Making Sense of Health and Wellness Literature - A Framework for Developing a Personal Action Plan

Purpose of this Commentary

This is a report on my thinking to date about what and how to research about health and wellness with the aim of developing a regime to:

• improve my general level of fitness 
• contribute to improved performance, enjoyment and safety while engaged in specific activities such as long distance walking

It will set out a framework which sets priorities for research and organizes the findings in a way that can be translated into a series of specific actions on my part to achieve some specific objectives.

I am not motivated by thoughts of prolonging my life as I've grown to appreciate the significance of accidents and chance which often have a greater influence on one's longevity than "good intentions" translated into action.  Rather, I am interested in measures that will improve the quality of life by enabling me to engage effectively in a variety of activities ranging from basic things such as sitting, walking and sleeping to more directed pursuits such as skiing, long distance hiking etc.  

Introduction

When I started to read about health and wellness a few years ago, I was confronted with a bewildering array of information:

• The array of subject material is vast - everything from dietary regimes and nutrition to the influence of swearing during high performance activities.
• In recent decades especially, the literature on health has exploded.  It is simply not possible to even consider sampling but a smattering of the sources e.g. when I Goggled "cardio vascular health" I got 3.5 million hits; 714,000 hits for "plantar fasciitis"; and 2.4 million for "barefoot running".  
• The quality and reliability of the information is variable - who and what to trust?

 A Commentary on the Literature (excluding the "quackery" and "beyond the fringe" stuff)

There is a bewildering variety of science-based studies.  Sadly, most of them are focused on "learning more about less" - a reductionist approach which misses the forest for the trees.  In part, this is driven by the quest for "originality" and scholarly reputation. It is also an outgrowth of the sheer number of graduate students and post-doctoral fellows looking for something to occupy their time. In some instances, it is a product of research which is intended to give high performance athletes that "extra edge" in high level competition, an activity where fractions of a second make a major difference.  (I'm not too interested in that stuff as I'm not in that league and further, the pursuit of those exercise routines can do real damage to people who are not trained to extreme levels.)

Most of the academic studies are  short-term in nature and limited in scope.  Sample sizes are often small with the result that it is difficult to achieve a meaning measure of statistical significance.  In my experience, this is the product of funding limitations and/or time constraints.

Also, authors are driven to publish results before long-term findings are in hand - a product of the "publish or perish" syndrome.  

Study methodologies are not standardized, meaning that it is difficult to compare or replicate results.  For example, many studies of exercise/diet regimes purporting to improve health and fitness are conducted with untrained subjects whose responses differ from trained or fitter individuals and visa versa.  

Those generalized, long-term population studies which exist, while interesting, only provide "averages".  It is difficult to extrapolate findings to the circumstances of an individual.  For example, an individual's response to an exercise regime varies from the general population in relation to a myriad of physical factors which simply cannot be embraced in generalized population studies.  This is complicated further by factors such as a subject's attitude and life style.  

It is difficult to separate out the "important" from the least important findings in terms of relevance to one's personal situation and needs.  For example, there is a growing body of literature which focuses on seemingly minute matters which authors claim could make the difference between winning and losing in the game of high performance athletics.  For "average Joe's and Jill's", I suspect that most of this stuff is not relevant. 

My Conclusion

I realized that I needed conceptual framework to direct my future reading in order to:

• maximize the useful return on reading time
• organize the findings into a mental framework in order to provide context and a basis for taking action on the findings
• priorize my reading to topics which are most applicable to my personal circumstances (life style, needs and expectations)

Preliminary Steps to Developing a Framework

Here is the approach.  It is not sequential.  Rather it is adaptive. It will change as new information becomes available.  The following is premised on the guideline that I will read only science-based, peer reviewed literature.  

1.   Comprehensive Overview

Some books provide an overview of the "playing field". They are useful in that they provide a perspective of how authors approach the topic and organize their thoughts.  This is invaluable as "how" one thinks influences "what" one reads.  I find that I am more comfortable with some "mental frameworks" than others.  For example, I much prefer science-based insights as opposed to more experiential viewpoints.  While I consider myself a spiritual person,  at this stage, I find myself more interested in the "what's, why's and when's".  I figure that I'll evolve into the more philosophical aspects through the process of "doing".

2.  Assessment of Personal Needs

In brief, it involves an identification of wants, needs and desired outcomes in response to an assessment of lifestyle, expectations for the future, and other considerations.  In essence, the "list" will assist in identifying specific areas for future research and setting priorities. 

3.  Focused Research

This where several themes identified during the aforementioned processes will be identified and explored.  I will assign a relative priority on the topics based on my personal needs and some of the comprehensive reading.

The comprehensive reading is useful for "building the base".  For me, this entails an examination of general items which are vital to the function of the system as a whole:

• cardio-vascular health and the associated elements of endurance, "heart health", 
• breathing: 
• balance
• posture 
• efficiency in movement (Alexander method)
• flexibility (not for its own sake, but for specific activities which are identified later)
• vision (I am interested in exploring an eye exercise technique used by my brother to "graduate" from the use of reading glasses)
• sleep 

There are specific activities that I want to pursue for two reasons: preparing myself to meet the physical demands specific to each activity; and, minimizing the chance of injury:

• walking ("foot fitness", efficiency in movement)
• swimming (cardio, endurance, efficiency in movement)
• snowboarding/skiing (strength, endurance, balance)
• sitting at the computer keyboard, piano (posture, hand/arm strength and flexibility)
• lifting and other movements associated with general tasks and activities such as canoeing, house and yard work: strength, balance, efficiency and safety of movement, injury prevention
• bicycling (endurance, efficiency of movement)

Many of the aforementioned activities have overlapping requirements and are also related to the general items noted previously. 

4.  Thinking about Implementation

This is the most important part.  I hope to develop a regime where I can "build the base" in a time efficient way and have time to focus on some of the specific needs associated with activities such as skiing.  In part, this can be done on a seasonal basis e.g. ski preparation starting in the late fall, cycling in the late winter, although a stationary bike could also be used throughout the year as a warm-up preparation for daily exercise.

This is premised on the expectation that a commitment will be made to follow the plan.  I've learned that after the initial three hard weeks, that an hour or so a day soon becomes a habit - also that much of the implementation does not have to take place in a gym or pool e.g. balance can be incorporated in daily activities such as putting on one's socks while standing on one leg with eyes closed. A major part of my knee strengthening takes place while watching TV, ditto for hand stretching exercises for the piano.

In a series of posts, I will report on my progress.  It will be akin to "notes to self".