Tuesday, January 10, 2012

Are you a Talk Walker, or a Walk Talker - My Challenge to Health Professionals

In health care it definitely helps if you know what your patients are going through.

It's not essential of course, thankfully there are far more diseases that I can treat than I have personal experience with, but common grounds give understanding and empathy that books and lectures simply can't.

But I'm not talking about diabetics being better at treating diabetics. I'm not talking about drugs or rehabilitative exercises.  Here I'm talking about the things we ask our patients to do in the hopes of improving the health of their lifestyles.

Because let's face it, when it comes to healthy living, health professionals sure are great at providing advice, but that's not to say the advice is always great.  I wonder how much better a health professional's healthy living advice would be if they actually lived it themselves?  At the very least, it would provide that health professional with a true understanding of what it takes to follow through, and at best, it would highlight recommendations that from a doability perspective, might stand a bit of work.  Either way, it'll help to provide true, genuine, empathy.

So if you're a health professional, my question to you is this. Do you actually walk your talk, or do you just talk it?


While I discuss a great many things with my patients, boiling it down, the bare bones thrust of my lifestyle recommendations usually involve eating every 3 hours, always including protein, tracking calories, weighing and measuring food, cooking (actually transforming raw ingredients) and exercising as often as they can enjoy.

And I'm not posting that to have a debate about the recommendations themselves.  Different approaches for different people, bodies and goals.  Some will succeed with 3 meals a day, some with intermittent fasting, some with truly low carbs, some with meal replacements, etc.  What I care most about is that a patient likes their approach enough to continue with it.  And while we have those recommendations up above as our base, we're happy to work with our patients on any approach they feel they might be able to sustain because the suggestion that there's only one way to go flies in the face of the evidence base.  Why I'm posting it here is so that you'll know what our base recommendations are so that you can judge whether or not I'm doing them myself.

Because I'm a bit of an open book. My food diary is publicly available on Tweet What you Eat. At the time of writing today, I haven't missed tracking a meal or a snack for 248 consecutive days. I'm not obsessing about it either - it doesn't consume my every waking moment of time or attention.  In fact, at this point I doubt it takes me more than 5 minutes a day of effort, and it's certainly not about being perfect. Have a peek and you'll see what I mean. For instance you'll find that this past weekend I went out twice to eat, including one insanely calorific pilgrimage for ribs. Scroll around some more and you'll see I also sometimes miss snacks, really enjoy alcohol, and also am partial to potato chips and sour patch kids. Good, bad, and ugly, I track it all - because it's not for judgment, it's just to know what the heck is going on and where and when I might stand to tighten my reins. 

Fitness diary wise, I use a new online service called Fitocracy.  Picture Facebook/Twitter, meets an exercise diary, meets an online role playing game. No, you don't pretend to be a dwarf and roll 20 sided dies for your constitution, but the more you exercise, the more you level up, and you can also complete quests, log, save and receive scores for your usual workouts (or your functional activities, they don't need to be gym based), and reach a community of folks who think exercise is important enough to get excited about. I've been tracking on Fitocracy for a little over a month and find it's a great way to stay on top of my goals and it does help give me a bit of a boost in motivation. Want to see what I'm doing exercise wise? Click here and feel free.

Now maybe I'm a bit hard core about this tracking business but of course I'd argue that the evidence base is solidly with me on its incredible value in cultivating healthy behaviours.

My challenge to you?
If you're a health professional, and you're providing lifestyle advice to your patients, commit, for at least a one month period, to make your life an open book, and not only try to live the life you encourage your patients to live, encourage them to watch!
Provide them with links to your profiles and maybe they'll even cheer you on. Honestly, if you've never tried to walk your talk, how can you truly be sure you're putting people on a walk-able path?

Dick Talens, the formerly obese teen role playing gamer turned fitness machine and Founder of Fitocracy has kindly provided me with some invites (it's still in a semi-closed beta).

If you're an allied health professional (including all you healthy living researchers and journalists), click here and not only will you be signed up, but you'll automatically be joined to the group I started just 2 days ago (Update:  Have been told that after clicking the link you need to sign up manually rather than a Facebook or Twitter connect). It's called The Talk Walkers.  Also?  Spread this post to all of your email, Twitter and Facebook colleagues and encourage them to do the same.

If you're not a health professional click here and you can still sign up and get immersed into one of the literally dozens of other groups, or simply decide to tool around with it on your own. (Update:  Have been told that after clicking the link you need to sign up manually rather than a Facebook or Twitter connect).

If you're not doing so already, it's definitely time you walked your talk.  You owe it not only to yourselves, but to your patients.

(Thanks Dick, for the links - to read more about Dick and Fitocracy, here's CNN's coverage)

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  1. Great little You tube clip--thought you might like it:


  2. Such great recommendations for patients---and I love the fact that you assure people tracking need not take over their lives. In my experience, people who haven't tracked food intake (or daily activity) believe it will be an odious, impossible task. But 5 minutes a day? Anyone can find time for that.

    Thank you.

  3. It's hardly onerous, especially if you are a smart phone user. I had gotten away from tracking my intake and big surprise when I started again, I am up on my portions and wasn't accountable for what was going in my mouth. Explains the weight gain during that time frame too.

    No excuses in 2012. Got a new Android based phone with a new food & exercise tracking app - today is day 2 and day 1 was eye-opening enough to get me back at it.

    And there are enough good FREE apps out there for iPhone and Android (I just dumped my iPhone although it had some good apps) and I played with 2 Android apps yesterday and there is one that I'm liking so far. Wish it had a space to add another snack (rather than lumping them into one "other" category) but good Canadian food database and this one allows me to scan a barcode so it's almost mindless. Truly easy to do.

  4. Anonymous10:25 am

    had a peek at your diary, dr. freedhoff. do you never eat vegetables, or do you just not include them in your summaries? Lol.

    thanks for the twye heads up... looks great - i started using it.

  5. LOL! I go on periodic salad binges, but I'm definitely guilty of fruit before veggies!

  6. This comment has been removed by the author.

  7. I'm so glad you posted about the tools you use as it's great to get recommendations.

    I've had a follower ask me if there's a site where you can track both your food intake and your emotions before / during / after eating as well. I couldn't find such a site myself but perhaps you know of one?

    Thanks so much. I've been following your blog for a few months now and you're one of my favourites (not only because you're a fellow Canadian!).

  8. Hi Gillian, thanks for the kind words.

    Tweetwhatyoueat (the one I use) you could certainly chart emotions too as you could submit them as 0 calorie inputs (kinda like I do with my exercise).


  9. Susanne9:47 am

    OK, if you are going to throw around pasta with smoked habanero cream sauce in your tweets like that, it's only fair that you share a recipe for it.

  10. Fair enough! Will post when I get home. If I forget, pester me.

    Of course for the smoked habaneros, I grew the peppers in the backyard and smoked them for 8 hours in my smoker, then dehydrated. I haven't seemed to be able to find them for sale anywhere here in Canada.

  11. Great post! I'm going to blog and tweet my exercise and food intake for a month, it's great for my patients to see that I follow the same basic principles I talk to them about. I always try to promote eating "real" food (nothing out of a package) and being active as much as possible!

  12. Anonymous1:43 pm

    hi! I know this is an old post, but thought you might know since you used it all the time too...
    I used to use tweetwhatyoueat for about a year or two, right when it started, from 2009-2011... but then I had a baby, etc, stopped tracking my food intake..
    I tried to get on the website yesterday but it's not coming up. I don't see any updates on their twitter account... Do you know if twye is gone for good? What are you using now? I liked that one the best because I would just text my food and calories then check out the totals on the website throughout the day...
    Which app/site do you suggest? :)
    Thank you!

    1. Our RD's favourite is myfitnesspal. Tweetwhatyoueat hasn't been very stable of late, though this has happened a few times and it's returned.

    2. Anonymous2:52 pm

      thank you!