1 Enhancing the Mind-Body ConnectionWeek 6 – Eight Weeks to Wellness Developed by Don Hall, DrPH, CHES Updated for Eight Weeks to Wellness. Updated DH and CM © LifeLong Health®

2 Your name, Health EducatorSponsored by: Lassen Foundation 2801 Williams Rd. Butte Valley, CA 95965 Your name, Health Educator © LifeLong Health®

3 ? What is Health? Health care generally means…? Life insurance means…?Wellness means…? ? Presenter: You may want to re-phrase the questions and wait for your group to answer. What does “health care” generally mean? What does “life” insurance mean? What does “wellness” mean? Attendees will likely continue to participate if you listen appreciatively and largely without comment as they offer answers to the questions. . © LifeLong Health®

4 Wellness is… Being physically fit Maintaining a healthy weightBalance work, play, rest Being happy and content in life Enjoying healthy foods Having a low cholesterol level Enjoying time with family and friends Feeling good! Having lots of energy Volunteering to help people Mentoring a troubled teen Nurturing spiritual health Wellness is a broad concept with many facets. PRESENTER: You may want to mention each or some of these aspects of wellness. © LifeLong Health®

5 World Health Organization Definition of HealthHealth is more than the absence of disease. It is also a positive quality. Health is physical, mental, social, and spiritual well-being. WHO Charter The World Health Organization also defines health positively and broadly. © LifeLong Health®

6 The Oxford Concise Dictionary defines health as …“physical, mental, and spiritual soundness”                                        Even the dictionary defines health broadly, including the physical, mental, and spiritual dimensions of life. © LifeLong Health®

7 Loma Linda University’s motto, written within its seal, says:To make man whole Without listing the individual aspects, Loma Linda University’s motto speaks to the conclusion of health: wholeness. © LifeLong Health®

8 Poor Health Can Have Many CausesUnhealthy lifestyle Smoking Sedentary living Poor eating habits Injury Microbes (germs) Genetic tendencies Lack of access to health care Excessive stress Being unhappy Anger/Hostility Loneliness Worry Attitude Lack of affection, love, acceptance We would expect that a multi-dimensional goal such as wholeness or health or wellness would be caused by many diverse factors. PRESENTER: You may want to mention some or all of these, calling attention to their diversity, for example, “lack of access to health care” and “attitude”. © LifeLong Health®

9 Many of the diseases from which men suffer are the result of mental depression. Grief, anxiety, discontent, remorse, guilt, distrust, all tend to break down the life forces and to invite decay and death. Ministry of Healing, p. 241 Diseases that break down the life forces are the “bad news” of mind-body relationships. © LifeLong Health®

10 Positive Emotions Promote HealthCourage, hope, faith, sympathy, love, promote health and prolong life. A contented mind, a cheerful spirit, is health to the body and strength to the soul. Ministry of Healing, p. 241 To be healthy, one must have a happy mind Dr. C. M. Pentz Positive emotions are the “good news” of mind-body relationships. © LifeLong Health®

11 Mind-Body Connection There is a close connection between the mind and the body Biofeedback can illustrate how the mind affects the physiology of the body Changes in heart rate and blood pressure Skin conductance changes measured by a galvanometer Psychoneuroimmunology – the study of how the mind affects immunity For optimum health, all dimensions of health need to be developed and work in harmony. Because the connection between the mind and the body is close, each needs to be developed. In our previous sessions we talked about improving the health of the body. In this session we are emphasizing several aspects of the connection between the mind and the body, beginning with the value of positive thoughts and the destructive nature of negative thoughts. © LifeLong Health®

12 Social Ties and Health People who lacked social ties: Not marriedHad little or no contact with family/friends, Did not belong to or attend church regularly Were not members of social groups/clubs Were significantly more likely to die during next 9 years compared to people with strong social ties Were more likely to die from heart disease, stroke, cancer, respiratory diseases, and digestive system diseases. Good Health Practices Study The well-known population study, the Good Health Practices Study, found several lifestyle practices associated with long life. Additionally, people without social ties were more likely to die from heart disease, stroke, cancer, as well as respiratory diseases and digestive diseases. Source Lisa Berkman and Lester Breslow, Health and Ways of Living, The Alameda County Study, pp , Oxford University Press, 1983 © LifeLong Health®

13 Social Networks – GHP StudySocial network factors include: Marriage Frequent contact with family/close friends Member of a church Member of a club or other social group People lacking these social networks were 2.8 times more likely to die in the next 9-years Relative risk, all cause mortality People in the Good Health Practices Study with social network factors were married, had frequent contact with their family or close friends, and were members of a church, club, or other social group. Without these social networks, people were nearly three times as likely to die during the 9-years after entering the study. Source Dean Ornish, MD, Love and Survival: the scientific basis for the healing power of intimacy, 1999. Social Network Score Good Health Practices Study © LifeLong Health®

14 Social Networks – Tecumseh StudyStudy included 3,000 men and women for 12 years Persons with high levels of social contact and relationships had significantly lower mortality levels Relative risk, all cause mortality A long-running population study in Tecumseh, Michigan, showed similar results: people with social contacts and relationships with other people were significantly less likely to die during the 12 years they were followed. Source Dean Ornish, MD, Love and Survival: the scientific basis for the healing power of intimacy, 1999. Social Network Score © LifeLong Health®

15 Social Networks – Swedish StudyThis study included 17,000 healthy men and women, followed for 6 years People who were most isolated and lonely (low social contact) had nearly 4 times the risk of dying during the study Relative risk, all cause mortality Another study Dr. Ornish reports is of 17,000 men and women. The most isolated and lonely, the people with the least social contact, were nearly four times more likely to die during the six years of the study than people with a high number of social contacts. Source Dean Ornish, MD, Love and Survival: the scientific basis for the healing power of intimacy, 1999. Social Network Score © LifeLong Health®

16 Social Support and Survival after a Heart AttackDr. Lisa Berkman studied survival rates of people suffering a heart attack Those with little emotional support were 3 times more likely to die. Of those who survived, after 6 months … 53% of those with no social support died compared to Only 36% with 1 person, and 23% for those with 2 or more people to provide social support Death Rates, heart attack Social support is a powerful aid to surviving a heart attack. Dr. Berkman found that people with little emotional support were 3 times more likely to die. Of the people who survived a heart attack for six months, over half of the people without social support died, whereas a little over a third of the people died if they had one supportive person in their corner. Fewer than a quarter of people with 2 or more people to provide social support died. Source Dean Ornish, MD, Love and Survival: the scientific basis for the healing power of intimacy, 1999. © LifeLong Health®

17 A Happy Mind Promotes HealthHappiness and life satisfaction are strong predictors of long life In the Alameda Co. study, unhappy people had a mortality rate 2-3 times those who were happy and satisfied with life. Alameda County Study Mortality rates all causes (per 100) In the Alameda County Study, people who had low levels of happiness and life satisfaction had significantly higher mortality rates, about twice higher for men and three times higher for women. Maintaining a positive mental outlook and a cheerful attitude goes a long ways to promoting good health. Source Lisa Berkman and Lester Breslow, Health and Ways of Living, The Alameda County Study, pp , Oxford University Press, 1983 n=4690 Happiness/Life Satisfaction © LifeLong Health®

18 Proverb A cheerful heart is good medicine,but a broken spirit saps a person’s strength. Proverbs 17:22 NLB The relationship between happiness and health has been recognized a long time. © LifeLong Health®

19 Depression Erodes HealthIn a study of 1,250 people who survived a heart attack, researchers found that 10 years later… Over 50% of those who were seriously depressed after the heart attack died 42% of those who were mildly depressed died Only 35% of those who were not depressed died Deaths (%) The deaths reported in this study were from cardiovascular causes. Reasons given as to why people with poor mental health had higher death rates from cardiovascular causes included: Depression and anxiety result in higher levels of two stress hormones, cortisol and norepinephrine, in the blood. Over time, too much cortisol may lead to a dangerous arrhythmia, PVC’s. Cortisol also increases the storage of fat in the abdomen which is associated with higher coronary risk. Excessive norepinephrine increases blood pressure, blood levels of LDL (low density cholesterol—so-called bad cholesterol), and increases blood clotting, which can lead to a heart attack or stroke. Originally published in Amer. J. of Cardiology Reviewed in The Johns Hopkins Health Letter, Health After 50, July, 1997. Am J of Cardiology, July 1997 © LifeLong Health®

20 Optimism and Health Status839 people in a study took MMPI personality assessment 30 years later researchers checked to see who was still alive or not For every 10 points increase in pessimism (T-score), mortality increased 19% Mortality Relative Risk Results 30 years later after completing a Minnesota Multiphasic Personality Inventory test for optimism or pessimism. For every 10 points increase in the T-score in pessimism, mortality rate increased by 19%. (A 10 point increase in the T-score is an increase of 1 standard deviation from the mean.) (The MMPI is the most widely used and widely researched test used by psychologists for testing adult psychopathology.) Source Maruta T, et al. Optimism vs. pessimism: survival rate among medical patients over a 30-year period, Mayo Clinic Proceedings, Feb 2000; 75:140-3 Mayo Clinic Proceedings, Aug 2002 Results of MMPI Test © LifeLong Health®

21 A Two-Way Connection Mind-Body health works in both directions.We’ve been looking at how mental health affects physical health. Now let’s look at how physical habits can affect mental health. For example, dependencies and mental health. Now let’s look at some dependencies and mental health. © LifeLong Health®

22 What are dependencies? Dependencies are learned behaviors (habits) that usurp personal control. They usually build up gradually. They are usually thought of as destructive. The bad news is that a dependency can control your life, but the good news is that dependencies are learned behaviors and thus can be unlearned, although with considerable effort in most cases. You may be unaware that a dependency is developing until it is well established. © LifeLong Health®

23 How do you recognize a dependency?Ever felt your life was out of control? Are there things in your life that you can’t live without? Do you need increasingly more of your (habit) to be satisfied? The bad news is that a dependency can control your life. The good news is that dependencies are learned behaviors and thus can be changed, although with considerable effort in most cases. Dependencies usually build up over a period of time and you may be unaware that it is developing until it is well established. © LifeLong Health®

24 How Dependencies BeginDependencies are said to begin with pleasurable activities that become a habit that eventually lessen our control over our own life. Most dependencies begin with a combined desire to avoid pain or discomfort and thereby gain pleasure. Most people learn very early to keep their hands off a hot stove. The pain of a burn is not associated with pleasure so no dependency is created. We avoid the pain of a burn so no habit of putting our hands on a hot stove is created. By contrast, dependencies such as smoking, alcohol, and drug use are associated with reducing pain, so they can become a habit. They may also offer pleasure to some people. This may also be true of uncontrolled gambling, excessive TV watching, excessive consumption of coffee and other caffeine drinks, etc. The pleasure gained from reducing pain or from escaping pain, when repeated over and over, form a habit. © LifeLong Health®

25 Destructive DependenciesControl our behavior Alter our personalities Diminish our health Destroy our relationships Absorb our resources Affect mental and emotional functioning Destructive dependencies control us more than we control ourselves. And how else are dependencies destructive? Remember: Being in control is a critical element of good health. © LifeLong Health®

26 Common Dependencies Caffeine Nicotine Overwork Alcohol GamblingStreet drugs Prescription drugs Television Food And . . . These are the most common dependencies in America. Some are obviously more devastating to life and health than others, but all can become obsessive and damaging to your life when they become excessive. Moderation is the rule in some areas and total abstinence is the only safe choice in others such as drug use. © LifeLong Health®

27 Caffeine In coffee, tea, cola drinks Creates a dependency over timedoubles blood adrenaline levels increases blood sugar (you feel down when low) Large intakes—five to six or more cups per day—can cause symptoms. The caffeine may interfere with your ability to relax or sleep, you might feel uptight or anxious, etc. It’s best to avoid caffeine, but if you choose to drink caffeinated beverages, limit your intake to one or two cups per day or drink “decaf” instead. Caffeine is one of the most common dependencies in America. Caffeine is usually only a problem when consumed in large amounts. Caffeine raises the body’s adrenaline levels and thus increases heart rate and blood sugar levels. It can also add to your stress level (adrenaline is a stress hormone) and cause stomach irritation. Caffeine is a diuretic, so it actually decreases water balance. For some people, taking in excessive caffeine before bedtime can interfere with sleep. Caffeine has been shown to heighten anxiety in some individuals. Two or three cups of coffee a day has not shown negative effects for most people. If you are pregnant or planning to become pregnant it is recommended that you reduce or eliminate caffeine from your diet. Some studies have shown that excessive caffeine can increase the risk of spontaneous abortion. Current research shows that when used in moderate amounts, for example one to two cups of coffee per day, adverse health consequences are minimal. As far as your health is concerned, however, a glass of water would be better for you than a caffeinated beverage. © LifeLong Health®

28 Nicotine Nicotine creates one of the strongest addictions.Most smokers become hooked as teenagers and then fight the addiction the rest of their life. Smoking kills more than 400,000 people yearly. Every cigarette smoked reduces life expectancy by 7-8 minutes. Disease Increased Risk Stroke X (2-3)* Heart disease X (2-4)* Lung cancer X (5-15)* Other cancers X (2-3)* COPD 25X (13-37)* range of increased mortality in due to smoking N Engl J Med 1997;337: Nicotine is a strongly addictive substance. Once a habit is established, it is extremely hard to break. The good news is that there are medications that are helpful in breaking the nicotine habit. Smoking and nicotine addiction is responsible for more deaths than all other dependencies/addictions combined. The younger a person is when they start smoking, the greater the risk. The increase in mortality of smokers compared to nonsmokers for leading causes of death is shown above. The average increase is shown first, then the range of increased mortality based on various studies is shown in parentheses (X stands for “times,” e.g., 2X equals two times the risk). Source Barendregt, JJ, et al. The Health Care Costs of Smoking. New England Journal of Medicine, 1997; 337: © LifeLong Health®

29 Quitting The best approach is to never start The good news . . .some 50 million Americans have quit stopping reduces your risk of heart attack and cancer no matter how long you’ve smoked there is help available in stopping today nicotine replacement therapy Certain drugs (Zyban) improve quitting rates Each month, thousands of smokers quit. If they can, you can too. There are helpful medications that can make your quitting experience easier and more successful. If you need assistance, talk to your doctor about nicotine replacement therapy and quit aids like Zyban that may help you stop smoking. Nicotine patches and nicotine gum are available at drug stores without prescription and have helped many people gradually overcome their addiction to nicotine and smoking. If you use a quit-smoking aid, be sure to follow directions carefully to ensure safety and the best results. © LifeLong Health®

30 Smoking and Probability of Dying Before the Age of 70Never smoking or stopping, significantly reduces your risk of early death compare to continuing smokers. Cancer Prevention 2 study includes over 1 million people, ages 35+. Men who smoke are nearly 2 and one-half times more likely to die before age 70 than men who so not smoke. Stopping also significantly reduces the risk of dying. The sooner you stop the greater the advantage in increased life expectancy. Cancer Prevention 2 Study ACS, Cancer Facts and Figures, 2003 © LifeLong Health®

31 Smoking and Probability of Dying Before the Age of 70Never smoking or stopping, significantly reduces your risk of early death compared to continuing smokers. Cancer Prevention 2 study includes over 1 million people, ages 35+. Women who smoker are twice as likely to die before age 70 as non-smoking women. Stopping also reduces risk significantly. The sooner you stop the greater the benefit. Cancer Prevention 2 Study ACS, Cancer Facts and Figures, 2003 © LifeLong Health®

32 Alcohol Some dependencies develop slowly — alcohol dependency is a good example. No one plans to become an alcoholic, but 14+ million lives are currently being seriously damaged due to excessive drinking. Alcohol is responsible for 85,000 premature deaths yearly. The NIH estimates the economic cost of alcohol dependency is $148 billion each year in the US—$616 for each man, woman, and child Alcohol dependencies are very costly including the lives affected and lives lost, economic costs, and the enormous damage done to society from: lost productivity alcohol-related illnesses and treatment costs property loss and health care costs from accidents caused by alcohol premature death (over 100,000 per year) Regular, heavy use of alcohol significantly increases the risk for: accidents, especially motor vehicle accidents mental problems, damage to the brain liver disease (cirrhosis is the 11th leading cause of death) high blood pressure, strokes, and heart disease fetal development (alcohol is a leading cause of mental disability in children) Not one of the 14+ million people addicted to alcohol today ever thought he or she would develop a drinking problem. They all started out thinking they could handle drinking, no problem. The safest course is to avoid alcohol. You can’t become dependent on something you don’t use. National Institutes of Health, Ninth Special Report on Alcohol and Health, July, 1997. © LifeLong Health®

33 John Hopkins University, Stroke, Dec 2003Alcohol and the Brain A new study by John Hopkins's University of 1,909 people (using MRI imaging) has shown that moderate drinkers have smaller brains then non-drinkers. Moderate drinking may have a toxic affect on brain cells. In this study, as drinking increased, brain atrophy was more common. Alcohol was clearly a risk factor for brain atrophy. 1909 people in their mid fifties were studied. MRIs of the moderate drinkers should that they had smaller brains then nondrinkers. Alcohol, they concluded, is clearly a risk factor for brain atrophy. John Hopkins University, Stroke, Dec 2003 © LifeLong Health®

34 Regular, heavy drinking can cause:High blood pressure Brain atrophy and mental problems Liver disease (cirrhosis) Certain cancers such as breast and bowel cancer Fetal development resulting in birth defects Accidents, especially motor vehicle crashes A host of society, family, and legal problems While some studies show a decrease in risk for heart disease in middle aged, high risk persons, alcohol is clearly a major risk factor for a host of other health conditions. A safer approach for heart health is to lower risks by losing weight, exercising, lowering BP and cholesterol, and other safier lifestyle approaches. National Institute on Alcohol Abuse and Alcoholism, 2004 © LifeLong Health®

35 How do you know if you are becoming dependent?Do you need a drink every day? When you drink, are you often unable to stop until you’ve had too much? Do you feel you need increasingly more alcohol to be satisfied? Doctors use the four “CAGE” questions to see if their patients might be dependent. One “Yes” raises suspicion. Two “Yes” responses indicate a dependency. If you think you need a drink every day to relax and enjoy yourself, you may be dependent. If you have a hard time stopping drinking once you get started, that’s also a strong sign of a drinking problem. Alcohol depresses your brain and body. Even though you may initially feel good after a drink, you will ultimately feel worse and want another drink to make you feel better again. If you drink, take the following short questionnaire that is often used by doctors to determine if their patients have a drinking problem. It is called the CAGE questionnaire. © LifeLong Health®

36 CAGE Questions Have you felt the need to cut down on drinking?Do you feel annoyed by people complaining about your drinking? Do you ever feel guilty about your drinking? Do you ever drink an eye-opener in the morning to relieve the shakes? A yes answer to any of the above questions raise suspicion of an alcohol dependency. Answering yes to two or more questions strongly indicates an alcohol dependency problem. Get help from your doctor, Alcoholics Anonymous (AA), or a counselor to deal with alcohol dependency before it creates serious health and social problems in your life. Drinking alcohol is not recommended. If you choose to drink, the U.S. Department of Health recommends limiting alcohol to no more than one drink per day for women and no more than two drinks per day for men. They also point out that the following people should never drink: women who are pregnant or trying to conceive children and adolescents individuals of any age who can’t restrict their intake to moderate levels individuals who plan to drive or work around machinery (remember, alcohol stays in the blood up to two to three hours after a single drink) individuals taking medication any time that having your judgment impaired might cause a problem (alcohol impairs judgment or decision-making capacity) Source USDHHS, USDA, “Dietary Guidelines for Americans,” 1995. © LifeLong Health®

37 Street Drugs An estimated 18,000 people, mostly young people, die yearly from using street drugs. People often take drugs to cope with problems or to find happiness. Drugs are illusive. They don’t solve problems. They often result in serious health and mental health problems and serious legal consequences. Drug use is a major health and social problem in our country today. The economic impact alone is about $100 billion yearly. Drug use is also responsible for much of the crime in our country; people turn to crime to pay for their drug habit. People often look to drugs to help them cope with life or to escape from reality. The only problem is that drugs appear to help make things better for the moment, but in reality it’s all an illusion. Nothing is resolved, improved, or made better by using drugs. Only more serious health and legal problems develop. The majority of people in prison are there due to drug problems. The families and friends of drug users often suffer financial and personal problems as a result of the drug abuse. The only safe course is to never start taking drugs. Drug use is a deadly trap in today’s society. Source National Institutes of Health, “Economic Costs of Alcohol and Drub Abuse,” News Release, May 13, 1998. © LifeLong Health®

38 Overwork Do you regularly work long hours, 50+ hours per week?Does your family wish they had more time with you? Do you sometimes use work as an excuse to avoid social contacts or family outings? Do you define your self-worth primarily in terms of the job you do? It’s important to create balance in your life. Balance is the key to prevent obsessive behavior. While work is good and necessary, there are other aspects of your life that are important too, especially your spouse and family. Set aside time for exercise, recreation, and other balancing aspects that keep you healthy and productive for a lifetime. Ideas to consider for adding more balance in your life: - Have things you can do in the evening for fun and recreation, especially with the important people in your life. If you lack good friends and a good social support network, invest some time in developing those relationships. - Take a good vacation every year — get completely away from work. - Plan mini-vacations as well. Each month take a day or weekend to go somewhere and do something special. - Each week have a special evening or day that is family day (or if you don’t have a family, a day or evening that can be spent with your spouse or friends). - What activities do you have in your life that you get excited about and enjoy doing? When was the last time you took time to enjoy these activities? - Other ideas: Help with a church or community project. Be a Big Brother or Big Sister to a child who needs help and direction in life. Volunteer to help out at your local school or be a coach for an after-school sport. As you become involved in other people’s lives, your own life takes on added meaning. © LifeLong Health®

39 Other Dependencies Compulsive TV watching can interfere with normal family interaction, physical activity, and adequate rest. Compulsive eating or eating to cope with stress can lead to obesity, diabetes, heart disease, and other serious problems. Other common dependencies can be compulsive TV watching and eating. The programs on TV can be pleasurable, but they can become a substitute for real living or important daily tasks. If you watch several hours of TV daily but don’t have time to exercise, get your studies done, do special activities with family, etc., then you may have a TV dependency. The average person watches TV many hours each day and each week. Try turning the TV off one or two nights a week. Limit your viewing to one or two programs in a night, then do something else. Find other activities you enjoy and do these activities regularly. Compulsive eating can also become a dependency, leading to serious health problems such as cancer and heart disease. Be aware when anything starts to dominate your life. Keep in control. If you find yourself out of control, get professional help or join a support group. Your physical and mental health will improve if you avoid or overcome the trap of dependencies in your life. © LifeLong Health®

40 Take Action Break the Dependency CycleThe good news is that you can change! When you recognize a dependency, do something about it before it gets worse. Keep trying. Never give up. Enlist support and help from family and friends. Get professional help if needed. Join a support group for your dependency if one is available. While changing, commit to an overall healthy lifestyle — eat well, keep active, get enough rest, and stay balanced. 1. Habits are learned, so they can be unlearned. 2. When you recognize a dependency, take action. Don’t wait for it to get worse before getting help. Over time, dependencies become stronger. 3. Keep trying even if you don’t succeed at first. Consider smoking, one of the strongest addictions. One study showed that nearly two-thirds of the people who repeatedly tried to stop, eventually succeeded. The average smoker who stops tries five or six times before becoming successful. Never give up. 4. Enlist the support of your family and friends. Get professional help if needed. Support and guidance from a counselor or support group can be a tremendous help in changing. In the case of smoking, there are medications you can take that can greatly increase your success. Ask your doctor for help. 5. Commit to an overall healthy lifestyle. Eat a balanced diet, engage in physical activities, and get enough rest. As you become stronger and healthier you will be better able to make healthy lifestyle choices. © LifeLong Health®

41 Take a Positive ApproachCrowd out what you don’t want with something good that you do want. For example, starting a regular activity program can help you stop smoking. The suggestions boil down to one principle. Think of something better. When the room is dark, we don’t curse the darkness. We turn on the light. Don’t concentrate on the problem. Surely we’ve noticed that when we try NOT to think of pink elephants, pink elephants are everywhere. That’s what we need to do with dependencies: don’t be controlled by them. “Overcome evil with good.” Romans 12:21. When there’s something in your life that you don’t want, then change that way of being. Re-think the way the want to live, then patiently, over and over, make that way of living into a habit. © LifeLong Health®

42 The Spiritual DimensionDevelop a spiritual life that provides Peace, Direction, Meaning, and Fulfillment in your life Developing spiritual strength can help give direction and meaning to your life. Faith or trust in a supreme being can also bring hope and comfort during periods of trial and sickness. Scientific studies show that people who trust in a higher power and have a meaningful religious connection recover more quickly from illness and live longer. Nurturing your spiritual commitment can help you live a healthier, happier life. Here are some approaches that have been helpful for many people: Spend a little quiet time each day in prayer, meditation, or contemplation. Learn what it means to love by caring for a child or helping those unable to help themselves. Be open to the inner voice of life that speaks harmony, kindness, and caring toward others. The spiritual dimension can help you integrate and prioritize life's components to achieve a full, rewarding, and meaningful life. © LifeLong Health®

43 Social Support, Religion, and Survival after Heart SurgeryPatients at the U. of Texas were asked before surgery: Do you participate regularly in church or a social group? Do you draw strength and comfort from your religion? In the next 6 months, among those: Without religion to provide comfort or strength: 3 times as many died. With no participation in social groups: 4 times as many died With neither social support nor religion: 7 times as many died Relative risk, all cause mortality The importance of social support and religion to survival after heart surgery is shown by a study at the University of Texas. Through asking two questions before surgery—”Do you participate regularly in church or in a social group?” and “Do you draw strength and comfort from your religion?”—investigators found predictable survival differences in the next 6 months. People who had social support and who drew comfort and strength from their religion were used as a norm or as the baseline. Three times that number of people died if they drew no strength or comfort from their religion. If people found strength or comfort in their religion but did not participate regularly in church or in other social groups, four times as many people died. Among people with neither social support nor religion, seven times as many people died. Surgery patients need people and the comfort and strength they can draw from religion! Source Dean Ornish, MD, Love and Survival: the scientific basis for the healing power of intimacy, 1999. © LifeLong Health®

44 Church Goers Live LongerStudied 2,025 persons, aged 55 and up, to see what factors would be the best predictors of longevity. Follow-up: 5 years The most significant factor predicting who was still alive? “Attending religious services.” Regular church attendance was the best overall predictor of all factors studied. Researchers considered income, education, chronic diseases, other illnesses, health habits, exercise, smoking, drinking, body fat, social participation, and psychological status. But none of these explained the results, church attendance was still an independent predictor and the strongest predictor. Dr. David B. Larson, president of the National Institute for Health Care Research, reporting on this study, concludes, “According to these data, attending religious services increases chances for living longer.” Source Oman, Douglas and Reed, Dwayne (1998) “Religion and mortality among the community dwelling elderly”, American Journal of Public Health, Vol. 88, No. 10, Amer. Jour. of Public Health, Vol. 88, No. 10, , 1998. © LifeLong Health®

45 The Mind-Body-Spirit Connection Is religion good medicine?Is religion good medicine? This is the question asked in the lead article of this issue of Newsweek. It depends. If your spiritual life helps you to be understanding, forgiving, helpful to others, fosters relationships, comfort, and peace, the answer is yes. If it makes you vengeful, violent, guilty, or isolated, No! Newsweek, Nov. 10, 2003 © LifeLong Health®

46 Newsweek Comments: Church Attendance“People who regularly attend church have a 25% reduction in mortality – that is, they live longer – than people who are not church goers.” This is true even after controlling for healthy lifestyles and social support. Linda Powell, epidemiologist, Rush Univ. Medical Center in Chicago Here is a quote from this Newsweek article on God and Health. The article emphasizes that the strongest evidence of the effect of religion on health is linked to regular church attendance. Newsweek, Nov. 10, 2003 © LifeLong Health®

47 Forgiveness and Health“People who forgive easily tend to enjoy greater psychological well-being and have less depression than those who hold grudges.” Survey of 1500 people by Univ. of Michigan, School of Public Health “There is a physiology of forgiveness. When you do not forgive, it will chew you up.” Dr. Herbert Benson, Head of Harvard’s Mind-Body Medical Institute Another example of faith and health is the concept of forgiveness. People who have a forgiving spirit have better mental health. Other studies also show that forgiveness helps improve physical health problems as well, such as blood pressure. Dr. Benson teaches a course for health professionals on Forgiveness and Health at Harvard University. Newsweek, Nov. 10, 2003 © LifeLong Health®

48 Religion Provides Comfort and Ability to Cope“Nobody disputes that in times of difficulty, religion provides comfort for an enormous number of people.” Richard Sloan, Columbia-Presbyterian Medical Center Research finds a link between beliefs and wellbeing: life satisfaction, hope, purpose, and meaning, are linked to lower rates of depression, less anxiety, and lower suicide rates. Harold Koenig, Director, Center for the study of Religion/Spirituality and Health, Duke University Religion can be a source of strength and comfort during crises in life. It can also help provide hope, direction, and meaning in life that leads to improved mental, emotional health. This article brings out that over half of all medical schools now include courses on spiritual health and healing. Newsweek, Nov. 10, 2003 © LifeLong Health®

49 Ways to Develop Spiritual StrengthGive of yourself tutor a child help build a home for someone in need minister to those in need (homeless, hungry, sick) Plan a quiet time daily for meditation, prayer, and contemplation Read inspirational books by great spiritual leaders Join a community of others of like faith Spend time alone in nature Nurturing your spiritual commitment can help you live a a more rewarding life. Here are some approaches that have been helpful for many other people interested in improving their spiritual life: Read from the Bible or other spiritual writings looking for principles and insights for life. Become acquainted with the thoughts and teaching of great people and spiritual leaders (for example, Martin Luther, Mother Teresa, Thomas Aquinas, Mahatma Gandhi, Billy Graham, C.S. Lewis). Talk about ways to grow spiritually with a friend, pastor, priest, rabbi, or other spiritual leader you trust and admire. Find a group and meet regularly with people of similar belief who are committed to spiritual development. Spending a little thoughtful time in contemplation can help you order and direct your life to what is really important to you and your community. Spend time weekly in helping, mentoring, and assisting others in your life beside your own needs. Ask your group what they like to do to develop their spiritual life. © LifeLong Health®

50 “It’s beneficial to have an end to journey towards,But the journey is what is beneficial in the end.” “Everybody needs beauty as well as bread, Places to play in and pray in, Where nature may heal, And give strength to body and soul alike.” John Muir For John Muir, reveling in the beauty of nature was spiritually uplifting. You may find a similar spiritual reward by spending time in nature’s unspoiled wilderness, resting in a mountain meadow, or relaxing by a bubbling brook. Everybody needs beauty as well as bread, Places to play in and pray in, Where nature may heal, And give strength to body and soul alike. John Muir

51 Summary for Balanced LivingBe active Eat well Get your rest Be social Be careful Get regular exams Avoid anything harmful Be grateful Be helpful Forgive others Enjoy life! 10 commandments for good health! © LifeLong Health®

52 Quiz According to the World Health Organization, what are the four dimensions of health? List 4 of the the primary causes of poor health. Psychoneuroimmunology is the study of what? T/F Thoughts we think can affect the circulation. T/F Social interaction/support affects survival. ____ is an emotion that damages the heart. What is a dependency? The two most destructive dependencies are? T/F Alcohol in moderate use, can cause brain atrophy. T/F People who attend church regularly live longer than than those who don’t. Physical, mental, social, and spiritual. Unhealthy lifestyle, injury, microbes, genetics, lack of access to adequate health care, mental/social health problems (depression, hostility, worry, excessive stress, negative attitude, lack of love/acceptance How the mind (emotions) affects the nervous and immune system. True (ECG study and ischemia) True, just as much as high blood pressure or high cholesterol. Hostility or anger A learned behavior that usurps personal control and is destructive to health. Smoking and alcohol abuse. True, according to MRI studies on social drinkers by John Hopkins University. True, according to several population based studies. © LifeLong Health®

53 Quiz T F Stress can be beneficial or destructive.T F Stress is caused by difficult people and difficult situations. T F Depression is an attitude problem. Name two health behaviors that may help prevent depression: _______ and ______. Three effective strategies when feeling overwhelmed are _______, _______, or _______. T F Change, even good changes, can be stressful. The best antidote for stress is ________ . T F Physical activity is a good stress releaser. T F Isolating yourself is a good way to deal with stress. Two positive ways to resolve conflicts are ___ and ___. ANSWERS: True. Stress can be beneficial or destructive. False. Stress is internal. We allow ourselves to be stressed by difficult people and difficult situations. False. Depression is real. Two health behaviors that may help prevent depression are physical activity, good eating habits; folic acid. Three effective strategies when feeling overwhelmed are saying “No”, setting priorities, and learning to delegate. True. Any change, even good changes, can be stressful. Relaxation is the best antidote for stress. True. Physical activity is a good stress releaser. False. Isolating yourself is not a good way to deal with stress. Two positive ways to resolve conflicts are to: Use good communication, Express feelings in "I" messages, Explore alternatives, and as a last resort, to Bring in an arbitrator, © LifeLong Health®

54 The End www.LifeLongHealth.us © 1997-2004 LifeLong Health®Enjoy your health! © LifeLong Health®

55 Walking Prevents Mental DeclineResearchers tested mental acuity of 5,925 people age 65+ at start and end of study. People who walked the least (less than ½ mile per day) had the most mental decline People who walked the most (18 miles per week) had the least mental decline The chance of mental decline decreased 13% for every extra mile walked Summary: “Exercise, such as walking, is one of the best ways to preserve your mental ability.” Physical activity is good for the mind as well as the body. In this study, researchers looked at exercise and mental decline in an older population. They found that people who were more active (walked the most) had the least mental decline. They concluded that “exercise such as walking is one of the best ways to preserve your mental ability.” Anyone interested in ways to keep the mind from deteriorating with age? Here is one good, proven successful approach. Walk! Stay active, physically and mentally. Both the body and mind need to be challenged to stay strong and functional. Source Primary researcher was Dr. Kristine Yaffe, chief of geriatrics at the Veteran’s administration Medical Center in San Francisco. Reported in a news article on the internet. Presented at the American Academy of Neurology annual meeting, May 9, 2001. Study presented at Amer. Academy of Neurology annual meeting, May 9, 2001 © LifeLong Health®

56 Mind-Body Health Means …Taking good care of the mind, body, and spirit, while caring and giving social support to others. That is… Creating healthy communities of family and friends Learning to communicate in ways that enhance intimacy with loved ones Developing empathy and love for ourselves as well as others Developing a spiritual dimension that brings comfort, strength, joy and fulfillment in life Living free of dependencies that take control over our life As well as developing good health practices – eating well, being physically active, avoiding smoking, etc. Taking good care of the mind, body, emotions, spirit, and supporting and helping one another © LifeLong Health®

57 Wholistic Health The message of good health should incorporate all aspects of health Mental Social Spiritual Physical This allows us to enjoy life in all its fullness We remain healthy as a whole person, or we become ill as a whole person, because when one part of us is ill, the other parts sympathize. To feel good and to be in health in all aspects helps us enjoy life. © LifeLong Health®

58 Faith Communities and MortalityDuke University studied some 4,000 people for six years They found that those people who attended church weekly had a 28% lower risk of dying; even after controlling for health habits, age, education level, and medical problems Relative risk of death Why would church attendees live longer? Some theories include: Churches provide social connections and support Members find comfort, forgiveness, and meaning in faith in God Church attendees usually live healthier lives than non-church goers (although they adjusted for health practices in this study). Church support may help people cope better in times of stress Source Journal of Gerontology, July/August, 1999 Weekly Church Attendance Journal of Gerontology, July/Aug. ‘99 © LifeLong Health®

59 The First Step in Overcoming a Dependency is Recognizing ItThink of a dependency as a bad habit. Do any of these statements apply to you? [ ] I feel unable to stop or control my habit. [ ] I need (a smoke, drug, special food, TV …) every day to survive. [ ] More and more of my life centers around my habit. [ ] I need more of my habit as time goes on to make it enjoyable. [ ] I often feel guilty about my habit. [ ] I get annoyed when people suggest I stop or cut down. [ ] My habit has caused problems between me and my family or job. [ ] My habit has caused (or is likely to cause) health problems for me. [ ] My habit is illegal and could cause significant problems at home, work, or school if I am caught. All of the above statements are indicative of a dependency. The more statements that are true for you, the more strongly a dependency is adversely affecting your life. If you think you have a dependency, you might want to discuss it with someone you trust. Choose someone you can confide in. If that person agrees that you might have a dependency, or if you feel strongly that you might have a dependency, take steps to change. Get professional help if needed! Take the first step toward getting control over your life by honestly answering these questions. © LifeLong Health®

60 Places to Turn for Help AA (Alcoholics Anonymous)Al-Anon (for spouses of alcoholics) Pastor Counselor/Doctor Wise friend Support groups Higher Power Most people with a dependency will need help in making a change. The first step to recovery is admitting that you need help and seeking help from a reliable source (as shown above). Divine assistance is always appropriate and forms the foundation for help in successful programs such as AA and others. © LifeLong Health®

61 General Well-Being and ExerciseA national study in Canada compared physical activity level and scores on a mental health test. People who were more active scored higher (better mental health) than inactive persons in all age and gender groups studied. Dr. Stephens summarized his findings by saying: “Physical activity is positively associated with good mental health, especially: Positive mood General well-being and Less anxiety and depression” Dr. T. Stevens conducted a national “General Well-being” survey in Canada comparing physical activity levels and scores on a mental health test. People who were more active consistently scored higher (better mental health and well-being) than inactive people for all age and gender groups studied. His conclusion, “Physical activity is positively associated with good mental health.” Study reported in: Dr. David Nieman’s book, Fitness and Sports Medicine, A Health Related Approach, p 466, 1995 In another large survey conducted by Wellsource including over 100,000 people, persons with high physical activity levels reported being happier on a “Happiness Scale” than inactive people (highly significant difference). Nieman, Fitness and Sports Medicine © LifeLong Health®

62 Resolve Conflicts If something is bothering you, don’t just stew about it, take action to resolve it. In resolving conflicts between people, try Reflective listening … let him or her know you understand Describe your position … I feel, I need, I think Explore alternatives … there is usually a mutually acceptable solution if you take time to find it If you are have a problem with another person, someone who is just driving you up a tree, it’s best to deal with it and not ignore it, hoping it will go away. Talking out problems and conflicts is essential for building good relationships and relieving hostility and frustration in your life. Resolving conflicts requires good communication skills. People need to know how you feel (just be sure to express it nicely). Express your needs or desire with “I” statements; “I think we need …”, “I feel this way about this situation …”, or “I need you to …” Good communication also involves hearing and understanding other people’s needs. Use reflective listening to clarify and let the other person know you understand what he or she is expressing. The ideal solution to any problem is not just what you want, but a solution that is helpful or agreeable to both parties. Look for mutually acceptable solutions, then you have a “win-win” solution. Try this approach above to resolving conflicts you may be experiencing. © LifeLong Health®

63 Emotions and High Blood PressureThis study showed that people who often felt Uptight or anxious Or unhappy or depressed Were twice as likely to develop high blood pressure in the next 9 years compared to people who were not unhappy. Relative Risk of High Blood Pressure The mind-body connection. People who are often anxious or depressed are twice as likely to develop high blood pressure in future years than those not bothered by these emotional problems. This shows the importance of dealing with feelings of being uptight, anxious, or depressed. If you have these feelings frequently, get help. Take time daily to unwind, relax, and have fun. It’s important to your long term health and well-being. Stress and emotions seems to be especially hard on the cardiovascular system. This is where regular, aerobic exercise can be of great benefit; strengthening the cardiovascular system and helping counteract the effect of negative emotions on the health of the body. Source: Archives of Family Medicine, Jan.-Feb., 1997 © LifeLong Health®

64 Worry and Heart Health A study of 1,759 people for 13.7 yearsLooked at worry and heart disease They found increased risks for heart attacks among those with increased levels of worry about: - Financial issues - Health Relative Risk of Heart Attack In this study, researchers looked at the effects of worry on heart health in 1,759 healthy men for 13.7 years. They found that high levels of worry significantly increased the risk of a heart attack. Worry over financial concerns and health issues were most closely related to heart problems. Persons with a high level of worry had a 70% increased risk of heart attacks compared to those who seldom worried. Those persons with the highest worry score had a 154% increased risk of heart attack compared to those who seldom worried. High levels of worry negatively affect heart health. Reference Circulation, Feb. 18, Also reviewed in Harvard Heart Letter, June, 1997. Source: Circ., Feb. 18, ‘97 © LifeLong Health®

65 Optimism and Health Status447 people in study Took MMPI personality assessment 30 years later they took SF-36 health status assessment A pessimistic outlook was linked to poor mental and physical health compared to optimistic or mixed outlook Population spread (%) A pessimistic outlook on life, reflected by higher scores on the MMPI PSM scale, was significantly associated with poorer physical and mental functioning as measured by the SF-36 health status and quality of life assessment taken 30 years later. Reference Maruta T, et al. Optimism-pessimism assessed in the 1960s and self reported health status 30 years later, May Clinic Proceedings, Aug 2002; 77:748-53 Mayo Clinic Proceedings, Aug 2002 Results of MMPI Test © LifeLong Health®

66 Heart Disease and Social Support Duke StudyRelative risk, all cause mortality Duke University studied 1,400 men and women who had angiograms and found at least one artery severely blocked Those who were not married or who had no close confidant were over 3 times more likely to die in the next five years Social Network Score © LifeLong Health®

67 Happiness/Depression Anger and Hostility Coping with StressMental Health Happiness/Depression Anger and Hostility Coping with Stress Now that we have established the value of social support, let’s look at happiness and at depression and at other aspects of mental health. © LifeLong Health®

68 Taking Action Breaking the Dependency CycleThe good news is that you can change! When you identify a dependency, do something about it before it gets worse. Keep trying, never give up. Enlist support and help from family and friends. Get professional help if needed. Join a support group for your dependency if one is available. While changing, commit to an overall healthy lifestyle — eat well, keep active, get enough rest, and stay balanced. 1. Habits are learned, so they can be unlearned. 2. When you recognize a dependency, take action. Don’t wait for it to get worse before getting help. Over time, dependencies become stronger. 3. Keep trying even if you don’t succeed at first. Consider smoking, one of the strongest addictions. One study showed that nearly two-thirds of the people who repeatedly tried to stop, eventually succeeded. The average smoker who stops tries five or six times before becoming successful. Never give up. 4. Enlist the support of your family and friends. Get professional help if needed. Support and guidance from a counselor or support group can be a tremendous help in changing. In the case of smoking, there are medications you can take that can greatly increase your success. Ask your doctor for help. 5. Commit to an overall healthy lifestyle. Eat a balanced diet, engage in physical activities, and get enough rest. As you become stronger and healthier you will be better able to make healthy lifestyle choices. © LifeLong Health®

69 That Means … Creating healthy communities of family and friendsLearning to communicate in ways that enhance intimacy with loved ones Developing empathy and love for ourselves as well as others Developing a spiritual dimension that brings comfort, strength, joy and fulfillment in life Developing good health practices – eating well, being physically active, avoiding smoking, etc. And what does it mean to be healthy in all aspects? It means: Creating healthy homes and healthy relationships Communicating in healthy, honest ways Having a healthy perception of ourselves and others Developing a spiritual understanding that is comforting as well as strengthening Developing healthy physical behaviors © LifeLong Health®

70 Health is . . . Looking, feeling, and performing your best. Tektronix CEO Freedom from pain for some. For others, health is becoming the best you can be. The Olympic Goal Determined by the choices you make. Abraham Lincoln More than the absence of disease, it is physical, mental, social, and spiritual well-being. WHO The attainment by all peoples of the highest possible level of health. World Health Organization These definitions of health are positive. Health is more than the absence of disease. The World Health Organization is the United Nation’s specialized agency for health. The World Health Organization, the United Nations specialized agency for health, was established on 7 April WHO's objective, as set out in its Constitution, is the attainment by all peoples of the highest possible level of health. Health is defined in WHO's Constitution as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. WHO is governed by 192 Member States through the World Health Assembly. The Health Assembly is composed of representatives from WHO's Member States. From © LifeLong Health®

71 Emotions and High Blood PressureThis study showed that people who often felt Uptight or anxious Or unhappy or depressed Were twice as likely to develop high blood pressure in the next 9 years compared to people who were not unhappy. Relative Risk of High Blood Pressure The mind-body connection. People who are often anxious or depressed are twice as likely to develop high blood pressure in future years than those not bothered by these emotional problems. This shows the importance of dealing with feelings of being uptight, anxious, or depressed. If you have these feelings frequently, get help. Take time daily to unwind, relax, and have fun. It’s important to your long term health and well-being. Stress and emotions seems to be especially hard on the cardiovascular system. This is where regular, aerobic exercise can be of great benefit; strengthening the cardiovascular system and helping counteract the effect of negative emotions on the health of the body. Source: Archives of Family Medicine, Jan.-Feb., 1997 © LifeLong Health®

72 Participate in CommunityBelonging to a social or community group promotes better health and a longer life A caring, supportive faith group A social club that provides opportunity for social contact service There is strength in community “United We Stand” People function best in a supportive community. We need support and encouragement from others. We also thrive when we are involved in helping other people. Improve your social connections by belonging to community groups. Get involved with causes greater than yourself. Experience the joy of being with and helping others. People who tend to isolate themselves usually don’t have good mental health. © LifeLong Health®

73 Hostility and Heart HealthDuke University studied anger and heart disease in 12,986 people. Those who scored high in anger had 2.7 times as much heart disease, six years later. Moderate anger people developed 35% more heart disease than those low in anger or hostility. Heart disease, relative risk This data is from the Atherosclerosis Risk in Communities study of 12,986 persons (white and black, men and women). Researchers found high hostility to be an independent predictor of a heart attack. Persons rated with high hostility had a relative risk of 2.69 compared to low hostility persons. Those rated with moderate anger had a relative risk of a future heart attack of 1.36 compared to those rated low anger. The researchers concluded: “Proneness to anger places normotensive (healthy persons with no high blood pressure) middle-aged men and women at significant risk for CHD morbidity and death independent of the established biological risk factors.” Dealing with Anger It’s not wrong to get angry. It’s what you do with your anger that makes the difference. Venting your anger by yelling or hitting only makes things worse. Take a break. Let time and/or physical activity diffuse your anger. Anger is a choice. No one can “make you angry” without your consent. When you start to get angry, ask yourself, “Is it really worth getting angry over?” Most of the time it really isn’t. Channel anger energy toward making positive change. Anger often follows fear, frustration, or hurt. Rather than getting angry, deal with the source of the problem. Get help if needed to resolve problems and conflicts. Say “I’m sorry”. Forgiveness is a solution to much of the anger in today’s world. Reference: Williams JE, et al. Anger proneness predicts coronary heart disease risk: prospective analysis from the atherosclerosis risk in communities (ARIC) study, Source: Circulation 2000 May 2;101(17):2034-9 Circulation, Vol. 101(17): © LifeLong Health®

74 Worry and Heart Health A study of 1,759 people for 13.7 yearsLooked at worry and heart disease They found increased risks for heart attacks among those with increased levels of worry about: - Financial issues - Health Relative Risk of Heart Attack In this study, researchers looked at the effects of worry on heart health in 1,759 healthy men for 13.7 years. They found that high levels of worry significantly increased the risk of a heart attack. Worry over financial concerns and health issues were most closely related to heart problems. Persons with a high level of worry had a 70% increased risk of heart attacks compared to those who seldom worried. Those persons with the highest worry score had a 154% increased risk of heart attack compared to those who seldom worried. High levels of worry negatively affect heart health. Reference Circulation, Feb. 18, Also reviewed in Harvard Heart Letter, June, 1997. Circulation, Feb. 18, ‘97 © LifeLong Health®