Introduction
Without question, a healthful lifestyle improves longevity and the quality of life. The key components of a healthful lifestyle discussed in this chapter are avoiding cigarette smoking, engaging in a regular exercise program, and practicing good sleep habits.
Smoking Is Deadly
A large body of research reveals that smokers have a three- to fivefold increase in the risk of cancer and heart disease compared with nonsmokers. The more cigarettes smoked and the longer the period of years a person has smoked, the greater the risk of dying from cancer, a heart attack, or a stroke. Overall, the average smoker dies seven to eight years sooner than the nonsmoker and has a greater burden of disease.
Tobacco smoke contains more than 4,000 chemicals, of which more than 50 have been identified as carcinogens. If you want good health, you absolutely must stop smoking! And here’s some good news: if you quit smoking now, it’s possible for you to reduce your risk of cancer to the same level as that of people who never smoked. Studies have found that 10 years after quitting, an ex-smoker’s risk of dying from lung cancer is 30% to 50% less than the risk for those who continue to smoke. After 15 years, an ex-smoker’s risk is almost the same as that of a person who never smoked. Quitting smoking also reduces the risk for developing heart disease, emphysema, and other cancers. You’ll live longer—and you’ll live better.1
Various measures, including nicotine-containing skin patches or chewing gum, acupuncture, and hypnosis, have all been shown to provide some benefit, but not much. In a systematic review of the efficacy of interventions intended to help people stop smoking, data were analyzed from 188 randomized controlled trials.2 Encouragement to stop smoking by a physician during a routine office visit resulted in a 2% cessation rate after one year. Supplementary measures such as follow-up letters or visits had an additional effect. Behavioral modification techniques such as relaxation, rewards and punishment, and avoiding trigger situations, taught in groups or individual sessions led by a psychologist, had no greater effect than the 2% rate achieved by simple advice from a physician. Eight studies of acupuncture showed an overall effectiveness rate of roughly 3%. Hypnosis was judged to be ineffective even though trials have shown a success rate of 23%; the reason is that in these studies no biochemical marker such as breakdown products of nicotine in the urine was used to accurately determine effectiveness. Nicotine replacement therapy (gum or patch) was effective in about 13% of smokers who sought help in quitting. All together these results are not very encouraging.
No matter what strategy you choose, it appears the best results occur when people quit cold turkey rather than trying to taper down. If you smoke, quit now! Here are 10 tips to help you.
1. List all the reasons you want to quit smoking, and review them every day.
2. Set a specific day to quit, tell at least 10 friends that you are going to quit smoking, and then do it!
3. Throw away all cigarettes, butts, matches, and ashtrays. If you feel the need to have something in your mouth, chew on raw vegetables, fruits, or gum. If your fingers seem empty, play with a pencil.
4. Take one day at a time.
5. Realize that 40 million Americans have quit. If they can do it, so can you!
6. Visualize yourself as a nonsmoker with a fatter pocketbook, pleasant breath, unstained teeth, and the satisfaction that comes from being in control of your life.
7. Join an online support group. While research on this is still in its early stages, doing so appears to double or even triple success rates.
8. When you need to relax, perform deep breathing exercises rather than reaching for a cigarette.
9. Avoid situations that you associate with smoking.
10. Each day you don’t smoke, reward yourself. Buy yourself something with the money you’ve saved, or plan a special reward as a celebration for quitting.
The Importance of Regular Exercise
Regular physical exercise is obviously vital to good health. We all know this, yet less than 50% of Americans exercise on a regular basis. While the immediate effect of exercise is stress on the body, with regular exercise the body adapts—it becomes stronger, functions more efficiently, and has greater endurance. The entire body benefits from regular exercise, largely as a result of improved cardiovascular and respiratory function. Exercise enhances the transport of oxygen and nutrients into cells at the same time as it enhances the transport of carbon dioxide and other waste products out of cells. You will find that exercise increases your overall energy levels.
Physical inactivity is a major reason so many Americans are overweight. This is especially true for children—research indicates that childhood obesity is associated more with inactivity than with overeating.3 There is also strong evidence suggesting that 80 to 86% of adult obesity begins in childhood. If you have kids, get them active. If you are not active yourself, make a change and get active, especially if you have weight to lose. Adults who are physically active tend to have less of a problem with weight loss for the following reasons:
• When weight loss is achieved by dieting without exercise, a substantial portion of the total weight loss comes from the lean tissue, primarily as water loss.
• When exercise (especially strength training) is included in a weight loss program, there is usually an improvement in body composition: an increase in muscle mass and a decrease in body fat.
• Exercise helps counter the reduction in basal metabolic rate (BMR) that usually accompanies dieting alone.
• Exercise increases the BMR for an extended period of time following the exercise session.
• Moderate to intense exercise may help suppress the appetite.
• People who exercise while on a weight loss program are better able to maintain the weight loss than those who do not exercise.
Exercise promotes the efficient burning of fat. Muscle tissue is the primary user of fat calories in the body, so the greater your muscle mass, the greater your fat-burning capacity. If you want to be healthy and achieve your ideal body weight, you must exercise.
Regular exercise exerts a powerful positive effect on mood. Tension, restlessness, depression, feelings of inadequacy, and worrying diminish greatly with regular exercise. Exercise alone has been demonstrated to have a tremendous impact on improving mood and the ability to handle stressful life situations.4
Regular exercise has been shown to increase powerful mood-elevating substances in the brain known as endorphins.5 These compounds have effects similar to those of morphine, although much milder. There is a clear association between exercise and endorphin elevation, and when endorphins go up, mood follows.6
If the benefits of exercise could be put in a pill, you would have the most powerful health-promoting medication available. Take a look at this long list of health benefits produced by regular exercise:
Musculoskeletal System
Increases muscle strength
Increases flexibility of muscles and range of joint motion
Produces stronger bones, ligaments, and tendons
Lessens chance of injury
Enhances posture, poise, and physique
Improves balance
Heart and Blood Vessels
Lowers resting heart rate
Strengthens heart function
Lowers blood pressure
Improves oxygen delivery throughout the body
Increases blood supply to muscles
Enlarges the arteries to the heart
Bodily Processes
Improves the way the body handles dietary fat
Reduces heart disease risk
Helps lower total blood cholesterol and triglycerides
Raises HDL, the “good” cholesterol
Helps improve calcium deposition in bones
Prevents osteoporosis
Improves immune function
Aids digestion and elimination
Increases endurance and energy levels
Promotes lean body mass, burns fat
Mental Processes
Provides a natural release for pent-up feelings
Helps reduce tension and anxiety
Improves mental outlook and self-esteem
Helps relieve moderate depression
Improves the ability to handle stress
Stimulates improved mental function
Relaxes and improves sleep
Increases self-esteem
The better shape you are in physically, the greater your odds of enjoying a long and healthy life. Most studies have showed that someone who is not fit has an eightfold greater risk of having a heart attack or stroke than a physically fit individual. Researchers have estimated that for every hour of exercise, there is a two-hour increase in longevity. That is quite a return on investment.
The Aerobics Center Longitudinal Study involved 9,777 men ranging in age from 20 to 82 who had completed at least two preventive medical examinations (on average 4.9 years apart) at the Cooper Clinic in Dallas, Texas, from December 1970 through December 1989. All study subjects achieved at least 85% of their age-predicted maximal heart rate (220 minus their age) during the treadmill tests at both exams. The men were further categorized by their level of fitness based on their exercise tolerance on a standard treadmill test. This measure is a sound objective indicator of physical fitness, as it has been shown to correlate positively with maximal oxygen uptake. The men were divided into five groups, with the first group categorized as unfit and groups two through five being categorized as fit. The higher the group number, the higher level of fitness.
The highest age-adjusted death rate (all causes) was observed in men who were unfit at both exams (122.0 deaths per 10,000 man-years); the lowest death rate was in men who were physically fit at both examinations (39.6 deaths per 10,000 man-years). Furthermore, men who improved from unfit to fit between the first and subsequent examinations had an age-adjusted death rate of 67.7 per 10,000 man-years, representing a reduction in mortality of 44% relative to men who remained unfit at both exams. Improvement in fitness was associated with lower death rates after adjusting for age, health status, and other risk factors for premature mortality. For each 1-minute increase in exercise tolerance between examinations, there was a corresponding 7.9% decrease in risk of mortality.7
The time you spend exercising is a valuable investment in good health. To help you develop a successful exercise program, here are seven steps to follow.
Step 1: Realize the Importance of Physical Exercise
The first step is realizing just how important it is to get regular exercise. We cannot stress enough how vital regular exercise is to your health, but what we say means absolutely nothing unless it really sinks in and you accept it as well. You must make regular exercise a top priority in your life.
Step 2: Consult Your Physician
If you are not currently on a regular exercise program, get medical clearance if you have health problems or if you are over 40. The main concern is the functioning of your heart. Exercise can be quite harmful (and even fatal) if your heart is not able to meet the increased demands placed on it.
It is especially important to see a physician if any of the following applies to you:
Heart disease
Smoking
High blood pressure
Extreme breathlessness with physical exertion
Pain or pressure in chest, arm, teeth, jaw, or neck with exercise
Dizziness or fainting
Abnormal heart action (palpitations or irregular beat)
Step 3: Select an Activity You Can Enjoy
If you are healthy enough to begin an exercise program, select an activity that you feel you would enjoy. Choose activities from the list below, or come up with some on your own. Make a commitment to do one activity a day for at least 20 minutes and preferably 1 hour. Make your goal the enjoyment of the activity. The important thing is to move your body enough to raise your pulse a bit above its resting rate. Try:
Bicycling
Bowling
Dancing
Gardening
Golfing
Heavy housecleaning
Jazzercise
Jogging
Stair climbing
Stationary bike
Swimming
Tennis
Treadmill
Walking
Weight lifting
The best exercises are the kind that elevate your heart rate the most. Aerobic activities such as walking briskly, jogging, bicycling, cross-country skiing, swimming, aerobic dance, and racquet sports are good examples. Brisk walking (5 miles an hour) for approximately 30 minutes may be the very best form of exercise for weight loss. Walking can be done anywhere; it requires no expensive equipment, just comfortable clothing and well-fitting shoes; and the risk for injury is extremely low. If you are going to walk on a regular basis, we strongly urge you to purchase a pair of high-quality walking or jogging shoes.
Step 4: Monitor Exercise Intensity
Exercise intensity is determined by measuring your heart rate (the number of times your heart beats per minute). This can be determined quickly by placing the index and middle fingers of one hand on the side of the neck just below the angle of the jaw or on the opposite wrist. Count the number of heartbeats for 6 seconds. Simply add a zero to this number and you have your pulse. For example, if you counted 14 beats, your heart rate would be 140. Would this be a good number? It depends upon your “training zone.”
A quick and easy way to determine your maximum training heart rate is to simply subtract your age from 185. For example, if you are 40 years old, your maximum heart rate would be 145. To determine the bottom of the training zone, simply subtract 20 from this number. In the case of a 40-year-old this would be 125. So the training range would be between 125 and 145 beats per minute. For maximum health benefits you must stay in this range and never exceed it.
Step 5: Do It Often
You don’t get in good physical condition by exercising once; you have to do it on a regular basis. A minimum of 15 to 20 minutes of exercising at your training heart rate at least three times a week is necessary to gain any significant cardiovascular benefits from exercise.
The key to getting the maximum benefit from exercise is to make it enjoyable. Choose something you have fun doing. If you can find enjoyment in exercise, you are much more likely to exercise regularly.
One way to make exercise fun is to get a workout partner. For example, if you choose walking as your activity, find one or two people in your neighborhood you would enjoy walking with. An added plus is that if you have plans to walk together, you will be more likely to actually get out there than if you depended solely on your own willpower. Commit to walking three to five mornings or afternoons each week, and increase the exercise duration from an initial 10 minutes to at least 30 minutes.
Step 7: Stay Motivated
No matter how committed you are to regular exercise, at some point in time you are going to be faced with a loss of enthusiasm for working out. Our suggestion is to take a break. Not a long break; just skip one or two workouts. This gives your enthusiasm and motivation a chance to recoup so that you can come back with an even stronger commitment.
Here are some other things to help you to stay motivated:
• Thumb through fitness magazines. Try ones such as like Men’s Health, Muscle and Fitness, or Runner’s World. Looking at pictures of people in fantastic shape can be inspiring. In addition, these types of magazines typically feature articles on new exercise routines that you may find interesting.
• Set exercise goals. Being goal-oriented helps keep us motivated. Success breeds success, so set a lot of small goals that can easily be achieved. Write down your daily exercise goal and check it off when you complete it.
• Vary your routine. Variety is very important to help you stay interested in exercise. Doing the same thing every day becomes monotonous and drains motivation. Continually find new ways to enjoy working out.
• Keep a record of your activities and progress. Sometimes it is hard to see the progress you are making, but if you write in a journal, you’ll have a permanent record of your progress. Keeping track of your progress will motivate you to continued improvement.
We also recommend that everyone engage in strength training (such as lifting weights or performing resistance exercises) at least three times a week. Strength training is especially valuable, as it not only increases muscle strength but also stabilizes blood sugar, promotes fat loss, and protects against age-related muscle loss.
The Importance of Sleep
Sleep is perhaps one of the least understood physiological processes. Its value to human health and proper functioning is without question. Sleep is absolutely essential to both the body and the mind. Impaired sleep, altered sleep patterns, and sleep deprivation wreak havoc on mental and physical function. Many health conditions, particularly depression, chronic fatigue syndrome, and fibromyalgia, are either entirely or partially related to sleep deprivation or disturbed sleep.
Over the course of a year, more than half of the U.S. population will have difficulty falling asleep. About 33% of Americans experience insomnia on a regular basis, with 17% of the population claiming that insomnia is a major problem in their lives. Many use over-the-counter sedatives to combat insomnia, while others seek stronger prescription medications from their physicians. Each year up to 10 million people in the United States receive prescriptions for drugs to help them go to sleep. (The natural treatment of insomnia is described in the chapter “Insomnia.”)
As with other health conditions, the most effective treatment of insomnia is based upon identifying and addressing causative factors. The most common causes of insomnia are psychological—depression, anxiety, and tension. If psychological factors do not seem to be the cause, various foods, drinks, and medications may be responsible. There are numerous compounds in food and drink and well over 300 drugs that can interfere with normal sleep.
Some of the benefits of sleep are probably mediated through growth hormone (GH). An anabolic hormone, GH has been called by some the “antiaging” hormone. Several research projects are now studying its rejuvenating effects when it is injected. The reason for the excitement is that GH stimulates tissue regeneration, liver regeneration, muscle building, breakdown of fat stores, normalization of blood sugar regulation, and a whole host of other beneficial processes in the body. In other words, it helps convert fat to muscle. Small amounts of GH are secreted at various times during the day, but most GH secretion occurs during sleep.
Sleep functions as an antioxidant for the brain: free radicals that can damage neurons are removed as you snooze. Most people can tolerate a few days without sleep and fully recover. However, chronic sleep deprivation appears to accelerate aging of the brain, causes neuronal damage, and leads to nighttime elevations in the stress hormone cortisol (see the chapter “Insomnia” for improving sleep quality).
Exactly how much sleep is required by an individual varies from one person to the next and from one stage of life to another. A one-year-old baby requires about 14 hours of sleep a day, a five-year-old about 12, and adults about 7 to 8. In addition, women tend to require more sleep than men. As people age their sleep needs may decline (the research is not clear), but so does their ability to sustain sleep, probably as a result of decreased levels of important brain chemicals such as serotonin and melatonin. The elderly tend to sleep less at night but doze more during the day than younger adults.
From observation of eye movement and electroencephalographic (EEG) recordings, we know that there are two distinct types of sleep: REM (rapid eye movement) sleep, which is when dreaming takes place; and non-REM sleep.
Non-REM sleep is divided into stages 1 through 4 according to level of EEG activity and ease of arousal. As sleep progresses there is a deepening of sleep and slower brain wave activity until REM sleep, when suddenly the brain becomes much more active. In adults, the first REM sleep cycle is usually triggered 90 minutes after going to sleep and lasts about 5 to 10 minutes. After the flurry of activity, brain wave patterns return to those of non-REM sleep for another 90-minute sleep cycle.
Each night most adults experience five or more sleep cycles. REM sleep periods grow progressively longer as sleep continues; the last sleep cycle may produce an REM sleep period that can last about an hour. Non-REM sleep accounts for approximately 50% of this 90-minute sleep cycle in infants and about 80% in adults. As people age, in addition to getting less REM sleep, they tend to awaken at the transition from non-REM to REM sleep.
Normal Sleep Architecture
Dreams are very important to our physical and mental well-being. A dream is a sequence of sensations, images, and thoughts passing through a sleeping person’s mind. We also use the word dream to refer to a wish, fantasy, desire, or fanciful vision. It is our dreams that propel us as we roll through this life. They are powerful, inspirational, and potentially healing. The famous author Anatole France said something about dreams and life that we think really hits home: “Existence would be intolerable if we were never to dream.”
The importance of dreams to mental health is obvious if you examine what happens to people who are deprived of REM sleep. In the early 1960s, the pioneering dream researcher William C. Dement conducted several interesting studies in which subjects sleeping in a laboratory setting were awakened the moment REM began to occur and then allowed to go back to sleep. The experiment continued for one week. During this time the test group reported increased irritability, anxiety, and appetite. In other studies people deprived of REM sleep exhibited profound personality changes—extreme irritability, depression, anxiety, and so on—that disappeared when they were allowed to dream again.8
Humans have been attempting to answer the question “Where do dreams come from and what do they mean?” since the dawn of civilization. Some ancient cultures considered the content of dreams to be more significant than the events of their waking lives, but the modern view of dreams was initially swayed a bit by fears that dreams might undermine moral conduct or that they are meaningless, the result of random nerve firings or physical discomfort. The emerging view is a more holistic one, as it recognizes that dreams have both physiological and psychological causes.
Modern psychology became fascinated with dreams through the work of Sigmund Freud, who saw dreams as the window to the soul. Freud’s classic view was that dreams were safe expressions of impulses and desires buried in the subconscious mind.
Other scientists in the early 1900s also began looking into dreams. Carl Jung, Alfred Adler, and William Stekel, as well as other psychologists who followed them, developed their own theories on the meanings and interpretations of dreams.
We believe that some dreams can aid us in working out issues in our waking lives. Dreams allow us an opportunity to view what is being imprinted on our subconscious mind. They are often symbolic attempts to sort out the options we can choose in life. Obviously, there are times when dreams are not psychologically meaningful. For example, if you are suffering from indigestion or a peptic ulcer and experience a violent dream where you are getting stabbed in the stomach, we would not recommend trying to uncover some deep psychological issue. The problem with trying to interpret every dream is that not every dream will be meaningful. Nonetheless, we think it is important to examine every dream for possible clues for personal growth.
If you are interested in learning more about dreams, we recommend going to the website of the International Association for the Study of Dreams (asdreams.org). This organization is “dedicated to the pure and applied investigation of dreams and dreaming.” Its purposes are to “promote an awareness and appreciation of dreams in both professional and public arenas; to encourage research into the nature, function, and significance of dreaming; to advance the application of the study of dreams; and to provide a forum for the exchange of ideas and information on dreams,” as its website notes.
Final Comments
Just like the other four cornerstones of good health, the importance of a health-promoting lifestyle cannot be overstated. Lifestyle definitely comes down to choices. If you want to be healthy, simply make healthful choices. Choose to not smoke. Choose to find physical activities that you enjoy and do them often. Make getting a good night’s sleep a priority and have fun with your dreams. These simple lifestyle choices will have a profound effect on your health and the quality of your life.
QUICK REVIEW
• Breathe clean air. Smoking is still a major contributor to an early death.
• Be physically fit. Physical inactivity is a major reason so many are overweight.
• Sleep well. Many health conditions are either entirely or partially related to sleep deprivation or disturbed sleep.