Real Food Assessment

Thanks to an active discussion on LinkedIn about how to implement an employee wellness program on a budget, I'm working on some new self-assessment tools to add to Move.Eat.Be.. The first one is The Real Food Assessment as a way for people to assess their current eating habits and discover opportunities for improvement. This tool stems from our work on the Real Food Label and is built upon The Real Food Hierarchy and The Real Food Plate all designed to help people eat more real food and less processed foods. If we can get people to choose 80% of their food from the real and almost real categories, we would go a long way to improving health and stemming the tide on obesity.


The Real Food Assessment

The idea with the assessment tool is to take an honest and general look at each of your meals (either daily or weekly) and determine if you choose mostly real food or mostly fake food. If you make most of your meals at home, from scratch, you're most likely in the green category. If you eat out frequently, you're closer to red. Simply put an "X" for each meal under the category that you think most closely matches your food choices.

For the detailed definitions of what belongs in each category, click on this link to The Real Food Plate information on our website. Remember, to make improvements in your health you must start by being honest with yourself and understanding where you are today. Knowing where you are today will help you craft a good plan for tomorrow's improvements.

As always, I love feedback as everything's better when we're working together. Feel free to comment, write to me and share with your friends and colleagues.

Why It Matters

From the Centers for Disease Control (CDC):

• Each year in the United States, chronic disease such as heart disease, stroke, cancer, and diabetes cause 7 in 10 deaths and account for about 75% of the $2 trillion spent on medical care.

• In 2010, the economic costs of cardiovascular diseases and stroke were estimated at $444.2 billion, including $272.5 billion in direct medical expenses and $171.7 billion in indirect costs.

• In 2007, medical costs attributed to diabetes included $27 billion for care to directly treat diabetes, $58 billion to treat diabetes-related chronic complications attributable to diabetes, and $31 billion in excess general medical costs

• In 2008, the estimated health care costs related to obesity were $147 billion 

• Indirect costs for employers associated with poor employee health, including absenteeism, presenteeism, disability, or reduced work output, may be several times higher than direct medical costs. Productivity losses related to personal and family health problems cost US employers $1,685 per employee per year, or $225.8 billion annually.

The health of our healthcare system and the health of our economy is directly related to our lifestyle choices. This isn't about "them" anymore. It is about all of us.

If you are healthy, your job is to help others get to better health. If you're not healthy, your assignment is to find someone to help you get healthy. Don't wait for the promise of a new diet pill or the hope for gastric bypass surgery. Do something right now. Every little choice matters. Every moment counts. Every day is a new day to take a step closer to a healthy lifestyle.

Good for you. Good for us. Good for our healthcare system. Good for our economy. We're in this together. Let's help each other.

Cogs of Wellness

Since HealthCamp DC a few weeks back, I've been doing more work on the idea of behavior change and how to help people make the best choices for their health. More and more, the signs seem to point to the importance of "that other stuff" being in good shape so one's eating and exercise habits are also in good shape. Not a new concept but perhaps it would help to look at it in a different way.

I'll pile all of the "other stuff" into a category called quest as in the cause, goal, idea, motive and purpose for what we do. Over our lifetimes, our quest will change and often we're working on more than one quest at a time. Sometimes we work on one quest for the sake of another quest. Ideally, all of our individuals quests compliment each other and work together.

I contend if our quests are in order we are feeling our best -- energetic, happy, excited. And, if we are feeling our best we feel even more motivated to take good care of ourselves, get regular exercise and eat healthy foods. The question is this... if we want to help people get more healthy should we start with diet and exercise or should we start with the quests?

Perhaps the quest is the biggest cog in the sustainable wellness machine.

The Recipe for Life

The Weight of the World

The Worldwatch Institute released new data today on the global trend of overweight adults. No surprise, but the news isn't good.

The smaller the world becomes through technology the larger the people of the world become. Maybe we need a state, province or small country to stand up and buck the trend. After all, good news and reversing the trend has to start somewhere. Re-teaching people to grow and cook their own food. Incorporating regular exercise into each day. Helping each person pursue their true calling. It wouldn't be so hard.

Anyone interested? We'll join you to help.

Carrot. Stick. Fish.

When workplace wellness programs began to get popular the common theme was to give employees incentives for participation. The wellness programs focused on biometric screenings and health risk assessments. Starting with knowing your numbers is an important piece of the wellness puzzle. The theory being when people knew their numbers they'd do something to improve them. The carrot arrived in the form of incentives which ranged from gift cards, a special luncheon with the boss, an extra day of vacation, etc. Did they work? For some people, yes. For some, they were suspicous of "big brother" intervening and didn't participate. Still others made some short-term changes but quickly fell back into their old habits.

Workplace wellness, take two. The stick! Some room in regulations gave employers the ability to punish those employees who didn't participate. Higher health insurance premium co-pays being the most popular stick. Do an HRA or you'll pay. Did the stick work? Again, for some. People respond to pain and spending more money is pain, particularly in this economy. Does the stick improve long-term wellness? The jury is still out on that one, but historically humans don't respond well to the stick over and over again. More people may be doing their HRA but are they investing the effort to make real improvements? Again, for some.

Most people, inherently, know what they need to do to get healthy.They may be deep in denial, but they know. You know. We all do. So, what are we misssing? Why haven't we yet been able to make positive lifestyle choices and wellness sustainable? I think it is the "how" we keep ignoring.

Everyone will recognize the popular quote from Lao Tzu, "Give a man a fish, you feed him for a day. Teach a man to fish, you'll feed him for a lifetime." What some wellness programs have missed, to date, is the fishing lesson. To make things more challenging, we have to acknowledge that each person might require a different fishing lesson. People are different. Their bodies are different, their lives are different, their budgets are different. Wellness needs to match the individual to be sustainable.

Teaching each person to fish for their own wellness requires time, enrollment, investment and a pathway. It is needs to be based on a series of small changes, over time, so new, healthy behaviors become habits. It needs to be accessible so each individual can get the lesson in the way they learn best. It needs to be experiential. I eat a donut; I feel awful in 30 minutes. I eat a piece of fresh fruit; I have more energy.

We can create all of the plans, programs and schemes in the world. But, until we empower people to learn how to fish by learning about themselves, we could be in the constant search for a bigger stick.

Mission to Change

At HeatlhCa.mp/DC yesterday, we created a session to talk about behavior change particularly as it relates to health and wellness. Behavior change, and figuring out how to get people to make positive choices for their health, is critical for our future. Diseases and conditions caused by lifestyle choices are eating our healthcare system alive and will take our economy down as well.

Yesterday, we made a quick list of the most obvious reasons people begin to change their behavior:

• Medical diagnosis (diabetes, heart disease being the most popular)
• Death of a friend or family member
• Pressure from our kids (worked great for smoking and seat belt use)

There are more but those, generally, are the biggies. What seldom makes the list are things like: "I know better." Why is that? We know we shouldn't smoke and yet some of us do. We know we should get, at least, some exercise each day and most of us don't. We know soda lacks any useful health properties, yet we drink it by the gallon. Some call this the "intent-behavior" gap. I mean to do the right thing, I just don't.

The holy grail? Figuring out why and doing something about it. I have a theory: People aren't making the best choices for their health because they haven't figured out their own purpose or mission.

To explore this theory, I asked a fellow HealthCamper (Doug from Infield Health) this question, "What got you out of bed this morning?" Doug's answer can best be summed up as wanting to make a difference, in healthcare and for his family. I asked the other group members to think about it, too. And, wondered with Greg from BreadForTheCity if such a question would be an important part of the work he does with their clients.

I contend if you are passionate about life, if you're working on something bigger than yourself and are driving toward your own important mission, you're more likely to make good choices for your own health. Why? Because you have work to do and you want to be sure you'll have the energy and health to see your "project" through to the end.

I'm beginning to think the "mission" part of life is the most important and perhaps more powerful than all of the exercise you can get and all of the vegetables you can eat. Perhaps we're going at this "wellness" thing from the wrong angle all together.

Maybe we need to help each person figure out their own personal mission and then support them to get there. After all, when you're working on something really important to you, there isn't anything that will get in your way.

I'd love to hear your thoughts...

Make Food Personal

The numbers of people sickened or killed by the E. coli breakout in Germany continue to increase. There are many theories ranging from mundane to conspiracy to biological warfare. The reason for the outbreak? It will take some time before the real source can be traced. The costs of the outbreak continue to grow as well. There is now talk of giving the farmers $220 million in compensation. The costs of treating the 2,400 sick are significant in addition to the costs of lost productivity.

The best solution I can think of and one each and every one of us can implement right now, is to eat more and more foods from your local area. Will eating local guarantee 100% protection from E. coli? No. However, it will significantly reduce the numbers of people affected. And, if you are buying produce directly from the local farmer you have the ability (and some say the obligation) to get to know the farmer and his practices. You can then make a more informed buying decision instead of the blind leap most of us take now when going to the grocery store.

Plus, if you know the farmer and an unfortunate E. coli outbreak were to occur, odds are you'd be less likely to file a lawsuit. Most local, family owned farms do everything they can to protect their animals and crops and the last thing they'd want would be to sicken the customers they also know by name and/or face. Plus, you'll be eating more nutrition, whole, real food.

Eating local is something you can do today. In many cities across the United States, there are farmer's markets held several times per week. If you live in a more rural area, go look for local farm stands or CSA. Odds are there are some nearby.

If we make food more personal again, for ourselves and our farmers, maybe we can protect each other from food borne illnesses. Seems like a solution worth trying.

Across the Stage

In a few hours, I will walk across the stage and gather my Master of Arts degree from Tai Sophia Institute. I started the program, now titled Transformative Leadership and Social Change, in January of 2008. Many things have changed, all for the better, since those first days. Could I catalogue them? Probably. Should I? Perhaps.

At a small gathering yesterday afternoon to celebrate and acknowledge my fellow classmates, I was asked if I was glad I attended. The answer is an unequivocable yes. Then I was asked why and what I had learned. While I have lots of answers, I didn't have "an answer" which surprised me. Maybe in the abundance of answers, I couldn't find only one. Or, I hadn't prepared my elevator speech just yet.

I've spent some time today reflecting on the last three years. I want to remember to appreciate and be grateful for what I've learned. And, I want to get clear on what educational pursuit is next. I am a life-long learner so it is only a matter of time before I enjoy the smell of another new text book.

For today, here is what I'm grateful for having learned:

• Sometimes, your biggest complaint is your best teacher. Whether that "complaint" comes in the form of a body ache, a person who is "difficult" to deal with or news you didn't want to hear, no matter.
• The hardest learning we will ever do is to learn about ourselves. It is also the most rewarding.
• It is not so much the what you are in this life; it is the how.
• Doing something, at least one thing, you are completely terrified of is a very important lesson in how to grow (mine was singing in public).
• Often, the best way to be a leader is to ask another question.
• The pathway to a fulfilling and happy life simply comes from the courage to stand up and own it.

Sure, there were many "academic" pursuits in the program as well... history, philsophy, science to name a few. Many of those were the gateway to expanded thinking, seeing things in a way previously considered impossible and learning to greet something new with wonder instead of suspicion.

You may have noticed the above list isn't "one" answer and maybe there shouldn't be an elevator speech for something such as this. And, maybe there can be so it is something we can all remember. I'll boil it down to this...

Inside each of us is a passion. Pursue it relentlessly and, when you find yours, help others to do the same.

Congratulations to the 2011 class of Tai Sophia Institute.

USDA Plate Postscript

Yesterday, the USDA unveiled a new food planning tool in the shape of a plate. This plate is a vast improvement over the food pyramids from years past and I applaud the USDA for not putting graphics of food on the plate. If you go to the USDA's website for the food plate, there is additional useful information on the kinds of food in each category. The vegetable and fruit category is good and you can click to a "food gallery" with photos and serving sizes in cups and by inches.

I also think the protein category is reasonable. It includes animal protein as well as beans, peas, nuts and seeds. Much better than the older version. The dairy category got a bit lost and not surprisingly so given the milk lobby. This category tells people to choose fat-free or low-fat milk (which are highly processed) and if you choose whole milk, the fat content makes that milk count as empty calories. There is still a great deal we need to learn about fats and how they impact the body. Are they "empty" calories? I don't think so. And, I also firmly believe less processing is better so I'm suspicious of the no-fat and low-fat dairy products.

Onto the grain category... even more disappointing. The USDA gets credit for defining whole grains and refined grains and including examples of both. They caved to the grain lobby by including whole wheat products (whole wheat bread, whole wheat crackers, whole wheat sandwich buns and rolls) in the list of whole grain examples and by including photographs of whole wheat cereal flakes, processed-looking oatmeal and what I'm pretty sure are WheatThins.

On one hand, they are correct in that the products on the "whole grains" list are certainly a more healthful choice than the items on the "refined grains" list. However, many highly processed and overly refined products are still allowed to get away with a whole grain or whole wheat label. If the USDA is including these types of "whole grains" in this category it also needs to update the rules and regulations on what "whole wheat" means while they reform food labeling. I'm hopeful those updates are on the way.

What I wonder, however, is how many people actually eat on a plate anymore. Some data suggests at least 21% of Americans eat a fast food dinner two or three times per week. I suspect the fast food for lunch numbers are even higher. Last I checked you don't get plates at such places. It will be interesting to see the reaction from the fast food contingent. The USDA has wisely released rules and guidelines for the use of the new plate icon and I suspect there are groups of people in conference rooms right now attempting to figure out how to put the plate on their packages. I don't really think the plate will soon appear on fast foods or the bags it comes in. Perhaps we also need a MyBag label...

The point? USDA did create a much improved food planning tool. It still has areas for improvement and there are still signs of special interest influence. This is the way our Government works. It can be different; for now, it is not. This tool is a great step in what I hope will be a concerted strategy to improve the way we eat. I can only hope the future will stress in the importance of eating whole, real food and avoiding the highly processed foods all too frequent in the American diet. If you need some help making better whole food choices while we wait for the USDA to catch up, see The Real Food Plate. 

USDA Food Icon

Here is it!

This is the USDA's new food icon which replaces the food pyramid. I love the simplicity of this tool. And, there is more information on the USDA website including the following summary:

Balancing Calories

• Enjoy your food, but eat less.
• Avoid oversized portions.

Foods to Increase

• Make half your plate fruits and vegetables.
• Make at least half your grains whole grains.
• Switch to fat-free or low-fat (1%) milk.

Foods to Reduce

• Compare sodium in foods like soup, bread, and frozen meals ― and choose the foods with lower numbers.
• Drink water instead of sugary drinks.

Simple, clear messages such as these will help consumers a great deal. While this tool doesn't go as far as "The Real Food Plate" we introduced yesterday, it is a huge leap better. Well done, USDA, well done.

The Real Food Plate

While the USDA hasn't yet released the new "food icon" which will replace the food pyramid, we (along with some food experts) are hopeful it will help people make better food choices.

I fear, however, the new food icon will miss an opportunity to help people learn how to eat more real food and eat less processed food. So, to get a jump on the USDA and further the conversation about Real Food, click on the image below for more information on The Real Food Plate^TM designed to help people recognize and enjoy more real food.