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Healthy Lifestyle BasicsDef: Health and Wellness Coaches are professionals from diverse backgrounds and education who work with individuals and groups in a client-centered process to facilitate and empower the client to achieve self-determined goals related to health and wellness. Successful coaching takes place when coaches apply clearly defined knowledge and skills so that clients mobilize internal strengths and external resources for sustainable change.By definition, health coaches are not content experts in health or disease; they do not diagnose or prescribe, unless a health coach has expertise through another profession that allows expert advice to be given. However, it is important for health coaches to have a solid working familiarity of current evidence-based recommendations provided by important public health groups such as the Center for Disease Control or National Institutes of Health. Relevant recommendations fall in the areas of health promotion and disease prevention, and include risk factors for chronic disease, basic biometric measures, and current lifestyle recommendations for optimizing health. This knowledge will allow coaches to appreciate the relative urgency of recommendations by a client’s health care providers, and to place the client’s behaviors and choices into an appropriate context. Healthy lifestyle ideals, as in most areas of healthcare, are continually evolving. Recommendations for everything from frequency of screening tests (e.g. mammograms, prostrate screening assays…) to optimal levels of biometric markers (e.g. total cholesterol, blood pressure…) change frequently. Additionally, these recommendations are normed for the populace at large, rather than for individuals. Therefore, caution and wisdom need to be applied in the application of any given guideline. In the study guide, we provide many active web links to recommendations and resources that are currently offered by leading government and medical agencies. However there are differing opinions and many controversies exist that are not always readily apparent within conventional expertise. For example, the CDC recommendation for dietary guidelines (Choose my Plate) has been contested by some experts in nutrition and alternative recommendations have been put forth such as Harvard’s Healthy Eating Plate. In such circumstances, we have tried to provide both resources, even though they may be contradictory. It is widely agreed that, there is no ‘one size fits all’ diet, and everything from ethnicity, family history, lifestyle, age, sex, body habitus, overall health, constitution, and environment need to be considered by and for any given individual. How these individual considerations are made vary widely between experts. We encourage health coaches to stay abreast of trends, controversies and evolutions in the lifestyle fields, since they will impact client choices and the resources they need.Healthy Lifestyle Basics – Updated April 19, 2016Minimum knowledge base for Health Coach Certification: recommended minimum~15-hour curriculum. Study and learning times will vary for each individual.Learning Objectives:[L1] Define health, health promotion and disease prevention, applying a whole person perspective.General knowledge about healthy living is required in order for a coach to define, identify, recognize, discuss, and understand the various topics that may arise in a coaching conversation. The Centers for Disease Control (CDC) has a robust, evidence-based website that provides valuable resources for the coaching process. Healthy People 2020, from the U.S. Department of Health and Human Services (HHS), offer a comprehensive overview of health promotion and disease prevention. The National Institutes of Health (NIH) National Center for Complementary and Integrative Health provides further exploration of a whole person approach to healthy living. In these course components, you will find useful links to Frequently Asked Questions, Fact Sheets, Surveillance Data, Trends, Maps and applicable media such as online videos. See resources below.Note: Hyperlinks to web resources throughout this document are subject to change or be revised without notice.WebsiteCDC: Healthy Living CDC: Well-being ConceptsCDC: Healthy People 2020 (after viewing home page, click all links in the upper left box)CDC: Healthy People 2020 Evidence-Based ResourcesCDC: Healthy People 2020 Topics & Objectives A-ZNIH: National Center for Complementary and Integrative Health (after viewing home page, click on “Health Topics A-Z”)NIH: Complementary, Alternative, or Integrative Health: What's in a name?CDC: National Health Statistics Report on Use of Complementary Healthcare (PDF)Estimated total learning time: 4 hours[L2) Identify 5 major risk factors (sedentary lifestyle, obesity, smoking, stress, poor nutrition) and their proximal causes for 6 most common chronic conditions (obesity, hypertension, diabetes, inflammatory diseases (including atherosclerotic cardiovascular disease and degenerative joint diseases), cancer, and chronic pain).Chronic DiseaseThe CDC reports that 7 of the 10 leading causes of death in the U.S. are chronic diseases, and almost half of Americans live with at least one chronic illness (source: CDC). Based on this statistic, you will most likely work with many clients who are dealing with chronic conditions. In the coaching conversation, your client will likely uncover some risk factors that may have exacerbated any chronic conditions. It will be important that you are comfortable discussing these issues with your client. The coach should be able to identify the common chronic conditions of obesity, hypertension, diabetes, high cholesterol, inflammatory diseases, cancer, and chronic pain, as well as understand their associated behavioral risk factors such as sedentary lifestyle, obesity, smoking, stress, and poor nutrition. See resources below.WebsiteCDC: Heart Disease FactsCDC: Overweight and Obesity (after viewing this link, stay on the page and click on each link in the middle section) CDC: Adult Obesity FactsCDC: Obesity Data, Trends and MapsCDC: Health Effects of Cigarette SmokingCDC: Smoking and Tobacco UseCDC: About High Cholesterol (after viewing home page, click on and read: “LDL and HDL: ‘Bad’ and ‘Good’ Cholesterol”, “High Cholesterol Signs and Symptoms”, and “Treating High Cholesterol”) CDC: Addressing the Cancer BurdenCDC: Top Ten CancersCDC: Diabetes Basics (after viewing home page, click on and read all links in the left side box)CDC: 2014 National Diabetes Statistics ReportCDC: How Diabetes Affects the Body (Video)CDC: Arthritis BasicsCDC: Arthritis At A GlanceCDC: Mental Health BasicsNIH: Chronic PainEstimated total learning time: 2.5 hours[L3] Understand basic biometric measuresScreeningCoaches must have a basic knowledge of the availability, usage and standard ranges of common biometric screenings in the areas of blood pressure, body mass index (BMI)*, fasting glucose, Hemoglobin A1c (HgbA1c), and lipid panels such as high density lipoproteins (HDL), low density lipoproteins (LDL), total cholesterol and triglycerides. See resources below.*Please note the controversy about the use of BMI for any individual, and the most recent article discussing this issue.WebsiteCDC: High Blood PressureCDC: High Blood Pressure Risk FactorsCDC: Measuring Blood PressureCDC: Body Mass IndexCDC: How is BMI Calculated?BMI Controversy: Tomiyama, A.J., Hunger, J.M., Nguyen-Cuu, J., & Wells. C. (2016). Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005-2012. International Journal of Obesity. ADA: Diagnosing Diabetes and Learning about PrediabetesCDC: Cholesterol Fact SheetEstimated total learning time: 30 minutes[L4] Understand evidence-based prevention for healthy weight, nutrition, physical activity, sleep, and emotional wellness, reducing behavioral risk factors, stress management and lifestyle preventive health.Optimizing Nutrition and Healthy WeightWhile the Internet provides numerous avenues for gathering health information, it is important for the coach to recognize, understand and seek evidence-based resources for prevention when working with a client. Understanding the optimal nutrition and healthy weight guidelines from recognized sources will give the coach a solid platform. The coach must understand the basics of a healthy diet, which includes knowledge of unprocessed (or minimally processed) whole foods, lean proteins, the importance of adequate fiber, the role of fats, and the recommended intake of fruits and vegetables. This knowledge is gleaned from reliable sources such as , the Office of Disease Prevention and Health Promotion () and the CDC’s Division of Nutrition, Physical Activity and Obesity. See resources below.WebsiteHealthy Eating Plate from HarvardHHS: Dietary Guidelines for Americans 2015CDC: Nutrition, Physical Activity and Obesity Data, Trends and MapsCDC: State Indicator Report on Fruits and Vegetables 2013 (PDF)CDC Podcasts: feeding Health with Michael PollanCDC Healthy Places: Healthy Food EnvironmentEstimated total learning time: 1.5 hoursEvidence-based Nutritional InterventionsIn addition to understanding the basics of optimal nutrition and healthy weight, the coach must be able to recognize current evidence-based nutritional interventions for the top 6 most prevalent health conditions: obesity, hypertension, diabetes, inflammatory diseases, cancer and chronic pain. The coach must also be familiar with the frameworks for a healthy diet from both a conventional nutritional approach as well as from the evolving framework of integrative nutrition, which takes into account the understanding of dietary effects on the inflammatory response underlying most chronic conditions. See resources below.WebsiteAmerican Diabetes Association: What Can I Eat? (After viewing the home page, click on and read “Making Healthy Food Choices”, “Understanding Carbohydrates”, and “Food Tips”)NIH: What is the DASH Eating Plan?Arthritis Foundation: Anti-Inflammatory DietCDC: Can Lifestyle Modifications Using Therapeutic Lifestyle Changes (TLC) Reduce Weight and the Risk for Chronic Disease? (PDF)Estimated total learning time: 50 minutesPhysical ActivityMany people know that regular physical activity helps improve overall health and fitness, but the knowledgeable coach will also recognize that risks for chronic diseases can be reduced with regular movement. The coach must know current recommendations for healthy adult exercise (based upon HHS guidelines) in the areas of cardiovascular activity, flexibility, strength, endurance and balance. The coach must know how to support their clients by helping them navigate appropriate ways to track physical activity and ways to increase daily activity levels apart from conventional exercise. See resources below.WebsiteCDC: Physical Activity Basics (after viewing Home Page, click on and read the 4 links under “Physical Activity Guidelines”)CDC: Facts about Physical ActivityHHS: Physical Activity Guidelines Risks of Physical InactivityHealthy People 2020 Physical ActivityACSM: How a Smartphone Can Benefit Your HealthWebMD: You Bought a Fitness Device. Now What?ACSM: Fit Society Page ACSM position on guidelines for exercise for healthy adults, 2011. HYPERLINK "" Estimated total learning time: 3 hoursSleepAccording to the CDC, insufficient sleep is a public health epidemic. Lack of sleep is linked to traffic accidents, work injuries, and occupational errors. Chronic diseases such as hypertension, diabetes, depression, obesity, and cancer can also be exacerbated by sleep insufficiency. Quality of life and productivity may also suffer due to inadequate sleep. The knowledgeable coach will have a basic understanding of sleep and the important role it plays in overall health and well-being as well as familiarity with common recommendations for healthy sleep hygiene. See resources below.WebsiteCDC: Insufficient Sleep Is a Public Health EpidemicCDC: Sleep Hygiene TipsEstimated total learning time: 10 minutesEnhancing Emotional WellnessBeing emotionally well is more than just managing stress. It also involves being attentive to your thoughts, feelings and behaviors whether they are positive or negative. The knowledgeable coach will be mindful about what this means to their clients by having a basic understanding of emotional intelligence and its importance in healthy management of relationships with self and others. Effective coaches should be equipped with tools and practices for supporting emotional awareness and agility in clients. The coach will also have a basic understanding of how a sense of purpose or life meaning impacts health. See resources below.PDF/Reading ResourcesOpen Hearts Build Lives Estimated total learning time: 25 minutesReducing Behavioral Risk FactorsThe knowledgeable coach will understand the health consequences of common issues including tobacco use, substance abuse, and depression. It is important to know when and how to make appropriate professional referrals for clients whose active risk behaviors exceed the scope and practice of coaching, such as alcohol abuse, prescription painkiller abuse, and other substance abuse. The coach should also recognize symptoms of depression and know how to refer for treatment. See resources below.WebsiteCDC: Smoking and Tobacco Use Basic InformationCDC: Smoking and Tobacco Use Health EffectsCDC: Mixing Tobacco ProductsCDC: Risk Factors for Prescription Painkiller Abuse and OverdoseCDC: Alcohol Screening and CounselingCDC: Binge Drinking (video)CDC: Safety Practices: Seat Belts, Car Seats and HelmetsCDC: DepressionEstimated total learning time: 30 minutesStress ManagementStress can be both positive and negative. The knowledgeable coach will be able to recognize negative stress and leverage positive stress. High levels of negative stress can be a barrier to making healthy lifestyle changes. The coach should know the basics of the physiology of stress, the relaxation response and stress management, and understand the wide variance that may occur with individual clients. The coach should be comfortable supporting their clients’ positive mental health, well-being, flourishing, and resilience. The effective coach will be knowledgeable about several mind-body practices such as breath work, mindfulness, imagery, and relaxation techniques. See resources below.WebsiteCDC: Managing Stress NIH: Relaxation Techniques for Health TipsEstimated total learning time: 50 minutesPreventionThe knowledgeable coach will have the skills needed to help a client shape goals to prevent illness and chronic conditions related to lifestyle such as hypertension, high cholesterol, type 2 diabetes, obesity, cancer, and heart disease. The coach should be familiar with current recommendations (as would be made by client‘s medical providers) for screening for common conditions based upon age and sex. See resources below.WebsiteCDC Prevention ChecklistAmerican College of Preventive MedicineNational Library of MedicineEstimated total learning time: 45 minutesThis document has been adapted, with permission, from Duke Integrative Medicine’s Healthy Lifestyle Basics for Integrative Health Coaches. ................
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