Mr. Garcia is a 65-year-old pre-diabetic patient. He’s just retired and moved to a new area. At his first visit with his new PCP, a nurse asks Mr. Garcia if he can usually understand a doctor’s instructions. “Absolutely,” he says. “I understand perfectly.”

But does he really?

Situations like this highlight the importance of distinguishing between two kinds of health literacy: subjective and objective. If doctors measure just one kind of health literacy, they may miss something.

Better understanding might allow Mr. Garcia to act sooner. He might get treatment or make healthier choices — and avoid diabetes. Smart changes now could mean avoiding the pain and expense of a chronic health problem later.

That’s why, when possible, it’s best to measure both subjective and objective health literacy.

Subjective Health Literacy: What You Think You Know

Subjective health literacy measures how health literate someone thinks they are. You can gauge subjective health literacy with questions like:

“How confident are you filling out medical forms by yourself?”

The nurse in the story above was measuring subjective health literacy, albeit informally. The questions don’t have objectively correct answers, which may be less threatening. It doesn’t feel like a test you’d take in school.

But there are disadvantages too. Patients often overestimate their own ability. And they may tell you what they think you want to hear—they may report strong health literacy even if they rarely understand or act on what a doctor tells them.

Objective Health Literacy: Measuring What You Know

A patient has to actually demonstrate knowledge to measure objective health literacy. One popular tool (The Newest Vital Sign) shows the patient a nutrition label, and asks how many calories they’d get by eating multiple servings, as well as other basic questions.

With objective health literacy, you know patients aren’t overestimating their own ability, or telling you what they think you want to hear. But because there are right and wrong answers, some patients feel like they’re back in school, and the memories aren’t always pleasant.

EdLogics’ Approach to Measuring Health Literacy

EdLogics measures — and strives to cultivate — both kinds of health literacy. We use only validated surveys. When we measure objective health literacy, we present questions a little differently, making them fun, adding graphics, and incorporating great design. It’s all gamified. You can win cash drawings — the more you play, the more likely you are to win.

Users do not feel like they’re back in school.

By measuring both types of health literacy, we put ourselves in the best position to understand how health literacy changes over time. This can help us further refine our suite of health literacy education games, and be even more effective in our mission to improve health literacy.

If it were possible to get “exercise credits” every time I thought about going for a run or hitting the gym, I’d be ready for the Olympics. Same for you?

With most people, the intention is there, but the motivation is missing. We know the health benefits of regular exercise, but it’s hard to get going.

Both the Centers for Disease Control and Prevention and the American Heart Association suggest at least 150 minutes of moderate exercise each week. That works out to 30 minutes a day, five days a week. The good news: It’s OK to divide the time into two or three sessions of 10 to 15 minutes each day.

For years, I preferred longer workouts. Running was my mainstay; walking was for old folks. I’d run three or four miles a few times a week, especially on mornings when the scale reported a couple extra pounds. For extra motivation, I’d occasionally enter races to put me in training mode.

There’s a lot you can do to fit in exercise. Think you’re too busy? Here are 10 simple ways to make time to move. If you have questions about how much or what type of activity is right for you, be sure to ask your doctor—and together come up with a plan.

1. Start your day sooner. Set your alarm 20 minutes earlier to get a quick workout in before breakfast. Walk the dog, or do some gentle yoga. It takes commitment, but you’ll feel great when you’re done—with the whole day still ahead. Of course, don’t let this cut into your sleep. If you wake up 20 minutes earlier, go to bed 20 minutes earlier.
2. Mix up your commute. Ride your bike if you work nearby, get off the bus or subway a stop or two early, or park your car a few blocks away. See how creative you can be in adding movement to your morning and evening commutes.
3. Make exercise part of work. Skip the conference room and schedule a walking meeting instead. Stand up during phone calls and work on your balance: Lift one foot an inch off the ground, hold for a few seconds, and switch. At lunchtime, ask a friend to walk a few blocks. And choose the stairs every chance you get.
4. Stretch at your desk. It’s easy to get involved in a project and find yourself sitting for hours at a time. Set a reminder on your phone or computer to pause for a few minutes every hour to stand up and move around. Stretch your legs, do a few squats or lunges, reach for the sky, or take a quick walk.
5. Find a buddy. Pair up with a friend for exercise. Pledge to get together for workout dates, and hold each other to it. Studies show exercising with a buddy can help keep you inspired and accountable. Mutual motivation can help reduce excuses.
6. Join a team. If you like team sports like volleyball, softball, or tennis, find a local group and sign up. Belonging to a team creates a deeper level of commitment—it’s harder to skip practice when you know others are counting on you.
7. Take a class. Most fitness centers and YMCAs offer a variety of spin, yoga, cardio, Pilates, and other types of classes. Many will offer a complimentary class for first-timers. Try one out and see if you get hooked.
8. Enter a race. For non-runners or casual runners, an organized race can be intimidating, and many host fun runs and walks along with more serious events. Regardless of whether you are competing for a personal best time or just participating for fun, races can be great events. Sign up for one that’s appropriate for your fitness level, and work with a trainer to prepare.
9. Take a 30-day challenge. There are lots of different types of online challenges these days. Planks and pushups are popular ones, and each are intended to encourage a daily activity that gets a little tougher each week. Look for a challenge you like—and see how well you do.
10. Write down specific goals. Know exactly what you’ll do and when you’ll do it. Think about obstacles and make a plan to overcome them. Saying you’ll “exercise more next week” isn’t enough. Instead, write something like “next Monday, Wednesday, and Friday morning, I’ll wake up at 5:45 a.m. and go to the 6:15 a.m. spinning class. I’ll be home in time to shower and leave for work.” The more specific your plan is, the better you’ll be able to reach your goals – and stick with them.

As a youngster, breakfast was always a favorite time of day. My siblings and I would convince Mom to buy all kinds of cereal, often based on the prize inside or the Saturday cartoon commercials. The kitchen table would be cluttered with boxes and, after we poured our selections, I’d build a small fortress around my bowl, where I’d read up on the games and offers on the back of each box.

One thing we didn’t do was read the nutritional label.  Actually, there wasn’t one in those days.

Nutritional labeling began in the early 1970s, when the Food and Drug Administration (FDA) proposed a format that would appear on packaged foods. Compliance was voluntary, except when the manufacturer made nutrition claims or added nutrients.

The Nutrition Facts we know today debuted in 1993 after the passage of the Nutrition Labeling and Education Act (NLEA) of 1990. The law gave the FDA authority to mandate packaged foods labeling and require that certain claims be consistent with regulations.

Consumers paid attention. In a study conducted about a year after the law went into effect, nearly half of participants said they changed their minds about buying a certain food because they read the nutrition label.

Still, certain diet-related health problems, like obesity and diabetes, have continued to grow worse. The food industry is often blamed as contributing to unhealthy eating.

Since many grocery shoppers look to nutrition labels for guidance (in the FDA’s 2014 Health and Diet Survey, 77% of Americans said they checked nutrition labels at least some of the time when buying a certain food), updating the labels became a focal point for change. In May 2016, the FDA unveiled a revised Nutritional Facts panel, which food companies will roll throughout 2017; nearly all manufacturers will need to comply by late July 2018.

Look for changes in these areas:

Clearer design

• Calorie information, serving size, and servings per container are all emphasized in big, bold print.
• An explanation of Daily Value, the percentage one serving provides of how much you need each day of a given nutrient to stay healthy

Updated nutrition information

• “Added Sugars” are called out in both actual amounts and Daily Value
• Nutrient lists include Vitamin D and potassium, in addition to the already required iron and calcium
• “Calories from Fat” is gone, but total fat, saturated fat, and trans fat remain
• Updated daily values for sodium, dietary fiber, and vitamin D
• Actual amounts of Vitamin D, calcium, iron, and potassium, in addition to the Daily Value

More realistic serving sizes

• Servings sizes are changing based on how people actually eat, rather than how they should. For instance, a serving size of soda is changing from 8 ounces to 12 ounces, and ice cream from 1/4 pint to 1/3 pint.
• For packages that contain between one and two serving sizes, calories and other nutritional information will be displayed as one serving, since most people are likely to consumer the entire portion in one sitting
• Dual column labels will reflect both the “per serving” and “per package” values on some products that can be eaten in one sitting, but contain more than one standard serving (think a large bag of chips or box of cookies).

Bottom line: There’s a lot to know about smart nutrition, and reading food labels is one important part. Eat a variety of foods and know your basic food facts: what to avoid, what to have in small portions, and what to enjoy more frequently.