Toasted ravioli and barbeque, two of the foods St. Louis is most famous for, fly in the face of healthy eating guidelines according to a new landmark study covered in a recent St Louis Post-Dispatch article. Known as the EAT-Lancet Commission report, the study calls for doubling the consumption of fruits, vegetables, legumes and nuts and a significant reduction in the amount of meat and sugar we take in.
As a health coach, this got me thinking about how my hometown of St Louis and the great State of Missouri stack up against these recommendations and, generally, how healthy and happy we are here.
Intuition told me that we might not fare so well. But once I dug into the mounds of research on the topic I was totally floored by how far off the mark we are on so many measures.
Missouri is near the bottom of the heap when it comes to overall health, according to America’s Health Rankings® Annual Report, the longest-running assessment of its kind, which looks at 35 different parameters of health. We rank 40th out of 50 states and it’s only gotten worse over the years. In 1990, we were at least in the middle of the pack at 24th.
The silver lining in all of this is that, as individuals, it is eminently within our power to avoid becoming one of these troubling statistics and to live healthy, balanced lives. We’ll explore how in a bit. But first let’s look at the underlying diet, exercise and other lifestyle patterns that have contributed to this disheartening state of affairs.
For starters, St Louis ranks second in the nation in per capita consumption of red meat. Considering that Americans eat four times more meat than the world average, that’s astounding. Add to that our state’s penchant for fast food, and it’s easy to see where this is headed. Missouri has some of the worst dietary habits in the country, with just over half of adults eating fruit once a day (11th lowest), and we rank in the top 10 in adult obesity. Even more disturbing is that the obesity rate in the Show Me State has nearly tripled since 1990. Tripled! Today, nearly one in three adults here has a body mass index (BMI) of 30 or more, the standard measure of obesity. And, if we look at adults 45 to 65 years old, a period when lifestyle-related diseases really start to take hold and a time when we must work ever harder to keep those extra pounds at bay, the obesity rate jumps to 39 percent. That’s on par with the average rate in West Virginia, our Union’s most obese state.
Of course, diet is just part of the equation impacting whole health. Regular physical activity is also crucial for staving off disease and the ill effects of aging. Here again, we lag most of the country, ranking 33rd out of 50 in the percentage of people who engage in physical activity beyond their regular jobs. Sadly, it’s the exercise habits of women that are largely responsible for this dismal showing. Nearly 29 percent of men meet recommended federal guidelines for aerobic and muscle-strengthening through leisure-time activities, which is higher than the overall national average, but less than 18 percent of women do. Since so many of my health coaching and fitness clients are female, this truly pains me.
So, with all this said, is it any wonder that Missouri ranks in the top 10 states for major cardiovascular disease? Or that we spend an astronomical $3.2 billion a year treating heart disease, stroke and hypertension, all diseases that are largely preventable. According to a 2018 study published in the journal JAMA Cardiology, 80 percent of heart disease cases in the United States were linked to lifestyle factors such as unhealthy weight, high BMI, high cholesterol, smoking, low physical activity and alcohol use. And lousy eating habits and poor physical fitness lead to other devastating diseases. Chief among them is diabetes, which impacts almost 700,000 people in Missouri, with another 1.6 million suffering from prediabetes. In fact, about 32,000 people in our state are diagnosed with diabetes every year, and the rate of diabetes here has nearly tripled since 1996. It’s a disease with potentially serious complications, including heart disease, stroke, amputation, end-stage kidney disease, blindness and death. Compounding the personal health costs is the whopping $5.9 billion we spend each year treating diabetes and prediabetes in Missouri alone.
Physical well-being isn’t the only aspect of ourselves that suffers when we don’t eat right and exercise. There’s no shortage of studies linking inactivity to depression. And obese people have a 55 percent increased risk of developing depression over time  and show lower cognitive performance even after controlling for other risk factors. So how does Missouri fare when it comes to mental health? Sadly, here’s where we make another troublesome top 10 list – the nation’s unhappiest states. It’s likely not a coincidence that our most obese state, West Virginia, is also our saddest.
These statistics are enough to make any one of us melancholy, my fellow Missourians. But I promised a silver lining, and here it is. We don’t have to be obese, we don’t have to be sedentary. We can change those ingrained habits that lead to disease, depression and suffering. As a certified whole health coach, I’ve seen it happen time and again.
The answer lies not in fad diets, extreme exercise routines or painful self-deprivation, but in a steady, balanced approach to whole health that incorporates sensible eating, regular exercise and sound stress management. My clients typically lose one to two pounds a week, which is the most sustainable way to lose weight and keep it off over one’s lifetime.
I work with my health coaching clients in a conversation setting, often in small groups, and stress the following principles.
Find your WhyPower (sm) – This tenet is so central to what I teach that I named my company after it. Too many people attempt to rely on willpower to achieve their goals, which is really the foundation of New Year’s resolutions, 80 percent of which are out the window by mid-February. But willpower is fleeting. We may have it in the morning but by the end of a long, hard day it dissipates and we find ourselves plopped in front of the TV scarfing down a quart of ice cream.
WhyPower, on the other hand, is a precept that sticks with you. I work with my clients to connect their weight loss and fitness goals with something larger, something that they truly value in life. I ask them to articulate in a few easy to remember words, why they want to make shifts. One great example is the 40-something mother with two small children who was so heavy that she had trouble getting up off the floor after playing with them. Her WhyPower mantra became “I want to be a fit mom, not a fat mom.” (Her words.) She lost more than 50 pounds. Another one is a 70-year-old, diabetic woman who wanted to “live actively and independently in retirement.” She lost 40 pounds and counting and went from a lifetime of sedentariness and loathing exercise to loving it and doing it nearly daily.
Be accountable – That oft-quoted African proverb: “if you want to go fast, go alone; if you want to go far go together,” rings so true for achieving health goals. Heading down that path with a spouse, a gym buddy, a group, or even a health coach like myself, makes it so much easier and more enjoyable. That’s why my health coaching groups experience so much success. The members lean on each other and they show up week after week not wanting to disappoint their comrades. Both aforementioned women were members of my whole health coaching groups.
Cultivate awareness – We must understand where we’re at to get to where we want to go. That’s why I encourage my clients to keep a food journal. It’s too easy to shovel a half a box of cookies into your mouth with hardly realizing it. But you’ll probably think twice about doing it when you know that you’re going to have to record it! Another aspect of awareness is being an avid label reader. You’d be amazed at what constitutes a serving or how much added sugar there is in seemingly benign products.
There’s more to it than just these three principles, of course. The EAT-Lancet report, in its emphasis on a plant-centric, whole foods diet is a great reminder of the shifts that will help us achieve whole health and live healthy, productive lives well into our 80s and beyond.
Gayle Wilson Rose is Chief Change Officer at WhyPowered Whole Health Coaching. She’s certified by the American Council on Exercise as a whole health coach, personal fitness trainer, with specializations in weight management and fitness training for seniors.