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Other/Mixed Feedback Request-Health/Wellness Curriculum

Other strength modalities (e.g., Clubs), mixed strength modalities (e.g., combined kettlebell and barbell), other goals (flexibility)
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Snowman

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I'm a first year medical student, and I have a bit of a pet project that I'm working on. My goal is to develop the curriculum for a health and wellness program by the time I graduate medical school, to include presentations, handouts, a resource directory, etc. The idea is that, wherever I end up after school, I'll be able to make a meaningful contribution to current health and wellness program, or even start one from scratch if need be. I also see it as an opportunity to "canonize" my knowledge, some of which is fact, and some of which is theoretical, and really examine what I believe. I fully expect this project to take the entire four years I have ahead of me, mostly making progress in fits and starts during academic breaks. That being said, the more feedback I get along the way, the more effectively I can shape the content to communicate what I want it to.

The only thing I have developed thus far is a booklet (about 20 pages), and that is what I have posted a link to. Before I explain what the booklet is, and what it isn't, I would like to make a request. Please be respectful of the fact that this is the very beginning of a long developmental process. It is an "immature" product, so to speak, and not ready for unlimited public consumption. I simply ask that, if you want to share this content, share this thread, not the bare content, out-of-context. I have the Google Doc set up so that it is "view only," so if you would like to make a comment (which I strongly encourage), you will have to make it within this thread.

What this booklet is:
  • A basic set of instructions for improving habitual behaviors regarding stress, nutrition, activity, and sleep, based on the common principles of many different, successful practices
  • A "just do this" set of instructions, comprised mostly of actionable guidelines, and minimal technical explanations
  • A product that can be handed out after, or in conjunction with, a period of more in-depth instruction
  • A sort of "functional summary" if you will
What this booklet is not:
  • A complete text encompassing all aspects of healthy living
  • An in depth comparison of various different diets, training programs, etc
  • A stand-alone resource for, well, anything
Disclaimer: I am not a doctor. Assuming I don't screw things up for the next four years, I will be, but I am definitely not one now. I am not the original author/developer of any of the content; it is only "mine" in regard to the specific way I have compiled and presented it.

I am open to any and all feedback. Even if you aren't sure if it's pertinent, the feedback I get will not only be guiding the evolution of my booklet, but also the development of the rest of the material I am going to produce over the next few years. I want to know what your questions are, what you did or didn't like, what strikes you as odd, where I got too wordy, and where my explanations are lacking. Due to my rather full schedule, I may not be able to promptly respond in-depth to all questions, but I will certainly (eventually) reply to all comments to the best of my ability.

Health and Wellness Booklet
 
I am not a doctor, just a knucklehead, but as a long time sufferer of myriad sleep disorders, I am pleased to see you have included a treatment of blue light, which I find is left off of almost every "sleep hygiene" list I see in popular media.
 
Thanks, @aciampa! As I move on to developing more "classroom" material in the next few years, you might be getting an email or two from me ;)
 
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@Snowman The booklet was a pleasure to read. Lots of good, practical info while staying within a layman's grasping of the subject matter. The "voice" you used also keeps the reader's attention and doesn't read like a set of dishwasher instructions. I've read through and I'll try to give you some feedback:

I really enjoyed your "uncompromising" stance on strength training (pg 15) and I firmly agree. There's a tragic unawareness of the role of strength especially within the elderly demographic. It's also a tough message to convey, which I think you've done really well.
(pg 16) Thank you for saying if it's been a while, or you don't know what you're doing, hire a coach. I also like how you've differentiated between exercise and non-excerise. When my patients tell me they've exercised by taking the stairs, I tell them "that's not exercise, that's life."
(pg 18) The sleep info is also very practical. I once read someone say: the bedroom is for sleeping and screwing, and that other noise/distractions can be detrimental to a good night's rest. I'm not completely on board with the Melatonin supplement recommendation. You've provided a myriad of actionable items for someone to have a better night's sleep without supplementation and adding that in afterwards, IMHO, sends the message "... or there's this pill..." Tragically, nowadays the general population is more comfortable knocking back pills than following the practical recommendations you provided. (full disclosure: I'm not a fan of exogenous melatonin supplementation. the clinical evidence behind it is very weak and it's often used as an umbrella supplement although many sleep disorders aren't affected by exogenous melatonin supplementation)

Grammatically, I'm no expert and it looks great, but perhaps there's a few too many non-essential words & clauses (I believe it's called). For instance, you use "however" in most paragraphs and sometimes even 2-3 times. And the other thing is "comma splicing." (I was notorious for these in college and my lady friend, who is a native German, is still). There's a few instances where the comma placement is unnecessary.

I hope this will be of some help to you. That's a great piece of literature you've put together. Keep it up, man!
 
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Thanks for the feedback @SolidBrawn! I went ahead and cut out some of the unnecessary "howevers" and I'll have to keep the commas and other extra words in mind as continue to edit it. I know I tend to be pretty comma happy, and it still gets me.
I revised the paragraph on melatonin a little. I want to address it, since it's something that a lot of people seem to know about and use anyways. The point that I want to make about it is that there is an appropriate way to use it, but it can very easily be misused. I don't want to totally disregard it, because I think infrequent doses can help people manage things like jet lag and night shift work. The ultimate goal is to be able to fall asleep and wake up based solely on an appropriately tuned circadian rhythm, which is really what I'm trying to communicate with that section.
 
Good question, @MattM. There are two things to be concerned about with morning carbohydrate intake.

1) When you wake up, your body is in a fasted state, and is predominantly using body fat for energy. Once you eat carbs, your blood sugar increases and your body switches over to predominantly using the carbohydrate for energy. Your body can switch back to using fat, but it can take a while. How long it takes depends on the individual. The nice thing about delaying carb intake is that it teaches the body to burn fat better.

2) This second point doesn't apply to everyone, but it's significant for the people it does apply to. If your body isn't good at stabilizing your post-meal blood sugar, your blood sugar can drop a little too low after eating starch or sugar. This stimulates hunger, specifically a desire to eat more starch or sugar. This means that, after the first time you eat carbs, you can spend the rest of the day bouncing between craving carbs and eating carbs. This can really cause a problem if you end up having 4 or more separate servings of starch or sugar on a daily basis, because it can start to feed the cycle of high insulin levels and insulin insensitivity. Luckily, it's really easy to tell if this applies to you or not. Do you eat carbs with 3 or fewer meals per day? Notice I asked "Do you?" not "Can you if you had to?" My very general advice is to delay carb intake long enough that you only end up eating 3 servings or fewer per day. For some people this is 7 am, for others it's 7 pm.

If you're confident that your body effectively burns fat, and you don't get locked into an eat/crave cycle after breakfast, then don't worry about it :). There is a connection between those two things, by the way. Rarely will you find a great fat burner who craves carbs, or vice versa.
 
Matt, you have an exceptionally keen understanding of how the body works already, and a fantastic ability to communicate it. I think you will be a great doctor!
 
Thanks @Anna C! It's exciting to be starting the next part of the process. There's still so much to learn! I suppose that never changes though :)
 
Well @MattM, adjusting is what it's all about. Finding the best intersection between what you enjoy doing and what you "should" do. It's often a moving target, so that keeps it interesting ;)
 
Matt, Great work - really nice actionable steps.

My only question would be - does the fasting belong? I know it is only in there as a bonus, I would say it is still a bit controversial and not everyone does well on it (I'm a hideous rebound eater after fasting so I steer well clear now).

I reckon you could put the sleep section in bold.
 
My only question would be - does the fasting belong? I know it is only in there as a bonus, I would say it is still a bit controversial and not everyone does well on it (I'm a hideous rebound eater after fasting so I steer well clear now).

You're not wrong, the section on IF is probably the most controversial part of the booklet, but I think it's important to take note of different approaches to IF. There's the weight loss approach, and the lifelong health approach (and of course the entire continuum in between).

The weight loss approach goes something like this: I decide I want to lose weight, and that IF is a good way to do it. I decide that I'm going start using the 16/8 format, starting on Monday. I wake up Monday, and instead of my normal breakfast of cold cereal, I just have coffee. I don't eat anything until lunch, and spend most of my morning tired, crabby, and cold. I finally eat lunch at noon. I feel good for an hour, but then my energy drops again, like I ate an entire Christmas dinner for lunch instead of just a chef's salad. I power through it, but I end up eating some kind of snack every hour or two until I finally make if home for dinner. I have a great big dinner, congratulate myself on a successful day of fasting, and commit to doing it 6 days a week until I'm at my target weight.

The lifelong health approach looks more like this: I decide I want to adopt some healthier habits, and that IF is on the list of healthy habits. I decide that I'm going start using the 16/8 format, starting on Monday. I wake up Monday, and instead of my normal breakfast of cold cereal, I have coffee, and grab a couple hard boiled eggs to eat when I get hungry. Not surprisingly, I get hungry about an hour and a half after my normal breakfast time. So I eat my eggs. I feel pretty satiated all morning, and when I do get little hunger pangs they go away when I drink some water. I eat a chef's salad for lunch, and I feel pretty good for most of the afternoon. I get the munchies around 3 or 4, so I have a handful of almonds, and that carries me through to dinner, which is a little bigger than normal, but not too much. I feel satisfied that I made a small change today and that my body responded pretty well. Hopefully in a month or two I'll be fasting for a full 16 hours a day for most day of the week.

I went back and made some edits to the fasting section to clarify that I'm after the second approach. Painless and slow. I think many people who try the first approach end up having a pretty negative experience, and don't get much out of it in the long term (I'm not saying this is what happened with you, obviously I have no idea how you approached it). Ironically, out of everything I suggest in the booklet, fasting is the thing with the most research backing up its efficacy in regard to health and longevity. If there was any single drug with as much positive research behind it, we would all be on it, but fasting is perceived as "hard," and "weird," and "that thing my crazy orthodox grandmother does all the time". The benefits, in my opinion, are truly too good to miss out on. Even an "easy fasting" approach that never goes farther than doing 16/8 three times a week, while you don't get the maximum benefit, is far better than nothing. Fasting turns on a number of beneficial metabolic and immune "switches" that rarely get turned on otherwise. You can certainly mimic certain parts of fasting using things like a ketogenic diet or multi-hour endurance endeavors, but that level of discipline and focus is probably out of reach for a large portion of my "target audience."
 
The weight loss approach goes something like this: I decide I want to lose weight, and that IF is a good way to do it. I decide that I'm going start using the 16/8 format, starting on Monday. I wake up Monday, and instead of my normal breakfast of cold cereal, I just have coffee. I don't eat anything until lunch, and spend most of my morning tired, crabby, and cold. I finally eat lunch at noon. I feel good for an hour, but then my energy drops again, like I ate an entire Christmas dinner for lunch instead of just a chef's salad. I power through it, but I end up eating some kind of snack every hour or two until I finally make if home for dinner. I have a great big dinner, congratulate myself on a successful day of fasting, and commit to doing it 6 days a week until I'm at my target weight.

I feel like you know me well.......
 
Simply wow!
Short, to the point, easily actionable!

Don't get tempted in the future to add more stuff, keep this format and you have a winner!

There are a few typos, a few misplaced or missing words, and a few "uncomfortable" phrases, but that is completely expected. Keep it up, and have it reviewed and proofread once ready for production by a professional editor and you'll be good!
 
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