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For years, 44-year-old Charlie Rolstone from the U.K. brushed off her migraines, motion sickness, and occasional blackouts as the side effects of spending too much time on her phone. But a medical emergency three years ago revealed a chilling truth that her symptoms stemmed from a rare brain disorder from her skull pushing against the brain.
An MRI taken during the emergency visit revealed that Rolstone had epilepsy and a Chiari malformation, a condition caused by an abnormal skull structure that forces the brain to extend downward into the spinal canal.
“I’ve had it my whole life, but my symptoms have only been getting worse as I’ve got older,” said Rolstone, SWNS reported.
“I’ve suffered with migraines since I was a teen. Whenever I cough, I also get a very piercing pain in my head, covering the back of my skull. It only lasts for, maybe, 30 seconds — but it’s enough to make me grab my head. I can’t even shout or raise my voice without getting a headache. These were symptoms I knew to be there, but I thought they were normal,” she added.
Rolstone thought she would grow out of the symptoms until she received the diagnosis while she was taken to the hospital after collapsing from a seizure. The doctors also found out that she had brain lesions and an aneurysm.
“I don’t know the full extent of the damage the condition has done, but I’m glad we’ve caught it now. That seizure saved my life — it revealed my Chiari malformation,” she said.
Rolstone now manages her migraines with painkillers and limits her phone use to reduce motion sickness. With medications for epilepsy, she has been seizure-free for 21 months.
Chiari malformation can be present with or without symptoms, and the signs depend on the type of condition. In Chiari malformation type 1, symptoms such as headaches, particularly while coughing or sneezing, neck pain, poor hand coordination, numbness in the hands and feet, and difficulty swallowing, typically begin in late childhood or adulthood, though the condition is often congenital.
In rare cases, individuals with Chiari malformation type 1 may experience additional symptoms, including ringing or buzzing in the ears (tinnitus), muscle weakness, a slow heart rhythm, curvature of the spine (scoliosis) linked to spinal cord impairment, and breathing difficulties.
Type 2 Chiari malformation is typically associated with a myelomeningocele, a form of spina bifida where the spinal canal and backbone fail to close properly before birth. The symptoms include difficulty swallowing, changes in breathing pattern, sudden downward eye movements and weakness in arms.
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Scaling New Heights: Conquering the World’s Most Daring Mountain Treks
The allure of the mountains is irresistible. For many, the thought of scaling the world’s most daring mountain treks is a tantalizing prospect, a challenge to be overcome. For others, it’s a personal quest, a test of resolve and endurance. Whatever the motivation, the allure of the high country is strong, and for those who dare to attempt the world’s most daunting peaks, the rewards are well worth the effort.
The World’s Most Daring Climbs
No. 1: Mount Everest, Nepal/China – 8,848m (29,029ft)
The highest peak in the world, Mount Everest is a behemoth of a climb, requiring trained mountaineers with experience and skill. The steep inclines, crevasses, and unpredictable weather conditions make it a formidable challenge for even the most experienced climbers.
No. 2: K2, Pakistan/China – 8,611m (28,251ft)
K2 is often referred to as the "Savage Mountain" due to its treacherous terrain and unpredictable weather patterns. The climb is steep, and the route is exposed, making it a test of physical and mental endurance for even the most seasoned climbers.
No. 3: Annapurna, Nepal – 8,091m (26,545ft)
With 16,000m (52,499ft) of vertical gain, Annapurna is one of the most challenging climbs in the world. The climb is physically demanding, with steep inclines and treacherous terrain, making it a true test of endurance for even the most experienced mountaineers.
No. 4: Nanga Parbat, Pakistan – 8,125m (26,650ft)
As the 9th highest peak in the world, Nanga Parbat is a formidable challenge, with steep inclines, snow walls, and crevasses. The climb is considered one of the most difficult ascents in the world, requiring expert knowledge and experience.
No. 5: Makalu, Nepal/China – 8,463m (27,766ft)
Makalu is considered one of the most unclimbed peaks in the world, with a sheer face that rises from the plateau at over 6,000m (19,685ft). The climb is physically demanding, with steep inclines and treacherous terrain, making it a true test of strength and endurance.
Conquering the World’s Most Daring Mountain Treks
For those who dare to attempt these climbs, the journey begins long before setting foot on the mountain. Months of preparation, training, and planning are necessary to prepare for the challenges ahead. Climbers must be in top physical condition, with a strong sense of focus and determination.
Physical and Mental Preparation
To conquer the world’s most daring mountain treks, climbers must be prepared to push their bodies to the limit. This requires a high level of physical fitness, including strength, endurance, and agility. Climbers must also be mentally prepared to face the challenges ahead, with a strong sense of focus and determination.
The Right Gear and Equipment
Climbers must also have the right gear and equipment to ensure a safe and successful ascent. This includes high-quality climbing gear, such as ropes, harnesses, and crampons, as well as specialized equipment like satellite phones and emergency beacons.
Conclusion
Scaling the world’s most daring mountain treks is a test of physical and mental endurance, requiring months of preparation, training, and planning. For those who are brave enough to take on this challenge, the rewards are immense, with breathtaking views, a sense of accomplishment, and a renewed respect for the power and beauty of nature.
FAQs:
Q: What are the most important skills for a climber to possess?
A: The most important skills for a climber to possess include physical endurance, mountaineering knowledge, and the ability to navigate using a map and compass.
Q: What is the most common hazard on high-altitude climbs?
A: The most common hazard on high-altitude climbs is altitude sickness, which can cause a range of symptoms, including headaches, nausea, and fatigue.
Q: How do climbers acclimatize to high altitudes?
A: Climbers typically acclimatize to high altitudes by gradually ascending to higher elevations, allowing their bodies to adjust to the lower oxygen levels.
Q: What is the most critical piece of equipment for a climber to bring on a high-altitude climb?
A: The most critical piece of equipment for a climber to bring on a high-altitude climb is a satellite phone or an emergency beacon, in case of medical emergencies or getting lost.
Under the Donald Trump administration, the Department of Health and Human Services (HHS) may re-evaluate policies related to the potential health risks of cell phone radiation and wireless signals, such as cancer—but research has not demonstrated such risks, according to Harvard T.H. Chan School of Public Health’s Timothy Rebbeck.
Robert F. Kennedy Jr.—the nominee for HHS secretary—has previously expressed concerns about cell phone safety, and it’s possible that, if confirmed, he would push for tighter regulations. But in a Dec. 10 Undark article, Rebbeck, Vincent L. Gregory, Jr. Professor of Cancer Prevention, said that studies have not found a connection between cell phone radiation and health issues. He explained that the types of radiation known to cause cancer—such as gamma rays and x-rays—have shorter wavelengths than those produced by cell phones.
“The best evidence is all pretty clear around cell phones right now, and I would make sure that the policy recommendations are not only based in science, but also don’t cause issues that are unnecessary,” he said.
Read the Undark article: In the Trump Administration Crosshairs: Cell Phone Radiation
Cell phones don’t cause brain cancer: study (Harvard Chan School news)
No link found between brain cancer and cell phone use, experts say (Harvard Chan School news)
MaKenna Lauterbach from Illinois was 36 weeks pregnant when she received the shocking diagnosis of a large tumor in her chest, revealing the real cause of the persistent cough and breathlessness during her pregnancy. The 26-year-old, who was diagnosed with stage 3 melanoma, is now stable and recovering, along with her healthy baby, thanks to the timely intervention and coordinated efforts of a dedicated team of doctors.
When Lauterbach experienced a bad cough while she was expecting, she knew something was wrong. Simple tasks, like walking to the barn to feed her horses, left her unusually winded, as if she had just run two miles. However, doctors were initially hesitant to perform chest scans due to concerns about radiation exposure.
When Lauterbach was almost due, the cough worsened to the extent that she started throwing up and had to be hospitalized for shortness of breath. The scans then revealed a grapefruit-sized tumor in her chest, blocking the artery to her right lung.
By the time Lauterbach received the diagnosis, she was in respiratory distress, the tumor obstructing her airway, putting both her life and her baby’s at risk.
After being airlifted to the intensive care unit at Northwestern Memorial Hospital in Chicago, her condition worsened, she went into labor, her blood pressure spiked, and the baby began showing signs of distress during contractions.
“Lauterbach was in real trouble, and we had to act quickly – this wasn’t something that could wait for Monday morning. When you’re pregnant with a baby that’s nearly full-term, your lungs already aren’t functioning at full capacity, and when you add a huge tumor on top of it, you run the risk of having respiratory collapse and cardiac arrest,” said Dr. Lynn Yee, maternal-fetal medicine specialist at Northwestern Medicine in a news release.
Doctors quickly prepared Lauterbach for extracorporeal life support (ECMO) and performed an emergency C-section, successfully delivering a healthy baby boy.
“Because of the tumor, the delivery happened so quickly. I was grieving the birth plan I had spent months preparing for, while also dealing with the news of my unexpected diagnosis,” Lauterbach said.
While her newborn remained in the hospital’s neonatal intensive care unit, doctors performed an advanced bronchoscopy on Lauterbach. The procedure revealed that her tumor was stage 3 melanoma, prompting the medical team to immediately begin developing a treatment plan.
“Lauterbach’s diagnosis was difficult to make because we weren’t sure if the melanoma started in the chest or somewhere else, and there isn’t much literature or published cases on how to best treat tumors like these, so we had to rely on the expertise that we’ve developed here at Northwestern Medicine,” said Dr. Kalvin Lung, a thoracic surgeon with the Northwestern Medicine Canning Thoracic Institute.
The medical team decided on surgery to remove the tumor. Before the procedure, Lauterbach was given three cycles of immunotherapy which helped shrink the tumor from 13 centimeters to nine centimeters.
“We think at some point, Lauterbach had a melanoma on her skin and her own immune system took care of it, but not before a cell or two may have escaped and eventually started growing inside her body,” explained Dr. Sunandana Chandra, medical oncologist with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital.
During the surgery, doctors had to remove her right lung parts of the main pulmonary artery, and lymph nodes. “The tumor was sitting on top of Lauterbach’s heart and extended into the right lung, impacting all three lobes and the entire main trunk of the pulmonary artery, which is why we had to remove the right lung,” said Dr. Lung who conducted the surgery along with Dr. Chris Mehta, a cardiac surgeon with the Northwestern Medicine Bluhm Cardiovascular Institute.
“It’s extremely rare to see this type of tumor invading into the major blood vessels of the heart. We may see something like this once every few years,” Dr. Mehta added.
Lauterbach’s latest scans show no evidence of metastatic melanoma, and while her cancer remains stable with no new tumors, she will continue immunotherapy treatments for the next year.
After years of careful macro tracking, Dr. Fundaro finally admitted to herself that the method no longer worked for her. Yet she was afraid to give it up.
If anyone should feel confident in their food choices, it would be Dr. Gabrielle Fundaro. After all, Dr. Fundaro has a PhD in Human Nutrition, a decade-plus of nutrition coaching experience, and six powerlifting competitions under her belt.
Yet, when she was really honest with herself, Dr. Fundaro realized that she felt far from confident around food. For years, she’d used macro counting as a way to stay “on track” with her eating.
And it worked… until it didn’t.
After years of macro tracking, Dr. Fundaro was tired of the whole thing. She was tired of making sure her macros were perfectly in balance. She was sick of not being able to just pick whatever she wanted off a menu and enjoy the meal, trusting that her health and physique wouldn’t go sideways as a result.
Yet the idea of not tracking freaked her out. Every time she quit tracking, she worried:
“What if I don’t eat enough protein, and lose all my muscle?”
“What if I overeat and gain fat?”
“What if I have no idea how to fuel myself without tracking macros? And what does that say about me as an expert in the field of nutrition?”
Something that would support her nutritional goals while also giving her a sense of freedom and peace around food.
Calorie counting wouldn’t do it. That was just as restrictive as counting macros—maybe more.
Intuitive eating didn’t seem like a good fit either. Intuitive eating relies heavily on a person’s ability to tune into internal hunger and fullness cues to guide food choices and amounts. After years of relying on external cues (like her macro targets), Dr. Fundaro didn’t feel trusting enough of her own instincts; she wanted more structure.
Meanwhile, at the gym, Dr. Fundaro began lifting based on the Rate of Perceived Exertion (RPE) scale—a framework that helps individuals quantify the amount of effort they’re putting into a given movement or activity. It’s considered a valuable tool to help people train safely and effectively according to their ability and goals. (More on that soon.)
While using the RPE scale in her training, Dr. Fundaro found she was both getting stronger and recovering better. There was something to this combination of structure and intuition that just worked.
And then, it dawned on Dr. Fundaro like the apple hit Sir Isaac Newton on the head:
With that, the RPE-Eating Scale was born.
Dr. Fundaro has since used this alternative method to help herself and her clients regain confidence and self-trust around food; improve nutritional awareness and competence; and free themselves from food tracking.
(Yup, Dr. Fundaro finally trusts her eating choices—no macro tracker in sight.)
In this article, you’ll learn how she did it, plus:
Invented by Gunnar Borg in the 1960’s, Rate of Perceived Exertion (RPE) is a scale that’s used to measure an individual’s perceived level of effort or exertion during exercise.
Though Borg’s RPE uses a scale that goes from 6 to 20, many modern scales use a 0 to 10 range (which is the range that Dr. Fundaro adapted for her RPE-Eating scale).
Here’s the RPE scale used in fitness.
| Rating | Perceived Exertion Level |
|---|---|
| 0 | No exertion, at rest |
| 1 | Very light |
| 2-3 | Light |
| 4-5 | Moderate, somewhat hard |
| 6-7 | High, vigorous |
| 8-9 | Very hard |
| 10 | Maximum effort, highest possible |
Originally used in physiotherapy settings, the scale is now frequently used in fitness training.
For example, powerlifters might use it to choose how heavy they want to go during a training session. Or, pregnant women might use it to ensure they aren’t over-exerting themselves during a fitness class or strength training session.
Because human experience is highly subjective and individual, the scale allows the exerciser to judge how hard they’re working for themselves. A coach can provide a general guideline, such as “aim for a 7/10 this set,” but it’s up to the client to determine exactly what that means for them.
Dr. Fundaro had used the scale many times with herself, and clients. She always appreciated the sense of autonomy it gave her clients, while still providing some structure.
So, she decided to take the same 1-10 scale and its principles, and apply it to eating.
The goal with RPE-Eating is similar to RPE when training: Develop the skills to determine what is sufficient for you, without having to rely on other external metrics (such as apps or trackers).
If you’ve ever practiced RPE-training, you’ll know it takes some time to get used to. RPE-Eating is the same.
Don’t expect to be in lockstep with all of your body’s internal cues at first, especially if you’ve been ignoring them for a long time.
With this in mind, apply the steps below to practice the RPE-Eating process.
RPE-Eating is not just another diet.
“It’s not about aiming to change your body,” Dr. Fundaro explains. “It’s not about feeling more control over your diet. Nor is it about feeling like you’re eating the ‘optimal’ diet.”
If your priority is maintaining a specific physique (such as staying ultra lean) or changing your body (building muscle or losing fat), this method can be adapted for that, though it isn’t the most efficient one to use.
Instead, RPE-Eating is about sensing into what your body needs and giving yourself appropriate nourishment—while building inner trust and confidence along the way.
“You have to trust that you’ll be able to nourish your body, and that you’ll be okay even though things may change in your body,” says Dr. Fundaro.
Admittedly, this can be challenging to do. It can also be difficult to let go of the expectation that you’ll hit the “right” macros at every meal—which RPE-Eating isn’t specifically designed to do.
However, if your goal is to build more self-trust, RPE-Eating can be a great tool to help you do that.
Before we explore this step, let’s distinguish between two motivators for eating.
First, there’s hunger. Hunger occurs when physical cues in your body (like a general sense of emptiness or rumbling in your stomach, or lightheadedness) tells you that you require energy—known to us mortals as food.
Then, there’s appetite. Appetite is our desire or interest in eating. It can stay peaked even after hunger is quelled, especially if something looks or tastes especially delicious—like a warm, gooey cookie offered after dinner that you feel you have to try, even though you’re technically full.
While it’s normal to eat for both hunger and appetite drives, the two can become mixed up. Especially if we have a history of dieting and tracking food.
The RPE-Eating scale helps you tap back into those true physical hunger cues, and learn the difference between hunger and appetite.
To put this in practice, try this before your next meal:
Using the RPE-Eating scale mentioned above, identify your current level of hunger. Record the number on paper or the notes app on your phone.
Then, eat your meal with as much presence as possible. (Note: This in itself takes practice. It can help to limit distractions, such as eating at the table rather than in front of the TV, and focusing on the flavors and textures of the food you’re eating, and how you feel eating it.)
About halfway through the meal, check in again. Based on the scale, how hungry are you now? As before, record the number.
If you’re still hungry, finish your meal. When you’re finished, repeat the same process, writing down where you are on the scale.
Once you’re done, take a minute and tune into what your body feels like. What does it feel like to be full? “Download” that feeling into your mind and internalize it in your body, as if you’re updating your phone with the latest software.
Repeat this for as many meals as you can. Aim to do it for one meal a day for a week or so, or for as long as feels good to you. Don’t worry if you forget: simply repeat the practice when you can.
The more you practice this, the better you’ll become at being attuned with your actual hunger cues. With time, you’ll likely find you develop more trust in your internal compass than what the latest diet tracker says for your needs.
(For more on fully-tuned-in, mindful eating, read: The benefits of slow eating.)
Have you ever come home after a super stressful day and you’ve basically thrown yourself onto a bag of chips or a carton of ice cream?
We might like to imagine ourselves eating every meal mindfully, using the RPE- Eating system to a tee, but life rarely works like that.
Chances are, there are certain situations that trigger you to eat more quickly, mindlessly, and beyond the point of hunger.
That’s okay.
Dr. Fundaro’s suggestion? Aim to become more aware of the situations that cause you to overeat in the first place.
To do this, you can practice something we use in PN Coaching: Notice and name.
When you find yourself scarfing down food faster than you can blink, simply try to notice what’s going on.
Can you name a feeling—such as anxiety, or sadness?
Can you identify a situation or moment that happened before you started eating—say, an argument with your teenager, or a nasty email from your boss?
Once you’ve identified the feeling, event, or person that’s triggered you to eat compulsively, see if you can also identify what you might really be needing or desiring.
Eating for comfort is normal. However, if it’s the only coping method we have, it can cause more problems than it solves in the long run.
When you find yourself with an urge to eat mindlessly, consider what non-food coping mechanisms might help you feel better. That could be 10 minutes away from your computer to close your eyes and breathe, a walk outside, or a quick call to a friend to rant—or just talk about something completely unrelated.
Getting to know your non-hunger eating triggers—plus widening your repertoire of self-soothing methods—is just as valuable as getting to know your hunger cues. Over time, this awareness will allow you to eat with more intention.
Even when you’re “adequately fueled” from a physical perspective, you might still feel unsatisfied from an emotional perspective.
That’s because, according to the RPE-Eating framework, eating should fulfill two criteria:
Satiety describes the physical sensation of being full; your calorie or fuel needs are met.
Satisfaction describes a more holistic feeling of being nourished; your calorie needs are met, but your meal also felt pleasurable.
If you ate to satiety only, your calorie needs might be met and your physical hunger quelled, but you might still feel unsatisfied—maybe because chocolate is on your “don’t” list, and even though you’ve eaten everything else in your kitchen that isn’t chocolate, nothing quite “hit the spot.”
In other words, you can eat to satiety at every meal, yet still be “restricting” foods.
You may not be restricting calories per se, but you may have banned entire food groups—baked goods, pizza, or whatever else curls your toes. This can lead to a feeling of constantly needing to police yourself, and doesn’t leave much room for the flexibility and spontaneity that real-life (enjoyable) eating requires.
(Plus, avoiding particular foods tends to work like a pendulum: restrict now; binge later. If you want to learn how to stop those wild swings, read: How to eat junk food: A guide for conflicted humans)
Satisfaction is a key part of eating.
After all, humans don’t just eat for adequate nutrients and energy. We eat for other reasons too: pleasure, novelty, tradition, community, enjoyment.
So, to take your RPE-Eating to the next level, Dr. Fundaro recommends trying it with meals and foods you genuinely enjoy.
If any foods or meals have been “off-limits,” try eating them using the RPE technique. (Macaroni and cheese, anyone?)
Practice using the scale with a variety of meals (including those you may have restricted previously), and notice how you feel over time.
With experience, you’ll get to know what it feels like to adequately fuel yourself with a variety of foods—including those you genuinely enjoy.
RPE-Eating isn’t for everyone, but might be a good fit for you (or your clients) if:
You feel dependent on food tracking, but you don’t want to be.
Every time you stop tracking, the loss of perceived control freaks you out and drives you right back to tracking.
You want to stop tracking, but you want to have some type of system or guidance in place.
You’re currently tracking (or considering tracking) your food intake, and you have elevated risk factors for developing an eating disorder such as high body dissatisfaction; a history of yo-yo dieting; a history of disordered eating patterns; and/or participation in weight class sports.
If you’re a coach looking to use this tool with a client, check out Dr. Fundaro’s resources. Remember this tool may not be for everyone, and how you apply it needs to be flexible.
Note: If you or your client struggles with disordered eating, this tool does not replace working with a health professional who specializes in eating disorders, such as a therapist, doctor, or registered dietician.
According to Dr. Fundaro, the best way to use RPE-Eating is in a weight-neutral setting.
While it could be used for weight modification, she doesn’t recommend treating it as another way to hit your macros or “goal weight.”
“I’m not anti-weight modification,” Dr. Fundaro explains. “I’m pro safe weight modification. I compare weight loss to contact sports. There are inherent risks but they can be mitigated through best practices.”
Dr. Fundaro elaborates: “Since RPE-Eating removes macro-tracking, which can increase risk of disordered eating in some people, and relies on biofeedback and non-hunger triggers, RPE-Eating provides a safety net that macro-tracking alone doesn’t provide.”
But if you do want to use RPE-Eating for intentional weight change, what should you do?
Dr. Fundaro recommends aiming to hover around the ranges that support your goal.
(As a reminder, a 1 to 3 on the RPE-Eating scale is categorized as “inadequate fuel; a 4 to 7 is categorized as “adequate fuel”; and a 8 to 10 is categorized as “excess fuel.”)
If the goal is weight gain, you’ll likely aim to eat within the 7 to 8 range for most of your meals.
If the goal is weight loss, you’ll likely aim to eat within the 4 to 5 range for most of your meals.
A key thing to remember is that you would never use RPE-Eating for extreme weight-modification such as for a bodybuilding competition. “That would be like using physio exercises to prepare for a powerlifting competition.” In other words, it’s not the right tool for the job.
If you’re skeptical and think this is just eating “based on your feelings,” keep in mind that RPE was once laughed at by lifters, too.
These days, RPE and autoregulation are widely accepted in gym culture and have been studied as a valid method for managing and guiding your training. 1
RPE isn’t perfect, but it’s pretty accurate and incredibly convenient. A lot more convenient than, say, using a velocity loss tracker for every set. 2 3
And while it might seem like it’s all feelings-based, the RPE scale is actually built around practicing the skill of interoceptive awareness—the awareness of internal sensations in your body.
The better you get at the skill of interoceptive awareness, the more you’ll be able to use that awareness to make informed decisions about your training.
RPE-Eating is similar: It builds the skill of sensing into your own body, and lets your internal sensations guide your decisions.
Similar to how the bar slowing down on a squat would indicate you’re getting closer to failure, experiencing the absence of hunger at the end of your meal would indicate you’re closer to being full.
Instead of tracking your glucose levels to validate your perceived hunger, you use internal cues that correlate with lowered blood sugar and coincide with hunger.
And, let’s be real: Being mindful of stomach grumbling or general hunger pangs is much more convenient and accessible than tracking glucose readings.
This process will not be perfect. You may undereat or overeat at first. But over time, with practice, you’ll build the core skills of RPE-Eating.
While this tool can be helpful, it’s just a tool. A screwdriver is great, but it isn’t useful when you need a hammer.
RPE-Eating can be great for helping you become more aware of your internal hunger cues and build a better relationship with food along the way.
It can also be more laborious. It requires paying real attention to your feelings (physical and emotional), and reflecting on them.
This can be difficult for anyone—but especially people who aren’t able to sit at the table and have a leisurely meal, like parents with small kids, or people with work schedules that require eating on-the-go.
If this is you, just use RPE-Eating when it does work for you—or simply pick and choose specific steps to use in isolation. For example, maybe you try RPE-Eating on the occasional quiet lunch break. Or, maybe you focus solely on developing your awareness of hunger and fullness cues, without trying to change anything else.
Tracking macros isn’t inherently bad. It can actually be a helpful tool to teach you more about nutrition. But it’s also not something most people want to do for the rest of their lives.
The problem is, if you’ve depended on tracking your food intake, stopping can feel scary.
In these cases, RPE-Eating can be used as a kind of off-ramp to help transition away from rigid and restrictive macro tracking.
(It can also help loosen the compulsion to “always finish your plate.” Though macros tracking and habitual plate-cleaning may sound different, they’re actually similar: both rely on external cues—such as macro targets or what’s served on your plate—to determine when you’re “done.”)
RPE-Eating won’t take away all the scary feelings that may come with changing ingrained ways of eating.
However, it can provide some structure and language to help you, or your clients, eat with less fear, less stress, and a bit more confidence.
“The goal,” says Dr. Fundaro, “is to know that you’re nourishing yourself—and you don’t need a food tracker to do that.”
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Click here to view the information sources referenced in this article.
1. Helms, Eric R., Kedric Kwan, Colby A. Sousa, John B. Cronin, Adam G. Storey, and Michael C. Zourdos. 2020. Methods for Regulating and Monitoring Resistance Training. Journal of Human Kinetics 74 (1): 23–42.
2. Hackett, Daniel A., Nathan A. Johnson, Mark Halaki, and Chin-Moi Chow. 2012. A Novel Scale to Assess Resistance-Exercise Effort. Journal of Sports Sciences 30 (13): 1405–13.
3. Zourdos, Michael C., Alex Klemp, Chad Dolan, Justin M. Quiles, Kyle A. Schau, Edward Jo, Eric Helms, et al. 2016. Novel Resistance Training-Specific Rating of Perceived Exertion Scale Measuring Repetitions in Reserve. Journal of Strength and Conditioning Research 30 (1): 267–75.
The post How to stop tracking macros and trust yourself around food appeared first on Precision Nutrition.
The U.S. Food and Drug Administration (FDA) has sounded the alarm on a nationwide recall of Systane brand eye drops, citing potential fungal contamination that could pose serious risks to eyesight.
Systane Lubricant Eye Drops Ultra PF, commonly used to temporarily relieve burning and irritation caused by dry eye symptoms, is now at the center of a nationwide recall. The product was distributed to multiple retail stores and online platforms.
Manufacturer Alcon Laboratories initiated the voluntary recall after a consumer reported foreign material inside a sealed single-use vial, which was later identified as fungal contamination.
“Fungal contamination of an ophthalmic product is known to potentially cause eye infections. If an infection occurs, it may be vision-threatening, and in very rare cases potentially life-threatening in immunocompromised patients,” the FDA stated in a news release.
The FDA has confirmed that no adverse events related to the recall have been reported so far. However, individuals experiencing quality issues or adverse reactions after using the product are encouraged to report them through the FDA’s MedWatch Adverse Event Reporting program. Complaints can be submitted online, by downloading and mailing the form, or via fax at 1-800-FDA-0178.
Each cardboard box of the product contains 25 sterile, single-use vials of lubricant solution for ophthalmic use. “The affected Systane Lubricant Eye Drops Ultra PF, Single Vials On-the-Go, 25 count is limited to lot number 10101, expiration date 2025/09. The product can be identified by the green and pink carton design, the presence of “Systane” and “ULTRA PF” brand names on the front of the carton, and the “25 vials” package size,” the news release stated.
Consumers who still have the products with them are advised to stop usage immediately and return to the place of purchase for a replacement or refund. Those who experience any issues potentially linked to the use of these eye drops should seek advice from a healthcare provider without delay.
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Based out of the UK, Vidyamala Burch is an award-winning teacher whose courses and work in the field of mindfulness and pain management have been recognized for the measurable ways they have served the common good. She recently launched a new program, HEALS, which offers a comprehensive, holistic approach for managing and living with chronic pain and illness.
As a writer who loves interviewing, I came to my conversation with Burch with my list of questions and a healthy dose of journalistic curiosity. I felt a little starstruck to get to meet her.
If I’m honest, though, these weren’t the only things I brought, because this conversation also felt personal.
So many people I know, myself included, have had experiences living with chronic pain and illness. I was nearly 40 years old when I finally found healing from more than 20 years of recurring and increasingly debilitating low back issues. I have many friends, some just in their 30s or 40s, who deal with fibromyalgia, chronic fatigue syndrome, recurring migraines, and other adrenal and nervous-system challenges.
My mother survived polio as a young child and lived with relentless chronic conditions for her entire life as a result. She passed away suddenly a decade ago, at the young age of 67. Polio wasn’t technically the thing that killed her, but I knew from many conversations with her in her final years that the long slogging decades of complications, disability, and pain made her long for relief. I was with her when she took her last breath, and I felt the surrender in her body, finally.
To suffer ourselves, or to watch people we love suffer over long periods of time, often without real answers or effective treatments—the questions that bubble up aren’t academic. They sit close to the bone and the heart.
Why did this happen?
Why did it go on for so long?
Why does it feel so lonely?
Where do these ailments come from, and why are they often so mysterious and so intractable, even in the face of intense medical interventions?
Can practices like mindfulness really offer anything meaningful into this complicated, messy world of living with chronic illness and pain?
Yes, I wanted to talk to Vidyamala, the expert on mindfulness and pain management. But I also didn’t want to waste the opportunity to talk to Vidyamala, the human being who has traveled this long road herself, and who understands intimately that the clinical ways we think and talk about physical suffering can’t meet us fully where we need to be met.
The clinical ways we think and talk about physical suffering can’t meet us fully where we need to be met.
Siri Myhrom: I’m curious about where the HEALS Program got its start for you. How do you see it as unique from and also working together with your other programs?
Vidyamala Burch: I developed Mindfulness for Health, which is our eight-week mindfulness program for people living with chronic pain and long-term health conditions. So the seeds for HEALS were way back in 2000, when I started running that [Mindfulness for Health] as an experimental course in 2001.
In my own experience as somebody who’s lived with chronic pain and disability for nearly 50 years now, mindfulness has been absolutely crucial to that journey because my life, my quality of life now, is really pretty good, notwithstanding my disability.
So mindfulness is foundational. And when I look at my own journey of reclaiming my quality of life, I realized that it was mindfulness-plus. So what I’ve done is I’ve worked on my nutrition. I’ve worked on how I move. I’ve looked at my sleep habits. I try to have time in nature. So if I looked at what’s worked for me, it was mindfulness plus these other dimensions. I felt that it would be really helpful to come up with an applied mindfulness program.
This is my vision, that people come through either doorway. You might come through the HEALS doorway or you might come through the Mindfulness for Health doorway. I see them as definitely complementary and as two doorways into the same room.
SM: Mindfulness talks a lot about awareness, and I have a question around that that’s maybe more personal. The people I know who live with chronic pain would likely say, I’m already very aware of my pain. I’m curious how you understand that word awareness, especially within a mindful context, and how does that serve to alleviate the suffering, rather than creating a focus on it?
VB: That’s an excellent question because it’s very counterintuitive. People might think, I’m very, very aware of it. And I don’t want to be more aware of it. And maybe people might think, The last thing I want to do is become aware of my body. My body is my tormentor. I want to just split off from my body.
So those are all very reasonable things to think about. What we do is right up front in both Mindfulness for Health and HEALS, we talk about how by using awareness, you can investigate this experience that you label pain. Investigate that and realize that it’s got two components. One component is your basic unpleasant sensations.
The other component is all things that you do to create extra suffering when you resist those basic unpleasant sensations. What most people call pain would be that whole set of sensations, plus resistance, plus depression, plus anxiety, plus secondary tension, plus breath holding, plus poor sleep.
Most people think that’s what their pain is. But actually, the only thing that’s a given in any moment are the unpleasant sensations. Everything else is added through our reactions. So you’re learning to accept the unpleasant sensations with kindliness, tenderness, to soften the resistance, and a lot of that secondary stuff can fall away. You’re just left with unpleasant sensations. People find that a very optimistic message.
We put that right up front in all our programs. Week one, we talk about primary and secondary suffering. The other thing about awareness that we really strongly emphasize— again, in week one—is that it’s awareness that gives us agency. If we’re aware, we have choices. If you’ve got no choices, you know, you’re just swept along by this thing that’s ruining your life as if it’s a kind of enemy.
Awareness doesn’t make it pleasant. I think this is one of the ways people misunderstand this: that if I’m mindful, I’m aware, then suddenly I’m going to love my pain. You probably aren’t, because your pain is unpleasant, but you’re going to learn to relate to the unpleasantness with much more spaciousness, much more kindliness, more acceptance.
One of the things I say is by coming closer and examining this experience, you realize it’s a process, not a thing. One of the ways I talk about that is to experience it as a river rather than a rock, because everything is changing all the time. Most people relate to their pain as a solid lump, like it’s a big boulder that’s kind of taken up residence. But it’s amazing to be able to experience it as a river rather than a rock. Just let it flow through the moments and then have this less-reactive mindset. That’s very liberating.
SM: Do you attract people who already have experience with mindfulness, or is it a mix of people?
VB: I iteratively develop my programs with potential audiences. The first one was a six-week program with people who know about mindfulness, who have a health condition and have worked with us before. I really wanted them to have a sense of co-creation. They gave me lots of feedback. Out of that, I made it longer, 10 weeks.
My second cohort was with people who didn’t know anything about mindfulness, but did have a health condition. It was people who were recruited from a cancer charity and a fibromyalgia charity, and that was very interesting as another test case. It went down very well with both those audiences.
Then the third pilot was with physicians from a primary care medical center. A lot of them didn’t know anything about meditation, didn’t have a health condition, but were trying it out for themselves, thinking about their patients. Again, very positive feedback. So I feel confident now that you don’t need to know anything about mindfulness to do this program.
SM: Where does HEALS fit into general medical care?
VB: I don’t know what it’s like in the States, but certainly over here there’s a crisis in our healthcare system—not enough money, aging population, multiple chronic health conditions.
Western medicine is particularly good with acute care. But with multiple chronic conditions all happening at the same time, Western healthcare isn’t brilliant. There’s more of a move towards a recognition that lifestyle has an enormous impact on our health and well-being, particularly with people being sedentary, eating a poor diet, scrolling on their phones late at night, not being able to sleep, all these kinds of things. There’s a whole field emerging of what’s called lifestyle medicine over here, which is called integrative care in the States. So we’re very well placed to be able to offer this program.
What’s unique about our program is that it’s got mindfulness as the foundation. I think a lot of people know what they should be doing for their health and well-being. They’ve got the information, but they don’t know how to make it stick. So my thesis is that mindful awareness is really crucial to that, because you have to know what you’re experiencing to have some facility and agency, instead of just being swept away by habitual behaviors. These people in general practice who tested the program said, “You’re absolutely on the right track. You’re ahead of the field. Keep going.”
SM: I notice, again relating to other people I’ve known with chronic conditions, that there’s an emphasis on tiny steps. Why is that effective?
VB: This has come out of my experience, and what I’ve observed is that a lot of people think you need to make big changes all at once—get another job, change your diet, change the way you exercise. When you do these big changes all at once, you don’t sustain any of them. You don’t know what’s affecting what because you’ve changed too many variables all at once. Very often you just need to change a tiny thing. In the program, I use a model called Tiny Habits, which is developed by B.J. Fogg. It’s a lovely model where you have a prompt, a behavior, and a celebration.
For example, for me to do a little bit more strengthening in my arms outside my office, I’ve got some straps. Every time I go in and out my office door, that’s the trigger. I go to my straps. It might be three to five movements, just a few. That’s the behavior. Then the congratulations, and you get a little dopamine hit, and then you’re going to want to do it again.
One of the things I’ve really learned from my own life, and this is a very important point, I think, is that you can bring about major transformation through tiny little nudges across a broad front for a long time. I always say to people that we won’t do any of these things perfectly, but if you’re doing all of them adequately, you’re going to experience change.
SM: It looks like the most recent cohort for HEALS is October 25th? Is that right?
VB: Yes, the first course booked out in 24 hours. That seems to be going very well. One of the things we’re doing in this program is using buddy groups testing. We divide into groups of four or five people based on geography. They decide for themselves how they want to keep in touch. Most of them are using WhatsApp. The idea is that they will contact each other daily, ideally so they can let people know how they’re getting on.
SM: Is the buddy system partly addressing the sense of isolation that can come with being in pain?
VB: Yes, I think so. Also, with these online programs, it helps to have something that’s more intimate, a daily reminder so that people are really forming connections. I think that’s very helpful in this tiny-habits method for behavior change.
SM: If someone came to you looking for help, but they were feeling skeptical, how would you describe this work in a way that would open up the possibility for them?
VB: We’ve used validated questionnaires in our three pilots and we’ve got hard data. Doing this work has measurable results. It makes people catastrophize about their pain less. It makes people able to function better in daily life. They’re less depressed, less anxious.
For people who live with chronic pain or health conditions, I say just try it and see what you think. You can have your pain and your illness and be miserable and have a very difficult life. Or you can have your pain and illness and be happier and have a more fulfilling life. So which one would you rather have?
By doing these very simple, evidence-based approaches, we know that it can help you reclaim your life. It doesn’t take long, 10-15 minutes a day, with a very supportive group for 11 weeks. We know that people are experiencing quite a strong improvement in quality of life. So it doesn’t seem like a big risk. It’s training and getting your mind working with you rather than against you. Most people don’t even realize that their mind is working against them. In the untrained mind, 75% of our thoughts are negative. It’s staggering. 95% of our thoughts, we’ve had before. We’ve got the same old undermining rubbish, just going around and around like the spin cycle on a washing machine, and you can do something about that. You can do something about it through these small changes across a broad front.
Would that be convincing to you if you were skeptical?
SM: Well, I dealt with chronic low back pain for about 25 years. I went to all kinds of different doctors. I tried all sorts of different modalities, and it was not an uncommon experience to go to an allopathic doctor and kind of feel like they don’t quite believe you. Especially in the US, there’s a tendency to prescribe opiates or recommend surgery, which I knew had a very low success rate.
For me, finding contemplative practice really did make a difference. But I think being able to speak to the exhaustion is important, because a lot of people who have been dealing with chronic issues, especially for a long time, it’s not that they want to give up. It’s that they’ve already tried 10 or 15 different things that haven’t worked.
VB: Yes, absolutely. Something we do at Breathworks is we believe people first, because I’m not interested in your diagnosis. I’m interested in your experience. With chronic health conditions, it’s sometimes hard to get a diagnosis. People are often not believed, and it’s awful. If someone says they’re suffering, I believe them. I think it’s really important that it’s an experience orientation rather than a diagnostic orientation.
We all have our habits of sort of resisting and fighting our experience. We can all learn to be more at peace with whatever’s happening. In my own case, you know, I’ve still got disability, I’ve still had all the surgeries, I’ve still got pain, but my overall pain has massively improved.
A lot has gradually fallen away over the years. My breathing is much more regulated, soft, and open. I’m fitter, I’m stronger. You get out of a downward spiral into a more opportunistic spiral.
You don’t have to be stuck with what you’ve got. There will be small changes you can make that will have an impact on your quality of life, because this quality of life is the thing that I think is most important, not whether you can walk or run. You know, I can’t walk and run, but I have a quality of life. I find that deeply, deeply moving. It’s unimaginably better than it was 30, 40 years ago.
SM: Yes, being with people who can just be with you and see you—that in itself is humane and tender and can initiate healing.
VB: Absolutely. One of the things that we hear again and again at Breathworks is that there’s a quality of lightness. One woman who came back the second week said, “I feel I’m learning to laugh again.”
She’d done awareness practice. She was in a lot of pain, had a difficult life, quite a lot of sadness, I think. It wasn’t like, Well, I’m becoming more aware. It was, I feel I’m ready to laugh.
I thought, that is so good, because we have a big group of people, many of them with really difficult circumstances. If we can help them find a way to bring some lightness into how they deal with their heaviness, they’re getting a great gift. I think particularly when one lives with difficulty, it is healing to find a way to relate to it in a more light, but not trivial way.
SM: In the process of discovering meditation and studying more deeply, did you have a moment where you thought, I really want to teach this to other people? Or did it happen in a more subtle way?
VB: I always go back to when I was 25 in intensive care in hospital, and I had this really big experience about the present moment, which changed my life. I knew that my pain was only happening one moment at a time and that most of my torment was about the future or the past.
That’s the very short version. I thought, I really, really want to figure out what it means to be present. How can I train in that, and how can I train my mind?
And interestingly that experience rose up out of hell. It was not an experience that happened in the bliss of a meditation retreat. No, it was an absolute existential kind of moment.
I had a social worker who was wonderful. She got me some tapes in the library, sort of beginning to meditate. I became a Buddhist a couple of years later, moved to England to live in a retreat center, and I was finding as I wasn’t really getting much guidance on how to meditate in the painful body. There weren’t many people around who seemed to know how to do that. I was always having to figure it all out for myself. People were very kind and very helpful, but the specifics of, how do you meditate when your back is absolutely screaming? It was a really hard thing to do.
Gradually I worked out how to do that with the help of Jon Kabat-Zinn. Actually, when I came across his book Full Catastrophe Living, that was massively helpful. I realized that I needed to learn to tend towards my experience and soften around it and release all this kind of extra suffering that I’m bringing through my evasion and my craving, really in my grasping for a different experience and my aversion to this experience.
With those two things together, I figured something out here, painfully and slowly over decades. And there’s going to be lots of other people like that young woman in hospital in intensive care, not knowing what the hell to do. There wasn’t any medical solution for my spine at that point. It was just like, we’re going to have to learn to live with it.
That’s why I wanted to teach, because I wanted to offer these to other people who were in the situation I was in so they didn’t have to have this 15 years of long, lonely journey. I was surrounded by incredible friends, and people couldn’t have been more supportive—but the specifics of how to meditate with pain, I wasn’t getting much.
When I started, I just wanted to help people. Now, 25 years later, I just want to help people. It’s a very, very simple motivation. And if I can help one person suffer less, that’s my journey.
When I started, I just wanted to help people. Now, 25 years later, I just want to help people. It’s a very, very simple motivation. And if I can help one person suffer less, that’s my journey.
SM: And it seems like it’s working. The response is there.
VB: It’s just very meaningful. It reframes all my suffering. More importantly, it helps others.
And what I really love about Breathworks and the HEALS program is, it’s not rocket science. It’s not some sort of advanced, metaphysical, complicated teaching. It’s: Be present. Know what’s happening. Let go of aversion and clinging. Release into the flow of love. Breathe and breathe out. And relax your bum. That’s my highest teaching now: Relax your bum.
That’s the whole. That’s it. You don’t really need much more than that. It’s very practical, very pragmatic. You don’t meditate to have a good meditation. You meditate so that you can cope with the moments in your daily life with a little bit more ease and grace and kindness and connection with others.
You don’t meditate to have a good meditation. You meditate so that you can cope with the moments in your daily life with a little bit more ease and grace and kindness and connection with others.
People quite rightly say, It saved my life, and I know it saved mine.