Last week we spoke about the importance of visualising our health and well-being in 5-10 years’ time.  What is our goal for the future?  What do we still want to accomplish?  How do we still want to be an active part of the future of our family? To change destructive or damaging behaviour is challenging, but the first place to start is by setting long-term goals.

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Fear is not a long-term motivator for change.  We can’t sustain a fearful approach to life and problems.  When the immediate danger is over, we tend to revert to our old behaviours.  How often when we are first informed that we have diabetes, or cancer or high cholesterol, anxiety drives us to want to change our lives.  But after a while, when the immediate shock subsides, we become lax in our restrictive commitments, and gradually slide back into the old ways. This is where having a mentor, or coach or support person is important – someone who can hold us to account in a firm but gentle way.

Unfortunately, it is not a good idea to use your spouse or parent, because you are likely to feel judged and criticised if you don’t keep to your promises. The concept of health coaching is catching on in South Africa and already an association of professional health coaches is being developed. The American College of Lifestyle Medicine provides on-line certification for these valuable resource people. 

In some places personal trainers take on that role.  But it could be your best friend, or a family member who has a similar interest in healthier living that can be your companion and keep you accountable. It is helpful if we can sit down with a mentor – a friend or supportive family member and work out a strategy of what we want to accomplish.  Keep in mind your long term goals, but then break that down into small steps along the pathway to that goal.

Sometimes the big picture can be daunting, and we give up in discouragement with the enormity of what we have to accomplish. 

The best approach is the SMART approach:

• Specific – develop specific steps in your mind. By being specific you are able to hold yourself accountable. For instance “I will eat a healthy breakfast every day;  I will exercise every day; I will get adequate sleep every night.”  It is helpful if it can be as specific as to what you will eat – helps you to make sure you buy the ingredients ahead of time; who you will walk with and when and where you will do it; when you need to start getting ready for bed – until how late you will watch TV.  These make your plans easier to implement.
• Measurable – if your commitments are measurable, you can assess your success e.g. ” I plan to walk an extra 5 minutes each day; I plan to replace my sugary drink with water 5 days per week; I plan to get to bed by 10pm every night of the week.” It is helpful to have a chart or graph that you can plot to record your progress.
• Attainable – You know what you are capable of achieving. You may set a goal to lose 10 kg, but when you find you are not even managing to lose 1 kg over a period of time, you become discouraged.  It would be better to work on small steps that you know you can achieve, maybe with a bit of help and encouragement.  There is nothing that breeds success like success.
• Relevant – work on things that are relevant to your goals. What are the changes that are going to make the biggest difference to the outcome – e.g. perhaps cutting back on the amount of fat in your diet is going to give you a quicker outcome than replacing sugar with whole foods.  Look for behaviours that fit in with your lifestyle and what you feel comfortable doing.  Keep in mind issues of safety and weather, time frames and family responsibilities in making your choices.
• Time-bound – set short-term goals e.g. “I will work on one week at a time, exercising 5 days this week. I plan to lose 2 kg by such and such a date.”  By providing a time frame, you have something definite to work towards.

Here is a useful article to explore the SMART approach in more depth: Next week we will look at how to deal with some of the excuses that we come up with in our quest to improve our health.  These are so often the causes of failure in our New Years’ resolutions. Stay well. Dave Glass

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital. He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology. An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc. He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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