~Behavior Change Contract~

         The beginning of everything is always tough! After squeezing out all my brain juice just to choose which behaviours I should change for a better functional life, I finally came up with one: To eat more fruits. 

        However, a goal has to be specific and measurable and so I came up with this: To eat a medium-sized apple everyday which has 72 calories and weighs 150grams approximately, so that I will be able to produce a much healthier load of stools. A diet low in fibre may result in watery and loose stool which is what I have been having.

         Why apple? Well, one of the reasons is due to the saying "An apple a day keeps the doctor away." Another reason will be the pressure from my parents as I haven't eaten any fruits in 2 months. 

         I also have found out that women need about 21-25grams of fibre daily while men need about 30-38grams (Zelman, 2011). For a medium size apple, from the USDA National Nutrient Database for Standard Reference, it has about 4.4grams of fibre which means that I am adding extra 4.4grams of fibre in my body daily and my stools will be firmer and less watery (Mayo Clinic staff, 2012; Mitchell, 2011)! 
         Therefore, hopefully there is a change in my stool after eating an apple per day. Besides, I may get rid of all the "naggings" of my parents if I have an apple per day (^.^).

         How do I know whether the feces are healthy or not? Well, good question! I have actually gone through some research articles indicating that Bristol Stool Chart is the most available chart to see the shape and how healthy feces are. At first, I had to find out whether or not I am having troubles in defecating. Although I do defecate daily, I still need some evidence. I came across a website from the work of Agachan, Chen, Pfeifer, Reissman, and Wexner (1996), http://www.medindia.net/patients/calculators/Constipation-Calculator-result.asp, to test out my constipation severity and it turned out to be normal! Therefore, it seemed I have got no constipation issue and so, I am only going to focus on the texture, shape and size of my own feces by having an apple per day.

          Okay, for the sake of time, in brief, the Bristol Stool Chart has provided a high degree of interrater reliability, intrarater reliability, and agreement among pediatric gastroenterologists (Chumpitazi, Lane, Czyzewski, Weidler, Swank, & Shulman, 2010). Admittedly, all the background study was really not much fun! 
       Here's my baseline data: 
For the past one week, I have always got the Type 5 stool, hopefully an apple a day may make a difference. The ideal type of stool will be Type 3 or Type 4, especially Type 4 with these characteristics:
* The feeling you need to go is definite but not irresistible
* Once you sit down on the toilet there is no delay
* No conscious effort or straining is needed
* The stool glides out smoothly and comfortably
* Afterwards there is only a pleasant feeling of relief
* All this is most likely if the stool is Type 4
You can also refer to this http://www.chirocolonics.com/stoolchart.html for further information (^.^)