The Newsroom    Published Thursday, Aug. 15, 2013, 10:45 AM
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The golden triangle

Galveston County Daily News, August 13, 2013

By VICTOR S. SIERPINA

No, I am not talking geometry here. When I refer to the golden triangle, it relates to the three essential components of well-being. These are: nutrition, activity and mind/body/spirit balance.

The media is recently filled with discussions of Obamacare and other big government programs to remedy health care problems in our country. Such problems are many, a fact I do not deny.

However, the libertarian streak in me is deeply suspicious of centralized, governmental involvement in something as personal as our health care.

The frequent tales of abuse, fraud, waste, perverse incentives and unintended consequences in such programs and government agencies are legion.

In fact, such proposed programs aren’t truly health care but are sickness care. They primarily are financial rather than health- or wellness-directed.

They also are oriented around a failed model of medical care in our country, which costs twice as much, on average, as other developed countries such as Germany, France, Canada and Great Britain.

Compared to them, the U.S. has much worse outcomes on infant mortality, longevity and other measures of health.

Because we spend more, we ought to get better outcomes, right? Not the case. Will governmental funding for uninsured patients fix this problem?

Well, it will give people who are uninsured access to our expensive health care system, drugs, surgery and the other high-tech approaches. But it is a bit like building a body-shop at the bottom of the cliff that needs a guard rail.

My favorite philosopher, the Chinese sage Lao Tsu once said, “The sage addresses the problem when it is small, therefore he does not face difficulty.”

Our problem is that we are addressing medical problems after they are already big. Obesity, diabetes, heart disease, cancer, dementia and other chronic diseases can be treated to some extent but wouldn’t it be ideal to reduce the number of people needing to be treated?

Any health care system, in order to be affordable and sustainable, needs to emphasize first and foremost prevention, health promotion and wellness.

Instead of making a lot of money fixing bodies that have fallen over the cliff, can’t we find better ways to keep them from dropping over in the first place?

This is where the golden triangle comes in. The emerging field of lifestyle medicine offers options to reduce morbidity and mortality by helping individuals and communities to reduce their risk of serious, chronic and fatal disease by modifications of lifestyle.

This is a team sport. It is hard to do alone and requires commitment by the individual, family, neighborhood, faith community, as well as medical and business sectors.

To encourage healthier nutrition, for example, we need to move beyond education to demonstration. I recently reviewed a project by UTMB students to teach uninsured patients about how to implement and understand how to shop, plan for meals, and prepare healthful, delicious comfort food on a limited budget.

This brings us to the first side of the golden triangle, nutrition. This ought to include mindful eating, with at least five servings of fruits and vegetables daily, lean protein sources, including plant sources like beans and soy, whole grains, and healthy fats like fish and olive oils. The Mediterranean diet is best evidenced to be a healthy overall model.

The next side of the triangle is making room in your life to perform regular physical activity.


The FITT prescription is a place to start: Frequency, Intensity, Type, Time. You don’t need a health coach or trainer to come up with this plan.

The U.S. Centers for Disease Control recommends 150 minutes weekly of moderate aerobic exercise and a couple sessions a week of some resistance training.

The 150-minute mark again is evidence based as a target for reducing all cause mortality and morbidity. A mix of enjoyable activities is the best bet to keep you motivated, interested and moving. Even short blocks of 10 minutes such as walking at a time can mount up throughout the day and week.

The final side of the triangle is mind/body/spirit balance. In our fast-paced world, we need to take time to reduce our stress level and allow our body to recover.

This can happen in as little as 10 minutes of personal practice. A wide variety of methods can help you accomplish this health-promoting portion of the golden triangle.

Personal prayer time, meditation, imagery, biofeedback, music, expressive writing or journaling or movement therapies like yoga or tai chi can all help this balancing process.

In the end, you are the only one who can create the conditions for your personal health and wellness.
Using the principles of lifestyle medicine can help us prevent so many from falling through the safety net.



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