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Barquist Health Clinic offers educational group wellness classes every Wednesday from 1:30-2:30 p.m. at their Fort Detrick clinic. Class instructors emphasize arming participants with not only practical tools to help them begin adopting healthier behaviors, but also instilling in them a renewed sense of empowerment.

Barquist hosts their wellness classes as part of an initiative to promote the Surgeon General’s Performance Triad. Classes are taught by trained health professionals and focus on pain management, sleep disturbance, coping with chronic illness and general healthy behavior.

The healthy behavior class taught on the third Wednesday of each month touches on each component of the Performance Triad -- Sleep, Activity, and Nutrition. At a recent session, psychiatric nurse practitioner and facilitator Clarissa Darr began the class by asking participants which aspects of healthy living they were most interested in, so that she and co-facilitator and registered nurse Capt. Patricia Alvarez could tailor the class to their unique needs.

Starting with nutrition, Alvarez instructed the class to plan out meals to ensure they eat small, frequent meals comprising three healthy primary meals and two snacks in between to maintain good nutrition. She referred attendees to USDA’s http://choosemyplate.gov for determining a recommended daily calorie intake, sample menus and recipes, and much more.

Alvarez explained that once participants know how many calories they should consume per day, they need to be able to translate those numbers into actual meals. To illustrate her point, she held up a plate of steamed broccoli, a sweet potato, chicken breast and a clementine and asked the class to guess the amount of calories represented on the plate. She then held up a blueberry muffin and posed the same question. After many incorrect guesses she enlightened her students stating that the complete meal was 380 calories and the muffin was 500 calories.

“So let’s say you have 1,800 calories to work with each day, you really need to think about your food choices. If you have this muffin for breakfast or a snack, that’s not leaving you with many calories for the rest of the day,” said Alvarez.

In addition to eating the right foods, Alvarez warned that calories should be consumed throughout the day as opposed to abstaining from breakfast and lunch and eating a 1,500 calorie dinner, for example. “You will overwhelm your body, and it will store those calories as fat. You need to keep your glycemic index steady,” she said. Alvarez offered other helpful tips during the session such as using a smaller plate when portioning out servings, eating slowly and getting proper rest.

According to Alvarez, proper rest is critical, not only in weight management, but in achieving optimal physical, mental, and emotional health. She acknowledged that acquiring a healthy sleep routine is especially challenging for soldiers returning from deployment where inadequate sleep was the norm. She added that getting optimal sleep starts with learning and practicing good sleep habits before, during, and after deployment.

Darr began a more in-depth discussion on improving sleep by reviewing stimulus control procedures. “Use your bed for sleep and sex only,” she said. She clarified that when people watch TV, eat or read in their bed they subconsciously associate their bed as a place to be awake instead of asleep.

To help create a bedroom environment conducive to sleep, Darr recommended that rooms are quiet, dark and at a moderate temperature. She shared that there are many steps one can take to help induce sleep at night beyond the obvious contenders such as avoiding caffeine.

Darr recommended participants avoid alcohol after dinner, nicotine prior to bedtime, exercise within two hours of hitting the sack, and daytime napping. “If you do take a nap, refrain from sleeping longer than 20 minutes,” said Darr. She explained that melatonin is a natural hormone which helps regulate when a person falls asleep and wakes. Exposure to too little light during the day can disrupt the body’s normal melatonin cycles. Given this scenario she added that this effect poses a unique challenge for shift workers.

“It is important to understand how your body’s biochemistry works,” said Darr. She commented that just as participants normally have a morning routine for starting our day so too do they need a routine for winding down. “If you watch TV prior to bedtime, watch something light-hearted and avoid intense TV programs or the news,” she said.

To help participants get a firmer grasp on how they can begin to change sleep behaviors, Darr said that it’s helpful to first understand our sleep/wake patterns and their impact on how they feel. She advised the class to maintain a two-week sleep diary. Darr passed out a sample diary produced by the American Academy of Sleep Medicine. She explained that the diary offers an easy way to track when one goes to bed and how long they sleep. It also helps keep tabs on any medicine, alcohol, or caffeinated drinks one consumes, along with other activities that may affect sleep or level of fatigue such as work schedules and exercise. Darr advised the group to examine their completed diaries and identify which behavioral patters were associated with good and poor sleep, and begin to modify behavior based on this personalized information.

Focusing on the third pillar of the Performance Triad, activity, Darr and Alvarez led a discussion on how attendees can get started on an exercise regimen.

“You need to set goals and they need to be specific,” said Alvarez. “If you tell yourself you are going to start walking, take this a step further and figure out where, when and with whom.”

Alvarez asked participants what steps they took to make themselves accountable in their daily lives. “Does grabbing a partner or simply stating your goals out loud in front of your peers, help you realize them?” she posed. She said that planning and committing to regular exercise “is a process -- a marathon, rather than a sprint.”

Darr emphasized that the original recommendation to walk 2,000 steps a day has increased to 10,000 steps per day. Alvarez added that simple to advanced pedometers and even apps for one’s cell phone can help track steps, distance, stairs climbed, and calories burned.

“Exercise for at least 30 minutes a day, 5 days a week, will also help control anxiety,” said Alvarez. She noted that if a person has trouble walking for extended distances, to try stretching or yoga. “Heavy housework activities such as vacuuming or scrubbing floors counts towards daily exercise too!” said Alvarez.

Concluding the class, Darr and Alvarez advised participants that research shows that long-lasting change occurs when it is carried out on a positive note. They encouraged the group to make positive behavioral changes not because someone made a hurtful comment, but because they want to feel healthier. “It takes 21 days to form a habit, so be patient with yourselves, the change will come,” said Alvarez.

Barquist offers its four wellness class on alternating Wednesdays. Pain management classes fall on the 1st Wednesday of every month; sleep disturbance classes are scheduled on the 2nd Wednesday; healthy behavior: eating exercise and sleep classes fall on the 3rd Wednesday; and coping with chronic illness is scheduled the 4th Wednesday of each month. To register for an educational group class, call the Barquist Health Clinic at (301) 619-7175.