April is Stress Awareness Month.  Uncontrolled stress can reek havoc on your mind and body, weakening your immune system and predisposing you to a number of ailments, including cardiovascular disease.  Regardless of the type of stress - whether good (eustress) which is associated with the positive events in your life; or, bad (distress) which depicts negative circumstances experienced, such as a death in the family - your body responds the same.  It is unable to discern the difference; therefore, the effects on respiration, heart rate, and blood pressure are the same - they go up.  When your body is under a chronic, persistent state of stress, health problems begin.  Although you are not able to completely rid your life of stressors, you can change your approach to them which, in turn, will minimize the toll they place on your mind and body.

My approach to the stressors in my life changed during the last semester of my undergraduate education after taking a "Stress and Health" course required to complete my major.  Up until that point, I was aware of the stressful situations and events in my life, but I was not mindful of them.  I addressed stress with a "look ahead" attitude, trying to rush time just to get the stressor "over with" and behind me.  Interestingly, what I learned in the course was that I actually needed to look back, not forward, to tackle the stresses in the present and the future.

The key to managing stress is perception.  Your perceptions of the events in your life are affected by the outcome of your earlier experiences.  The instructor of my college "Stress and Health" course stated that each one of us has experienced at least 3 or 4 major turning points in our lives which define who we are in the present; and, that we evaluate the potential impact of current stressors based on these defining moments.  This can lead to a distortion of the present reality.  My instructor stated that by identifying and evaluating the circumstances around our own life's turning points, we could then begin to "reshape" our perceptions of, and reactions to, current and future stressors.

An in-class assignment required us to "take a look back" at those moments in our lives.  The reflection involved a problem-solving process devoted to redefining the meaning of those events toward a more positive outlook.  We were to "let go" of the emotions associated with events out of our control, and learn from those situations that were within our control.  The premise of the activity was that by becoming mindful of the stressors and the circumstances that surround them, you are able to explore your abilities to cope; thus, minimizing your body's physiologic response.

You cannot eliminate stress, but you can change your reaction to it.  For those situations out of your control, practice relaxation techniques (e.g., deep breathing, yoga, meditation, aerobic exercise, etc.) to modify your physiologic response.  For those events within your control, identify the steps that you need to take to alter the outcome toward the positive.  And, don't be afraid to take a look back in order to proceed forward.

If you are one of those individuals who struggles to maintain a healthy body weight, despite following a healthy diet and engaging in regular exercise, you are not alone. Weight management can prove to be a challenge for many - hence, the large market for weight loss products. It is easy to become discouraged when your attempt to lose weight is unsuccessful. However, you should not perceive your struggle as a failure. Rather, view the setback as an opportunity for personal growth.

You may need to reevaluate your weight loss plan. If it is not working for you, it may mean that you simply need to change your approach. Maybe you need to alter the timing of your meals or change your mode of exercise. Everyone's physiology is different; therefore, not all diet plans and exercise regimens will have the same effect. Consider the following points below and determine if they would fit into your journey toward better health:

• Weight Train To Maintain - muscle mass starts to decline around the age of 30, by about 1% per year. This can have a negative impact on your metabolism. Weight training increases your energy expenditure and some research indicates that it mobilizes fat from your abdominal region (decreases visceral fat). Muscle tissue has a greater metabolic demand than fat tissue. To boost your metabolism as you age, ensure you are including at least 2 days of weight training as part of your exercise regimen. Exercises should work the major muscle groups of your body. The average adult should attempt to perform 2-3 sets of 8-12 repetitions per strength training exercise (this may need to be altered based on your personal goals and fitness level).
• Add Yoga To Your Exercise Routine - A study published in the Journal of the American Dietetic Association found that those individuals who performed yoga were more likely to practice "mindful" eating in which they ate more slowly and stopped eating when they were satiated compared to subjects who did not practice yoga. Yoga goers also had lower BMIs.
• Watch When You Eat - Although consumption of a post-exercise meal that is rich in carbohydrates is recommended for athletes to maximize their performance, it may not be the best option for the average individual looking to lose weight. A study published in the August 2005 issue of the Journal of Applied Physiology found that the exercise-induced caloric deficit achieved by walking on a treadmill was negated when a carbohydrate-rich supplement was consumed immediately after exercise. Therefore, if weight loss is your goal, you do not want to consume a high carbohydrate meal immediately after exercise.
• Manage Your Stress - when your body is in a stressed state it releases cortisol. Cortisol plays a role in mobilizing energy for the body in these situations. Chronic stress results in high concentrations of cortisol. High levels of this hormone can result in fat being deposited in the abdomen (visceral fat), subsequently leading to obesity if not controlled. High levels of cortisol can also increase your appetite and cravings for "sugary" and high-fat foods. Over-consumption of these foods can cause weight gain. If stress is a problem for you, try scheduling "down" time, reducing your workload by delegating tasks, and/or engage in stress management techniques (e.g., deep breathing exercises, yoga, etc.,).

Achieving a healthy lifestyle is a process. It requires frequent "checks-and-balances" to stay the course. Setbacks should not be viewed as failures, just indicators that changes are needed.

Resources:

Journal of Applied Physiology, August 2005, pp. 2285-2293, "Improved Insulin Action Following Short-Term Exercise Training: Role of Energy and Carbohydrate Balance," Black, S.E., et al.

Journal of the American Dietetic Association, August 2009, pp. 1439-1444, "Development and Validation of the Mindful Eating Questionnaire." Framson, C. et al.

ACSM's Health & Fitness Journal, September/October 2005, pp. 20-23, "Cortisol Connection: Tips on Managing Stress and Weight," Maglione-Garves, C.A. et al.

Irritability, increased heart rate, rapid breathing, tense muscles, headache, upset stomach - we all have experienced at least one of these symptoms when under stress. The best approach in managing stress is to take measures to avoid or prevent the triggers. But, sometimes that just is not possible, especially during a holiday celebration when family and friends are gathered in close quarters. For these situations, you need to arm yourself with "in-the-moment" coping techniques that offer a break in the stress cycle. Below you will find 5 stress-reducing moves that will help you to "blow off steam" (and get a little exercise) so that the only thing you will notice bubbling over this holiday season is the champagne.

• Stretch It Out: When muscles are tense, a good stretch will work wonders. For tight neck muscles, place your arms behind your back and slowly tilt your head to the right until you feel the stretch on the left side of your neck. Hold the stretch for a count of 10. Repeat the exercise to the left. Next bring your chin toward your chest and hold for a count of 10 (you should feel the stretch in the back of your neck). If you are experiencing tension in your shoulders and upper back, then cross your arms in front of your body while bending forward at the hips. Hold for a count of 10.
• Mountain Climber's Oasis: Have a little extra energy that needs to be burned off before everyone arrives? Take it to the stairs. Climb up and down the staircase for 5 minutes. No staircase? A porch stoop or raised hearth works just as well.
• The Kitchen Is Your Gym: Is Aunt Mildred frowning upon the taste of your holiday feast? Excuse yourself from the table and perform 3 sets of 10 countertop push-ups in the kitchen. Need to get that serving tray from the top shelf of the cupboard? Perform 1 set of 10 heel raises before you do, then perform an additional 2 sets of 10 with it in your hands.
• Fighter's Reprieve: Sometimes nothing would feel better than being able to give the ol' 1, 2, punch. Try this exercise to relieve the tension - while out of the way of others, assume a boxing position (feet staggered with knees slightly flexed and elbows bent at your sides with hands formed into fists). Into the air (or mattress or pillow - please not another person!), jab your right fist to the left, then your left fist to the right. Repeat this sequence until you have completed 10 punches per fist. Perform 3 sets. To increase your energy release, and to sneak in a little core strengthening, tighten your core stabilizers while performing this activity.
• Laugh: While laughter is not often thought of as exercise, it really is. It requires contraction of your core stabilizers and facial muscles (and, if you are an animated laugher, even your arm and leg muscles). Intense laughter raises your heart rate, blood pressure, and blood flow during the episode. After a bout of laughter, your muscles relax - this can last up to 45 minutes. Your blood pressure may be lower after laughing as well.

Stress doesn't have to put a damper on the holiday spirit. With a little planning to minimize triggers, and the development of a coping strategy, you should be able to enjoy the festivities of the season to the fullest.

Resource:

Evidence-based Complementary and Alternative Medicine: eCam, posted 06/26/2008, "Humor and Laughter May Influence Health: III. Laughter and Health Outcomes," Bennett, M.P. and Lengacher, C.

Give yourself the gift of health this holiday season and schedule time for you. Nourishing your physical, mental, emotional, and spiritual self will allow you to tackle the busy days ahead with ease. A sustained self can get more out of life and can readily give back to others, fostering social growth and community. Changes to make a better you do not have to be grandiose. Small steps in the right direction can add up and be of better benefit in the long run. Take it one day at a time.

Day 1: Schedule a physical exam with your physician.

• Even if you are not feeling ill, visiting your doctor on an annual basis is a good idea. Some chronic diseases, such as hypertension and diabetes, can be present initially without symptoms. By the time symptoms do arise, damage to your body can have already occurred. Your doctor will perform tests, such as blood work, to detect any underlying health conditions that should be addressed.

Day 2: Replace one "bad" habit with one "good" habit.

• If skipping breakfast is your norm, find a way to make it a part of your regular morning routine. Yogurt smoothies are a good option for busy individuals or those who are not hungry for a big breakfast first thing in the morning.

Day 3: Designate at least one meeting at work as an "active conference."

• Tired of sitting through business meetings all day? Tell your co-workers and clients to take a hike - with you that is! Take your meetings to the outdoors or the hallways of your office building. Great ideas can arise from discussion during a brisk walk. Take a mini tape recorder along for the jaunt to dictate and record concepts and solutions discussed.

Day 4: Turn your television off for the day.

• Engage your mind in a good novel or how-to book. Don't like to read? Take up a new hobby such as photography. Challenging your mind with new tasks helps to improve and maintain brain health.

Day 5: Volunteer.

• Give yourself an emotional boost and lift your spirit by helping others. It can be a simple gesture, such as helping a neighbor take his trash to the curb. Or, you can touch more than one life at a time by helping to serve meals at a shelter.

Day 6: Schedule your biannual dental appointment.

• A healthy mouth leads to a healthy heart. Bacteria in the mouth can lead to heart disease and other heart-related conditions (American Academy of Periodontology).

Day 7: Buy local.

• Support the community within which you live and buy locally grown, produced, and manufactured products. For example, Michigan-grown Honeycrisp apples are in abundance at the market now!

Day 8: Eat at least one meal that consists only of fruit, vegetables, whole grains, and nuts and seeds.

• Breakfast suggestion: Bowl of cooked farina with 1 TBS. of honey, 2 TBS. of chopped dates, and 1 TBS. of chopped pecans.
• Lunch suggestion: Tomato and cucumber salad with 2 TBS. of white balsamic vinegar, 1/2 TBS. of sesame seeds, and 1/4 cup of lentils on toasted whole wheat pita bread.
• Dinner suggestion: Half of a baked acorn squash, filled with cooked wild rice, 1/8 cup of golden raisins, 1/8 cup of dried cherries, and 1/4 cup of chopped walnuts.

Day 9: Engage in at least one stress management technique.

• Take a yoga or Pilates class. Not enough time for a session? Turn off the lights and take 15 minutes to perform deep breathing or visualization exercises at your desk.

Day 10: Hand deliver holiday gifts to your neighbors.

• Load up the wagon, cart, or sled with hand-made or store bought sentiments and hit the road walking. Trekking through your neighborhood to personally bring well-wishes to your neighbors will do wonders for your heart - physically and emotionally.

Day 11: Designate a house cleaning day.

• Get in some exercise while preparing your home for the holidays. Vacuuming and scrubbing the bathroom can challenge your cardiovascular system and help strengthen your muscles.

Day 12: Brighten your room with eco-friendly light bulbs.

• Save money and help to create a better environment for yourself and future generations by replacing mercury-powered light bulbs with a more earth-friendly option - compact fluorescent bulbs.

Stretching is a good form of relaxation from life's stresses. It promotes circulation, reduces muscular tension, and helps to develop body awareness. The next time you feel that life has taken you one step forward only to push you two steps back, take a few minutes to perform the following stretches to clear your mind and relax your body.

Crescent Lunge - stretches muscles of the abdomen, hip, lower back, front thigh, chest, shoulders, and upper arms

Step One: Kneel on the ground. Lift and bend your right knee, placing your right foot flat on the ground in front of you.

Step Two: While gently tightening your abdomen, lift your arms straight above your head making sure to keep your shoulders down and back. At the same time slightly lean into your right leg at the hips. Hold for a count of 15. Return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Knee to Chest - Stretches muscles of the buttocks and lower back

Step One: Stand with your feet shoulder width apart and your arms to your sides.

Step Two: Lift your left knee toward your chest with your hands. If needed, you may perform this stretch against a wall for balance. Hold for a count of 15. Slowly return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Warrior - Stretches muscles of the abdomen, hip, back, front thigh, lower leg, ankles, chest, shoulders, and upper arms

Step One: Step forward with your right leg. Toes of your right foot should be pointing straight ahead. Toes of your left foot should be pointing slightly in.

Step Two: Bend the knee of your right leg to 90 degrees. Keep a slight bend in your left knee. Slightly lean into your right leg at the hips. At the same time, lift your arms straight above your head. Hold for a count of 15. Slowly return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Extended Triangle - Stretches muscles of the groin, hip, thigh (back), lower leg, ankles, and arches of the feet

Step One: Stand with your feet separated greater than shoulder width apart. Point the toes of your right foot out to the right. The toes of your left foot should be pointing slightly in.

Step Two: From your hip, bend to the right while extending your right arm toward your right foot. At the same time, raise your left hand toward the sky. Do not bend at the knees. Hold for a count of 15. Slowly return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Extended Side Angle - Stretches muscles of the groin, hip, thigh (back), lower leg, and ankles

Step One: Stand with your feet greater than shoulder width apart. Point the toes of your right foot to the right. Toes of your left foot should be pointed slightly in.

Step Two: Bend your right knee to a 90 degree angle. At the same time, extend your right arm down toward your right ankle while reaching with your left arm over your left ear. Hold for a count of 15. Slowly return to the starting position. Repeat. Perform 1 set of 3-5 stretches per side.

Stretching Tips

• Perform a warm-up of at least 5 minutes before beginning stretches (e.g., walking)
• Perform stretches in a slow, controlled, and gentle motion
• Do not bounce while performing the stretches
• Stretch only to the point of tension, you should not feel pain while performing the stretch
• Do not hold your breath while stretching; breathing should be slow and steady
• Do not perform these stretching exercises if you have any musculoskeletal condition that may be exacerbated by the stretches

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.