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What does it mean to be healthy? Is it just lab values? What about your relationship with food and exercise? Let’s dive in, with research!

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Today’s Wellness Wednesday post was spurred by the recent documentary, What the Health.

I feel like I can’t stop hearing about it – I’ve had patients ask me about it, read many dietitians view points of it, and done some research myself.

So, today I’m talking about what it means to be healthy.

What Does it Mean to be Healthy?

Here’s what general society thinks healthy means.

Healthy – you may think it means having perfect cholesterol, triglycerides, blood pressure, being thin and looking “fit.”

I used to think that. I used to think all of those things equated to health and being healthy.

Tack on an hour of exercise every day and you were “more healthy” (while also underfueled in sport).

I used to think anything related to obesity meant unhealthy.

Fast forward a graduate degree in public health and nutrition, years of nutrition courses, and some anecdotal work with patients, my view on what health entails has changed.

That isn’t the picture of health I have anymore.

How to Define Health

I was recently asked for an Instagram interview to define health in my own words. This is how I answered.

“Health is so much more than your physical state and your blood numbers. Health encompasses your whole being – your mind, your body, your relationships, and how they are all connected. To me, health encompasses making food choices that make you feel good, incorporating movement and exercise that uplifts you, and surrounding yourself with people who motivate and inspire you.”

Sarah Schlichter, MPH, RDN

I continued to share, “I view health from the inside out, rather than the outside in. Health is cupcakes with friends, a good night’s sleep after a long day of work, a quick run in the middle of the day to sort out your stress, or a nice long book and a bath before bed. There’s no right or wrong way to do it – it’s just what works for you.”

Things to Consider about Public Health and Overall Health

Are you in a supportive, caring and nurturing environment? Do you have access to food, and understand what to do with it?

Do you have people (or animals) you can turn to who uplift and motivate you? Make you happy?

Do you have a variety of foods you like, that you know how to prepare to create a nourishing meal? 

Do you have access to food? Some of the Socioeconomic environment is out of our control. But, it’s hard to deem people “less healthy” if they have less access to food.

This becomes more of a public health and access issue.

Do you move your body in ways that feels good for you?

I think we all understand the dangers of sedentary activity.

Sitting all day looking at screens is not doing anything for our internal processes, and it’s also not providing any energy.

Finding some movement that you enjoy and can stick to – whether it be walking, yoga classes, running, having a personal trainer, ballet, jump roping, what have you. Any movement is good for you!

On the other hand, though, excess activity is not always better.

In fact, overexercise is linked to burnout, eating disorders, and other health implications.

Sometimes what you need is rest, and to do less to be “healthy.”

Many of my clients have either lost their periods or over-stressed their bodies from overexercise and underfueling.

Health is a fine median between the two – finding movements and exercises that feel good for you, uplift your spirits, make you stronger physically and mentally, and are maintainable.

Feelings of Guilt

Do you have feelings of guilt when you eat something you think you shouldn’t? Or guilt or shame for feeling hungry in the first place?

If you’re second guessing everything you put into your mouth, or feeling shameful and guilty about your food choices, those feelings will certainly take a toll on both your mental and physical health.

Firstly, you should read some books on intuitive eating.

Secondly, understand that those feelings aren’t normal – and you shouldn’t feel like that’s a normal way of life.

There is freedom in practicing food flexibility and being flexible with food.

Maybe you get to the point where you declare you are done dieting!

If you’re hungry shortly after you just ate, try to look at it with curiosity rather than shame.

• Did you eat enough at your last meal?
• Are you just having a hungrier day?
• Did you do a longer/harder or different workout yesterday?
• Did you sleep well last night?
• Are you stressed?

All of these questions could play a role.

Don’t ever get mad at your body for being hungry. Don’t fear hunger – Hunger is a signal to you. The more you honor it, the more you develop trust with yourself.

The hunger fullness scale can help with this.

Hunger means your body is working properly!

Food Rules

Do you avoid certain foods because of scary thoughts about them?

To me, being healthy means being able to eat any food you want in the moment. Nothing is off limits because everything has a place.

You want ice cream at 11 am? Great.

Pancakes for dinner? Been there.

A day without salad and greens after overloading the day before? You go, girl.

Truthfully, when you eat the food you want in the moment, you won’t continue to crave it or overeat it in the future.

Attaining health means there are no good or bad foods.

You view food as food – a vehicle for social pleasure, taste, memories, and/or for sustenance. If you’re stressing about the food, it won’t go to its desired purpose anyway.

Some days will have more veggies, others will have less or even none.

I ate two and a half cupcakes the other day – that’s not the norm for me, but I wanted them in the moment and now I’m good for a little bit.

That’s how our body works once we learn to trust it.

Self Care for Health

Do you prioritize sleep? What do you do to relieve stress?

Stress is unavoidable – we all have it. It can affect our health if we let it control us.

This article from the New York Times puts a practical spin on changing the way we view stress.

Too much stress is not healthy. It increases cortisol and is linked to chronic disease.

It’s important to have non-work related outlets.

Things that make you happy. People that make you happy. There are several health benefits to social relationships.

Things you like to do, that don’t necessarily have to be exercise or health related.

Reading, coloring, painting, doing ceramics, handlettering, etc. All of these are great outlets.

I love calling my grandmother – she always tells me to eat more brownies and run less, which gives me a good laugh.

Do you take life too seriously?

Relax. Take it day by day, and write down 3 things you’re grateful for EVERY DAY.

Are you doing work you love? If you dread your job every day, what changes can you make? Can you do anything differently in your home life to avoid feeling anxious and overwhelmed?

Final Thoughts about What it Means to Be Healthy

If you haven’t figured it out yet, I’m not an “extreme” dietitian – I don’t believe in paleo, or low carb, or one way of eating because research shows that those ways of life don’t work for everyone.

I also don’t believe in restrictions of any kind, unless you have a food allergy/sensitivity/moral beliefs.

Otherwise, I view food as food and try not to think too much about it.

My parting thoughts:

• I think the What the Health film is very biased overall, and has and will continue to “scare” many people who watch it. The film is certainly fear mongering. We only have 3 macro nutrients to eat (fat, protein, carbohydrates), and this documentary bashes a good portion of protein and fat.
• 1 egg per day is NOT the same as smoking 5 cigarettes a day (this claim is ridiculous and not backed by science).
• I am in support of including more plant based foods in our diets, but I don’t think it’s all or nothing, like the documentary portrayed. Vegan meal prep won’t work for everyone, and that’s okay. While including more plant-based foods in our diets does come with several health benefits, including moderate animal portions does too. They don’t talk about the latter point (because it is very skewed)
• Obesity, heart disease, cancer, and the like are all very multi-factorial diseases. These diseases are not caused by one thing, one food group or one nutrient. I think it’s important to remember this.

Remember that documentaries like this are trying to prove a point – they aren’t showing you all of the evidence, but rather only studies that support their side.

References:

• Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care. 2016 Jun;22(7 Suppl):s176-85. PMID: 27356115.
• Cohen S, Janicki-Deverts D, Miller GE. Psychological stress and disease. JAMA. 2007 Oct 10;298(14):1685-7. doi: 10.1001/jama.298.14.1685. PMID: 17925521.
• Riva A, Falbo M, Passoni P, Polizzi S, Cattoni A, Nacinovich R. High levels of physical activity in female adolescents with anorexia nervosa: medical and psychopathological correlates. Eat Weight Disord. 2022 Feb;27(1):151-162. doi: 10.1007/s40519-021-01126-3. Epub 2021 Mar 11. PMID: 33704692.