An Interview with Dr. Elizabeth Cleino, Advocate for Wellness

Dr. Elizabeth Cleino, with her dog on her lap

Editor's Note: Elizabeth Cleino has worked in the Wellness field for over six decades. She earned the BSN from Vanderbilt University and the PhD in higher education related to nursing from the University of Alabama. She and her husband have practiced the wellness philosophy since 1975.

Among her many jobs, she has served as the Director of Druid City School of Nursing and as faculty member at University School of Nursing in Tuscaloosa, and geriatric case manager. Dr. Cleino has received the following honors:

  • Alabama Nursing Hall of Fame 2011
  • Vanderbilt University Nursing Alumni President's Award for Distinction 2008

Interview with Julie Brock, “For Seniors” Editor

Julie: Dr. Cleino, would you please tell us what you mean by wellness?

Dr. Cleino: I'm always glad to talk about wellness, my favorite subject. You may have to change your ideas about health and illness in order to understand and then to practice wellness. You have to accept the fact that we have been made wonderfully by our Creator; that our bodies, our minds, our emotions and our souls are holistic—that is, each is definitely influenced by the other.

When we are under a lot of stress, particularly prolonged stress, we are very likely to develop a serious illness. We also have to accept that there are degrees of wellness just as there are degrees of illness. We know that there are minor illnesses, like a cold, or more serious conditions like cancer, and there are many gradations of wellness too.

Think of illness and wellness being on a continuum. At the center point there is no illness; neither is there much wellness. Health is not just the absence of disease. We can be more well, or even more so. We were made to be full of energy to enjoy life and to be able to love and be loved, to enjoy God's great creation. And then we were given the right to make choices. Our life choices will determine if we are a little bit well or a whole lot well or a little sick or a lot sick,

It turns out that about 75% of our illnesses are directly related to the way we choose to live. The good news is that we are "Chairman of the Board of our own health" and we can decide if we want to move up the ladder to high-level wellness.

Julie: What is involved in this wellness program?

Dr. Cleino: Leaders in the field have helped us by identifying four major areas: nutrition, physical fitness, stress management and social or environmental concerns. Remember th,at self responsibility is essential to each.

Let's start with nutrition. We have all been exposed to the food groups that guide us in selecting the type and amount of food we need in our daily diet. Whole grains, fruits and vegetables should be the mainstay of our diets and they are the most nutritious when eaten as soon out of the garden or off of the tree as possible.

A good rule to follow is that fresh is better than frozen. Frozen is better than canned. And canned is better than highly processes foods with preservatives. Foods should not be over cooked. Streamed is better than fried. Salt should be used as little as possible. Lean meats, fish, and dairy products are included to round out our nutritional needs.

Desserts should be used sparingly and not as a substitute for a balanced meal. Many people are now living where meals are provided by someone else, so it may be necessary to work with the cook to get the nutrition they need. We were never meant to overeat. Obesity is a big risk factor for illness. If we are working for greater wellness we must control our weight.

Another component of the wellness program is physical fitness. Our bodies were intended to be strong, to move freely, and to do the work that needs to be done at any age. Because we have acquired so many modern conveniences, it is easy to become sedentary and forget that exercise is the key to a healthy heart, muscle strength, flexibility, and indeed all functions of the human body. As we get older we may need to restrict our exercise program to Tai Chi, stretching, walking, swimming, or even rocking. The payoff includes more self-esteem, better digestion, more restful sleep, more positive outlook on life, better balance, slowing of the aging process and overall better health. For more on how you can participate in an exercise program if you have vision loss visit Fitness and Fun.

A third area is stress management. Remember that whatever affects our emotions, also affects our bodies and also what affects our bodies affects our emotions. When confronted with an acute stressful situation it is obvious how our body reacts-- our heart rate goes up, breathing becomes rapid and shallow, and physical strength increases. It is not usually the acute stressors that cause us the most trouble, but the hundreds of small irritants that we are called on to manage day by day.

Learning to reduce our constant stress begins with recognizing the effects—muscle tightness, neck and back aches, dry mouth, stomach knots, headaches, sweaty palms, irritability etc. Becoming aware that you can do something about it is the first step to management. My favorite immediate stress reducer is deep breathing. This is easy to learn and always available for use. Learning how to deal with the issues that trigger the stress response is well worth the time. Again, exercise is a very good way to manage stress as is just knowing that you can take control. For information on coping with vision loss and other losses in order to reduce stress in your life, visit Coping with Vision Loss and Everyday Living.

The other component that affects our search for wellness includes the environment in which we live: the culture, social norms, religious affiliations, news media, television messages, movies, etc. In order to progress in the wellness lifestyle we have to recognize the many environmental factors are trying to keep us from pursuing our goal. Television ads will try to get us to drink soft drinks with either large amounts of sugar or with sugar substitutes that are very harmful when water is always better. The message is often, "Don't deal with stress in a healthy way, just take my magic pills."

Do your friends or family encourage you? Does the place where you live make it easy to live a healthy lifestyle? My advice is to find a friend or a group that is committed to growing in wellness so that each one of you can help the others. Learning to grow into a more vibrant life together is a fun thing to do with surprising payoffs.

Julie: Are supplements part of a Wellness program?

Dr. Cleino: We wouldn't need to take extra vitamins and minerals if we had the perfect diet. Most of us are not able to eat enough fruit fresh and vegetables to supply our body's need for minerals and vitamins. Most of us, particularly when we are older cannot maintain the optimum amount of Vitamin D. In order to get what our bodies need, most of have to rely on some supplementation. The rule is to use only what we need as they in no way can substitute for wholesome food.

Editor's Note: Good nutrition is good for the eyes as well. In fact, studies suggest that eating antioxidant-rich foods such as fresh fruits and dark green leafy vegetables (kale, collard greens, and spinach, for example) may delay the onset or reduce the severity of dry AMD. These types of vegetables contain lutein, which may protect the macula from sun damage, just as it protects the leaves of these vegetables from sun damage.

How Did You Get Involved in the Wellness Movement?

Dr Cleino: Well, as a student of Nursing at Vanderbilt University, I was introduced to the promotion of health before learning to care for the sick. In a course in Public Health, we went to visit families in their homes, and learned to assess the status of their health, to help them to deal with chronic disease, and to teach the prevention of infectious disease through immunizations. We also attempted to teach good nutrition and good health habits.

Some 30 years later, I was in charge of an area-wide health planning agency. We worked to improve the emergency medical system, then to provide facilities, equipment and personnel for acute medical care—recruiting physicians in specialties like open heart surgery and neonatal care. Then we turned our attention to prevention of disease health promotion and finally to a new field called Wellness.

I was intrigued when I learned that fully 75 per cent of our health or illness was determined by our own life choices—what we eat, whether we smoke, are obese, use ordinary good health practices, or exercise. I visited with the pioneers (physicians, nurses, health educators, and exercise physiologist) who were writing the books, giving lectures and setting up wellness programs. I was so excited about this new program that as I left the planning agency I went out on my own to spread the good news that we can take charge of our own health by choosing a life style that will help us to grow in health and wellbeing.

My husband and I made changes in our daily routine. We began by making small changes in our diet: decreasing the amount of fat and salt and sugar and increasing fresh fruits and vegetables; going from fried to grilled and from white to whole grained breads. We noticed right away that we were feeling healthier .We also began a regular walking program. We had more energy, less bad days and generally were more healthy. We were climbing up the ladder of wellness and feeling great without much help from those around us.

There are lots of helps now with Wellness programs in the work place, water aerobics, pilates, yoga, walking trails, nutrition classes, stress management classes etc. I recommend getting on board! All you have to gain is your health and wellbeing.

For more information on healthy aging, visit the Health and Aging section of VisionAware.

If you are a person with vision loss, you can use VisionAware to learn additional ways to adapt the wellness philosophy in your life. For information on cooking and eating visit Cooking and Meals: Master Your Kitchen.

For information on sports and exercise visit Sports and Exercise.

For videos containing tips for healthy living and personal stories from others with vision loss, visit the VisionAware Videos page.

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