A hike in the Chugach Range on a sunny day is definitely self-care.
I have just retired after enjoying 32 years as a primary care provider. My clinical focus has been on creating wellness, rather than managing disease, primarily through good nutrition and positive self-care. I have observed that women, especially those born before the early days of legally bolstered equal rights, have often been made to feel that their role is to serve men. We are unfortunately seeing a persistence or revival of sexism at personal, community, state, and national levels. It is not selfish to take good care of yourself. It is the basis for a more functional and caring global society. Also, men, please step up your self-care. It is your responsibility. It feels really good to be good to oneself.
I've noticed over the years, in intimate conversations with patients, that they will say making healthy, sustainable lifestyle choices can feel great, or, if a new concept, can feel like deprivation.
"Why can't I just .... eat whatever I want to taste, or drink wine every night, or just watch TV (instead of getting outside for a walk)?" What I often heard about was the perceived uphill struggle to implement healthy choices, every day, and most of the time. It is hard, at first. Our culture pressures us to buy junk food (bottled sodas are typically cheaper than bottled water at airports and schools, for example) and to work obsessively then need to "get wasted" (TGIF, and "happy hour"). Very little has been done to address the addictiveness of screens, which increasingly isolate us from really connecting, with depth, to ourselves and our fellow humans. True connection is only possible with self-compassion and gentle human to human encounters.
Uncompromised self-care flows from a curiosity about our highest self and why we uniquely were bestowed with the blessing of this one wild and wonderful life. When we commit to loving ourselves, to feeling good about who we are, and follow through with health-promoting lifestyle choices, then walking lightly uphill is less of a struggle. The high road does indeed require a bit more effort, but the view is so much better.
I have found starting the day with meditation works wonders in setting the tone (to be good to myself and everyone I encounter). A meditation teacher once gave me the helpful mnemonic RPM: rise, pee, then meditate. Meditate first thing. Personally, after 10-20 minutes of meditation (the app Insight Timer is a great place to start) I really like to dry brush my entire body, starting with a big clockwise movement over the belly, following the direction of the large intestine. Then complete the rest of the body, stroking towards the heart and making sure to include palms and soles. I use a smaller, softer brush for my face. Then I do a few moments of cold water walking-in-place in the bathtub (a big basin works well), followed by splashing armpits and whatever joints might be feeling a bit achy with that bracingly cold Alaskan tap water. If you are lucky enough to live by a stream or the ocean-go for it!
Another healthy aging tip is that after age 60 or so most folks do much better paring down to 2 meals a day with maybe a light snack in between. The daily fasting period should be a minimum of 12 hours (overnight) where only water is taken. Giving the gut a nice long rest every day is the only clinically validated method for promoting healthy longevity. The other top tip for extending the life of your skin and organs, especially the brain, is to avoid alcohol.
By far the No. 1 factor in preventing cognitive decline as we age is optimal nutrition. All mammals are designed to burn both sugar and fat for fuel. Sugars (simple carbohydrates including grains, especially if processed into flour, and "sweets") turns into fuel quickly but also must be burned up metabolically within a few hours so as to not turn into triglycerides, a type of fat that is typically stored around the abdomen and eventually creates fatty liver, fatty heart, fatty lungs, and fatty guts none of which work as well. Fat is trickier to turn into fuel but can provide much more durable energy. This is why athletes can "carbo load" before an event and not gain weight, whereas folks with medium levels of activity will live longer if regularly going into mild ketosis. That means you are restricting carbs so that your metabolism is required to burn fat (including fat you already have stored on your body) as the fuel source. The only way to lose weight is to be in ketosis. It's pretty easy to go into mild ketosis with 12-16 hours a day of fasting, and by recognizing the ratio of carbs to fat at every meal. Unless you have reactive hypoglycemia, which is fairly rare, consider two meals daily, with about equal amounts of carb calories and fat calories. If you don't want to weigh food and count calories, eyeball your plate as you are serving up: half your plate should be vegetables, mostly cooked, some raw, and the other half would ideally contain equal portions of some good fat (salmon, sardines and most of those tasty little tinned fishes, eggs, nuts, full fat dairy from happy cows, avocado, coconut) and some whole (not processed) carb like a potato, or other root vegetable, brown rice, quinoa, corn, and legumes.
Our bodies are mostly made of water. When you feel like snacking (but it's not time for one of your meals) try drinking water. A little lemon squeeze can help. Water is often surprisingly satisfying.
Organize your day around self-care and you will establish a foundation for durable reserves of energy to also be the friend/partner/community member that you want to be.
Emily Kane is a retired naturopathic doctor based in Juneau.
