I’m sharing a gym in Rochester, Minn., with 16 men and women. We are part of a pilot program for a new venture called the Mayo Clinic Healthy Living Plan. We were told to wear comfortable clothes and athletic shoes, but the hardcore workout we all expected never shows up. Instead, we are introduced to a concept called NEAT, which stands for Non-Exercise Activity Thermogenesis. Our bodies are built to move, we are told, and every bit of movement—not just exercise—makes a difference.
A small, clip-on device we had been given, called a KAM (for Kinetic Activity Monitor), measures how much, how often, and how fast we are moving. Each point on the KAM represents a percentage increase over our resting metabolic rate. Low readings are supposed to spur us into action.
We review research that reveals the damage that sitting in front of a computer does to our bodies. We look at studies that show how exercise improves memory and attention span. Other studies are trotted out that discuss the positive impact that exercise has on colon and breast cancer, erectile dysfunction, low back pain, stroke, insomnia, osteoporosis, fatigue, anxiety, depression, dementia, falls, and more.
Here’s the cool part. All these messages are delivered while we are strolling on treadmills, moving along at an easy, one-mile-per-hour clip. No sweat, but we are burning calories, which is the point. The class ends with a quote from Edward Stanley, Third Earl of Derby, who reputedly said: “Those who think they have not time for bodily exercise will sooner or later have to find time for illness.”
Return to Rochester
I’ve been a fan of Mayo since 1997 when I traveled to Rochester to participate in the clinic’s Executive Health Program. I had two primary goals at the time. First, to get the answer to a burning question—did an annual physical exam make sense or was a once-a-year strip-and-search overkill? The second was to determine whether the $1,500 Mayo charged for its 2 1/2 days of exams and consultations was worth it.
Dr. Donald Hensrud, an internist who ran the program, was my supervising doctor. He suggested ways to deal with my chronic headache, blood pressure, and cholesterol problems. One of his associates, a urologist, laid out a sensible program for dealing with my enlarged prostate. Another, an orthopedist, assured me that my cranky back was not a candidate for additional surgery.
I returned to Mayo the next year for a follow-up. This time I left with exercises to strengthen the muscles in my neck, good suggestions for dealing with the gout and kidney stones that had appeared since my last visit, and the feeling, once again, that Hensrud and the men and women who poked and probed while I was at the clinic knew what they were doing.
I liked everything about my visits, and I spelled it out in two Coins2Day articles: “Me & The Mayo,” July 21, 1997, and “The Checkup, Part II,” Oct. 26, 1998. When Hensrud sent me an invitation this February to participate in a pilot for Mayo’s new Healthy Living Plan, it was a no-brainer. Count me in.
And yet, I had doubts. Everyone knows that exercise and sleep are good for you and that extra pounds and stress aren’t. What, I wondered, does Mayo have up its sleeve that’s new and different enough to make its brand of healthy living sink in? The three-day program is priced at $4,500. I couldn’t help wondering what Mayo would do to make sure that the participants would put its recommendations into play once we left town and re-entered the real world.
The Mayo Clinic was founded in 1859. A nonprofit with a worldwide reputation for smarts and a patient roster to prove it, the clinic that started as a one-building facility in Rochester has evolved into an operation that now includes destination hospitals in Jacksonville and Phoenix/Scottsdale plus a network of smaller clinics and hospitals in 64 communities throughout Minnesota, Wisconsin, and Iowa. Mayo’s more than 7,500 staff physicians, residents, and fellows treat approximately 2 million patients a year. Another 2,000 physicians and scientists are involved in research.
The Executive Health Program I attended continues to grow, attracting 7,760 patients last year. The new Healthy Living Plan, or HLP as it’s called, is just getting going.
Getting Started
At 11:30 Monday morning, our group checked in, got our schedules, and toured the Dan Abraham Healthy Living Center, a sprawling building that was funded by the founder of Slim-Fast Foods, who will celebrate his 90th birthday in August. The locker room is seriously beautiful. The machines that will measure and test our body composition, aerobic capacity, and strength are awesome. The dining room is lovely. Ditto for the meeting rooms, the kitchens where we will cook low-calorie meals, and the nooks and crannies where we’ll be able to hunker down and chill out.
One other thing: The men and women who staff the center are slim, trim, upbeat, and friendly. I’ve never seen so many healthy bodies and smiling faces. Scary.
Helping ourselves to the buffet, we filed into the bright, cheerful dining room and got started. Dr. Warren Thompson kicked things off with the tale of a 40-year-old woman with two kids, a stressful job, too many pounds, and over-the-top blood pressure, cholesterol, and glucose readings. He first saw her in 2002. After many ups and downs, relapses and recoveries, she now has the variables under control, thanks to many of the things we’re about to discover.
“The state of being healthy in body and mind is determined in part by genes, behavior, and luck,” Dr. Thompson told us, “but we intend to help you design and implement an individualized wellness plan that will help you achieve optimal health.”
Dr. Thompson presented statistics on heart disease, cancer, dementia, and the other major killers, citing study after study that showed how poor eating habits, lack of exercise, and stress keep surfacing as the culprits. “Optimists live longer than pessimists,” he reminded us, adding: “People who don’t smoke, are physically active, eat at least five fruits and vegetables daily, and consume moderate amounts of alcohol can expect to live 14 years longer than those who don’t.” We’ve heard it all before, of course, but the numbers were sobering.
Dr. Mathew Clark, a psychologist, told us that sources of stress are everywhere, from work and family to unexpected illness and financial problems. “Lack of control,” he said, “equals stress.” One way to get life under control is to put things into perspective by constantly asking yourself: “Is this something that’s going to matter five years from now?”
This was followed by the NEAT experience on the treadmills, then by a presentation from Hensrud, who took us through the key points of nutrition. Our diet has gone dramatically downhill in recent years, he said, and that’s sad because what we eat has a powerful effect on heart disease, cancer, obesity, and a long list of others. Okay. What’s the answer? Recognize that obstacles exist, Hensrud said, create strategies to overcome them, make intelligent changes in your diet, and—with Mayo’s help—make the changes part of your life.
Managing Stress
The rest of the week was a blur. Day 2 started with a 7 a.m. Blood test for cholesterol, triglycerides, and glucose. This was followed by height and weight measurements; blood pressure, heart, and pulse readings; one stress test to identify strength deficiencies, a second to assess cardiovascular conditioning.
Then things got serious: A series of machines measured the lean and fat composition of our bodies, another examined our muscular endurance, flexibility, and balance. It was impressively high-tech. I particularly liked the Lunar iDXA, an open-air dual X-ray absorptometric device that scanned our bodies, sending back data on bone density, spine geometry, and regional tissue conditioning—or something like that.
Later that day I had my first one-on-one with Dr. Kristin Vickers Douglas, my wellness coach. This was followed by a session called SMART (short for stress management and resilience training) that introduced us to the benefits of five-minute breaks, paced breathing, hugs, and walks around the block. The day ended in a glistening kitchen where a chef demonstrated ways to make healthy food that tasted as good as it looked.
Day 3 began with an hour of Yoga. In the next session—Balance, Fitness and Strength—we created personalized physical activity plans, then put them into action. At some point someone told us that Einstein came up with the theory of relativity while riding a bike.
The afternoon started with a hands-on cooking class—we made orzo, mixed vegetables, and chicken—and ended with Pilates. It also included another session on resiliency: We took walks, looked for positives in negative situations, and were told that smiling and saying hello to strangers is a good way to start the day. I’m from New York, I told the class, and I suspect some of this might be problematic.
My final day, which had slots for electives, included a session in the gym where I tried out a bunch of new moves I had learned; another one-on-one with Dr. Vickers Douglas, who gave me new ways to think about resiliency and new things to try; and another spin on the slow-moving treadmills.
Of all the lectures, demonstrations, and drills, the NEAT wrap-up produced the most surprises. As we were doing our thing, strolling along at a leisurely pace, Nolan Peterson, one of the fittest people I have ever met, spelled out what getting up and moving about can do for the heart, soul, and other key parts of the body.
Peterson introduced us to a family of video games that got us playing tennis and skiing in sync with images on the screen. He showed us desks and ergonomic computer stands that would enable us to stand rather than sit while we worked, and he reminded us about the calories we burned while we were on the treadmills. Slowly but surely, it began to sink in.
My workout routine also has a new look. I’ve been a gym rat all my life, but I was turned on by the new core strengthening exercises I learned. I also figured out what interval training is all about. Rather than rolling along at a steady pace on a stationary bike for 15 minutes, I discovered that peddling at a modest pace for, say, three minutes, then at a fast pace for 30 seconds, then repeating the procedure three or four times, is a great way to get the blood flowing, muscles pumping, and heart pounding in a way that makes the weight lifting, stretches, and other exercises dramatically more productive. It also feels good.
Dr. Vickers Douglas provided another unexpected takeaway. It involved a study by a Harvard psychologist, Ellen Langer, who asked 84 maids at seven Boston hotels to describe how much exercise they got. A third of the group said none. The others said they didn’t work out regularly. After examining the women, Langer concluded that virtually all had the fitness levels of sedentary people. She then divided the group in two. The first was told that pushing vacuum cleaners, scrubbing tubs, and making beds used more than enough energy to meet the surgeon general’s recommendations for daily physical activity. The second group was given no guidance.
A month later Langer re-examined the women. The maids in the second group showed no measureable changes. The ones in the first lost an average of two pounds and showed a 10-point drop in systolic blood pressure and meaningful reductions in their body fat and waist-to-hip ratios. Although they made no changes in behavior, the first group of women felt “significantly healthier” and now considered themselves to be regular exercisers.
Langer saw it as a lesson in mindfulness, a theme that’s developing a growing following. In a Feb. 3, 2014 cover story titled “The Mindful Revolution,” Time magazine presented a series of studies that suggested that “finding peace in a stressed-out, digitally dependent culture may just be a matter of thinking differently.”
Dr. David H. Newman, director of clinical research at New York’s Mt. Sinai School of Medicine, shared similar thoughts in a Jan. 7, 2014 column in the Huffington Post. Pointing to a recent study of candidates for knee surgery, only some of whom actually had surgery, he said: “Subjects who underwent the fake procedure experienced just as much improvement in pain and activity as those whose meniscus was actually repaired.” The effectiveness of fake procedures, he concluded, “is a testament to the power of mind and body, and a critical window into human healing.”
Hensrud is enthusiastic about the Mayo’s new concept. It’s based on solid medical research, he says, and it works because it’s not one size fits all. “We create individualized plans to help people reach their personal wellness goals, and we stay in touch so the success they achieve here continues once they get home.”
At 3 p.m. On the Wednesday following my return to New York, I received a call from my coach. She asked how things were going. Fine on the exercise front, I said. I’ve incorporated interval training, yoga, and new core exercises into my gym routine. I’m taking the stairs and getting off the subway one stop before my destination. I’m also about to do a lot more standing. In one of those stranger-than-fiction strokes of luck, a Time Inc. Staffer overhauled his office recently and I inherited an ergonomic stand. It’s now being installed at my desk, where it will hold my computer and keyboard.
I’m also doing okay on the nutritional front. I lost three pounds while I was in Rochester, and they’ve stayed off. I’ve lost an inch in my waistline. I’ve replaced muffins with nuts. I’m eating healthy lunches, and I pitched in as sous chef this weekend when my wife whipped up one of Mayo’s chicken and orzo dishes.
Stress is another thing. I returned to a huge pile of work, unexpected deadlines, a computer that has a mind of its own, a printer that prints when it feels like it, and a bunch of challenges outside the office, all of which knocked the stuffing out of my plans to be upbeat and happy.
Stuff happens, my coach said. Hang in there. This is a long-term process, and change doesn’t take place over night. When the going gets rough, she said, you might try focusing for a few minutes on an emotionally neutral subject—a character in a novel, say, or a photo on the wall—anything to move your mind into stress-free territory. Later in the call she suggested I might want to add Mayo’s meditation app to my iPhone. I gave it a shot. It only cost $2.99, and turned out to be a cool way to slide 10 minutes of slow, relaxing breathing into a busy schedule.
Dr. Vickers Douglas and I had two more Wednesday afternoon phone calls. She was supportive, made good suggestions, and wouldn’t let me get down on myself. As a result of the calls and my class notes, some of the resiliency stuff I heard in Rochester—the stuff that struck me as airy-fairy—is beginning to make sense. I still don’t talk to strangers on the subway, but I’m smiling and saying good morning to people on the elevator in the Time/Life building. And no one has slugged me yet.
Taking My Medicine
The formal part of the program I attended didn’t kick off until noon on Monday. I used the free time that morning to schedule an appointment at the clinic to tackle a medical issue—chronic dryness and pain in my eyes. After a thorough exam and discussion of the drops, steroids, plugs, and procedures I’ve tried over the years, Cherie B. Nau, a senior associate in the Mayo ophthalmology department, suggested I might want to go for a punctual cautery occlusion, a fancy term for a procedure in which the openings in the corner of my eyes are cauterized shut, closing the passageway through which the modest amount of tears I produce escape.
It didn’t sound like fun, but what the hell. I returned to the clinic at 4:30 that afternoon and was introduced to Heidrun Gollagly, a surgical resident. Dr. Gollagly looked me over and agreed that the procedure would be a good one to try. The tool she planned to use to cauterize the openings didn’t look too dangerous. There will be about three seconds of sharp pain in each eye, she said, and there was. There might be pain and bleeding during the night, she added. There wasn’t. I woke the next morning feeling fine, and now, three months after the cauterization, the dryness and burning I had been living with for years are virtually gone.
It was great to blend a little medicine into my visit to Rochester, and it’s something I suspect others are apt to do. It’s a double play that makes sense.
What’s New
It’s now three months since my visit to Rochester. I haven’t made any real progress on the resiliency front, but I’m working out regularly, doing more walking, and I’ve lost another two pounds.
But enough about me. How are things at the new Healthy Living Plan, which officially launched on June 2? Shaping up nicely, says Hensrud. We’re a startup, a work-in-progress, and new wrinkles are regularly being added to the program. The spa facilities at the Abraham center are now up and running, so participants have an assortment of new electives to add to their schedules. The programs now end with a low-key graduation session at which participants are encouraged to discuss their experiences, share ideas, and swap contact data. Most important, follow-up contacts with Mayo coaches have been extended to six months, and they now include phone calls, secure email messaging, and web postings.
For an overview of what the program looks like, go to healthyliving.mayoclinic.org/services-/the-healthy-living-plan.php.
