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Even If You Backslide, Resolving To Improve Your Health Is Worthwhile

Even If You Backslide, Resolving To Improve Your Health Is Worthwhile

By Harvard Health Letters, Premium Health News Service

If you’ve ever made New Year’s resolutions that include adopting better health habits, you probably know they aren’t easy to keep. The reason resolutions often don’t work is because lasting change is usually not accomplished in a dramatic leap but through a series of incremental steps. However, research suggests that any effort you make is worthwhile, even if you find yourself backsliding from time to time.

Even if you don’t want to make a formal list of promises to yourself, the dawn of a new year is still a good time to take inventory of your health and to consider what beneficial changes you can reasonably accomplish. Dr. JoAnn Manson, professor of medicine at Harvard Medical School and chief of preventive medicine at Brigham and Women’s Hospital, Boston, Mass., cautions not to embark on something you’re not committed to.

“No matter how good an activity is for you, you’re not going to be able to sustain it if you hate doing it,” she says.

If you make resolutions this year, you may want to consider some of the following. They’re ranked in order of difficulty, easy ones first:

1. Floss every night

Flossing keeps plaque (collections of bacteria) from building up on your teeth and reduces gingivitis and periodontal disease—two conditions that can lead to tooth loss. Recently, scientists have also discovered that flossing might save more than your smile.

A series of studies have revealed associations between periodontal disease and increased risk of cardiovascular disease, diabetes, osteoporosis, and even death. In a study of 5,600 healthy people in a retirement community, people who flossed nightly had a 30 percent lower risk of dying within the decade than those who didn’t floss or who flossed at other times of the day.

It’s hard to find an excuse for failing to floss. Dental floss is readily available and comes in a variety of widths, textures, and flavors. There’s even a special version for people who have bridges or braces. Flossing isn’t hard to work into your schedule: it takes less than two minutes.

2. Walk 30 minutes a day

A brisk 30-minute daily walk is one of the most efficient ways to reduce your risk for heart disease, stroke, dementia, diabetes, osteoporosis, and colon cancer. It will also help you sleep better and ward off depression.

Walking is the simplest and least expensive form of exercise. You don’t need to join a gym or health club or invest in special clothing or equipment. If you’ve tried to get going before and have had trouble keeping with the program, you may want try the following:

—Enlist a buddy. Most things are easier when you don’t try to do them alone, and the obligation to meet a friend for a walk may be just what you need to get started and keep you going. Just make sure that your friend is as committed as you are.

—Dress appropriately. If you’re not comfortable, you won’t want to keep going. Wear shoes with good support. In any climate, it’s wise to dress in layers that you can shed as you heat up. It’s also a good idea to use sunscreen and to wear sunglasses on bright days, even in the winter.

—Start slowly. If 30 minutes seems daunting, begin with a five-minute walk and add another five minutes each week. You’ll be up to 30 minutes by six weeks.

3. Learn something new

Dementia research is indicating that becoming a perpetual student may help to preserve your memory and reasoning ability. This doesn’t mean maintaining a pursuit you’ve already mastered, like crossword puzzles or chess, but gaining a new competency. And physical exercise is as important as mental exercise. Here are some of the best things you can do:

—Study another language. If you’re already bilingual or multilingual, don’t let your second or third languages languish. A study published in 2013 indicated that now-bilingual immigrants to the United States who couldn’t read or write English when they first arrived in this country pushed dementia back an average of four years later than similar people who spoke a single language. If you haven’t mastered a second language, try to learn one.

—Learn to play a musical instrument. You might also resume playing one you put away years ago. Now that the pressure to make the high school orchestra is off, you may enjoy making music for your own enjoyment.

—Acquire a new physical skill. Any form of exercise can reduce the risk of dementia, but mastering a new physical skill has additional benefits. Take up a new sport, try a pottery or dance class, or even make an effort to do more tasks with your non-dominant hand.

—Enroll in a class. See what the local college, university, or community college has to offer. Many communities also have adult education courses that offer opportunities as varied as poetry writing, painting, and web design.

4. Eat better

Like exercise, a healthful diet will reduce your risk of most major diseases. In short, that diet contains at least:

—five servings of fruits and vegetables a day

—protein primarily from nondairy sources, such as fish, poultry, nuts, beans and other legumes

—whole grains

—polyunsaturated and monounsaturated oils

—no foods containing trans fats.

Unlike exercise, good eating isn’t free, and it may take some effort to change your grocery shopping and cooking habits. If you’ve been using a lot of processed convenience foods, you may want to start by making one substitution at a time.

For example, replace white bread with a whole-grain version, use olive or canola oil instead of butter, or snack on nuts or fruit instead of chips or cookies. If you’re unsure about what changes to make in your diet because of your medical problems, your primary care doctor can refer you to a nutritionist to help get you started.

5. Make new friends

Expanding your social connections can reduce the risk of cardiovascular disease and dementia and increase your chances of living longer. And adding new friends later in life can be particularly important if your circle is shrinking because of death or relocation.

There are all kinds of ways to form new connections. Joining groups of people who share your interests or goals, especially in your neighborhood, is one of the best. It also helps if the group you join includes people of different ages, backgrounds, and perspectives. Volunteering can be a particularly good way to introduce yourself to new people and social circles.

6. Lose weight if you need to

If you are overweight—particularly if you have excess abdominal fat—your risk of heart attack, stroke, diabetes, and breast cancer is higher than it should be. Carrying too much weight can also contribute to arthritis, tendinitis, and sleep apnea. A loss of 5 percent to 10 percent of your body weight can reduce your health risks substantially.

The pledge to lose a few pounds might be the most commonly made—and broken—New Year’s resolution. If you’re considering trying to shed pounds, don’t set a low weight or a small clothing size as a goal. Instead aim for a body mass index (BMI) of 25 and a waistline under 35 inches.

If you’ve tried and failed to lose weight before, ask your doctor to refer you to a nutritionist for counseling. A nutritionist can help you identify the foods and eating habits that may be keeping you from losing weight and design an eating plan that is both nutritious and satisfying. And if you’d like some emotional support in sustaining a new way of eating, your nutritionist should be able to help you find a group program.

7. Stop smoking

Smoking ranks at the top of the practices most likely to harm your health, increasing the risk of heart disease, stroke, chronic obstructive pulmonary disease (COPD), and lung cancer, as well as many other cancers. If you’re still a smoker, you know how hard it is to stop. If you need some encouragement, consider the following:

One year after quitting, you’ll have cut your excess risk of heart disease in half.

Five years after quitting, you will have eliminated your excess risk of stroke.

Ten years after quitting, you will have reduced your excess risk of lung cancer by half.

Fifteen years after quitting, you will have eliminated your excess risk of heart disease.

If you’ve failed before, don’t try to go it alone. A medically based cessation program can help you develop a realistic plan for quitting. Such programs can provide the appropriate drug treatments and psychological support and your insurance is likely to cover most of the costs. — Harvard Women’s Health Watch

Photo: Wikimedia Commons

I Firmly Resolve Not To Improve Myself!

I Firmly Resolve Not To Improve Myself!

It’s that time of year when Americans — ever the strivers, according to Alexis de Tocqueville — turn to thoughts of self-improvement. What’s your New Year’s resolution?

Mine is simple enough: I’m forgoing New Year’s resolutions. I’m going to remain my shabby, unimproved self and be happy about it. What better way to start 2015?

Once upon a time, I was quite the dedicated maker of New Year’s resolutions, which ended up broken halfway through February. More than once, I recall, I resolved to forswear profanity. What a &#!* idea that was! (Sorry, Mom.)

While having a youngster in the house has calmed my cussing a bit, I’m still prone to an outbreak that would shame a sailor every now and then. It’s quite the stress-reliever, and — contrary to popular belief — is not a sign of a poor vocabulary. My lexicon of cuss words is, in fact, rather well developed. I don’t know how to spell them all, but I can repeat them with clarity and stellar enunciation.

Perhaps my most repeated resolution has been the claim that I’m going to get organized. Well, that’s just nuts. My lack of organizational skills is a congenital defect, and fixing it would require a personality transplant. So I’ve learned to live with it.

My home workspace is perennially a fire hazard; I store important documents so I can find them later, only to forget where I put them; I’m constantly forgetting loved ones’ birthdays. (No, no, I don’t need any more calendars. I have several, digital and analog. But I forget to look at them.) By now, my friends and siblings know that birthday cards will show up several days late, so I just buy the “Sorry I forgot” cards weeks in advance.

It’s taken me a few decades, though, to give up on the idea of a new and improved version of me. It’s tempting to believe that the right books, the right lectures or the right seminars can lead to a better life.

Apparently, the notion is deeply embedded in American culture, threaded through our civic and social fabric. Back in the mid-19th century, de Tocqueville, the visiting French historian, found that “equality suggests to the Americans the idea of the indefinite perfectibility of man.”

Perhaps that explains why self-improvement is a multi-billion-dollar industry in the United States. Go to any bookstore, and you’ll find a self-improvement section, with explicit instructions on eating better, sleeping better and, of course, looking better. You’ll be told you can be a better husband or wife, son or daughter, mother or father. And you can certainly be richer. I’ve read 7 Habits, 21 Secrets, and 10 Days to …, well, just fill in the blank.

There are classes to take. Erhard Seminars Training (EST), which started in the ’70s, has evolved into The Forum, which urges you to “redefine what’s possible.” There are motivational speakers to listen to in person or on digital media. You can spend hundreds of dollars to sit in a hard chair in an auditorium for a day of speeches by the rich and famous — sessions that may not improve you very much but certainly help the speakers.

In my childhood, there was Norman Vincent Peale, telling you the “Power of Positive Thinking.” These days, there’s Oprah — a self-improvement industry unto herself. There’s even a career path called “life coach.” Who knew? I thought that’s what parents were for.

Having tried and failed at self-improvement, I’m ready to settle in with my bad habits. I’m not going to count the number of steps I take each day en route to better health. Indeed, I’ve already lost the gadget that was supposed to help me keep track. (Did I mention I’m disorganized?)

I’m not going to be neater. I will continue to step over assorted files on the floor of my study and crawl through the dust bunnies under my bed when I lose a sock. My clothes will not be organized by season. (I will try to sort the clean laundry from the dirty, but I won’t always succeed.)

I am, however, going to be content with my unimproved self. That I firmly resolve.

Cynthia Tucker won the Pulitzer Prize for commentary in 2007. She can be reached at cynthia@cynthiatucker.com.

Photo: gigi_nyc via Flickr

The Automatic Way To Keep Your New Year’s Resolutions

The Automatic Way To Keep Your New Year’s Resolutions

Many New Year’s resolutions are about redemption. Maybe you aren’t the sort of person you want to be. Maybe you aren’t kind enough to others (strangers, co- workers, family members). Maybe you suffer from a self-control problem involving cigarettes, alcohol or gambling. Maybe you procrastinate; maybe you’re impatient or impulsive. Maybe you haven’t taken steps that would enable you to make your life better — with more time off from work, a vacation in a gorgeous setting, an adventure or two.

On New Year’s Eve, you resolve to make a change. But within a month, you’re back to your normal patterns. How come?

Some clues can be found in a study with the revealing title, “Everyone Believes in Redemption.” The paper, by the economists Robert Letzler of the Federal Trade Commission and Joshua Tasoff of Claremont Graduate University, doesn’t involve New Year’s resolutions. But it demonstrates that people suffer from both unrealistic optimism and inertia, which make it hard for them to carry out their plans.

Letzler and Tasoff gave the participants in their study an opportunity to earn $20 by redeeming a mail-in form. The subjects were instructed to print out a “certification page,” which they were required to include with their form.

Participants were also asked to predict the likelihood that they would send in the form. As it happens, their responses were wildly optimistic. Actual redemption rates ended up being about 50 percent lower than what the participants predicted. In other words, they resolved to mail in the form, and they fully expected to do so — but ultimately they didn’t. (Similar patterns are observed in the real world; each year, American consumers fail to mail in at least $1 billion in potential rebates.)

Can anything be done to help? Letzler and Tasoff tried three different interventions.

First, they informed people about the low redemption rates of earlier participants. But this information, helpful though it would seem, had no effect on people’s optimism about what they would themselves do or on the likelihood that they would mail in the form.

Second, Letzler and Tasoff sent people emails to remind them of the approaching deadline for redemption. The researchers had reason to think that this intervention would be effective, because reminders have been found to work in (for example) getting people to pay their bills and to come to doctor appointments. But in the case of the rebates, reminders had no effect. People ignored them.

Finally, Letzler and Tasoff eliminated the requirement that subjects print out and submit a certification page as part of the redemption process. This was the only intervention that worked. By making things easier, they increased redemption rates by about 20 percent.

The important lesson here is that simplification brought people’s predictions closer in line with reality by changing their behavior, not their beliefs. Once the process became a bit easier, people became more likely to take action and thus to make good on their predictions.

When people are unrealistically optimistic about what they will do, Letzler and Tasoff conclude, it is because they don’t pay enough attention to the costs and burdens involved. When they resolve to act, and when they make inaccurate predictions about their own behavior, the benefits of action are salient, but the costs are not.

Consider New Year’s resolutions in this light. It’s easy to resolve to be more altruistic, to exercise greater self-control, to be more patient, or to enhance one’s life, but it’s costly to do these things. Suppose that you aren’t always as generous and kind as you would like to be, or that you have trouble resisting temptation, or that you don’t give yourself enough time off. If so, it’s probably because it’s costly to do those things, and it’s hard to anticipate those costs and burdens in advance.

The best remedy is to find ways to reduce such costs and burdens. If you want to be more altruistic, you might set up automatic monthly gifts to your favorite charity. If you want to increase your self-control, you might alter your environment so that you run into temptations less often — for example, by keeping less food in your refrigerator. If you want to have an adventure or two, you might accompany your New Year’s resolution with a purchase, today or tomorrow, of a plane ticket.

Months or even weeks after New Year’s, many people learn that optimism and inertia are a potent combination. To overcome them, it helps to make redemption automatic — or at least a lot simpler.

Cass R. Sunstein, a Bloomberg View columnist, is the Robert Walmsley University professor at Harvard Law School and a former administrator of the White House Office of Information and Regulatory Affairs. He is the co-author of  Nudge and the author of  Simpler. He is also author of  Conspiracy Theories and Other Dangerous Ideas, forthcoming in March.

Photo: nigelhowe via Flickr

Shaft The Long-Term Unemployed And The GOP’s Other 2014 New Year’s Resolutions

Shaft The Long-Term Unemployed And The GOP’s Other 2014 New Year’s Resolutions

Right now, Republicans are thrilled with themselves.

In 2013, they prevented both gun safety and immigration reforms, while enjoying the adrenaline rush of holding the economy hostage and actually shutting down the government for 16 days.

And because HealthCare.gov got off to such a craptastic start, they’re currently poised to keep their House majority, which they were able to retain in 2012 even though their nominees received more than a million fewer votes than Democratic candidates.

So what’s this merry band of total bummers planning for 2014? More of the same.

Here are five New Year’s resolutions you can be sure the GOP will do its best to keep.

1. Cut 1.3 million people off unemployment insurance.
Congress has extended unemployment insurance benefits more than a half-dozen times since the 1950s, and it has never cut them off when the long-term unemployment rate was higher than 1.3 percent. It is currently 2.6 percent and Republicans in both chambers are refusing to extend the emergency benefits for the long-term unemployed that first went into effect ion when the Great Recession began, even though George W. Bush extended emergency benefits multiple times. Even in nearly every Republican-held swing district, a majority of the public wants these benefits extended. But the Republican mania to cut the deficit, even though it has been cut in half, continues.

For some Republicans — like Senator Rand Raul (R-KY) — cutting off those who can’t find work when there are two applicants for each open job is doing them a favor. But there’s no evidence that backs up that cruel claim.

2. Deny five million of the hardest-working Americans health insurance.
Medicaid expansion was designed to help those who work but earn too much to qualify for basic Medicaid. This encourages Americans to rise out of poverty and is the closest thing to a “public option” in Obamacare. Thanks to the Supreme Court, states can opt out of the program — even though the government covers 100 percent of the costs at first and 90 percent in perpetuity — at any time. And 25 Republican-led states have done just that, leaving nearly five million in a “coverage gap” where they cannot afford any coverage.

They’re doing this knowing they’re denying billions of dollars that would grow their states’ economies, driving up the cost of insurance in their marketplaces and endangering the lives of 27,000 residents in the process.

3. Try to cancel millions of Americans’ health insurance.
Republicans are just as committed to the repeal of the Affordable Care Act now as they were before their failed attempt to defund it by forcing a government shutdown. Any GOP candidate who suggests that we should simply fix the health care law instead of completely ripping its existence from the fabric of history is forced to retract the statement and repent. The problem for Republicans now is that repeal is no longer theoretical. Repeal now means canceling the coverage of the three million young adults on their parents’ plans, the more than three million people who have signed up for Medicaid or the State Children’s Health Insurance Program and the at least one million people who have selected paid private plans through the health care exchanges.
Savvy Republicans who recognize this may not be the smartest move could simply try to repeal the individual mandate, the least popular part of the law. Then they’ll be arguing to raise the rates of millions of Americans by as much as 27 percent. while leaving millions more uninsured.

4. Continue to demand cuts to Social Security and Medicare benefits without asking the rich or corporations to give up any tax breaks.
There’s a simple way to solve the Social Security “crisis.” First, admit that there isn’t a crisis. The program is fully funded for decades (and would be funded even longer if we passed immigration reform). Then either raise the cap on the payroll tax or tax millionaires slightly more to keep America’s greatest poverty-reducing program funded forever.

Medicare is a bit more complex.

President Obama has proposed reforms to the program, which would instantly be more viable with simple progressive fixes like negotiating for drugs the way the Veterans Administration does for its health care plan. But making cuts to Medicare benefits right now would be reckless given that the reforms to the program in the Affordable Care Act have shrunk the growth of costs over the past year to zero percent — yes, zero. If this trend continues, we’ll have essentially eliminated our entire long-term debt problem. Still, many Republicans demand cuts to benefits, asking America’s seniors to pay more while refusing to give up the massive tax breaks we give to millionaire investors, owners of second homes and corporations that offshore jobs.

The budget deal forged at the end of the year will likely delay any cuts for two years. But you can be sure that Republican candidates for Congress will campaign for “entitlement cuts” in 2014. And instead of asking the richest to pay more, most will be touting “tax reform” that will ask them to pay even less.

5. Show up for work even less often than they did in 2013.
The House of Representatives was only in session for 126 days in 2013, leading to the least productive American Congress in recorded history. How will the Republican leadership top itself in 2014? By working even less.

Just 113 days of work await members of the House in 2014, a reduction of about 9 percent, which is coincidentally nearly identical to Congress’ approval rating.

Photo: Gage Skidmore via Flickr