When You Know What You “Should” Do (But Knowing Isn’t The Problem)
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When knowing what to do isn’t the problem
Often, we know what we need to do. Sometimes, knowing isn’t the problem!
The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.
While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.
What is Motivational Interviewing?
❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞
Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice
It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.
However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.
Three Phases
Motivational Interviewing traditionally has three phases:
- Exploring and understanding the issue at hand
- Guiding and deciding importance and goals
- Choosing and setting an action plan
In self-practice, maybe you can already know and understand what it is that you want/need to change.
If not, consider asking yourself such questions as:
- What does a good day look like? What does a bad day look like?
- If things are not good now, when were they good? What changed?
- If everything were perfect now, what would that look like? How would you know?
Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?
This is a critical process:
- Give your answers numerically on a scale from 0 to 10
- Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
- In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
- After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.
Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.
Some things to ask yourself at this stage of the motivational self-interviewing:
- What’s a good SMART goal to get you started?
- What could stop you from achieving your goal?
- How could you overcome that challenge?
- What is your backup plan, if you have to scale back your goal for some reason?
A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.
The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.
Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”
Secret fourth stage
The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.
For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.
When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.
Want to learn more?
We only have so much room here, but there are lots of resources out there.
Here’s a high-quality page that:
- explains motivational interviewing in more depth than we have room for here
- offers a lot of free downloadable resource packs and the like
Check it out: Motivational Interviewing Theory & Resources
Enjoy!
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Lychees vs Kumquats – Which is Healthier?
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Our Verdict
When comparing lychees to kumquats, we picked the kumquats.
Why?
In terms of macros, everything is comparable except for fiber, of which kumquats have 5–6x as much fiber, which means a very significant win for kumquats in this category.
When it comes to vitamins, lychees have slightly more of vitamins B3, B6, C, and K, while kumquats have a lot more of vitamins A and B1, and moderately more vitamins B2, B9, E, and choline. A fair win for kumquats here.
In the category of minerals, lychees have a little more copper, phosphorus, and selenium, while kumquats have 11x as much calcium, as well as a 2–3x more iron, magnesium, manganese and zinc. An easy win for kumquats.
Both fruits have great phenolic profiles, being both rich in antioxidants.
All in all, enjoy both, but if you’re going to pick one, kumquats easily win the day!
Want to learn more?
You might like to read:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- When Bitter Is Better: Enjoy Bitter Foods For Your Heart & Brain ← kumquats have a bitter citrus taste, while lychees are quite sweet and mellow
Take care!
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How Not to Age – by Dr. Michael Greger
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First things first: it’s a great book, and it’s this reviewer’s favorite of Dr. Greger’s so far (for posterity: it’s just been published and this reviewer has just finished reading the copy she got on pre-order)
Unlike many popular physician authors, Dr. Greger doesn’t rehash a lot of old material, and instead favours prioritizing new material in each work. Where appropriate, he’ll send the reader to other books for more specific information (e.g: you want to know how to avoid premature death? Go read How Not To Die. You want to know how to lose weight? How Not To Diet. Etc).
In the category of new information, he has a lot to offer here. And with over 8,000 references, it’s information, not conjecture. On which note, we recommend the e-book version if that’s possible for you, for three reasons:
- It’s possible to just click the references and be taken straight to the cited paper itself online
- To try to keep the book’s size down, Dr. Greger has linked to other external resources too
- The only negative reviews on Amazon, so far, are people complaining that the print copy’s text is smaller than they’d like
For all its information-density (those 8,000+ references are packed into 600ish pages), the book is very readable even to a lay reader; the author is a very skilled writer.
As for the content, we can’t fit more than a few sentences here so forgive the brevity, but we’ll mention that he covers:
- Slowing 11 pathways of aging
- The optimal anti-aging regimen according to current best science
- Preserving function (specific individual aspects of aging, e.g. hearing, sight, cognitive function, sexual function, hair, bones, etc)
- “Dr. Greger’s Anti-Aging Eight”
In terms of “flavor” of anti-aging science, his approach can be summed up as: diet and lifestyle as foundation; specific supplements and interventions as cornerstones.
Bottom line: this is now the anti-aging book.
Click here to check out How Not To Age, and look after yourself with the best modern science!
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How often should you really weigh yourself?
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Few topics are more debated in health than the value of the humble bathroom scale. Some experts advocate daily self-weigh-ins to promote accountability for weight management, particularly when we’re following a diet and exercise program to lose weight.
Others suggest ditching self-weigh-ins altogether, arguing they can trigger negative psychological responses and unhealthy behaviours when we don’t like, or understand, the number we see on the scale.
Many, like me, recommend using scales to weigh yourself weekly, even when we’re not trying to lose weight. Here’s why.
Diva Plavalaguna/Pexels 1. Weighing weekly helps you manage your weight
Research confirms regular self-weighing is an effective weight loss and management strategy, primarily because it helps increase awareness of our current weight and any changes.
A systematic review of 12 studies found participants who weighed themselves weekly or daily over several months lost 1–3 BMI (body mass index) units more and regained less weight than participants who didn’t weight themselves frequently. The weight-loss benefit was evident with weekly weighing; there was no added benefit with daily weighing.
Weighing regularly means we know when our weight changes. Andres Ayrton/Pexels Self-weigh-ins are an essential tool for weight management as we age. Adults tend to gain weight progressively through middle age. While the average weight gain is typically between 0.5–1kg per year, this modest accumulation of weight can lead to obesity over time. Weekly weighing and keeping track of the results helps avoid unnecessary weight gain.
Tracking our weight can also help identify medical issues early. Dramatic changes in weight can be an early sign of some conditions, including problems with our thyroid, digestion and diabetes.
2. Weekly weighing accounts for normal fluctuations
Our body weight can fluctuate within a single day and across the days of the week. Studies show body weight fluctuates by 0.35% within the week and it’s typically higher after the weekend.
Daily and day-to-day body weight fluctuations have several causes, many linked to our body’s water content. The more common causes include:
The type of food we’ve consumed
When we’ve eaten a dinner higher in carbohydrates, we’ll weigh more the next day. This change is a result of our bodies temporarily carrying more water. We retain 3–4 grams of water per gram of carbohydrate consumed to store the energy we take from carbs.
Our water content also increases when we consume foods higher in salt. Our bodies try to maintain a balance of sodium and water. When the concentration of salt in our bloodstream increases, a mechanism is triggered to restore balance by retaining water to dilute the excess salt.
The morning after a big pasta dinner, we’ll carry more water weight. Dana Tentis/Pexels Our food intake
Whether it’s 30 grams of nuts or 65 grams of lean meat, everything we eat and drink has weight, which increases our body weight temporarily while we digest and metabolise what we’ve consumed.
Our weight also tends to be lower first thing in the morning after our food intake has been restricted overnight and higher in the evening after our daily intake of food and drinks.
Exercise
If we weigh ourselves at the gym after a workout, there’s a good chance we’ll weigh less due to sweat-induced fluid loss. The amount of water lost varies depending on things like our workout intensity and duration, the temperature and humidity, along with our sweat rate and hydration level. On average, we lose 1 litre of sweat during an hour of moderate-intensity exercise.
Hormonal changes
Fluctuations in hormones within your menstrual cycle can also affect fluid balance. Women may experience fluid retention and temporarily gain 0.5–2kg of weight at this time. Specifically, the luteal phase, which represents the second half of a woman’s cycle, results in a shift of fluid from your blood plasma to your cells, and bloating.
Most of our weight fluctuations are water-related. Engin Akyurt/Unsplash Bowel movements
Going to the bathroom can lead to small but immediate weight loss as waste is eliminated from the body. While the amount lost will vary, we generally eliminate around 100 grams of weight through our daily bowel movements.
All of these fluctuations are normal, and they’re not indicative of significant changes in our body fat or muscle mass. However, seeing these fluctuations can lead to unnecessary stress and a fixation with our weight.
3. Weekly weighing avoids scale obsession and weight-loss sabotage
Weighing too frequently can create an obsession with the number on the scales and do more harm than good.
Often, our reaction when we see this number not moving in the direction we want or expect is to further restrict our food intake or embark on fad dieting. Along with not being enjoyable or sustainable, fad diets also ultimately increase our weight gain rather than reversing it.
This was confirmed in a long-term study comparing intentional weight loss among more than 4,000 twins. The researchers found the likelihood of becoming overweight by the age of 25 was significantly greater for a twin who dieted to lose 5kg or more. This suggests frequent dieting makes us more susceptible to weight gain and prone to future weight gain.
So what should you do?
Weighing ourselves weekly gives a more accurate measure of our weight trends over time.
Aim to weigh yourself on the same day, at the same time and in the same environment each week – for example, first thing every Friday morning when you’re getting ready to take a shower, after you’ve gone to the bathroom, but before you’ve drunk or eaten anything.
Weigh yourself at the same time on the same day of the week. Alexanderstock23/Shutterstock Use the best quality scales you can afford. Change the batteries regularly and check their accuracy by using a “known” weight – for example, a 10kg weight plate. Place the “known” weight on the scale and check the measurement aligns with the “known” weight.
Remember, the number on the scale is just one part of health and weight management. Focusing solely on it can overshadow other indicators, such as how your clothes fit. It’s also essential to pay equal attention to how we’re feeling, physically and emotionally.
Stop weighing yourself – at any time interval – if it’s triggering anxiety or stress, and get in touch with a health-care professional to discuss this.
At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register here to express your interest.
Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Glycemic Index vs Glycemic Load vs Insulin Index
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How To Actually Use Those Indices
Carbohydrates are essential for our life, and/but often bring about our early demise. It would be a very conveniently simple world if it were simply a matter of “enjoy in moderation”, but the truth is, it’s not that simple.
To take an extreme example, for the sake of clearest illustration: The person who eats an 80% whole fruit diet (and makes up the necessary protein and fats etc in the other 20%) will probably be healthier than the person who eats a “standard American diet”, despite not practising moderation in their fruit-eating activities. The “standard American diet” has many faults, and one of those faults is how it promotes sporadic insulin spikes leading to metabolic disease.
If your breakfast is a glass of orange juice, this is a supremely “moderate” consumption, but an insulin spike is an insulin spike.
Quick sidenote: if you’re wondering why eating immoderate amounts of fruit is unlikely to cause such spikes, but a single glass of orange juice is, check out:
Which Sugars Are Healthier, And Which Are Just The Same?
Glycemic Index
The first tool in our toolbox here is glycemic index, or GI.
GI measures how much a carb-containing food raises blood glucose levels, also called blood sugar levels, but it’s just glucose that’s actually measured, bearing in mind that more complex carbs will generally get broken down to glucose.
Pure glucose has a GI of 100, and other foods are ranked from 0 to 100 based on how they compare.
Sometimes, what we do to foods changes its GI.
- Some is because it changed form, like the above example of whole fruit (low GI) vs fruit juice (high GI).
- Some is because of more “industrial” refinement processes, such as whole grain wheat (medium GI) vs white flour and white flour products (high GI)
- Some is because of other changes, like starches that were allowed to cool before being reheated (or eaten cold).
Broadly speaking, a daily average GI of 45 is considered great.
But that’s not the whole story…
Glycemic Load
Glycemic Load, or GL, takes the GI and says “ok, but how much of it was there?”, because this is often relevant information.
Refined sugar may have a high GI, but half a teaspoon of sugar in your coffee isn’t going to move your blood sugar levels as much as a glass of Coke, say—the latter simply has more sugar in, and just the same zero fiber.
GL is calculated by (grams of carbs / 100) x GI, by the way.
But it still misses some important things, so now let’s look at…
Insulin Index
Insulin Index, which does not get an abbreviation (probably because of the potentially confusing appearance of “II”), measures the rise in insulin levels, regardless of glucose levels.
This is important, because a lot of insulin response is independent of blood glucose:
- Some is because of other sugars, some some is in response to fats, and yes, even proteins.
- Some is a function of metabolic base rate.
- Some is a stress response.
- Some remains a mystery!
Another reason it’s important is that insulin drives weight gain and metabolic disorders far more than glucose.
Note: the indices of foods are calculated based on average non-diabetic response. If for example you have Type 1 Diabetes, then when you take a certain food, your rise in insulin is going to be whatever insulin you then take, because your body’s insulin response is disrupted by being too busy fighting a civil war in your pancreas.
If your diabetes is type 2, or you are prediabetic, then a lot of different things could happen depending on the stage and state of your diabetes, but the insulin index is still a very good thing to be aware of, because you want to resensitize your body to insulin, which means (barring any urgent actions for immediate management of hyper- or hypoglycemia, obviously) you want to eat foods with a low insulin index where possible.
Great! What foods have a low insulin index?
Many factors affect insulin index, but to speak in general terms:
- Whole plant foods are usually top-tier options
- Lean and/or white meats generally have lower insulin index than red and/or fatty ones
- Unprocessed is generally lower than processed
- The more solid a food is, generally the lower its insulin index compared to a less solid version of the same food (e.g. baked potatoes vs mashed potatoes; cheese vs milk, etc)
But do remember the non-food factors too! This means where possible:
- reducing/managing stress
- getting frequent exercise
- getting good sleep
- practising intermittent fasting
See for example (we promise you it’s relevant):
Fix Chronic Fatigue & Regain Your Energy, By Science
…as are (especially recommendable!) the two links we drop at the bottom of that page; do check them out if you can
Take care!
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The Most Anti Aging Exercise
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We’ve referenced this (excellent) video before, but never actually put it under the spotlight in one of these features, so here we go!
Deep squats
It’s about deep squats, also called Slav squats, Asian squats, sitting squats, resting squats, or various other names. However, fear not; you don’t need to be Slavic or Asian to do it; you just need to practice.
As for why this is called “anti-aging”, by the way, it’s because being able to get up off the ground is one of the main tests of age-related mobility decline, and if you can deep-squat comfortably, then you can do that easily. And so long as you continue being able to deep-squat comfortably, you’ll continue to be able to get up off the ground easily too, because you have the strength in the right muscles, as well as the suppleness, comfort with range of motion, and balance (those stabilizing muscles are used constantly in a deep squat, whereas Western lifestyle sitting leaves those muscles very neglected and thus atrophied).
Epidemiological note: chairs, couches, and assorted modern conveniences reduce the need for squatting in daily life, leading to stiffness in joints, muscles, tendons, and ligaments. Many adults in developed countries struggle with deep squats due to lack of use, not aging. Which is a problem, because a lack of full range of motion in joints causes wear and tear, leading to chronic pain and degenerative joint diseases. People in countries where squatting is a common resting position have lower incidences of osteoarthritis, for example—contrary to what some might expect, squatting does not harm joints but rather protects them from arthritis and knee pain. Strengthening leg muscles through squatting can alleviate knee pain, whereas knee pain is often worsened by inactivity.
Notwithstanding the thumbnail, which is showing an interim position, one’s feet should be flat on the ground, by the way, and one’s butt should be nearby, just a few inches off the ground (in other words, the position that we see her in for most of this video).
Troubleshooting: if you’re accustomed to sitting in chairs a lot, then this may be uncomfortable at first. Zuzka advises us to go gently, and/but gradually increase our range of motion and (equally importantly) duration in the resting position.
You can use a wall or doorway to partially support you, at first, if you struggle with mobility or balance. Just try to gradually use it less, until you’re comfortable deep-squatting with no support.
Since this is not an intrinsically very exciting exercise, once you build up the duration for which you’re comfortable deep-squatting, it can be good to get in the habit of “sitting” this way (i.e. deep squatting, still butt-off-the-floor, but doing the job of sitting) while doing other things such as working (if you have an appropriate work set-up for that*), reading, or watching TV.
*this is probably easiest with a laptop placed on an object/surface of appropriate height, such as a coffee table or such. As a bonus, having your hands in front of you while working will also bring your center of gravity forwards a bit, making the position easier and more comfortable to maintain. This writer (hi, it’s me) prefers her standing desk for work in general, with a nice ergonomic keyboard and all that, but if using a laptop from time to time, then squatting is a very good option.
In terms of working up duration, if you can only manage seconds to start with, that’s fine. Just do a few more seconds each time, until it’s 30, 60, 120, and so on until it’s 5 minutes, 10, 15, and so on.
You can even start that habit-forming while you’re still in the “seconds at a time” stage! You can deep-squat just for some seconds while you:
- pick up something from the floor
- check on something in the oven
- get something out of the bottom of the fridge
…etc!
For more on all this, plus many visual demonstrations including interim exercises to get you there if it’s difficult for you at first, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Mobility For Now & For Later: Train For The Marathon That Is Your Life!
Take care!
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3 signs your diet is causing too much muscle loss – and what to do about it
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When trying to lose weight, it’s natural to want to see quick results. So when the number on the scales drops rapidly, it seems like we’re on the right track.
But as with many things related to weight loss, there’s a flip side: rapid weight loss can result in a significant loss of muscle mass, as well as fat.
So how you can tell if you’re losing too much muscle and what can you do to prevent it?
EvMedvedeva/Shutterstock Why does muscle mass matter?
Muscle is an important factor in determining our metabolic rate: how much energy we burn at rest. This is determined by how much muscle and fat we have. Muscle is more metabolically active than fat, meaning it burns more calories.
When we diet to lose weight, we create a calorie deficit, where our bodies don’t get enough energy from the food we eat to meet our energy needs. Our bodies start breaking down our fat and muscle tissue for fuel.
A decrease in calorie-burning muscle mass slows our metabolism. This quickly slows the rate at which we lose weight and impacts our ability to maintain our weight long term.
How to tell you’re losing too much muscle
Unfortunately, measuring changes in muscle mass is not easy.
The most accurate tool is an enhanced form of X-ray called a dual-energy X-ray absorptiometry (DXA) scan. The scan is primarily used in medicine and research to capture data on weight, body fat, muscle mass and bone density.
But while DEXA is becoming more readily available at weight-loss clinics and gyms, it’s not cheap.
There are also many “smart” scales available for at home use that promise to provide an accurate reading of muscle mass percentage.
Some scales promise to tell us our muscle mass. Lee Charlie/Shutterstock However, the accuracy of these scales is questionable. Researchers found the scales tested massively over- or under-estimated fat and muscle mass.
Fortunately, there are three free but scientifically backed signs you may be losing too much muscle mass when you’re dieting.
1. You’re losing much more weight than expected each week
Losing a lot of weight rapidly is one of the early signs that your diet is too extreme and you’re losing too much muscle.
Rapid weight loss (of more than 1 kilogram per week) results in greater muscle mass loss than slow weight loss.
Slow weight loss better preserves muscle mass and often has the added benefit of greater fat mass loss.
One study compared people in the obese weight category who followed either a very low-calorie diet (500 calories per day) for five weeks or a low-calorie diet (1,250 calories per day) for 12 weeks. While both groups lost similar amounts of weight, participants following the very low-calorie diet (500 calories per day) for five weeks lost significantly more muscle mass.
2. You’re feeling tired and things feel more difficult
It sounds obvious, but feeling tired, sluggish and finding it hard to complete physical activities, such as working out or doing jobs around the house, is another strong signal you’re losing muscle.
Research shows a decrease in muscle mass may negatively impact your body’s physical performance.
3. You’re feeling moody
Mood swings and feeling anxious, stressed or depressed may also be signs you’re losing muscle mass.
Research on muscle loss due to ageing suggests low levels of muscle mass can negatively impact mental health and mood. This seems to stem from the relationship between low muscle mass and proteins called neurotrophins, which help regulate mood and feelings of wellbeing.
So how you can do to maintain muscle during weight loss?
Fortunately, there are also three actions you can take to maintain muscle mass when you’re following a calorie-restricted diet to lose weight.
1. Incorporate strength training into your exercise plan
While a broad exercise program is important to support overall weight loss, strength-building exercises are a surefire way to help prevent the loss of muscle mass. A meta-analysis of studies of older people with obesity found resistance training was able to prevent almost 100% of muscle loss from calorie restriction.
Relying on diet alone to lose weight will reduce muscle along with body fat, slowing your metabolism. So it’s essential to make sure you’ve incorporated sufficient and appropriate exercise into your weight-loss plan to hold onto your muscle mass stores.
Strength-building exercises help you retain muscle. BearFotos/Shutterstock But you don’t need to hit the gym. Exercises using body weight – such as push-ups, pull-ups, planks and air squats – are just as effective as lifting weights and using strength-building equipment.
Encouragingly, moderate-volume resistance training (three sets of ten repetitions for eight exercises) can be as effective as high-volume training (five sets of ten repetitions for eight exercises) for maintaining muscle when you’re following a calorie-restricted diet.
2. Eat more protein
Foods high in protein play an essential role in building and maintaining muscle mass, but research also shows these foods help prevent muscle loss when you’re following a calorie-restricted diet.
But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado.
3. Slow your weight loss plan down
When we change our diet to lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several physiological responses to defend our body weight and “survive” starvation.
Our body’s survival mechanisms want us to regain lost weight to ensure we survive the next period of famine (dieting). Research shows that more than half of the weight lost by participants is regained within two years, and more than 80% of lost weight is regained within five years.
However, a slow and steady, stepped approach to weight loss, prevents our bodies from activating defence mechanisms to defend our weight when we try to lose weight.
Ultimately, losing weight long-term comes down to making gradual changes to your lifestyle to ensure you form habits that last a lifetime.
At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register here to express your interest.
Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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