diabetic and was told that it runs in his family.
This past August, there was a launch of a plant-based lifestyle program at Bellevue Hospital in New York City. Doctors, nurses, dieticians, and life coaches will help at least 100 patients across all five boroughs adopt healthy eating patterns focused on legumes, whole grains, fruits, vegetables, nuts, and seeds while reducing animal products, fried foods, refined grains, and added sugars. Michelle McMacken, director of NYC Health + Hospitals/Bellevue Adult Weight Management Program, is director of the program.
At Montefiore Hospital, Dr. Robert Ostfeld spearheaded the Cardiac Wellness Program where plant-based nutrition is the prescription for management of cardiac disease. The population most affected by these diseases are non-white populations. Dr. Kim Williams, past President of the American College of Cardiology, advocates for a plant-based diet for heart disease prevention. Affronted with a high cholesterol, he decided to take measures into his own hands, and adopt a plant-based diet.
While medical doctors are beginning to advocate this lifestyle, nurses should also set an example of this lifestyle approach. Nurses are part of the health care discipline and minority nurses, especially, need to set an example. We want patients to take control of their lives. We can teach patients eating a plant-based diet instead of a standard American diet, as a form of primary prevention. Like any diet, it may take time to adjust, but this is not just a diet, it is a lifestyle. Patients would need to make an informed decision as to whether they would want to incorporate it into their lifestyle or not. There is enough supportive evidence out there that a patient can access such as documentaries, “Fork Over Knives” and “Fat, Sick, and Nearly Dead.” There are a variety of resources, including the 21-Day Vegan Kickstart program, to include in dietary prescriptions to help patients treat and prevent obesity, type 2 diabetes, and heart disease. This will require support from the patient’s primary provider, and, whether the provider is an advocate of this lifestyle or not, it should be considered. Benefits such as less medication, weight loss, and improvements in mood as well as cholesterol have been shown. Dispel the myths about a plant-based diet and protein.
This is a plea as something to consider to take better care of ourselves and take control of our lives. There have been many initiatives and programs to lose weight. Drastic measures have also occurred due to the outcomes of being overweight, such as drastic surgery and restrictions from carbohydrates. Patients are sometimes misinformed and have to get rid of the idea that medications will solve the problem—it only delays the problem. There is a possibility of reversing diabetes and cardiac disease. This is a decision that the person has to make: continue with their lifestyle with animal protein and processed carbohydrates or see a reduction in their overall weight and health by incorporating a plant-based diet.
A plant-based diet may be considered “extreme” by some people in altering their lifestyle. But given the choice between a plant-based diet or open=heart surgery, it can be posed to the patient which one they consider as extreme. Again, it is a personal choice, an evaluation of familial and cultural values would be assessed to fit the needs of the patient. Surgery can be viewed as a band-aid in that it will manage the symptoms temporarily unless the patient alters their lifestyle. Of course, it helps if the patient has a supportive network to embrace the lifestyle. It can start off as small, simple steps, as little as incorporating a plant-based meal in their day and slowly add these meals to their lifestyle. There are vegan starter kits to kick a healthier you.
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