Healthy Food & Healthy Living by Dr. Ayala

The positive mindset: Can you think yourself fit?

I usually feel quite good about my activity level.

But there’s a group of women I occasionally hang out with that both inspires me and makes me feel like a sloth – these wonder women average about 2 hours of exercise daily and occasionally run marathons.

The inspired part is brilliant. But it appears that feeling like you’re slacking, just feeling less fit in comparison, isn’t good for you.

Placebo exercise?

A new study led by Octavia Zahrt and published in Health Psychology, found that people who thought themselves less active than others were 71 percent more likely to die, even after accounting for their actual activity level.

The study analyzed data from three nationally representative studies, included more than 60,000 people and gathered many health parameters, covering actual activity levels, weight, smoking and many others. It also asked participants how much exercise they think they’re getting compared to their peers.

Feeling that you exercise less than others predicted a remarkably worse outcome regardless of illness, age, and the amount of actual active time. Perceived under-exercising seemed bad for overall health.

The power of thinking positively

Accepting the power of the mind requires no magical thinking.

Our mental and emotional states influence our body. Recall the last time you were scared — you felt your heart beat faster, your breathing become rapid, your hair standing on edge, and all thoughts about food evaporate. This is called the startle response, and it’s an extreme example of how our state of mind enacts a cascade of physiological responses.

It should come as little surprise that other thought processes translate into more subtle changes in all our organs. Our body secretes hormones, releases transmitters, conveys electrical signals, activates immune cells and enacts an incredible array of actions in response to what our brain thinks or perceives.

It is indeed wondrous, but if you think about it again, not that surprising, that there is healing power to our thoughts and our beliefs. This has been called by different names including the power of suggestion, the power of positive thinking, and the cure within. The phenomenon though is well known, and what it describes is that sometimes symptoms and health status can be alleviated or worsened as a result of an individual expecting or believing that they will.

Apparently, the placebo effect works for fitness as well.

And in the case of exercise, perception can affect our physiology directly, and can also become a motivator. When people believe they’re way behind others it might make them give up rather than step up to the challenge. On the other hand, thinking you’re ahead of the crowd can motivate you to improve even further to maintain that perceived advantage.

Getting motivated about exercise

Inactivity is a major health issue, and positive peer pressure has been one of the great inspirations to push us to do more. But then, there’s also that messaging centered on scaring us all the way to the gym. And for any given level of activity, people may perceive the amount of energy they’re expending and the number of steps they make as a good effort, or as terribly deficient.

This study shows that these perceptions matter.

Stress, being overweight, and eating poorly affect our health negatively, but worrying about these risks to our health is even worse – we’re adding another dose of ill effect that’s a product of our mind. Stressing over stress can kill you!

That of course doesn’t mean that actual exercise isn’t important. It’s super important. But just as believing that a medical procedure or medication will have positive results augments the intervention’s efficacy, exercise amplified with a positive attitude increases its power.

Last weekend I climbed a mountain with my husband, and as we were passing a much younger couple my dear man said “we’re at the top 0.1 percentile of fitness for our age.” Instead of analyzing the sentence’s accuracy, I thought: What a great attitude!

This study reinforces the notion that we should not only do good, but also feel good about it.

At the end of the day, tell yourself that you’ve given your body the gift of sufficient activity. The saying that you’re as young as you feel appears to also be also true for fitness.

Be kind to you.

Dr. Ayala

Does diet soda cause diabetes?

Google’s autocomplete suggests common queries and ranks them according to the most searched ones. At number 1 about diet soda: is it good for you.

The answer to that question should be easy, but can it can also become quite philosophical.

The simple answer is clearly “no” – the only good ingredient in diet soda is water, which is very good for you, but water is the basis of any drink, and it comes from the tap, free.

On the other hand, it is perhaps better than some other drinking options, and everything’s healthier than a donut. If diet soda helps people avoid other, more harmful foods and drinks, perhaps it is a step in the right direction and it might have a role in improving health in some specific situations.

The latest on diet soda and diabetes

Soda and other sugary drinks are associated with diabetes. Diabetes affects about 1 in 10 American and is a serious and costly disease. Excess added sugar is an established risk for diabetes, sugary drinks are the leading source of added sugar, and many studies show a clear association between soda consumption and the development of type 2 diabetes. These include randomized controlled studies that showed that sugary drinks aren’t just associated with diabetes – they cause obesity, insulin resistance and chronic inflammation, which are the harbingers of diabetes.

The association between diet soda and type 2 diabetes is a little less clear. Several studies showed a link between drinking diet soda and diabetes, stroke, metabolic syndrome, heart disease and hypertension. These were mostly observational studies, and it’s hard to tease out whether people who have early signs of type 2 diabetes switch to diet soda, or if diet soda indeed contributes to glucose intolerance and diabetes.

When the answer isn’t clear, we await more data.

A new study, just published in the American Journal of Clinical Nutrition followed a group of about 65,000 postmenopausal women. Over more than 8 years 4675 of them developed diabetes.

Both sugary drinks and diet drinks were associated with the development of diabetes.

The more artificially sweetened drinks the women drank the greater their risk of diabetes, and the association stood even when controlled for other risk factors such as obesity.

The risk from diet sodas was however smaller than that associated with regular, caloric soda.

Better than …something

Diet drinks were designed to help people lose weight. Several studies showed an initial weight reduction when people switched from full calorie to non-caloric drinks. Most of these studies were small, short-lived, and sponsored by the beverage industry. Theoretically at least, if you’re a heavy soda drinker, switching to the diet version can help lower your caloric total intake.

But many more studies show that diet drinks are associated with weight gain, and many experts worry that artificial sweeteners are actually fueling the obesity epidemic, perhaps messing with hormonal and metabolic signaling, or changing the gut bacterial population in a detrimental way.

Drinking a lot of sweet drinks – made with sugar or with non-caloric sweeteners – is clearly not healthy. But one can still argue that there are shades of unhealthy, and that the proof tying diet soda with diabetes is weaker than the evidence linking full calorie drinks to this disease.

Maybe a better-phrased question would be “which is worse?”

Dr. Ayala

Full disclosure: I co-founded Herbal Water, where we make organic herb-infused waters that have zero calories and no sugar or artificial ingredients. I’m also a pediatrician and have been promoting good nutrition and healthy lifestyle for many years.