We sent a professional health snoop to track four women who thought they were living right. The upshot: major health upgrades for all from our team of experts.
It is 6 A.M. on one of those unfailingly blue-sky days in Los Angeles, and Kara Fox is starting the morning as she starts every morning: having a mug of Taster's Choice instant coffee filled liberally with heavy cream. It's unlikely that any other nourishment (if this pale brown breakfast can be called nourishment) will pass her lips until dinnertime—except for maybe an apple, a few spoonfuls of cottage cheese, some trail mix. Fox, 60 and arguably one of the more glamorous grandmothers, is on a kind of perpetual, self-imposed parole of food restriction in order to stay a size zero and continue to fit into some damn beautiful clothes. But all that may change...
The idiosyncratic habits of Fox and three other women, all good sports, were the focus of O's "spy in the house" project. The inspiration was a call to the cofounder of the National Weight Control Registry, a data bank of around 4,500 long-term weight losers. James O. Hill, PhD, sends ethnographers—cultural anthropologists— into the homes of successful dieters to ferret out their secrets. Such a clever method seemed like a good way to investigate the healthy (or not so healthy) behaviors of O's four women. Asking questions about a diet or workout may lead to a somewhat rosy version of the truth, but dispatch a trained observer with an acute eye for detail to poke around the house—dust on the treadmill? cookie crumbs in the bed?—and all habits are laid bare.
Enter (literally) Inga Treitler, PhD, one of Hill's anthropologists and director of ethnography for the TerraNova Group in Atlanta (her job entails observing and evaluating human behavior to compile research, often for corporate clients or health professionals). Treitler agreed to take notebook and camera on the road for O, to get a nonjudgmental and judicious peek into the refrigerators, medicine cabinets, closets, and cars of our subjects, shadowing them at home and at work, at the gym and the grocery, and wherever else they go during a typical day.
Once Treitler completed her four missions, she joined a SWAT team of healthcare professionals, including Hill, to evaluate the findings. Aside from his work with the Registry, Hill is director of the Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver, coauthor of The Step Diet Book, and cofounder of America on the Move—a national program that coaches people to take an additional 2,000 steps per day (about a mile), while cutting 100 calories. Pamela Peeke, MD, and Miriam Nelson, PhD, rounded out the team. Peeke, an expert in women's health based in the Washington, D.C., area, is the author of Body for Life for Women and Fight Fat After Forty. Nelson is director of the John Hancock Center for Physical Activity and Nutrition at Tufts University in Boston and the author of the Strong Women book series (Strong Women Stay Young, Strong Women Stay Slim, Strong Women Eat Well).
The goal of this project was for each woman to receive a customized health-upgrade prescription. (We'll check in with them in the August issue to see how well it's working.) But there's no reason they should be the only ones to benefit. "Even without a team of professionals," says Treitler, "people can play investigator to their own lives"—and give their health a lift.
Pulling bits and pieces out of Kara Fox's charming "spirit box" (stones gathered from favorite places, a half-smoked cigar from a man she loved who died, a bell "to summon your angels") leads into a winding conversation about life and beyond. Halfway through it's clear to Treitler that this woman, a former commercial photographer and design executive in the advertising and marketing industry, has a strong spiritual side. She believes that periodically you should move 37 things in your house to shake up the feng shui. She believes that dreams are prophetic and windows to the soul. She keeps stalks of "lucky" bamboo in groups of threes. She's suspicious of X-rays.
These ideas seem fairly innocuous. But other convictions of questionable logic from specious sources may have a detrimental effect on her health. Which is why Treitler is staring, astonished, at a nearly empty refrigerator, its only contents evidence of Fox's extremely restricted eating: olives, baked tofu sticks, diet soda, frozen grapes that made an ice pack for a relative's recent eye surgery, and the heavy cream for her coffee ritual. "I bought that half-and-half by mistake," she says, pointing to a neglected carton. Fox is currently following the rules of a bet she made with her brother: no refined sugar, flour, rice, or potatoes (the first one to crack owes the other a big check). But her favorite pre-bet meal was frozen yogurt. "Just because it's called yogurt doesn't mean it's healthy," Treitler reminds her.
All of us live with some inconsistencies and contradictions. Fox tries to eat only organic dried fruit and won't own a microwave, yet she rarely reads labels to check for artificial ingredients or preservatives. Her two grown children were brought up on wheat-germ-oil shakes and lunches so wholesome that they traded with other kids at school. But Fox recently self-published a collection of recipes from family and friends that rely heavily on convenience foods, such as Mom's Easiest Chicken made with canned apple-pie filling, onion-soup mix, and bottled French dressing. Periodically, she prepares a cracker from flaxseeds that are soaked and put in a countertop dehydrator for 24 hours; she snacks on the dried mixture, out of her conviction that the high rate of colon cancer in this country is due to lack of fiber in the diet. But desirable fiber intake for adults is 25 to 35 grams a day, and she's getting only a fraction of that amount from her nibbling. (She's also about ten years overdue for a baseline colonoscopy.)
Moving into the bathroom and infiltrating Fox's medicine cabinet, Treitler finds homeopathic preparations for bruises alongside serious prescription pain meds—"just in case" she falls and breaks a leg and has to "wait for paramedics." (In the meantime, she hasn't had a bone density scan in five years.) On display around the sink are beautiful soaps that look untouched, the kind you find in guest bathrooms at parties and hesitate to use. What's used in this room, Treitler determines, is the scale. At least twice every single day.
Eat, darling, eat. Fox is 5'5" and 104 pounds. "She's so small because her body has adapted to a famine eating pattern," says Hill. "The body has a miraculous way of adapting no matter how whacked-out your diet. She's experiencing some muscle loss, and there's a risk of declining functionality." Her diet is exquisitely unbalanced, and the bet is very dangerous for her, according to Peeke. "She's got to ramp up her nutrition like there's no tomorrow with whole foods and whole grains," she says. "It would be great for her to work with a nutritionist until she understands what her body needs. She's got to get more nourishment to protect the integrity of her precious immune system."
Chew your food, not your vitamins. Fox takes calcium in the form of chocolate-flavored chews that list, as the first two ingredients, corn syrup and high-fructose corn syrup. Nelson and Peeke agree that the chews are basically fortified candy and recommend tablets of calcium citrate. Some experts think the citrate is better absorbed than calcium carbonate, while others maintain that's true only for people with decreased stomach acid. Either way, at Fox's age the recommended daily allowance is 1,200 milligrams of calcium a day plus 400 IU of vitamin D.
Trade waif for wellness. The National Institute on Aging has stressed that there are four important components of living well past age 50: strength, endurance, flexibility, and balance. Fox's regular Pilates workout, which she performs admirably, is great for the last two, but she needs to add cardiovascular exercise for endurance, and resistance training (in the form of hand weights or even ashtanga yoga) for muscle strength. Building muscle mass will result in an increase on the bathroom scale, which will be hard for the frequent weigher to tolerate, and living in Los Angeles, Fox is surrounded on every side by a culture that idealizes the superslim look. "But most women become more compact," Peeke says. "Think of Linda Hamilton in Terminator 2. Small people will develop small muscles. And it will optimize the ability of her metabolism to burn calories because muscle uses more energy than fat."
Model Lady Macbeth. Even after a season of flu shot shortages, when the Centers for Disease Control and Prevention advised regular hand washing to keep from getting sick, Fox thinks that soaping up too often or too thoroughly deprives the body of necessary bacteria. But the CDC's advice is backed by research: A 1996 study of Detroit schoolchildren, for example, found that those who washed their hands four times a day missed up to 51 percent fewer school days from illness.
Know your numbers. Precision is essential to Fox's sense of well-being—her bottled water lined up like an army of toy soldiers on the shelf, her bed made the moment she awakens, her plants devoid of brown leaves, her sports car as tidy as the day it left the showroom. A propensity for order can bode well for making a transformative change, according to Treitler. "I always look at people's cars and offices," she says. "Do they have logical systems? Are they consistent?" What works against Fox is her resistance to information if recommendations do not fit her mental mold. One of Peeke's litmus tests for healthy self-awareness (which Fox fails) is, Can she tell you her cholesterol? "If someone her age doesn't know that number, it's a very bad sign. It means: I don't want to know, I'm perfectly fine."
Perusing bottles of vitamins in the kitchen cupboard of radio talk show host Yolanda Gaskins, Treitler realizes that carbon-dating might be needed (the prize goes to a supplement that includes ox bile with a 1995 expiration date).The refrigerator is more current but no less scary. Seduced by low prices, Gaskins buys supersize everything at Costco, much of which goes unused until unusable. Opening the freezer, Treitler finds a virtual henhouse of chicken wings, prepared precisely six to a package and marinated in a preservative-laden dressing, along with Brobdingnagian bags of mixed vegetables and enough oatmeal cookies to supply a Girl Scout troop (sometimes eaten frozen, Gaskins admits). "For a single woman who doesn't entertain," observes Treitler, "she has tons of food—but it's practically all nutrient diminished."
What's even more noticeably missing is a place to eat. Although Gaskins's apartment is furnished with obvious care, the dining room has become a walk-in closet. Sitting down to dinner was not a habit ingrained in childhood, Gaskins says. She and three younger siblings often made do with frozen potpies or fast food. ("I think we ate the first million sold under the golden arches," she jokes.)
As an adult, she still doesn't sit down much. Only a year out of Georgetown Law school, Gaskins found legal work so lacking in soul satisfaction that she picked up a phone and "just started calling people" to jump-start her childhood dream of a broadcasting career. A natural in front of the camera and at the microphone, she has been career-propelled cross-country, from a stint with CNN in Atlanta to her own radio shows in Los Angeles, Dallas, and now back in her hometown of Washington, D.C., where she's sent nationwide via satellite.
In her late 40s, Gaskins sometimes starts the day healthfully with a soy-based smoothie whirled in her blender and a workout, but often she's too exhausted for the gym. When she goes off-air at midnight, adrenaline keeps her awake—she might get only a couple hours of sleep before dragging herself out of bed at 7 A.M. and onto the computer looking for news and information that she'll use on her show.
When Treitler presses her to name some comforting foods, Gaskins mentions meals that would be emotionally and physically nourishing—like roasted sea bass, rice, and fresh spinach—but she rarely feeds herself in such a way, turning more often to bread or pasta. She tends to overindulge at a restaurant buffet or party, eating the cheesecake because "it's included"—a common food rationale that often progresses to "Since I was bad, I might as well...." Gaskins is also a classic stress eater, operating on the unconscious calculation: stress + reward = pastry. Over the last few years, while renovating several houses bought as investments, trying to reconnect with family members who've been distant, and developing a media-training company, she's gained 30-plus pounds. And poking around in the closets, Treitler discovers that Gaskins isn't holding back on buying clothes for her new weight, including more coats than you'd find at the Burlington Coat Factory.
Since her days as vice president of her college class and cheerleading captain, Gaskins has been an overachiever who made it entirely on her own. "Her one attempt at finding a mentor was a miserable and dangerous failure with someone who tried to exploit her," Treitler concludes after one conversation. And with her constant moving, Gaskins has not developed a good support system—she hasn't even seen a doctor in two years. But she's always "on," connected to her cell phone by a wireless earpiece that she wears as if it were an essential hearing aid. Treitler is intrigued by the framed photos of a thinner Gaskins interviewing Denzel Washington and Mario Cuomo. "But she has not internalized her achievement and repeatedly sells herself short," says Treitler. "Continuity with her social networks is by cell phone, so she's not exploiting her strong suits: charisma and persona. She has a lot of plans and goals, but everything is in the future—'I should do more,' 'I wish I could....'" Even the inside of her SUV manifests works in progress and a life in transition—a three-foot-high promotional poster of herself and a huge mother of a pole from Home Depot that's the basis of some improvement project must be moved to receive passengers. "I hardly ever say, 'I've worked enough today—I can go do something else to have a well-rounded life,'" Gaskins admits. "I hardly ever say, 'It's good enough.' My 100 percent is somebody else's 200 percent. My goals are almost always just beyond reach. And finding that quiet space where I feel I've done enough is foreign to me."
Face the weight. Although pear shapes like Gaskins are typically better off than apple shapes from a health standpoint—excess abdominal fat being a known risk factor for heart disease, diabetes, and certain cancers—the experts say that she should lose those recently added pounds. Eventually. Weight loss should not be a primary goal. One visit to the studio revealed to Treitler that despite Gaskins's fastidious preparation and strong ambitions, her radio show doesn't reflect the scope of her talents and intellect. If her work becomes more satisfying and engaging, other successes will follow.
Take a reality check. The coats of many colors and loose-fitting wardrobe are evidence of what Peeke labels shrouding—they're letting Gaskins get used to things that augment her disassociation, allowing her to become comfortable with a larger image of herself. Peeke also talks about overweight people taking care of the "visible protein ends"—hair, teeth, and nails—instead of addressing the real problem ("You don't see your arteries getting clogged. You don't see the fat deep inside your stomach, which raises the risk of heart disease"). This seems to be true of Gaskins, who has a collection of hair accessories and a pirate's bounty of costume jewelry. "She's adorning herself in the easy places," says Peeke. "She needs what I call the clothes-o-meter: a well-fitting outfit that can be a monitor of her behavior. If it's too tight, she cuts back on food and gets more active."
Break the stress-food connection. "She's eating for reasons other than hunger," says Hill, "and she has to find different ways to relieve stress, like taking a walk or calling a friend." One ploy from Peeke is to place signs that read THE ANSWER IS NOT HERE on the refrigerator, the pantry, the wine rack. Other signs saying THE ANSWER IS HERE go on the bathtub, the treadmill, a pair of sneakers, a pile of novels. "I teach people: Whatever decision you make, you wear the next morning," says Peeke. "Celery wears well. Heaps of pasta don't." To get at the root of why she's eating, Gaskins should try to figure out what's causing her stress, then rethink the problems as less potent. A mantra such as "It is what it is" can help. And she can't make it too easy to overeat under stress by being hungry. She might experiment with nibbling on something every three to four hours, including smart snack combos of protein, carbs, and a little fat (like low-fat string cheese and an apple, or hot chocolate made with skim milk and good cocoa powder).
Get fresh with food. The whole team wants to wean her from Costco. A natural foods co-op would be a healthier and still economical idea. Wherever she shops, fresh produce is a better choice than Gaskins's freezer fare. "She possesses tremendous sensuality in her movement and her home environment," says Treitler, "but she's not eating to meet those needs. Getting her back to the physical pleasure of food, which she so obviously relishes, is a goal." And her next purchase should be a table where she can actually sit to eat a meal.
Update the Flintstones. The experts recommend a multivitamin for women over 45 (expiration date in the future, please), plus 1,000 milligrams daily of omega-3 fatty acids (available in fish oil capsules) to help guard against heart disease. She should also take calcium (the RDA for women ages 19 to 50 is 1,000 milligrams) and, to help absorb it, vitamin D (200 IU), "the unsung hero of bone health," says Nelson.
To sleep, perchance to dream. Recent research suggests that sleep deprivation may contribute to weight gain (see "You Need 8 Glasses of Water a Day...," page 208). A study of about 1,000 people published in 2005 in the Archives of Internal Medicine found that the more they weighed, the less sleep they got. Other new studies, although small, suggest why. When subjects were deprived of sleep, they showed higher levels of a hormone that increases appetite and lower levels of one that makes you feel full. And earlier research has suggested that sleep deprivation can interfere with the ability to metabolize carbohydrates, which may lead to weight gain. Then again, you don't need to be a scientist to know that when you're tired, you're less likely to exercise and more vulnerable to the energy-lifting charms of candy, cookies, and ice cream.
Pull the plug. Everyone urges Gaskins to stop living on the cell phone and to spend more face time with others.
Find a mentor and pay it forward. Nelson suggests that Gaskins call people she admires in the D.C. area and ask if they'll have lunch. And being a mentor to others, perhaps children or older adults, might be grounding. "She's a social person whose beauty and intellect can intimidate people," says Treitler, "and she doesn't suffer fools. But she's a self-starter and a risk-taker, and she needs to be in leadership roles."
As Marijane Funess sits at the kitchen table ordering groceries through the online service of her local supermarket, the whole family gathers around the laptop asking, "Mom, can we go down this aisle?" And Funess, whose own childhood meals were mostly defined by frozen and canned foods, beams when her family is eating a traditional home-cooked dinner that includes meat, starch, and veg. But Treitler unearths quite a collection of salty, sugary, processed foods in this kitchen. One cupboard is filled with the chips, snack cakes, beef jerky, and packaged ramen noodles favored by 7-year-old twins Veronica and Nicholas, who expect candy for dessert, following the example of their dad. "It's three dark chocolate kisses per child," says Funess. "But they always ask, 'How many ' Like I'm going to change it." The fridge holds the makings of fried-egg sandwiches, the favorite late-night meal of 18-year-old Gregory, her son from an earlier marriage. He often starts the day with a doughnut picked up en route to school and usually doesn't eat again until 10 P.M. because the medicine he takes for attention deficit disorder kills his appetite. All three kids could live on ham.
Funess has a theory: Everyone is a "light switch" or a "dimmer." If you're a dimmer, you can eat a handful of corn chips, a few macadamia nuts, a one-inch brownie without wanting the whole pan. But a light switch is either on or off—once you start on the chips or nuts or whatever is your poison, you can't stop. Funess is a light switch, one who doesn't care about cookies but considers cereal with milk and sugar so dangerous that she avoids it altogether. For most of her 47 years, she has been able to eat what she wants, or at least hide it well on her 5'3" frame, but last year she packed on an extra 15 pounds. She's since lost weight on a Monday-to-Friday regimen of high protein and limited carbs: yogurt and banana for breakfast, avocado and tuna for lunch ("I eat it right out of the can like a cat"), iced tea with Equal throughout the day, and some kind of meat for dinner (tonight it's pulled-pork sandwiches for the family—no bread for mom). On weekends she indulges in dinners out (pasta, dessert) with her husband, Richard, a public relations executive.
Having put aside her own PR career for motherhood—except for the occasional project—part of every day is devoted to fitness, including twice-weekly tennis games with friends in the gracious New York suburb of Pelham and three classes a week that fuse the principles of yoga, Pilates, and core conditioning. Funess is full of energy, talks at warp speed, and multitasks like crazy, getting an NPR fix while making school lunches or supervising homework during dinner prep. Although she feels guilty about any time spent away from her family in pursuit of intellectual stimulation (like her addiction to computer Scrabble), it's obvious that she manages some soul satisfaction—in her monthly book club, in periodic synagogue attendance, and in a terrific neighborhood support system. ("If you have a life-threatening illness, this where you want to live," she says.) It's also obvious that family values in this family aren't just talk—every summer there's a surprise educational vacation (the kids get picked up at school on the way to the airport, having no idea where they're headed) and the house is brimming with photos of the extended clan. But behind some of those photos are health omens: a mother who had two heart attacks (Funess is on cholesterol-lowering medicine) and a depressed and alcoholic father who took his own life.
Although her bedroom, with its calming peachy colors and silk neck pillows, could be a sanctuary, Funess has trouble falling asleep, and Treitler easily finds the source of her insomnia: a pullout TV in the closet. Ever since 9/11 claimed the lives of several in her community, Funess has been even more of a late-night news junkie than she was before.
Real women have carbs—the healthy kind. Genetics might explain Funess's fear of cereal: New research from Princeton University links the brain chemical galanin to both alcohol and food addictions, and another study from the Royal Ottawa Hospital shows that some alcoholics specifically crave sweets to increase levels of serotonin. "It's not hard to connect the dots," says Peeke. "It wouldn't be surprising that someone with a genetic history of alcoholism is addicted to refined carbs—her biological hardwiring makes her more vulnerable." But healthy carbohydrates such as whole grains, vegetables, and fruit are missing from her diet, which could put her at risk for macular degeneration or diverticulitis, and her higher than normal consumption of protein can deplete calcium from bones, says Peeke. Getting about 15 to 20 percent of calories from protein is optimal for bone health.
Bone up. Since Funess underwent in vitro fertilization to conceive the twins (a possible increased risk factor for ovarian cancer, according to some studies), she gets regular gynecological checkups, including a vaginal ultrasound, but has never discussed calcium supplements with her doctor. (She's not alone: According to a 2004 survey by the National Women's Health Resource Center, 59 percent of women over age 40 have not asked their doctor about their bone health or had a bone-mineral density test.) Peeke recommends a baseline test immediately. Funess should also start taking calcium (1,000 milligrams) and vitamin D (200 IU) supplements. Eating calcium-rich vegetables like bok choy, kale, and broccoli will help—she needs more greens in her diet anyway.
Talk is not cheap. Processing the shock of a parent's suicide can take years, and Funess's hyper pace suggests she may still have some unresolved pain. "A book group can create an opportunity to unburden emotionally without going through therapy," says Treitler, "and she seems to be intellectually matched—practically every woman in this community now wearing bunny slippers to pick up the morning paper used to be the CEO of something. But even after four years, the club members are not part of her inner circle of friends. Although the club meets some of her needs, it's not addressing her emotional ones." So perhaps, the experts suggest, a support group or therapy would be helpful.
Wolfgang Mozart beats Wolf Blitzer. Funess's nighttime TV ritual is wreaking havoc with her levels of cortisol, a stress hormone, according to Peeke. "The National Sleep Foundation advises that you use your bed for sex and sleep, period," says Nelson. "If you have sleep problems, even reading, which is not close to the stimulation of TV, should be done in a chair. Maybe she could check into MSNBC online for ten minutes earlier in the evening and once in bed listen to music instead."
Hold the Equal. Sparkling water mixed with fruit juice, pomegranate seeds, or cucumber slices is a better choice than that artificially sweetened tea—not to mention the kids' soft drinks. The latter are mostly made with high-fructose corn syrup, which according to some recent research is metabolized differently from other sugars and hits the liver as if you were a Strasbourg goose being fattened for foie gras.
Tough love. Treitler suggests that while Gregory's still living at home, Funess enlist him to set a better example for his adoring younger siblings. "If he becomes a leader instead of a rule breaker," she says, "he will be more empowered to change his own eating behaviors." She recommends that the younger kids experiment with the Hocus-Pocus Magical Cookbook, by Donna Boundy, which comes with a wand and spells to recite while cooking and getting subtle nutrition lessons. And Nelson assures Funess that the children will adapt. "The data on kids' food preferences show that it's really about what's there for them," she says. "They will not go hungry. When they venture out into the world, they'll eat what they want, but their mother has a lot of control over what's served and should slowly change the availability of food in her own home. Introduce a good thing; remove a not-so-good thing. It can take a year to transform those habits. The dark chocolate has some antioxidant properties, but you get so much fat that it counterbalances the good effect. Sadly, don't expect it to prevent heart disease."
A Whole Foods Market in suburban New Jersey has become a petri dish for Treitler: She watches as Alethea Lodge-Clarke finishes shopping with her two little boys and a clerk offers a taste of a new soy beverage. Three-year-old Julian (just like his mom) is eager to try it, but 5-year-old Simeon (just like his dad) turns up his nose.
Lodge-Clarke, 35, an account manager for Microsoft, and her husband, an applications developer at Morgan Stanley, met at college in New York City—two ambitious techies who grew up in Jamaica. But they have almost comically contrary diets. Knowledgeable and conscientious about food choices, Lodge-Clarke no longer eats meat; she brews green tea several times a day (sometimes throwing out what she believes is the more caffeinated first draw) and makes drinks from a "greens and grains" powder that is basically dried broccoli ("You have to eat too many vegetables to get what you need," she says). A kitchen check reveals a cabinet full of sugar-free chocolates and Hershey's syrup, but Lodge-Clarke denies touching any of it. "I eat only the good stuff," she says, pointing to the basement, where she has Treitler climb over several pieces of futon furniture and other household detritus to a stash of fine Belgian chocolates stored intentionally—almost inaccessibly—in the far-corner closet.
Budget is not a concern for Lodge-Clarke—on weekends she spends whatever she deems necessary for quality shopping at three different stores: the supermarket for staples, the health food store for anything fresh, and an ethnic market for the sweet yams, plantains, ginger, and mangoes that she uses in Caribbean dishes. She makes brown rice for herself and white rice for her husband, which leads us to his habits. Where she is all steel-cut oatmeal, wild Alaskan salmon, and natural peanut butter, he is Entenmann's Louisiana Crunch Cake, Lucky Charms cereal, and Ben & Jerry's Cherry Garcia. She feels she must bring home alien things like Doritos and corn dogs—"otherwise I'll hear, 'There's nothing to eat in the house.'" Having been an athlete in school, Lodge-Clarke has a strong, muscled physique, although at 5'5" and 143 pounds, she's still carrying a good bit of pregnancy weight three years after her last child was born and pulls out the bathroom scale only at Treitler's direction. Three days a week at the local gym is helping: yoga, an elliptical machine (which she pedals while watching the cooking channel on TV), and a "body pump" class. She chooses the right weights and knows her limitations, Treitler observes, even though the instructor gives little instruction. But at certain times of the month, exercise makes her ravenous and tempted by the less-wholesome aisles at Whole Foods.
Lodge-Clarke is going for her second postgraduate degree, hoping to transition into the retail hospitality group at Microsoft, and collapses by 10 P.M., often with the two little boys in her bed, while her husband works at his computer until 3 or 4 in the morning. Treitler finds, among all the technical manuals on their bookshelves, one volume entitled The Art of Sexual Ecstasy, which Lodge-Clarke wryly notes dates from "back in the day."
It's all in the family. Of the four women, Lodge-Clarke has the healthiest routine. She's made assertive, deliberate decisions about her self-care—although she's still getting a fair amount of caffeine from her green tea and might consider decaffeinated. Now she needs to apply her acumen and creativity to improving the health of her family. Lodge-Clarke is wise enough to recognize that she can't force changes in her husband's habits—Peeke notes it usually takes a health scare to move a man to action—but the team would like the boys to receive a unified message. Children learn preferences from their parents about the way to cook and eat, and they learn that it's possible to leverage one parent against the other. Peeke proposes that the boys be enlisted in reforming their dad's eating behavior. "It's worked for smokers," Peeke reminds us. "A wife can nag all day, but it has much more impact when a kid tells a parent, 'That secondary smoke is bad for me.'"
Make a date with a married man. "There's a great work ethic here and connection to family," says Nelson, "but the couple need to notice each other, have some protected time together." Instead of taking turns handing the kids off to each other, as they usually do, a trustworthy babysitter could provide them more time alone, perhaps even to work out at the gym together. Getting more involved in their community, especially with neighbors who have kids the same ages as theirs, would offer opportunities to socialize with adults while the young ones play.
Table the food differences. The couple also need to be more present with their sons. They could start by having a family meal, eating the same food, three times a week or consistently on the weekend. The Journal of Adolescent Health recently reported that families who eat together consume healthier fare. Treitler is a fan of giving foods amusing child-friendly names: Whole wheat pasta shells are "boats" and broccoli florets are "trees."
Preempt the monthly munchies. Lodge-Clarke is so tuned in to her body that she can feel each ovulation (a pain known as mittelschmerz), but that also means she's at an advantage in planning ahead. "There is plenty of evidence to show that women's appetites are associated with their menstrual cycle," confirms Peeke, "so she can be prepared with appropriate foods to help quell the impetus for refined sugar and fat. Cottage cheese with raisins and walnuts is a good combination; crunchy peanut butter on a multigrain cracker with no-preservative jam is a mini PB&J."
Take a time-out. Although Lodge-Clarke does an acrobatic job of juggling her work, travel, family, gym, and school, she's at risk of running herself ragged. The experts say there's a real need for her to foster a mind-body connection every day—which can be as simple a gesture as putting a lavender-scented eye pillow over her eyes for a few minutes and maintaining a blank mental blackboard. Her life, like that of many women, is not a continuum but a series of cycles, often including education, career development, and childbearing. "Women's lives are not so unilinear as men's," says Treitler. "Women feel like they lose direction and every little tornado will last forever: Your body will never be your own again after pregnancy, you'll always be running after a toddler.... If a woman appreciates that each cycle is a way station, she can throw herself into every minute of it and really be empowered."
Next: Finding your health blind spots
Ox, Gaskins, Funess, and Lodge-Clarke each have different problems, and different strengths. But if there is one thread that makes them all candidates for a healthy upgrade, it's their blind spots. Even smart women who know what they're supposed to do can slip into selective denial, perhaps finding it too painful to look at a problem or taking a basically good idea too far. Gaskins has glossed over her weight gain and shrouded her larger size. Funess's protein-centric diet is putting her bones at risk. Lodge-Clarke overlooks the way her healthy agenda is sabotaged at home, and what she's missing emotionally. Fox flatly ignores her body's requirements, sacrificing nutrition in the name of weight control.
There's certainly a need for all of them—for all of us—to make some downtime for ourselves, to step off life's treadmill occasionally (make that regularly) and unplug. Even Fox, who's no longer governed by the quotidian demands of children or career, has phones ringing constantly in her life—justified because she must be available to elderly parents and young grandchildren, except that very few of these calls relate to family concerns. If she were more selective about her social network, she would feel less "busy, busy, busy," and in fact would have more time for meaningful pursuits, like the volunteer work she used to do with young violent offenders. "This would help her get over the need for control in her own life and into affecting other people's existence," says Treitler. "Writing a check doesn't touch your life like being in the trenches. It's about getting your hands dirty."