Supporting Healthy Bodies at UNC: Navigating Obesity, Eating Disorders, and Weight Bias

When discussing health, you’ll notice a trend between two approaches – weight normative and weight inclusive.

aha-screengrab
Screenshot from American Heart Association, 1/25/2015

The weight-normative approach includes the many principles and practices that emphasize achieving a “normal” weight when defining health and well-being. This approach rests on the assumption that weight and disease are related in a linear fashion, with disease and weight increasing in tandem. Under the weight-normative approach, personal responsibility to make “healthy lifestyle choices” and maintain “healthy weights” are emphasized.  The approach prioritizes weight as a main determinant of health and as such, weight management (calories in/calories out) as a central component of health improvement and health care recommendations.

weightinclusive
Photo Credit: Prevention Magazine

Instead of imagining that well-being is only possible at a specific weight, a weight-inclusive approach includes research-informed practices that enhance people’s health regardless of where they fall on the weight spectrum. Under this paradigm, weight is not a focal point of treatment or intervention. Instead the weight-inclusive approach focuses on health behaviors that can be made more accessible to all people. These are behaviors such as exercising for pleasure, eating when hungry and stopping when full.

So is one better than the other? We’ll look at three questions to figure that out:

  1. What happens when people believe that everyone should reside within a certain body size / weight range?’
  2. What happens when people try to reach that certain body size / weight range?
  3. Does higher body weight / larger body size cause poorer health?

What are the effects of the belief that all people should reside in a “healthy” body size / weight range?

warning
Photo credit: Words over Pixels

Bad things happen – weight bias, weight stigma, microaggressions and more.

The emphasis on achieving a “healthy” weight implies that there is a healthy or normal weight that each of us should be striving to attain and maintain, which gives credibility to cultural messages prizing leanness and weight loss. These socially prescribed ideals can become internalized – and when that happens, it’s connected to body shame, body dissatisfaction, eating disorders, and potentially harmful muscle-enhancing behaviors.

Emphasizing “good weights” and “bad weights” produces the opportunity for weight bias.

weightstigma
An image from Georgia’s problematic anti-obesity campaign, Stop Sugar-Coating It

Weight bias and weight stigma refer to negative weight-related attitudes and beliefs that manifest as discrimination, stereotypes, rejection and prejudice toward individuals of any size. Common negative stereotypes about higher-weight people include ideas that they are lazy, stupid or worthless – and this results in behaviors targeting them including bullying, harrassment, pressure to lose weight, and weight related microaggressions.

micro
Photo Credit: More Bad News About Weight Stigma in Health Professionals

Microaggressions are intentional or unintentional verbal, behavioral, or environmental indignities that communicate hostility or negativity toward people who hold less power in society. For example, a doctor recommending a diet for a patient who presented with an issue unrelated to weight would be a weight-related microaggression.

Complimentary weightism is another type of microagression. Some examples include an anorexic student hearing that she “looks healthy” after disclosing that she has an eating disorder. And really – anyone being told they are “looking good” puts the focus and importance on appearance. The compliment could unknowingly congratulate someone who is using problematic behaviors like vomiting or restricting calories to control their weight.

Another example of complimentary weightism is when thinner people are “hated” for their thinness –  “I hate you because you can eat whatever you want.”

complimentary-weightism
Photo Credit: Some eCards

Research shows that weight stigma is associated with increased calorie consumption, a pattern that challenges the common wisdom that pressure to lose weight will motivate overweight individuals to lose weight.

Instead…

love-your-body
Photo credit: I Stand Against Weight Bullying

When people believe that folks of all sizes and weights can be healthy, it results in less shame, increase trust and rapport, improved outcomes such as pro-health lifestyle changes and improved psychological well-being.

What happens when people attempt to reach a “healthy” or “normal” weight to improve their health?

Bad things – weight cycling, disordered eating and emotional distress.

The literature says that attempts to reach a healthy or normal weight rarely work. Research has repeatedly shown that dieting is not an effective means of weight management. No weight-loss initiatives have generated long-term results for the majority of participants. In fact, there are serious risks of dieting, including weight cycling, disordered eating, and emotional distress.

weightcyclingWeight cycling, or the repeated loss and gain of weight, is an almost inevitable result of dieting. Nutrition and fitness education interventions that focus on weight management are rarely effective long-term, as clients often lose weight and then gain it back.

Weight cycling alone may be enough of a reason not to recommend weight management because it is linked to adverse physical health and psychological well-being, including higher mortality, higher risk of osteoporotic fractures and gallstone attacks, loss of muscle tissue, hypertension, chronic inflammation, and various forms of cancer.

In order to maintain lost weight, formerly overweight dieters may need to consume fewer calories than their same-weight counterparts who were never overweight. During calorie restriction and weight loss, metabolic rate is often lowered, and folks may need to employ more rigid dietary habits or excessive exercise routines that may be deemed disordered.

disordered-eating
Photo Credit: Unite Virginia

“The best-known contributor to the development of eating disorders is body dissatisfaction.”- National Eating Disorders Association

Dieters are 12 times more likely to binge eat. A third of  “normal dieters” become pathological dieters, and of those, 1/5 – 1/4 develop eating disorders.

The weight-normative approach promotes the view that weight can be controlled easily through willpower and reduction of poor lifestyle habits. But there is ample scientific evidence that people have little choice about what they weigh due to the interplay between involuntary genetic and environmental factors. Recently, 97 regions of the human genome were identified as playing a role in the development of obesity, including the control of appetite and energy use.

obseigenic
Photo Credit: American Nutrition Association

Plus, multiple uncontrollable external factors impact weight. Socioeconomic status influences weight in numerous, complex ways. America’s obesogenic environment leaves many Americans with little access to high quality fruits and vegetables and ample access to addictive, engineered, intensely marketed processed foods.

People who are focused on achieving a “healthy weight” may struggle to reach their weight-based goals, in large part due to the external factors mentioned above. This struggle often results in a sense of learned helplessness. Any adopted healthy behaviors like being more physically active, getting better sleep, or eating more mindfully may be seen as futile if attempts to reach and maintain a specific weight continually fail.

learned-helplessness
Photo credit: I Stand Against Weight Bullying Tumblr

Weight loss promotion and achieving a “healthy weight” may instill a sense of learned helplessness in the majority of people who are unable to achieve weight-based goals. If attempts to reach and maintain a “healthy weight” continually fail or are seen as impossible given available resources, the practice of healthy behaviors may be seen as futile. If I go to the gym for a week or two regularly and see no change in my goal of reaching a desired weight, I will likely learn that nothing I do helps.

Finally, it’s important to remember that when we attribute weight-related stereotypes to each other, it affects the well-being of ALL OF US. It makes even students who are at a normal weight terrified of gaining weight. The negative effects reach across the weight spectrum.

Instead…

weight-inclusive-3
Photo credit: I Stand Against Weight Bullying Tumblr

The weight-inclusive approach focuses on the PROCESS – being active because it’s fun, and eating when hungry / stopping when full. In doing so, it results in reduction of risk factors (like sedentary lifestyle) and improved physiological measures (like blood pressure or blood glucose) in lieu of pounds or BMI. There are four decades of research proving the positive impact of weight-inclusive interventions. One study looked at folks over a 2 year span and included a “diet group” and a health-at-every-size group. Over the 2 years, 41% of the diet group left the study versus only 8% of the weight inclusive group. In the same study, the researchers offered 6 months of weekly interventions and 6 months of aftercare group support to a diet group and a weigh-inclusive group. The health at every size group members maintained their weight, improved in all outcome variables, and sustained improvements. Diet group participants lost weight and showed initial improvement in many variables but by the end of the study, the lost weight was regained and little improvement was sustained.

Longitudinal studies repeatedly indicate that freedom from weight bias along with body satisfaction correlate with reduced risk for all of the following: unhealthy dieting behaviors, sedentary behaviors, eating disturbances, and weight gain. These findings hold regardless of the participant’s actual weight. 

Does higher body mass index cause poor health?

Nope.

The weight-normative approach rests on the assumption that weight and disease are related in a linear fashion with weight and disease increasing in tandem. The belief is that to be healthy and avoid disease means achieving or being in pursuit of a lower weight if overweight or obese. A weight-normative approach believes that recommending weight loss to these individuals is not a function of weight bias but of health imperative.

But data does not support that a higher BMI causes poor health. correlationA higher BMI is associated with various diseases, but causality is not well-established. Interestingly enough, when accounting for socioeconomic status, nutrition, physical activity levels, and weight bias, even the correlation between a higher BMI and disease is vastly reduced or disappears. The risk for all-cause mortality is lowest for people in the overweight category and highest in the underweight BMI range.

weightcurve
Flegal’s U-shaped Curve

In 2013, Flegal’s very well-known and very-debated meta-analysis showed that the risk for all-cause mortality is lowest for people in the overweight category with the highest risk in the underweight BMI range. The U-shaped curve is a well-known image used to describe the obesity paradox.

Instead… fat-and-fitStudents can be fat and fit. A 2011 study found that metabolically healthy obese individuals had a lower risk of heart failure than normal-weight people who were insulin resistant. And what does “metabolically healthy” mean? Certain characteristics exist in people who were both obese and metabolically healthy: normal BP, cholesterol, and blood sugar levels, normal insulin sensitivity and good physical fitness.

Many studies show that obesity and healthy are not mutually exclusive. And culture is starting to agree. Joni Edelman, a registered nurse and writer, recently blogged about her own experience of losing weight and truly becoming obsessed with the calorie counting and incessant exercise necessary for her to achieve a BMI in the normal/healthy range. She is an example of someone who feels healthier and happier at a higher weight.

healthier

“There is a cultural belief that people have to be dissatisfied with their weight (or any aspect of their appearance) to be motivated to improve it. This belief has not found general support in the literature; in fact, the reverse is supported:  people are more likely to take care of their bodies when they appreciate and hold positive feelings toward their bodies.” Tylka et al, 2014

What should we do?

scale

Emphasize self-compassion

Help your loved ones shift away from habitual appearance monitoring, which is associated with lower self-care and ignoring physical health, to attending to their bodies in more positive ways that emphasize self-care. People are more likely to take care of their bodies when they appreciate and hold positive feelings toward their bodies.

Remind your friends that you’re perfect just the way you are! That unconditional positive regard goes a long way in helping people feel supported and confident in their ability to make changes when THEY are ready.

Reframe body blame and shame as internalized weight bias that has little to with someone’s actual weight or size.

“What does your body provide your life that you enjoy?”

“Be gentle with yourself! You’re amazing!”

“I love you just the way you are. No matter what.”

Appreciate all bodies – don’t compliment them, just appreciate them.

Placing a focus on appearances is problematic. Avoid: “You look great!” “Have you lost weight?” “I can tell you’ve been working out!” “You look really strong!” Again – you don’t know what behaviors your comment is supporting. And on the flip side, negative comments just make people feel bad about themselves.

Some alternatives? If you can’t stop talking about how people look – focus on how they did their hair that day or compliment their shoes. But even better? Tell them what you’re feeling – or ask about their self-care.

Instead:

“I’m really glad I ran into you.”

“What’s new with you?”

“I could use some new ideas. What do you do to take care of yourself?” and then, “how does it make you feel? Has it impacted your sleep?”

Focus on behaviors

Instead of encouraging a friend to work out more or eat differently, do it with them and make it fun and easy!

“Do you want to go for a run with me?”

“Wouldn’t it be fun to bike to the quarry and go swimming this weekend?”

“Can I make you dinner?”

“Let’s go to bed early tonight so we can play outside all day tomorrow!”

Make it sustainable

Sustainable change means that the behavior is supported, easy, and fun. One easy way to incorporate more physical activity is to move as a part of other activities. If you’re running errands, actually run them (or walk, or bike). If you have to drive, park a few blocks away so you get to move a bit more. Try to eat intuitively and encourage your friends to do the same.

“What if you and I walked to dinner instead of taking the bus?”

“Will you be my lunch buddy?”

“Hey, I got you this water bottle! I’ve noticed how much more water I drink when I carry it with me and fill it up at each water fountain I go by. I feel so much better when I’m hydrated!”

“How can I help you reach your health goals?”

Encourage quality of life as an end goal

Avoid focusing on how exercise makes bodies look, or exercise as a way to “make up for” food choices. And avoid focusing on calorie counting. Help your loved ones reconnect with their bodies –  focus on internal body awareness rather than engage in external appearance monitoring. Consider how healthy behaviors make you and your friends feel.

“It feels so good to be outside, doesn’t it?”

“Endorphins are amazing!”

“I love how good I feel after eating a meal like that.”

“Whoa, I’m full. I love this yummy food but I know if I eat more I’m going to be uncomfortable. Let’s save some leftovers to eat for lunch tomorrow.”

Critically evaluate the evidence for weight loss treatments and communicate them

Reading this blog is a good start. Question what you see and hear about health. You’re going to see body-focused health messages everywhere! Start talking about them and actively work to change the culture.

“Did you see that article about achieving a “spring break body”? What a crock! All bodies are beach bodies! And it’s not possible to do something that is healthy and sustainable but changes someone’s body over the next two weeks. I wrote a letter to the editor to ask them not to publish misleading and body-shaming articles like that anymore.”

Work to increase access, autonomy and justice for individuals of all sizes

There are several body-positive groups at UNC and lots of simple steps you can take to advocate for more weight-inclusive practices on campus.

“I’m taking the Embody: Carolina training next month. Want to do it with me?”

“I noticed that my department’s offices don’t have chairs that would fit people of all sizes, so I asked the office manager to add a wider chair to the room. The next time I went in, there was a new, larger chair!”

Trust that people move toward greater health when given access to stigma-free health opportunities

UNC is a great place for this. Campus Rec, Campus Health, and Student Wellness staff have all been trained on body-positive principles. And our community offers so many ways to stay healthy!

Want to learn more?

What do you think about this article? What ideas do you have to support health at every size on campus?

Sara Stahlman, MA, is a marketing and communication coordinator at the Campus Health Services at the University of North Carolina at Chapel Hill. She is also a member of the ACHA Healthy Campus Coalition and the ACHA Health Promotion Section.

Toni Hartley, MPH, RD, LDN, is a clinical nutritionist with Lutz, Alexander Nutrition Therapy. Antonia specializes in medical nutrition therapy for people with disordered eating patterns. She promotes Health At Every Size® principles both in her office and in her speaking engagements and practices a non-diet approach.

References

Bacon, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005). Size acceptance and intuitive eating improve health for obese, female, female chronic dieters. Journal of the American Dietetic Association, 105(6), 929-936, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005).

Bacon, L. (2010). Health at every size: The surprise truth about your weight. Dallas, TX: BenBella.Health at every size: The surprising truth about your weight. Dallas, TX: BenBella.

Flegal, K. M., Kit, B. K., Orpana, H., & Graubard, B. I. (2013). Association of allcause mortality with overweight and obesity using standard body mass index categories: a systemic review and meta-analysis. Journal of American Medical Association, 309(1), 71-82.

Leibel, R. L., & Hirsch, J. (1984). Diminished energy requirements in reduced-obese patients. Metabolism: Clinical and Experiential, 33(2), 164-170.

Locke, A. E. et al. (2015). Genetic studies of body mass index yield new insights for obesity biology. Nature, 518(7538) 197-206.

Mann T., Tomiyama J., Westling E., et al. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychology, 62, 220-233.

Neumark-Sztainer, D. (2005). Can we simultaneously work toward the prevention of obesity and eating disorders in children and adolescents? International Journal of Eating Disorders, 38(3), 220-227.

Puhl, R. M., & Brownell, K. D. (2006). Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity, 14(10), 1802-1815.

Schvey, N. A., Puhl, R. M., & Brownell, K. D. (2011). The impact of weight stigma on caloric consumption. Obesity, 19(10), 1957-1962. impact of weight stigma on caloric consumption. Obesity, 19(10), 1957-1962.

Shisslak, C. M., Crago, M., & Estes, L. S. (1995). The spectrum of eating disturbances. International Journal of Eating Disorders, 18(3), 209-219. 

Tylka, T. L., Annunziato, R.W., Burgard, D., Danielsdottir, S., Shuman, E., Davis, C., & Calogero, R.M. (2014). The weight-inclusive versus weight-normative approach to health: evaluating the evidence for prioritizing well-being over weight-loss. Journal of Obesity, 2014(2014), 18 pages.

How to Make Healthy Choices Concerning Alcohol and Other Drugs

Know the Facts
Know the Facts

Enjoying alcohol responsibly can be a healthy part of your college life. When it comes to alcohol and other drugs, the first step in making healthy choices is to understand what you’re putting into your body, what the substance’s effect on your body will be and the potential risks involved. These guides can help you. The second step is to recognize how you personally react to specific substances in various doses. According to the Bowles Center for Alcohol Studies at UNC Chapel Hill, most of the harmful effects of alcohol come from drinking too much. For example, it may be important to know that you should avoid tequila because things get out of control when you start taking shots. The third step is to recognize the situations in which you find it difficult to control yourself or in which you make decisions that you later regret. Do you always end up drinking more than you originally planned when you go out with certain friends? Have you not remembered a single Halloween since you started college except through embarrassing Facebook photos the next day?

The following tips may be helpful if you want to pay more attention to your drinking habits.

Before going out. Let your friends know how much you’re planning to drink before you go out. You can watch out for each other and step in before a friend has had too much. This also requires that you count the number of drinks that you have over the course of an evening, which is always a good thing. You count how many tacos you eat at the food truck, don’t you? Speaking from purely anecdotal evidence, people seem to draw the line at 4 tacos in one sitting.

When you’re out. Don’t accept alcohol or other drugs unless you know what’s in it. Are you really going to drink whatever is in that red cup from that sketchy guy that’s been hitting on you all night? If you don’t know what kind of alcohol, how much alcohol, and what else might be in your drink, politely decline and ask for a Zima. That way they’ll know you’re a person of impeccable taste.

Throughout the night. Alternate alcoholic beverages with water. Alcohol causes dehydration because it’s a diuretic and effects the balance of vitamins and minerals in the body. The liver also requires water to process alcohol, leading to further dehydration. Drinking lots of water throughout the night slows down your drinking, gives your body a chance to process the alcohol, and prevents next-day hangovers.

When school gets stressful. Some students may turn to alcohol and other drugs as a way to cope with stress, which may gradually turn into dependence – and that’s a high price to pay for the temporary respite you might gain. If you are concerned about your alcohol or drug habits, check out the Student Wellness website for resources or write us an email to set up a one on one appointment with a trained staff member. We are here to help.

This blog was originally posted on August 31, 2011. It has been edited for clarity. 

Get outside, UNC! Your outdoor exploration checklist

“Wilderness is not a luxury but a necessity of the human spirit.” -Edward Abbey

The woods and water can be an integral part of your UNC experience. The triangle region is full of outdoor spaces to camp, hike, run, and paddle.

Ask any outdoor enthusiast and these spots will be on their list of adventures while at UNC. Explore them! We start with those closest to campus and swirl outward across the state.

Learn more about these spots – and then, go play outside! (pro tip:Don’t feel comfortable adventuring on your own? Check out Outdoor Rec’s Expeditions! They provide gear, guides and routes for some of these fantastic adventures.) Continue reading

The Importance of a Training Log

It’s a rare occasion for me to walk into the SRC or RHRC and see people working out with a training log.  Why is that?  Writing down and keeping track of each workout is so important to your success.

A training log can really be whatever you want it to be.  If you are always in the weight room, record the exercise you did, how many reps of how much weight and how many sets you performed.  Then, set a goal to lift more and see yourself progress over the weeks.  If you are an elliptical hog (that’s me!), write down the level of intensity or your estimated calories burned (although the machine is not completely accurate!), and set a goal to do the same routine at a higher intensity or burn more calories in the same amount of time.

Here are some reason why keeping a training log is worth doing:

Motivation: After a few weeks, being able to look back on how far you’ve come is so encouraging.  Maybe you can bench press 20 extra pounds or you can run a mile 25 seconds faster.  Looking over your progress will give you the confidence to push even further.

Keep You On Track: If you have a specific goal in mind, keeping a training log will hold you accountable to it.  Sometimes, people will even write down their daily workout routine a week in advanced so that they won’t skip their gym time for a nap or a repeat episode of Jersey Shore (am I the only one who is guilty of this?).  Write down everything so you can push yourself.

Evaluation:  A log will help you see what worked and what didn’t.  Maybe you’ve been stuck doing the same number of deadlifts at the same weight for weeks or your three-mile run hasn’t been getting any faster.  You can evaluate what you need to do to get to your goal, so next time you throw in some extra sets to your routine or do a few sprints during your next run.  And if you are seeing the results you want, perfect!  Keep going!

Help You Switch Things Up: After doing the same routine for a number of weeks, your body gets “used to” the workout.  This can lead to a plateau in your results.  Seeing that you’ve been doing the same old thing for the past month may encourage you to change it up – maybe the order that you typically do each exercise or even the workout entirely.  If you’ve been running a lot, try a spin class.  If you’ve been doing regular pushups, try triceps (aka triangle) pushups.  Keep your muscles guessing!

Reality Check: Let’s be honest – sometimes we don’t train as hard as we think we do.  You were at the gym for an hour, but spent three minutes between each set so it wasn’t that intense.  Writing down everything will help you see what you’ve really done.  You might realize that you do a lot of arm exercises but not enough lower-body exercises.  A log will help you see what you need to do more or less of.

Check out the few examples of training logs below!  But feel free to find one that fits YOU and your routine best!

 

Workout Wednesday blog posts are written by UNC Campus Recreation. Each Wednesday we swap blog posts with the Tar Heel Tone Up blog so that readers can view more diverse post topics that will benefit their health and wellness. Workout Wednesday blog posts can be found both here and on tarheeltoneup.com.

The How’s and What’s of Sun Protection

The best way to defend your skin from damage and long term skin issues is to protect your skin early and often from the sun’s ultraviolet (UV) rays. The most common sun protection method is using a quality sunscreen.t is recommended in a sunscreen?

  • At least SPF 30 (although going above that doesn’t offer much greater protection)
  • Broad spectrum meaning the sunscreen covers both UVA and UVB rays
  • Water resistant is preferable. This is especially important for water exposure or sweating.

How much sunscreen should be applied?

One fluid ounce (enough to fill a shot glass) is the amount generally considered enough to cover exposed body areas, although this varies based on a person’s body size. It is important to apply and rub in to all exposed body areas.

How often to reapply?

Sunscreen should be initially applied 20 minutes before sun exposure and reapplied at least every two hours under “dry conditions” (no contact with water and not sweating).

No sunscreen is truly waterPROOF or sweatPROOF; the sunscreen may be water/sweat RESISTANT. These types of sunscreens work best when applied before getting wet (before being in water or prior to getting sweaty) and should be reapplied every 40-80 minutes if getting wet from water or sweat.

If you are using bug spray, the sunscreen should be applied first, followed by the bug spray; it is best to avoid sunscreen/bug spray combination products because they have different reapplication schedules.

What are the differences between the different sunscreen types – chemical vs. barrier?

Chemical sunscreens (such as oxybenzone) are very popular and work by absorbing and filtering harmful UV radiation from penetrating the skin. This sunscreen type is often colorless and remains as a thin layer on the skin.

Barrier, or physical, sunblocks (such as titanium dioxide or zinc oxide) physically block harmful UV rays from reaching the skin. Barrier sunblock can provide high protection from thsunscreene sun, but a quantitative SPF is difficult to specify. This sunscreen type is more common in formulations for babies because chemical sunscreens can sometimes irritate babies’ skin. Some folks find this sunscreen unfavorable because it does not rub in as well as chemical sunscreens (nor is it supposed to rub in as well in order to function properly!). There are colorful options that can be fun, or you can go for the nose-specific “Dad style” of barrier sunblock application modeled below by The ‘Hoff:

What about parts of my body I can’t apply sunscreen to?

Protect your eyes! Look for sunglasses that promote UV400 protection; these filter out 99.9% of UVA and UVB rays. Lips are not immune to the sun’s rays either; use a lip balm that has SPF protection too.

What about clothing with UV protection?

UPF (Ultraviolet Protection Factor) is similar to SPF in that it is a quantitative system used to describe how much UV protection clothing provides. For reference, most clothing typically has a UPF of ~6, while most sun protective fabrics have a UPF of 30 and others can exceed a UPF of 50! These are great options if you are going to be outside on a boat all day or doing other activities where applying/reapplying sunscreen may be difficult.

What else am I forgetting about sunscreen?

  • Check expiration dates! Yes, sunscreen can expire, and when it does, you will be frustrated and burnt. Expiration date locations on products vary, so be sure to look over bottles before applying! See below for examples of expiration date locations:expiration
  • Apply on cloudy and cold days This is especially important to note for your face when skiing; the white snow can reflect the sun’s rays back up to your face to intensify the damage.
  • Don’t forget the tops of your feet; take off those flip flops when applying sunscreen.
  • Scalps can and do burn. To my fellow short-haired folks: rub in sunscreen to the scalp. If you part your hair, apply sunscreen to the exposed line. Wearing a wide-brimmed hat is a good option or addition for head/scalp sun protection.
  • There are also several makeup brands/products that contain SPF. Give these options a try to protect yourself from your daily excursions into the sun’s harmful rays.

How to treat/manage sunburn if the steps above are not followed?

  • Take cool baths/showers.
  • Apply moisturizer that contains aloe vera or soy to soothe burned areas. You may also apply a thin layer of OTC hydrocortisone to particularly uncomfortable areas to help with redness, itchiness, and inflammation. (Note: do not use hydrocortisone on large areas of the body, not for more than 4 times per day, and not for longer than 2 consecutive weeks.)
  • Drink extra fluids. Water is preferred; alcoholic and caffeinated beverages can actually cause further dehydration.
  • If appropriate, you can also take over-the-counter NSAIDs (ibuprofen or naproxen) to help with pain and reduce inflammation. Be sure to take NSAIDs with food, plenty of fluids, and as directed by the package or your healthcare provider. If you are taking any other medications, ask your pharmacist or healthcare provider to ensure NSAIDs are safe for you to use.
  • Avoid using products that end in “-caine” (such as benzocaine).
  • If your sunburn forms into blisters, do NOT pop the blisters! The blisters are there to aid skin healing and protect against infections.
  • If the sunburn is over a large surface area of your body, or if you are worried an infection has set in, see your healthcare provider to see if prescription medications are warranted.

Can some medications that can enhance sunburn possibility?

Yes! Several medications can enhance sunlight sensitivity of your skin. Check medication labels and/or ask your pharmacist or healthcare provider if medications you take can cause increased risk of sunburn. Examples of common medications that can have this side effect include:  Tetracyclines (e.g., doxycycline, minocycline); Thiazides (e.g., HCTZ); Sulfonamides (e.g., sulfamethoxazole/trimethoprim); Phenothiazines (e.g., promethazine); Quinolones (e.g., ciprofloxacin, levofloxacin). If you are taking any of these medications, be sure to take special care of your skin by wearing sun-protective clothing and reapplying sunscreen with any sun exposure for the entire duration you take the medication and even a few days after your last dose.HHS Sunscreen

Be sure to look for SPF 30+ products available at the Health Heels Shoppe in the basement of UNC Campus Health Services (see photo below) and at the Pit Stop at UNC Student Stores for your sun protection needs.

 

 

John Taylor Schimmelfing is a Pharmacist at Campus Health Services. John graduated from Elon before obtaining his PharmD from the UNC Eshelman School of Pharmacy. He also happens to be a National, World and Junior Olympic jump rope champion, which clearly qualifies him as an expert on all things jump rope related such as whether jump rope is two words or one (it’s two!). 

Sources:  American Academy of Dermatology; American Melanoma Foundation

Exercise While Studying!

It’s exam time and that means hours and hours of sitting while staring at a book or computer screen. Taking short exercise breaks is a great way to refresh your mind and feel rejuvenated. Hopefully, you can still make it to the gym like usual. But if you feel trapped in your room or the study lounge, don’t hesitate to push out some of these moves!

For these moves, you don’t need any equipment – you can just use your bodyweight! You can tone from head to toe by just taking a few steps away from your desk.

ARMS: Dips, Push-Upsguy_pushup_down_position

LEGS: Wall Sit, Lunges; SquatS

ABS: 
Bicycle Crunch, Plank

 

Just remember, both gyms are operating have different hours during exam time. Click here for the schedule. Also, there are fewer group fitness classes then normal so check out those updated schedules as well! While you’re studying, don’t forget to eat healthy snacks for focus, take breaks here and there and stay hydrated (especially if you’re drinking a lot of caffeine!).

 

Workout Wednesday blog posts are written by UNC Campus Recreation. Each Wednesday we swap blog posts with the Tar Heel Tone Up blog so that readers can view more diverse post topics that will benefit their health and wellness. Workout Wednesday blog posts can be found both here and on tarheeltoneup.com.

Pre- and Post- Workout Nutrition

Protein shakes, whey protein powder… But when do you use these?  Before or after exercising?  How do you fuel up for a workout and how do you help your muscles recover?

Ms. Mary Ellen Bingham, MS, RD, CSSD, head sports nutritionist at UNC, recommends “book-ending”.  This means you eat something small both before and after your workout.  To fuel up and in order to have enough energy to get through your time at the gym, eat within about an hour prior to exercising.  Then, eat again within 30 minutes – don’t wait until lunch or dinner time to eat.  These don’t have to be complete meals, but more so, snacks.

Check out the image below on nutrient timing that Ms. Bingham created. (Click for larger image).

For pre-workout, carbs will give you the energy to push yourself and not get exhausted.  Try crackers or toast with peanut butter, fruit, a small granola bar or a handful of pretzels.  Post-workout, you want to refuel your muscles.  First and foremost, make sure to drink water!  All that sweat is going to leave you dehydrated, so you need to be drinking before, during and after your workout.  Additionally, have a combination of both carbs and protein such as trail mix, a sports bar, a smoothie or – the classic drink that promotes fast muscle recovery – low-fat chocolate milk.

Previously, I interviewed Dr. Abbie Smith, an assistant EXSS professor.  If you read this interview (I don’t want to repeat it all!), you’ll find other similar advice.  Dr. Smith gave me nutritional advice for those trying to gain muscle, those trying to lose fat, what “cheat days” are all about and supplement information.  That blog post is extremely informative and can clear up some further questions you may have about nutrition for athletes.

So, if they’re right for you, continue with your protein shakes, nutrition bars or whatever your usual pre/post workout snack may be!  Remember – carbs before and a combination of carbs and protein after.

 

Workout Wednesday blog posts are written by UNC Campus Recreation. Each Wednesday we swap blog posts with the Tar Heel Tone Up blog so that readers can view more diverse post topics that will benefit their health and wellness. Workout Wednesday blog posts can be found both here and on tarheeltoneup.com.

Workout Wednesday: 5 Things to Bring to the Gym

What should you bring to the gym other than your sneakers and some clothes that you can break a sweat in?  To help make every workout successful and enjoyable, here are five items to bring along with you.

  1. Headphones – Nobody wants to hear Kanye West blasting through your headphones while you’re on the rowing machine.  But listening to music while your exercise is important – just do it at a volume that won’t make you half-deaf!  It’ll help get you through a tough workout and keep you from getting bored.  One of my favorite ways to workout is to push your hardest during each chorus and recover during the rest of the song.  By the time your favorite playlist is over, an hour will have already passed and it’ll be time to hit the shower.
  2. Water Bottle – Drinking water while you exercise is essential.  Of course, you need to hydrate before working out, but continue to do so while you’re sweating buckets.  This will keep your energy high and body fueled.  If you’re working out for more than an hour, consider filling your water bottle with a sports drink!
  3. Towel – This one is easy.  You don’t even have to remember to throw one into your bag.  You can check out a towel at the gym!  When you hand over your One Card to be swiped into the gym, ask for a towel.  Then simply return it when you leave – and be sure to have an employee swipe your card again or you might get charged!
  4. Smart Phone – Ignore the texts and Facebook notifications.  Click here to check out some the latest and greatest apps for your workout.  Your phone can be a great tool to keep you focused on your goals and to help you see results quicker!
  5. Snack – If you’re hitting up the gym between classes or have a meeting to go to after your sweat session, you may not have time to stop by your dorm and grab a bite to eat.  Post-workout nutrition is incredibly important!  Getting a combination of carbohydrates and protein (ideally a 3:1 ratio) will help your muscles recover and rebuild.  Pack a protein bar, a small turkey sandwich or some trail mix.  After you finish on the treadmill and head out the door to whatever your next appointment is, eat a little something.

If you’ve got all these items packed, you will be rockin’ your next workout at the gym.

Workout Wednesday blog posts are written by UNC Campus Recreation. Each Wednesday we swap blog posts with the Tar Heel Tone Up blog so that readers can view more diverse post topics that will benefit their health and wellness. Workout Wednesday blog posts can be found both here and on tarheeltoneup.com.

Power Poses to Challenge Self-Doubt

This blog post was originally published on March 24, 2015.

I’ve heard it called Impostor Phenomenon or sometimes Impostor Syndrome, but it tends to announce itself more like…”OH MY GAH, YOU HAVE NO IDEA WHAT YOU’RE DOING DO YOU?! SOMEONE ELSE WOULD HAVE KNOWN EXACTLY WHAT TO DO AND WOULD HAVE DONE THIS WAAAAAY BETTER. THEY’RE GONNA KNOW! THEY’RE ALL GONNA KNOW!” …At least that’s how it shows up in my head.

But whatever you call it, false feelings of not-good-enoughness are pretty common. Google it. Some researchers estimate that as many as 70% of people feel this way at some point in their lives. And while it can happen to anyone, researchers find this phenomenon especially common in women, people of ethnic and racial minorities, and anyone who’s trying something new or who feels different from the people around them.

Common or not, these automatic thoughts of impostordom can stall or stunt a person’s progress in life in major ways. And fears of having one’s “shortcomings” “found out” can keep folks from reaching out and connecting with others who could help.

There are a lot of theories out there about where this comes from and lots of advice for what to do about it, but I happened upon a TED talk the other day that gives scientific evidence to something I’ve learned doing theater.

ITC ensemble members using Image Theater techniques.
ITC ensemble members using Image Theater techniques.

With Interactive Theatre Carolina, we use a range of theatrical tools to help folks better understand themselves and discuss the world we live in. One technique we use is Forum Theatre—sometimes called a “rehearsal for real life,” which seeks to empower regular folks to make courageous and healthy choices by practicing changing the outcomes of problematic scenarios. Another technique we use is called Image Theatre, in which participants strike poses and audience members discuss and analyze the stories and associations the body postures convey. A “picture’s worth a thousand words,” right?

This TED talk references a study in which Amy Cuddy, a social psychologist and researcher at Harvard Business School, reports findings that support that rehearsing for real life…is also real life. She finds that changing our body language not only influences the messages we send to others but also the messages we send to ourselves at the chemical level.

In short, striking powerful poses (poses that open the body and take up space) alters hormone levels—increasing testosterone and decreasing cortisol (a stress hormone)—which results in a person actually feeling more powerful. The opposite happens, as you might imagine, when a person strikes a low-power pose (body closed off and made small). These changes are measurable and almost instant; Cuddy’s subjects only held the poses for 2 minutes.

Will striking a power pose and altering my brain chemistry suddenly make me capable of being the next president? Highly unlikely. But could striking a power pose for a few minutes before leading a presentation help me interrupt some negative self-talk that might otherwise hold me back? Probably.

Check out some of the articles embedded and below for other strategies to get past fears of being an impostor in your own life. If you’ll excuse me, I’m going to stand like a starfish for the next 2 minutes and have a brave afternoon.