Hole Health 2020

HOLE Health

Keeping elders at home and healthy

April 29, 2020

A special supplement to the

While some services have been suspended, grocery and meal delivery has kept seniors indoors.

See page 4.

Cover photo: Janette Miller shops for groceries Thursday at Smiths for elders so they can stay home during coronavirus pandemic. Miller said she has been buying groceries almost daily for between two and four people since the pandemic reached Jackson last month. BRADLY J. BONER / NEWS&GUIDE

2E - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, April 29, 2020

Our choices today Health Advisory: will make tomorrow COVID-19 update T his year’s Hole Health section looks different, just as our community looks different.

St. John’s Health Fair, something many of us look forward to every spring, has been canceled. No one is lacing up their shoes for the annual Jackson Hole Spring Runoff 5K. We’re seeing less of our loved ones and friends, and with face masks on, even less of the faces of strangers.

But we do it all because how we live today affects how we live tomorrow.

Many of the stories in the section this year stay true to that concept. We examine the expanded offerings of fitness studios, which have moved from straight calorie-burning exercise to adding classes that also treat the mind and spirit. Seniors (virtually) opened their

We have expanded testing criteria.

• Call 307-739-4898 x3

for a phone evaluation if you have: • a fever, cough, shortness of breath, sore throat, muscle aches, loss of sense of smell or taste, or flu symptoms • been exposed to someone with coronavirus (COVID-19)

doors to show us how they’re staying healthy at home with the help of the services of the Senior Center of Jackson Hole. We dive into the burgeoning field of lifestyle medicine, and how buy-in to lifestyle changes now can mean better outcomes for both patients and hospitals down the road.

These stories serve as a reminder that our health — individually and as a community — sets the framework for our future. Though things look different this year, how we treat our health remains the same: The choices we make today affect the life we have tomorrow.

Be well.

— Tom Hallberg and Melissa Cassutt, Hole Health editors

• traveled to a high-risk area* • If you have difficulty breathing, call 911 or go to the Emergency Department at 625 E. Broadway and call 307-739-4898 x1 before you arrive to receive instructions.

Special supplement written, produced and printed by the Jackson Hole News&Guide Publisher: Kevin Olson Associate Publisher: Adam Meyer

• Recover at home and self-isolate.

In most cases, COVID-19 does not require medical treatment beyond fever control and oral fluids.

Editor in Chief: Johanna Love Managing Editor: Rebecca Huntington Deputy Editor: Melissa Cassutt Layout and Design: Andy Edwards, Samantha Nock Photographers: Bradly J. Boner, Ryan Dorgan, Kathryn Ziesig Copy Editors: Jennifer Dorsey, Mark Huffman, Addie Henderson Features: Billy Arnold, Melissa Cassutt, Jennifer Dorsey, Tom Hallberg, Mike Koshmrl, Julie Kukral

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HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, April 29, 2020 - 3E

Fitness studios adopt wellness creed Offerings shift to include nutrition, meditation and holistic healing.

By Jennifer Dorsey

C

ustomers of Core Changes with Carey walk in knowing they will get a great TRX workout or power yoga session.

But studio owner Carey Clark points out that studio is also known for its fitness challenges, which stress a healthy eating component as part of the fitness focus.

And she recently offered a seven-day online detox (clean eating) class, knowing that the social-distancing mandates of the COVID-19 crisis might be leading some people to stray from healthy routines. She sees her role as more than just fitness classes.

“It’s my job to help motivate people, educate them and keep them on track,” Clark said.

And healthy eating is a critical part of a fitness program.

“You can’t over-exercise a bad diet,” Clark said Core Changes with Carey is just one example of how fitness studios are more than places to exercise. They’re also places to pursue wellness.

According to the National Wellness Institute, a professional development organization in Miami, “Wellness is an active process through which people become aware of, and make choices toward, a more successful existence.”

It’s multidimensional and holistic, the organization says, and encompasses lifestyle, mental and spiritual well-being, and the environment.”

It means exercising, avoiding harmful additions, maintaining a healthy diet and striving for a calm mind.

At Inversion Yoga, for example, the calendar is packed with yoga classes, but you can also sign up for guided meditation sessions.

Akasha Yoga’s schedule includes Zenity Now, which “integrates principles of Yoga and the 12 Step Recovery Program into a movement-based meeting.”

Also on the menu at Akasha are sessions on Ayurveda, a holistic healing system developed

COURTESY PHOTO

Kate Kosharek teaches Pilates and MELT, among other things, at Dancers’ Workshop.

several thousand years ago in India.

Dancers’ Workshop — which many in the community associate with dance classes and performances — has significantly expanded its wellness program with a variety of exercise classes.

Five members of its Contemporary Dance Wyoming troupe are certified in various disciplines.

So while you can still take a salsa, hip-hop or line dancing class you can also sign up for classes like MELT, Pilates Mat and Gyrokenesis.

DW’s Jennifer Striegel and Babs Case said that teaching those classes helps the instructors keep their bodies in the best possible shape for dancing and provide for their own livelihood — i.e., they don’t have to get other jobs. And stu-

DO YOU FIND YOU ARE DRINKING MORE THAN USUAL DURING COVID-19 UNCERTAINTY?

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dents embraced the new offerings.

“There was such high demand that it made sense to expand the instructors and the offerings,” Striegel said.

With Jackson stuck in stay-at-home mode because of the pandemic, many fitness providers have switched to online classes so they can continue to promote wellness.

“We are online seven days a week, morning noon and night, so people can just keep moving and stay as well as they can, not just physically but mentally,” Dancers’ Workshop’s Striegel said.

Contact Jennifer Dorsey at jennifer@jhnewsandguide.com or 732-5908.

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4E - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, April 29, 2020

Keeping elders at home and healthy While some services have been suspended, grocery and meal delivery has kept seniors indoors.

email, phone, occasionally by photo of a piece of paper. She compiles the lists and deploys a masked shopping team, who check items off two to four lists.

“It’s really important to have the support and the personalization as far as having someone call you to say, ‘Hey, I had a question about your list,’” Crow said. “When you hear a familiar voice it goes a long way, especially with isolation, of course.”

Bobbi and Ed Taylor, 73 and 75 years old, started using the program about three weeks ago.

“The shopper has been really good,” Bobbi Taylor said. “Janette [Miller] has been a lot of fun and she’s prompt.”

By Melissa Cassutt

W

hen the pandemic is over, Erin Crow plans to buy a game show buzzer and quiz the grocery store staff on product locations.

On which aisle would you find cat food? Bleach?

Parmesan cheese?

The last one, she said, is a trick question. It’s in three places.

Crow, along with a handful of other staff, has become intimately familiar with Jackson Hole’s three major grocery stores by picking up food and supplies for the community’s most vulnerable. While seniors shelter in place the Senior Center of Jackson Hole has adapted its services to keep its clients healthy, including expanding a program that checks off all the items on a senior’s weekly grocery list and delivers the goods.

“Things have changed up a lot,” said Crow, the Senior Center’s home care manager. “We made the call the morning of March 17 that we were going down to only essential services.”

It was a big adjustment for many of the center’s clients, who are accustomed to daily meals in the dining hall, regular fitness classes and weekly card games. Dozens of others connect with the Senior Center each day for personal, respite and homemaking care. But as of mid-March the center streamlined its services to get the most vital ones to their clients while keeping them — and its staff and volunteers, many of whom are also in the high-risk category of 60 years or older — safe and healthy.

Groceries to go One such change has been a boost to its home delivery program, which skyrocketed from eight clients to over 60. The program was designed to provide goods to those who face a “physical hardship” getting out to the grocery store. But because of shelter-in-place recommendations — and many adult children calling their elderly parents and grandparents, encouraging them to stay put, Crow

Keeping seniors in their homes

RYAN DORGAN / NEWS&GUIDE

Nancy Hughes checks in with Shirley Burzynski after delivering a bag of food Thursday. Hughes volunteered with Meals on Wheels 20 years ago and recently found some time to help the program again.

said — more seniors have shut themselves in their homes.

In turn the center expanded its outreach, a move supported by a few grants and one that has also kept Senior Center staff employed.

“I would have a lot less work and it would not be as gratifying,” Crow said.

Seniors pay for the groceries themselves, but the center provides the labor and delivery free of charge.

Crow sits at incident command, taking orders by

Though much of the home-care program has been scaled back, the center has kept about 20 clients in rotation for personal care, which includes assistance with things like getting out of bed, showering and toileting.

Other services that fall under homemaking, specifically light housekeeping, have had to temporarily go by the wayside in an effort to decrease the number of people entering the homes of the elderly.

But, knowing these changes are disruptive, the staff has worked hard to adapt, Crow said.

During regular telephone check-ins they ask how the client is feeling, if anyone they know has contracted COVID-19, what they’re doing to keep busy.

They ask if they have a mask and how things are going around the house.

Then the staff will problem solve.

If a person needs a mask, someone will drop one off. If a senior is struggling to stay on top of the dishes, the center will bring over a stack of paper plates or offer Meals on Wheels meals, Crow said.

“We want people to stay independent as long as possible,” she said.

It’s mostly the staff doing the work, as many volunteers have had to take a step back. But a new wave of helpers came forward in mid-March to pick up Meals on Wheels shifts and help pack curbside meals, Senior Center Activities and Volunteer Coordinator Hannah Sell said.

“I think we have had between 15 to 20 new people who have reached out,” Sell said. “They’ve just all been amazing, just stepping up and taking things See SENIOR CENTER on 5E

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How to have Meals on Wheels come to you Seniors who are 60 and older who live in the Meals on Wheels delivery area are eligible to sign up for meals at this time. Learn more about the program at SeniorCenterJH.org/meals-on-wheels or call the Senior Center of Jackson Hole at 733-7300.

Seniors can also pick up curbside meals between noon and 1 p.m. Monday through Friday. Lunches costs $4. A breakfast meal can be picked up at the same time ($2 suggested donation), or a morning pick-up time can be scheduled.

Call 733-7300 by 3 p.m. the day before to schedule pick-up for the following day.

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Though some services have been cut back the Meals on Wheels program has picked up with hot meals going out to anyone 60 and over who requests meals to be delivered, a change from the typical program that has additional qualifying requirements.

The center eased program requirements as a way to encourage seniors to stay at home and provide for those who do.

“There were a lot of people that we were already serving, and that continues to be the case,” Sell said. “But now there are new people who are on Meals on Wheels for their main meal of the day, and that’s keeping them out of the grocery stores. They’re able to stay in their home more because they’re getting their food delivered.”

In addition to delivering hot meals and stocking pantry shelves, the programs are also a way for the center to check on its clients, one of the most important parts of senior health.

A 2018 survey conducted by Cigna showed that “Loneliness has the same impact on mortality as smoking 15 cigarettes a day, making it even more dangerous than obesity.”

“When we talk about seniors, social isolation is a risk factor for people because it can be that detrimental to your physical health,” Sell said. “On a regular basis a lot of seniors already report being lonely, so the programs that we have here fill the need for people wanting to socialize and be around other people.

“Now, in this time in COVID-19, we’re all isolating. I think we’re going to see what the effects of that are not only on our community but especially seniors.

We’ve been trying to stay creative with it — we’ve been doing some check-in calls.”

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conducted by staff, but one voice on the line is Beth Shockley, who has been a Meals on Wheels volunteer for the past three years. She started about a year after she was a client of the program after two hip replacements.

She stepped back from her regular Friday delivery duties — she’s 72 years old herself — and has been placing phone calls to those on her route.

“I’ve been keeping in touch with my people, ‘my peeps,’ because you get to be friends with them,” she said. “Consistency is really important in all of our lives. I just don’t want them to think that I abandoned them just because I’m not over there delivering the meals.”

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Waiting for hot meals Those on the other end of the program anxiously await the meals, which now include breakfasts.

“Boy, I really swear by them. They are very good,” 89-year-old Jeanine Mayer said. “Usually I eat the breakfast at lunchtime and eat on the meal during the afternoon.”

Those who are still mobile can also tap into the Senior Center’s curbside pickup, which provides inexpensive or free meals to seniors Monday through Friday. The Taylors have been regulars at the drive-thru, picking up meals two to three times a week for themselves and their disabled adult son, Jonathan, who is also at home with them all day during the pandemic.

Though they hadn’t connected with any of the center’s remote services prior — they were regulars in the fitness center — they found the transition into their new normal pretty seamless.

The Senior Center “just let us know about something and asks us if we want it,” Bobbi Taylor said.

“They make their services very available,” she said. “You don’t feel like you’re really asking for charity or help.

They just really have stepped up.”

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6E - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, April 29, 2020

Lowering costs, improving lives, even during a pandemic

Lifestyle medicine aims to Lowering costs, improving lives One statistic reveals the economic reverse chronic conditions, potential of lifestyle medicine: Acand it’s even useful cording to the American College of Lifestyle Medicine, 86% of all health during a pandemic. care funding goes to treat chronic conBy Tom Hallberg

I

surers is only one part of the appeal.

Improving patients’ lives is the other.

To do that the field is based on six pillars: nutrition, exercise, sleep, healthy relationships, stress management and avoiding risky substances. For each ditions, and 80% of that spending is patient who enters St. John’s program the treatment will look different, related to poor lifestyle choices. because each one will have If health care systems can unique risk behaviors. reverse or prevent chronic Natalie Stewart, a conditions without costly registered nurse in the procedures and mediWellness Department, cations, patients and is the first lifestyle hospitals save money. medicine-certified “When you want exploring solutions nurse in Wyoming. In an instrument to an initial screening improve patient outshe identifies which comes, one of the offerings are right for most cost effective patients. They might and universal ways to need wellness coaching, do that is bring lifestyle nutrition counseling or ermedicine modalities into gonomic evaluations to improve that population,” Dr. Catherine their workspace and avoid the aches Collings said.

Collings is president-elect of the and pains that come from repetitive American College of Lifestyle Medi- motions or bad posture at work.

The Centers for Medicare and cine, the physician group that promotes the field and provides practi- Medicaid Services offers limited reimtioner education. She said lowering bursements for lifestyle medicine, so costs for hospitals and in- the program is a cash-pay system —

t was September when Julia Heemstra told the St. John’s Health Board of Trustees about an exciting new program she was developing — lifestyle medicine. She described a set of treatments with the potential to reverse chronic conditions and improve patient quality of life, while lowering the use of medication.

The emerging field of medicine combines wellness offerings with behavioral alterations, and it has the potential to do two things that are music to hospital administrators’ ears: save lives and cut costs.

“We investigated cutting-edge treatment around the nation,” she told the board. “Lifestyle medicine is the most cutting edge.”

Throughout the winter the hospital released details about the program. It would combine existing Wellness Department services under the lifestyle medicine umbrella, and take its first patients March 1.

Then the coronavirus swept across the globe, forcing Heemstra, who runs the hospital’s Wellness Exercise: Department, to put Near-daily exercise is part her plans on hold. of any weight loss regimen.

Setting goals that gradually increase your level of exercise makes it easier to stick to a workout plan.

what works

something that could be difficult for patients on government insurance, who generally have lower incomes but could benefit from lifestyle medicine.

CMS data shows that in 2013, 42.4% of Medicare beneficiaries reported a heart problem, and their out-of-pocket costs were nearly double the costs of patients without a heart condition. The Centers for Disease Control and Prevention reported that more than 40% of American adults were obese, and that the prevalence increased in those without a college degree, who have been shown to make far less money over the course of their lives.

Without strong reimbursements from government insurance programs, some of the populations that would benefit the most from lifestyle medicine may not be able to afford it.

That may not be the case for some in Jackson, however, because Heemstra said the St. John’s Health Foundation has funds to assist those committed to making changes though the lifestyle medicine program.

For Heemstra, better patient outcomes take precedence over finances, though the two are intertwined.

“Within St. John’s as a whole, I think it’s important to keep that in mind that the program is about preventing, treating and reversing disease,” she said. “That turns the financial side around pretty significantly.”

See LIFESTYLE MEDICINE on 7E

Stress Management: Stress, especially during a pandemic, is often unavoidable, whether the source is work, family, finances or another part of life.

Techniques like meditation and mindfulness are used to help lower cortisol levels and improve mental health.

THE SIX PILLARS OF LIFESTYLE MEDICINE

Healthy Relationships: Cultivating interpersonal relationships increases a person's sense of belonging and creates a support group for maintaining other life goals.

Lifestyle medicine, a relatively new field, uses existing knowledge of the effectiveness of lifestyle changes on chronic conditions like diabetes and heart disease, coupled with the teachings of behavioral modifications, to help patients improve their quality of life.

Avoiding risky substances: St. John's offers tobacco cessation counseling to help patients end their use of tobacco products and vapes. In its COVID-19 self care kit, the Wellness Department encouraged employees to take days off from drinking alcohol as well.

SOURCE: AMERICAN COLLEGE OF LIFESTYLE MEDICINE

Nutrition: Plant-based diets are part of this pillar of lifestyle medicine.

Decreasing the amount of meat in your diet has been shown to lower levels of inflammation and increase fiber and nutrient intake.

Sleep: Stress and the increased use of screens in everyday life, from work to watching television, can make getting seven to nine hours of sleep difficult. Lifestyle medicine practitioners encourage setting a routine before bed to make getting to sleep easier.

AN DY

ED W AR DS /

NE WS &GU IDE

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, April 29, 2020 - 7E

LIFESTYLE MEDICINE Continued from 6E

Seeing big results Stephanie Snow wasn’t living the life she wanted.

The pastry and catering supervisor at St. John’s had high blood pressure and wanted to lose weight. Her doctors told her she should have her gallbladder removed because of gallstones, and she had diabetes.

Her medical expenses included doctor’s visits for the gallstones and a medicine called metformin, which controls blood sugar levels. If she were to have her gallstones removed she would have needed surgery, another large expense.

After Snow started working at St. John’s a couple of years ago she entered the Wellness Department’s programs, which are now part of the lifestyle medicine program. She greatly improved her condition through wellness coaching, nutritional counseling and exercise.

“I needed to lose about 160 pounds, and I’m at 90,” she said. “I canceled my surgery and avoided having my gallbladder taken out.”

Snow lowered her blood sugar and blood pressure to normal levels, allowing her to not take blood pressure medication and stop using the metformin after about 10 months. She’s not alone in seeing such improvement.

A 2012 study published in the Journal of the American Medical Association found aggressive lifestyle changes were far more likely to produce a partial remission in diabetics than typical diabetes care.

Those who received typical care had a 2% likelihood of a partial remission at both one year and four.

In the group that made significant lifestyle changes, which included lowering saturated fat intake and increasing exercise, 11.5% of patients experienced a partial remission in the first year, defined as the lowering of blood sugar levels to less than 6.5% without the use of medication. That number fell to 7% by year four but was still significantly higher than the control group.

Part of Snow’s regimen was to start exercising.

She ran in the Spring Runoff 5K last spring, walking parts and jogging others. Then she set a goal to run the whole thing this year, so she started putting miles in on the treadmill and doing Pilates to build strength.

Heemstra encouraged her to accelerate her training goals and run the Turkey Trot, the annual Thanksgiving race. Snow obliged, dedicating herself to and finding value in her training.

“Setting goals for yourself and accomplishing them builds your confidence and lets you know ‘I can do this,’” Snow said.

Snow’s “emotional and mental stability was rocky” before she started working with the Wellness Department, but in addition to feeling physical benefits from her work with the Wellness Department she has experienced psychological improvements.

Exercise is often correlated with weight loss, as well as lowered blood sugar levels, but it also benefits mental health.

“A number of studies have previously demonstrated that exercise may offer a number of comparable benefits to antidepressant mediation in those with depression,” found a literature review published by the Neuroscience and Behavioral Reviews journal.

The review looked at 20 studies with a total of 1,353 participants. Though the results and outcomes were obviously unique to each study, in the aggregate the review found exercise may have positive effects on biomarkers like inflammation to cortisol levels.

It cautioned that more research was needed to confirm the results of the studies. Anecdotally, Snow said, shifts in behavior correlated with changes in mental health.

“In the program, you look at your emotions and get OK with those emotions,” she said. “Then I could find alternatives for what to do when I’m stressed.”

Old habits die hard Lifestyle medicine practitioners jump at the chance to work with a motivated client like Snow.

Maintaining behavioral changes long enough to see lasting benefits is difficult, which is one reason new diets pop up all the time.

A 1999 study in the International Journal of Obesity that followed adults for four years found the most common actions taken to lose weight — increasing exercise, decreasing fat intake, reducing food and calorie intake — were used only 20% of the time, and the duration of use was brief. Studies have shown that most dieters regain half of what they lost in two years, but willpower is not the only factor that may contribute to weight regain.

A study that followed contestants on the television show “The Biggest Loser” found metabolic changes from dieting resulted in people burning fewer calories throughout the day. Other analyses have found satiety hormones may become less reactive as people ease out of diets, and changes in the gut microbiome may result in physiological changes that make it harder to keep weight off, Scientific American reported.

The myriad — and little understood — physiologi-

KATHRYN ZIESIG / NEWS&GUIDE

Cyclists ride along Gros Ventre Road last week. Getting out for exercise is an important pillar of overall wellness.

TRAVIS J. GARNER / NEWS&GUIDE FILE

BRADLY J. BONER / NEWS&GUIDE

Ways to manage stress are important as we stay at home, and even more important should one contract COVID-19.

Developing and maintaining a healthy diet is one of the six pillars of lifestyle medicine.

cal changes that make it difficult to avoid regaining weight happen in line with the fact that it is difficult to maintain the extreme lifestyle changes that often accompany dieting. Though little evidence exists as of yet on patients’ tendency to stick with changes that result from lifestyle medicine programs, practitioners try to leverage behavioral science to create sustainable patterns because they are aware of the statistics in other realms like dieting.

Collings, a cardiologist, described a hypothetical heart attack patient, someone who would be an ideal candidate for lifestyle medicine. Once that person recovers she doesn’t simply hope the episode will be lasting motivation. Instead the trauma, along with continued physician support, is the impetus for changes in diet and exercise.

“Fear is not a very profound behavior change modality,” she said. “It’s not a good sustainer, but it’s a good initiator.”

Practitioners develop incremental goals with patients, ones they feel connected to and accountable for. For Snow that meant small changes to the way she ate, and gradually increasing exercise until she was able to run the Turkey Trot.

In the end, addressing people’s likelihood to revert to old habits is integral to the field.

“The final thing is when you no longer need those nudges, it’s a new normal, a new way you orchestrate through your life,” Collings said. “That’s a lifestyle as opposed to a diet or new exercise routine.

“The general approach is not making it about willpower, but making it about skill power.”

of pandemic lifestyle medicine still makes the most sense in regards to how we can protect ourselves and treat ourselves,” she said.

During the 2010 H1N1 influenza pandemic, Korean researchers found smokers were more likely to contract the flu than nonsmokers. Studies of Israeli army personnel reflect that finding, showing female smokers had a 60% risk of contracting the flu, as opposed to a 41.6% risk in nonsmokers.

The authors of the Israeli army study also stated in another report that 68.5% of smokers contracted H1N1, compared with 47.2% of nonsmokers. Similar statistics for the coronavirus are hard to come by because it is so new, but the Centers for Disease Control and Prevention say lifestyle factors like smoking or obesity are linked to COVID-19.

One study of more than 4,000 patients in New York found obesity and age were the two strongest determiners of whether someone developed a critical illness from COVID-19. Of the roughly 1,600 hospitalized patients included in the results, 41.1% had a critical illness.

Roughly 40% of hospitalized patients were obese, compared with just 14.5% of those who had a mild reaction. The paper was in preprint at press time, meaning it had not been peer-reviewed, but its finding that lifestyle factors like smoking, obesity and heart disease were comorbidities tracks with preliminary studies done by the CDC and in China.

Heemstra acknowledged lifestyle medicine couldn’t reverse chronic conditions during the outbreak’s relatively short time window. But she said stress management, eating well and exercising are ways people can stay healthy, so if they contract the virus they have a better chance of a mild reaction.

Regardless of when St. John’s can restart programs like lifestyle medicine, Heemstra sees the pandemic as a chance for people to recognize the value of following the pillars of lifestyle medicine.

“It’s so spotlighted right now,” she said. “What’s so overlooked all the time is how our quality of life is improved by doing these things every day, even not in the middle of a pandemic.”

Staying healthy in the face of COVID-19 Despite the promise of lifestyle medicine, social distancing has brought the St. John’s program to a halt. Some pieces could be done online, but the practitioner-patient relationship that is key to accountability and support is hard to develop online.

Instead, Heemstra adapted the pillars into a monthlong COVID self-care kit for St. John’s employees. It gives them one exercise, meditation or challenge to do each day. Included are things like avoiding screens for a set amount of time before bed or choosing a night of the week to not drink alcohol.

“We’ve been grateful to observe that even in time

Contact Tom Hallberg at 732-7079 or thallberg@jhnewsandguide.com.

8E - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, April 29, 2020

Rx for the blues? Get outside and move Scientific literature is increasingly proving that outdoor recreation and even just being outside pays dividends for the brain.

By Mike Koshmrl

W

hen Christian Beckwith is feeling cooped up and stressed by the middle of a workday, he looks to move his legs.

In the 1,571-foot ski hill looming over Jackson’s southern horizon he finds a reliable outlet for getting the zoomies out and easing the mind all at once.

“I call my little hike up Snow King for lunch my antidepressant,” Beckwith said, “because if I don’t get it I can be overwhelmed by what’s going on in the world.”

Beckwith, who founded the SHIFT conference, runs a business that depends on events — and bringing a lot people together. It’s a livelihood that’s proved especially stressful as the world has careened deeper and deeper into the COVID-19 crisis, which is being combated by keeping people apart and causing all sorts of events to cancel.

It’s not the same inside Instead, Beckwith could hop on a StairMaster, pace off 5,300 steps and perform essentially the same physical endeavor, he said. But there’s one key difference.

“If we spend that time outside,” Beckwith said, “we feel better.”

The connection between the outdoors and emotional well-being is something that Beckwith is yearing to learn as much about as he possibly can.

Now in its seventh year, SHIFT, which operates under the new Center for Jackson Hole, has turned its attention to exploring the importance of nature in human health. That’s a mission that’s more relevant than ever.

“What we’re seeing around the country is this surge in interest and usage of the outdoors,” Beckwith said. “We’re seeing a deeper appreciation for the physical benefits, but really the mental benefits

BRADLY J. BONER / NEWS&GUIDE

The physical benefits of outdoor recreation are evident, but there are a lot of studies and books that say spending time outside also makes us happier and cognitively sharper.

of spending time outside.”

In Jackson Hole, with its tremendous access and opportunities, residents seem to have connected those dots, consciously or not. Their response to coping with COVID-19 and shelter-in-place directives is a case in point.

“The sidewalk outside my house,” Beckwith said, “I’ve never seen it so teeming.”

Good for the brain There’s a growing body of scientific literature underpinning assertions about the positive mental health affects of the great outdoors. Science writer Florence Williams, author of the recent book, “The

Nature Fix,” knows all about it.

“In the last five or 10 years we’ve seen a deep body of research showing that there are serious benefits mentally to being outside,” Williams said. “Those include benefits that make us both emotionally happier and also cognitively sharper.

“Human beings are really evolved to read information in the natural world, and so there’s something spending time there that puts our brains at ease, even on a subconscious level.”

In the outdoors, nervous systems calm down. The frontal cortex and other parts of the brain that get overtaxed by modern indoor life, reading emails and See OUTSIDE on 9E

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OUTSIDE

Continued from 8E

problem solving are in turn put at ease.

“In a time when we’re kind of sensorily deprived and spending so much time indoors and on screens,” Williams said, “the benefits of the outdoors are more important than ever before.”

“It’s a little bit like eating spinach,” Williams said. “Sometimes I don’t really feel like getting up and going outside in the rain, but I know if I do I will feel better afterwards.”

A future prescription

Beckwith said that society as a whole poorly understands the mental health benefits of being outside. The cause of nature as Rx, he said, could use its Smokey Bear, or some other Even a little bit helps emblem or moment that resonates It doesn’t require a major back- and helps crystalize the connection. packing trip or skin to the top of the “The science needs to be developed Tetons to get the job done. Some Jap- more robustly,” he said. “And the anese research has determined that story of that science needs to be told just 15 minutes out in the open air more objectively. One of the challengcan improve moods, blood pressure es is the narrative.” and respiration.

A recommendation to spend more G e n e r a l l y, time outside Williams said, could someday the research sugbe part of the gests that there’s prescription for a “dose curve,” someone facing and the more outa mental health door exposure, challenge. the better. Be“I think cliniing in a dynamic cians of all sorts environment are starting to with a lot of biolook more closely diversity, birdat this research,” — Florence Williams Williams song and little said.

AUTHOR OF “THE NATURE FIX” “But I think we human-produced sound is ideal in have a long way that regard. to go. This isn’t “But there’s also a lot of evidence really something that’s taught in medshowing that being in urban nature ical school or in psychology programs.” can really start us down the path toOne reason to believe nature will ward feeling calmer and happier,” she be given a longer, harder look by docsaid. “There are still a lot of benefits tors is that traditional forms of medito be gained even from just a view cine and approaches aren’t curing a outside your window of trees and lot of pervasive problems, like depresgrass.” sion, anxiety and obesity.

Williams, a denizen of the Wash“So I think there’s an increasing ington D.C., area, takes the expert willingness to look outside the box at advice to heart, especially during dif- things, like nature, that make us feel ficult times like now. When she spoke happier and better,” Williams said. to the News&Guide last week she was driving with her son to a trailhead as Contact Mike Koshmrl at 732-7067 or env@jhnewsandguide.com. raindrops clattered on her car.

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“There are still a lot of benefits to be gained even from just a view outside your window of trees and grass.”

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10E - HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, April 29, 2020

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D

r. James Raniolo can say with near certainty that the majority of people in Jackson have lower than recommended levels of vitamin D in the winter.

Our bodies make vitamin D when our skin is exposed to sunlight, so it’s no surprise that our risk of vitamin D deficiency increases with the avalanche danger. Vitamin D deficiencies can lower your energy levels, weaken your immune system and leave you at risk for depression, hair loss and chronic pain — but can be easily solved by taking a supplement you can buy at the grocery store.

Supplements — a broad term that includes vitamins, minerals, amino acids, enzymes and herbs or botanicals — can be found in any healthoriented grocery store and bought without a prescription. They can come in the form of pills, tinctures, powders, drinks and even shaped like Flintstones characters — like those you probably ate as a kid.

Supplements are used to fill gaps in nutrition when we’re unable to achieve optimal health through our diet, environment or because of other imbalances or diseases.

“It’s not just hippies on the fringe.

It’s not just people who are on a health food crunch.”

— Kathleen Osterman-Meisner JACKSON HOLE GROCER

“Optimally, you would like to get all your nutrients from food,” naturopathic physician Monique Lai said. “But the nutrient value in food has gone down significantly in the past 40 years, and I think that’s why more people are looking towards supplements.”

Supplements to the rescue?

Assuming we cannot eat our way to health, more doctors are looking to supplements to help prevent and manage nutritional diseases.

However, none of the supplements you can buy at a store are legally allowed to claim they are effective treatments for diseases, as opposed, say, to how Lipitor can claim it treats high cholesterol.

According to Dr. Raniolo, a doctor of osteopathic medicine, that is partly because many off-the-shelf supplements simply have doses too low to be dramatically effective. If you’re dealing with more serious symptoms or illnesses, physicians such as Raniolo or Lai can prescribe physiciandispensed brands of supplements that have much higher doses than anything you could pick up off the shelf or buy online.

Still, choosing supplement-based treatment methods over pharmaceutical drug-based ones is not standard procedure in Western medicine.

Raniolo’s private practice, the Wyoming Center for Optimal Health, is dedicated to helping people reduce their reliance on pharmaceutical

BRADLY J. BONER / NEWS&GUIDE

Vitamin D is one of the most used supplements, and has the support of many doctors.

drugs. He is passionate about the benefits of some supplements.

“When you spend the time to actually read the source medical literature, it becomes absolutely undeniable that some of the most effective treatments that we have are based in natural compounds,” Raniolo said.

Raniolo is working to launch a website, AmericanVitalityAssociation.org, that pools relevant medical literature about nutrient-based medicines into one place.

How to pick supplements Supplement use is widespread among Americans. According to the FDA, three out of four Americans use dietary supplements on a regular basis.

“It’s not just hippies on the fringe. It’s not just people who are on a health food crunch,” said Jackson Whole Grocer Assistant Manager Kathleen Osterman-Meisner, who has 27 years experience in the supplement field.

“We’re seeing a lot more people being sent in by their health care professionals to find supplements,” she said.

While supplements are becoming more popular, it’s important to note that not all supplements are created equal.

The FDA has started to impose stricter limits on the supplement industry in the past few years, but there are still a great many lowgrade supplements on the market that are filled with chemicals and fillers that can do more harm than good.

As with food, when you’re buying supplements it’s important to read the ingredients closely and buy from brands and stores you trust.

Jennifer Nelson-Hawkes, a board-certified holistic health practitioner and owner of Simply Healthy, said to avoid supplements with waxes, gums, dyes or harsh additives like titanium dioxide or magnesium silicate.

Nelson-Hawkes said that supplement are not meant to be a chronic crutch.

That said, unregulated or overuse of certain supplements can be dangerous, and a fixation on being “healthy” can have its own health kickbacks, such as orthorexia disorder.

“Health is not about being perfect all the time,” Lai said. “Health is about knowing your body. There is no perfect here.”

Contact Julie Kukral via 732-7062 or entertainment@jhnewsandguide.com.

HOLE HEALTH, JACKSON HOLE NEWS&GUIDE, Wednesday, April 29, 2020 - 11E

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University of Utah researcher Jakob Jensen’s study of how people perceive messaging about COVID-19 shows that people are experiencing “message fatigue” His study was designed to determine whether people feel exhausted by messaging or overloaded by the amount of information, and whether they feel messaging is repetitive or exaggerated.

How to reduce your ‘message fatigue’

By Billy Arnold People are wearying of the deluge of COVID-19 information and finding some relief, experts say, could involve something as simple as taking a break.

“People need to unplug and maybe limit the information they’re looking for,” said Deidre Ashley, executive director of the Jackson Hole Community Counseling Center.

Jakob Jensen, a University of Utah professor, has been studying how people have responded around the nation to information about the coronavirus. Seven weeks into his study, in which his team surveys 400 people nationwide on a weekly basis, Jensen said it appears the public is experiencing “message fatigue.”

In a nutshell, that means people Jensen are tired of hearing similar messages, day in and day out. And the rate at which people are experiencing that fatigue is also particularly high.

“Normally, message fatigue is around 10% to 15%,” Jensen said.

“To see message fatigue as high as 50% in the national surveys — it’s pretty high for something that is not a day-to-day occurrence.”

There’s any number of reasons people might be worn out. One might be information overload.

“As consumers in the 21st century, we get messages from our local area, but then we also get a smattering of messages from around the world,” Jensen said.

“Even if locally your messaging is on point, you’re drinking from a very large well.”

It doesn’t help that some messages have been contradictory.

The Centers for Disease Control and Prevention, for example, initially did not recommend that people wear masks in public. But the advice changed. While the CDC still recommends against buying medical-grade masks (so as to preserve them for frontline hospital workers), the nation’s top medical agency now recommends that people wear face coverings in public.

Jensen said back and forths like that can wear people down.

“That one was difficult for sure,” Teton County Director of Health Jodie Pond said, acknowledging that mask advice was mixed. The conclusion now, she added, is that people should wear masks in spaces where they can’t maintain 6 feet of distance.

The reason for the flip-flop, Pond said, is in part that information is changing constantly.

“We’re learning new things, even by the hour,” Pond said.

Jensen said conflicting messages — and messaging fatigue in general — can hurt mental health.

“We see stress being strongly linked to a lot of these negative perceptions about messages,” he said.

“And I think it’s a two-way street.

More stress equals more message fatigue. More message fatigue equals more stress.”

To fight that, Jensen and Ashley said, people should be aware of just Ashley how much information they’re letting into their lives.

Being intentional with the media you consume, digital or otherwise, is something Ashley recommends, whether the community is dealing with COVID or not.

“It’s just a condition of our world … with everything accessible and at your fingertips,” Ashley said.

“And right now it’s even more of a firehose.”

One way to be intentional is to choose and focus on a trusted, local source of information.

In Teton County health officials have been promoting JHCOVID. com as that resource since the beginning of the outbreak. Pond described it as “one place, linked to other trusted sources” like the CDC, the Wyoming Department of Health and Teton County’s own virus dashboard.

But if the information deluge is still coming — as it likely will — Ashley and Jensen said selectively tuning out is something people should consider.

“If someone is feeling fatigued and they’re feeling like it’s repetitive and they’re feeling overloaded, take a break,” Jensen said. “That’s kind of old advice. But I think it’s good advice.”

Contact Billy Arnold at 732-7063 or barnold@jhnewsandguide.com.

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