Ethics of the Body: Wellness
By William Cutrer, M.D.
Beloved, I pray that in all respects you may prosper and be in good health, just as your soul prospers. 3 John 2, NASB
“But I buffet (discipline) my body and make it my slave, so that after I have preached to others, I myself will not be disqualified.” 1 Cor. 9:27
Our physical health has spiritual significance in that God has entrusted us with the gift of humanity. Indeed, humans are made in God’s image, yet embodied. And when Christ came to identify perfectly with our humanity, He took on not just human form, but a human body—complete with the physical needs of nutrition, hydration, rest, and recovery. The very lifestyle of Christ may best exemplify a “wellness” lifestyle, evidenced as it was by regular exercise (walking), nutrition (broiled fish, whole grain breads) active ministry in community, and powerful devotion in solitude. Each of these represents a key element to our anthropology—wellness of mind, body, and soul.
As Paul told the Corinthians, humans need both physical and spiritual discipline. To illustrate his points he incorporated many athletic metaphors, including those of runners and boxers. Clearly when he used the word “buffet” (1 Cor. 9:27, quoted above), he meant the word we pronounce with stress on the first syllable. Yet most who read this word now envision a long table filled with delectable foods at an “all you can eat buffet” where we harm our bodies for lack of self control.
That lack of self control represents the absence of one of the key elements of a healthy lifestyle – responsibility. Each of us is responsible for the choices we make, whether it is the food we choose to nourish our bodies, the activities we pursue to keep ourselves fit, or the decisions we make to follow Christ moment by moment. To create a wellness lifestyle is to accept responsibility for the choices we make and to continue to grow and learn how to better care for this magnificent, Christ-like, human body we have been given.
What is Wellness?
Wellness is a proactive choice to create a lifestyle that enables an individual to live fully—integrating spirit, mind, and body for a life of meaning and purpose. Consider how most people in their youth envision their lives at age forty or beyond. Few would answer, “I plan to be overweight, under-fit, addicted to caffeine, stuck in a job that I hate, in a career going nowhere, and married to a couch potato.” Yet while this vision is not what anyone aspires to, a glance at the American public indicates many have arrived at this very state.
The proactive nature of wellness requires action be taken before such a dismal outcome. The individual bears responsibility for making informed, intelligent decisions about health and well-being. The impetus for choosing a wellness lifestyle should be to live a life of purpose and meaning, obedient to the teaching of Scripture, fulfilling God’s calling. Contrary to the popular bumper sticker, the one who dies with the most toys does not win. “Winning” comes from a life well lived, a life of service to the Lord and others, a life of sharing and caring for the world and those around us. We enter this life crying, while those around us are smiling. Perhaps when we leave this earth, we do so with the roles reverse—those we leave behind shed tears of joy for a life well lived while we smile when we hear the Lord say, “Well done good and faithful servant, enter into the joy of my kingdom” (Matt. 25:21).
Wellness encompasses all that we are and expands beyond the absence of illness into every sphere of our existence. This article will focus on a narrow segment of our complex humanity—our physicality. Though made in the very image of God, we inhabit flesh. Unfortunately, humanity’s fall into sin corrupted every cell, every strand of DNA from the first couple down through the succeeding generations. Thus illness, disease, deterioration and ultimately death await all of Adam and Eve’s descendants until the return of Christ.
The late comedian Bob Hope spoke wisely when he said, “The key to living is to die young—at an old age.” While our physical capabilities gradually diminish, our spirits can remain vibrant as we grow in intimacy with our Lord each day. Yes, we age and fail, yet we can glorify God with and through our bodies until that day when we meet the Lord and later receive resurrection bodies, equipped anew for eternity.
As we pursue wellness, we can either live in obedience, worship, and gratitude, or we can be self-focused, making even good health an idol. Our relationship with God should supersede attention to our physical wellbeing. The apostle Peter listed many virtues of the Christian life: faith, moral excellence, knowledge, self-control, perseverance, godliness, brotherly kindness and love. And he concluded with, “For if these qualities are yours and are increasing, they render you neither useless nor unfruitful in the true knowledge of our Lord Jesus Christ” (2 Peter 1:5 –8). Thus even if aging or physical limitations greatly hamper our abilities, we can still be useful and fruitful as we grow in the Lord’s grace.
Fitness
On the other hand discipline yourself for the purpose of godliness; for bodily discipline is only of little profit, but godliness is profitable for all things, since it holds promise for the present life and also for the life to come. 1 Timothy 4:7b – 8
As seen in the overview diagram, aspects of body “wellness” include fitness, nutrition, and stress awareness and management. Begin with an honest evaluation of where you currently stand. Prayerfully consider your physical conditioning, which includes weight for height (BMI)[1], cardiovascular condition, strength, flexibility, and balance. Some abilities reflect genetics, others age, nutrition and activity schedule. With the guidance of your physician, set personal goals. Reasonable target weight, fitness level and appropriate exercise regimens are available in books, magazines, online, and with the assistance of a personal trainer available at our fine health and fitness center here on SBTS campus.
A simple formula for fitness regardless of your current activity level would be “4 x 30 x Comfortable x Large.”
· The 4 represents 4 days per week, the minimum number of days of activity to begin achieving fitness. This allows more days of activity than inactivity, helps develop the habit of fitness, and still allows for days of rest and the always unplanned occurrences that make life so unpredictable and enjoyable. Are more than 4 days per week better? Absolutely! Going from no days of activity to 4 days of activity is the big challenge, though. Adding additional days beyond the first 4 should be a joyful experience clearly demonstrating that fitness is becoming a part of a lifestyle and not just something that has to be done.
· 30 minutes at a time. Longer is better, but building up to longer periods should be done slowly and gradually. A thirty-minute routine gives the heart time to work at elevated workloads, strengthening cardiac muscle. That thirty-minute timeframe allows the metabolism to increase, thereby burning more calories. This sustained elevated heart rate and metabolic rate also combine to continue the higher rate of caloric burn long after the actual activity is completed, a post-exercise benefit.
· “Comfortable” refers to a comfortable pace, the intensity of the activity. The talk test is the simplest way to measure this. You should be working harder than you are at rest, but not so hard that you cannot talk to someone next to you. You may or may not be able to engage in deep, philosophical discussions, but you should always be able to communicate with those nearby.
· Large muscles are the ones to involve in any fitness program. Large muscles include legs, hips, core muscles of the abdomen, and lower back. While including upper-body muscle groups would be ideal, getting the body moving is the first step, literally and figuratively. A fitness routine can include any number of available activities that are highly beneficial to body, mind, and spirit. The best plan incorporates a variety of activities—not only to avoid boredom but to enable cross-training, that is, using multiple activities to avoid overuse injuries and reach fitness goals. Such activity can include walking, jogging, biking, swimming—any activity that engages the large muscle groups over a period of time. Variety can be very helpful as any exercise targets specific muscle groups and not others, so just jogging, for example, can lead to overuse injuries if not coupled with flexibility and balance work. Weight-independent exercise (biking, swimming) has an advantage of being less stressful to joints and enjoyable even during pregnancy. Having a fitness partner can provide essential encouragement on those days when you’d rather do anything but exercise.
Resistance exercise, using free weights, weight machines, elastic bands or other devices develop muscular strength and bulk depending on how the exercise is conducted. Free weights help develop balance when used with proper technique, but having a partner to spot your lifts can help you avoid injury when moving large weights. The machines are safer than free weights in this regard.
As with cardiovascular work, regular resistance exercise is important, but rest and muscle recovery are important too. In general don’t exercise the same muscle group two days in a row. Allow at least a 24-hour rest, recovery, and rebuild time. Also as with cardiovascular exercise, a resistance exercise routine can quickly bore or discourage, so select activities you enjoy and vary them.
Flexibility work is important in protecting the joints, thereby allowing maximal range of motion and superior performance in athletic endeavors and physical exertion. Whether you enjoy stretching activities alone or Yoga programs, you can find a variety of such exercises to incorporate into your cardiovascular and/or resistance work. In fact beginning serious weight work without a warm up with stretching, flexibility movements, and balance moves could easily lead to injury. As for balance, most of the yoga poses and some of the stretching exercises will allow some balance development. Again, making flexibility work a priority can prevent injury, enhance performance, and make your workout time more enjoyable.
As we age, the joints tend to stiffen, range of motion becomes more limited, and the propensity to lose balance and fall increases. So gentle stretching, flexibility/balance poses can improve the quality of life.
Choose activities that you will enjoy. No one stays with an exercise program if it’s too hard, too boring, too stressful, or too “un-fun.” Here are some suggestions for making your “bodily discipline” more pleasant so you can achieve that “little profit.”
• Find support. Many people find the friendship and camaraderie of their chosen activity itself to be the most motivating factor in staying involved with fitness. Having a partner or a group tends to support your commitment and provides you someone to depend on—as well as someone who depends on you.
• There are always opportunities to exercise independently, and for some such times become another bonus of their fitness program—time alone to think, reflect, ponder, pray.
• Take time to “smell the roses.” If training becomes solely training, just a matter of time and distance, miles and minutes, then the great gifts of our bodies and our world are being lost in the narrow pursuit of better fitness. Walks, runs, bikes, and hikes provide opportunities both to enjoy the wonders of the human body and also the wonders of the world around us.
• Slower, gentler activities such as yoga, Tai Chi, and Qi Gong provide excellent opportunities not only to stretch and strengthen the body but also allow for quiet meditation and reflection, perhaps time to consider the integration of spirit, mind, and body.
• The best advice from the marketing world is Nike’s slogan: Just do it!
Nutritional Awareness
Whether then you eat or drink or whatever you do, do all to the glory of God. 1 Cor 10:31 (NASB)
An essential facet of overall wellness relates to the intake of calories: what we eat and drink. America as a nation has been richly blessed, yet the statistics covering recent decades show a remarkable downward spiral in wellness mirroring a steep rise in obesity. Though the normal range for body weight is quite broad, one third of all Americans—72 million people—have broken through the limits into “overweight” and even beyond that to the “obesity” category. This includes 16% of all U.S. children.[2] Looking beyond our borders, one billion people in the world are now overweight, 300 million of whom are obese. And obesity brings with it associated medical issues.
Being obese “confers physical stress on multiple biologic processes and is associated with an increased risk of developing cardiovascular disease, Type 2 Diabetes, hypertension, osteoarthritis, and certain forms of cancer, not to mention sleep apnea, asthma, and fatty liver disease.” Remarkably “a reduction of only 5 to10% of body weight improves lipid profiles, insulin sensitivity and endothelial function (reducing clotting risk and inflammation).” [3]
Most of us understand the balance between energy expenditure and calories consumed, but perhaps a simple review buttressed by the newest research in weight loss can be instructive. Our bodies are the temples of the Holy Spirit… and we should glorify God in our bodies. That includes choosing to eat wisely.
We can estimate how many calories each person needs based on his or her height and current weight. Using this information, we can also determine whether weight gain or loss are needed and what the neutral nutrition needs are. Basic truths include the fact that fat contains twice the calories that protein and carbohydrate carry for the same basic weight of food. A calorie (more technically a Kilocalorie) represents the energy available to be burned in a given amount of food. For example, one gram of protein contains four calories, and one gram of fat contains nine calories. To burn up one pound of fat, a person would need to expend about 3,500 calories! Or put another way, each extra 3,500 calories consumed generates one pound of fat if not burned by exercise or the normal activities. Clearly, weight gained is acquired slowly, and wisdom requires for long term success at weight loss that it be burned off gradually. Fad diets, crash diets, and diets that involve only one food group or type are generally bad for one’s health and contrary to an overall goal of wellness. In addition the rebound weight gain after these dramatic programs often exceeds the starting weight.
The simplest formula for weight management is, ‘Calories In = Calories Out.’
‘Calories In’ represents your daily caloric intake, what you eat and drink on any given day.’Calories Out’ are the calories you burn during exercise and normal daily activities. If you burn off as much as you eat each day your weight will remain the same. If you wish to lose weight, rather than making drastic adjustments to your diet or over-exercising, a healthier choice would be to slightly reduce caloric intake and slightly increase activity levels. This pattern allows for responsible choices and changes to be made slowly and gradually, making them easier to adopt and incorporate into your lifestyle. No one gains 50 pounds overnight – they gain it one pound at a time! Weight loss follows the same pattern, although it comes off much slower than it goes on!
A healthy diet includes a wide variety of foods that include a balance of protein, carbohydrates, and some fats, all of which are prepared in healthy ways. That is, bake it, broil it, roast it, but don’t fry it. Also, beware of rich sauces and heavily buttered dishes (butter is basically fat). By wisely selecting food and preparing it with good health in mind, you can eat well, feel satisfied, and still be moving toward your ideal body weight and percentage body fat. (Underwater weighing is the best measure, but skin fold calipers and some of the newer electrical impedence devices for measuring body fat are quite useful.)
Most foods now come with package labeling clearly providing the number of calories, carbohydrates, fat grams, and protein, but the information may be so detailed that it confuses. Can “low fat,” diet, fat-free items really be worse that the more fat-filled items? Absolutely, if the fat grams have been replaced by more sugar. In such cases, if you consume many such products, you may wind up gaining weight. Sugar is a simple carbohydrate that the body absorbs quickly. Sugar shoots the blood glucose higher causing the release of insulin, which drives the blood sugar back down, perhaps lower than when you started, resulting in lightheadedness and hunger. So even snacks can be detrimental.
A diet plan of three “square meals” daily will virtually guarantee failure. The 4- or 5-hour time span between the three big meals triggers some bodily responses that actually cause it to slow the metabolism, and cling to the “fatty stores” to protect against anticipated famine. Thus wisdom means eating more frequent, smaller meals that still total the proper number of calories. Snacks between meals would be planned for, and they might include fruits, and definitely include protein, as protein does not have the wild impact on the blood sugar and insulin system.
Many programs are available for creating an appropriate nutritional program. Weight Watchers® with its point system can be very helpful and far more “doable” than tracking calories. Monitoring “fat grams” can be useful as well. Many calorie-restricted balance meals are available.
Still, constant vigilance, awareness, and commitment to wellness over time has been shown to bring the best results. A recent study of more than 800 dieters assigned different diet plans demonstrated that no diet was superior. The determining factor was consistency and accountability with counselor visits.[4]
Eating Disorders
Most articles on nutrition focus on obesity because of the sheer volume of statistics, but a discussion of wellness must also include mention of increasing numbers of those struggling with eating disorders. For such people the flood of information about obesity and wellness can make them feel unacceptable or worthless if their body image doesn’t match the “norm.” As mentioned, more than half of adult Americans are overweight, with one-third exceeding 20% of their normal, healthy weight. And such information can motivate some to abuse their bodies in efforts to conform either to the norm or to what they perceive as the norm.
Eating disorders are potentially fatal problems affecting an enormous number of our young people. Data collected by the American Anorexia and Bulimia Association (AABA) suggests that 1% of all female adolescents suffer with anorexia, while 4% of college-aged women suffer from bulimia.
Anorexia
Anorexia (also called anorexia nervosa) is characterized by a preoccupation with dieting as well as thinness as a body image. While our society exalts the super-slender model build, anorexics go way beyond even this to excessive weight loss. They experience a genuine fear of fat and gaining weight. When they look into a mirror, even when they are emaciated with almost zero body fat, they still see their body shape as obese. The sufferer does not recognize the problem!
Twenty percent of anorexics die without treatment! And even with treatment, the death rate approaches 3%. With the best available treatment, roughly sixty percent fully recover and another twenty percent experience some improvement.
The lives of these individuals revolve around food and weight concerns. Refusing to eat is all about control. Early symptoms include depression, loneliness, helplessness, and hopelessness. Telltale symptoms include hair loss, cold hands and feet, fainting spells and compulsive, excessive exercise. Such exercise can be hidden, often done in middle of the night, taken to the extreme. Anorexics lie about their food intake, lie about the exercise, and often cover up the fainting spells and irregular heart rhythms that characterize a metabolism that’s totally out of balance.
In addition medically, when the menstrual cycle fails because of significantly depressed estrogen levels, calcium is lost from the bone, just like in an aging woman. Key organs in the body shrink and lose functionality. Blood sugar and blood pressure often fall below normal levels.
Bulimia
Bulimia is an eating disorder characterized by binge eating (rapid and massive consumption of food at one sitting) followed by purging (induced vomiting, laxative abuse, diuretics). Some estimate that as many as 5% of college women are bulimic. Though they may not be severely underweight, the process of binging and purging leads to intense guilt and shame.
As with anorexia, those suffering from bulimia have a preoccupation with body weight and shape. The purging can trigger depression and mood swings, Rather than being in control, the person suffering from bulimia may often feel out of control.
Forced vomiting can cause dental problems as well as throat and stomach issues. Heartburn, bloating, and swollen lymph glands can indicate bulimia. Once again, in young women, because the nutritional status is poor, the menstrual cycle disappears. Dehydration can result, as well as permanent injury to the intestines, liver, and kidneys. Also, the imbalance in blood chemistry can lead to abnormal and potentially fatal cardiac rhythms. Obviously, eating disorders deserve prompt attention.
Fluid Intake
What you drink may affect the weight and nutrition equation. Your body needs plenty of water, which perfectly satisfies thirst and bodily requirements and has zero calories. I would recommend you gradually shift to water as your primary beverage and squeezed fruit or vegetable juices when you need flavor. Common soft drinks are loaded with sugar giving a calorie boost and triggering the insulin reaction leading to more hunger. Sports drinks can be reasonable if used as an exercise recovery drink, but they may contain too much sugar and excessive salt. What about the carbonated waters and diet drinks? Wisdom would be to avoid these. The carbonation can trigger the insulin response according to some new research, and the long-term effects of the artificial sweeteners are uncertain. Caffeine, so popular to lace drinks with now, is indeed a stimulant. Caffeine will accelerate heart rate, increase blood pressure, and draw fluid from the body, possibly causing dehydration. God designed us to need water and to thrive on it. So drink up!
In summary…
Avoid extremes and “gimmicky diets”
Balance your caloric intake
Prepare your food properly from a wellness standpoint
Drink plenty of water
And here’s another—Follow the 80% Rule. That is, if 80% of the time you eat healthy, enjoy the other 20%! Of course you can still have pizza. You just can’t eat the whole thing in one sitting. Desserts are fine, as long as you understand the caloric impact and factor that into your dietary plan.
Stress Awareness
Be anxious for nothing, but in everything with prayer and supplication with thanksgiving let your requests be made known to God and the peace of God which surpasses all comprehension will guard your hearts and mind in Christ Jesus.. Phil 4:6,7.
Casting all your anxiety on Him because He cares for you. I Peter 5:7
Having considered the impact of nutrition and exercise, both essential to overall wellness and life in the body, we now turn to consider stress. Stress has both negative and positive consequences and has enormous impact on successfully walking worthy of God’s high calling for each believer.
First of all, there is “normal stress.” Only the dead are stress-free, and that would apply only to the believing dead. Stress is an inevitable, inescapable part of the human experience, and in proper amounts, it’s essential to living maximally.
Stress is defined as the normal internal physiological mechanism that adapts us to change. For example cold temperatures are an external stress. The body responds to it in the ways designed within our humanity to preserve heat (constricting blood vessels) and ultimately preserving life (sacrificing non-essentials—fingers and toes) to shunt life saving blood to the essential organs (brain, heart, lungs). The body has a remarkable ability to respond to external stress through internal mechanisms, but some basic pathways follow virtually all forms of significant physical, emotional, and even intellectual stress (remember the stress of the last unannounced quiz?).
When your body interprets environmental factors as stressful, the stress response is initiated. Pulse becomes more rapid, as does breathing rate; blood pressure elevates; and the body is prepared for a fight-or-flight response. Key hormonal mediators of this response are adrenaline (also called epinephrine, made in part from the adrenal gland) and a surge of corticosteroid hormones including a powerful one called cortisol. Focus is heightened, but fine motor control is lost (remember that near miss car collision and how your hands and feet felt like cement?). Thus, if athletic performance or quick thinking are needed, the stress response enables one to run faster, farther, or quickly assess the stressor as real or imagined. These are “good stress” responses.
Yet if you live under the constant impact of stressors, the cumulative effects of adrenaline and cortisol will lead to “distress” and the breakdown of the human body. Symptoms would be headaches, backaches, irritable bowel symptoms, migraines, fatigue and ultimately physical collapse or emotional meltdown.
Easily identified current stressors in the lives of the minister and those preparing to serve include not only the educational process itself but financial, relational, grief, even church-related issues and a host of other incidental surprises. Everyone living will face stress, but will the level of stress become overwhelming or remain manageable?
The danger for the minister is recognizing the difference between handling stress appropriately (while growing deeper in one’s personal spiritual walk) and burnout, defined by a noted Christian counselor as “compassion fatigue.” Compounding stressors lead to physical fatigue whereas crossing over the “manageable” line leads to emotional fatigue, depression, and a loss of interest in your calling to serve.
How does one identify and overcome the cumulative effects of abundant stressors?
When physical exhaustion from over-engagement leads to flattened emotions and lack of motivation, be on alert. When you feel anxious, hostile, frustrated and resentful of the demands of your calling, your stressors may be overwhelming your capacity to respond.
Practically speaking, how can we walk in the Spirit with the enormity of demands facing each that would serve the Lord?
· Respect your body: You won’t get another until the Lord returns, and this one suffers the effects of fallenness.
· Care for your body: Apply what you learned in the fitness and nutrition sections.
· Eat Right: Be careful of everything you put into your body.
· Exercise: Do so regularly and responsibly. Fitness is for everyone, not just the elite athlete.
· Practice the disciplines: Even as exercise and nutrition are everyday essentials, so too are prayer, Bible study and reflection, worship, fasting, giving, solitude, and silence.
· Practice community: The church body needs your body! We are interdependent. Learn to be comfortable both in community and in solitude.
· Sleep: This one’s really not optional. Cumulative sleeplessness depresses the immune system and ages you faster. Skipping proper sleep will catch up to you.
· Learn to say no: Your yes is meaningless if you cannot appropriately say no. Give others in the community of faith an opportunity to serve.
· Play: Allow time to enjoy God’s creation, those you love, and those who love you.
· Create margin: Allow sufficient space in your schedule to be interruptible so God can use you to minister to people and needs that are unplanned.
· Laugh more: It releases endorphins in the brain making your joy a neurochemical reality.
· Remember Christ: He’s our immovable anchor beyond the veil, our Savior, Redeemer, Brother and Friend.
Or do you not know that your body is a temple of the Holy Spirit who is in you, whom you have from God, and that you are not your own? For you have
been bought with a price: therefore glorify God in your body. 1 Cor. 6:19
· In a country in which more than half of adults are either overweight or obese, in a place where diabetes kills 220,000 Americans annually, we must engage in the countercultural practice of caring for our bodies, because they belong to God, purchased by the blood of Christ and indwelt by the Holy Spirit.
· Consider a quote that very powerfully and eloquently expresses the integration of spirit, mind, and body;
· We are not human beings having a spiritual experience.
· We are eternal spiritual beings having a temporal human experience.
And part of the human experience that we are meant to enjoy is the care and respect we give this marvelous body we have been given—or perhaps better said, loaned to us for our time here on earth. God’s design of our bodies is flawless. It is our responsibility to care for and use them to the best of our abilities, each of us with a wide and varying range of talents and gifts. With that thought in mind, it is neither selfish nor narcissistic to make time for the care of the body. We are all better at whatever we do when we feel healthy, confident, and whole. With proper nutrition, exercise, and attention to the stresses of life, we place ourselves in the best condition to deal positively with whatever demands life presents. We are whole when God is the center of our lives and we are using His vessel (our body) in His service.
Pursuing wellness is not something we can do completely on our own, however. It has been said “You alone can be well, but you can’t be well alone.”
None of us knows all there is to know about being well, but in today’s rapidly expanding, information-exploding world, the possibilities for learning are endless. We need to learn more and more from others but, perhaps more importantly, also be there to share and care for those who are fellow pilgrims on the journey of faith. Wellness is a part of the human experience, a part in which we have the responsibility to create our lifestyles. It is within every one of us to be well. What choices will you make? How will you respond to this gift of another day?
This is the day the Lord has made, I will rejoice and be glad in it. Psalm 118:24
[1] BMI = weight (kilograms) / height(meters squared) CDC.Gov accessed 2/28/09
[2] CDC.Gov accessed 2/28/2009
[3] Overweight and Obesity: Key Components of Cardiometabolic Risk, Clinical Cornerstone, Vol. 8, Issue 3, Dec.2007.
[4] Comparison of Weight-Loss Diets with Different Compositions; New England Journal of Medicine, Vol 360:859-873, Feb 26, 2009.