Spotlight on Self-Care: The SMILE Score
If you have read my recent contributions to the TKP newsletter you likely already know this about me…I work hard to focus on POSITIVE ways to stay healthy. I have been a RDN (Registered Dietitian Nutritionist) for over 30 years and one thing I know is that (especially) in the world of nutrition—the focus was not always on positive things that you could ADD INTO your life. My early introduction to nutrition was on deprivation—what had to be taken out, removed or even identifying GOOD and BAD foods, etc. Well, I am here to tell you that never worked for me and most of my clients and patients have shared that same sentiment. So, I try hard to look at the “To-Do” positive things that can help me and the people around me (family, clients, co-workers, patients, students, etc.).
During the COVID 19 pandemic I was introduced to a tool/resource that not only is in keeping with this positive mindset but it also offered up a method and acronym to help me focus on my self-care. I fell in love with this tool and then had the distinct pleasure of getting to know the woman who created it. The tool is called the SMILE Score and the creator is Dr. Laura Vater. I was honored to have her as a guest on my podcast and adore her EVEN more after spending time getting to know her and developing friendship. Let me tell you a bit about her and the SMILE Score. Her story is powerful and relatable. Who knows—the SMILE Score might end up being a helpful tool for you or someone you love.
First- a little back story from Dr. Vater in her own words: “With busy schedules at work and at home, it often feels challenging to prioritize our health. Even when we try to make healthier choices, the information we read can be conflicting and overwhelming. Sometimes we don’t know where to start. I am a physician with many demands on my time. I’m also a wife and a mother. Despite having a medical degree and extensive knowledge about the human body, I have often struggled to prioritize my health. Two years ago– during a particularly hard month, I found myself feeling even more anxious and exhausted. I knew I needed to take care of my health, but I was tired and inconsistent. I started to search for ways to simplify my approach. As I explored the data on habits that promote health, I found a clear message: get enough sleep, be physically active, find healthy ways to de-stress, connect with others, and eat a mostly plant-based diet. I wanted to find a memory tool to reinforce this information, especially after spending years synthesizing complex information with the help of memory aids. Frustrated that I could find none, I decided to create one—what I have named the SMILE Score. This simple tool has changed how I think about health. It serves as a daily self-assessment and provides a consistent strategy to get back on track. Each letter (S, M, I, L, E) represents one healthy habit and counts as one point (see figure below). The daily score ranges from 0 to 5. I have found that if my score is high (4 or 5), I often feel better. When my score is low (0 to 2), my energy and mood are also lower. The SMILE Score has helped me reliably live healthier and feel happier, and I hope it will help you too.”
Thank you, Dr. Vater 😊
Ok, let’s break it down and explore each of those letters (S,M,I,L,E) down a bit more.
S – Sleep Enough. Did I rest today? Was my sleep restorative?
Sleep is essential for health. Chronic sleep deprivation is linked to obesity, diabetes, heart disease, high blood pressure and stroke. Further, when we don’t sleep enough or feel restored in the morning, we may not have the energy or motivation to make other healthy choices.
There are many reasons why we don’t get the recommended 7 to 8.5 hours of sleep per night. Stress, anxiety, artificial light at night, shift work or long working hours, too much caffeine, chronic pain and urinary issues can all contribute.
Here are some strategies to help improve sleep:
- Keep your bedroom dark, quiet and cool. Keep the television out of the bedroom and turn off audible phone notifications.
- Be consistent. Go to bed and arise at the same times each day, if possible. If you are a shift worker or work long hours (like I do), prioritize sleep when you can.
- Reduce your exposure to artificial light at night by decreasing evening screen usage, turning on the night shift feature on your phone, or by wearing blue-light-blocking glasses.
- If you have a medical reason for not sleeping well, such as chronic pain, anxiety, frequent urination, sleep apnea or hot flashes, talk to your doctor about strategies to help.
M – Move My Body. Did I exercise today?
Regular physical activity helps us live longer. It decreases risk for heart disease, diabetes, dementia and some cancers. It also reduces the risk of osteoporosis and falls in older adults. In the short term, it boosts mood and energy, improves sleep and reduces stress.
Current guidelines recommend that adults get at least 150 minutes of moderate-intensity exercise (such as brisk walking) or 75 minutes of vigorous-intensity exercise per week. Adults should perform strengthening activities at least twice per week.
Here are some ways to be more active:
- If you have time constraints, add small amounts of exercise into your routine. Do 10 minutes of yoga or strength training before showering, or add 20 minutes of stairs at lunchtime. Consider adding a brisk evening walk to your routine.
- If you get easily bored with exercise, vary your workout routine. Consider interval training, group fitness classes, or asking a friend to join you.
- If you have a chronic condition or disability, work with a physical therapist to determine which activities are best.
I – Inhale. Exhale. Did I meditate today?
Research has shown that meditation increases the level of neurochemicals in our brain that decreases anxiety and stress. Meditation has also been shown to improve sleep, reduce pain and enhance creativity. There are many types of meditation, and there is no right or wrong way to meditate. Components of meditation can include breathing deeply, focusing on different parts of the body to increase awareness, repeating a mantra, praying, walking in nature, focusing on gratitude or even reflecting on literature. If you are new to meditation, consider taking a group class or using an app to help guide you. Start with a few minutes each day and see how it makes you feel.
L – Love & Connect. Did I meaningfully connect with someone today?
Social connection is essential for health and longevity. It strengthens our immune system and decreases anxiety and depression. Studies have shown that a lack of social connection is more harmful to our health than obesity or smoking. It is important to foster connections with others, and it is not the quantity, but the quality of relationships that matters most. Consider calling a loved one, saying a kind word to your spouse, spending intentional time with your children or having coffee with a friend. Even small connections with your colleagues, patients or clients can provide meaning at work and added health benefits. If you do not have close connections, it is never too late to foster relationships. Find new ways to connect with others, such as joining a faith group or community organization.
E – Eat to Nourish. Did I choose healthy foods today?
The choices we make about food affect our health to a high degree. Unhealthy eating habits are linked to diabetes, heart disease, stroke and certain types of cancer. Eating well can decrease inflammation in our bodies, improve energy levels and prolong our lives.
Nutritional recommendations can be conflicting and confusing. The good news is that emerging data provides a simpler message. We should:
- Consume mostly plant-based foods that are not highly processed. This means getting most of our nutrition from vegetables, nuts, legumes (such as beans or lentils), fruits and whole grains.
- Try to eat in moderation.
- Limit sugar-filled beverages.
- Choose organic and local foods whenever possible.
In my mind, the key to nutritious eating is finding true enjoyment of real food.
SMILE Score Summary:
It is important to find simple strategies that help prioritize health.
Sleep, exercise, meditation, connection with others and nutrition are essential for optimal physical and mental health. The SMILE Score is a memory tool that can help you consistently live healthier and feel happier. I hope that you found this interesting and potentially helpful for your health Journey. As I said at the beginning of this article, I am constantly looking for ways to focus on the positive things we can add into our life to help us not only live longer but thrive. Have a great day!
-Toni Toledo, MPH, RDN Nutrition Care Manager
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