You say, “tomato,” I say, “That’s bad-ass.”

A girl I’ve known for many years now as That Chick Who Does Everything That I Would Do If I Were Slightly More Athletic and Less Afraid of Competition posted some pictures of herself doing New and Different Athletic Things—namely rolling tires as tall as her—and, as usual, I had one of those jealous moments where I thought, Why don’t I roll large tires around? What kind of mediocre fitness have I been doing up ‘til now?  I’ve come to terms with the fact, of course, that these types of feats aren’t meant for me.  The last time I took a boxing lesson, the most bad-ass athleticism I’ve attempted, I left in tears.  Note, too, though, that the last time I took a strength-training class involving very light weights taught by one of my best friends, I also burst into tears.  Yes, I’m a bit of a pansy. Anyway, all of this is to say that normally I stalk her Facebook page to allow myself to live vicariously through her triathlon victories and sparring with various large, heavy objects, then go off to do the same ol’ pushups I normally do.  You know what?  It works for me.  We all get our jollies somehow.

Anyway, we’ve talked a bit recently about the fact that she started taking some medication that caused her to gain weight, and how it’s been a bit of a mind-fuck (my language, not hers) because she’s always been the person who’s very conscientious about nutrition and exercise and, at points, been struggling to stay out of the land of overly-restrictive eating disorders.  Now, all of a sudden she’s overweight and boom—she has this physical body that contradicts the internal identity she’s held since her teen years.

Now, I don’t know the specific details of her health at this point, but from what I’m seeing on Facebook and hearing in our general conversations, she’s still “healthy”—I mean, hello, moving massive tires, people!—but because we do often focus on body shape and body fat to gauge health, it made me wonder how we as individuals do quantify health for ourselves.

And I’d like to put emphasis on this word, “ourselves.”  Once, I got into a discussion with a friend about another friend who’d undergone significant weight loss (20 or so pounds) and general lifestyle changes in the time we’d known her.  I’d been arguing that the third party still didn’t necessarily have perspective of what it’s like to really alter your lifestyle because even when she was “unhealthy” she was “healthy” by others’ standards—she never, gasp, wore pants that were a double digit size, for instance, worked out regularly, understood proper nutrition, etc.  She’d never been so unhealthy that she had to really shift her mindset to get healthy, or, perhaps more importantly to me at the time, she’d never been in a position where her appearance caused others to stigmatize her for her perceived healthfulness or lack thereof.  To me, she was a skinny fit girl who just didn’t live up to her really high standards of skinniness and fitness.

The friend I was talking to responded with a strong argument: even if it doesn’t seem to others that the girl in question was unhealthy, in her own perspective she was unhealthy and out-of-control from her norm.  And as much as I’d like to make believe size doesn’t matter ever, I know that my body is a different shape when I’m taking good care of myself and when I’m not taking care of myself—although by some people’s standards, both versions of me might still seem “healthy” or both “unhealthy.”  The only person anyone can gauge herself against is her own self. (And, on that note, the only person one can judge fairly is herself as well.)

Similarly, the moment that drove me to start exercising—and I’m not entirely sure I understand my logic to this day—was sometime after my first year of college.  I’d gained a lot of weight my freshman year from a love of bagels with peanut butter, Baby Ruths, and watching every episode of Daria on my computer between classes.  Anyway, I gave blood while visiting my parents on some break or another, and when the nurse ran the typical vitals before throwing me on the chair, she took my pulse.  “Wow,” she said.  “Do you run? Your pulse is 60. You must be in good shape.”  Since I was in the worst shape of my life, healthy by no stretch of the imagination, I wondered what would happen if I actually got off my butt and started running a few days a week.  Turns out my resting heart rate hovers in the high 40s during the day when I take care of myself.  60 beats per minute means my body’s undergoing stress.  It’s not good or bad; I come from a people with sluggish hearts.  But, my point is: our measures of health are relative, whether you talk about size or other methods of measurement. 

That friend I mentioned in the beginning presents an interesting question, then: when you’ve gotten to know certain signposts of health for yourself—whether you weigh X pounds, have Y blood pressure, can run Z miles in a row—and something shifts so those signposts are no longer relevant, how do you figure out what’s healthy at this point?  Women often see this shift as they age—My metabolism isn’t what it used to be is a common refrain, as is My arms used to be so toned, but now I have these turkey wings.

One philosophy that I ascribe to is the concept of Health at Every Size, in part because the focus of those who practice HAES is that following healthy habits ultimately helps improve health, regardless of changes in weight.  In an article for the Huffington Post discussing HAES, researcher Linda Bacon writes, “Compared to control groups of people on weight loss programs, people who accept themselves and their bodies as they are tend to exercise more and eat better. They do better medically, on blood pressure, cholesterol, insulin sensitivity and similar measures, and feel happier in the long run. They adopt longer-lasting exercise habits. And guess which group weighs less, two years out? Neither! In the HAES study I conducted, both groups ended up with weights where they started, albeit with the dieters having endured another wearying and health-damaging deprivation-loss-regain cycle.”

Which leads me to ask: how often are our measures of health actually byproducts of health, the results or symptoms of maintaining healthy habits?  We come to assume that if we put in a specific amount of change in the health vending machine (aka, our bodies), we will get our treat of choice (waist size X/blood pressure Y/body fat  Z)—if I do this much cardio every day and eat this kind of salad for lunch, my body will respond in some predetermined fashion.  We expect a regimented, “if, then” sequencing where we can predict the outcomes easily, and therefore use the presumed outcomes as our measure of our progress rather than looking at the factors we can control and measure—the dietary choices, the exercise, the amount of sleep, and so on.  And, for the most part, this method works, as long as we know our bodies well, know how they function when we treat them properly and how they function when we don’t.  Sometimes, though, the outcome does come in an unexpected form, like those study participants who stayed the same weight but improved their insulin sensitivity, cholesterol, etc.

And, frequently, a wrench gets thrown in the way—a medication that causes weight gain, or bone spurs in your feet that make the running and step classes you used to love unbearably painful, or a downward shift in the metabolism that happens with age—and you have to reassess.  Are you really that much less healthy than before, or did the conversion formula, the way your body turns input to output, change?  How do you know whether you need to change your habits—maybe they weren’t good enough, maybe you were just sliding by in the way that 20-somethings can—or do you need to change your understanding of your body?

The US Department of Health and Human Services explains health maintenance simply: “The more risk factors you have, the more likely you are to get the disease.  For instance, if you eat healthy, exercise regularly, and control your blood pressure, your chances of getting heart disease are less than if you are diabetic, a smoker, and inactive.” (page 4)  In other words, each little piece adds up.  And while one factor may shift, that doesn’t mean all the others are suddenly negated.

Oftentimes I’ll see seemingly fit and healthy women in the club, and they’ll talk about how unhealthy they’ve gotten recently.  We’ll do their measurements, take their blood pressure and maybe do some strength and cardio assessments, and, guess what!  They’re still healthy, just not healthy for them.  But consider this: according to the World Health Organization and the National Institute of Health, the healthy range of body fat percentage is 21% to 33% for women between 20 and 40, 23% and 35% for women between 40 and 60, and 24% and 36% for women over 60. These ranges are fairly broad, so someone who measures her health by her body fat percentage could go from, say, 21% body fat to 27%, and still be considered healthy by general standards, while she may have gained a clothing size or two.

Even considering the “healthy habit input” rather than the “output,” we get a fair amount of wiggle room for what’s healthy.  According to the American College of Sports Medicine, the recommended amount of physical activity is between 20 to 60 minutes of exercise that gets your heart rate up to 55 to 90 percent of its maximum 3 to 5 days a week.  (Governmental guidelines are more vague: 30 minutes of moderate activity most days of the week.)  Fun fact: using maximum heart rate to determine aerobic fitness is not an exact science—some people can function at a higher heart rate than expected by equations, some lower, or some can be right on par but take much longer than average to recover from exertion.  So, once again, I may still work out 45 minutes a day, 3 days a week, and be healthy by standard guidelines, but I may not exercise at the same intensity, or maybe I used to work out 60 minutes 5 days a week. 

In short, there are many ways to gauge health and fitness, from person to person, but also within our own standards, over our lifespan. Recognizing this variability ultimately makes health more accessible—what’s healthy for your personal trainer may not be exactly what’s healthy for you, nor what was healthy for you two or ten years ago may be healthy for you now; this isn’t an excuse to slack off on the exercise front and just eat donuts. Instead, acknowledging strengths, weaknesses, and obstacles allow you to better set realistic goals and maintain motivation along the way. 

So: How do you judge your health?  What form has “healthy” taken for you over the years?  Where have you done well, and what could you do better?

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