Healthy Living Without Really Trying (cont.)

KATZ: It is generally unwise to rely on exercise alone to lose weight, because tasty calories are so readily available to us all, that it's quite easy to eat back the benefits of physical activity. Consequently, it is advisable to combine strategies for increasing physical activity with strategies for controlling calorie intake.

But any physical activity you add to your day will likely do you good, whether or not it leads directly to weight loss. First, physical activity promotes health. This is clearly desirable, independent of weight loss. Second, the more active you become, the more appealing further additions of physical activity tend to become.

If you are sedentary the idea of going for a long walk on the beach or a hike or a bike ride when you are on vacation might be rather intimidating. If you routinely have added 1,000 or 2,000 steps to your daily routine, your level of fitness might now make those activities look more appealing.

As a result, physical activity tends to be habit forming, and the more you do the more you can do. Your energy level tends to rise, your interest in your health tends to increase, and the next thing you know you're paying more attention to the fuel that powers that physical activity -- namely, your dietary choices.

People who become more active generally improve their diet as well, acquiring an overall interest in their health and vitality along the way. So 500 steps a day is not the solution to losing a significant amount of weight, but it is the start of something much bigger that can achieve both weight loss and health promotion.

MEMBER QUESTION: How do you fit in exercise when you have limitations or have lost weight due to disease?

KATZ: Unless you are severely disabled by illness or injury, there is almost always some way to be physically active.

For example, if you have arthritis-related trouble with your joints, swimming might be both good for fitness and somewhat therapeutic. If you have limitations in the use of your legs, there are aerobic activities designed exclusively for the upper body. For example, there's a stationary bicycle designed to be pedaled with your arms rather than your legs.

There are many other options, as well. There is also the opportunity to simply tense the muscles around your body for brief periods involving no equipment and no stress to the joints. This approach, discussed in Stealth Health, is referred to as isometric exercise.

In general, I recommend to my patients who have significant physical challenges of any kind to confer with a physical therapist or trainer to get individualized recommendations for fitting physical activity into their lives. This is one of those things when if there is will, there is almost always a way.

ZELMAN: How does stress impact energy, weight, and immunity -- three areas the book claims to improve if you follow the daily tips?

KATZ: There is a new branch of medicine rapidly evolving called "psychoneuroimmunology." This branch of medicine is testimony to the powerful effects of stress and mental health in general on physical well-being.

We know that stress directly influences the levels of many powerful hormones in the body. Among these, are cortisol, adrenaline, noradrenaline, and even insulin. Hormone levels, in turn, have effect on both the nervous system and the immune system. As a result, there is rather convincing evidence that people with high levels of stress tend to get more heart disease, may be at increased risk of cancer, and are likely subject to more frequent infections.

The study of these interactions between stress, immunity, hormones, and nervous system function, is still in its infancy. But even so, the evidence is already compelling that stress is on the short list of major health influences.

ZELMAN: It must have been hard to select the top ten tip list. How and why did you choose these ten:

  1. Drink a cup of tea in the morning.
  2. Walk 30 minutes daily.
  3. Quit smoking.
  4. Enjoy a glass of wine each evening.
  5. Take five minutes daily to close your eyes and breathe deeply.
  6. Talk to a friend.
  7. Eat fish twice a week.
  8. Take a multivitamin daily.
  9. Eat whole foods rather than processed.
  10. Get a good night's rest.

KATZ: It was tough to choose. What we were looking for was a combination of: relatively easy to do; strongly supported by science; multiple benefits.

For example, we recommend moderate consumption of wine. This clearly can offer multiple benefits to those for whom alcohol does not pose a health hazard. Wine can be quite pleasurable, can enhance appreciation of a meal, and can directly lower heart disease risk by two well-established mechanisms.

In each case, we were looking for tips that conferred multiple benefits as a way of rewarding the stealth-health approach.

MEMBER QUESTION: I feel so overwhelmed with the changes I need to make for myself and my family. Where do you suggest I start?

KATZ: I would be inclined to choose physical activity as the initial focus. This, despite the fact that I am a dedicated nutritionist. The reason is, if you are feeling overwhelmed, adding physical activity to your daily routine is simple, and likely to be immediately rewarding.

You mention a family. Permit me to suggest that you make some time. Don't find time, but make time each day to have some physically active recreation with them.

I could provide many examples, but here is a simple one from the Katz family repertoire. Take turns choosing your favorite music and put it on for half an hour in the evening and dance. All of a sudden, what seemed overwhelming has turned into a bit of family fun. Starting your quest toward better health can be as simple as that.

Once you have energized yourself, whether it's from walking or dancing, you can start accumulating other stealth-health tips into your life. Don't overshoot and don't get intimidated. Remember, you are the boss. Make small changes that are acceptable to you. Slow and steady progress is fine, as long as you move in the right direction. You can do it. Good luck.

ZELMAN: Your pearls of wisdom are so profound and hopefully ones our readers will find inspirational, like your book. You inspired me to go out and buy a bean-grinding coffee maker with a timer; it is a great tip to "wake up and smell the coffee." Coffee has gotten good press lately yet your first top ten tip is to drink tea.

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