Tag Archives: mobile health

Eustress, or YOU Stress?

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You may have heard that stress is good for you. Or you may have heard that stress is bad for you. Confusing? That’s because not all stress is equal. Hans Selye, who was one of the first researchers to focus on stress, coined the term “eustress” to refer to stress that gives you a feeling of fulfillment, success, or other positive feelings. An example of eustress is the stress you feel when competing in a contest for which you are well prepared, or when you are engaged in a challenging job that you enjoy.

Eustress enhances your functioning and is good for you because it makes you feel more alive, interested, and engaged with life.

Distress is the bad kind of stress. It can either be acute (you encounter a hostile dog that chases you) or chronic. Acute stress is the normal and helpful reaction of the body to a threat, when the body releases adrenalin and cortisol into the system, helping you to react more rapidly, run faster, and think faster. While it may leave you feeling shaken, you needed that extra oompf to escape the threat.

Chronic stress is the kind of stress imposed by modern life. The body actually doesn’t know the difference between a rabid dog and a difficult boss; any threat will cause the body to release stress hormones, and the body will react accordingly with elevated blood pressure, accelerated heart rate, and other symptoms of stress. The problem is that when a person is chronically stressed, it can cause a lot of health problems.

Selye mentions that chronic stress leads to anxiety, withdrawal and depression, but there is as much or more physical damage caused by chronic stress as psychological damage. Many respected medical institutions, including Stanford University Medical Schools, the National Institutes of Health and Mayo Clinic, estimate that as much as 90% of preventable disease is caused by stress.

This is because those stress hormones—so helpful when we are confronted by real danger—can cause damage to our tissues when they are always present in our systems. They can cause:

  • High blood pressure
  • Head and muscle aches
  • Immune system impairment
  • Asthma
  • Heart attacks
  • Breathing dysfunction
  • Constricted arteries, high cholesterol
  • Stroke
  • Weight gain
  • Digestive issues such as ulcers, irritable bowel syndrome
  • Accelerated aging

And these are just some of the physical issues created by chronic stress. Clearly, the less chronic stress we feel and the more time we spend in eustress, the better off we are.

If you are aware you are chronically stressed, then you can take steps to do something about it. But many people accept a state of chronic stress as normal. That’s the way they always feel, so they cannot recognize or accept they are in a state of continual stress. Most people are not going to proactively address a problem they think they don’t have.

So how do you determine whether or not you’re stressed? Consider whether you experience any of the physical issues mentioned above. Do you have a lot of indigestion? Do you have trouble sleeping? Do you find it impossible to lose weight, even though you eat carefully and exercise? Do you have high cholesterol or high blood pressure? These conditions may indicate chronic stress, especially if you find you have a lot of these issues.

You can also detect stress through heart rate variability, or HRV. HRV is the variation in the time interval between one heartbeat and the next.

When we think of our heart rate, we generally think of a number between 60 and 90 beats per minute. This number represents the range for the average heart rate. In fact, your heart rate changes from beat to beat. When you inhale your heart rate speeds up and when you exhale it slows down. So rather than referring to a fixed pulse of, say, 60, the heart rate will actually vary between, say, 55 and 65. HRV is a measure of this naturally occurring irregularity in the heart rate. Nearly a quarter-century of clinical research has shown that when HRV levels are high, a person experiences low levels of stress and greater resiliency. When HRV levels are low, this is an indication of greater stress and lower resiliency.

General practitioners and internists are generally not set up to measure HRV, even though it’s been studied for about 30 years and is an accepted vital sign. You can measure your own HRV using a commercially-available heart monitor such as Wahoo or 60-Beat and an app like SweetBeat™ for the iPhone, which was designed specifically to monitor stress levels using HRV.

Regardless of how you choose to detect stress, it is critical to lower stress levels in pursuit of better health. The good news is that there are many simple and inexpensive ways to reduce stress, including deep breathing, meditation, nutrition, exercise, yoga, and much more. Do the things that help you to experience eustress, and avoid the things that cause you distress. A simple concept, but one that may bolster your health and prolong your life.

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Do you wonder whether you are experiencing chronic stress? Download SweetBeat™, the iPhone stress management app: http://itunes.apple.com/us/app/sweetbeat/id492588712?mt=8

 

Maybe, Baby, It’s Those Baby Steps That Work!

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Some of us at SweetWater Health recently attended the 2012 Mobile Health Conference on the Stanford University campus. The theme was “Baby Steps.” The conference was oriented to mHealth entrepreneurs, but what the speakers had to say about baby steps really applies to any human being seeking to make changes in his or her life—especially those really difficult changes, like trying to lose weight or live a healthier lifestyle.

Part of the message was that behaviors are hard to change. They’re even harder when we take on a whole raft of changes at once, which is what we usually do when we’re trying to lose weight. Here’s a sample of what many of us try to do all at once:

  • Give up anything with sugar in it
  • Reduce fat in our diet
  • Eat more fruits and vegetables
  • Cut down on or give up red meat
  • Give up or cut down on bread, cereals, rice, pasta, etc.
  • Eat smaller portions
  • Exercise for an hour a day
  • Always take the stairs instead of the elevator
  • Attend some sort of weight-loss meeting every week
  • Journal what we eat/count points/count calories or carbs every day
  • Walk at least 10,000 steps a day (in addition to exercising)
  • Some diets demand things like eating only cabbage soup, drinking a supplement twice a day instead of eating, eating only prepackaged meals, or following a complicated diet regimen based on blood type—an endless array of exotic and difficult behavior changes.

That’s a HUGE number of changes for most people! Somehow, we think we can squeeze all this in to our routine day, which includes taking care of our families, working, shopping, cooking, cleaning, and laundry. Talk about feeling stressed. And the results are predictable; we blow another weight-loss effort and feel guilty. (More stress. And if you’ve been following this blog, you know stress can make you gain and retain weight.)

The underlying message was that it’s easier to change behaviors if you just take baby steps, and when something doesn’t work, don’t keep trying to make it work; try a different baby step instead.

Not everyone can walk every day, for instance. So walk when you can, and on the days when you can’t, just try to get in 10,000 steps. If you always forget your pedometer, go up and down the stairs a few times; tomorrow, as Scarlett O’Hara famously remarked, is another day.

Another thing we tend to do is beat ourselves up if we eat something not on the “approved” list. Because we’re feeling bad anyway, we figure what the heck, in for a dime in, for a dollar, and throw the rest of the Oreos down the hatch after the first guilty cookie. Although the experts tell us truthfully that it’s better not to have temptations around the house in the first place, circumstances aren’t always ideal, and some of us have spouses and children who don’t share our issues. Look, it was just a cookie, it’s not like you stole a car. Enjoy that one cookie to the absolute maximum, and go do something else—like take a walk.

You wouldn’t begin training for a marathon by running 26 miles and 385 yards the first day. Add a step, do something else if it doesn’t work, and cut yourself some slack if you slip up. Eventually, all those baby steps add up to real progress in behavioral change.

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 As we’ve mentioned before, stress is a major cause of illness—responsible for up to 90% of preventable disease, according to medical institutions like Stanford University Medical Center and Mayo Clinic. And as mentioned previously, stress can actually cause weight gain and retention, even when eating habits don’t change. One baby step you can take to reduce stress is SweetBeat™, the stress management iPhone app from SweetWater Health. Learn more about SweetBeat on our website, http://www.beathealthy.com. You can read the app description and download SweetBeat here.

What Swedish Chickens Tell Us About DNA

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For a long time, the conventional wisdom was that our DNA is fixed; whatever genetic characteristics we were born with are the traits that will characterize us throughout our lives. While DNA changes do occur, we have thought that they occur only very slowly—over millions of years, like the evolutionary changes that enabled small-brained primitive primates to develop into homo sapiens. This means if we were born with the genes that predispose us to heart attack or obesity, we are doomed to be fat and short-lived.

Not true. Or rather, it is true that the DNA we were born with doesn’t change, but it turns out that DNA isn’t the whole story. A new field called epigenetics has shown that lifestyle and conditions you are exposed to in life can change how your DNA is expressed—and those changes can sometimes be inherited by your offspring.

Epigenetics refers to heritable changes in the “wrapper” of proteins that surround the DNA. It does take many generations for the genome to change, but the epigenome can be changed by the addition or subtraction of a methyl group. A good analogy is that DNA, or the genome, is the hardware (hard to change) and the epigenome is the software (easy to change).

A methyl group is one carbon atom attached to three hydrogen atoms. When a methyl group attaches to a specific spot on a gene, it can change how the gene is expressed; it can dampen the gene’s effect or turn it off–or it can turn a gene on or boost its effect. This process is called DNA methylation.

So where do the Swedish chickens come in? In 2007, researchers at the University of Linköping in Sweden created the henhouse from hell, designed to stress the chickens that lived in it. The experimenters manipulated the lighting, causing the chickens to lose track of when to sleep, when to eat, and so forth. The discombolulated birds demonstrated a significant decrease in their ability to negotiate their way through a maze to find food.

When the chickens were moved back to a non-stressful environment, they conceived and hatched chicks that also demonstrated poor skills at finding food in a maze—even though they had never been stressed. The research went on to demonstrate that the mothers’ exposure to stress had resulted in a gene expression that the chicks inherited.

The chicken experiment is only one of many animal studies that have proved the validity of epigenetic theory. Another study, this time focusing on human beings (coincidentally, Swedish humans), also proves the point. In the 1980s, a preventive health specialist, Dr. Lars Olov Bygren, studied the effects of feast and famine years during the 19th Century in a remote population of people living in northern Sweden. He wanted to see if there were long-term effects, not just on the people who had experienced the feast or famine years, but also on their children and grandchildren.

Bygren discovered that people who had gone from normal eating to over-eating during the times of overproduction produced children and grandchildren who lived significantly shorter lives than those whose progenitors had endured famines.

So what does this all mean to us on a day-to-day basis? Epigenetics is a new science, and while the human genome has been mapped, the human epigenome has not yet been fully deciphered. We don’t really know enough to be able to say, “Do this” and “Don’t do that.” But we do know—thanks to the Swedish chickens and people—that stress and nutrition play major roles in epigenetics.

The best we can do with this new knowledge is actually old wisdom:

  • Eat a wide variety of fresh foods and stay away from highly processed foods such as sugar to assure getting enough vitamins and minerals, and also to avoid additives (whether or not additives can influence epigenetics is not known)
  • Don’t eat too much
  • Get plenty of sleep
  • Reduce stress as much as possible

The last point—stress reduction—has a previously unrealized link to weight loss. As we mentioned last week, researchers have discovered that dieting—especially crash dieting—can inhibit weight loss or even cause weight gain. This is because the stress created by dieting triggers the body to produce cortisol. Cortisol is the “fight or flight” hormone, and it can inhibit weight loss in a variety of ways—especially in an individual who is chronically stressed (and may not even be aware of it because “stressed out” feels normal). Cortisol floods the body with glucose, delivering a quick jolt of energy to the large muscles needed for flight. At the same time, cortisol suppresses insulin to prevent glucose from being stored, as the body under stress needs to use that energy immediately. (Remember, all these mechanisms evolved when a threat meant more than being a few pounds overweight; it meant becoming someone’s dinner.)

Elevated cortisol levels can retrieve triglycerides from storage and relocate them to visceral fat cells (those that lie under the muscles deep in the abdomen), causing the fat cells to grow. Cortisol can also stimulate appetite and craving for high-calorie foods. This is because the body’s logic tells it that if you are under threat, you need to keep the calories coming.

So reducing stress can have a positive effect on weight loss, especially if you follow a reasonable regimen aimed at losing weight gradually over a long period of time. Weight lost quickly via crash diets merely triggers the body’s cortisol mechanisms, resulting in the yo-yo weight loss/weight gain cycle we all know so well.

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Tired of being stressed? Download SweetBeat™, the iPhone stress management app: http://itunes.apple.com/us/app/sweetbeat/id492588712?mt=8

 

 

Five Things You Didn’t Know About Losing Weight

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We have been told for decades that losing weight was simple: eat fewer calories and exercise more so that you burn more calories than you consume.

Right.

If losing weight (and keeping it off) was simple, don’t you think that we would all be slender? But those of us who have struggled with weight loss, those of us who have lost weight only to put it all back on again—sometimes with interest—have long suspected that weight loss and sustaining healthy weight is not so simple as we have been led to believe.

Recent research has shown that there is indeed more than meets the eye when it comes to losing weight. Here are a few of those recent findings:

1. The Role of Stress. Researchers at the University of Pennsylvania found that stressed-out mice that had a history of quick weight loss due to dieting (imposed by the researchers, not by the mice) ate more high-fat foods than stressed mice that had not been made to diet. The study found that the stressed dieters had higher levels of the stress hormone corticosterone, and were more likely to exhibit “depressive” behavior than their non-dieting brethren. Even after the dieting mice were allowed to eat as much as they desired and had returned to normal weights, the changes in their brains respond to stress persisted.

Lesson Learned: while this study has not yet been tried on human subjects, it indicates there may be a link between quick weight-loss diets and a permanent change in the way the brain responds to stress. This may explain why so many people become “yo-yo” dieters, losing and gaining weight over and over again.

2.  Weight Loss Reduces Risk of Cancer. Moderate weight loss can reduce levels of inflammation that have been linked to the development of certain cancers, according to a study published in the May 1, 2012 issue of Cancer Research. The study was done on a group of post-menopausal women whose goal was to lose 10% of their body weight. During the one-year study, cancer-reactive protein levels dropped by about 36% in the women who only dieted, and about 42% in women who dieted and exercised. The researchers said that obesity drives inflammation, and inflammation drives the development of cancers, particularly cancers of the breast, lung, colon, and endometrial cancer.

Lesson Learned: Even modest weight loss will reduce the risk of some common cancers. Diet and exercise combined are the most effective ways to lose weight.

3.     Not All Calories Are Equal. A 2011 study at Harvard University showed that calories from potatoes (especially French fries, of course), red meat, and soda will cause more weight gain than the same number of calories consumed by eating fruits, vegetables, whole grains, poultry or fish. The study followed 120,000 non-obese, healthy Americans for up to 20 years.

Lesson Learned: It’s not just how much you eat—it’s also what you eat. Potatoes, sugary drinks, red meats, and refined carbohydrates (such as sugar, corn syrup, and white flour) will put on more poundage than fish, fowl, fruits, vegetables and whole grains.

4.     Sleeping Helps Lose—or Gain—Weight. The same study from Harvard found that study participants who slept less than six hours or more than eight hours a night gained more weight during each study period than those sleeping around seven hours a night. According to Michael Breus, PhD, author of “Beauty Sleep,” sleep deprivation increases levels of the hormone ghrelin, which stimulates appetite, and reduces levels of leptin, which tells us when to stop eating.

Lesson Learned: Aim at getting about 7.5 hours of sleep a night to avoid creeping weight gain.

5.     You Can Predict When Willpower Is Low. Every dieter has experienced this scenario: You are invited to a party where you know there will be lots of yummy and fattening food. You talk to yourself firmly about sticking to the vegetable crudités. But when you get there, the food is so beautiful and delicious-looking, and all home-made, too—and you wind up eating your day’s allowance of points or calories long before it’s time to go home.

How do you know when your willpower is going to let you down? If you monitor your heart rate variability (HRV), you can predict when your willpower is strong—or weak. When HRV levels are high, so is your will to resist. When HRV is low, your willpower will be low, as well. So if you monitor your willpower before that party and see it’s down in the dumps, you can give it a helping hand. You could eat before you go to the party, for instance. Or you could decide to stay home and avoid temptation altogether. HRV can be measured easily at home or on the go with SweetBeat™, an iPhone app, plus a compatible heart monitor (widely available in sporting goods stores or at http://sweetwaterhrv.com/store.html).

Lesson Learned: Willpower and HRV are tightly coupled. When HRV is low, don’t put yourself in a position where you know you will be tempted to go off the diet. The more we learn about weight loss, the more likely it is that we will be successful at it. Losing weight is hard; make it a little easier by using real data to give yourself a break.

A Modest Proposal for Lowering the Cost of Health Care

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Are you happy with the cost of health care? Maybe you are—maybe you’re one of those fortunate people who are employed by an organization that offers group coverage at a reasonable cost to employees.

If you’re one of the people who are not in this enviable position, you have probably opted for catastrophic coverage alone, because individual insurance for a family has now reached the point where few middle-class Americans can afford comprehensive coverage. Or maybe you’re one of the 17% of Americans who are uninsured.

So, why is health care so expensive? There are lots of opinions about this, and here are a few:

  • The insurance companies are charging too much because they are greedy
  • Doctors and hospitals are charging too much because (pick one) a) the cost of malpractice insurance is so high; b) insurance companies and/or Medicare/Medicaid don’t reimburse them enough; c) they are greedy
  • Medical technology and pharmaceuticals have become increasingly expensive, driving costs up
  • People are living longer, and adults age 65+ have the highest level of health care spending among all age groups, with the majority spent on the treatment of chronic disease and end-of-life issues
  • People are eating too much processed food and corn syrup, which has resulted in a huge upswing in obesity-related diseases such as diabetes and cardiovascular disease

Whether or not you subscribe to any or all of these opinions, health care has become an increasingly contentious wrangle on the national scene, with government, business, the medical community, Teapartiers, liberals, the insurance industry, lobbyists—and, of course, lawyers—brawling in the streets (sometimes literally!).

So what are you going to do about it? Yes—YOU. It should be increasingly clear that the squabbling over health care costs and who is going to pay for them is not going to end any time soon. No one is going to swoop down like Superman and make everything better for us. There are too many opinions, too much divisiveness, and too much money at stake for us to imagine that much will be resolved in the foreseeable future.

But what can one person do to affect the situation? The answer is: one individual can do nothing to affect “the situation,” but we can all do something to make a difference to ourselves and our families. America was founded by individualists, people who wanted to change their lives for the better—people who were so unwilling to allow others to chart the course of their lives that they were willing to face a hostile wilderness and fight a few wars to achieve their goals. When it comes to health care, we must now think of ourselves as pioneers, mapping our own destination through virgin territory.

Fortunately, we now have many tools at our disposal that our ancestors lacked. (Louis and Clark would have made much better time if they had had GPS instead of Sacagawea.) The Internet allows us to research medical conditions, enabling us to make better health care decisions. Because we are highly motivated to find out everything about our own medical conditions, we can end up better informed than our doctors at times. There is a wealth of information online about diet, nutrition and exercise. It does require discretion to wade through all the claims and disinformation that is also online, but intelligent people go to reputable sources and ignore the rest.

Another development more recent than the Internet opens a new dimension of self-care that promises even more control over our own health: self-monitoring. The advent of mobile technology, combined with advances in sensor technology and software, has brought self-monitoring to the consumer market. We are now in the earliest stages of this development, but there’s a lot of exciting stuff going on:

Scanadu: this company, founded by Walter De Brouwer, is trying to create a real-life tricorder, like the ones used by Bones and The Doctor on various versions of “Star Trek.” Scanadu is seeking to develop a device that will scan the body for medical conditions without invading the body, without taking samples, without contacting the body, and potentially without cooperation from the patient. The Scanadu tricorder would put medical diagnostics directly into the hands of the consumer. It’s not here yet—but keep an eye out.

AirStrip: Airstrip has a mobile monitoring system that measures heart rate, blood pressure, temperature, and multiple other medical parameters, displaying the information on an iPhone. At present, this is available only for clinicians who are remotely monitoring hospitalized patients, but the technology can clearly be scaled for consumer use.

SweetBeat™: This iPhone app from SweetWater Health, LLC is designed to detect and monitor stress, and also has a relaxation tool to help users reduce stress. Using a compatible consumer heart monitor (available from many sources, including Wahoo! And 60Beat), SweetBeat actually monitors the nervous system, looking at heart rate variability (HRV). HRV is affected by many factors, but SweetBeat is tuned for stress, which is the underlying cause of many diseases. (Authorities such as Stanford University Medical School and Mayo Clinic say that 90% of diseases are caused by preventable stress). SweetBeat gives the user a real-time picture of what the autonomic nervous system is doing, and tools to quickly and effectively lower stress.

These are just a few of the things available (or soon-to-be-available) that help individuals monitor their health. It’s early days yet; we will be seeing a great deal more in the near future. Keep tuned, because health in the future will be more about preventive health to keep you out of the traditional health care system, and tools that allow you to detect health problems before they become critical (and expensive).

So here’s to the future. Here’s to your health. Here’s to your pocketbook.

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Download SweetBeat™, the iPhone stress management app: http://itunes.apple.com/us/app/sweetbeat/id492588712?mt=8

What You Need To Know About the “New Biofeedback” and Stress

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We are all familiar with what biofeedback means. Some of us have experienced the use of biofeedback when learning how to do something. For instance, a student learning to drive can use a machine that measures reaction time and tells the student whether he braked in time to avoid an accident (or not).

There’s a new term, “generative feedback,” that is just coming into use, so you may not know what it means. Generative feedback is a subset of biofeedback, and means feedback that drives change in behavior.

For example, hybrid cars have a visual display that tells the driver when she is driving in a way that conserves fuel most efficiently. A driver soon learns that when she accelerates too quickly, accelerates on downhill slopes, brakes unnecessarily, or fails to take advantage of gravity and momentum in general, she is wasting gas. She modifies her behavior as a result of the feedback, and saves money. Generative feedback doesn’t just report results; it drives change.

It’s not as easy to change some behaviors. We may say we want to be less stressed-out, but it’s hard to know how to do that in the moment when your boss has just dumped a task on you that is due tomorrow—when she could have passed it along to you three weeks ago—and you are already behind because you’re trying to cope with an understaffed project. It’s not like the hybrid car example, where there is clear feedback, and it’s obvious and easy to modify the behaviors.

Worse, some people don’t even know when they are stressed. Stress doesn’t care whether you know it or not—it wreaks its damage on the body anyway. High blood pressure has been called the “silent killer,” but stress is even more damaging. Stress can cause high blood pressure as well as a host of other illnesses, including heart disease, gastric disease, and more. The annual medical cost of treating stress-related medical problems was estimated by Kessler and Greenberg in “The Economic Burden of Anxiety and Stress Disorders” at $100 billion per year in the United States alone.

This is because we lack generative feedback to drive behavioral change. It’s not enough to just desire to change. We need to know what a given behavior does in our bodies, and we need to see the results of a change in behavior. This gives us the motivation—and the means—to make a lasting change.

“All very well,” you might say. “But I haven’t got the time or the money to pop into my doctor’s office every day to monitor my stress levels—even if the doc had the time for me, which he most certainly doesn’t.”

And that’s where today’s mobile technology comes in. Using an inexpensive heart monitor like runners use, SweetBeat™ for the iPhone, iPad and ITouch monitors stress levels no matter where you are or what you’re doing. SweetBeat tells you when you’re too stressed, and provides a tool for reducing stress on the spot. You can literally watch your stress level drop as you breathe regularly and deeply, bringing your nervous system back into balance.

Even better, you can upload your SweetBeat sessions to MySweetBeat on the SweetWater Health website. In MySweetBeat, you can see your sessions on a calendar, color-coded by average stress level. You can view session summaries or look at a graphed version of your session and see where stress peaked or dropped. Now you have information that you can use to manage your stress and work to avoid or reduce exposure to stressful situations.

For instance, you may notice that your stress is highest when you meet with your boss. You can’t avoid meeting with your boss, but you can take a few moments before the meeting to reduce your stress before the meeting begins. Because you know that you are stressed in this situation, you may be able to find other ways of making it less stressful, such as suggesting meeting in the conference room instead of her office—or you may even decide you need to find a new boss!

The old chestnut says that knowledge is power. Generative feedback is knowledge about what’s really happening, and gives you the means and motivation to effect positive change in your life. Go for it!

 

 

Heart Disease Plagued Cavemen, Too

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We think of cardiovascular disease as the result of our modern couch-potato, fast-food lifestyle, but it ain’t exactly so. A 5,000-year-old mummy discovered on the Italian side of the Öetzal Alps and nicknamed “Öetzi” or “The Iceman,” might have died of a heart attack if someone hadn’t killed him first. Scientists have found that Öetzi was genetically predisposed to heart disease, and at the age of 45, already had hardening of the arteries.

Of course, stone-age people probably lived stress-filled lives (Öetzi WAS murdered, after all) and their nutrition, while 100% natural and organic, was literally catch-as-catch-can. Stress is still a factor in modern heart health; to find out more about stress and how you can easily detect and manage it, check out http://www.sweetwaterhrv.com.

Download SweetBeat™, the iPhone stress management app.