(upbeat music) - Well, it's a new year.

Want a new you?

Or maybe just a tweak or two?

This edition of "Community Connection," new year wellness and health tips for you.

So I get the best to discuss that.

Dr. Diana Bitner, true.

Women's Health here.

Shanthi Appelo, Blue Cross Blue Shield of Michigan.

Glad that you are here as well to talk about wellness and obviously nutrition.

Physical therapist Terence Reuben.

Mary Free Bed, sports rehabilitation.

You're gonna make me faster and better.

Hello to you, Terence.

- Hi.

- And all three of you.

All right, so let me begin with you, Dr. Bitner.

Tell me how you are involved in this niche of health and wellness.

- Sure.

Well, I am an OB/GYN by training, so I've always been very interested in women's health.

And I have pivoted my career from delivering babies to supporting women in their total wellness, so I started true.

Women's Health.

and I care about this because I don't want women to suffer from symptoms of aging, but also to be empowered to age how they want.

So we have a whole team to support women in their wellness.

- Good.

Thanks for what you do.

Shanthi, tell me about you and your passion.

- Yeah, sure.

So I'm a registered dietician.

I'm the health and wellness spokesperson for Blue Cross Blue Shield of Michigan.

I've worked in nutrition through a few different lenses.

I've worked in a clinical setting, taught in a university setting, and most recently I worked in public health and work site wellness.

So just really love how nutrition can influence how we feel and just how we can live a better life.

- Right.

Terence Reuben, tell me about your niche please.

- Yeah, so I'm a physical therapist specializing in sports medicine for the past 30 years.

And yeah, I'm that old.

(chuckles) But my passion is in dealing with people that want to lead healthy lifestyles and get them back to their sport in optimal performance shape.

- Right.

I want to bring that elephant in the room as we talk about new year resolutions, goals, whatever term.

Obviously the goal is to make ourselves bigger and better.

Is it true that we break these resolutions perhaps within six weeks?

And if that's true, why Dr. Bitner?

- I think it's because number one, the goals aren't maybe heartfelt enough.

I think it's really important to get to what really means something.

Not maybe somebody else's goal, let's say just a weight loss or I'm gonna run because my partner runs, but what do I really care about?

And I think that's one of the main reasons.

- What are your thoughts, Shanthi, as far as perhaps where nutrition's involved?

- I think sometimes we set too lofty of goals.

We might want to lose 20 pounds in five months, but that can be extremely difficult, especially if we want to be able to be in it for the long run.

That's really what it's about, to be able to live healthy in the long run.

And oftentimes if we deprive ourselves for too much, it makes it really difficult to reach that.

- What do you have to say, Terence?

- I am not a fan of these resolutions just because it's one of those things where we set ourselves up from the get-go to fail, because we would take on more than we can handle.

So I think if you break down the components of our lives and what's considered healthy or wellness things, initiatives, and we try to tackle smaller bits at a time, we can have much more realistic goals and expectations.

- Great.

Dr. Bitner, what should be a goal or two medically to live our best health that we can, that are changeable goals.

Obviously some of our goals aren't, we can't change our DNA, but what can I do to really make my health as good as it can be?

- Well, I think number one in medicine, so often we tell people what their goals should be.

And I think it needs to be the other way around, that we need to ask people what their goals are.

And we talk a lot about milestone events.

So say someone has a child's wedding coming up or a big birthday coming up, anything that means something to them.

Yesterday I saw a patient.

It's their 40th birthday in two years, and she's really gunning for how that will be because she remembers her mom wasn't healthy at her 40th.

So she wants to flip it and change her trajectory.

So that means something to her.

So then I really want to get in her head about what does that mean to you?

Healthy, freedom of movement.

So Karen's like, she's got some hip pain, she's got some back pain, so she wants to be freedom of movement.

She was to fit in her clothes.

So again, I think it's finding that goal that is really meaningful to each person.

- Right.

Well, we know we have choices when we eat and Shanthi, let me bring you in to, well, I guess what are some musts when it comes to this change of habit forming?

- Well, I briefly mentioned that it's so important to fit in your favorite foods.

Along those same lines, it's so important to reduce the guilt we feel surrounding food.

if you're enjoying something that maybe doesn't fit into your usual plan.

So for me, that means I never go without pasta, but it does mean that I fit it in, in small way.

So, you know, a small appetizer of ravioli or gyoza or something like that, or half a cup at a meal.

So just finding ways to not make myself feel so deprived, right?

- Yes.

I'm just gonna throw this out.

Is the 80/20 rule still the best way to go?

80 good, 20, I won't say bad, but- - 90/10.

- 90/10?

You want to go there?

- 90/10.

- I like Diana's approach here, but yeah, I mean, it definitely just depends on what works best for you.

But some of the things to help you get there though is make healthy food fun, learn something new, experiment.

I find myself pretty experienced in the kitchen, but there are still so many new ways that I can learn to cook foods, find new ways that vegetables taste good, and that makes the 90/10 easier too.

- We have a nutritionist who's a Culinary Institute trained chef.

And so we'll do cooking classes and recipes and our patients meet with her one-on-one, and she really wants to help them in their culture and their food choices.

Like what they love, how can we make good choices around that and be mindful?

- Great.

Thank you for that.

All right, Terence.

Let's bring in the conversation of exercise.

Why is exercise important?

And of course, what are the benefits perhaps we forget with our daily goal?

- Yeah.

I think the balance that we need from both a mental and a physical state is important.

And so every choice we make when it comes to exercise has to be something that is an achievable goal.

So way too often, we'll have clients that say, well, it's the new year.

I want to exercise every day so I can lose weight, or so I can do this event.

And I think we forget about the idea of how do I live a healthy life?

How do I not get out of breath going up the flight of stairs?

And if there's something that is bothering me, whether it's the hip pain or knee pain, is it there things that I can do to help manage my physical body so that I can achieve those smaller step goals?

Realistically, when you set too big of an expectation, it's hard to achieve, but you do want to have a plan with whatever goal you set.

So the planning, I think, is the key to a lot of people continuing or creating this longer-term impact on the exercise, their health, their fitness, and their wellness.

But I want to stress again the importance of the mental health in all of this, because if you hate your body and you hate yourself, that's not a good place to start.

So the first thing you want to do is look in the mirror and appreciate who you are and where you are in life, and be thankful for that moment.

And then from there, check on the little things that you can do to improve your health and wellness along the way in a positive direction.

- Let's stay on this topic of mental health that should be discussed as much as physical health.

Dr. Bitner, what do you have to say about responding to Terence and keeping our mental health in shape?

- Well, mental health is huge.

First of all, when we get stuck in flight or fight, we tend to do and say stupid things or make poor choices.

So if we can really stay grounded in gratitude and our breathing practice, the mindful eating part of it, for example, but to really be mindful so we can cope with our stress in a very practical way.

But also explain, for example, we make brain chemicals that help us cope and deal and stay grounded.

And if we're not sleeping, those brain chemicals aren't made as much.

We tend to make these brain chemicals when we're sleeping.

So it's to focus on those daily habits, including sleep.

But then also thinking, all of the unresolved events that we're all dealing with every day, they use up all our brain chemicals.

And so it's how can we resolve unresolved things?

How can we deal with family stress or drama and just minimize the things that aren't resolved?

Is it seeing a therapist?

Is it working through difficult relationships and just, the serenity prayer is key to me, and we talk about it a lot here at true.

It's like, what can I change?

What can I not change?

And the wisdom to know the difference.

And then back to those basic habits.

- Shanthi, I have a feeling there's a truth to the statement we are what we eat.

So how much does a nutritional choice that I make, well, make my mental health strong or weak?

- Well, I'll echo what Dr. Diana said, and that is getting enough sleep definitely influences our eating choices.

If we are deprived of sleep, we're not gonna make the best choices.

Not getting enough sleep too influences the hunger hormone.

So we might not feel that our satiety is the way it should be after eating something.

We might feel that our appetite is more than it would be if you got more sleep.

Same with mental health.

So a lot of stressors that add on to trying to lose weight, right?

So if we can get those kinds of things under control, manage our stress, feel good on that level, it can help our weight so much, especially when it comes to those hormones.

- Well, I think about stress too.

It makes our insulin go up, right?

So when we're in a stressful response, our body's response is I've got to store food for later.

So when we have that stress response to whatever it is, it makes us crave sugar.

And especially around the menopause, that's even worse.

- Stand by for a menopause discussion.

Back to you, Terence.

Exercise.

You live long enough, you're gonna experience an injury, hopefully mild, but how do I prevent an exercise injury or maybe, well, going too quick, too soon?

- Yeah.

The Bermuda triangle of exercise is doing too much, too fast, too soon.

And so by being able to separate that out and metering out the exercise, the activity, I think that's the key there to physical health and balance.

Quite often, we are so engaged in wanting to perform the activity itself that we forget how to prepare ourselves for that activity.

So for example, a good warmup and a stretch routine is important to prepare it to do the activities that you're about to do.

And then the timing of how you do those.

So for example, if you have longer workouts, what is your nutrition like and your hydration like during those workouts, something often ignored.

We go for a three hour bike ride or a three, four hour run if we're trying to train for a longer distance event, and all we carry is just water instead of trying to balance that off with the electrolytes and some of the nutrients that we would need to sustain our bodies over that time.

And when your system gets depleted of those nutrients as Shanthi would attest to, you're gonna start setting yourself up for injury because your body does not have the right nutrients it needs to perform and function in the way that you're demanding of it.

So I think when it comes to your physical activity, exercise is being very realistic about what you're doing, having that plan in place, but also balancing it out with the right nutrition and hydration during the activity.

- Great.

Shanthi, if you can expand on that, why the importance of fuel choice is needed in all aspects of life.

- Yeah, absolutely.

When it comes to exercise, something that I recommend, especially when we're combining exercise to nutrition into weight loss, is that we can oftentimes plan, like Terence was saying, our meals into that routine.

Because oftentimes what happens is people will work out, they'll have their protein shake afterwards, and what it does is adds a lot more calories.

So instead, fitting in that exercise routine, into your daily schedule of eating already, or vice versa, that can be really helpful.

But yeah, absolutely.

Those nutrients play a huge role in not only how you perform during exercise, but also during recovery, protein being very important there.

- Yes.

I had a Facebook question.

Impact of six small, nutritional meals on weight loss.

What do you think Shanthi?

- So the small meals, one of the reasons that that can be really helpful is because we don't overdo it at any point, right?

So if we skipped breakfast, we skipped lunch, but we're gonna plan for this dinner we have tonight because we've saved up all day for it, that can make us overeat, not feel so comfortable, and then we deal with this food guilt.

So a lot of the time having these small frequent meals can be helpful because not only does it make us feel sustained throughout the day, it makes us feel satisfied, but it can also prevent us from overeating.

- And if you do it right, you get to eat more often.

There you are.

Dr. Bitner, let's discuss the topic of menopause.

No secret.

You've written a book on it.

You are our expert.

So where does my new year resolution land me if one is in this state of life?

- Well, I hear Shanthi and Terence talking about all these healthy habits.

And one thing I see a lot is that women talk about their weight gain during the midlife transition and into menopause.

And one of the big reasons we see that happen is because of lower muscle mass and insulin resistance.

So women tend not to sleep as well, they tend to crave simple carbs more, and they're not maintaining their muscle mass.

So we know that if women maintain their muscle mass through the menopause transition, it's easier to keep their weight down, and again, they don't get into that cravings sugar cycle.

So what happens when we lose estrogen, it disturbs our sleep, more hot flashes, night sweats, but again, we develop more insulin resistance, and again we're craving those simple carbs.

So again, it's putting all of our talents together to talk about this phase of life.

But if women know, number one, what is their phase, and number two, added in their family history.

If a woman had a history of diabetes and pregnancy or a family history of diabetes, she even more is going to gain that belly fat, or we call it the menopot, during the menopause transition.

So it's going back to the habits and then even thinking about considering taking estrogen, for example.

So we know that women who take estrogen medication during the menopause transition and after have less insulin resistance, a little lower risk of developing type two diabetes.

They have better management of their sugars if they in fact do have pre-diabetes or diabetes.

So it's looking at hormones for more than symptom management.

It's looking at it for overall wellness.

So, I mean, I could talk about that forever, of course, but it's such an important transition that women know about.

- And then I want to add that.

I think that's often ignored by the males as well, because we always look at women and transition through menopause, but men go through a very similar kind of- - Man-pause.

- And so, hey.

I'm 54 years old.

I've lived through some of those hot flashes.

I know what it's like.

I thought I was having a heart attack the first time.

But we don't talk about it because we're guys, right?

But we should.

And the more we can talk about this and learn how to adjust our diets, our sleep, and our exercise around those factors, the more successful we would be of creating good, sustainable outcomes through our activity.

- Well, we have a thermostat in our brainstem and one of the things that modulates those neurons is substance P, which also changes with stress.

And so we know that when women get adrenaline, or men get an adrenaline rush, they can also get a hot flash.

And so as we modulate our stress, as we're hydrated, but then also look at estrogen.

Then as we lose estrogen, then the thermostat regulation isn't as strong, so we're more responsive to stress and dehydration.

So again, it all fits together.

- Yes.

I want to go into the, is it ever too late to start?

And let's start with nutrition.

Now say, Terence is 54.

Boy.

I wish I was.

And wants to begin some changes, now is the time to change.

How does he start?

- Well, it's never too late to start.

It really isn't.

Even if you've had that poor diet for half of your life, if you start adding in some of those plant foods, some of those unprocessed foods, it is absolutely gonna not only reduce your risk for chronic illness, you think heart disease, diabetes, all those things, but it's also gonna make you feel so much better.

I mention plant-based diets a lot because there's such a growing body of evidence in the way that it can reduce inflammation, in the way that it can help disease management, but it truly can help you live longer.

One of the reasons for that is we look at ultra-processed foods, for example.

You think those packaged snacks, the frozen meals, even things like turkey bacon that we think are, oh, it's a little bit healthier, but a lot of those things can increase inflammation.

One of the things that it can also do is make us less sensitive to insulin.

So we think in diabetes, for example, we eat something, our body breaks down the carbohydrates into glucose that wants to get into the cell to be used for energy, but instead it gets stuck in the blood.

And so we want that insulin to be able to let in the glucose to be used for energy, but that can sometimes be difficult because of our food choices, and other factors, of course.

So if there's anything one person can do, it's definitely to add a few more plants and cut out some of those ultra-processed foods.

- So the big part of it too is the fiber, right?

Because then, sorry, the sugar doesn't get into the blood as quickly.

So a sweet potato is so much better than a white potato, especially in someone who's insulin resistant because of all the extra fiber.

And then of course, gut health, right?

So we recommend our patients have a third of a bottle of kombucha every day to keep those healthy gut bacteria going and live on the fiber.

- There's so much there.

There's so much there.

And I like that you mentioned that, because not only does fiber help with the response to carbohydrates in diabetes, but it can also help reduce LDL cholesterol.

If we think of heart disease, for example, fiber and all of these components of plant foods are so helpful for all aspects of health.

- Again, it's fuel.

All right, Terence.

Tell me about where to start with my exercise if I'm 54.

- You want to start with at least getting the right gear on yourself.

So you're gonna be starting off, let's say, with walking.

Make sure you have the right shoes and the right clothing.

It's amazing how a little things like wearing a cotton shirt versus a tech shirt can affect where the shirt's gonna grab, and then you can end up chafing, which then is gonna make your walking more miserable.

So you have to walk before you run.

So if you're unable to get in a good, consistent 20-minute walk at a brisk pace, you don't want to just start running right away.

And if you're gonna start running, started it with an interval of a little bit of a walk and a little bit of a run, depending on what your body can tolerate.

I encourage people to seek out the sports stores to get their gear and not just buy it online, because the customer service you get there and the recommendation for the right product is pivotal.

Sometimes we think something looks good because of the nice color, but they don't actually, they're not the right gear for us.

So the gear is important.

The way you start and the slow buildup is also important, but then you also want to intersperse that word, low load weight training.

So we're so used to wanting to go to the gym and try to lift heavier weights and do too much.

Again, too fast, too soon.

And what I recommend is going with much lower weights, and start off with even just one plate on your exercise equipment and see if you can do repetitions of 30 and 25 and 20 instead of three sets of 10.

And when you look at that higher repetition, lower resistance kind of workouts, you build a circulatory response to your muscles.

And as you improve that over time, then you can bring the load back in and decrease the repetitions to get your body to build and balance better.

So it's about that interspersing your core and your weight training with your actual sports-specific exercises to give you the balance that you need from a physical standpoint.

- As you know, with low estrogen, the ligaments and tendons get so much tighter.

So stretching just becomes so, so important.

- Yes.

We are near our end.

I always ask for closing comments.

Before, I did have one more Facebook question.

Dr. Diana Bitner, if you would just answer.

10 to 15 minute power nap.

Yea or nay?

- Yes.

But I always, when I take a power nap, I set my alarm for 20 minutes, so we don't get into this super deep sleep.

So we just want to get a little bit of N2, that restorative sleep, and then pop back up.

So definitely recommend that little power nap, but set an alarm so you don't get groggy and irritable.

- Yes.

What do you leave us with?

What are you charge us for this 2022, Dr. Bitner?

- Be informed and have a plan.

We can't just have accidental aging, where we're responding to stressors.

It's to think forward, know your history, and have a plan and find those tools that can help you live well, seek out.

If you had a financial project for yourself, you can get your tools together, you find your experts and you make a plan, you set a budget.

Do the same with your health.

And we talk about all those habits together.

We call them the SEEDS or the Seven Essential Elements of Daily Success.

It's get your habits, make a plan and make it happen.

It's possible.

- I like what's behind you.

True.

Women's Health.

It looks like I'm doing some curl ups, maybe some yoga.

I'm getting my sleep.

You walk the talk, ma'am.

- Yeah, I gotta put my head, but those are the seven essential elements.

So it's about getting your water, your good nutrition, micronutrients, especially vitamin D, and getting your sleep, getting your exercise, all three components and meditation and gratitude.

- Start today.

How do we find out more about you and yours?

- At truewomenshealth.com.

You can find about our practice and we have lots of great free content on all apps, on all social platforms.

So we just really want to reach as many women as we can and tell women it is possible.

- Great.

Shanthi Appelo, what do you leave us with?

- I think as we head into this new year, as we have new health goals, I think a lot of the answers we already have.

If you look at your past successes and your past failures, think about what's worked for you in the past, think about what hasn't worked, and form a plan based on that.

Because oftentimes what I see is someone's often lost weight before when I'm working with them and they want to go back, for example, to a low carbohydrate diet, because it's extremely effective and it works fast.

But I always challenge people to think back and see why you're back in this place.

So I leave you with that.

You probably do have the answers (laughs).

And for more information, we have a great website, Blue Cross Blue Shield of Michigan hosts a website called ahealthiermichigan.org.

I put up several recipes each month.

We have a lot of great health tips and more there, so check it out.

- And what's for lunch for you, Shanthi, today?

- Ooh, that's a great question.

That is a great question.

(laughs) I guess I didn't plan as well as I usually do, but you know, I love those tuna packs that are flavored already.

I usually throw that on top of a salad if I don't have anything else.

- Just keeping you accountable.

'Cause if turkey bacon or whatever you said earlier came out, we'd shut you off.

Not really.

90/10, 90/10.

Terence Reuben, what do you leave us with?

You running today?

- Yeah.

Actually today, the four mile run and then we're meeting up with our run group.

So yeah, we'll be running.

But what I want to leave people with is don't make these drastic changes based on, hey, I want to live longer or hey, I want to lose weight.

What you should be looking at is I want to have a healthy lifestyle.

And it's not the years in your life that matter, but rather than life in your years.

So make the best of that moment to give you the best today and the best tomorrow.

I think sometimes we look too far ahead at this long stretch without actually enjoying that moment.

And especially in our communities, we spend so much of time in wanting something else that is unattainable, instead of enjoying the now.

So look at your opportunity, look at where you can exercise, look at where you can get healthy, seek out some help if you need that, either with a trainer or with a physical therapist, so that you can have the balance and you can lead a healthy life.

- Great.

We find out more about you how?

- MaryFreeBed.com, and you can also use our phone number at 616-840-PLAY.

That's 7529.

So P-L-A-Y.

840- - Good to play.

Thank you for your super advice for this super year to come, 2022.

Take care you all.

Thank you.

- Thanks, Shelley.

- And thank you for watching.

Kudos to you.

Health and wellness in 2022.

Let's go get 'em.

Take care.

If your organization would like to be considered for a Community Connection segment, or are you having events you would like to be added to our community calendar, email your information to irwinshh@gvsu.edu.

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