December 2014 Health Bulletins

	Ask the Doc Dr. Davis Smith is director of health services at Westminster School, Simsbury, Connecticut

“How do we know if we are overweight in an unhealthy way?”
— Stella M.,* University of California, Irvine
*Name changed for privacy

What the old me would have said
A few years ago I would have thought this was a very straightforward question. I would have…

• Referred you to a BMI table, such as this one.
• Talked about the different categories: underweight, normal weight, overweight,
  and obese. 
• Mentioned that I’d heard some debate about the usefulness of BMI, especially that it isn’t helpful for high-muscle-mass individuals, but concluded that it’s pretty reliable and the best measure we’ve got of the relationship between weight and health.

My conversion
Since then, I’ve read and heard some stimulating and challenging perspectives—in particular a talk by Ragen Chastain, a self-described Fat Person and Activist, and a review of the obesity literature by my colleague and friend Alexandra Hall, MD. Beyond this, I’ve been casually following some of the newer research about diet. All this learning has made me more sensitive to these issues and open to broader perspectives about health and size.

What the new me is saying
Weight is an unreliable measure of health
We can say confidently that weight alone is usually not a good measure of health, except in the case of extremely underweight or overweight individuals. 

The value of physical activity
Substantial and compelling evidence points to the value of regular exercise, both resistance and aerobic—but especially aerobic, whether or not it leads to weight loss. 

The value of good nutrition
Similarly strong evidence shows that eating well is good for us, though defining “eating well” is complicated. There’s a strong argument to be made that a diet composed mostly of meals you prepare yourself from whole ingredients (e.g., a stew of chicken, carrots, onions, herbs, salt, pepper, and barley) is likely to be healthy.

Psychological implications
The psychological implications of weight and body image can’t be overlooked.  If you spend a lot of time thinking about—especially hating—your body, that’s not healthy.

It’s easy to feel we should be ashamed of our bodies. Industries are looking to promote that shame and capitalize on it by selling us bogus diets or phony pills. It’s hard to combat a very thin-centric concept of what is beautiful—and, by extension, healthy. Still, most of us better start now, because our bodies are never going to look like the ones in the magazines. We can be beautiful and healthy without six-pack abs or buns of steel. If body image is problematic for you, seek out a counselor with expertise in this area. Also: Don’t be part of the problem. Never judge or shame someone else because of his or her body type.

More resources
Online fitness test
Is it okay to be fit if you’re fat? Harvard Medical School
Healthy eating for college students
Regan Chastain’s blog

	Ask the Trainer Frankie Romeo is a certified personal trainer, small group training coach, and graduate student at Lipscomb University in Nashville, Tennessee

“How do you break a plateau when lifting weights?”
— Kyle L., Cazenovia College, New York

Resistance training is the most effective method for building muscular strength. However, it’s not uncommon to experience a plateau—a delay in progress. For example, someone who is new to weightlifting might initially raise their bench press 10 pounds each month, but on the fourth month be unable to add additional weight. Plateaus are the result of our bodies’ adaptation to specific exercises and intensity levels.

To overcome these plateaus, it’s important to diversify our workouts and modify our exercises. In other words, keep the body guessing. Here are three proven ways to do just that:

1. Change the grip 

• Are your hands always in the same position? Depending on the exercise, you may want to move your hands closer together or farther apart. For example, performing the close-grip bench press with hands about one foot apart will help engage the triceps, whereas performing the standard, wide-grip bench press with hands slightly past shoulder-width apart uses primarily the chest and shoulders.
• Train the muscles you feel are weaker and that may be inhibiting progress.
• Alternating a supinated (palms facing out), pronated (palms facing in), and neutral (palms facing each other) grip can change some exercises. This is most suitable for pull-ups, bicep curls, and shoulder raises.

2. Alternate the load

• Incorporate both low resistance and high resistance into your routine, even for the same exercises. For example, if you back squat twice a week, you might benefit from having a “light” day and “heavy” day rather than focusing on one or the other.
• The number of sets and repetitions will vary depending on the level of resistance. Don’t train the same muscle group within the same 48—72 hour timeframe.

3. Vary the tempo
Don’t forget about the speed and pace of your training.

• An isotonic muscle contraction has a concentric (muscle shortening) phase and eccentric (muscle lengthening) phase. Instead of lifting a weight and quickly lowering it before the next repetition, try slowing down.
• For instance, a bodyweight squat could have a tempo that includes a three-second eccentric contraction. This means you take three seconds to lower into the squat.
• There is also an isometric contraction; i.e., holding an exercise in one position without moving. You could pause at the bottom of the squat for two seconds before raising and finishing the repetition. A technique like this can help you better stabilize the body at what is usually the most difficult point in the lift—which makes the workout easier at regular speed. 

	Ask the Relationship Educator Joleen M. Nevers, MAEd., CHES, AASECT, is a certified sexuality educator and the health education coordinator at the University of Connecticut.

“How many condoms are too many condoms?”
— Jose R.,* Eastern Kentucky University, Richmond
* Name changed for privacy

Optimum number of condoms each time = 1
Great question. Students might think that using more than one condom for sexual activity will provide more protection. That is not the case. Using more than one condom at the same time causes friction and may lead to a condom breaking. This is true also for the use of male and female condoms together. Don’t double up.

Pleasure it up
To increase pleasure and reduce friction when using either one male condom or one female condom—lubricate! Water-based and silicone-based lubricants are:

• Compatible with latex, polyisoprene, polyurethane, and nitrile, the materials condoms are made of.
• Absorbed by the body and not dangerous to ingest (though I don’t suggest eating it; I’m talking about ingesting small amounts of lube via sexual activity).
• Most condoms today incorporate a silicone-based lube.

Preventing pregnancy
For pregnancy prevention, combine another form of contraception with either a male or female condom. For example, while a man uses a male condom, his female partner might use hormonal contraception (such as the Pill, the Ring, the Patch, the Shot, or a hormonal IUD). Or the female partner might use the female condom and hormonal contraception.

	Ask the Professor Amy Baldwin, MA, is the director of university studies at the University of Central Arkansas.

“Is it better to read the whole passage, or skim and pick up important points?”
— Trenton B., Suffolk University, Boston, Massachusetts
* Name changed for privacy

I imagine I know what answer you want to hear. I would love to say that all you need to do is skim your reading and you’ll be just fine. But that wouldn’t be true. So read this answer thoroughly.

Skimming vs. not reading at all
If your choice is between not doing the reading at all and skimming, then you are better off at least touching the material.

Skimming vs. reading
There is no substitute for reading the whole assignment from beginning to end.

But if sometimes you just can’t swing it…
Maximize the time you have. These strategies work, too, for previewing the material before you read it in its entirety.

Headings
If you’re reading a lengthy text, look for headers within the material that signal the main ideas.

Topic sentences
Read all the topic sentences for each paragraph. Often, they are located at the beginning or end of the paragraph.

First and last paragraphs
The first and last paragraphs of a reading assignment often contain a lot of valuable information and summarize the main points.

Preface or introduction
If you have a book to read and not a lot of time, read the introductory material or preface, which will often give you information about major themes and events.

What makes us creative—and what kind of creative?

Find your type

Creativity is hot in psychology research, and researchers are finding creative ways to explore it. They’ve shown that openness to experience is the key personality trait associated with creativity. But what does this mean?

There are many ways to be open to experience, wrote Dr. Scott Barry Kaufman, a cognitive psychologist who focuses on intelligence, creativity, and personality, in Scientific American. Maybe you’re intellectually curious, or have a wicked imagination. Perhaps you immerse yourself in complex problem solving. Or maybe you’re more interested in emotional experience.

Four types of openness
Openness to experience can be broken down into four types, which manifest creatively in different ways, according to Dr. Kaufman’s study in the Journal of Creative Behavior (2013). The research involved 146 high-achieving British students aged 16—18.

FIND YOUR CREATIVE TYPE

You score highly on IQ tests
Traditional measures of intelligence (i.e., IQ tests), including scores for verbal reasoning and working memory, reflect explicit cognitive ability. They don’t seem to represent particular personality types. Explicit cognitive ability is more relevant to creative achievement in the sciences than the arts.

You’re driven to engage in ideas, rational thought, and the search for truth
You goal-directed types tend to be industrious, assertive, and persevering. Those traits represent your intellectual engagement. Intellectual engagement is more relevant to creative achievement in the sciences than the arts. It seems a better predictor than explicit cognitive ability of scientific creative achievement.

Your decisions are based on emotions, gut feelings, and empathy
You might be more volatile, compassionate, enthusiastic, assertive, and impulsive than the average dude. That’s affective engagement in action. Affective engagement is more relevant to creative achievement in the arts than the sciences. Actually, it might even be detrimental to scientific creativity. (Don’t let that make you drop physics. This is a generalization, and people are complicated.)

You’re into aesthetics, fantasy, art, and culture
Are you searching for beauty? Are you more compassionate, enthusiastic, assertive, and impulsive than most of us? Maybe also less industrious and orderly? That’s what aesthetic engagement looks like. This is more relevant to creative achievement in the arts than the sciences.

Get thee to a theater

Plenty of learning (and becoming better people, and all that) occurs outside of school. Now we’re getting a sense of how effectively it can happen inside a theater. We’re better off seeing a play performed live than reading it or watching the movie version, new research suggests. Live theater seems to make us more tolerant and empathic, too.

In the first randomized study of the effects of live theater on students, high schoolers were assigned by lottery to see stage productions of Hamlet or A Christmas Carol, or no live theater, by researchers at the University of Arkansas. Here’s what they found:

Knowledge and vocabulary
Students who saw a play performed live demonstrated considerably better knowledge of its plot and vocabulary than students who had read the same play or seen it performed on screen. “Plays are meant to be seen performed live,” wrote Dr. Jay P. Greene, professor of education reform, who led the study, in Education Next. “The story can be conveyed in a movie, but it doesn’t engage the viewer in the same way.”

Tolerance for others
Students who attended live theater later demonstrated greater tolerance for human diversity and difference. Here’s how students responded to statements relating to tolerance:

“Plays critical of America should not be allowed to be performed in our community.”

• Students who saw a live play: 9 percent said yes.
• Students who did not see a live play: 21 percent said yes.

“People who disagree with my point of view bother me.”

• Students who saw a live play: 22 percent said yes.
• Students who did not see a live play: 30 percent said yes.

Understanding others
Students who saw live theater seemed to have an improved ability to read the emotions of others. They scored higher than non-theater-going students on the Reading the Mind in the Eyes Test, which is thought to measure the ability to infer other people’s thoughts and feelings by looking at their eyes.

In a previous study, the researchers found that students who participated in a field trip to an art museum demonstrated increased knowledge, tolerance, historical empathy, and critical thinking than students who didn’t.