One of my personal pet peeves is hearing the phrase, “It is what it is,” from my patients. I have been hearing this statement more and more frequently lately.

Usually, I get “It is what it is,” in response to questions about a patient’s unhealthy behaviors, when they’re explaining to me why they haven’t started an exercise program, or when justifying poor dietary choices. “Hey, it is what it is, Doc.” I think that this actually means, “This is something I don’t like about myself, but I don’t think I can do anything to change it and I really don’t want to talk about it.” It wasn’t too long ago that doctors simply didn’t speak to their patients about lifestyle. Today, we know that our patients’ lifestyle choices are central to their enjoying a long and healthful life. We can’t afford to be complacent when it comes to properly taking care of ourselves.

I’ll explain. I honestly don’t believe that my patients are truly satisfied with the status quo. I think that they’re probably just as frustrated with some of their health habits and dietary choices as their doctor is. They just don’t seem able to make a change. I want to start a dialogue about ways we can make that change happen.

So what are the main issues that we need to contend with? Here are some sobering statistics from the U.S. Department of Agriculture and the Center for Disease Control. First, we are not getting enough fruits and vegetables, and we are eating more processed and fast foods. In 2005, only 32.6% of the U.S. adult population consumed fruit two or more times a day, and 27.2% of people ate vegetables three or more times per day. Only 23.8% of people in 2005 ate five or more servings of fruits and vegetables per day, which is actually down from 24.7% in 1998. Next, we are eating outside of the home more than we used to and portion sizes served in restaurants have increased to the point of silliness. We consume over a third (1/3) of our total calories from food prepared away from home, which is up from less than a fifth (1/5) in 1977.

Furthermore, we are not active enough. Over 25% of people in the United States get no leisure-time physical activity, and only 48% of people get the recommended amount of physical activity. Even more significant, rates of obesity in the United States are rising, which increases the rates of diabetes, cancer, high blood pressure, heart attacks, and strokes. In 2005, 60% of the U.S. adult population was overweight, 24% were obese (up from 15% in 1995), and 3% were extremely obese. Finally, we are spending more time watching television, playing video games, and surfing the internet, and have fewer social connections than in the past.

So, we have identified “what it is.” But does “it” really need to be this way? The good news is that we have an ever-growing arsenal of tools to combat these trends. The first step is to recognize that it’s possible for every one to lose weight, become more active, and begin to eat a healthier diet. We need to stop accepting what we’ve grown used to and think about what can be done to make a change for the positive. The end of complacency is at hand!

There are many trends in our favor. One great example is athletic apparel and shoes. Workout clothes and footwear continue to become more fashionable, comfortable, and supportive. Athletic shoes aren’t just gym shoes and “tennis shoes” anymore. Companies are designing affordable, state-of-the-art shoes for running, walking, cross-training, skate-boarding, cycling, and even weight-lifting. There are shoes to fit all foot sizes, widths, and arch heights with support for ankles, metatarsals, and heels. Additionally, the cost of belonging to a gym has continued to drop due to market factors like competition, which increases access to fitness classes, strength training equipment, and cardio machines. More and more malls are offering mall walking programs and more parks and “green spaces” are being created so that people can get out and be active. Finally, American adults have more leisure time than ever before. Research from Mark Aguilar and Erik Hurst at the National Bureau of Economic Research has found that, since the 1960’s, the amount of time that Americans spend at work has decreased by around 8 hours a week while time spent on leisure activities has increased by over 6 hours a week.

There are plenty of other positive societal developments that will help us. It’s ironic that in an age of fast foods, overly processed foods, and generally unhealthy eating habits, it’s never been easier to include fresh, healthy, whole foods, SuperFoods in other words, in every one’s regular diet. Every supermarket in the country has a tremendous variety of affordable SuperFoods to choose from every day of the year. Just check out the the extensive shopping list in SuperFoodsRx Fourteen Foods That Will Change Your Life, by Steven Pratt, M.D. You’ll see what I’m talking about.

Improvements in non-stick cooking pans let us cook food with less oils and fat. Furthermore, advancements in food storage and refrigeration help us keep fruit and vegetables fresh longer.

Change can be difficult, but there are ways to get moving in the right direction. I have created a list of things you can do to start making a difference in your health:

1. Make a list of your goals. Start generally with things like “be active” and “eat healthy.” Expand the list with specific goals like “eat broccoli 5 times a week” or “walk 30 minutes on Monday, swim 20 laps on Tuesday, bicycle 2 miles on Wednesday…” Keep the list handy and add to it as you come up with more healthy goals. I recommend people keep a list on their refrigerator at home and a copy on their desk at work.
2. Make a plan. Keep a schedule with planned exercise and meals. Make sure you and every member of your family are aware of what will be happening and when it will happen. Talk with your spouse and children about planning the new schedule. Keep the schedule where everyone can see it easily.
3. Keep open communication about your plans and goals for healthy lifestyle changes. Communication is important to ensuring support, acceptance, and compliance with the changes.
4. Plan meals and make a shopping list. Keep to the list and avoid impulse buying.
5. Make changes to your plans and schedule as you identify what works and what doesn’t. Be flexible and willing to change, and always keep in mind your goals to be active and maintain a healthy diet.
6. Work with a friend. It is easier to keep up an exercise schedule and meal plan when you are working with a friend and are accountable to someone else.
7. For the first week or two of a new routine, “Just Do It.”(Apologies to Nike) You may be sore, you may be tired, the weather might be bad, and you may not even like a new activity when you start out. It usually takes some time to get into a new program and enjoy a novel routine. Initially, you may need to force yourself to keep to the schedule and keep to your new habits. Over time, you will find that things get easier and that you enjoy your new lifestyle.
8. Turn off the television. Not forever, but just decide to watch less. Check out your favorite shows. Make it a treat. Don’t instinctively turn it on when you walk in the room. You won’t burn calories watching TV no matter how much you’re into the latest episode of Survivor.
9. Talk with co-workers about the changes you are making in your lifestyle. They are likely to have ideas and experiences that will make things easier. You might find allies who will help keep you active and healthy. Realize that most people are in the same boat. They want to make a change, but feel it will be difficult or that they have no support. Be vocal about healthy changes you are making and ask others if they have ideas that have worked for them.
10. Draw on those support systems. Friends, family, and neighbors, can help you sustain a healthy lifestyle during tough times. If you’re so inclined, a little spirituality will also help keep you on track.

Always remember that you and your family are worth the initial effort. Once you are living a healthier lifestyle, the benefits in energy level, fitness, and overall health will overshadow the early extra effort that seemed so difficult to work through. Remember, “it” doesn’t have to be “what it is.” It can be whatever you make it.