AHA’s “Simple 7″…Not So Simple After All

The other night I read on the back of a friend’s T-shirt the following list of guidelines from the American Heart Association (AHA)’s latest heart-healthy lifestyle campaign, called “Life’s Simple 7“:

  • get active
  • control cholesterol
  • eat better
  • manage blood pressure
  • lose weight
  • reduce blood sugar
  • stop smoking

From my medical training, I recognized each of these 7 items as addressing the major risk factors for coronary artery disease and therefore heart attacks and strokes.

However, from my journey of learning about the connection between mind and body, and especially the ways in which our mind dictates the feelings, behaviors, and results we see in our lives, I noticed that these “Simple 7″ are not so simple at all.

Four of the seven guidelines involve behavioral changes. Three of the seven can be addressed with pharmaceutical drugs but are also dependent on these behavioral changes in order to have maximum impact. These areas of behavior change – exercise, diet, weight loss, and smoking cessation – are typically the most challenging and frustrating for both patients and doctors in a preventive setting.

Why?

Because it’s easy to read just two words – like “lose weight” – and to know what they mean. However, it’s much more challenging to look at your own underlying thought patterns and the payoffs you are getting for behaving the way you are right now. If you weren’t getting any payoff for keeping at your current weight, your mind wouldn’t allow you to be at this weight. However, it takes some willingness and openness to really ask yourself what those payoffs might be. The answer may just cause you to want to change. Or it may send you running as far away from that answer as possible.

How many primary care physicians see their patients once a year, and give them this same list of seven “simple” recommendations, only to see them come back the next year with the same results or worse?

Before you start to beat yourself up over your inability to measure up to the AHA’s “Simple 7″ lifestyle improvements, let’s look at each of them from a life coach’s perspective.

“Get active”

What does this mean? On the AHA website, three suggestions are provided for “moving more”. Parking farther away from the office door, taking the stairs instead of the elevator, and doing active fun activities with your children (including an endorsement for Nintendo’s Wii).

OK. I can see the logic in each of these small steps. However, it takes energy to want to move. It takes space to even consider putting these small changes into a person’s life. It takes a certain amount of inner freedom to even experience fun from doing activities with your children.

Why not look at the thoughts you have about yourself as you’re driving to work? Or the thoughts going through your mind as you press the elevator button to go to your cubicle or office? Or the thoughts you hold onto after you get home and you’re supposed to be “having fun” with your family?

I’ve learned that what we say to ourselves about what we do is a much more powerful motivator than what we actually do.

Our unexamined mind clutter is what prevents us from acting in the ways that we “know” we want to. No matter how many times we hear it, or how many suggestions we read, our actions won’t change until we change our thoughts. It’s the rare primary care doctor who has the training, capacity, and desire to delve into these issues with patients and find out what the patient really needs in order to change. Telling someone they will die early – and asking them if they want to see their children grow into adulthood – is a common strategy, but I’m skeptical that motivation by fear will work in the long term for developing the kinds of life-affirming habits we’re talking about.

“Eat better”

What does this mean? “Better” is a term that translates differently in each person’s mind when it comes to food. Learning what to eat, when to eat, how to select and prepare food, and creating the rituals around eating are all included in this idea of “eating better”. With the typical grocery store offerings, it takes some education, innovation, and motivation to choose “better” foods and actually get satisfied from eating them.

Identifying what drives our food choices and eating habits is another journey into the thoughts behind our feelings and actions. Maybe we’re choosing foods because we believe they represent love. Often it’s an old memory of love. Maybe we’re afraid to let go of those choices because we believe we’d be letting go of our ability to be loved. Maybe we watched a parent eat healthy, choose all the “right” foods, and die at an early age anyway, so we believe a story that “it doesn’t matter what I eat, I’ll die young anyway.” Each of these is a thought that can be acknowledged and questioned, leading to a pattern of eating that comes from a deeper place of awareness.

“Lose weight”

This I suppose goes hand in hand with the two items above. But as Oprah’s very public, decades-long journey has shown us, it is not so simple to simply “lose weight”. On AHA’s website, a great story of holistic life improvement, which resulted in weight loss, is highlighted on this page: “[Jennifer E.] changed her career, left unhealthy relationships, devoted herself to morning meditation, and began volunteering with a local women’s health initiative. Self-care became non-negotiable.” Clearly, Jennifer’s journey to health and wholeness involved more than losing weight.

I believe weight loss is a result of, not a means to, feeling better about yourself. There are many life coaches whose practices focus on weight loss as an entry point to total lifestyle enhancement.

“Stop smoking”

Again, two simple words, but a lifetime of effort, mostly failed efforts for people who do not address the underlying thoughts behind their smoking addiction. There is no question that the single most beneficial act that will improve a smoker’s lifespan is to quit smoking. That knowledge doesn’t stop the millions of smokers from continuing their habit.

Chemical dependency is one excuse; social stigma is another. The bottom line is we humans are powerfully driven by the content of our thoughts. And most of us have not been taught to observe our thoughts, or shown that we can train ourselves to believe different thoughts at any time during our lives, through practice.

Not So Simple…

I love that the AHA is acknowledging the whole person in their campaign to educate Americans about heart health. That our hearts are not “simply” the organ in the center of our chest that pumps blood throughout our system, that our vasculature is not “simply” a plumbing system transporting blood to our body parts. The AHA is attempting to get Americans to think about all aspects of our lives as contributors to healthy hearts.

What I see, as a life coach, is that ALL of our behaviors are driven by feelings we have in our bodies, which originate in our thoughts about the circumstances in our lives (never the circumstances themselves). A healthy heart is a symptom of living a balanced life, physically, emotionally, mentally, and spiritually. And a clear mind is a healthy starting point.

The “Simple 7″ list is a good start for focusing on the most tangible areas of behaviors that impact our overall risk of heart disease. And with our health care system’s current toolkit of interventions, drugs, surgery, office visits, and hospital stays, none of these factors will be significantly impacted in most patients.

Already there are physicians waking up to the fact that behavior and lifestyle changes are inadequately addressed in our medical system. If we want to have healthier bodies, we need to start by waking up to our own thoughts. It may be simple, but it’s not easy. If you’re struggling in one of these areas and don’t know what to do, take a breath. Ask yourself, “What hurts?” and “Why?”. And follow your thoughts to a treasure of information about what’s motivating you. The medical system has trained patients to believe we are passive and largely ignorant about what’s happening in our bodies. I believe we need to coach patients back to a greater connection with their own bodily wisdom – the wisdom we are all born with.

To live and feel healthier, you don’t need a diagnosis. You need space to discover what’s true for you, and the reassurance of knowing that you have the ability to create the healthy lifestyle you desire. It’s that simple.


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