I want to extend a special “Thanks!” to our audience, as response to the previous post regarding observations and comments has been outstanding. Our community of HEALTH orientation and CARING for each other extends far and wide. It’s actually the true form of “healthcare,” but that’s a slightly different topic I’ll save for another time. This post has some reporting on overall progress with Project JACKED.
The intervention group continues to make significant strides toward our target outcome, which is really improved health and performance. Sure, everyone is losing weight, dropping body fat, increasing muscle mass, but they are all noting how they look and feel better than they have in years. Skin is glowing, strides are bouncing, and I continue to be impressed with how youthful and energetic folks are getting. And all of this is coming from simple lifestyle tweaks, using nutrition, activity, and sleep strategies, to get results.
I readily admit that I had, going into JACKED, and still have, a confirmation bias. Of course I expected the interventions to work. Not just because of the way I assembled the strategies of wellness. Not just because there were mountains of peer-reviewed research supporting the dietary and training methods we employed. But because I knew, I just knew, based on common sense, that health is in most cases an easily attained goal when you simply do the right things. And this is more true when you have a way to experiment and customize the interventions to get that best-fit, personalized system. One size doesn’t fit all, but the JACKED approach is helping our team members to JACKEDify their own lifestyle. Project JACKED is a lot of things…it’s a system of health enhancement, it’s a story of how real people succeed in wellness, and it’s also a research project. I violated one of the key principles in research, because I held a very strong bias. Forgive me if you can.
Here’s where things get sticky. I have to talk about the control group and this isn’t going to be comfortable. As I had mentioned previously, 12 subjects agreed to participate in the Project JACKED control group (they volunteered and were not randomly assigned or blinded). The requirements for the control group were that they would not participate in the JACKED interventions, and would continue to practice their pre-existing lifestyle patterns, which included being long-term non-exercisers (we did not control for chores or job duties, but none of these subjects participate in any form of exercise program), and also consistent consumers of the Standard American Diet (SAD). The SAD consumption was determined via questionnaire which identified dietary habits, preference for packaged, processed, and “fast” food, and an analysis of macronutrient and micronutrient content (performed by this author). I felt guilty in asking the control group participants to join the study and I had more difficulty in recruiting this group than the intervention group. I actually felt as though I was being negligent and committing healthcare malpractice by allowing people to continue with perceivably unhealthy habits. It was as though I was doing them a disservice by not immediately and strongly beseeching them to change their ways and improve their health habits, whether they used Project JACKED or not. I got around my guilty conscience by emphasizing that every control group participant could quit at any time, and that I would personally provide them with a complimentary JACKED program, including free health coaching, regardless of whether they decided to drop out or if they reached the completion of the term of the program.
Well, we lost one (control group participant) the other day. We started with 12 controls and now we have 11. I feel bad about this occurrence and I need to explain the circumstances. Even though the control group does not receive any of the education and coaching from which the intervention group benefits, I stay in contact with each of them on a weekly basis to check in and also to record some data on bodyweight, blood pressure, daily habits, and how they are feeling overall. In a phone conversation, the individual in question, a male (subject CM2, who was the second man to sign up for the control group), reported the onset of a number of symptoms that he seemed to become aware of recently.
CM2 told me that, over the past week or so, he had become increasingly cognizant of the following: an increase in weight, abdominal bloating, extreme thirst, frequent urination, significant appetite-mood-energy swings, blurred vision, and swelling in his ankles. As we are all probably aware these days, those are telltale symptoms of type 2 diabetes. I’m not a physician and I never pretend to be one, so I recommended that he immediately get an appointment with his doctor for proper diagnosis and treatment of this condition. I asked that he keep me informed of his status because I was acutely concerned and I also offered to provide advisement in any way that was indicated.
Several days later CM2 called me and reported that his physician had diagnosed him with type 2 diabetes. Blood tests had revealed elevated levels of fasting glucose and insulin, and his HbA1c had also surpassed diagnostic criteria. CM2 also said that, upon reflection, he had noticed these symptoms gradually increasing for several weeks but hadn’t thought too much about them. Given the presentation, his doctor wanted to treat CM2 with the prescription drug Metformin to address the insulin resistance, and would also be conducting an oral glucose tolerance test (in which blood sugar responses are measured after ingesting a sweet syrup solution). A low-fat, whole-grain and fruit-based diet was prescribed and CM2 was advised to start a walking program, but given no specifics on how to approach this exercise. The plan was to re-evaluate in one month and assess progress, with the consideration of using injectable insulin if results were unsatisfactory. Not wanting to overstep my bounds, I offered to provide some supportive consultation regarding the diet and exercise plan. Since newer research supports the consumption of lower carbs and higher fats in the treatment of type 2 diabetes, I wanted to share some of the articles and books I had with CM2. I also wanted to give him some simple suggestions regarding a walking program, footwear selection, and the use of a basic heart rate monitor.
I got shut down. CM2 said he would rather just follow the advice of his physician, and trust in the medication to fix this problem, which he thought was just a bummer of a genetic card he had been dealt. I lobbied that insulin resistance, and his resultant diabetic condition was a product of consuming the SAD, and magnified by sedentarism. This is all supported strongly by research. I suggested to CM2 that he could consult with his physician and share some of the dietary studies that showed a potentially better, and real, solution to his problem. This was significantly different from the one-page “healthy whole grain” menu he was given at the medical office. Our conversation was polite, but my suggestions were kindly refused. I was a bit disappointed, but not really surprised or offended by this conclusion (which I hope is temporary). I wanted to leave the door open so I thanked him profusely for being in the study and made sure he knew that he could reach out to me any time for advice or assistance. I also asked his permission to check up on him with a phone call each week because I genuinely cared about his health. He said yes to that and so I’ll continue to call him, but I’m still processing all this as I put finger to keyboard.
I guess dismayed is the best way to describe how I’m feeling about CM2. Another of my hypotheses in the study is being proven to be true, but it causes me much consternation. I theorized that the control group parameters (SAD/sedentarism) would not only inhibit participants (all people, really) from health increases, but that it would actually act as an accelerant of decay and reduction of healthspan. Well, that happened. I kinda knew it would. And I bet you did, too. We probably had a bias that a less than optimal lifestyle is harmful. The problem, as I see it, exists in that it’s not our relatively small collective of health-minded individuals who have to hear the messages of wellness. Our conundrum is that we have to find a way to not give up on the masses, and help them to understand how health really works, and how it really is our own (each and every one of us) responsibility to maintain it. At the risk of appearing apoplectic, I get frustrated when I try to educate, help, and convince others of the path to wellness. I’m sure you do too. But let’s not throw our hands up and say it’s hopeless. It’s not. Let’s keep persevering to spread the word, the magic, the love…whatever you want to call it. We have to blend the quixotic with the practical, but we can get this world healthier. And CM2, if you are reading this, I hope you are not offended. I’m always here for you.