Maggie McKay (Host): This is A Podcast a Day with Memorial Health System. I'm your host, Maggie McKay. Joining us today is Deanna Shuler, Director of the Department of Community Health and Wellness, to discuss how small lifestyle changes can improve our health. Thank you so much for being here today. Welcome.

Deanna Shuler: Hi. Hello. Thank you.

Host: So, what are some scientifically proven small lifestyle changes that can have a significant impact on long-term health outcomes?

Deanna Shuler: Well, when people are really interested in improving long-term health, we really think about just five or six different things. So first off, avoiding risky substances like tobacco, nicotine, alcohol, those types of things. Improving nutrition. So, incorporating a lot more plant-based whole foods, plants, veggies, fruits, et cetera, into your diet and kind of avoiding the overprocessed convenient type of foods. Incorporating more physical activity into your day doesn't have to be a lot, but just moving your body more throughout the day. Definitely focusing on getting restorative sleep. So, seven to nine hours of sleep a night is really ideal for most people in order to feel well. We really want to make sure we're also fostering positive social connections and healthy relationships.

And then, ultimately, also, we really want to be trying to manage our stress. You know, certainly we can't avoid it altogether, but developing some healthy coping strategies to help with some of those stressful situations. So, those six things are really the most important.

Host: We can do that. How effective are incremental changes, like walking more or improving sleep duration compared to, say, drastic lifestyle overhauls?

Deanna Shuler: So, most human beings really actually appreciate the smaller incremental changes, versus the overhaul. You know, we don't really do well when we do those drastic changes. Maybe for a short period of time, we are successful. And, you know, certainly there are people who are outliers and are able to make a drastic change and sustain it. But really, consistency with small changes leads to better sustainability of those lifestyle habits over time. So, baby steps, but baby steps done every day.

Host: You touched on this. But let's talk about it a little more. Can incorporating short bouts of physical activity throughout the day provide the same benefit as longer structured exercise sessions?

Deanna Shuler: Yes. Actually, there's a lot of evidence that says one of the most important things that you can do is breaking up sedentary behavior throughout the day. There have been studies that show someone who might do an exercise session 30, 45 minutes, an hour a day, but then still is sedentary the remainder of the day, they still are at a higher risk of developing chronic diseases versus the person who is just mobile throughout the day, moving a little bit more, you know, aiming for 7,000, 8,000, 10,000 steps at a time. Just like I said, naturally moving your body more throughout the day is really one of the most beneficial things that you can do and can actually be better in a sense than just doing one bout of physical activity a day.

Host: I have a coworker who is always walking around reminding all of us what we should be doing. I don't know how he gets any work done. He is constantly on the move. But he's in good shape, so... What are some practical ways to help patients gradually reduce sedentary behavior in the workplace, like we're talking about not sitting for eight hours?

Deanna Shuler: Yeah. Well, it's funny you mentioned your coworker who was walking. So, kind of an on-trend fun kind of thing is to do a walking meeting. So, you know, if we think about the times that we have to be in meetings, we might spend hours a day in a meeting or in multiple meetings. If you can just take 10 or 15 minutes of a couple of those meetings where maybe you're doing some brainstorming or planning and you don't really have to be in front of a screen or be writing something down, you and a handful of folks could certainly be up and walking and discussing things as you go. So, that's one kind of fun way to do it.

Other times, we really need to be a little bit more strategic. Oftentimes people in the workforce are in front of their screens or at their workstation for a very long time. And if they're really ingrained in their work, they're not going to want to get up and move around, or they're not even going to think about it. So, setting a little reminder whether that's a reminder on your phone, putting something actually in your calendar that pops up on your screen to just remind you. So, those little things can sometimes be helpful just to kind of get yourself up and away from your desk, you know, every hour if possible, throughout the workday.

One thing that I really encourage people to do if they have the opportunity is an adjustable workstation. So, the ability to stand some, sit some, that really can go a long way towards just helping to break up some of that sedentary behavior.

Host: How can families create environments that support incremental health improvements for all members, especially children and older adults?

Deanna Shuler: To me, one of the most important things when you're looking at maybe an entire family taking on some lifestyle is figuring out where everybody is. Not everybody is going to be ready to implement the same level of change at once. You know, so for example, mom and dad might be, you know, gung-ho on changing their diet, going to the gym every day. You know, maybe their teenagers are not. Maybe there's, you know, a grandparent that lives in the home, maybe that person is not ready to incorporate physical activity. So, understanding that that change might look different for everyone in the family.

Also, incorporating choices for everyone. And I think that's particularly helpful for children and older adults. Rather than saying, you know, "Go outside and play." Maybe a better way to approach it would be, "Hey, do you want to go throw the baseball around or would you rather play ping pong?" Or, you know, if we're talking about healthier eating, "Would you rather try broccoli tonight, or should we go for cucumbers?" You know, really just letting people make some choices. It creates some autonomy, a little bit of control over what they're doing and just helps them have a little bit more ownership in the lifestyle changes.

Host: What are the psychological mechanisms behind habit formation that make small lifestyle changes more sustainable? Because like New year's resolutions, you're all gung-ho, and then half a month into it, you're like, "Oh yeah, I forgot to do that."

Deanna Shuler: Right. There are certainly a couple of strategies that work well for most people. So, one of the most important things is understanding what you are looking for in your healthy behaviors and kind of creating what we would consider a wellness vision. So, knowing what the healthiest version of you actually looks like.

So, to your point about the New Year's resolution, first would be figuring out what you're actually working towards. But with regard to habits and implementing some behavior changes, there's a concept called habit stacking, which is very helpful for a lot of people. So essentially, you take one habit or one behavior that you do consistently every single day. So, we'll say brushing your teeth. Most of us are in that good habit. And then, you add onto that, whether it's right before or right after a new habit or a new behavior you are trying to incorporate. So, let's say you're trying to drink more water throughout the day. Maybe you place a bottle of water on your bathroom counter. So you go in, you brush your teeth. You see the water bottle, you drink the water. At night, you go in, you brush your teeth, you drink the water. So again, placing a new habit right alongside before or after a current habit.

Other things that you can do, just what's considered re-engineering or rearranging your environment to kind of reduce some of the friction that we feel when we're trying to create new behaviors. So, for example, if you are really trying hard to stay away from the donuts. And you always have donuts on your kitchen counter. Every time you walk in there, you're going to see those. It's going to be really difficult to say no to that. However, if you simply replace the donuts, either move them, don't put anything there, or put a healthier option there, it reduces that friction. You might still think about those donuts, but it is going to be easier for you to avoid actually having them. So, changing your environment a little bit to make the healthy choice, the easy choice, and then trying some habit stacking and adding a new behavior on top of one that you already do.

Host: I love that, habit stacking. I've never heard of that. That's a great idea. How can dietary diversity and balanced nutrient intake be encouraged through small shifts in grocery shopping habits? Because we go to the grocery store and you see Oreos and microwave popcorn and, you know, everything you shouldn't be getting.

Deanna Shuler: Sure. So yes, the grocery store can be quite a challenge. You know, there had been for a while recommendations to shop along the perimeter of the grocery store. So, you would really find the more healthful, whole foods, more plant-based foods, for example, walking into the produce section in a grocery store. That can still be a useful strategy just kind of going back to the changing up your environment a little bit, avoiding those things that you're really trying to not consume. That has, I think, become a bit more challenging sometimes. I think grocery stores have caught on and a lot of them are actually rearranging their own environment. And so, instead of just walking into the produce aisle, there's produce and frozen pizzas. So, that strategy is not as effective as it used to be. So, probably understanding your grocery store is going to be important. And that's not something I think I would've given advice on 10 years ago, but knowing how to navigate yourself around the grocery store.

You know, the other thing, as we kind of get closer to spring and summer, we have to take into consideration the options for fresh seasonal produce, because that can certainly be a way to improve your health, improve nutrient density, nutrient diversity by incorporating a lot of different produce, different colored fruits, vegetables, and things like that into your diet. So, maybe hit up the farmer's market instead of the grocery store first. And that would be helpful.

Host: How can healthcare practitioners personalize small lifestyle recommendations for their patients with specific conditions or mobility limitations?

Deanna Shuler: Well, you know, I think that question in and of itself is kind of the answer. I mean, our practitioners really are the very best people to talk with when it comes to your health. In particular, if you have chronic conditions, they should have a background on you so they know if you're dealing with a heart condition or blood pressure or you've had a knee replacement. And so, your mobility is limited, so them having that background really can help you move forward in an appropriate way.

Sometimes when we skip the practitioner and we decide to take this stuff on our own, we end up overdoing doing something that might end up being harmful. So, when it comes to you know, your health and your lifestyle, they really do want to help give that advice about chronic disease prevention really is about your everyday lifestyle, and how you can make those changes. So, they're really the best people to start with.

Host: In closing, Deanna, is there anything else you'd like to add that we didn't cover?

Deanna Shuler: I think, you know, a phrase that I've started using several years ago is just don't overcomplicate what it means to be healthy. You know, there are so many things out there. We get fed so much information, and it's not all good information. And at the end of the day, you know, if we consider our nutrition, moving our bodies more, getting a good night's rest, managing your stress, having good social relationships and connections, and then of course avoiding things like tobacco and alcohol, they're all fairly basic. And no matter what your lifestyle, health and wellness vision is, they're really going to be the things that are going to help in the long run.

Host: Well, you've given us so many great ideas that are actually useful and we can put into practice beginning today. So, thank you for sharing your expertise and making the time today.

Deanna Shuler: Thank you for having me.

Host: Again, that's Deanna Shuler. To find out more, please visit mhsystem.org/community. And that wraps up this episode of A Podcast a Day with Memorial Health System. Again, visit mhsystem.org to learn more and to connect with a provider. And be sure to subscribe for more conversations from Memorial Health System.