CHANGEing Health

“If  we could give every individual just the right amount of nourishment and exercise, not too little not too much, we would have found the safest way to health” – Hippocrates

A few years ago, I had the good fortune to be connected with Dr Khursheed Jeejeebhoy, a senior nutrition researcher from Toronto. He introduced me to the CHANGE idea. “CHANGE stands for Canadian Health Advanced by Nutrition and Graded Exercise. CHANGE was a collaboration of researchers from across Canada who were working on a protocol to support lifestyle intervention in the primary care setting. As a family doctor with an interest in health promotion, I was very happy to get involved and contribute to the project.

Health eating and exercise advice is not new. Hippocrates was quoted as saying “If we could give every individual just the right amount of nourishment and exercise, not too little not too much, we would have found the safest way to health”. Despite these old ideas and abundant research supporting the benefits of healthy eating and exercise, the translation of these ideas into people changing their lifestyles has been poor.


Current physical activity guidelines for adults ages 18-64 recommend at least 150 minutes of moderate to vigorous aerobic exercise weekly, completed in intervals of at least 10 minutes, along with at least 2 days per week of resistance training. However, 85% of Canadians fall short of the current physical activity recommendations. In relation to healthy eating, 60% of Canadians report eating less than 5 daily servings of fruits and vegetables. In contrast, on any given day, 25% of Canadians will eat from a fast food outlet. These behaviours have resulted in 66% of adults being overweight or obese, with rising rates of hypertension, diabetes and obesity. Many of us need to RE-LEARN how to live a healthy life.

Costs of medications are increasing. Cardiovascular disease (CVD) is the most expensive clinical condition, accounting for 11.6% of the total costs of illnesses and 13.9% of all drug prescriptions. Estimates for the cost of lifetime treatment of high cholesterol and hypertension to prevent CVD through the use of cholesterol lowering medication and blood pressure medication is $36 billion in Canada. Combined an expanding older adult population, these costs for the health care system are immense. Novel method of promoting healthy lifestyles and caring for patients with lifestyle-related illness is required.

CHANGE started as a protocol for MetS patients in family doctors’ offices, but the potential is much larger. CHANGE can be applied across the age spectrum and within various contexts (CHANGE schools, CHANGE workplace, CHANGE communities, CHANGE media). Through this blog I hope to share some of the questions from patients and the tips and resources (links to articles, books, and videos) that may assist other people in living a healthy lifestyle and in doing so – “CHANGE Health”.

Feel free to send me ideas or comments that you think would be useful for people working on CHANGEing their lifestyle.


  • While at a conference last weekend, I was giving a talk on nutrition and physical activity. During my presentation, I encouraged everyone in the room to get out of their chairs and stand throughout my presentation. Then I went a step further and led the group in doing sets of sit-to-stand (squats) every 15 -20 minutes. Afterward one of the participants (a rural family physician from Alberta) told me that he thanked me for the idea to put a few squats into his day. “So easy”, he said. I encourage others who are presenting to get people out of their seats and include some easy exercises. Also, if you spend most of your day sitting, try to add some standing or squats into your day.

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