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In the fitness world, coaching and training pregnant and postpartum women is often considered a niche market.

Granted, it does take a special set of skills to safely coach women who are pregnant or postpartum, but…

Did you know that more than 85 percent of women will have children at some point in their lives? 

That means among your female clients, almost 9 out of 10 will either become pregnant, be pregnant, or be postpartum. When you look at it this way, that’s not such a niche market, is it?

So if you’re working with women, it only makes sense to know exactly how to work safely and effectively with pregnant and postpartum clients.

(While we’re only going to discuss — and quiz you on! — pregnancy here, you can test your knowledge about the postpartum period here.)

Let’s get started with an overview of the top pregnancy-specific health and fitness topics we’ll be quizzing you on.

6 Pregnancy Topics Coaches and Trainers Need to Master

There are six key areas that every health and fitness professional should know about in order to help keep their clients safe and healthy while training during pregnancy:

  1. Anatomical and physiological changes during pregnancy
  2. Musculoskeletal concerns during pregnancy
  3. Exercise modifications during pregnancy
  4. Nutrition considerations during pregnancy
  5. Prenatal coaching and psychology
  6. Leadership and professionalism

If you can master these six topics, you’ll be in a fantastic position to serve your female clients really, really well.

Here’s why.

Anatomical and Physiological Changes During Pregnancy

When a woman becomes pregnant, her body begins making huge changes to allow for the growth and development of the baby while maintaining her own health. Early on, this primarily presents as hormonal and metabolic shifts, but as her pregnancy progresses and the fetus grows, she may also begin to see changes in her:

  • Weight
  • Posture
  • Breast size
  • Pelvic floor
  • Abdominal wall, with a primary expansion at the linea alba
  • Respiratory system (e.g., breathing more deeply)
  • Cardiovascular system (e.g., an increase in resting heart rate)

While this is not by any means an exhaustive list, these changes can, in turn, affect things like balance and aerobic capacity and may cause incontinence, aches and pains, nausea, or other symptoms. Obviously, there are some major implications for exercise and training here!

Knowing how to work with or around these anatomical and physiological changes will set you apart from other trainers. And not only that, it will give you the tools you need to help accommodate your client’s changing body (such as a softening of her fascia and connective tissue resulting from hormonal changes) while helping her feel strong and powerful.

Musculoskeletal Concerns During Pregnancy

While diagnosis and treatment of musculoskeletal conditions are beyond the scope of practice for a coach, being aware of the signs and symptoms of common pregnancy-related issues is vital for a health and fitness professional.

Just to scratch the surface, conditions coaches and trainers should be familiar with — and understand exercise implications for — include:

If you’re able to recognize these issues, not only will you be able to refer your client to the appropriate professional, but you’ll also be able to take her condition into account and adapt her programming as needed — both of which can help increase the likelihood of a positive outcome for your client.

Exercise Modifications During Pregnancy

As your client’s pregnancy progresses, you will need to implement the proper modifications to her exercise program. While many seem to believe that “You’re safe to continue doing xyz as long as you were doing it before pregnancy,” this piece of advice is actually inaccurate and doesn’t convey the many factors that can impact exercise during pregnancy.

Being aware of the different considerations that inform exercise modifications during pregnancy can help you support your client in a way that will keep her both active and safe while still giving her a bit of a challenge.

Nutrition Considerations During Pregnancy

Now that she’s pregnant, your client may be more interested in her nutrition, even if that topic was of little interest to her in the past. Not only will she hear and read conflicting — and often misguided — advice about what to eat, she’ll hear that she should be eating “x more calories” or that she’s now “eating for two.”

Plus, your client may be navigating nutritional challenges during her pregnancy, like severe food aversions, which can make it more difficult for her to achieve the type of nutrition she’s striving for. If you’re knowledgeable about this, you can help her by providing evidence-based guidance and support. You can also guide her in developing healthy and sustainable nutrition habits so she can continue eating healthfully through pregnancy and beyond.

Prenatal Coaching and Psychology

If you truly want to stand apart as a coach and help women achieve (and sustain) their health and fitness goals, then mastering both the science of psychology and the art of coaching is crucial. And when it comes to pregnancy, that means understanding the ups, downs, crossroads, challenges, joys, heartbreaks, barriers to consistency, cultural considerations, privacy concerns, and mental and physical changes that can be part of the ride.

But it’s even more than that. It’s also recognizing and being able to compassionately talk to your client (if she wants) about sensitive topics like pregnancy loss, body image struggles, mental health problems, and her overall well-being — and knowing how and where to refer her if she needs specialized help.

Leadership and Professionalism 

To provide the highest level of service and care for your pregnant clients, it is critical that you can provide them with the most up-to-date information in a way that demonstrates both your knowledge and your humanity, and be able to help your clients navigate situations while still remaining within your scope of practice.

This means not only being able to handle certain tricky conversations, but also being able to point your clients to the appropriate health professional — hopefully vetted by you — when the situation warrants it.

Taking Stock

While we just gave you a rundown of the importance of the six topics we’re going to quiz you on in just a moment, we want to say it one more time:

Developing your skills in these areas and preparing to work specifically with women through pregnancy will make a huge positive difference in the lives of your clients — and in yours as well! 

This quiz is a chance to take stock of where you’re at and ask yourself:

  • “How confident am I when coaching or training clients who are pregnant?” 
  • “Do I know everything I need to know? Or do I have some hidden gaps in my knowledge?”

It’s a simple and low-stakes way to identify the areas where your skills and knowledge are solid — and where you still have room to grow.

Quick tip: When you’re answering the questions in the quiz, be honest with yourself. Instead of being uneasy about the areas where you’re less knowledgeable, see it as an exciting opportunity to learn more! 

At the end of the quiz, you’ll find our recommendations for evidence-based resources tailored to your results.

These resources, as well as the information here, were developed by the same team of experts behind our Pre- & Postnatal Coaching Certification, a cutting-edge, comprehensive curriculum designed to teach health and fitness professionals exactly how to confidently coach pre- and postnatal women and keep them safe, healthy, and strong — both during and after pregnancy. Our experts include PhDs, pelvic health physios, pre- and postnatal fitness experts, OB/GYNs, university researchers, midwives, psychologists, doulas, and more.

Quiz Time!

Before we begin, it’s important to note that the questions in this quiz are focused solely on specific situations you may encounter or experience with your clients who are pregnant, meaning we are not testing you on the basic coaching skills that anyone working with clients should have. For example, you will not see questions about:

  • Basic coaching communication and listening skills
  • General anatomy and physiology
  • Building rapport and trust with your clients
  • Aerobic capacity, blood pressure, or fat distribution
  • Helping clients set behavior-based goals
  • Or many, many more essential coaching skills

Rather, you will see questions on the pregnancy-specific topics you read about a moment ago. Please note, though, that not every question will be relevant to every woman, as there are variations in experience and in anatomy.

For each of the questions, give an honest assessment of your knowledge on a scale of 0–5, where 0 means you know nothing about the topic, and 5 means you’re an expert.

Coach Pregnancy Quiz

Topic #1: Anatomical & Physiological Changes During Pregnancy

Your client explains that she’s concerned about diastasis recti in pregnancy, and asks if there’s anything she can do to prevent it. How well-equipped are you to discuss this topic with her?
Not at all equippedTotally prepared
After a set of squats, your client tells you that she feels particularly winded, and wonders if it’s something she should be worried about. How well versed are you about the changes to a woman’s respiratory system during pregnancy and what it means for your client in terms of exercise?
I don’t knowI got this
Your client tells you that she’s been feeling more clumsy now that she’s entered her third trimester, although she’s struggling to understand why. How much do you know about postural changes during pregnancy and how they can affect your client’s balance?
Not muchI know all about it
Your client is in her second trimester of pregnancy and has gained about 20 pounds so far. She’s heard conflicting advice about weight gain in pregnancy and wonders what’s “normal” and what’s not. How prepared are you to discuss this with her?
I’m notI’m an expert

Total for this section 0/20

Topic #2: Musculoskeletal Concerns During Pregnancy

Your client shows up with what seems like carpal tunnel syndrome symptoms. Do you know how to properly handle the situation?
NopeAbsolutely
One of your clients is in her third trimester of pregnancy, and complains that her back has been hurting a lot. How knowledgeable are you about suggesting exercises that may help alleviate back pain during pregnancy?
Not at allI’m an expert
One of your clients has been complaining of a sharp pain in her groin during your sessions together. Do you know what steps to take to address the situation?
I’m not sureYes, I’m on it!
After a set of squats, your client complains of some discomfort, and you ask her to describe exactly what she’s feeling. As she’s describing her symptoms, are you able to identify which ones could be potential signs of pelvic organ prolapse?
NopeAbsolutely

Total for this section 0/20

Topic #3: Exercise Modifications During Pregnancy

One of your regular clients has just become pregnant for the third time. She asks you what this means for her strength training program. How confident are you in answering her question right away?
Not confident at allI’m on top of it!
One of your bootcamp clients has expressed her desire to keep taking your class even though she’s pregnant. How comfortable are you providing her with the proper modifications?
Totally uncomfortableI got this
A new client wants to start working with you. During your initial meeting, she mentions that she’s just beginning her second trimester of pregnancy. How knowledgeable are you about the considerations to keep in mind when creating her exercise program?
I have no clueI’m an expert!
Your client tells you that while she enjoys her exercise sessions with you, her partner is worried that she “may be overdoing it.” How confident are you about the level of exertion that’s appropriate and safe for your pregnant client during her cardiovascular workouts?
I’m unsureSuper confident
One of your clients is in her third trimester and wants to know which exercises she should be avoiding and why. Do you know what to tell her, and how to explain your answer?
I don’t knowI know all about it
Your newly pregnant client, who used to train four times a week before pregnancy, comes to you wondering how her pregnancy will affect her workout schedule in the months to come. Do you understand the implications of pregnancy when it comes to exercise frequency?
There are implications?I understand it all!
Your client is an avid runner, and she approaches you to ask if it’s safe for her to keep running — it’s her first pregnancy and she’s unsure of what she’s “allowed” to do. How confident are you in answering her?
Not comfortableI’ve got it covered!

Total for this section 0/35

Topic #4: Nutrition Considerations During Pregnancy

One of your clients tells you she’s been struggling with food choices since she became pregnant, as many of the things she used to eat are no longer palatable to her. Are you aware of the tips you can give your client, while staying in your scope of practice, to help her manage her food aversions during pregnancy?
I don’t know what to sayYes, totally
Your client wants to know what you think of the whole “eating for two” idea. How much do you know about how to help women adjust their calories during pregnancy?
No idea!I’m an expert!
Do you know which tips you can give your client to help her keep up a sufficient water intake during pregnancy?
I’m not sureYes!
Your client asks if you can help her develop better eating habits now that she’s pregnant. Do you know how to teach her a habit- and skill-based approach?
I do notYes, that’s my jam!

Total for this section 0/20

Topic #5: Prenatal Coaching & Psychology

A client you’ve been training for a while confides that she just learned she’s pregnant. You can’t quite tell how she feels about the situation. Do you know how to respond?
I don’t know what to sayI’ve got this!
Your client has always been very active and wants to set some ambitious training goals for herself during pregnancy. Do you feel prepared to discuss these goals with her?
Not reallyI know what to do
Do you have a clear idea of what types of comments and information are appropriate to share — and what comments may actually be harmful — when it comes to discussing your client’s pregnant body with her?
Are there things I shouldn’t say?I’m an expert
You get a text from your client canceling her upcoming training sessions for the next two weeks. After you ask her if she’s OK, she discloses that she just experienced a miscarriage. How prepared are you to properly support this client through pregnancy loss?
Not at allI know exactly what to say
You catch your client wincing at her reflection in the mirror. She tells you that she doesn’t like how her pregnant body looks. How comfortable do you feel discussing your client’s body image struggles during pregnancy in a compassionate and non-dismissive way?
Not veryI’ve got this!
Your client admits that she’s been considering canceling her next session because she’s struggling with energy and motivation during her first trimester. How prepared are you to adjust your client’s workout according to her varying energy levels on any given day?
I’m not sureI can handle it

Total for this section 0/30

Topic #6: Leadership & Professionalism

Your client confides that she’s been diagnosed with gestational diabetes, and asks you if you can guide her in managing her condition. How confident are you handling this conversation?
I don’t know where to start100% confident
Do you know how to create a referral network of like-minded health professionals — like a pelvic health physiotherapist, a urogynecologist, and a mental health professional, just to name a few — so you can ensure your clients get the best care possible?
Wait, I need to do this?Got it covered!
Your client comes to you with a troubled look in her eyes, and confides in a low voice that she’s been “leaking” when she sneezes, and she’s worried because she doesn’t know what’s wrong with her. Her cheeks are flushed with embarrassment, and you can feel her anxiety. How comfortable are you discussing urinary incontinence during pregnancy with your client?
I don’t knowI’m a pro
How proactive are you in providing the most up-to-date, evidence-based recommendations and information to your clients when it comes to exercising during pregnancy?
I haven’t looked in a whileI’m all over it!

Total for this section 0/20

How Did You Do?

Feel like you totally rocked this quiz? That’s awesome! Not so sure how you did? No worries! That’s why GGS is here — to make sure you get the information you need to feel 100% confident in each of these scenarios.

To get a better idea of where your skills are already top-notch and where you have opportunities to continue learning and expanding your coaching skill set, click on the green button below to calculate your results. There you will find customized recommendations for which FREE articles and courses will be most useful to you.

Looking for even more detailed information and ready to take your knowledge and skills to the next level? Consider enrolling in our world-class Pre- & Postnatal Coaching Certification. You’ll learn exactly how to keep your pregnant and postpartum clients safe, healthy, and strong — and you’ll get the skills and knowledge you need to confidently and effectively coach, train, and empower women to be their strongest selves.

Remember: No matter how you scored in any of these areas, we’re here to help!

Your Results

#1: Anatomical & Physiological Changes During Pregnancy

|

SCORE: 0/0

SEE RECOMMENDED RESOURCES

#2: Musculoskeletal Concerns During Pregnancy

|

SCORE: 0/0

SEE RECOMMENDED RESOURCES

#3: Exercise Modifications During Pregnancy

|

SCORE: 0/0

SEE RECOMMENDED RESOURCES

#4: Nutrition Considerations During Pregnancy

|

SCORE: 0/0

SEE RECOMMENDED RESOURCES

#5: Prenatal Coaching & Psychology

|

SCORE: 0/0

SEE RECOMMENDED RESOURCES

By taking any of the steps above, whether it’s…

  • Reading an article to start gaining a better understanding of different prenatal topics
  • Signing up for one of our FREE 5-day courses to learn exactly how to coach women to move and eat in a way that’s safe and healthy, not only for their baby — but for them, too
  • Enrolling in our world-class Pre- and Postnatal Coaching Certification

… you’re helping raise the standard of care for women everywhere.

No matter how big or small your goals may be, you have a very real opportunity to create meaningful change in the lives of the women you work with — and the industry as a whole — and we’re here to support you every step of the way.

We know that you have it in you to make the kind of difference you want to make.

The post Are You Ready to Coach Pregnant Women? Take the Quiz! appeared first on Girls Gone Strong.

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You don’t have to swing to get that kettlebell thang going. Weigh the merits of these exercises for yourself.

Kettlebells are basically giant balls of metal with a handle on them. They trace their origins to Eastern Europe, the word girya (kettlebell) actually appears in a Russian distionary circa 1704(1).

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There’s something about a cocktail that can turn any mundane activity into a celebration. The colorful garnish, the refreshing fizz, the pretty glass… it’s the whole package.

For various reasons you just might not want alcohol. That doesn’t mean you have to skip out on the cocktail experience. These mocktails feature Ritual alcohol alternatives, which add the same bite and flavor enhancement that a shot of tequila or gin adds to a cocktail, without the boozy effects.

Here are three refreshing summer mocktails using Ritual’s keto-friendly alcohol alternatives.

Refreshing Summer Mocktail Recipes Using Alcohol Alternatives

mocktails alcohol alternatives

Tip: For a calorie-free and sugar-free option, we use liquid monk fruit sweetener in place of simple syrups that are typically used in cocktails. Some may prefer no sweetener while others will prefer a few drops, so add sweetener to taste.

Dragonfruit Margarita

Serves: 1

Time in the kitchen: 2 minutes

Ingredients

  • 1 oz. Ritual Tequila Alternative
  • 2 scoops Primal Kitchen Dragonfruit Collagen
  • 1/2-1 oz. lime juice
  • 1 oz. water
  • 6 oz. club soda or seltzer
  • 1-2 drops liquid monkfruit sweetener
  • Slices of lime
  • Ice

Directions

Pour some salt onto a small plate. Press a slice of lime around the rim of a glass and then press the rim of the glass into the salt to make the salt rim. Combine the Primal Kitchen Dragonfruit Collagen, tequila and water in a shaker or blender and mix until well combined. Pour over ice. Stir in the lime juice and pour in the club soda. Add liquid monkfruit sweetener to taste and garnish with slices of lime.

mocktails alcohol alternatives

Nutrition Information

Calories: 70
Fat: 0g
Total Carbohydrates: 5g
Net Carbohydrates: 4g
Protein: 10g

Blackberry Gin Fizz

mocktails alcohol alternatives

Serves: 1

Time in the kitchen: 2 minutes

Ingredients

  • 1.5 oz. Ritual Gin Alternative
  • 10 blackberries
  • 4-6 oz. cucumber melon seltzer
  • 1-2 drops liquid monkfruit sweetener
  • 1 oz. lime juice
  • Sliced cucumber
  • Ice
  • Optional: mint or basil leaves

Directions

Add the gin and half of the blackberries to a glass (you can add basil or mint at this time too). Muddle the gin and blackberries together.

mocktails alcohol alternativesAdd ice, lime juice, seltzer and cucumber slices and stir.

Add in additional cucumber slices and the remaining blackberries as garnish.

Nutrition Information

Calories: 38
Fat: 0g
Total Carbohydrates: 11g
Net Carbohydrates: 6g
Protein: 1g

Bubbly Whiskey Cherry Lemonade

mocktails alcohol alternatives

Serves: 1

Time in the kitchen: 2 minutes

Ingredients

  • 1.5 oz. Ritual Whiskey Alternative
  • 6 pitted cherries
  • Juice from 1/2 lemon
  • Optional: juice from ½ orange
  • 6 oz. sparkling lemon seltzer
  • Liquid monkfruit sweetener to taste
  • Slices of lemon and cherries to garnish
  • Ice

Directions

Muddle the cherries and whiskey together. Add the lemon juice and orange juice if you are using it.

mocktails alcohol alternativesStir in the seltzer and liquid monkfruit sweetener to taste. Add ice and garnish with lemon slices and cherries.

Nutrition Information

Calories: 40
Fat: 0g
Total Carbohydrates: 9g
Net Carbohydrates: 8g
Protein: 0g

Primal-Kitchen-frozen-coming-soon

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Whether you can’t sleep without socks on, or absolutely can’t stand wearing socks to bed, you probably have a strong opinion on the issue. But this isn’t just a matter of preference; science could be pointing toward the importance of sock-clad feet for better quality sleep, healthier skin, and even an improved sex life. Read […]

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Research of the Week

Humans were breeding sled dogs at least as far back as 9500 years ago.

High-carb meals depress postprandial energy expenditure.

Antidepressant effects of ayahuasca may be linked to its anti-inflammatory effects.

Among senior men, low protein intake is deadly.

Taking glucosamine linked to lower mortality.

New Primal Blueprint Podcasts

Episode 435: Jennifer Fulwiler: Host Elle Russ chats with Jennifer Fulwiler, a best-selling author and standup comic.

Primal Health Coach Radio, Episode 70: Laura and Erin chat with JR Burgess, who shares an incredible number of health coaching insights, techniques, and innovations.

Media, Schmedia

How minor are the “minor side effects” of proposed COVID-19 vaccines?

Humans have been in the Americas for far longer than previously suspected, according to new evidence.

Interesting Blog Posts

Why Athenian apartments have stood the test of time.

Where are all the preemies?

Social Notes

Salt.

Everything Else

New Canadian mask deactivates 99% of coronavirus.

Gut bugs convert type A blood to universal donor blood.

Are kids actually getting more nature these days?

Things I’m Up to and Interested In

Interesting results: How has the Paleo community changed over the years?

I hope this ends up working: New blood test promises to show cancer 4 years before symptoms appear.

Cool map: Accelerating use of iron across the world.

Interesting line of research: What slows you down when training—pain or effort?

Good news: Exercise fights the coronavirus blues.

Question I’m Asking

What do you think of this video? Should we change our relationship with nature?

Recipe Corner

  • Looking for something to do with all that canned tuna you bought during the pandemic? Make spicy tuna cakes.
  • The meatball knows no national or ethnic boundary.

Time Capsule

One year ago (Jul 18 – Jul 24)

Comment of the Week

“It is indeed warm in Hawaii, but most people here like to avoid the heat as much as those in any other warm region (such as Florida), so it’s not clear that Hawaii’s lower infection rate is largely due to the weather.

While isolation from other states and quarantine rules surely do play a role (though many break quarantine as it’s largely unenforceable), a likely bigger factor is that the vast majority of people in Hawaii consistently wear a face covering and provide distance when around others.

This may be due in part to Hawaii’s culture, where the concept of “family” (?ohana) extends to the entire community and caring about elders and others is fundamental, but I am glad for it nonetheless.”

Mark’s comment illustrates the near-limitless range of potential confounding variables.

thousand_island_640x80

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Tea offers so many health benefits, but if you’re drinking it at the wrong temperature, you may be doing your body more harm than good. In fact, even brief exposure to certain temps when drinking tea may increase your risk of esophageal cancer. Read on to find the perfect temperature for drinking tea and “tea […]

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The only 12-week, three-phase, three-methods, fat loss plan, you’ll ever need to lose quarantine weight gain.

If you want to improve muscle definition and fast-track your way to washboard abs, then use this fat loss specific, three-phase, muscle-preserving training system. Everyone is wondering what they need to be doing post-COVID lockdown

 

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how to break bad habitsOver the past few months, you’ve probably picked up a few habits you might not be thrilled with right now. Maybe your new normal has you staring mindlessly at the fridge looking for something snacky (and packing on a few extra pounds). Putting your workouts off ‘til the gym reopens. Or managing your stress with another drink, another bag of chips, or another hour of scrolling through your social media feed.

A lot of my clients have noticed that the bad habits they used to have are resurfacing too. Which is totally normal given the circumstances.

So, what gives?


Stay on track no matter where you are! Instantly download your Primal and Keto Guide to Eating Out.


How Bad Habits Start

There are two factors typically associated with starting a bad habit. Stress and boredom. If you’ve been self-isolating for the past four months, I’m sure you can see where I’m going with this.

In a study from the University of Buffalo, researchers looked at the coping strategies of children ages 8-12 when placed under stress. Each participant was asked to complete a speech stressor on one day and read magazines the next. After each of the activities, they were given a free-choice period with access to food, screen time, or play time. Researchers found that the kids were more apt to choose an unhealthy behavior like snacking or watching TV than they were to go outside and play.1

Other research highlights the detrimental effects of boredom on bad habits, including one study  where participants were asked to complete a high-boredom task and a low-boredom task. Results showed that the higher-boredom task increased their desire for less healthy foods as a way to distance themselves from the experience of boredom itself.2

Of course, sometimes there are deeper issues at work. It could be a fear or limiting belief that’s causing you to create and hold onto a habit that’s not in your best interest.

Why Habits are Hard to Break

If it feels like your bad habits are nearly impossible to break, you’re not alone. And there are three important reasons for this.

  • They’re wired in your brain. When you repeat a behavior enough times, it actually changes your neural pathways.3 And those pathways get stronger each time you repeat that behaviour. Basically, your habits rewire your brain.
  • They provide a benefit. On the surface, it might be hard to see what benefit snacking mindlessly or laying on the couch has. But upon deeper examination, those habits prevent you from feeling something you don’t want to feel (stress, panic, boredom, etc.).
  • They’re part of a pattern. Are you triggered to eat when you walk into the kitchen? Or pour a drink once you’ve shut your laptop for the day? Often times, your habits are part of a bigger pattern that may be associated with emotional or environmental factors.

Break Your Bad Habits for Good

It’s helpful to understand how bad habits get started and why they’re so hard to break. But it’s not enough. You’ve also got to know and put into practice the strategies that allow you to finally stop the habits that continuously interfere with your goals.

Strategy 1: Acknowledge it.

It’s hard to change something if you don’t realize what that somethingis. Be aware of the times you spend procrastinating, grabbing a “healthy” protein bar instead of making lunch, pressing the snooze button, or any negative behaviour you want to change.

ACTION STEP: Write down when and where your habit typically takes place, and what triggers it to start.

STRATEGY 2: Make it more difficult.

I once had a client who couldn’t stop binging on nuts. The simple answer to that is to stop buying them! According to James Clear, one of the leading authorities on habit building (and habit breaking), you’re less likely to complete a bad habit if it’s more challenging to do. So, if you always sleep in, put your alarm in the other room. If the TV takes up too much of your time, hide the remote. If you can’t stop eating nuts, get them out of the house.

ACTION STEP: Brainstorm 1-2 ways you can make your current bad habit harder to do.

STRATEGY 3: Reframe your situation.

Reframing is a strategy I use all the time with my health coaching clients. Say you want to exercise more and getting up early is the only way to squeeze it in. Changing your mindset from I have to wake up early to work out to I get to wake up early can be a total game changer when it comes to breaking bad habits. Same goes for ditching your quick toast-for-breakfast routine for a more leisurely meal of eggs and bacon. Try saying, I get to enjoy an epic protein forward breakfast instead.

ACTION STEP: Jot down a habit you want to break, using the I get tostrategy to reframe it.

STRATEGY 4: Hold yourself accountable (or work with an accountability partner).

There’s a big difference between people who say they want to change their bad habits and those who actually do. When you hold yourself accountable for your actions, you’re telling yourself that you’re worth it — that this change is important enough for you to make it a priority. I’ve been working with an accountability partner to help me break my habit of mashing the snooze button. Because my partner and I have the same goal, we help each other stay accountable.

ACTION STEP: Get clear on what habit you want to break, the reasons you want to break it, and how you’ll hold yourself accountable.

STRATEGY 5: Replace it with a good habit.

Knowing that stress and boredom are the two biggest elements for starting (and continuing) a bad habit, it’s crucial to have a good habit in place for when those two feelings come on. Say, for example, you’ve got the habit of dealing with work stress by mindlessly scrolling through Facebook. What if you went for a quick walk around the block or did a short breathing exercise? By replacing the habit you want to break with one that gives you the same, or similar benefit, you’re more likely to stick with it.

ACTION STEP: Notice the emotion that triggers your bad habit. Then, think of a positive behaviour to do instead to alleviate that feeling.

How to break bad habits (recap)

  • Acknowledge it
  • Make it more difficult
  • Reframe your situation
  • Hold yourself accountable
  • Replace it with a good habit

What bad habits are you trying to break? What strategies have you used that worked — or didn’t work? Tell me about your experience in the comments below.

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coronavirus covid-19 updateIt’s been a couple months since I did a post explicitly about COVID-19, or SARS-COV2, or coronavirus, and since the pandemic is still happening and is on everyone’s mind, I’m going to do another one today. This time, I’m going to do a big picture look at where we stand on transmission risks, reinfections, immunity, and what I think we need to keep in mind as we go forward.

Where do we stand with coronavirus?

How is it transmitted—and how can we avoid it?

What’s the deal with herd immunity?

What are my thoughts on the biggest challenges yet to come?

What’s the riskiest place to be?

Indoor areas with low air circulation. Things seem to be spiking in hot areas where everyone stays indoors blasting the air conditioning and breathing in recycled air because it’s so damn hot outside. In regions where people get out into hot weather, like Hawaii, the virus is virtually non-existent. There are certainly other factors at play—Hawaii is an island protected by thousands of miles of water, for one, and they have a strict quarantine protocol for visitors—but many transmissions have been linked to indoor areas with AC.

Furthermore, all indications are that it’s harder to get infected from a “glancing blow.” Viral load—the number of viral particles you actually take in — is a big factor. If the initial load is small enough, your immune system has a better chance of fighting it off. If the load is too big, your immune system can get overwhelmed. What’s “too big” a load is different for everyone, but all else being equal, a larger viral load is worse. That’s why health care workers who spend a lot of time around infected patients are at a greater risk. But if you’re passing someone on the street? It’s going to be a much lower risk.

Is coronavirus easy to transmit outdoors?

I asked about this on Twitter the other day, wondering if anyone had good evidence of outdoor transmission. There were many responses. Some of the more notable ones.

  • A 4th of July beach party in Michigan. Hundreds of people standing close together in knee high water, lots of house boats, “several” cases of coronavirus. There was also a house party a couple hundred miles away the same weekend that produced 40 cases. The indoor house party was much more virulent than the outdoor beach party.
  • A Memorial Day party at the Lake of the Ozarks in Missouri. Very crowded, looked iffy. One attendee ended up with coronavirus, but officials haven’t identified any other positive cases linked to the party. I wasn’t able to find any recent updates to the contrary. The outdoor lake party didn’t seem very dangerous in this instance.
  • No cases detected after the July 4th speech at Mount Rushmore. They could still pop up, given the potential lag time between exposure and symptoms, but it looks good so far.
  • There were also transmission cases after an outdoor graduation event and indoor prom on the same weekend. 19 students tested positive. All students attended both events, so it’s hard to determine if the cases occurred at the graduation event (which probably had indoor parties afterward) or at the prom (or both).

An earlier Chinese study found that out of 7,300 instances of person-to-person transmission, only one occurred outdoors.1 It happened during an extended conversation.

Overall, the most recent study I could find on the subject came to a similar conclusion.2 Researchers searched through PubMed, media stories, and any other legitimate reports on transmission events and found that the vast majority of transmissions occurred indoors.

This is good news, if it holds. It means people can feel a little safer about going outside, getting sunshine, getting physical activity, and living their lives. Avoid crowds and wear a mask when you’re around people, but I’m cautiously optimistic that being outdoors is the safest place to be.

Does COVID-19 spread through breathing?

This has always been the great fear. Does the virus spread through aerosol from simple breathing, talking, or are sneezes, coughs, and yelling required? Are aerosolized viral particles enough? Or do we need larger droplets?

A new pre-print just came out that has people worried. They took breath samples from symptomatic COVID-19 patients, found live viral particles in the aerosolized droplets, and found they could replicate on isolated human cells.3

However, before you freak out, the story is more complicated than that.

Not all the samples grew; some subjects’ breath samples “didn’t take.” Some samples actually saw their viral particles decline in number. The smallest particles were the most successful at replicating, but the smallest particles also contained the lowest viral load.

The rate of growth was fairly low compared to how actual infections play out. The most successful samples only grew by 400% after six days. And that’s in an isolated human cell. When an entire human gets infected with COVID-19, the virus grows by thousands of percentage points every 8 hours or so.

That said, the virus is aerosolized, some of that aerosol contains replicable viral particles, and if you breathe enough of them in—probably by staying indoors with an infected person or people for an extended period of time — it’s possible to be infected. It’s pretty clear that larger droplets remain the big risk, though.

Can you be reinfected with COVID-19?

A pretty convincing thread of anecdotes out of Iran (one of the earliest and hardest-hit countries) claims that reinfections are occurring. This would suggest that immunity wanes, at least in some people.

Some experts have floated the idea that COVID-19 may be the type of virus that stays with you and cycles through active and dormant periods, like Epstein-Barr or herpes does. It hasn’t been around long enough to know yet whether or not that is the case.

Can we reach herd immunity for coronavirus without a vaccine?

At first, the antibody immunity data wasn’t very encouraging: antibody levels in the population weren’t anything close to crossing the herd immunity threshold, and the antibody response to COVID-19 seemed to diminish and wane after a few months.

But more recently, scientists are finding evidence of robust and widespread T-cell immunity. T-cells from other coronaviruses, like SARS, various animal coronaviruses, and perhaps even the common cold may work on COVID-19. This cross-immunity is long-lasting, too; even though SARS hit 17 years ago, many of the subjects in the study still had T-cell immunity against it.4 In another study, between 20-50% of unexposed people showed t-cell activity against COVID-19.5

From what I’m reading and hearing from experts, this has the potential to be a hugely positive development. My hope is that the huge death numbers are behind us, or at least trending that way. I hope those T-cell cross-immunity numbers persist in subsequent reports. I hope we start looking at T-cell immunity and not just antibody immunity.

Where I Stand

We’ll beat this thing. Of that there’s no doubt. We’ve made it to the other side of epidemics with much more primitive knowledge, tools, and technology. But here’s what I really worry about, other than the deaths, potential long-term health ramifications, and anything “physical.”

I’m seeing a lot of fear. I’m seeing people lose their appreciation for the rest of humanity. I’m seeing people use dehumanizing language to describe people who have different views on the seriousness of the virus. Neighbor doesn’t wear a mask? Don’t assume they’re evil or callous. Neighbor wants people to shelter in place? Don’t assume they’re authoritarians-in-waiting.

I worry about people who are too scared, too paralyzed to do the kinds of activities that are actually quite low-risk and would probably increase health and resistance, like going outside for hikes (even, gasp, with friends and family), getting sun and fresh air and exercise, moving through space and time rather than sitting hunched over your smartphone, scrolling through your echo chamber of choice.

Relax. Stay cautious and vigilant, yes. Stay safe. Don’t put yourself or anyone else at risk. No flippancy. But don’t forget to have fun and loosen up where you can. Low- to no-risk activities are out there. Do those.

If you have kids, they’re stressing out too. Believe me, they’re like sponges. They reflect what you’re giving off. Do it for them, if nothing else.

Lose the vitriol and the fear, more than anything. That stuff doesn’t go away so easily. Those divisions we’re building up between neighbors and family members and citizens may persist long after the pandemic has ended. Don’t let that happen!

We can do this.

Anyway, that’s how I’m viewing this whole coronavirus thing right now. Cautious but optimistic. What about you? How are you handling everything? Where do you see things going in the next few weeks?

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