A couple of months ago, I came across another incentive program.  This time, the State of Alabama is encouraging employees to lose weight by telling them that a $25/month insurance fee will be charged to them if within one year they do not make any progress on adopting a healthy lifestyle.  Note that this insurance fee is not applicable for all those employees who are already considered healthy.

In both cases, people are being encouraged to adopt healthy behaviours which is a positive thing.  However, it feels like the incentives are coming from opposite ends of the spectrum; reward versus punishment.

The State of Alabama has clearly said that they have not yet determined what would be considered to be progress.  This is likely a very difficult and touchy word to define in this case.  What is progress for one person may be a walk in the park for another.  The challenge here will be to ensure that they are able to define progress in a way that is relative to all employees.  Setting a fixed amount of weight such as in the case of the town of Varallo, may not be the best way to go.  People are different and progress needs to be defined based on those differences.

Though the intention seems to be the promotion of healthy behaviours among employees, the method by which this employer is trying to achieve this can be argued to be inappropriate.  All employers want healthy employees.  From an economic perspective, it’s a huge cost savings for an employer to invest in preventative health measures than to pay for long-term medical treatment for employees who are already in varying stages of disease.

However, when preventative health measures become imposing mandatory screenings or risk financial punishment, an employer cannot help but expect a backlash.  We often forget that people behave in certain ways because this behaviour is working for them in some way or another.  Neither family, friends nor physicians (least of all an employer), can bully anyone into changing their behaviours, no matter how well-intentioned they may be.

Simply putting systems in place, such as free health screenings, free doctor visits and access to health programs is ignoring a huge factor in behaviour change.  People need to understand the reward and the return that they will receive by putting themselves through the additional hassle and headache of screenings, doctors visits and workout programs.  My hunch is that for many, an employer’s transparent attempt at saving money won’t be sufficient to encourage such a behaviour change.  The other question is how much of an impact will $25 make on these employees’ salaries?

The other thing that this plan fails to address is the fact that most people likely know the risks of the behaviours that they have adopted.  We all know that smoking leads to cancer, but there are many people who still smoke.  We know that eating high fat foods will lead to weight gain and possibly heart disease; yet we do it anyway.  Simply knowing that something is bad, is not enough to make someone change their mind about doing it.

Then again, what do I know?  I’m just a lowly employee who is trucking along and doing what works for me.

As someone who has never dealt with any type of back pain, this was a new experience for me; and not a pleasant one.  By all accounts, my injury was fairly minor and did not cause any nerve or disc damage to speak of.  And though I was happy to hear that it was nothing serious, my heart goes out to those who have to deal with this, and more severe pain, on a regular basis.

For those of you who have had back pain, you have probably explored many types of treatment.  However, this was a new world for me.  When my coach suggested that I see a chiropractor, my initial reaction was to cringe and reply skeptically, “A what?”.

Ever since I was a child, I have grown up with this kind of fear of chiropractic medicine.  Whether this resulted from watching too many 60 Minutes or Dateline episodes, I couldn’t say.  But I can say that the dreaded “Crack” of the chiropractor was never a particularly pleasant story.  This, coupled with the fact that my past injury experience has always been with physiotherapists, I remained skeptical.  However, in this case, my coach convinced me to at least give her chiropractor a try.

I have now had about 6 sessions with the chiropractor.  Recovery has been somewhat of an upward climb, and not without some bumps in the road (Note to self: don’t sneeze!!).  However, it has been a rather positive experience; albeit very different from what I was used to.

I found that chiropractic treatment is a far more active form of treatment on the part of the practitioner.  I think my chiropractor worked up a bigger sweat than I did while I was doing my exercises!  She chose to use Active Release Therapy (ART) to treat the stiffness in my hip and the pain in my back.  This soft tissue treatment approach was an approach that I wouldn’t even expect from a physiotherapist.  And though I still find it painful to go through this treatment, it is a good kind of pain; a sort of active or participatory massage. I have also noticed that with ART, I can get almost immediate results.  What could be better than that?!

However, it’s important for me to mention that even though ART seems to yield very quick results, it is up to me to maintain the improvement.  It’s up to me to do my assigned exercises at home in order to continue to recover from my injury.  Like any form of treatment, at some point, it is up to the patient to do what they can to supplement the treatment that was given to them by their practitioner.  At the end of the day, it’s you who will have to deal with the injury or disease and it’s up to you to choose how you want to live with it.

So all in all, though I continue to receive skeptical remarks from friends and family, my chiropractic experience was a positive one.  And though I’m sure there is variation in philosophy among chiropractic doctors, I do believe that there are a few out there who aren’t, to put it in the words of my own chiropractor, quacks.  Do your research, get references from people you trust, and above all, don’t be afraid to say no to your chiropractor (or any doctor) if you aren’t comfortable with the treatment that they’re proposing.

I’m sure you’ll all be happy to hear that my back is feeling much better now; and without even a single crack!

That hasn’t stopped people from using the Wii Fit to some creative ends however. Injured athletes, for example, are getting rehabilitated by using the balance board. Doing the tedious and repetitive exercises required by rehab is a bit more fun when you can make it a game.

Other people have tried using the Wii Fit as an exercise tool — with varying success. Others have even wondered if the Wii Fit could be used to retrain the balance systems of people suffering from balance disorders.

I just hope I can get one soon to try it out!

After paying monthly membership fees for a year to one of the larger exercises facilities in Toronto, I decided to cancel my membership when I realised that I could count the number of times I actually went to the gym over the past year on one hand. Not a very good track record and I think rather hypocritical of me to not practice what I preach.

In any case, I decided that I needed to find something that I actually enjoyed. I remember being a kid and really loving to move around. I took all sorts of dance and gymnastics classes, not to mention loving school gym class and joining just about every school sports team that I could. When did exercise become such a chore?

Well, I recently decided to go back to what I love and sign up for some adult programs in Toronto. Let me tell you, it was the best exercise-related decision I have ever made!

I spent about 6 months on a waiting list before I was able to register for ballet classes at the National Ballet School of Canada last year. Don’t be intimidated by the name of the school. The adult program has classes for all skill levels including those who have never put on a pair of ballet shoes before and the teachers are wonderful at maintaining a balance between proper technique and dancing. Don’t think that ballet is just for girls either! There is a great mix of both men and women in all levels. If you were ever interested in ballet as a child, let me tell you that there is no such thing as too old to give it a go again.

Finally, I haven’t run away, but I have definitely joined the circus! Toronto School for Circus Arts offers some great classes that let you run around and jump off the walls while still getting a great workout. I’ve currently signed up for the more traditional strength and stretch class along with a tumbling class (reminiscent of my gymnastics days, but far more difficult and painful than what I remember!). The strength class uses an exercise ball for many of the exercises and it is one of the best workouts I have ever endured. There is absolutely no way of cheating your way through exercises when you are depending on the ball for “stability”.

The flexibility class is based on active isolated stretching. I was familiar with the theory behind this type of exercise, however the actual activity was new to me. I’ve gone to two classes so far and I have yet to master any of the positions in a way that engages any kind of meaningful stretch. However, these two classes have shown me several weaknesses in my body that I never would have noticed had I not engaged in such an exercise and, like anything else, the actual stretching will come with time and practice.

In a few months, I might consider trying out some of the other circus activities such as trapeze, trampoline, or aerial silks. But for now, I think I’ll take it slowly and stick with what I’m familiar with.

One of the cons of going the route of organized classes is that the upfront cost is probably higher than a simple gym pass. However, the definite pro, at least for me, is that I look forward to going to each of these classes every week, I make a point of not missing them and I absolutely love participating in these activities. The actual exercise is simply an added benefit.

I’m not discrediting the benefits of exercising at a gym. However, I think we sometimes forget that we can go back to the things we used to enjoy and still reap physical benefits while having fun.

I have to wonder where the line between protecting children’s health and making it everyone else’s problem will be drawn. As someone who has unfortunately been afflicted by the “disability” of severe nut allergies, this issue is one that hits close to home.

I will agree that the incidence of food allergies in children seems to have exploded in recent years. I never knew of another child in grade school who also had any kind of food allergy. I alone, had to look out for myself and make sure that I did not trade snacks with classmates or eat baked goods at the school bake sale.

This lesson was something that was ingrained in my head from the moment my family discovered this “disability”. It is a lesson that I do not doubt all parents with children of food-borne allergens ingrain in their heads. It is a lesson that can save their lives and is of invaluable importance.

However, the continuum on which society becomes responsible for this affliction is a large continuum indeed.

On the one hand, young children may not be able to distinguish what ingredients may be in certain types of food, or may not remember to wash their hands after eating their snacks. In this type of environment, a complete ban on known allergens is likely the only answer to protect the child’s health and safety. At this point, I do not think it is unreasonable to impose such a ban on children’s snacks at schools.

On the other hand, there is the request of a young woman, Aly Young, back in February 2006, to ban peanuts from large public venues; in this case, the Air Canada Centre. I’m not arguing that the large amounts of fresh peanuts isn’t deadly to those with nut allergies. I’m not arguing that the closed space of certain public venues, be it sports arenas, restaurants, or classrooms doesn’t exacerbate individual reactions. These are all valid concerns that can have dire consequences.

What I do take issue with, however, is the blanket imposition of bans left, right and centre. It is human nature to react negatively to the imposition of responsibility for other peoples’ issues and concerns. This is not to say that society as a whole has any mal-intent towards those with such allergies (at least I like to think that isn’t the case). However, if it were suddenly mandated by your organization that you participate in corporate lunch and learns, you cannot deny that your initial reaction would be a loud groan and sigh. In and of itself, the request has the best interests of both the corporation and the individual employees in mind. But it is the imposed obligation that takes away the willingness and openness to respond in a positive manner that could potentially lead to beneficial change.

At some point, we all will be old enough to take responsibility for our own health and safety. It’s a harsh world out there. One that will not always care about what ails you. And though we may sometimes feel that we are all out to fend for ourselves, I cannot help but believe that most people have an innate sense of humanity and goodwill toward others (It must be Christmas time!).

Bans and the imposition of regulations may be needed in some instances. But whatever happened to good old fashioned respect and asking for something that you need and/or want by calmly explaining your situation?

You may be surprised.

Nobody is denying that obesity has become a significant health crisis in the western world; and one that needs to be addressed in short course, no less.

However, I can’t help thinking that a letter home to parents is a pathetic attempt at addressing the real issue. Let’s see how well it goes over when parents read a letter essentially saying “You’re child is fat!”.

We have all heard the ever increasing percentages of obesity rates in the western world. Click here to see an estimate of worldwide obesity rates based on BMI in 2005 and a prediction of rates in 2015, courtesy of WHO.

Though the efforts to combat obesity have gone global, there is a part of me that feels like we have heard the word “obesity” so many times in recent years, with solid education programs only beginning to be put into place, that I fear some of us have lost the fear that used to be associated with the word.

Remember when your mom kept telling you to clean your room? At some point, her pleas began to fall on deaf ears. We learn to tune things out when there are no immediate consequences or necessary involvement on our part.

In any case, I got to thinking about how difficult it would be to read a letter telling you that you have essentially not been keeping your child’s best interests in mind and have put his/her life in such grave danger that immediate action is required to prevent the unimagineable.

Then I began thinking about what positive steps a parent may want to take once they’ve let this horrible piece of news sink in, and how huge that mountain of “lifestyle change” must seem without any idea of where to begin or where to get support or information.

So, with a mountain looming before me, I began to do a little bit of research about what types of information are available and how people can access information and programs within their own communities. Let me tell you, I was amazed at what I was able to find.

The internet is a great resource for information; just be careful about the source of the information that you are looking at. Government based websites are always a good place to start. For example:

• HealthyOntario provides some great articles on different health-related topics so that you can get a better understanding of certain health problems. There are also some interesting tools here that allow you to do a self-assessment of symptoms you may be experiencing as well as test some health measurement tools.
• Active2010 is a government strategy to increase physical activity in Ontario by 2010. This website provides many activity-specific resources that are available in your area. There is also a link to the Pause to Play website that is geared toward kids.
• 211Toronto is also one of my newly discovered internet resources for health-related information as well as community based services and programs in your area. If you weren’t able to find what you were looking for online, feel free to call 211 in the Toronto area and you can speak with someone in person who can provide you with information on what you are looking for. Note: 211 is currently only available in select cities. However, a strategy is in place to make this service available to all canadians by 2011.

Another phone number that has been made available to Ontarians is Telehealth Ontario provided by the Government of Ontario. You can dial this phone number to speak with a nurse who can assess symptoms, provide advice and/or information on any number of health related topics. This service 100% free and confidential and you do not need an OHIP card to access this service.

For those of us who prefer in-person information, your local community health/resource centre is always a great place to start. They will have information on programs in the area in which you can participate in. Many of these programs are free of charge and they often allow you to physically participate in programs, rather than simply provide you with information. The YMCA is an example of a community resource centre that many of us are familiar with.

Finally, the good old community public library often has information on community activities that you may find helpful. Don’t be afraid to ask the librarians for information as they can also point you in the direction of the types of resources that you are looking for.

I realise that all of these resources are very Toronto/Canada-centric. However, my point is that all the information and resources you could possibly want are out there and it is a matter of having a starting place to look for it all. Once you’ve started your search, there’s no guessing where you may end up.

Don’t let yourself be a victim of the boy who cried “Obesity!”. There is help, information, resources and programs galore. You’re not alone in climbing the mountain of “Lifestyle Change”.

Mike Howard on the Diet Blog poses some interesting initial questions to consider about this incentive program. I also wondered about these questions and have finally come up with some good reasons why I like this program along with some areas that could possibly be improved on.

Why I like this program:

The health benefits that accompany weight loss are undisputable. The list of health benefits range from decreased risk of heart disease, diabetes, cancer, etc. to increased lifespan; which all adds up to increased quality of life. Who can argue with that?

The requirement of maintaining the weight loss for a period of 5 months supports the general school of thought that it takes at least 3 weeks for an activity to become a habit. Assuming that people are losing weight and maintaining the weight loss through a variety of healthy lifestyle changes, once the 5 months is completed, their healthy lifestyle changes will no longer be just changes, but will have become part of their daily life.

Finally, I’d be lying if I said that the financial reward wasn’t a welcome bonus. As much as adults may like to think that they have outgrown their childhood need for immediate reward, I highly doubt that any individual would turn down such a reward. Some of us may say that the financial reward is unnecessary and that we maintain our health for personal health benefits. If this is the case, then all the power to you! But if someone was willing to recognize you for your efforts, would you really turn them down?

Where I think this incentive program could improve:

By setting a fixed amount of expected weight loss (4 kg for men and 3 kg for women), the program excludes a large segment of the population including those individuals who already maintain a healthy weight through healthy lifestyle activities. Shouldn’t these individuals also receive recognition for their efforts?

Also, for those individuals who may need to lose more weight in order to be considered within the healthy weight range, these fixed numbers may imply that no further weight loss is required to reap full health benefits. One way to address this issue may have been to state a weight loss requirement of at least 10% of an individual’s initial weight. By requiring weight loss of a certain percentage, you ensure that individuals are able to tailor their weight loss so that they will indeed benefit from their individual efforts.

A measurement method that takes into account the fact that all individuals are different would be to require individuals to acquire a Body Mass Index (BMI) of between 19 and 24. This measurement takes into account the fact that individuals of different heights may have different weight requirements.

Another measurement method that would be more accurate while also moving the focus away from the scale is to measure body composition. In my opinion, this is the best, but also most complicated, option. Body composition essentially moves away from the scale completely and measures the percentage of body fat to lean body mass. By measuring body composition, the emphasis is less about what the scale says, and more about whether your body is mostly made up of the healthy lean body mass rather than the unwanted fat mass.

The last caveat that I hate to even mention, is the possibility that people may choose unhealthy methods to obtain intial weight loss and then to maintain that weight loss throughout several months. Weight loss supplements and overnight miracles are marketed to us so many times a day they are hard to ignore. The easy answer to a monetary reward may be too difficult to pass up.

Finally, an important part of changing one’s lifestyle is to ensure that you are doing it properly and without potential self-harm. For this reason, I need to include the importance of seeing a healthcare professional BEFORE you embark on the road to a healthier lifestyle. Your healthcare professional will be able to identify areas of concern and ensure that all of your efforts are not for naught.

Without knowing the details of Varallo’s incentive program, it would be presumptuous of me to say that their program will fail. I am sure that some careful consideration went into the development of this plan and that they have covered all of the points above.

It would be misleading to look at the two lists above and conclude that my list of possible areas of improvement outweighs what I actually like about the program. I think this was an incredibly creative and most likely effective program at bringing awareness and motivation to the general public.

It is innovative programs such as this that I believe will be integral in reaching the general population and provide learning opportunities and tools for people to become self-sufficient and responsible for their own lives.

Now what will we come up with next?

Here we thought that trying to sell the idea of losing weight for personal health benefits was motivation enough. What were we thinking?

The mayor of Varallo has decided that all citizens of Varallo who manage to lose a certain amount of weight within one month will receive a monetary reward of 50 euros. On top of that, if individuals are able to keep the weight off for a period of 5 months, they will receive an extra financial reward of 200 euros.

I’m living in the wrong country!

I have to say that this is the first that I have heard of such an incentive program, and I would be very curious to know how successful it has been in convincing people to shed the pounds.

It seems that Varallo’s mayor has implemented a program based on a growing understanding of workplace health and cleverly expanded it to include the general population.

Organizations today, at least in North America, are faced with increasing costs resulting from their employee health benefit plans. Employees are essentially sicker today than they were several decades ago and claiming a higher amount of drugs related to disease management through their workplace health benefit plans.

The workplace health movement is growing and it encourages organizations to look at how they can invest in their employees’ health BEFORE they become sick and require medication on an ongoing basis. It is a concept of investing in the prevention of disease rather than the maintenance of health once already affected by disease.

As any organization or healthcare system can tell you, the cost of maintaining an individual’s health once already affected by disease is significantly higher than investing in the prevention of disease. I can only imagine that any corporate organization would be happy to learn of new ways to save money or increase their profit margin. But I speculate…

I also wonder whether such an incentive program might prove beneficial in a country such as Canada that provides universal provincial healthcare to its citizens.

(I will not profess to having a deep understanding of the Canadian healthcare system, nor will I suggest to have a potential solution to address the currently injured state of Canadian healthcare. In this case, I really am only wondering.)

Is there a way for provincial governments to directly invest in peoples’ health prior to the onset of disease? Would a government sponsored economic incentive program for individuals to lose weight be effective in a country such as Canada?

I realise that this is an oversimplification of the issues affecting Canadian healthcare. However, I cannot help but think that the little Italian town of Varallo may have discovered an incredibly direct and effective way of positively influencing the health of its citizens that Canada may do well to at least look into.

Who knows? Like many organizations who are beginning to see a positive return on their investment, Canada may also realise that a concrete prevention strategy may prove to be beneficial on all fronts in the future.

Some new research from the University of Calgary is telling us that it will.

Apparently after a high fat meal, our bodies become more prone to stress. We react with increased “blood pressure, [raised] heart rates and [increased] resistance of blood vessels” to situations that wouldn’t normally invoke such a significant stress response.

I guess a high fat meal doesn’t just mean an extra 30 minutes on the treadmill anymore! Eeps!!

So two major things that we try to avoid like the plague in our efforts to lead a simply healthy life, stress and a high fat diet, have now come together to deliver a double blow to our efforts.

Don’t let this discourage you!

You wouldn’t want to increase your level of stress for no reason would you? So if choosing to go to McDonalds was a difficult option to turn down before, now you have a compelling reason to forego the BigMac and opt for something healthier. Perhaps it’s not such a difficult decision after all.

The hard part will come when you are already feeling the pressure. I don’t know about you, but it is when I’ve got 5 things on the go with zero time left to finish and people depending on me to get it all done, that I like to reach for the grease!

Next time though, before I go through the drive-thru, I may stop and think twice about what means more to me: Immediate reward or long-term success?

Sometimes no matter how hard you try to keep yourself healthy, there are uncontrollable factors that can, and will, make you sick.

Dilemma: Can I afford to take a day, or two, off to rest and recover knowing the amount of work that awaits me at work and at home?

It’s a dilemma we’re all familiar with.

A simple cold or flu is not the end of the world, but it is then that our already jam-packed schedule, stressful workloads and tight deadlines will seem doubly so. And yet, we think that if we just push through it, ignoring what our bodies are trying to tell us, that things will get done effectively.

WRONG!! Why don’t we ever learn?

There will always be work to do regardless of how hard you work. There will always be responsibilities at home that cannot be ignored. There’s really no point in fighting it.

So with that in mind, prioritization becomes of the utmost importance when recovering from a cold or flu.

Priority #1: There will inevitably be things that require your urgent and immediate attention. If you must, take care of those things to the best of your ability through the coughing, sneezing, aches and pains.

Priority #2: Once all of the urgent tasks are done, take the day off! I know you’ve given the same piece of advice to a friend or co-worker who was feeling just as rundown as you feel at this moment. You should listen to your own advice once in a while!

Priority #3: Don’t go home and watch TV, play on the computer, clean the house, etc. You took the day off to rest and take care of yourself, and that’s just what you should do.

I realise that the world doesn’t stop working just because you happen to not feel well. (Believe me, I was completely sensitive to the dozens of emails waiting for me when I returned to work the next day.)

All I am saying is that there are times when you need to stop and listen to what your body is trying to tell you. Nobody needs a coughing, sneezing, runny-nosed “hero”.