Design for Health and Wellness - Essence and Existence
The health programme that I set out in this short article is based on the detailed information and advice I received, and the practices and habits I was encouraged to acquire, by a number of health professionals in the health and lifestyle classes I attended from 2017 onwards: doctors were involved, but I dealt mainly with nurses, physios, and trainers. I have also taken notes from the anxiety classes I attended in 2019 and in 2020. Since the information and advice I was given from all these sources converged towards the same conclusions, it was fairly easy for me to distil the essence and formulate it into a clear and practicable health programme centred on diet and exercise. I have left the detailed explanations of how everything works out. It is enough to know that everything here is embedded in concrete explanations of the physiological processes at work. This is very much a document concerned with the practical, forming the basis and content of a personal health and fitness regime that is within reach of all in decent health. It's a guide to refer back to and act on.
I listened and learned in my classes. I took the handouts home and followed the links provided to take notes. Everything here possesses a solid medical rationale. To simplify, it’s all about arteries, circulation, and extremities. Those three words distil the essence of the information and advice, underlining the importance of blood flow to a healthy body. The body serves as an early warning system. You learn the hard way to pay attention, read the signals, and take proper and effective action. And you learn also that you can take control of your health and be proactive.
This plan was, in origin, a recovery programme. What plan is appropriate for each person depends upon each person's state of health and circumstances. I have always been fairly fit, able to walk long distances at a time as well as do a few hundred press-ups of some description. My health problems, it became clear in time, stem from anxiety issues arising from an only recently diagnosed neurological condition. Each person is different, with different conditions and hence different needs. Which programme is appropriate for you depends upon your state of health and is something for you to work out in consultation with health professionals. This is the plan that works for me.
Although I set this plan out in terms of steps, these are not 'steps' at all, as in stages, but things that are to be done in conjunction.
Step 1: Fitness and Exercise
The surest way to improve bodily functioning is through regular physical activity. Exercise also positively affects brain-wave activity, which makes you feel energized. Working out regularly builds stamina, preventing or delaying fatigue.
Raise your heart rate
To get your heart pumping, make a conscious effort to add 5,000 steps to your daily hoofing, roughly 2 miles. Or whatever target is realistic for you, building up to that two miles. Walking can rev up hormones, flush stress, whittle away fat, and rejuvenate the body, filling you with renewed vigour, confidence, and the glow of good health. Aim to walk a number of extra steps daily. I don't make a fetish of numbers and targets. These simply add pressure, make exercise a chore rather than something that is enjoyable, and invite a failure that can be debilitating. But if you need numbers, find a meaningful and reachable target and enjoy reaching it. The aim is to reach a number of steps which research shows to boost overall fitness and health. It also takes the weight down, meaning all your health measures go up.
Build strength
Do push-ups, ab curls, and squats to build strength and stamina. These exercises strengthen the shoulders, chest, abdominals, buttocks, and legs and prevent muscle fatigue. I do these exercises with dumbbells and exercise bike. And I hike miles and uphill. There is also yoga.
To promote optimal flexibility-the ability to use muscles and joints through their full range of motion perform stretches every day. Regular stretching will help relieve stress, a major contributing factor to physical problems. When performed in a slow and focused way, stretching can be an excellent relaxation therapy as well as a tension easer.
This programme will achieve measurable changes in flexibility, strength, and flow. This programme is a lifestyle, and not a few hours' worth of quick changes. I used to do bursts of 500 pressups a day, before returning to a sedentary lifestyle in front of the computer. Quick exercises and bursts and short-term fixes are fools gold. An effective health regime is a lifestyle commitment to feeling good emotionally and physically.
But if you need it simple:
Maintain a healthy weight
Maintaining a healthy weight can improve your blood flow and reduce your chances of diabetes, high cholesterol, and heart disease. I don't make a fetish of numbers when it comes to weight. I have a fair amount of muscle, which is heavier than fat, boosting my weight, but in a good way. The key here is 'healthy' weight.
The Need for a Fitness Programme and Plan
You need a fitness programme and plan for a number of reasons:
It provides structure and is something to fall back on, add to, and modify as you go. A structure places you firmly within something solid, ordering and coordinating activities to a meaningful and tangible end;
It provides goals and a goal, breaking down your exercises into achievable targets, working towards an ultimate end;
It provides a checklist, enabling you to score little goals and win little victories each, all leading to a greater end;
It helps prevent over-training or under-training, keeping you on course;
It prevents burnout.
The fitness programme that I have devised is modest and within easy reach but is not for beginners. People need to check any health programme they undertake against their own health issues and needs. I gathered these details as part of my recovery programme having suffered a heart attack. That said, I have always been fairly fit, able to walk long distances at a time as well as do a few hundred press-ups of some description a day. The point is that I was fairly physically fit to begin with. Others may not be so fit and hence should be careful with exercise. This is the programme that works for me.
Exercise
I use 4kg dumbbells. That's not heavy at all but enough to ensure a decent level of fitness. The important thing is to exercise regularly, not impress people with how much you are lifting (I once tried to impress my doctor with numbers and she just shook her head - you are not aiming to be an Olympic athlete). In cardiac rehab, we used 1kg, with the real tough guys going to 2kg. As some indication of what I'm coming back from here, the nurses would regularly take the 2kg weights off me and make me rest during the circuits. (Although I still say it was a combination of my competitive nature, natural tendencies to show-off, and social anxiety that sent my pulse rate to 'pathological' levels). I do 80 of each dumbbell exercise (below), taking some two minutes or more. In cardiac rehab, each exercise would be for one minute only, before moving to the next. I should really halve this to 40 and do two circuits, as in rehab. We would also perform a lengthy warm-up exercise, walking around the room, stretching arms in various ways, limbering up, getting the blood circulating. And we would also wind down at the end. That would fill an hour. I tend to take thirty-forty minutes but filled with more intensive exercise. To do these exercises there is a need for a decent level of health in the first place. I worked up to this after six months in recovery.
Likewise using the exercise bike. I do 30 minutes at 30 km per hour, meaning that I do 15km. In cardiac rehab, we only did one minute in the first circuit, then one minute in the second. And nothing like 15 km. The rule is not to push yourself. You need to breath harder, but not hard. The first signs of stress or pain and you stop. I started off doing 10 minutes at 12km per hour and then moved on up.
These exercises are for the indoors. In addition to these, there are activities in the great outdoors. I can hike and ramble for miles. I was taught in cardiac rehab to walk at least 30 minutes a day. If you work, get up early in the morning and walk. The nurse told me that she goes for a walk at 7-30 in the morning. I complained about rain, cold, and bad weather, only for her to tell me I was soft and that there is no link between colds and wet and cold weather. I was also told that if I didn't do at least 30 minute walk or exercise, then all of the dietary changes I may make would be negated. So get out and walk! I don't drive so am used to walking to the shops and such like. I ramble and hike uphill too in the country. It feels good to be outdoors and it does your heart and soul good too.
There are many variations of the dumbbells exercise programme, all of which can be found on the Internet. This is the one that works for me.
Dumbbells Exercise Programme
The thirty minute programme – perform 80 of each of the following whilst moving your feet on the spot.
The one hour programme – perform two sets of the thirty minute programme.
Biceps curl (arms up and down, bend at the elbow)
Alternating Biceps Curl (as above, just taking turns between left and right)
Shoulder Press (arms raised in the air, up and down)
Alternating Shoulder Press (as above, left and right in alternate turns)
Lateral Raise (arms at the side holding the dumbbells then raised parallel to the shoulder and then down and back again)
Triceps Kickback (bend forwards and move arms like a skier, feel the tension in the top back of the shoulder)
Alternating Side Bends (or Stretches) (stretch down left and right in turns; don't move on the spot on this one, unless you want to look like a penguin)
Upright Row (pull the dumbbells up and down in front of your body, in a rowing action)
Cross Body Hammer Curl(aka the cross chest hammer curl) (right hand dumbbell moved to left shoulder then left hand dumbbell moved to the right x 80)
Goblet Squat (holding the dumbbells squat up and down. If you are feeling really fit, then stand and raise the dumbbells over your head before squatting again)
A picture paints a thousand words.
Biceps curl.
Alternating Biceps Curl
Shoulder Press
Alternating Shoulder Press
Lateral Raise
Triceps Kickback
Alternating Side Bends (or Stretches)
Upright Row
Cross Body Hammer Curl(aka the cross chest hammer curl)
Goblet Squat
That's really not difficult to follow. You quickly internalize these exercises and get into the habit of doing them. That's great for someone like me who struggles with instructions and needs things as simple as possible. There are variations of the Goblet Squat. I pick the dumbbells up from the floor performing each squat. It is also possible on the upward movement to raise the dumbbells high by extending the arms fully upwards. Be careful, though. I found that when performed too vigorously and too quickly, the squats with weights put too much stress on the knee. I have to say that I suffered with serious knee pain for a month or more and I believe it was as a result of going hell-for-leather on the Goblet Squat. Which underlines the lesson - never push too hard too quickly. It should all come nice and easy, with just enough pressure to get you breathing quicker and the heart beating faster. Try squats without weights. Or halve the numbers and go slow. It is a good exercise for the pelvic floor.
The nurses also taught me Kegel exercises to exercise the pelvic floor muscles. I hesitate to comment further here. When I let it be known that these exercises were part of my regime, I received gentle teasing from the odd woman friend, who assured me that these were exercises for women. They may well be. But I was assured by the trainers and nurses who introduced me to Kegel exercises that they were of benefit to everyone (the trainers and nurses were women, of course).
The sceptical should take note of what it says on the NHS site: “What are pelvic floor exercises?”
The exercises are of benefit to all people regardless of sex, since “people of all genders have these muscles.”
So I feel somewhat vindicated. Studies indicate that pelvic floor exercises have a positive impact on the body's functioning. Links are available for those who wish to know more.
Exercise Bike – 30 minutes on the exercise bike at 30km per hour means 15km. Every one in five minutes should be done with intensity to get the heart rate up. I try to do this five days a week. I put my headphones on and watch something of interest on YouTube. Queen concerts are very good. Football. Northern soul. Whatever gets you excited. I started with 10 minutes at just over 24kmph. You can vary time and speed to your own needs. Sometimes I do 10 minutes of high intensity, sometimes 20 with less intensity. It depends. I would do 30 minutes at least 4 times a week. That's for me, having built up to that level from modest beginnings.
One final point - stay hydrated: drink water. Hydration is important for your overall health. So try to get about two litres of water a day. I always forget this one. I need a nice water bottle. I've been meaning to get one from the Liverpool Heart and Chest Hospital Charity, £3.99. It's not the most attractive bottle I have ever seen, but I feel a certain loyalty to the place that saved my life.
Step 2:
Practice stress management
Practising stress management is great for your overall mental and physical health. A constant stress that develops into anxiety can seriously damage your health and increase your chances of developing cardiovascular disease and diabetes.
Stress management techniques include:
deep breathing exercises;
spending time with loved ones;
spending time outdoors;
pursuing a hobby or interest;
keeping a journal;
meditation;
mindfulness.
Things I learned from my anxiety classes:
practice mindfulness; live in the moment, shut the rest out.
practice breathing techniques. We were taught the 3-5 technique, breathing in for 3 seconds and breathing out for 5. It had already been established that I was fairly fit (I had boasted about hiking mountains (whilst saying nothing about complaining all the way up them, not to mention falling down them) - so I was taught the 7-11 technique. Breath in for 7 seconds and then breath out for 11 seconds. The important thing is to make sure that you are doing the deep diaphragmatic breathing as opposed to the shallower lung breathing. This requires that you breath deep down into your stomach so that your diaphragm is moving down and pushing your stomach with each breath you take.
Practice sleep hygiene
Sleep is important for your vascular health, which affects your body's ability to function.
Go to bed at a reasonable time and sleep well, and the body's functioning will improve.
Yoga and Tai-Chi
A point on Yoga and/or Tai-Chi – which combine both steps 1 and 2.
With my usual genius, I missed the Yoga and Tai-Chi classes during cardiac rehab. This came as something of a relief to me at the time, because I tend to struggle to follow verbal commands and instructions. I'm none too clever when it comes to the written ones for that matter, but that's besides the point. There are many good things to be taken from these disciplines. I'm not great at these things, but am looking to add something from them that I can use. Have a look round. There are usually Yoga and Tai Chi offered at a local community centre. It may be good to join, to get out, get fit, and meet others at the same time. They are putting yoga on at the local football club, so I may give it a go, expand my horizons beyond the corpse and the tree positions, which are the only two positions I know.
Personally, I've always preferred to keep moving to the sound of a jolly tune rather than try to follow instructions. Like this one by Ottowan, "Hands Up (Give Me Your Heart)." "God I hate this," the cardiac nurse in charge said as soon as it came on as we were put through our paces, promptly putting her hands down and stopping (as we all put ours up and started moving all the quicker). She probably hears this song every day. I wouldn't mind hearing it every day. I like a jolly tune.
"Let me be your Romeo, your wonder boy,
And your super champ.
Let me take you to the milky way.
On a holiday (On a holiday)”
Another time, perhaps.
Step 3: Diet and Nutrition
Health and happiness - bodily functioning and performance - is greatly impacted by what you eat and how much you eat.
Reduce portion size
Try to eat 10 percent less at each meal or about 500 calories less a day. I cut pies and pastries out and reduced cake to a Sunday treat, as it had been when I had been growing up in simpler, more financially straitened, and healthier, times. We learned to look forward to and appreciate treats when they were just that – treats and not staples. The effects were dramatic as the weight dropped off me. Often, pastry serves no purpose other than to wrap some decent and tasty food up. It’s a dead-weight, and should be dropped like all dead-weights.
Avoid fatty foods
Fatty, high-calorie foods act as a shock to the blood vessels and cause them damage. The fats injure your blood vessels to the point where they are stunned, preventing them from being properly responsive when signals are transmitted from the brain. Nerves lose their sensitivity when cholesterol builds up. The top saturated-fat culprits to avoid include egg yolks, butter, cream, fatty red meats, and coconut oil. I was also advised to choose natural products like butter – spread thinly – to substitutes.
Eat fruit and vegetables daily
Fruit and vegetables help lower your cholesterol level, which combats cardiovascular disease and increases blood flow. Leafy green vegetables are excellent sources of folic acid, calcium, magnesium, and zinc. Citrus fruits offer plenty of vitamin C. Blueberries possess the highest amounts of free-radical-crushing antioxidants.
Drink black or green tea
Both are high in antioxidants. A cup of tea has many disease-fighting benefits, among them protecting against cancer and maintaining heart function and strong bones. If you hate green tea, then re-educate your taste! (I have reduced milk in tea to a minimum. I remain to be persuaded about green tea).
Spice up your foods
Chile peppers, ginger, and other spicy foods increase circulation.
Here is a more detailed list of friendly foods.
DIET
Breakfast, dinner, main meal, treats, snacks, afters, drinks
Basically fruit and vegetables.
Fruit salad – chopped fruit with fruit juice and Greek yoghurt.
Breakfast
Porridge, oatmeal (contains the amino acid L-arginine, beneficial for improving blood flow, loaded with soluble fiber and complex carbs, zinc, folate), wheat germ (contains vitamin E, the antioxidant that helps strengthen your immune system and helps keep your blood from clotting)
Salad
Beetroot (high in nitrates, which open up blood vessels and increase blood flow), olive oil (this omega-3, use fatty-acid-filled oil instead of fatty dressings), tomatoes (bursting with beneficial components like potassium, vitamin C, and most importantly, lycopene, which is key to increasing blood flow).
Anytime
Eggs (rich in the mega vitamin B6, which is high in protein which improves stamina); garlic and onion (healthy add-ons to top off fresh veg, contains the compound allicin, which helps thin the blood, relax the arteries, and in turn, improve the circulation resulting in greater stamina).
Main Meal
Broccoli (its vitamin C content boosts blood circulation); brussels sprouts (high in indole-3-carbinol, making testosterone more dominate in the body); carrots (packed with vitamin A); potatoes (source of potassium, a nutrient which boosts circulation, keeping the blood flowing where it needs to go); spinach (iron, increases circulation); kale (contains an omega-3 fatty acid called alpha linolenic-acid. Kale is very high in nutrients and very low in calories, making it one of the most nutrient-dense foods in existence); shitake mushrooms (source of vitamin D, contains choline, which helps activate and enhance the neurotransmitter, acetylcholine (ACH), triggering the body's message system); teff (builds muscles, amps production of testosterone, and also contains iron which helps prevent fatigue and promote stamina.)
Chilies and hot sauce (contain the chemical capsaicin, which stimulates nerve endings, and raises heart rate, raises testosterone levels).
White fish (cod) (an essential lean source of protein, high in magnesium).
Fruit salad and ‘snacks’ and ‘afters’
Apples; avocados (filled with juicy, omega-3 fatty acids—the good-for-you kind that boost heart health. They’re also rich in vitamin B6 and folic acid, which have the power to ramp up your energy, too. Avocados are rich in vitamin E. One medium (150 gram) avocado provides 21% of the DV for vitamin E. A medium (150 gram) avocado also provides 9% of the DV for zinc, an essential mineral); bananas (contain a special enzyme called bromelain, which delivers a blood-thinning effect, also high potassium content, which is crucial for blood circulation); black raspberries; cherries (contain anthocyanins, which prevent plaque from building up in the arteries, allows for optimal blood flow); cranberries (high in Vitamin C and high in vitamin B which helps reduces stress levels. Pour them into your porridge); grapes (a good source of potassium, a mineral that helps balance fluids in your body. Potassium can help bring down high blood pressure and lower your risk of heart disease and stroke. Black grapes are much higher in antioxidants than green or red grapes); pomegranate (high in potassium, which helps regulate healthy blood pressure), strawberries (contains Vitamin C); watermelon (contains lycopene, which helps relax blood vessels and increase blood transmission).
Greek yoghurt (high in potassium, which improves circulation, but also helps regulate sodium in the body, raises stamina).
Celery (has a combination of Vitamin E, magnesium, niacin, potassium, and zinc, which boost stamina, and contains arginine, an amino acid that expands blood vessels); figs (high in iron, fiber, potassium, and magnesium).
Brazil nuts (maybe the best source of selenium, eat a handful a day), cashew nuts (source of zinc, a testosterone booster, lowest fat content of any nut), pine nuts (contains high amounts of zinc, boosts blood flow); peanuts (one of the most nutrient-dense, affordable snacks, contains ample amounts of protein, fiber, and healthy monounsaturated fats, cholesterol-free, contains the amino acid I-arginine, which helps relax and widen blood vessels, thus increasing blood flow throughout the body); peanut butter (l-arginine is carried over to the spread, improving blood circulation); walnuts (for their omega-3 fatty acid content, keeping artery walls free of plaque, allowing adequate blood flow).
Dark chocolate (contains a compound called tyramine, increases dopamine levels in the brain—aka the “pleasure hormone”: your stress levels are lower, your libido is higher; cocoa also increases blood flow and relaxes blood vessels).
Drinks
Ginger (contributes to healthy blood flow, add it to tea); honey (pour over some fruit or into your coffee, contains a mineral called boron, which helps regulate testosterone and increase stamina); red wine (good for your cholesterol, contains both nitric oxide, which helps relax the arteries and increase blood flow, and the compound quercetin, which helps block the enzyme that triggers your body to push out testosterone); coffee (burns off fat, acts as a stimulant in the body, and helps increase circulation); green tea (contains catechins, which blast away belly fat and speed the liver's capacity for turning fat into energy, catechins cause blood vessel cells to release nitric oxide, which increases the size of the blood vessels, leading to improved blood flow).
Step 4:
LIFE
Get out, join in, participate in the community, spend time with others, find common interests, be active and undertake activities, get a job, volunteer, find people to amuse and entertain and who are amusing and entertaining in turn, do things that you enjoy doing. Don't get dragged into the swamp of neuroses that is anti-social media news and politics. Be productive, creative, and imaginative in whatever you do and pay zero attention to detractors: they know nothing about nothing. If I want to listen to my Eurovision favourites, I will and will do so without apology. If people don't get it, that's their loss. If you can find people who share your interests, all well and good. Do some sharing!
Oh, and seriously cut down pies, pastries, cake, and biscuits. That's what I did in 2017 and 2018 and it worked wonders on overall health.
Healthy Lifestyle Cycle:
Diet;
Exercise;
Friends and Family;
Work;
Play;
Relaxation;
Sleep.
I'll end with the class motto during cardiac rehab – 'keep those feet moving.'
And keep breathing. It's a good start.