#092 Do Mormons Live Longer?

April 11th, 2015 by

Do Mormons Live Longer?

Mormons don’t drink, they don’t smoke, and they even have detailed health guidelines in their scriptures.  They also tend to have a tight knit spiritual community.  Does this translate into better health and a longer life expectancy?

In 2008, UCLA researchers published the “Mormon Longevity Study” in the journal Preventive Medicine.  In this article I will share the results of the Mormon Longevity Study, evaluate the role of spirituality on lifespan, and compare the results of this study with longevity studies of other religious groups.

Please read on to learn more about the health lessons we can learn from these religious communities which may benefit your own health and lifespan as well.

The Mormon Health Code

Mormons have an additional set of scriptures based on modern day revelations called the Doctrine and Covenants.  It should be noted that this health code originated in 1833 which was long before processed foods, GMOs, and our modern forms of “wheat” and sugar were available.  In section 89 of the Doctrine and Covenants, Mormons have the following health code guidelines:

1. Do not drink alcohol

2. Do not use tobacco

3. Avoid “hot drinks” (this has been interpreted by church leaders to mean coffee and non-herbal teas)

4. Plant based foods are encouraged (fruits, herbs, vegetables, etc.)

5. Animal meat should be eaten sparingly (fish is not mentioned)

6. Grains are the “staff of life” (this recommendation came before commercial grain processing was available)

Monthly Fasting

In addition to the health code discussed above, Mormons are also instructed to fast monthly for personal spirituality and to help the poor.  This fast is defined as going without food or water for 24 hours.  The cash equivalent of what was saved by not eating or drinking for 24 hours should then be given as a donation to help the poor.

There are many health benefits from this practice.  For example, this monthly fast alone could prolong life through developing individual spirituality, the “Volunteer Effect,” and the activation of longevity genes as well as the prevention of heart disease.

1. Individual Spirituality

Cultivating individual spirituality has been shown in medical studies to be a powerful predictor of longevity among the centenarian community.  In addition to a monthly fast, Mormons are encouraged to pray, meditate, and perform acts of selfless service each day.

2. The “Volunteer Effect”

In addition to developing personal spirituality, there is also the “Volunteer Effect” of the monthly fast.  Study after study has shown that volunteers are happier, healthier, and even live 22% longer than those who choose not to give of themselves.  Outside of the monthly fast, every Mormon is encouraged to accept a volunteer service position within the church.

3. Intermittent Fasting Activates Longevity Genes and Prevents Heart Disease

Lastly, intermittent fasting has been shown to activate the genes that promote longevity.  Indeed, my colleague, Dr. Ben Horne, has shown that the practice of intermittent fasting prevents obesity, diabetes, and heart disease.  As heart disease remains the number one killer in the U.S., intermittent fasting could have a significant impact on lifespan.

Tight Knit Community

Perhaps the health benefits of the Mormon faith have nothing to do with their health code, spirituality, or other aspects of their faith.  Based on the work of Dr. Juliane Holt-Lunstad, which was covered in a previous article that I wrote, studies show that the single most important factor in health and longevity is the social support structure you have in place.

In other words, the closer you are to your family, your neighbors, and the more friends you have appear to be the most important aspect for a long and healthy life.  Attending church regularly provides instant access to this social support system.  This social support system can be lifesaving as you go through difficult challenges in your life.

The lesson here is that even if you are not religious, regularly meeting with other people in a supportive and nurturing environment can have significant health benefits.  Perhaps you could achieve the same health benefits by regularly participating in a supportive book group, joining with others in a shared hobby, or even social bonding through volunteer or humanitarian opportunities.

The Mormon Longevity Study

In 2008, UCLA researchers James E. Enstrom and Lester Breslow asked the question of whether the “Mormon Lifestyle” reduced mortality among active Mormons living in California.  This study included the health status of 25,647 people and followed them for 24 years.  This study later became known as the “Mormon Longevity Study” or the “UCLA High Priest Study.”

Before I share the results of this study, it should be pointed out that the Mormon Church had no influence on this study.  This study was supported entirely through grant money from the American Cancer Society, National Cancer Institute, Wallace Genetic Foundation, and the Block Foundation.

As you might have guessed, the Mormon lifestyle among Californians translated into a significant survival advantage.  Indeed, this lifestyle translated in up to an extra 9.8 years of life!

In this study, researchers defined the most faithful Mormons as “High Priests.”  They selected high Priests as their study sample group as men who have achieved this priesthood calling typically have lived a life faithful to Mormon teachings.

In this study, researchers found that the more positive health characteristics Mormons had the longer lives they lived.  Specifically, here are the 7 positive health characteristics that contributed to an extra 10 years of life in Mormons:

1. Married

2. Never smoked

3. Attend church weekly

4. At least 12 years of education

5. Moderate body mass index (BMI)

6. Regular physical activity

7. Proper sleep

Do You Have to Be a Mormon to Live 10 Extra Years?

No, you don’t have to convert to the Mormon faith to gain an extra 10 years of life.  For example, the Seventh Day Adventists, who are a religious group based primarily in California, also have a strong health code.  Interestingly, their health code is very similar to the Mormon health code.

Indeed, among a study of 34,192 faithful Seventh Day Adventists, researchers found that this way of life also conferred an extra 10 years of life.  This finding led researchers to title their study, “10 Years of Life: Is It a Matter of Choice?

Studies of other religious denominations have also shown survival advantages.  Even in China where religious believers have suffered persecution by the Chinese communist government in the past, have shown remarkable survival advantages.

Is Spirituality or Religion Necessary for a Long Life?

As I have reviewed hundreds of studies on spirituality, religion, and longevity, the key factor in my research is the powerful effect of having a strong social network on survival.  As discussed, having a close family as well as lots of friends appears to be the primary factor in longevity.

Religious organizations provide a strong social support structure and purpose to life.  They are also very effective in reducing emotional stress and suffering during challenging life struggles.

Putting It All Together

Individual spirituality and strong social connections are both powerful predictors of health, happiness, and longevity.  Whether or not you participate in an organized religion, cultivating personal spirituality and close relationships with family members and friends may also give you an extra 10 years of life!

Have you found organized religion or individual spirituality to help you with our own health?

#091 Avocados Lower Cholesterol Naturally

April 11th, 2015 by

Avocados Lower Cholesterol Naturally

In this podcast Dr. Day interviews Dr. Jared Bunch about a recent article he wrote for Everyday Health on avocados lower cholesterol naturally.

This podcast discusses the following topics:

1. Nutritional benefits of avocados.

2. Avocados or statins to lower cholesterol.

3. The recently published study showing that avocados can significantly lower cholesterol.

Subscribe to the Podcast

If you liked this podcast, please be sure and subscribe to the Dr. John Day Show in iTunes or Stitcher Radio.  The transcript for this podcast is posted below.

Avocados Lower Cholesterol Naturally Podcast Transcript

John: Hi. This is Doctor John Day. Welcome to the Doctor John Day show. I am so thrilled. I got Doctor Jared Bunch on the show again. So, I guess we didn’t scare you off last time.

Jared: I’m here to stay.

John:  I really like this article that you just wrote at Everyday Health, and it’s called, “This High Fat Food Can Lower Your Cholesterol.” I’m looking at your stats for this article with 5,000 shares on Facebook!  That’s amazing. So I guess you hit on something that really resonated with a lot of people in this article.

Jared: Yeah, we were really excited about the general flow and the sharing of the article. It really took off and was featured on the everydayhealth.com main website for about one week.

John: So I heard that you even came in ahead of Sanjay Gupta’s article.

Jared: Well, we never quite know where we are, but when it stays on the main page, that usually is a good sign that a lot of people are interested in it.

John: There is definitely an interest with 5,000 shares on Facebook and counting.  Let’s dive into this article and try to learn more about avocados. I like how you started your article with the confession that if you had just one meal left in your life, that you would look for Mexican food and avocados.

Jared: Absolutely. I think we all have had that thought at one time – what would be our last meal? We had that discussion one night as residents at the Mayo Clinic. We were all sleep deprived. It was about 2:00 AM, so we were all thinking this may be our last meal anyway and mine came down to Mexican food. I have a passion for that.

John: Now does that include guacamole?

Jared: I do like fresh guacamole, and I do like peppers as well, so yes.

John: What sort of nutrient benefits are we getting from avocados?

Jared: Avocados really are on a short list of most people for a superfood. They’re filled with lutein. Lutein is a powerful antioxidant. It’s actually quite interesting. It’s been a nutrient that’s been used for eye protection. It concentrates in the eye and may protect the eye from ultraviolet light. There’s fiber in it. It’s a rich source of potassium. Most people when they think of potassium, think of potato skins, bananas, and oranges.

Few people think of avocados, but avocados, pound for pound, beat out bananas and most other food sources for potassium. They’re loaded in vitamins, including C, D, E, and K. They’re low in sodium. An avocado may only contain 2.6 miligrams of sodium and they have about 0.7 grams of protein in them. And finally, they’re also one of the food sources that contains a fair amount of zinc and so it also may help you ward off colds and some of the other things that zinc shows a protective benefit for.

John: They are also high in fiber.  Considering that our daily fiber goal is 30 grams, and the average American only eats 15 grams of fiber, just one avocado almost gets you to the US daily average.

Jared: Yeah, absolutely. One normal sized avocado will almost get you there.  That’s why it’s one of the superfoods that we tend to advocate.

John: Now, avocados, is similar to our last podcast together with coconuts.  For years, avocados and coconuts were shunned, but now there’s a renaissance where avocados and coconuts are all the rage. What suddenly redeemed these two foods?

Jared: Well, there’s clearly a change in thought about eating and diets. And approximately 20 years ago, everything was centered around reducing fat. We found out that they may actually be a more harmful than diets that do contain healthy fats. And as they are a food source that is rich in healthy fat, avocados are one that we can consider. Just like coconuts.

John: For those in our audience who’ve been following the medical literature or even in the lay press lately, statins have really taken a beating. First, several weeks ago, there was a study that came out that the diabetes effect with statins may be much greater than we had previously anticipated. It actually reported that statins result in a 47% increase in diabetes. And then a couple of weeks ago at the American College of Cardiology meetings, there was a study from the Cleveland Clinic showing that statins may increase coronary calcifications. Based on your article, would you consider avocados an alternative to statins?

Jared: I wouldn’t call it an alternative.

John: Okay, so you’re not willing to go that far then?

Jared: Not quite yet. Lots of people can’t take statins.  One of the biggest concerns with statins is an inflammatory muscle disorder called myositis and this can lead to significant muscle injury.  Fortunately this is super rare.

About 10-15% of statin users will develop joint pain and muscle pain so they end up stopping these agents. In fact, in clinic today, I saw two people that, over the past two weeks, stopped their statins, because the pain was too significant to continue and they just couldn’t do what they wanted. So, lots of people are looking for alternatives. They have high cholesterol. Their doctor said, “Let’s lower your cholesterol,” and they can’t use statins – the most common drug. So they have another drug called zetia, but unfortunately that does not have the same benefits of statins. It can be used in combination with statins to some benefit, but does not have the same strength or heart protective benefits.

And so a lot of the medical community is waiting for a new class of drugs called a PCSK9 inhibitor, and those were mentioned at the recent American College of Cardiology meetings.  The pharmaceutical industry has tremendous interest in finding a statin alternative. But many people have asked, “But what can I do for myself?” They exercise, they try to lose weight, they increase the fiber in their diet, and their cholesterol is still high. That’s where I wanted to introduce the avocado as a potential option.

John: At least with my patients, most would rather take an avocado than a statin drug. How effective are avocados at lowering cholesterol?

Jared: Again, that gets back to that fats. Some fats are good for you and some are bad. Polyunsaturated fats from animal products can be harmful. Monounsaturated fats from plant-based foods can be healthful. In fact, we talked previously about coconut oils and things like that which can actually lower cholesterol. We’ve had that knowledge for some time, but not necessarily studied it in a very scientific way.

That’s what was interesting about a recent study in the Journal of the American Heart Association. This is a open-access journal supported by the American Heart Association and it often has trials that focus on some of these different therapies that maybe of interest. And this was a study that looked specifically at the potential benefit of avocados in people that have high cholesterol. Whenever we look at the beneficial effects of foods it’s good to go to reputable journals where we can trust the science and trust the outcomes, in trying to understand if they would give us benefit. And so this was a study of 45 people that were either overweight or obese, and had high cholesterol.

John: How high was their cholesterol in this study?

Jared: These were all people that in general had cholesterol levels over about 200.

John: And that’s total cholesterol above 200. So 45 people overweight to obese people all with a total cholesterol above 200.

Jared: Yes, and so they were randomized to take part in three diets. They actually studied these people after every diet. They would be on these diets for, I believe, five weeks. One diet was what we were talking about before, a low-fat diet.

John: So, going back to the diet of the 1980s, and 1990s.

Jared: Exactly. Kind of when I was growing up with my family, my mom wanted everything without fats.

John: Did you have those SnackWells fat-free cookies?

Jared: Oh yes [laughter]. There’s nothing snack well about them.

John: And the skim milk that looked like water in your cereal bowl?

Jared: Exactly. [laughter] I remember. I’m a product of the 1980s.

John: What were the other 2 diets in this study?

Jared: The other was on a moderate fat diet of healthy fats.  In addition, they had one medium sized avocado a day.

John: And what about group three?

The third group was also on a moderate fat diet. Now we know that avocados have monounsaturated fats that may lower cholesterol, so the author said, “Well we need to substitute something that has some monounsaturated fat, so we can truly understand if the avocado is unique.” And so in this one, they had additional foods, such as olives, that they introduced that would provide that healthy fat content. Every single participant was on all of these diets at one point in time. After they completed one diet, they had a two-week washout period before they had to start the next diet.

John: Each person tried all three diets, then?

Jared: Yes, and the order in which they participated was random, so you wouldn’t assume that the third diet took advantage of the two diets before it.

John: So, the only difference between the second and third diet was that the second diet got an avocado a day and in the third diet they got a different type of healthy fat.  What did they find?

Jared: That’s what I thought was quite interesting. The diet that contained the avocado had the greatest reduction in bad cholesterol or LDL cholesterol. In fact, the LDL cholesterol in just five weeks decreased on the average of 13.5 milligrams per deciliter.

John: Just for reference, if you start one of your patients on a statin, how much LDL reduction do you typically see?

Jared: I continue to raise the statin dose until I receive the desired level. You’ll often see reduction of about 20 mg/dL.

John: So if a patient, say, did still require statin, maybe they only require half the dose as long as they’re getting their avocado a day?

Jared: Yeah, that’s definitely a possibility. And we do know that symptoms with statins are often dose-dependent. And so one of the options physicians turn to is trying a different statin or lowering the dose and hoping that it reaches a level where the patient could tolerate it.

John: What happened with the other moderate fat diet in this study?

Jared: The other moderate-fat diet also reduce LDL cholesterol. In the moderate fat diet without avocados they were able to reduce it by on average of 8.3 mg/dL in five weeks. The low-fat diet really didn’t do a lot. In fact, we didn’t see much change in cholesterol at all. And so consuming these healthy fats actually helps lower our the bad fats in our body.

John: What does avocado do to LDL particle size and does size matter?

Jared: Size definitely matters in many things in life. The smaller and more dense your LDL particles, the worse. When I was in training, there was a lot of interest in saying, “Are all LDL particles alike? Are all good cholesterol HDL particles alike?” And so what they started to do was study them, and break them up by size and density, and that’s when a lot of insight came into fat, and how fat circulates and how it invades the vessels and inflames the vessels and causes disease. And they found these very small, dense LDL particles were the ones that could enter the vessel, enter the plaques, cause inflammation and tended to be those that were the most hazardous.

John: So when it comes to bad cholesterol, bigger is better.  Is that what you’re saying?

Jared: Yes–

John: And avocados will help you to grow bigger LDL particles?

Well, not as much as– they help the bigger LDL particle. The one diet out of all of them that changed the ratio of small dense particles was the avocado diet. And compared to the other moderate diets, the avocado itself had a unique property in lowering these dense particles. And so not only lowering bad cholesterol, you’re lowering preferentially the worst part of the bad cholesterol. I think that’s tremendous insight that requires a lot of additional study.

John: You bring up a good point.  When we look at the cholesterol-lowering-effect of avocados, it’s modest, not quite to the level of a statin, but perhaps there’s even more bang for your avocado in that it’s not just reduction, but it also changes the nature of LDL.

Jared: Absolutely. It has a unique benefit in the treatment of cholesterol.  While this is a small study it was well designed and performed.

John: Certainly in the medical world, it seems like – and many of our listeners will tell you is, one day we hear something’s bad for you, then the next day we hear that the same thing is good for you, and so we like to try to look at this as far as a trend in the right direction. In your research, has there been other work done on avocados and its effect on cholesterol and heart health?

Jared: There have been smaller studies that also show some benefit with avocados in lowering cholesterol.  I hope that these smaller studies on avocados lead to a much bigger trial. You know, five weeks isn’t a long trial of any drug and we had this significant improvement in five weeks. Well, what if they continued for six months or a year? Would we see the cholesterol drop further and the dense LDL cholesterol drop further?

John: While this can’t be accepted as gospel yet, it is a great first step. I think it really gets back to what Hippocrates said, “Let food be your medicine,” and clearly there seems to be a great benefit here with avocados.

Now, at the end of your article, you mention that before we get too enthusiastic about an avocado a day, we can’t forget about the the caloric load of an avocado as well as some food allergies. Can you expand on this?

Jared: Yes. Unfortunately, a lot of the things that make avocados a superfood also make it a little bit dense in calories. An average avocado will contain about 250 calories, and so that’s not a small amount if you’re watching your weight. So you may not want to eat a lot of them even though there is some benefit, because it can cause weight gain, and weight gain can sometimes negate some of the benefits.

I went running today for five miles.  When I finished my calorie counter said I’d burned 500 calories, so eating two avocados would have completely offset everything I ran off.

John: That’s a lot of exercising just to work off two avocados [laughter].

Jared: That was good guacamole.

John: Ah, so that’s how you like your avocados. Then it’s with the guac, huh?

For me it’s guacamole, yes. I need some peppers in it as well. The other interesting thing with avocados that I didn’t know is there has been some reports that in people with latex allergies, they can have similar allergic symptoms if they eat avocados. So, if you’re somebody that’s been exposed to latex and have had a severe allergic reaction it would be best to consult your doctor and maybe talk to an allergist before eating one.  Obviously, if you have a latex allergy, and you’re doing fine eating avocados, continue to do so.

John: I must confess I’m not a big guac fan.  I’m learning to enjoy avocados in some of our homemade salad dressings.

Jared: They are awesome in salads. They are also awesome on sandwiches.

John: Fantastic. Now this has been great, and if people want to learn more about this article or about some of the articles that you are writing, how can people find you in the Internet?

Jared: Absolutely. I’d love them to read my articles and comment, good or bad, and engage other viewers in conversation. It’s at everydayhealth.com under columns. My column is known as “Rhythm of Life.” I’m the one cardiologist there. You can also follow me on Twitter@TJaredBunch. As soon as these articles come out, I’ll send links to them so you can immediately read them through Twitter.

John: As always, Jared, it’s great to do this with you. We’ve been partners now in our cardiology practice for many years and now we’re doing these podcasts together. Thank you so much for coming on the show and sharing with us everything we always wanted to know about avocados.

Jared: My pleasure. Thanks for inviting me.

John: Thank you so much and thank you for tuning in.

#090 How to Prevent Alzheimer’s Disease

April 3rd, 2015 by

How to Prevent Alzheimer’s Disease

My dear friend just learned this week that her father was diagnosed with Alzheimer’s Disease.  The tragedy is that he is only 50 years old.

Does Alzheimer’s run in the family?  Is there anything you can do now to prevent you from suffering the same fate?  In this article I discuss the 10 things you need to do now to minimize your risk of ever suffering from this devastating condition.

Do You Have the Alzheimer’s Gene?

If you have a family history of Alzheimer’s Disease then there is a high chance that you have the “Alzheimer’s gene.”  Specifically, half of all people with Alzheimer’s Disease have the ApoE4 gene.  While this is the most important gene for Alzheimer’s Disease, there are also other “lesser” genes which may also be involved.

The ApoE gene controls cholesterol and lipid metabolism.  There are 3 main forms of this gene, ApoE2, ApoE3, and ApoE4.

If you have the “ApoE2” form then you are protected against developing Alzheimer’s Disease. ApoE3 is the “normal” form of this gene and has no increased or decreased risk of Alzheimer’s Disease.  Unfortunately, about 25% of Americans have at least one copy of the ApoE4 form which puts them at significant risk of high bad cholesterol (LDL) as well as heart disease and Alzheimer’s Disease.

We each have two copies of the ApoE gene.  One from our mother and one from our father.  If you have just one copy of the ApoE4 gene then your risk of Alzheimer’s Disease is increased 2-3 fold.  Tragically, if you have 2 copies of the ApoE4 gene your risk of Alzheimer’s Disease is increased 20-30 fold.  Not only does the ApoE4 gene put you at high risk of Alzheimer’s Disease, it also causes the disease to develop as early as age 30.

How Do You Know if You Have the ApoE4 Gene?

You can now know if you have the Alzheimer’s gene for a little over $100.  You don’t even need your doctor to help you with this test.  This is something you can order for yourself online.

Not only will you learn your Alzheimer’s gene status, you will also learn about thousands of other genes for cancer, obesity, autoimmune diseases, etc.  Other than filling out a few online forms all it requires of you is some of your saliva in a test tube.  To learn more, I describe the details of how to test your genes in a previous blog post.

Are Your Genes Your Destiny?

Do our genes determine whether or not we will develop certain diseases?  Absolutely not!  Our DNA is not our destiny.

Our genes just represent the seed.  For a seed to grow it requires the right nutrients in the soil, water, and sunlight.  The same is true for our genes.

If we can live a perfectly healthy lifestyle we can turn the ApoE4 gene off.  This is done through a process known as epigenetics.  In fact, only 25% of our health future is determined by our genes.  The other 75% is completely up to us based on the decisions we make every day.

How Do You Silence the ApoE4 Gene?

Fortunately, even if you have the ApoE4 gene it doesn’t need to cause high cholesterol, heart disease, and Alzheimer’s Disease.  While this often happens with our Western lifestyle, we have scientific evidence from 3 groups of people living an ancestral lifestyle who do not suffer any bad effects from the ApoE4 gene.

1. Pima People Living in Mexico

The Pima people reside in Arizona and Mexico.  They were once known for their lean bodies, great athleticism, and health.

Unfortunately, after being driven from their native lands and way of life, the Arizona Pima people were given government rations of white flour, sugar, canned goods, and industrial oils to keep them from starving.  A few generations later they now have one of the highest rates of obesity, diabetes, and Alzheimer’s Disease anywhere in the world.

In 1999, researchers studied a group of Pima people still following the traditional Pima diet and lifestyle in Western Mexico.  Even among those Pima people with the ApoE4 gene, they saw no evidence of high cholesterol, heart disease, or Alzheimer’s Disease.  The researchers concluded that this ancestral lifestyle protected the Pima people from the ravages of the ApoE4 gene.

2. Yoruba People Living in Nigeria

Later, in 2004, researchers evaluated two groups of people of African descent with regards to the ApoE4 gene and Alzheimer’s Disease.  Of the two groups in this study, one group lived in Indianapolis, Indiana and the other Ibadan, Nigeria.

As expected, the ApoE4 gene increased the risk of Alzheimer’s Disease in African Americans living in Indianapolis.  However, quite unexpectedly, the ApoE4 gene had absolutely no effect on the risk of Alzheimer’s Disease among the Yoruba people living in Ibadan, Nigeria.

Once again, the researchers concluded that the traditional diet and lifestyle of the Yoruba people living in Nigeria silenced the ApoE4 gene and protected them from developing Alzheimer’s Disease.

3. Sub-Sahara Africans

In 2014, researchers reviewed data published in 522 studies on the risk of dementia in Africa.  As with the previous two studies, this study came to the same conclusion.  In Sub-Sahara Africa, Africans who have the ApoE4 gene but yet still eat the traditional diet and follow the traditional lifestyle completely silenced the ApoE4 gene.

Are ApoE4 People the Canary in the Coal Mine?

In the past, canaries were used in coal mines to warn miners of impending danger.  The build up of toxic gases in the mine, like carbon monoxide or methane, would kill the canaries long before the miners were affected.

In our modern Western way of life, people with a copy of the ApoE4 gene represent the canary in the coal mine.  In other words, the Standard American Diet (SAD) and physical inactivity harms people with the ApoE4 gene long before people with the other forms of the ApoE gene.

For people with the ApoE4 gene, to escape the fate of the canary in the coal mine, they must give up the Standard American Diet (SAD) and embrace a physically active lifestyle.  Indeed, studies have shown that for people with just one copy of the ApoE4 gene, a poor diet and lifestyle increases the risk of Alzheimer’s Disease by 11-fold!

How to Prevent Alzheimer’s Disease: 11 Strategies

If you have a family history of Alzheimer’s Disease then odds are that you also have the ApoE4 gene.  If you have this gene or a family history of Alzheimer’s Disease, let me share with you 11 ways to prevent this tragic fate.

1. Exercise Faithfully

For people with the ApoE4 gene or a family history of Alzheimer’s, exercise is the single most important thing they can do to decrease this risk.  While exercise is good for everyone, the benefits seem to be most pronounced in people with the ApoE4 gene.

It doesn’t matter what form of exercise you do as long as you do something physical every day for the rest of your life.  In addition to exercise, make sure you minimize any sitting throughout the day.

2. Maintain a Perfect Weight

Following exercise, maintaining an ideal weight is absolutely critical for people with the ApoE4 gene or a family history of Alzheimer’s Disease.  Unfortunately, I have found that most people have no idea what their ideal weight is.  If you weigh more than your ideal weight this extra weight can turn the ApoE4 gene on.

People with the ApoE4 gene or a family history of Alzheimer’s need to have a body mass index (BMI) at least lower than 25 which is the bare minimum to no longer be considered overweight.  To learn your own BMI, here is an excellent online BMI calculator.

3. Keep Your Mind Active

Countless studies have shown that stimulating your mind over a lifetime can help to prevent Alzheimer’s Disease.  The same is true for people with the ApoE4 gene or a family history of Alzheimer’s.

4. Eat a Low Cholesterol Diet

New dietary guidelines in the U.S. will now stop recommending that people avoid cholesterol in the diet.  While dietary cholesterol does not affect blood cholesterol levels in most people, this is not true for the 25% of Americans who possess at least one cope of the ApoE4 gene.  For people with the ApoE4 gene, minimizing dietary cholesterol still matters!

5. Avoid Trans Fats and Minimize Saturated Fats from Animals

As with dietary cholesterol, saturated fats may no longer be dangerous to cardiac health as was once thought.  Once again, this is true for most Americans, not those with the ApoE4 Alzheimer’s gene.  For these people, minimizing saturated fats from animal products (meat and dairy) are critical to preventing dementia.

Trans fats are still rampant in processed foods, fast foods, bakery items, and restaurant foods.  Anything processed or prepared could be loaded with trans fats.   Even if the label says no trans fat this may not be the case due to loopholes in U.S. labelling laws.  You have to read the ingredient list carefully.  Trans fat for people with the ApoE4 gene are particularly dangerous.

6. Make 9 Servings of Fruits and Vegetables the Goal

The American Heart Association now recommends 9 servings of fruits and vegetables each day.  While fruits and veggies are good for everyone, people with the ApoE4 gene or a family history of Alzheimer’s seem to benefit the most.  Indeed, studies have shown that fruits and vegetables can decrease the risk of Alzheimer’s Disease by 76% in people with the ApoE4 gene.

7. Minimize Sugar

It goes without saying, if you want to protect your brain you need to minimize any added sugars or even foods that behave like sugar in the body.  This includes fruit juice and 99% of breads, pastas, crackers, pastries, breakfast cereals, white rice, french fries, etc. If you enjoy these foods, you can be part of the 1% to eat the healthier options I have discussed in other blog articles.

Many researchers now feel that any elevation in blood sugar levels can be toxic to the neurons in our brains.  Do your brain a favor and stick to lower glycemic foods to help maintain a healthy blood sugar level.

8. Use Supplements Wisely: B12, Fish Oil, Turmeric, and Vitamin D

Having the right amount of B12, turmeric/curcumin, and vitamin D can be protective of Alzheimer’s Disease in people with the ApoE4 gene or a family history of Alzheimer’s.  However, people with the ApoE4 gene need to be very cautious with fish oil.  Higher doses of fish oil in people with the ApoE4 gene can actually increase the risk of Alzheimer’s Disease.

I should point out here that eating fish has been shown to be very helpful in preventing dementia in many studies.  However, for people with the ApoE4 gene there may not be as much of a benefit.

 9. Avoid Smoking and Alcohol

Both smoking and alcohol activate the ApoE4 gene.  Thus, for people with the ApoE4 gene, abstaining from smoking and alcohol are important in minimizing the risk of dementia.

10. Minimize Stress

We all know that stress is dangerous to the brain.  Once again, this is most pronounced in people with the ApoE4 gene.  In these studies, perceived stress directly reduced memory.

11. Avoid too Much Iron and Copper

Iron and copper are critical micronutrients for health.  However, when levels of copper or iron get too high in the body this can trigger dementia.

Final Thoughts

Does Alzheimer’s run in the family?  Do you have the ApoE4 gene?  What have you found that has been helpful in maintaining a healthy brain?

Disclaimer

Do not self diagnose or treat based on anything you have read in this article.  I am not recommending genetic testing or any supplements in this article.  If you have a family history of Alzheimer’s Disease, please discuss with your physician which lifestyle changes would be most important to decrease your risk of Alzheimer’s.

#089 How to Test Your Genes

April 3rd, 2015 by

How to Test Your Genes

Have you ever wondered what secrets your genes hold?  Will you live a long and healthy life or will you suffer from the diseases that run in your family?

These are the same questions that I had.  I had to know what my future looked like so that by making the right changes now I could change my fate.  You may discover that you have an easily correctable genetic defect, like difficulties absorbing vitamin B12, which could save you from developing dementia later in life.

In this article I will step you through this painless and inexpensive process that I went through in order to have a glimpse at my own genetic future.

Step 1: 23andMe

In order to discover my genes, I “Googled” 23andMe.  After filling out the online form and paying $99, they sent the DNA test kit to my home.

The kit included a test tube to spit into as well as a self-addressed container to send it back for analysis.  The process was so simple and it just took me a few minutes to complete.

In less than a month, 23andMe contacted me to let me know my test results.  The report had my genetic ancestry.  I learned that I am 97% European and 3% Neanderthal.  The 3% Neanderthal is much higher than most people.  Perhaps this explains some of my quirky behavior.

I also learned that I have 929 genetic relatives in the 23andMe database.  The company even offered me the option of connecting with my genetic relatives.  As I am still new to the world of “DNA relatives” and still am not sure if I trust the intentions of the 23andMe company, I decided to opt out of this service.

In addition to my ancestry, 23andMe also provided me with my raw genetic data.  Unfortunately, due to a recent FDA ruling, they can no longer provide you with a detailed report of what this raw genetic data mean.

At the time I received email notification of my 23andMe results, Dr. Jared Bunch and I were traveling home from a medical society meeting in Washington DC.  I remember checking, gene by gene, with Dr. Bunch against a known database of genes to see if I was at risk for the diseases that run in my family.  It was tedious and I remember thinking, there had to be a better way…

Step 2: Promethease Report

Fortunately, I eventually stumbled upon Promethease with my internet search using the inflight internet service on my Delta Airlines flight home.  For just an additional $5 I could allow them to tap into my 23andMe raw genetic data and provide me with a detailed report of what my genes mean.

Within 15 minutes of uploading my 23andMe data to Promethease, I had a 310 page genetic report that I could understand.  For the rest of the flight home I devoured each page of this report.  For people without a medical or scientific background, you may not be able to understand a lot of what is in this Promethease report.

What Does the Genetic Report Tell You?Genetic engineering scientific concept

There is a lot of interesting data in this Promethease report.  For example, I learned that I have all of the “fat genes.”  This explains why I have to be so careful about everything I eat and to exercise religiously or I quickly gain weight.

I also found out that I am able to taste “bitter,” that I am slow caffeine metabolizer, and that I am not lactose deficient.  From a nutritional standpoint, I learned that I lack the gene that properly converts beta-carotene to the active form of vitamin A, retinol. This means that I need to make sure I am getting enough vitamin A to prevent nutritional problems down the line.

This report also tells you if you have the “longevity genes” allowing you to possibly live a long life.  You can even learn if you have the “smart gene,”, how well you memorize things, if you can smell asparagus in your urine, if you will go bald, or if you are at risk for becoming obsessive compulsive, or developing an addiction.  The report also shares the following:

1. Your risk for most known cancers.

2. Your risk for heart disease, diabetes, high cholesterol, or high blood pressure.

3. Your risk for most autoimmune diseases.

4. Your risk for serious neurologic conditions including Alzheimer’s Disease, Parkinson’s Disease, etc.

5. Your risk for many other conditions including eye diseases, skin problems, depression, etc.

How Accurate is the 23andMe Genetic Test?

Can you rely on the information from this test?  This is a question the FDA is currently grappling with.  One thing to remember is that no medical test is 100% accurate.  In fact, this Bloomberg article argues that 23andMe may only be 50% accurate based on an evaluation by genetic guru Craig Venter on 5 of his patients.

One area where 23andMe really missed it for me was that they said I had the “bald gene.”  The men in my family keep their hair.  I turn 48 this month and still have a full head of hair.  However, 23andMe was surprisingly accurate when it came to my ancestry and other medical conditions that run in my family.  I have not yet independently verified the results of my 23andMe genetic test.

We have all heard stories of people who “passed” a cardiac stress test only to suffer a heart attack shortly after the test.  I would look at these genetic tests as just a “screening” test–like a stress test.  You cannot act on the results until they have been independently verified.

If you find something serious, like say the Alzheimer’s gene (ApoE4), then you would want to contact your physician for additional testing to confirm the results.  This is why we, as cardiologists, generally recommend an angiogram or cardiac catheterization to verify the results of an abnormal cardiac stress test.

Can You Really Trust 23andMe?

As part of this process, 23andMe will also ask you about your family history.  This is clearly their attempt to gather as much information about us as possible.  Whether this information will be used for good or evil, only the future can tell.  Given the company’s close relationship with Google, it is quite possible that by combining your DNA with your online surfing habits this company will know more about you than you could ever possibly know yourself.

My guess is that the company will continue to use this genetic information, in partnership with pharmaceutical and biotech companies, to create blockbuster drugs that generate billions of dollars for the company.  For example, according to this report, 23andMe has already received millions of dollars from Genentech to look at possible new treatment options for Parkinson’s Disease.

The $99 for the test kit is likely just a “loss leader” to have a shot at the really big money in the future.  Already, close to one million people have already given their genetic information to 23andMe according to this Forbes report.

Are There Any Competitors to 23andMe?

Over the last few years there have been a number of competitors to 23andMe that have either gone bankrupt or have been bought out by bigger companies.  Perhaps this is because they did not have the deep financial backing of a Google or Genentech like 23andMe.  Many of these competing companies no longer sell direct to consumer but rather require you to go through your healthcare provider. To learn more about the 23andMe competitors, here is a blog article to review.

Do You Want to Know Your Genetic Future?

In deciding whether or not to have this test done, this is probably the most important question you need to answer.  For example, if some people know they are at high risk for developing Alzheimer’s Disease at a young age they could go into a deep depression. On the other hand, for some people this could be empowering as it would motivate them to do everything possible to silence the Alzheimer’s gene.

Can You Silence Your Genes?22-1

Just because you have a cancer gene doesn’t mean you are destined to suffer from that cancer.  Indeed, from the Danish Twin Study we know that only 25% of our health, happiness, and longevity is determined by our genes.  The other 75% is completely up to us.

The decisions we make each and every day determine which genes are “turned on” and which genes are “turned off” through a process known as epigenetics.  Our genes are just the “seed.”  Whether or not the seed grows depends on the nutrients in the soil, sunlight, and water.

The same is true for us.  Living the perfect lifestyle may not allow that cancer gene to ever do anything.  In most cases, the choice as to whether we suffer from our genetic fate is really up to us.

What Are the Dangers of Knowing Your Genes?

Knowing your genes certainly comes with some risk.  Besides potentially becoming depressed based on your report, it is possible that insurance companies could discriminate against you based on this genetic information.  For example, you may not be able to get life insurance based on the results of genetic testing.

Fortunately, the results of these tests do not go into your medical record unless you choose to share them with your physician.  As of the time of writing this article, I am not aware of any insurance companies being able to extract this information from 23andMe or Promethease.

Also, as mentioned above, at some point your genetic data could be combined with your online searching habits.  This could create such a clear picture of you that insurance companies, future employers, or even government officials would salivate to get their hands on this data.  Once you give them your DNA you will never be able to protect your most priceless information.

Should You Do It?

At the end of the day, the decision as to whether you decide to do genetic testing is completely up to you.  It is a painless and easy process to go through to get the testing done.  23andMe and Promethease have both done a great job at streamlining the process to make it as easy and painless as possible.

For me it was important to know what my genes said.  Learning this information has only strengthened my resolve to live as healthy as I possibly can to escape the medical conditions I am at risk of developing.

If you want to do it but yet don’t trust 23andMe with your genetic data, then you could consider getting the test done anonymously.  In other words, you don’t provide 23andMe with anything but your own saliva and an address to mail the kit to.  You can even create an alias email account for this transaction.

Have You Tested Yourself?

If you have taken the plunge and had your genes tested, how was the process for you?  Are you glad you did it?  How has your life changed based on this new information?  Do you worry about giving up your genetic information?

Disclaimer

In this article I am not recommending personal genetic testing.  I also have no financial relations with any companies mentioned in this article.

Any genetic information you provide could be used to harm you or your family now or in the future.  Also, the information you receive from these tests could be inaccurate leading to unnecessary physiological distress or medical tests.  If you are interested in doing your own genetic testing, please discuss the potential implications of this decision with your physician first.

#088 How to Eat Healthy for Cheap

April 3rd, 2015 by

How to Eat Healthy for Cheap

A reader recently commented, “you recommend healthy eating because you can afford it as a cardiologist.”  Sadly, I have found that many people use “cost” as an excuse not to eat healthy.

Can you really put a price tag on the lost years of work from diabetes, obesity, or other medical conditions?  Also, what about the co-pays for all of the medications, doctor visits, and medical procedures?

We have all seen how even the homeless in any big U.S. city can afford to eat at McDonalds.  If the homeless can afford the Big Mac Meal at McDonald’s, then I am going to use this as my cost baseline for comparison.  Indeed, even without considering the long-term medical costs of the Big Mac Meal, I am going to show you that healthy eating can be much cheaper than eating at McDonald’s.  I will also share with you my 10 best strategies on how to eat healthy for cheap.

The Big Mac MealMOSCOW, RUSSIA-October 6, 2014: McDonald's food. McDonald's Corp

Who didn’t love a Big Mac growing up?  My favorite was always the Big Mac.  In high school I would order 2 Big Mac’s, a large order of fries, and a chocolate shake.

Big Mac’s have certainly gone up in price since I used to indulge myself with them in the 1970s and 1980s.  In fact, according to the Fast Food Menu Price website which tracks the cost, the average cost of the Big Mac Meal in the U.S. is currently $5.69.

Wild Alaskan SalmonIMG_8947

Too often we feel that eating real meat, especially wild salmon, is beyond our reach financially.  It may surprise you just how cheap real meat can be.

After receiving this reader feedback yesterday, I decided to literally “run” to the Costco next door to my hospital on my lunch break.  Armed with my iPhone camera, I was determined to document how affordable healthy eating can really be.

This bag of frozen wild Alaskan Salmon costs $29.79 at the Costco in Salt Lake City.  Assuming a typical 3-ounce serving size of salmon, which is about the size of your fist, there are 16 servings in this bag.  This works out to be $1.86 per serving.

Organic SaladIMG_8957

Nothing goes better with wild salmon than a heaping fresh salad.  Organic salad mixes are also very affordable at Costco.  A large “bucket” of either organic spring mix or organic spinach both cost $3.99.  Assuming a heaping 2 cup salad, the cost is just $0.80 for the greens.

A very healthy and cheap salad dressing is to just add a little organic extra virgin olive oil and balsamic vinegar.  A serving size of organic extra virgin olive oil and balsamic vinegar from Costco adds an additional $0.23 to the salad.

With the wild salmon, heaping organic salad, and our organic extra virgin olive oil and balsamic vinegar salad dressing from Costco we are now up to a total of $2.89–still $2.80 below the price of the Big Mac Meal.

Fresh Organic FruitIMG_8952

The meal would not be complete without fresh organic fruit to go with it.  Even if you went crazy with fruit and added a cup of fresh organic strawberries, an organic apple, and an organic banana the cost would only be $1.79 ($0.67 for the strawberries, $0.87 for the apple, and $0.25 for the banana).

Thus, the grand total for the wild Alaskan salmon, organic salad, and organic strawberries, apple, and banana comes to $4.68 which is still more than a dollar cheaper than the Big Mac Meal!

12 Tips on how to Eat Healthy for Cheap

Hopefully by the above example you can see how eating large portions of healthy food can be much cheaper than a trip to McDonald’s.  Let me now give you my 12 best strategies on how to eat healthy for cheap.

1. Shop Costco

Costco now carries many organic and other healthy foods.  Of course, if you are trying to save money then you must have a shopping list when you enter Costco.  Otherwise, you will come out $300 poorer by buying useless stuff you don’t need.

In addition to wild Alaskan salmon and fresh organic produce mentioned above, large bags of nuts or organic dairy items can all be purchased for a very reasonable price.  If there is not a Costco in your neighborhood other mega stores, like Sam’s Club, Walmart, or Target, now carry fresh organic foods at a very reasonable price.

Please note that I have no financial relationship with Costco.

2. Go Big

Whole Foods doesn’t have to be “Whole Paycheck.”  If you buy in bulk they will give you a 10% discount on any food item at Whole Foods.

My wife just bought a 50 pound bag of fresh organic oats at Whole Foods.  By buying the 50 pound bag, in addition to our 10% bulk discount, this works out to be just pennies for each serving of organic oats.  Bulk sized bags can also be great for food storage in the event of a financial or natural disaster.

Once again, please note that I do not have any financial relationship to Whole Foods.

3. Skip Organic for the Clean 15

You don’t have to buy organic produce for everything.  For example, the pesticide residue is extremely low on these “Clean 15.”

If finances are tight then just spend the extra money for organic when it comes to the “Dirty Dozen.”

4. Buy Frozen Organic Fruits and Vegetables

If fresh fruits and vegetables are either not in season or too expensive then buy them frozen.  Flash frozen produce might even be packed with more nutrients than “fresh” produce that has been sitting in the grocery store for a few days.

A serving of flash frozen organic fruits or vegetables at Whole Foods is generally well under $0.50.  If you buy 10 bags they will even add on the 10% bulk discount.

5. Buy Nuts in Bulk at Costco

Costco has incredibly low prices for large containers of walnuts, almonds, pecans, pistachios, cashews, mixed nuts, etc.  Nuts are very filling and are extremely healthy.  If there is not a Costco near you, Amazon also sells nuts in bulk at a very affordable price.

6. Buy Legumes in Bulk

Lentils and beans are extremely cheap and are very nutritious.  Costco now sells organic lentils and beans in bulk.  Fortunately, canned beans appear to be just as healthy as dried beans.

Alternatively, you could work with your local Whole Foods to buy 50 pound bags of various dried lentils and beans.  Whole Foods even offers organic options at a very affordable price.

7. Don’t Buy Drinks

Water is still the healthiest thing you can drink.  Save your money on the fruit juices, sports drinks, soda pop, etc. and instead focus on drinking water.  To spice it up you can even add in a little lemon or lime.  Lemons and limes in bulk from Costco are very affordable.

If you like almond milk or coconut milk you can also easily make your own.  There are many websites which will walk you through the process.

8. Share a Meal at a Restaurant

Ever since Jane and I started dating in 1991, we always made it a habit of sharing our meals when we went out.  In those days we were both still in college and could not afford to each get our own meal.

To this day we still refuse to buy 2 meals when we go out.  Nothing frustrates us more than to have a restaurant charge us a “meal sharing fee.”  In addition to sharing an entree, we always both get a small dinner salad and a side or two of vegetables.

Not only does this allow us to order the healthiest items on the menu for a cheaper price, but it also helps us to keep our portion sizes in check. You would be surprised at how cheap restaurants often will sell a side of vegetables for.  Some restaurants will even throw in a side of extra vegetables for free.

9. Farmer’s Markets and Community Supported Agriculture (CSA)

Farmer’s markets and CSA are two other very affordable options to get very fresh organic produce.  Most cities in the U.S. have farmer’s markets or CSA opportunities during the warmer months.  We regularly participate in both in Salt Lake City.

10. Grow a Garden

Probably the very best way to get the most nutritious and cheap produce is to grow your own garden.  While we have struggled with this over the years, many have successfully implemented this option.

Even if you live in an apartment, you can still grow a small organic garden by your window or even on the balcony.  Flower pots can make a garden almost anywhere possible.

11. Buy an Organic Animal for Your Freezer

Organic or wild animal meats can be expensive.  This is probably a good thing so that animal meat becomes a treat or a condiment rather than the main fare.

A better option would be to buy a butchered organic animal and then put it in your freezer.  There are even options to buy a quarter of an animal if freezer space is limited.

12. Get Some Chickens

Some of our neighbors are now raising their own chickens for fresh organic eggs or even meat.  If you have a little bit of land and your local home owner’s association does not forbid this, it could be a great option.

As you can see, eating healthy does not have to be expensive.  Start today.

How do you eat healthy for cheap?

#087 Coconut Oil versus Olive Oil

April 1st, 2015 by

Coconut Oil versus Olive Oil

Is coconut oil or olive oil best for the heart?  In this interesting interview, I press Dr. Jared Bunch to answer this and other questions based on an article he recently wrote on Everyday Health.

In this podcast interview we discuss the following topics:

1. Why is it that the Vedda people living in Sri Lanka as well as some Polynesian cultures are protected from heart disease, despite many cardiac risk factors, by eating coconuts?

2. Is coconut oil good for weight loss?

3. How does coconut oil affect cholesterol levels?

4. What is the best type of coconut oil to buy?

5. Why does Dr. Bunch feel olive oil may be better than coconut oil for the heart?

This Podcast is Available on iTunes and Stitcher Radio

If you enjoyed this podcast, please subscribe to the Dr. John Day Show in iTunes or Stitcher Radio.  Also, please be sure and recommend this podcast to a friend, family member, or coworker!

Transcription of the Coconut Oil versus Olive Oil Podcast

John: Hello and welcome to the Dr. John Day’s Show. I am so excited today to have as a guest, my partner, Dr. Jared Bunch. Dr. Bunch is a very famous cardiologist at Intermountain Medical Center. Please welcome Dr. Bunch.

Jared: Thank you. It’s a pleasure to be here.

John: Now, Dr. Bunch writes an article for the Rhythm of Life at Everyday Health. How many people read your articles last year? Was it like a million people?

Jared: Yes, from what I understand, we had over a million unique people looking into the article during the year. So quite a bit of people and quite a bit of opinion on the different pieces that are posted.

John: Definitely. Now Jared, one of your most recent articles certainly got a lot of attention.  I actually posted a link to this article on my Facebook page and I got a lot of shares and comments.  The article was on coconut oil versus olive oil. I loved this article. Certainly, coconut oil is very popular right now. Olive oil has been popular for quite some time. How did you come up with this concept to write about these oils?

Jared: I’ve been interested in olive oil for a long time as it’s been part of healthy diets, in particular, the Mediterranean diet.  Many of the people in Utah are quite interested in alternative therapies and alternative diets and more and more people are asking about coconut oil. We’re bringing in samples to try, and I had friends trying it and so I decided to research the topic further.

John: Interesting. You know though there hasn’t been a whole lot of data yet on coconut oil.  In contrast, olive oil has been around a long time.  Probably the thing that interests me the most is that there are a number of studies in the medical literature about coconut eating cultures.  These cultures eat coconuts everyday and they don’t seem to get heart disease despite other risk factors. For example, the Polynesians have issues with obesity, but yet some coconut eating Polynesian cultures have low rates of heart disease.  In your article, you talked about the Vedas people of Sri Lanka. Do you want to comment a little bit about that?

Jared: Yes, the Vedas people were one of the most interesting aspects of what I learned about coconut oil.  Another term for them were the “tree people,” and they live in these small communities in Sri Lanka. Their diet – their routine diet – mainly is coconuts, and wild game they can catch. Depending on the season of the year they also eat different fruits and vegetables.  But really from day-to-day, they count on game meat and coconuts. These people just don’t develop heart disease.  Many of them do die from other things, like hunting accidents.

Researchers have gone out and performed the traditional tests we use here in the United States to look for heart disease–looking at them with imaging, on stress test studies, and even with our current technology, they did not find heart disease or evidence of early heart disease in this population. So these were people that really have preserved healthy hearts throughout their life.

John: It’s really fascinating. How can this group of people smoke and do other things, but yet the coconuts seem to be protective. And what about when they move into the cities? Once they move into the cities they may lose some of that social cohesiveness that may have helped to promote health and longevity.

Jared: That’s one of the interesting things when you look at healthy populations.  The first question that a lot of researchers have is, “Well, is it their genetics?”  Perhaps it was their lifestyle and the culture they lived in that was healthy. So these people, many of them had to move in to the city due to various stresses on their habitat, and there they adopt more of the common lifestyle of the Sri Lankans, and approximately 40% begin to smoke. They have jobs that aren’t quite as active, but they do continue to eat coconut, and their incident of heart disease is about one in a hundred thousand, which is far below the risk in our country on orders of magnitude – not even a percent. Even though they’re smoking, they’ve been urbanized, they’ve changed their surroundings, and they start to smoke, and fortunately, they still don’t have a lot of heart disease.

So that does bring up a suggestion of the significance of their genetics, but it also brings up the lifestyle they carry with them, and that’s their tendency to consume a lot of coconuts – about 200 a year.

John: Wow. Now can we replicate that here in the United States if we start using coconut oil?

Jared: That’s a great question. I don’t know if I could eat 200 a year. I could probably drink 200 pina coladas a year [laughter]. I don’t know if I could eat a lot of coconuts, but that’s what you would hope. You’d hope to learn from people that have been able to evade disease. So we have to look at their lifestyle and say, “What can we do?” We probably can’t go and shoot small game, live in a jungle, and be very active in a small community, but we can eat healthier and one of possibilities is enriching our diet with more coconut.

John: Interesting. It seems like – at least on the internet – that coconut oil seems to be good for everything. We’ve talked about heart disease. Another thing is that a lot of people are saying coconut or coconut oil may also help with weight loss. Is there any truth to that?

Jared: Yeah, there is. That is one of the areas of coconut oil that truly has been studied as a means to lose weight. They took 20 obese men and they had them consume about 30 milliliters of coconut oil a week and that’s not a lot. Some people who try it say, well, it changes the flavor in things. It adds a coconut flavor. I can eat it for some things, but I can’t for other things. But 30 millimeters of oil over a week isn’t that much even if you tend to use it just for certain food sources. In obese men, that was the only change they made to their diet. Their weights decreased. That’s fairly significant without changing any other variable, so that gave us some excitement about the potential of weight loss product. It does stem from being rich in medium chain fatty acids. These are healthy for our bodies. They are healthy nutrients, but it does take the body a little bit more energy to break them down into useful products. Things that take the body more energy to break down consume more calories and then you get more weight loss. And so those are exciting aspects of coconut oil.  It also gives promise for future studies as a weight loss dietary aid.

John: Yeah, very fascinating. As a cardiologist, you see patients all the time with high cholesterol. What is the impact of coconut oil on cholesterol levels? Is that something we need to worry about?

Jared: This one’s a good one for me because as a Caucasian white male, I suffer from a slightly high LDL or bad cholesterol and a slightly low HDL, good cholesterol, so it’s a bad mix. And a lot of people with a Northern European ancestry have this trouble, as well.  Not a lot of things raise good cholesterol. Exercise does a little bit. Red wine does a little bit. Coconut oil is one of the things that does as well. It does raise the good cholesterol. Now it does raise bad cholesterol as well. And that’s from polyunsaturated fats.  Polyunsaturated fats are one of the unhealthy by-products of meat consumption. But when we consume them in an oil – in a plant oil – these are what make the plant oil opaque. It’s a different type of polyunsaturated fat . It does raise that protective healthy cholesterol. We often see in clinic people that have slightly high LDLs, but if they have a very high protective good cholesterol, HDL, then they’re relatively protected from heart disease. It is a unique medication for those two aspects of cholesterol management. And clearly if it helps with weight as well, then weight loss can lower LDL on its own. Sometimes when you adopt coconut oil to a healthy lifestyle with other things that lower LDL, you’ll overall come out a winner.

John: We’ve talked about how the Vedda people and some Polynesian cultures are protected from heart disease by eating coconuts.  We have also talked about weight loss from coconuts. Coconut oil tastes great. Also, it seems to be relatively benign on cholesterol. Why is it in your article that you gave the nod to olive oil as the better of the two oils?

Jared: I think it comes from a few things. It sounds almost like I’m a politician [chuckles]–

John: I have to pin you down on this.  I was actually surprised when I read through the comments on this article you wrote for Everyday Health.  I would’ve predicted that the readers would have beaten you up on this point. People were very kind to you with their comments [chuckles].

Jared: Well, I think they’re kind in general to me because they know I’m a novice at this. I think one, they knew I gave coconut a good shake, and I’m still optimistic about it. I think there are three reasons.

One is there’s just so much more data on olive oil. Olive oil is part of some of the most healthy heart friendly diets that we know of. The Mediterranean Diet has numerous studies that show that it lowers cholesterol, heart attack risk, and stroke risk–olive oil is the main product of this healthy diet. So coconut oil is a newcomer. It may reach the same level of success as olive oil, but it’s going to take some time and adaptation across many cultures. The Mediterranean diet not only helps a White race or an Asian race, it has been shown to help races of all kinds throughout the world. So I think that’s where olive oil has a strong lead on coconut oil.

The second is coconut oil contains more calories. So it can in larger quantities lead to some weight gain.

And then I think the third thing that I’ve realized after I wrote this column is people– it’s easier to add olive oil to a lot of food. For example, even today, I was speaking to a friend who is just starting to use coconut oil, and he used it on some eggs, and he served his family the eggs and the eggs had a coconut taste to it. And so he thought, “These eggs taste good, but there is something just different.”

John: Something different about these eggs?

Jared: Yes. So if you add them to brownies or omelets it has a little coconut flair to it. So it takes some time to get used to it and perhaps that’s what our brains told us when we added olive oil instead of canola oil or corn oil. But that, I think, takes a little bit of time to get used to.

But I think that’s a distant third, where the number one is the rich research we have with olive oil.  And in time there will be more and more articles coming out on coconut oil.

John: With all of this, what oil do you use in your home?

Jared: We have lots of olive oil. And partially after writing all of that, we still do use a lot of oil, but we’ve started to substitute coconut oil to see whether it has a role in our family. We’ve used it in things like waffles and pancakes, things that are more sweet, and brownies to substitute for more traditional oils and it works. It’s almost seamless in those, and actually it’s quite good. I haven’t yet tried it on things like eggs and some things that were traditionally consumed in a Mediterranean diet with olive oil, so I need to try and experiment one at a time and see if I like that flavor. But I’ve come to really enjoy olive oil. I use it on most of my vegetables and most of the dishes we cook and so it’ll take some time. We go through a lot of olive oil in our house.

John: Sure. So, at the end of the day it really comes down to a personal decision. Both of these oils appear to be heart healthy. There is a lot more data on olive oil than coconut oil. What type of coconut oil should our listeners buy?

Jared: There’s two main products out there. There’s what we call virgin coconut oil and this is coconut oil that is removed from coconut milk through a process called wet extraction. It’s largely free of refining, and it’s thought to be quite healthy, because it minimizes any loss of the elemental properties of the oil, through refinement and processing. There’s a second one called copra oil, and now this is removed from the coconut meat, the dry meat itself, and it requires some deodorizing, some bleaching, some refining, and it’s thought that in the process of making this ready as a food source, it loses some of the heart-healthy benefits like phenols and antioxidants. And so generally, we’d recommend using the virgin coconut oil products. You’ll see a lot of debate about these on the internet, as to how to classify what’s virgin, extra virgin, etc.  Those standards really aren’t in place, but we want to use the least refined oil as possible, the purest elemental source in order to hopefully take advantage of a lot of the natural nutrients in it without exposing ourselves to some of the things that can occur through processing of the product.

John: Sure. Certainly, if you’re making salad dressings or using it with vegetables dipped in hummus or something like that, olive oil seems to make a lot of sense. But what about for cooking? With the low smoke point of olive oil, is that potentially an issue when cooking?

Jared: Yes. Smoke points can influence what type of things you cook with. Olive oil has a lower smoke point and so it will develop smoke at lower temperatures. Coconut’s a medium range smoke point, so you’re able to cook at a little bit higher temperature. And then your peanut and sesame seed oils have very high smoke points.  For most of the cooking we do at my house we can get away with olive oil because we cook at lower temperatures.  If you are a true chef and you use a variety of ranges and cook hot, coconut oil may have an advantage compared to olive oil.

John: Sure. Maybe as we are starting to come to the end of this podcast, what are some of the most interesting uses of coconut oil that people are promoting on the internet these days?

Jared: The more people that venture into coconut oil, the more applications are promoted on the internet. In fact, there’s a site called the Wellness Mama and this person recently put out 101 unique uses of coconut oil. Everything from helping keep away diaper rash to psoriasis. They promoted it to help with skin– for sunbathing, helping your fingernails grow, there’s lots of things. If you have an interest in the many potential applications, you can go to the Wellness Mama website It’s welnessmama.com and you’ll see a very interesting article of 101 unique ways to use coconut oil including how to make your own soap of coconut oil [chuckles].

John: That one I haven’t yet seen. Now certainly for those who were following the medical news this week, there was an interesting study about researchers in Sri Lanka using coconut oil in rice to turn it into a resistant starch. Apparently, cooking your rice in coconut oil, then cooling it over night, and reheating it the next day dramatically lowers the glycemic index, as well as the calorie load of rice. So yet another interesting use of coconut oil [chuckles].

Jared: Well, this probably does promote the use of rice and coconut oil.  For the people in Sri Lanka, coconut oil on the skin appears to be something that helps reduce inflammation and itching from mosquito bites.

John: Sure. And even for us here in Salt Lake City with our dry climate, coconut oil has got to be better for your skin than some of the chemicals in commercial lotions.

Jared: Now that is an area with a lot of value as far as our experience. It does appear to be a very good lotion for the skin. And if you have an interest in that, people generally like the aroma of coconut, so it naturally blends into some of the various fragrances used in these products.

John: Yeah, definitely. So, if people want to learn more about you, how can they find your Everyday Health articles?

Jared: I would love to have them to read them, and to share them, comment on them and then also contact me if I can do better. If you go to everydayhealth.com and then go to the Healthy Living tab you will see the columns. If you scroll down, you’ll find Rhythm of Life .  I’m the only guy there.

John: Certainly. Do you agree with Dr Bunch’s conclusion that olive oil is the winner? You can leave a comment on his article or on my website below. We’d love to hear your viewpoint. Thank you so much Jared for participating with us on this exciting topic, and I look forward to reading the comments from our listeners. Thank you for tuning in.

#086 10 Surprising Ways to Stop Allergies

March 29th, 2015 by

10 Surprising Ways to Stop Allergies

Increasingly, more and more Americans are suffering from seasonal allergies.  Is it climate change or are we too “clean?”

Regardless of the cause, I will share 10 surprising ways to stop allergies.  What we eat may be more important in controlling seasonal allergies than taking medications or locking ourselves inside.

My AllergiesAllergy Season Ahead

I remember dreading my lawn mowing duties as a child.  My parents had an acre of land and it would take me a couple of hours to mow and trim the yard.

Each time I mowed the lawn my eyes became itchy, puffy, and watery.  If I rubbed my eyes too much they would sometimes become swollen shut.

My nose was even worse.  It would get so bad that I would have to breath from my mouth.

In those days we did not have any non-sedating antihistamines.  All that was available was Benadryl.  To survive the lawn mowing experience each week, I had to pretreat with 50 mg of Benadryl.  The problem was that Benadryl would make me so sleepy that I walked around like a zombie for the rest of the day.

Interestingly, my seasonal allergies seemed to disappear at about the same time I starting eating healthy.  At the time I did not give this much thought.  Could there be a scientific basis as to why my seasonal allergies resolved?

Is Climate Change Causing More Seasonal Allergies?

Many scientists have speculated that rising global temperatures are too blame for more seasonal allergies.  Warmer temperatures mean longer growing seasons for plants and longer pollen exposure for us.  Indeed, scientific studies have now shown that climate change is making the allergy problem worse.

Hygiene Hypothesis

The hygiene hypothesis states that because we are not being exposed to enough dirt, bacteria, fermented foods, etc. during childhood, our immune systems fail to develop properly.  Indeed, studies show that an immature immune system may lead to a higher risk of allergies, autoimmune diseases, and even Alzheimer’s Disease.  While the hygiene hypothesis is most important for children, even adults might benefit from getting dirty once in a while.

Crete: The Land without Seasonal AllergiesChania, Crete

Is it possible to live in a place where people don’t suffer from allergies?  Crete is one such place.

Crete, the legendary birthplace of Zeus, is a small Greek island in the Mediterranean.  Besides being known for their exceptionally healthy lives, the people in Crete also rarely suffer from seasonal allergies.

As researchers have studied this phenomenon, they have concluded their their exceptionally healthy Mediterranean Diet protects them from the usual seasonal allergies.

While I am not suggesting that allergy sufferers should move to Crete, what I am saying is that there are powerful lessons we can learn from these people to prevent seasonal allergies here in the U.S.

10 Surprising Ways to Stop Allergies

While most people assume that the key to fighting seasonal allergies is to lock yourself up indoors or take medications, few understand how our diets can determine if we will even react to pollen in the first place.  To help you conquer your seasonal allergies this year, let me share with you 10 surprising ways to stop allergies.

1. Eat Fermented Foods (Probiotics)

Through mechanisms that have not fully been worked out, fermented foods or probiotics seem to protect us against seasonal allergies.  Many studies have confirmed this finding.  Perhaps by introducing fermented foods we are helping to retrain our immune systems through the “Hygiene Hypothesis.”

2. Eat GrapesLarge bunches of ripe black grapes on vine

Interestingly, half of all children living in Crete eat grapes each day.  Those who eat grapes regularly are 81% less likely to suffer from seasonal allergies or asthma.

In particular, red grape skins may be the most protective part of the grape.  Researchers aren’t sure if it is the antioxidant effects or the resveratrol in the red grapes that offers allergy relief.

3. Go Nuts

In addition to protecting your heart and brain, nuts also seem to protect against seasonal allergies.  Indeed, eating nuts 3 or more times a week has been shown to cut seasonal allergies in half.  Once again, it could be the antioxidants of nuts or even the vitamin E that is protective against seasonal allergies.

4. Eat Oranges

Orange eaters experience 70% less seasonal allergies.  Other studies have shown that even vitamin C, from any source, may help to protect against allergies.

5. Love Fish

In addition to the heart healthy effects of fish, fish has been shown to decrease the risk of seasonal allergies by 55%.  The high omega 3s of oily fish are known to decrease inflammation and may help the immune system to better behave when exposed to pollen.

6. An Apple a DayPicking An Apple

While an apple a day won’t keep the pollen away it just might keep the allergy doctor away.  Studies show that apple eaters are 86% less likely to suffer from seasonal allergies.

7. Eat Fresh Tomatoes

Tomatoes are yet another superfood when it comes to preventing seasonal allergies.  Indeed, studies have shown that tomatoes can reduce seasonal allergies by 68%.

8. Minimize Animal Meat

In a large study of 156,035 Australians, researchers reported that those who ate the most animal meat were 18% more likely to develop seasonal allergies.  Animal meats are well known to increase inflammation and oxidative stress.

As this was just an observational study, it is not clear whether it was how the meat was prepared or whether it was animal meat from fast food restaurants that contributed to the increased risk of seasonal allergies.

9. Minimize Dairy Except for Yogurt with Live Bacterial Cultures

From the same Australian study, dairy also appeared to increase the risk of seasonal allergies by 18%.  This is not surprising as dairy is one of the most common causes of food allergies as well.  However, yogurt with live bacterial cultures, has been shown to consistently decrease the risk of seasonal allergies.

10. Avoid Processed Foods

One thing that has been consistent with many studies is that people eating the “Standard American Diet” (SAD), which is high in processed and prepared foods, have a much higher risk of developing seasonal allergies.  For example, even eating margarine once a week more than doubled the risk of developing allergies.

The Anti-Allergy Diet

To put all of these data together, the best way to avoid seasonal allergies is to eat a healthy diet.  The diet which has been shown to fight allergies is one high in fruits, vegetables, nuts, fish, and fermented foods while low in animal meat, dairy (except yogurt with live bacterial cultures), and processed foods.  In other words, this is the Mediterranean Diet or the diet eaten faithfully by most people living in Crete.

While living in Crete would be nice, a Mediterranean Diet may be all that is needed to escape your allergies this year.

Have you found that a healthy diet has helped you with your seasonal allergies?  If so, please share your experiences below in the comments section so that others may benefit.

Disclaimer

If you suffer from seasonal allergies, please work with your physician to treat this condition.  You may have specific health conditions that require a diet different from the Mediterranean Diet.  Please do not self diagnose or treat based on anything that you have read in this article.

#085 How Much Calcium Do You Really Need? You May Be Surprised…

March 21st, 2015 by

How Much Calcium Do You Really Need?

No one wants brittle bones or to be hunched over.  While the American Dairy Association would have us believe that the answer is to drink more milk, some studies suggest that more milk might actually make things worse.  Popping calcium supplements instead may just increase your risk of a heart attack.  In this article, I’m going to share six things you need to do for strong bones and attempt to answer the question, how much calcium do you really need?

My Calcium Story

The milk industry had convinced me that “got milk” meant “got healthy bones.”  My favorite was this commercial where Mr. Miller’s arms fall off because he did not drink his milk.

For years I tried to follow our government’s advice and get my 3 servings of dairy each day for calcium.  Also, for the first 40+ years of my life I suffered from acid reflux.

When I was young I thought heartburn was “normal” so I never mentioned it to my parents.  As an adult I would buy the “Costco packs” of omeprazole (Prilosec) to make sure I always had enough on hand for my heartburn symptoms.

I also frequently got food stuck in my esophagus.  I thought this was something I had to live with as it was present from my earliest childhood memories.

In my early 40s, while racing to finish lunch prior to a surgery, I got a small bean stuck in my esophagus.  I could not dislodge the bean.  I was panicked because my nurse was paging me to start a surgery.

Fortunately, my partner was able to help me with the surgery as I needed an urgent endoscopy to remove the bean.  I had the endoscopy done without any sedation so that I could get back to my patients.  With the endoscope, my gastroenterologist could clearly see that my esophagus was severely inflamed, narrowed, and scarred from years of untreated eosinophilic esophagitis (EE).

I was put on a steroid and a high dose of Nexium.  I was also told that eosinophilic esophagitis is often due to food allergies and that it was usually a waste of time to try and find the specific food allergen.

Shortly after this time I hit my health crisis.  As part of my turn around, I cut out sugar, processed carbs, dairy, and animal meat except for an occasional wild fish.

I’m really not sure what “cured” me of acid reflux and eosinophilic esophagitis.  Perhaps it was the diet or the nearly 40 pound weight loss that came from eating this way.

Regardless, it is interesting to note that both lifelong conditions did go away when I changed my diet.  If I occasionally have dairy, the heartburn symptoms may come back.  While I have never been tested for food allergies, I suspect that I may have a food allergy to dairy.

When I discovered this possible food allergy to dairy, I started taking calcium supplements to ensure I was getting my recommended 1,000 mg of calcium each day.  However, after seeing the studies linking calcium supplements to heart attacks, I stopped these supplements.  Am I putting myself at risk of developing osteoporosis?

How Much Calcium Do You Really Need?cow and milk

Our government recommends 1,000 mg of calcium each day for adults.  Older Americans need to target 1,200 mg.

Having enough calcium is critical for our bones and teeth.  If there is not enough calcium, the body may pull it from our bones. Osteoporosis occurs when our bone mineral density is low.

Interestingly, the U.S. and Northern Europe have the highest dairy intake in the world. Despite this high dairy consumption, the U.S. and Northern Europe also have the highest rates of osteoporosis and hip fractures.  If dairy is the only answer, how do you explain these findings?

Do We Really Need 1,000 mg of Calcium Daily?

Is 1,000 mg of calcium really our daily target?  What will happen if we don’t reach this number?

Of course, there is a certain amount of calcium that we need each day in our diet.  Studies of animals who are deprived of calcium consistently show that they develop osteoporosis.

When researchers have looked at this question, they have been very surprised.  Getting the targeted amount of calcium, either through dairy or calcium supplementation, does not decrease the risk of bone fractures.  Surprisingly, some studies have even shown that getting more calcium may actually increase your risk of fractures.

Non-dairy eating cultures, like Asia, typically get very low amounts of calcium in their diets.  Indeed, in countries like China where 92% of people are lactose intolerant, their risk of fractures may be six times lower than the U.S.!  Of course, these are studies of Chinese eating their ancestral diet, which was real food, rather than a “modern” diet.

The bottom line is that we really don’t what the right amount of calcium is.  For example, some studies suggest that 300 mg may be okay for physically active Asians eating an ancestral diet.  For those of us living in the “modern world,” the number is probably much higher.  As everyone has different calcium needs, please speak with your healthcare provider to determine what the right number is for you.

What Are the Best Non-Dairy Sources of Calcium?stamp printed in Republic of Guinea commemorates the birth of Po

Contrary to what the milk industry would have us believe, there are also natural non-dairy sources of calcium.  For example, the following things are all very high in calcium:

1. Mineral water

2. “Greens” (spinach, broccoli, kale, etc.)

3. Sardines and canned salmon

4. Sesame seeds

5. Almonds

6. Legumes

7. Oranges

To put the recommended 1,000 mg of daily calcium into perspective, you could get 100% of your daily needs from 143 almonds.  Likewise, you could hit the same 1,000 number with either 6 oz of tofu or four cups of cooked spinach.  As you can see, by combining your daily greens with almonds, legumes, and fruit you can easily hit the daily calcium goal.

Since I have been tracking my daily calcium intake with the free Cronometer app on my smartphone, I consistently crush the 1,000 mg goal without the need for dairy.  For example, I hit 165% of my calcium target yesterday (1,675 mg) mainly from lots of greens and natural mineral water with some legumes, almonds, and fruit.

6 Ways to Prevent Osteoporosisbigstock-Fracture-Distal-Radius-forear-78727889

If dairy and calcium supplements are not the only answer to preventing osteoporosis, how can we prevent this debilitating condition?  As no one wants to walk around hunched over, let me suggest six strategies to prevent osteoporosis.

1. Stay Physically Active

Physical activity is the best way to keep your bones strong.  Weight bearing activities like walking, hiking, running, dancing, skiing, weight lifting, etc. are particularly important.

You would think that Tour de France cyclists would have exceptionally strong bones from all of their grueling training.  Interestingly, world class athletes performing non-weight bearing sports, such as swimming or cycling, often have much weaker bones.

The same is true for astronauts.  Within just a few days in space astronauts will lose 20% of their bone mass.

Gravity really is our friend.  Weight bearing exercises are critical for bone health.

2. Get Enough Vitamin D

Vitamin D is critical for healthy bones.  Studies show that your risk of osteoporosis is also determined by your latitude.  For example, the farther you live from the equator the higher your risk of osteoporosis.  Sadly, the strong media messages warning us of the dangers of sun exposure and skin cancer may actually be increasing our risk of osteoporosis.

Unfortunately, if you live in a higher latitude city, like our family in Park City, it is simply impossible to get all of your vitamin D needs from the sun alone.  There are some foods, like salmon, which are very high in vitamin D.  Besides fish, other natural sources of vitamin D include milk, eggs, and mushrooms.

For most people living in higher latitude cities, vitamin D supplements are often required to maintain normal vitamin D levels during portions of the year.  To find out if you are vitamin D deficient, please speak with your physician about getting tested.

3. Get Enough Vitamin K2

An often overlooked aspect of good bone health is vitamin K2.  Most people have simply never even heard of vitamin K2.

The role of vitamin K2 is to put calcium in your bones and keep it out of your arteries where it can cause heart disease.  Indeed, studies have shown that getting enough vitamin K2 in your diet not only strengthens your bones and teeth but also prevents heart disease.

The very best food source of vitamin K2 is natto or fermented soy beans.  Natto is considered a delicacy in Japan. Perhaps this helps to explain why osteoporosis and heart disease are so much lower in Japan than the rest of the world.

We can also get some vitamin K2 from the conversion of vitamin K1 to K2 by our bodies.  Foods high in vitamin K1 are greens like spinach, broccoli, and kale.  Other foods high in vitamin K2 include liver, eggs from grass fed chickens, and some cheeses like gouda and brie.

To read more about vitamin K2 and see if you have these 9 signs of vitamin K2 deficiency, please read the article I wrote on this subject.

4. Get Enough Calcium

While our government recommends at least 1,000 mg of calcium daily for most adults, we really don’t know exactly how much calcium we need each day.  If you do take calcium supplements, some studies suggest that supplementing calcium alone may increase the risk of osteoporosis.  Calcium may be most beneficial when it is consumed with the right amount of vitamins D, K2, A.

When tracking your calcium intake from food, don’t forget about the contribution from water.  Indeed, the “harder” your water, the higher your daily dose is of calcium and magnesium.

5. Avoid Very High Protein Diets

Although the science has not fully been worked out, some studies suggest that diets off the chart in protein may weaken bones.  Indeed, studies show that the excessive amounts of protein that some people eat puts them at higher risk of hip fractures.

6. Avoid Soda Pop

Did your Mom tell you that soda pop was bad for your bones?  It turns out that this advice may be true.

Many researchers feel that the phosphoric acid in soda pop alters the phosphorous/calcium balance in the body.  Perhaps this is why many studies have shown that soda drinkers are more likely to have osteoporosis and fractures.

Instead of soda pop, choose water instead.  Mineral or “hard water” is very high in natural calcium.  As long as you are not drinking reverse osmosis water, you are getting some calcium in every glass you drink.

Disclaimer

Please discuss how much calcium, vitamin D, vitamin K2, and vitamin A you need with your physician.  Also, please work with your physician to minimize your risk of osteoporosis.  Do not self diagnose or treat based on anything that you read in this article.

#084 How to End Loneliness with These 7 Strategies

March 13th, 2015 by

How to End Loneliness with These 7 Strategies

Would you believe me if I told you that loneliness and social isolation was more dangerous to your health than smoking or even being an alcoholic?    How about twice as dangerous as being obese?

Do you ever feel alone in a room full of people you don’t know?  I know I often feel this way.

Over the last 20 years the number of people in America who said they have no one to talk to has tripled!  Is it the internet, our cell phones, or all of the demands that are placed on us that are causing us to feel more lonely and become more socially isolated?

Social Isolation

Why are we becoming more socially isolated?  Facebook was supposed to keep us in touch with friends and family, right?

This is something I see everyday in my cardiology practice.  Increasing job stress, family responsibilities, and our cell phones are making our lives more unmanageable.  The very technology that was supposed to make it easier for us to connect with others is paradoxically making us more socially isolated.

While I am fortunate to have a very close family, I must admit that with the many demands that I face it is hard for me to invest enough time in developing close friendships.  Do you have the same challenges?  Is this putting our health at risk?

Why Do Asians Live Longer?

According to the World Health Organization, 3 of the top 4 countries with the longest lifespan are all in Asia (Japan, Singapore, and Hong Kong).  What is it that allows Asians to live so much longer than the U.S. and the rest of the world?

Since my immersion in the Asian culture at the age of 19 as part of my volunteer church service within the New York City Chinese immigrant community, I have been fascinated with the very close social support system of Chinese families.

Multiple generations all live under the same roof.  Each generation contributes to the other generations in the home.  Everyone is needed and everyone has an important role to play.  No one is isolated and no one is put “out to pasture.”  This cultural approach is completely opposite our very independent spirit in the U.S.

We saw this same social support system in China’s Longevity Village.  In fact, a study of China’s centenarians in Bama, County where the Longevity Village is located, showed that 74% of the centenarians lived under the same roof with 4 or 5 generations!

Could this close family support system be the secret to their longevity?  Or is it the fact that very few people live alone in Asia?

Friends and Family Are the #1 Longevity Factor

In one of the biggest studies ever done to explore the role of friends and family on longevity, Dr. Julianne Holt-Lunstad from Brigham Young University (BYU), published a study of 308,849 people.  In this study she found that of all the common longevity factors, such as exercise, maintaining a healthy weight, or not smoking, that being socially connected was the most important.  Indeed, her study showed that people who were socially connected lived 50% longer!

With regards to mortality, here are the key findings of this study:

1. Social isolation is more dangerous than smoking 15 cigarettes a day

2. Social isolation is more dangerous than becoming an alcoholic

3. Social isolation is twice as dangerous as obesity

As a cardiologist, these data surprised me.  Is loneliness really more dangerous than smoking? In my cardiology training at Stanford University, I was taught that heart disease and longevity had more to do with diet, lifestyle, smoking status, and genetics than not having enough friends and close family members.

If these data are really true, why is it that so little is mentioned about the important role of friends and family members on the American Heart Association’s website?  I had to find out more…

A Behind the Scene Look at the Loneliness and Longevity Study

To get a better understanding of the implications of this study, I was able to catch up this week with the lead researcher, BYU’s Dr. Julianne Holt-Lunstad, who is currently living in the Netherlands on a sabbatical research assignment.

I asked Julianne how she even became interested in this subject.  She shared with me that she has been interested in the role of friendships and family relationships to cardiovascular health and longevity for the last 10-15 years.  She told me that she always knew there was a link but even she was surprised that relationships have twice the impact on longevity as obesity and even carry more weight than smoking 15 cigarettes a day or being an alcoholic.

Her study involved pooling all of the data from 148 previous studies on the subject to draw an even stronger statistical correlation.  To help explain the results of this study, she has published additional research showing that relationships can influence our blood pressure, heart rate, and stress levels.

While having strong relationships can certainly help us to eat better, exercise more, or even go to the doctor’s office regularly, Julianne shared with me that these factors were not even included in the results of her study.  In other words, the longevity benefits of relationships go beyond just trying to live healthier to be around longer for your family and friends.

Is it Social Isolation or Perceived Loneliness that Increases Risk?

As part of my conversation with Julianne we touched on the topic of whether it is actually loneliness or just perceived loneliness that impacts our lifespan.  This topic lead nicely into her most recent research which you may have seen in the news recently.

Once again, this was another large meta-analysis study which included 70 independent studies of 3,407,134 people followed for an average of 7 years.  Here are the key findings of Julianne’s even larger study:

1. People who reported feeling lonely were 26% more likely to die

2. Socially isolated people had a 29% increased mortality

3. People who live alone were were 32% more likely to die

As you can see from this data that both living alone and the subjective feeling of loneliness were both powerful risk factors for an early death in this study.  Julianne shared with me that when both were present this was a particularly dangerous sign.

At our very core, we are programmed to be socially connected.  When we live disconnected lives it impacts our hearts and our health.  Our very survival depends on our ability to meaningfully connect with others.

How to End Loneliness with These 7 Strategies

Based on our work in China’s Longevity Village and from landmark studies, like Dr. Julianne Holt-Lunstad’s work discussed in this article, I now encourage my cardiac patients to spend more time with friends and family.  The healing that comes from close relationships likely offers more long-term benefits than any medications or procedures I can offer.

Social isolation and perceived loneliness, can both be difficult to overcome.  As I am, by nature, an introvert I have had these same struggles as well.  Let me share with you 7 strategies that I have found helpful.

1. Reach Out to Others

I realize that when you feel lonely the natural tendency is to expect others to reach out to you.  The important thing to remember is that studies show that 90% of people report feeling shy or lonely as well.

In reality they are hoping that you will reach out to them as they are feeling the same way.  Break the ice and be the one who reaches out first.  Be the person to talk to the person sitting next to you at the school function, church meeting, or the sporting event.

2. Focus on the Needs and Feelings of Others

Sometimes when people are feeling lonely they have too much bottled up inside of them. When they then do get the chance to talk with others they dominate the conversation.

My grandmother was this way at the end of her life when she was more socially isolated.  When I regularly reached out to her it was hard for me to share my feelings as she needed to talk.  I knew she was lonely and would let her talk. This is something that I often see with my lonely patients as well.

If we are feeling lonely inside it is critical to remember to also be interested in the needs and feelings of others when we have opportunities to connect.  If you want to end loneliness then others need to feel that you really care about them.  Give others the chance to share their feelings.

If they feel you care they will love you back.

3. Reconnect with Old Friends

It is always easier to reconnect with an old friend than to find a new friend.  With the powers of the internet, nearly every old friend can be found.

As I have reached out to old high school friends, medical school classmates, and extended family members, I am always amazed at how excited they are to be reconnected. Life is too short to live without our old friends!

I challenge you to connect with one old friend this week.

4. Volunteer

Unfortunately, only 27% of Americans take advantage of all the health benefits that come with volunteering.  Volunteers, by definition, are more socially connected in ways that really matter.  Perhaps this is why studies show that volunteers are happier, healthier, and even live 22% longer!

I have found that my volunteer opportunities keep me connected to people I would never have connected with otherwise.  Volunteering can take on many different forms.  It could be at your church or even your local hospital or elementary school.  There is so much you can contribute!

5. Get a Dog

Many studies have shown that having a pet, especially a dog or a cat, can help to prevent heart disease and increase your lifespan.  While there are many possible explanations for these benefits, one of the most important, and least understood, is the benefit of companionship that comes with an animal.

Perhaps this is why the American Heart Association recently published a position statement recommending pets, especially dogs as the data are strongest with dogs, as a way to prevent heart disease.

Believe or not, dogs will actually help you to connect with more people.  Everyone loves a friendly dog.  Dog owners also tend to congregate at parks and schools where dogs can be exercised.

6. Find People Like You

While the internet, Facebook, and Twitter can paradoxically make us feel more alone, these technologies do have the capability of helping us to identify more people like ourselves.  With a simple search you can instantly find thousands of people just like you.

Once you identify these people look for opportunities to meet in person.  If you are that person who loves to quilt or scrapbook you may be amazed to find that there just may be a group meeting in your neighborhood!

7. Don’t Forget Your Family

Of all the strategies listed, this is probably the most important. Our families are key to our happiness and our health.  This is something that they understand in Asia and many other areas of the world.

While we don’t have to live as multigenerational families under the same roof, we do need to stay in touch with our family.  I realize that sometimes it can be hard with our busy lives but from a larger perspective our lives really do depend on it!

What have you found that works to prevent feeling lonely?

#083 How to Maintain a Healthy Weight

March 13th, 2015 by

How to Maintain a Healthy Weight

All her life Mary struggled to maintain a healthy weight.  She had spent thousands of dollars on all of the diets and programs.  When I saw her in my cardiology clinic she even described herself as the “poster child for the yo-yo dieter.”

Half of all Americans are worried about their weight.  Unfortunately, the deck is stacked against these people as studies have shown that up to 98% of dieters will regain all of their weight in just 2 years.

We all know people who have beaten the odds.  These “outliers” have somehow lost the weight and kept it off.  What secrets can we learn from these outliers that will help us to maintain a healthy weight?

10,000 People Who Lost 66 Pounds and Kept it off for 5 Years

In 1994 researchers Rena Wing from Brown University and James O. Hill from the University of Colorado were convinced that there had to be more people who had successfully lost and maintained their weight loss.  TFemale feet on bathroom scale with question mark symbolhey also wanted to understand what were the most important factors to successfully maintaining a healthy weight.

This collaboration led to the formation of the National Weight Loss Registry.  They advertised widely and have now collected a group of 10,000 people who have lost an average of 66 pounds and have successfully kept that weight off for 5.5 years. From these 10,000+ outliers they have published many scientific studies.

The key message from the National Weight Loss Registry is that successfully keeping weight off is very possible.  With a few simple techniques we can all maintain a healthy weight!

Intentional Versus Unintentional Weight Loss

I should point out that in this article I am defining successful weight loss as intentional weight loss.  Often, people may experience significant unintentional weight loss.  If this occurs, physicians need to know immediately as this could be a sign of a significant hormonal or metabolic abnormality or even an undiagnosed cancer.

The Number 1 Factor in Maintaining a Healthy Weight

Study after study has shown that the secret to maintaining a healthy weight is to exercise about an hour a day.  Data from the 10,000+ successful people in the National Weight Loss Registry also showed the same thing.  Of these 10,000+ people, 90% of them reported exercising an hour a day as their strategy to keep the 66 pounds off for more than 5 years.  The main exercise reported by these people was brisk walking.

IMG_8785I realize that in our hectic lives it can be very difficult to carve out an hour each day to exercise.  For me, this is why I use my treadmill and bike desks everyday (see photos).  This allows me to multitask so that I can both maintain a healthy weight and get my work done simultaneously.

Other ways to get in the hour of exercise while doing something else could be to bring a treadmill or stationary bike into your front room.  This can be a guilt free way to watch TV.

I also love a good book.  I have found that listening to books through Audible on my iPhone is a great way to “read” books and exercise at the same time.

If you are the type that does not have an hour to spare and would rather not exercise while doing something else, some studies report that high intensity exercise works just as well.  Thus, you could maintain your healthy weight by turning the intensity dial up.

Exercise: Weight Loss Versus Weight Maintenance

While exercise has been shown to be the number 1 factor in maintaining a healthy weight, I need to point out that exercise alone is rarely effective as a weight loss tool.  The reason is that to even burn 1 pound of fat (3,500 calories) it would require an enormous amount of exercise.

To put this into perspective let me give you an example.  If I ran a 4 hour marathon (26.2 miles) I would only burn 2,852 calories.  All of the effort in running a grueling marathon would not even burn 1 pound of body fat.

Thus, for weight loss eating the right foods in the right amounts is critical.  Once we get down to a healthy weight then exercise is critical to maintain the weight loss and avoid becoming part of that 98% that gains the weight right back.

Mary

In Mary’s case, her yo-yo dieting ended when she finally resolved to completely kick the sugar and processed food habit.  In addition to eliminating the sugar and processed foods it was also important for her to completely eliminate all simple carbs.  She made a simple rule that she would not eat anything that had a glycemic index of more than 50.

In addition to these simple dietary changes, she also committed to an hour of exercise each day.  This was the more challenging part for her as she had to change her daily routines and make some new friends to maintain this exercise habit.

These changes were made 3 years ago and she has not gained 1 of her 50 lost pounds back!  She is proof that it is not difficult to maintain weight loss.

The 5 Strategies of People Who Can Keep the Weight Off

There is much more we can learn from the 10,000+ success stories in the National Weight Loss Registry.  Here are the 5 main strategies used by these people.

1. Exercise

As mentioned, 90% of these successful dieters exercised about an hour a day to keep the weight off.  The main form of exercise reported was brisk walking.

2. Diet Changes

Fully 98% of the people in the National Weight Loss Registry reported that their diet had forever changed.  I have found that for many people, just getting rid of sugar and processed/prepared foods is all that is required to get down to a healthy weight.

3. Breakfast

Eating breakfast was reported as a successful weight maintenance strategy in 78% of the people. If you are not a breakfast person, you can still maintain a healthy weight as 22% of the people in the registry did not regularly eat breakfast.

4. Weigh Yourself Regularly

Weighing yourself at least once a week was reported as another key to success in 75% of the people in this registry.  While we can rationalize all we want about how we look, the scale doesn’t lie.  The scale can be a periodic “reality check” to make sure we are still on the right track.

5. Limit Your TV Time

Interestingly, 62% reported limiting their TV time to less than 10 hours per week as a successful strategy to maintaining a normal weight. To me, this means limiting the time you sit.  It is not just the TV but this would also apply to movies, surfing the internet, etc.

What strategies have worked well for you to maintain a healthy weight?  Do you agree with the 5 strategies reported by the 10,000+ successful people in the National Weight Loss Registry?

Disclaimer

Please work under the direction of your physician if you are trying to lose or maintain a healthy weight.  They can help to guide you and monitor your progress to minimize the risk of any problems that might arise from your efforts.

 

#082 3 Easy Ways You Can Optimize Dietary Iron and Cardiac Blood Flow

March 9th, 2015 by

3 Easy Ways You Can Optimize Dietary Iron and Cardiac Blood Flow

Conventional wisdom would have us believe that when it comes to iron in the diet, more is better.  New research suggests that eating too many iron rich foods may damage the heart.  In this article, I will teach you three easy ways to optimize dietary iron and cardiac blood flow.

Should Jennifer take the iron supplements her doctor prescribed?

Jennifer was borderline anemic.  In other words, her hematocrit and hemoglobin blood tests were in the low normal range.  Marci also had heavy menstrual bleeding each month.

While she wasn’t too concerned, her doctor recommended eating plenty of red meat and even prescribed iron supplements.  Marci, though, was worried about this treatment plan given her strong family history of heart disease.

Why are women protected against heart disease prior to menopause?

For years, cardiologists, like me, have wondered why women don’t seem to get heart attacks prior to menopause.  We used to think it was the estrogen that protected women until more recent studies showed that supplemental estrogen may actually increase the risk of a heart attack or stroke.

Hand drawing the symbol for the chemical element iron

Could the answer as to why women get heart disease 10 years later than men simply be because their iron levels are much lower?  It could be that these regular monthly periods may actually be a blessing for women by allowing them to get rid of extra iron through this monthly blood loss.

To support this theory, studies show that women that have irregular or just occasional periods have a much higher risk of a heart attack.  In men, regular blood donors have an 88% lower risk of a heart attack!

Were physicians from the Dark Ages actually onto something with their practice of blood letting?  It appears from these, and other studies, that those who regularly lose blood (and iron) from monthly periods or blood donating seem to be protected against heart disease.

Why Do We Need Iron?

If people who regularly lose blood (and iron) are protected against heart attacks, why do we worry so much about getting enough iron in our diet?

It turns out that we need oxygen to survive.  Our red blood cells carry all the oxygen we need to the rest of our body.  If we don’t have enough iron then we won’t make enough red blood cells and we will become anemic, like Marci.

Like with most things in life, there seems to be a “sweet spot.”  Iron is no exception.  Too much iron and we are at risk of a heart attack from iron overload.  Not enough iron and we become anemic which also puts us at risk of a heart attack.

Who is at risk for iron deficiency?

The main groups of people at risk for iron deficiency in the U.S. are menstruating women and young children.  Approximately 10% of women and 15% of young children in the U.S. suffer from iron deficiency.  People with ongoing bleeding issues are also at risk for iron deficiency.  In these people, they must focus on foods high in iron to avoid becoming anemic.

The Number One Group of People at Risk for Too Much Iron

At the opposite end of the spectrum is a genetic condition called hemochromatosis which affects up to 5% of the population.  Because of this genetic abnormality, these people hold onto iron and are at high risk of heart attacks, diabetes, and other conditions.

Studies show that even people without hemochromatosis, but still carry one copy of the gene, have a heart attack risk twice that of everyone else.  Also, just taking in too much iron may cause heart attacks regardless of whether they have hemochromatosis or not.

Which foods are highest in iron?T-Bone Steak On The Grill

Would it surprise you that red meat is one of the highest sources of iron in the diet?  Other forms of meat are also high in iron.

With our meat heavy diets in the U.S., our risk of iron deficiency anemia is much lower than most of the world.  For us, it usually is not the lack of iron but rather too much iron that may be the problem.

Iron in food comes in two different forms.  One is heme iron which is the type of iron found in animal meat.  Heme iron is easily absorbed by the body.

The other form of iron, non-heme iron, is the type of iron found in plant-based foods.  Non-heme iron is not absorbed as well from the gut.

Plant-based foods high in iron include some vegetables, like spinach, as well as legumes, nuts, and seeds.  Interestingly, vitamin C can help you to absorb more iron whereas foods high in calcium tend to block iron absorption.

3 Reasons Why Iron May Be Dangerous for the Heart

Researchers are still not sure why studies have consistently shown that people who eat a lot of red and processed meats seem to be at increased risk for heart attacks.  Processed meats include deli meats, hot dogs, pepperoni, sausage, etc.

In the past it was felt that it was the cholesterol and saturated fats in red and processed meats which caused the increased risk of heart attacks.  Now, as newer research has shown that dietary cholesterol and saturated fats are not as much of a problem for most people, researchers are looking for other explanations as to why red and processed meat eaters are more likely to have heart attacks.

1. The Iron Overload State

One possible theory is due to an iron overload state.  Studies have consistently shown that iron overload is associated with heart attacks.

2. Heme vs. Non-Heme Iron

A second theory may be that it is the type of iron that matters.  For example, high levels of heme iron, which is the type of iron found in red meat, is consistently associated with heart attacks in studies.  However, non-heme iron, or the form of iron found from plant-based sources, may prevent heart disease.

3. Iron May Damage Endothelial Cells

A third theory is that iron is directly toxic to the inner layer of our arteries.  This theory is supported by a recent Japanese study which showed that by injecting iron intravenously into young healthy men you could cause their arteries to constrict.  In addition, the oxidative stress, or “rusting” which comes from excessive iron may cause plaque build up within the arteries.

Can too much iron cause Alzheimer’s Disease?

Iron overload is not just dangerous to the heart but is also dangerous to the brain.  For example, iron overload states lead to iron accumulation in the brain which damages the hippocampus.  The hippocampus is the part of the brain responsible for our memories.

Indeed, iron overload has now been implicated as a cause of Alzheimer’s Disease.  Based on these studies, some researchers now recommend decreasing red and processed meats to protect against Alzheimer’s Disease.

What should Jennifer do?

In Jennifer’s case, her borderline anemia or low hematocrit/hemoglobin wasn’t any cause for concern.  Given her strong family history of heart disease, she focussed her efforts on optimizing her iron stores from non-heme iron.

To achieve this goal, she made sure to eat legumes like lentils or beans, spinach, and sesame seeds every day. As lentils, beans, spinach, and sesame seeds are very high in non-heme iron, things quickly changed.  After a couple of months of eating this way, her borderline anemia resolved and she had more energy than ever.

How to Optimize Dietary Iron and Cardiac Blood Flow

Iron overload is an increasingly recognized cause of heart attacks and dementia.  To protect yourself from the risks of iron overload, let me suggest the following:

1. Get Your Iron and Blood Levels Tested

Your doctor can order some simple blood tests to check your iron levels and to see if you are anemic or not.  If your levels are low, boost your intake of lentils, beans, spinach, and sesame seeds.  Even if your iron levels are normal, eating more non heme iron sources like lentils, beans, spinach, or sesame seeds is very safe unless you have hemochromatosis.

However, if your iron levels are high, or your have hemochromatosis, you may want to consider reducing meat intake.  Based on this information, you can then adjust your diet to optimize dietary iron and cardiac blood flow.

2. Minimize Heme Iron

If you are not menstruating or regularly donating blood, you may want to consider minimizing heme iron by limiting red and processed meats.  If your iron levels are too high, or you suffer from hemochromatosis, then you will definitely want to limit all meat intake.

Studies have not yet been done to see if the carnivores among us, or those who love meat with every meal, can be protected by donating blood to lower their iron levels.  Work with you doctor to determine what the right amount of meat is right for you to optimize dietary iron.

3. Donate BloodAob

If you are healthy enough to donate blood then you may want to consider becoming a blood donor.  As mentioned, studies show that blood donation decreases the risk of a heart attack by 88%.  While blood donation will definitely decrease your iron levels, other possible benefits of blood donation include lowering your blood viscosity and the benefits that come from volunteering.

Blood viscosity is a function of how well blood flows.  The more red blood cells you have the more blood tends to clump together which impedes blood flow.  Blood donors lower their blood viscosity by donating their red blood cells.  Studies have shown that a lower blood viscosity is associated with a lower risk of a heart attack.

There is also the possibility that much of the benefit of blood donation is from the volunteer effect.  Unfortunately, only 27% of Americans give of themselves as volunteers.  Those that do volunteer experience great benefits.  For example, a recent meta-analysis of 40 studies showed that volunteers, who gave at least 15 minutes of their time each week, lived 22% longer and were much happier.

If you are interested in experiencing the tremendous health benefits that come from becoming a blood donor, please speak with your physician to make sure it is safe for you.  Also, if you have any iron issues be sure to also work with your physician to optimize dietary iron.

#081 10 Ways to Boost Brain Function with BDNF

March 1st, 2015 by

10 Ways to Boost Brain Function with BDNF

Did you know that you have a 1 in 3 chance of developing Alzheimer’s Disease or another form of dementia? Is there a way to boost brain function now and prevent dementia later in life?

The solution may be to raise your BDNF levels. In this article I will share with you 10 ways to boost brain function naturally with BDNF.

What is BDNF?

Brain derived neurotrophic factor (BDNF) is a protein which can be thought of as “brain fertilizer.” BDNF helps the brain to develop new connections, repair failing brain cells, and protect healthy brain cells.  Having enough BDNF around can protect our brains from neurodegenerative diseases like Alzheimer’s Disease and Parkinson’s Disease.

When BDNF levels are high, acquiring new knowledge is easy, memories are retained, and people feel happier.  Indeed, BDNF can even be thought of as a natural anti-depressant.

Unfortunately, when BDNF levels fall the opposite occurs. People have difficulties learning new things, Alzheimer’s Disease and other forms of dementia occur, and depression is much more common.

Clearly we want more BDNF!

Airplane Pilots and BDNFPilot with airplane on a background of sky

As we age our BDNF levels naturally fall and we may find it more difficult to do the complex tasks that were much easier for us when we were younger.  Perhaps this explains why your parents or grandparents may not feel as confident driving a car as they did when they were younger.

Even worse, about 1 in 3 Americans have a mutation in the gene coding for BDNF so that in these people BDNF levels fall much faster than they should with age.

A few years ago Stanford University researcher, Dr. Ahmad Salehi and his colleagues, wanted to know just how well these people with genetically lower levels of BDNF with aging functioned with complex tasks over time.

To better understand this question, they designed a study whereby they had 144 airplane pilots, ages 40-69, perform an annual flight simulator test at Stanford University over at least a 3 year period of time. They found that in the pilots without the mutation that their scores and BDNF levels just slightly decreased over time.  However, in the pilots who had the mutation causing a much faster drop in BDNF levels with age, their scores on the flight simulator test dropped twice as fast as those without the mutation.

The message of this study is that BDNF levels naturally decrease with age.  However, for the 1 in 3 people with the mutation in the gene coding for BDNF, their BDNF levels will fall precipitously with aging making complex tasks very difficult to perform.  Thus, if we want to maintain or enhance brain function as we age we will need to do everything possible to keep BDNF levels high.

Turn Old Brains Into Young Brains with BDNF

To reverse the effects of decreased BDNF on aging brains, researchers in Brazil had an interesting idea. What would happen if they put old rats into an exercise program. Could they then increase the BDNF levels and brain function of these old rats with an exercise program?

After 5 weeks of just mild intensity exercise for these old rats, Brazilian researchers were able to show that exercise reversed the age related cognitive decline. Specifically, this exercise program significantly increased BDNF levels and the old rats learned faster and their memory was improved.

While it is hard to extrapolate the findings of these 35 old female rats used in this study to humans, there is still a lesson to be learned here. By getting the old sedentary female rats to start running for 15 minutes 4 days of the week on a rat treadmill their brain function improved so much that it was almost as good as the young rats.

The key message of this study is that even short periods of exercise can have a dramatic effect on BDNF, learning abilities, and memory strength.

Exercise Boosts BDNF and Cognitive Function in the Young as Well

The beneficial effects of BDNF are not just for old brains. Even young brains seem to benefit as well.

To test this hypothesis, Irish researchers designed a study whereby they coaxed sedentary male college students to start exercising.  In this study, they wanted to see what the effects of an exercise program would be on BDNF and memory abilities.  As these were young college students, researchers pushed them much harder on the stationary bicycle than the old Brazilian rats were pushed on the rat treadmill in the previous study.

This high intensity exercise boosted both the BDNF levels and memories of these young college students.  Once again, the message is clear.  Exercise improves BDNF and brain function in both the old and the young.

BDNF is Critical for a Healthy HeartVector grunge card with hand painted heart

BDNF’s effects are not just on learning and memory.  BDNF is also critical for a properly functioning heart.

In a recent study from Johns Hopkins University, Dr. Ning Feng and colleagues, genetically created a mouse that lacked BDNF receptors on the heart.  In other words, they altered the genomes of these mice so that their hearts could not sense BDNF from the brain at all.

Interestingly, researchers found that in these mice hearts without the influence of BDNF that they quickly developed heart failure.  Even though this study was done it mice, it does raise the question of whether heart failure, which is common in the elderly, may also be a function of declining BDNF levels.

It is well known that depression is a common cause of heart disease.  People that are depressed also tend to have much lower levels of BDNF.  Could the link between depression and heart disease be due to low levels of BDNF?

BDNF May Control Our Lifespan

Researchers are now speculating that BDNF could be one of the key regulators of our lifespan.  Indeed, studies have shown that BDNF is closely correlated to lifespan.  BDNF may just be how our brains control our lifespan.  Could BDNF represent the sand in an hourglass in that when the BDNF is gone our lives are over?

10 Ways to Boost Brain Function with BDNF

By this point in the article it is pretty clear that for optimal brain and heart function we want more of this substance around.  How can we increase BDNF levels beyond just exercise?  Let me give you 10 scientifically proven ways to raise BDNF levels.

1. Exercise

Exercise is the very best way to boost BDNF levels.  As seen from the studies already discussed in this article, even short bursts of exercise can dramatically raise BDNF.  We must create a lifelong habit of exercise to keep our brains and hearts functioning optimally.

2. Avoid Sugar, Processed Foods, and HFCS

Just as exercise can raise BDNF levels, sugar, processed foods, and high fructose corn syrup (HFCS) all do the exact opposite.  Many studies have now shown that rats fed the Standard American Diet (SAD), which is high in sugar, bad fats, and HFCS, have lower levels of BDNF.  These lower levels of BDNF from the Standard American Diet result in rats which are not as smart and have memory difficulties.  Clearly, for optimal brain function we have to eat the right foods to increase BDNF levels.

3. Intermittent Fasting

Interestingly, there is a growing body of data that time restricted feeding, or intermittent fasting, may also increase BDNF.  Intermittent fasting is merely the act of resting our guts periodically which then triggers a cascade of hormonal events in our bodies which boost our body’s repair mechanisms.

Intermittent fasting does not have to be hard.  Studies show that even fasting as short as 12 hours can have a beneficial effect. To fast for 12 hours is really as simple as skipping that pre-bedtime snack and not eating again until breakfast the next day.  To learn more about the role of intermittent fasting please read my article Intermittent Fasting, Weight Loss, and Longevity.

4. Mental Stimulation

Exercising our brains with mental stimulation also increases BDNF.  Like everything else, the old adage “use it or lose it” also applies to the brain.

5. Eat Oily Fish

Recent data have shown that a diet high in omega 3s can improve BDNF levels and boost brain function.  Unfortunately, studies also show that up to 95% of Americans are deficient in the omega 3 fatty acids.

The best studied way to get more omega 3s is to include oily fish in your diet.  My favorite way to do this is with the very affordable wild Alaskan salmon that we buy at Costco.

While there are certainly non-fish forms of omega 3s, like those found in walnuts, chia seeds, flax seeds, etc., these have not been studied as well and may not be as critical as the DHA and EPA forms of omega 3s found in oily fish.

Fish oil supplements can certainly boost omega 3 levels in the body.  However, omega 3s, in the form of fish oil supplements, can easily go rancid, they may increase the risk of prostate cancer, and they may even accelerate heart disease and dementia in the 25% of the American population that carries the ApoE4 gene. Thus, given these concerns with fish oil, I recommend that my patients try to get their omega 3s from real fish sources.

6. Be with Family and Friends

Close nurturing relationships have been shown to boost BDNF.  These are the relationships that come from real friendships or spending time with family members.

7. Get Some Sun

Even something as simple as getting some sun each day can boost BDNF levels.  Look for opportunities to get out of your home or your office building and feel some of the sun’s healing effects each day.  Of course, one always has to be sun smart to avoid skin cancer.

8. Eat More Curry/Turmeric, Red Grapes, and Blueberries

Curcumin, which is found in turmeric and to a lesser extent in curry, has been shown in to increase BDNF and can even prevent Alzheimer’s Disease.  Learn to use these spices with the foods you make to protect your brain.

Do you like red grapes?  If so, you may just be in luck.  Resveratrol, found primarily in red grapes, has also been shown to boost BDNF levels.  If red grapes aren’t your thing then the anthocyanin in blueberries have also been shown to raise BDNF levels.

9. Do Something to Reduce Stress

Managing stress is key to optimal health.  BDNF is no exception.  People who are under a lot of stress produce less BDNF.  Could this be why people often don’t think as clearly when they are feeling very stressed?

Stress is a part of modern life.  Find something, anything, that you can do each day that helps you to keep life in perspective and allows you to unwind mentally.

10. Get At Least 7 Hours of Sleep

As with stress, sleep is critical for health.  As you might expect, BDNF is reduced with sleep deprivation.  If you struggle with getting at least 7 hours of sleep, like me, this study suggests that regular exercise can help to keep BDNF levels up even if your sleep is compromised.

What do you do to keep your BDNF levels up and your brain and heart functioning optimally?

Disclaimer

Please do not self diagnose or treat based on anything that you have read in this article.  Also, if you are considering changing your exercise program or diet, please discuss this with your physician first.

#080 How To Overcome the 5 Most Addictive Foods

February 25th, 2015 by

How To Overcome the 5 Most Addictive Foods

Do you struggle saying no to pizza, chocolate, chips, cookies, ice cream, or french fries?  If so, you are not alone.  We are all in this same boat together.  This article will help you to overcome your food addictions and finally shed those extra pounds!

Are You a Food Addict?

Did you see the recent media coverage asking if you are a food addict?  Can foods really be addictive?

There is a growing body of scientific data that foods are every bit addictive as cocaine or alcohol.  An addiction is defined as something we feel compelled to do even though it will bring us harm.

While food may not seem as “dangerous” as an illegal drug, addictive foods can bring also untold suffering on people and families.  For example, having your knees hurt with every step you take from carrying extra weight around, undergoing open heart surgery,  having chemotherapy for a preventable cancer, or depriving your children/grandchildren of your nurturing guidance by dying prematurely are all real consequences of food addictions. By this definition, some foods can definitely count as an addiction.

The Most Addictive Foods: Scientific Study

Researchers are increasingly becoming aware of what makes foods so addictive.  Indeed, researchers have now been able to identify which foods have the highest addictive properties.

In this recently completed provocative study of 504 individuals by Dr. Erica M. Schulte and colleagues from the University of Michigan, they were able to scientifically rank the most addictive foods.  Interestingly, the most addictive foods share the same properties as illegal drugs in that there is a high dose of a processed drug delivered very rapidly to the body.

The 5 Most Addictive Foods

Based on the criteria established by Schulte and colleagues from the University of Michigan, here are the most addictive foods with their accompanying score:

1. Pizza: 4.01

2. (Tied) Chocolate and Chips: 3.73

3. Cookie 3.71

4. Ice Cream 3.68

5. French Fries: 3.60

As I reviewed this list of the top 5 most addictive foods, I must confess that I have struggled with all of these foods myself.  From previous blogs I have publicly confessed that I still struggle with pizza from my hospital’s cafeteria.

Pizza really is a drug for me and I have to treat my hospital’s cafeteria like an alcoholic must treat a bar.  To stay “sober” I cannot even step foot into my hospital’s cafeteria or I will feel compelled to buy the slice of the veggie pizza despite knowing as a cardiologist what this processed food is doing to my body.

What Makes a Food Addictive?

As part of this study from Schulte and colleagues they identified exactly what makes a food addictive.  Interestingly, their research showed that foods in their natural forms do not cause addictions.

For example, grapes or poppy seeds do not cause addictions.  However, when grapes are processed into wine or poppy seeds are processed into opiates, with a rapid delivery of the drug to the body, is when they become addictive.

The same is true for foods.  Wheat kernels, sugar beets or sugar canes, tomatoes, and milk are not addictive.  However, when you refine the wheat into white flour, the sugar beets/cane into processed sugar, etc. these foods become highly addictive in the form of pizza.

Have you ever heard of someone being addicted to chewing on cocoa leaves?  However, if you process the cocoa leaves and then add in some milk and sugar you then have a highly addictive food product called milk chocolate.

The 4 Reasons Why Food Becomes Addictive

Based on the research from Schulte and colleagues, these are the 4 food properties they identified which causes foods to become a drug:

1. Processed Foods

2. Added Sugar

3. Added Fats

4. Refined Carbohydrates (like white flour)

From this list it appears that the way to avoid the “food drugs” is to simply eat foods in their natural states.  Indeed, from the research done by Schulte and colleagues there were no addictive properties from fruits, vegetables, beans, brown rice, etc.

How To Overcome the 5 Most Addictive Foods

Now that we know what makes food a drug and which “food drugs” are most likely to get us “hooked” how can we resist these addictions and stay thin?  Let me give you the 5 strategies I have found most helpful for me and my patients.

1. Eat the 5 Most Addictive Foods in their “Unprocessed” Forms

Since foods in their natural states carry no addictive potential, the key is to eat these “food drugs” in their natural or unprocessed states.  Here are my examples:

Healthy Pizza

To overcome the number 1 food drug, simply commit to only eating pizza if you make it yourself.  Pizza can be very healthy and nutritious if done right.

For your pizza dough, try using  my wife’s real bread recipe as your pizza dough.  Make your own pizza sauce with fresh tomatoes, olive oil, and fresh garlic.  Put fresh vegetables and organic cheese on top of the pizza.  Don’t even think of adding sugar to this pizza!

Healthy Chocolate and Healthy Chips

Yes, chocolate can be very healthy if it is very dark and without all of the sugar.  Here is a link to my article on the top 10 health benefits of dark chocolate.

Chips, like chocolate, can be very healthy as well.  For example, you can make delicious kale chips by using fresh kale, olive oil, and salt and baking them in your oven.  If you love potato chips then try this same approach using sweet potatoes.

You can also use a food dryer and simply dry thin slices of other fruits and vegetables. Our children especially love the dried banana chips Jane makes.

Healthy Cookies

Cookies can be made to be very healthy and delicious without the risk of getting hooked.  Here is Jane’s chocolate chip cookie recipe our children love.

Healthy Ice Cream

Ice cream can also be very healthy as well.  For example, here is a recipe for home made coconut milk ice cream.  I would consider using real honey (raw honey that is if you don’t have an food allergy or really young children), real maple syrup, or real stevia as the sweetener.

Healthy French Fries

Yes, french fries can be healthy.  Just thinly slice up a sweet potato, put a little olive oil or salt on it, and bake.  An incredibly healthy treat!

2. Attack the Root Causes of Our Food Addictions

If we are honest with ourselves there is a real reason for our food addictions.  In other words, we may be using food simply to “medicate” ourselves.

If we can get at the root causes then these foods will be less likely to get us hooked.  To read more on this fascinating subject, please see Jane’s blog How to Overcome Emotional Eating.

3. Stay Away from the “Bar”

As a recovering alcoholic must stay away from the bar, we too must stay away from our own “bars.”  As mentioned above, my “bar” is my hospital’s cafeteria where there is always a fresh and hot slice of veggie pizza calling my name.

The “bar” could also be our own homes.  As a recovering alcoholic would not keep alcohol stashed in the house the same is true for those of us who are recovering food addicts.  Always maintain a junk food free home.  You can’t control the food drugs others bring to work or for social events but you can control what comes into your home.

This recommendation can be tricky as we cannot let our fear of eating unhealthy foods keep us from interacting with others.  Indeed, studies have shown that social isolation may be as dangerous to our health as smoking 15 cigarettes a day!

In my case, I have found that if I always pack a lunch to the hospital then I can stay away from the hospital cafeteria.  I can then eat my lunch with my team of nurses, technicians, office staff, and other physicians in our break room far away from the temptations of the hospital cafeteria.  This way I can get the benefits of both nutritious food and social interaction.

4. Take Care of Yourself

It seems like a “no brainer” but by simply taking care of yourself you will have added willpower and less of a desire to eat addictive foods.  Get enough sleep at night and some sun during the day, do something to manage stress and unwind each day, exercise daily, and by spending time with friends and family you will recharge your willpower batteries.  For some added ideas, please read my article 10 Ways to Break Your Sugar Addiction.

5. Eat Real Food First

The last strategy is to always eat real food first.  If you focus on filling up with real food first then hopefully you will lose the desire for the addictive junk.  To learn more, read our article on The Real Food First Diet.

Closing Thoughts

Food addictions are every bit as real as drug or alcohol addictions.  I have found that most of my patients who struggle with weight issues also struggle with food addictions.  The problem is that by trying to satisfy our addictions we never feel better but only worse in the end.

The first step for an alcoholic to recover is to recognize that they have a problem.  The same is true for food addictions.  Don’t wait until your health hits rock bottom before making changes.

Do you also struggle with food addictions?  What has worked for you in overcoming food addictions?

#079 Can You Live 7 Years Longer by Smiling?

February 22nd, 2015 by

Can You Live 7 Years Longer by Smiling?

Would you believe me if I told you that researchers can predict exactly how long you will live based entirely on a photograph of you?  Sounds like fortune telling, right?  Interestingly, science backs up this claim and in this article we will discuss how smiling can help you to feel better today and extend your life.

Baseball Cards, Smiling, and Longevity Study

In 2009, researchers Ernest L. Abel and Michael L. Kruger from Wayne State University had an interesting idea for a study.  Could whether a professional baseball player happened to smile on their baseball card photograph in 1952 predict how long they would live?

To test this interesting question, Abel and Kruger analyzed all 230 baseball cards from 1952 where the athlete was looking at the camera.  Five “judges” were then selected to analyze each baseball player’s smile.  Each baseball card was rated based on 3 categories. No smile, partial smile, or a full smile (Duchenne smile).

In order to keep the study fair, judges were not told what this study was about.  All they knew was that they had to rate the smile of each baseball player.

Because these were all Major League Baseball players, much of their medical history like age, height, weight, career length, marital and education status was all public knowledge.  Interestingly, while the number of years they played professional baseball and if they attended college improved longevity, the most important factor was whether or not they smiled on their 1952 baseball card.

This simple act of smiling on their 1952 baseball card determined their longevity.  Here are the results:

1. No Smile: Average lifespan of 72.9 years

2. Partial Smile: Average lifespan of 75.0 years

3. Full Smile (Duchenne Smile): Average lifespan of 79.9 years

As you can see, the baseball players with a full smile or a Duchenne smile lived 7 years longer than those baseball players who refused to smile on their 1952 baseball card photo.

Can we believe the results of this baseball card study?

Certainly, it would be very easy to dismiss the results of this study as a random statistical finding.  However, the results of this study are right in line with other studies on smiling.

For example, studies have shown that whether or not you are smiling on your childhood photos determines your likelihood of having a successful marriage.  In other words, researchers concluded that if you didn’t like to smile on your childhood photographs that you were more likely to be divorced.

Other studies have shown that whether or not you are smiling on your senior yearbook photo determines marital satisfaction as well.  In addition to happiness, some researchers have concluded that smiling can make you appear more attractive and intelligent.

These are just a few of the many studies that have all shown the same thing.  Smiling in a photograph seems to predict happiness and longevity.

How do explain the results of smiling?

By this point in the article you are probably wondering, how can just the simple act of choosing whether or not to smile in a photo determine your health, happiness, and longevity?  I too, wondered the same thing.

Many scientists now believe that the simple act of smiling provides a window to our mental and emotional health.  If we are happy and healthy then we are much more likely to smile.

Can you fake a smile?

Certainly, in the baseball card study, researchers did not know whether the photographer asked the baseball players to smile or not in 1952 as this could have impacted the results.  While this may have determined whether baseball players didn’t smile or gave a partial smile it likely did not affect the results of a full smile or a Duchenne smile.

To be scored as a full smile or a Duchenne smile in this baseball card study, baseball players had to raise the corners of their mouth (contraction of the zygomatic major muscles) and show crow’s-feet wrinkles around the eyes (contraction of the orbicularous oculi muscles).  While it is certainly possible to learn how to move all of these muscles simultaneously and fake a genuine smile, for 99% of us we simply cannot fake a real smile.

Thus, if baseball players showed a Duchenne smile then we can be pretty sure that they were at least feeling happy inside at the time of their 1952 baseball card photo.

Thin Slicing

While this may seem complex to analyze whether or not someone is genuinely smiling, your subconscious brain is able to instantly make this determination of a real versus a fake smile without you even realizing it.  Indeed, studies show that your brain can make this determination within 180-430 milliseconds.

Being able to quickly “sum someone up” in a split second is also known as “Thin Slicing.”  This ability is something that has allowed the human race the ability to quickly sense danger or friendship since the dawn of time.  By smiling we send others a strong signal or “first impression” that we are happy and emotionally stable inside–someone who is trustworthy, open to friendship, and cooperation.

We naturally gravitate to and prefer to be around people that smile.  We go out of our way to help people that genuinely smile toward us.

IMG_8890

I Didn’t Smile in My Senior Yearbook Photo

Did you smile in your high school yearbook photo?  If this thought has crossed your mind then you are not alone.  I also wondered the exact same thing.

As I am writing this article I had to open up my old senior year high school yearbook for the first time since I graduated from high school.  It was covered in dust but I found it in our basement.  I had to find out if I smiled in my senior yearbook photo.

Unfortunately, I did not smile.  In 1985 I was “too cool” to smile.  As you can see from this photo, I was not about to smile.

High school was certainly a challenging time for me and I wasn’t always happy inside.  I always felt woefully inadequate and wondered what others thought of me in high school.  This was readily apparent from this photograph.

Perhaps this is why I have not yet attended a high school reunion.  This year will be my 30 year high school reunion and I am committed to going if I am in town.

Based on this high school photo of me, researchers would predict that I would get divorced, live an unhealthy life, and die young.  Fortunately, I started smiling in all of my photographs in college.  It was in college when I finally became emotionally mature enough to be happy inside.  Perhaps this is why Jane and I are still happily married after 22 years.

Fake It Until You Make It

What should you do if you don’t feel like smiling?  The old adage, fake it until you make it may just be true in this case.

Could faking a smile, until you really feel like smiling, actually make you happier and allow you to live longer?  Would you believe it if I told you that there was actually good science to support this argument?

Indeed, there have been a number of studies that have shown that even forcing a fake smile can make us feel happy.  In probably one of the most interesting studies on this subject, researchers taped up the faces of 88 college students forcing them to smile.

Even with their cheeks taped up in a fake smile, these college kids felt 85% happier.  While I certainly do not recommend that you walk around with your cheeks taped up in a smile all day to keep you happy, there is an important lesson to be learned here.

When we smile, forced or not, neurological signals are sent to our brain stimulating the “happiness centers” of our brains.  Thus, when it comes to smiling, we really can fake it until we make it.

Take Home Message

The take home message of this study is that smiling can allow us to feel better today and just may allow us to live an extra 7 years of life.  Don’t just start smiling in your photographs to live longer but also learn to smile at everyone you see.

My challenge to you is really quite simple.  Smile at everyone you see today.  If you can make it a habit then you just might be happier and live longer!

Did you happen to smile in your high school yearbook photo???

 

 

#078 Squat Toilets, Hemorrhoid Prevention, and Longevity

February 21st, 2015 by

Squat Toilets, Hemorrhoid Prevention, and Longevity

Are you like 50% of Americans who have developed hemorrhoids by age 50?  Do you worry about your parents or grandparents falling in their homes?  Are you losing leg muscle strength as you are getting older?

If you answered yes to any of these questions then perhaps the answer just might be a squat toilet.  This article is just for you.

My First Experience with a Squat Toilet

At the age of 21 I was on a plane to Taiwan.  I had just completed 2 years of volunteer church service helping the Chinese immigrant population in New York City and I was eager to try out my new Chinese language skills and immerse myself in the culture by living in Asia for the first time.

I still remember the first time I went out with my Chinese friends in Taiwan.  We were busy enjoying the exciting night markets of Taipei, Taiwan when I suddenly needed to find a bathroom.

Perhaps it was travelers diarrhea.  Perhaps it was because I was not yet used to the food.  After finally finding a public bathroom, I was devastated to see that the only option available was a squat toilet.

How do you use this thing I thought?  There was no one else in the bathroom that I could ask.  As I was desperate I thought I would give it a try.

At first I thought “this isn’t so hard.”  Then my legs got wobbly, I lost my balance, and fell backwards.  It was gross.  Fortunately, no one saw me.

From then on I was always careful whenever I went out in public and did everything possible to avoid another encounter with a squat toilet.  I, like most Americans, lacked the lower extremity muscle strength, balance, and flexibility to use a squat toilet.

Is the key to longevity a squat toilet?

Would you believe it if I told you that 97% of the centenarians in the Bama County of China’s Guangxi Province are still able to independently use a squat toilet while in their 100s?  China’s Longevity Village is part of Bama, County in Southwest China near the Vietnam border.  Could this be the real reason for their longevity?

Depending on how long and how many times you use the bathroom, using a squat toilet could be the equivalent of doing about 10 squats each day.  This could be an incredible work out throughout the day for every day of your life.

Could this be an additional reason why obesity is rarely, if ever seen, in rural Asia where squat toilets are still common?  Could this answer why falls are rarely seen in rural China among China’s elderly?

The Dangers of Falling

Every day in my cardiology clinic I see older patients who are at risk of falling.  Many of these patients are also on blood thinners.  For anyone with aging parents or grandparents this is a real concern.

In fact, 90% of all hip fractures come from falls.  Of those who do fall and break a hip, the vast majority of them are either dead or still in a nursing home 1 year later.  This is definitely not how we want to spend our last days on Earth!

Falls are a very rare event in China’s Longevity Village.  Even the centenarians have excellent balance as they take their daily walks on the Village streets.  I suspect their great balance comes from being lean, not taking any medications, and from having excellent lower extremity strength from a lifetime of squatting.

Could falls in the elderly be just another manifestation of the American lifestyle?

Hemorrhoids Are Completely Preventable

Did you know that the word “hemorrhoid” was the number 1 searched for topic on Google in 2012?  Could this be because we are too embarrassed to bring this topic up with our doctor?

Hemorrhoids are definitely painful and embarrassing.  They are also totally unnecessary.  Once again, could hemorrhoids be yet another manifestation of our American lifestyle?  Once again, we could not find any cases of hemorrhoids in China’s Longevity Village and studies have shown that hemorrhoids are indeed rare in rural China.

What Causes Hemorrhoids?

If we know what causes hemorrhoids then we can take measures to prevent them.  According to medical studies, here are the big 4 causes of hemorrhoids.

1. Sitting and straining on the toilet

2. Not enough dietary fiber and water (constipation)

3. Not enough physical activity

4. Obesity

As you can see from the list, these are all easily preventable.  By simply tweaking our lifestyles, hemorrhoids never need to occur again.

The 3 Benefits of Using a Squat Toilet

1. We Were Not Meant to Sit

Sitting is indeed the new smoking.  While sitting is dangerous at home or at the office, could the same also be true in the bathroom?

Studies show that our body position is important when we have a bowel movement.  For example, squatting improves the anorectal angle allowing for better emptying of our colons and decreased intraabdominal pressure.  The end result of a better body angle during bowel movements is a lower risk of hemorrhoids.

2. Saves Time

Is there just not enough time in the day to get everything done that you need to get done?  Studies show that you can cut the amount of time you use the bathroom by 61% with a squat toilet.  The amount of saved time could really add up over the course of a lifetime!

3. A Daily Work-Out

Is it hard to find time to get to the gym?  Depending on how often you typically sit to use the bathroom you could potentially get your daily work-out just from using a squat toilet.

This is a great way to multitask.  You could get your work out done while using the bathroom.  This is so much healthier than reading a magazine or playing on your phone for 20 minutes while using the bathroom.

The list of benefits from doing squats as part of your daily work-out routine is endless.  In addition to strengthening your legs, it strengthens  your core muscles, improves balance, and improves flexibility.  If you suffer from knee pain it could just be because you have inadequate leg strength, balance, or flexibility.

My Confession

I need to make a confession.  Despite knowing the benefits of using a squat toilet, on our first two visits to China’s Longevity Village I did not use one.

While our room had a squat toilet I did not use it.  Instead, I used a chair with a hole cut out in the bottom and positioned it over the hole in the ground where the squat toilet was.

Interestingly, our children did not have any problems at all using a squat toilet.  Perhaps I was still too fearful from my first encounter with a squat toilet.

Action Items

1. Daily Squats

Even if you have no intention of ever using a squat toilet, doing squats daily can strengthen your legs as well as improve your balance and flexibility.  To learn how to do squats here is a great resource with an explanation and video.

Got bad knees or you are too big to do squats?  Here is a short video showing how you can still enjoy the benefits of squats even if you have bad knees or you are too big to do a traditional squat.

2. Don’t Read or Play on Your Phone While Using the Toilet

Sitting too long on the toilet can increase your risk of hemorrhoids.  If you like to read or play on your phone while using the toilet then you will probably sit longer.

While sitting in any form is not good for our health, there is an additional health concern with reading or using the phone while sitting on the toilet.  According to this BBC report, fecal material was found on 1 in 6 iPhones.  This is clearly not a healthy practice.

3. Increase Your Fiber, Water, and Physical Activity

To minimize your risk of hemorrhoids, increase your fiber, water, and physical activity.  Our bodies were designed to get more fiber, water, and physical activity than we typically get in the U.S.  This will also help to decrease the amount of time and straining required while on the toilet.

4. Convert Your Western Toilet to a Squat ToiletIMG_8894

For $25 you can easily convert your Western toilet to a squat toilet.  Basically, this is just placing a stool next to your toilet that allows you to squat.  There are a number of different manufacturers, such as Squatty Potty, and you can buy this on Amazon.

Even better would be to build your own squatting platform for free.  This is what I have done.  With some bricks we had laying around our house I was able to build this squat toilet.

If you do choose to build your own please make sure it is very stable to reduce your risk of falling.  Mine is definitely not stable at all.

Now with this unstable squat toilet I will definitely never be able to use my iPhone again while on the toilet.  Perhaps this will help me in my training to use a squat toilet before we return to China’s Longevity Village again in the fall.

With a squat toilet now you can do as they do in rural Asia and get in your daily squats without even having to schedule a time to work out.  Have you ever tried a squat toilet?  What was your experience?

Disclaimer

If you do not typically do squats or use a squat toilet please discuss this with your doctor first before trying.  Also, depending on your level of physical conditioning, squats could result in significant injury.  If you are not used to using a squat toilet then you may also fall and get seriously injured while trying to use one.

#077 The Easiest Diet to Lose Weight: Focus on Fiber

February 20th, 2015 by

The Easiest Diet to Lose Weight: Focus on Fiber

Have you ever tried to drop a few pounds?  Did you struggle to follow a complex new way of eating?  If so, please read on as this article is just for you.

This is exactly the question researchers sought to answer in this new study that was just published in the prestigious Annals of Internal Medicine.  How well would just encouraging people to eat more fiber compare to the very rigid American Heart Association (AHA) Diet?

“Eat More Fiber” versus AHA Diet

In this study, researchers recruited 240 overweight people who also had diabetes, high blood pressure, or high cholesterol and randomized them to either eat more fiber or follow the AHA Diet for 1 year.

“Eat More Fiber” Study Group

I should note that the “eat more fiber” group really did not eat that much fiber.  They were only encouraged to eat 30 grams of fiber each day which is the bare minimum amount of fiber that any adult should eat.

At the end of the study, the “eat more fiber” study group really did not do that good of a job.  They were only able to average a measly 23.5 grams of fiber daily which only represented a 4.7 gram improvement from what they were eating before the study started.

To put things into perspective, a 4.7 gram improvement in fiber is the equivalence of eating 1 more apple since an apple has about 5 grams of fiber. However, given that the average American only averages about 15 grams of fiber each day, 23.5 grams of fiber could be considered a significant accomplishment.

AHA Diet Study Group

In contrast, the AHA Diet was very strict.  Here is the AHA Diet as taken from the AHA website.

1. Eat fruits, vegetables, nuts, and whole grains.

2. Eat lean meats, including fish at least twice weekly.

3. Eat fat-free or low-fat dairy products.

4. Cut back on partially hydrogenated vegetable oils to reduce trans fat.

5. Keep saturated fat to no more than 5-6% of total calories.

6. Cut back on beverages and foods with added sugars.

7. Keep sodium less than 2,400 mg per day.

8. Drink alcohol in moderation.

Interestingly, by following this very complex AHA diet, study participants also increased their fiber intake.  However, on the AHA diet, people only increased their fiber intake by 1.3 grams per day to a total fiber average of 20.8 grams.  Thus, in comparison to the “eat more fiber” group, the AHA group ate about a half an apple less fiber each day.

Key Findings of the Eat More Fiber vs. AHA Diet Study

What happened after 1 year of following these diets?  I should note that study participants were not encouraged to exercise.  Thus, any changes were based only on the diet they were randomized to.  Here are the key findings:

1. The “Eat More Fiber” Diet was just as effective at weight loss as the complex AHA Diet.

2. 90% of the “Eat More Fiber” group could stick with their diet 1 year later.

3. The “Eat More Fiber” group lost 1 pound of body weight for each extra gram of fiber they averaged each day.

4. Eating 5 extra grams of fiber each day reduced daily calories by 200 per day.

These findings are really very interesting.  Adding just 5 more grams of fiber each day reduced caloric intake by 200 calories and resulted in a sustained weight loss that 90% of study participants could do.  This really has to be the easiest diet ever to follow.  However, the one thought that kept coming back into my mind was what would the results have been if the “eat more fiber” group really did eat more fiber?

Medical Benefits of a High Fiber Diet

A high fiber diet has additional benefits of lowering blood pressure, blood sugar, and cholesterol.  In addition, fiber causes people to feel full and decreases the hunger hormones.

Despite these proven medical benefits of increased dietary fiber, these findings were not observed in this study.  I suspect that this was because study participants only increased their fiber intake by 5 grams each day.

The Traditional High Fiber Diet of China’s Longevity Village

The findings of this study are right in line with our research in China’s Longevity Village.  In this village, everything the villagers ate was high in fiber except the fish which they ate 1-2 times each week.

Villagers ate fruits and vegetables with every meal.  They also ate nuts, seeds, legumes, and whole grains every day.  All of these foods are extremely high in fiber and nothing was processed.  Sugar was just not a part of their diets.

After we returned back to the U.S. following our first visit to the Village, this was one of my guiding dietary principles as well.  I was overweight and all of the diets I had previously tried did not work for me.  Desiring to model my diet after those in the Village, I simply required that everything I ate be high in fiber with the exception of fish.

Almost overnight my daily fiber intake went from around 15 grams a day to an average of 70 grams of fiber each day.  Within just a few months my weight dropped 30 pounds without ever experiencing hunger from these changes.

To this day I still average 70 grams of fiber each day and I have easily kept the weight off for 3 years.  To track my daily dietary fiber intake I have used the app Lose It!

How to Increase Fiber in 6 Simple Steps

Here are my 6 simple tips to increase the fiber in your diet.  If you are not used to eating fiber you will need to gradually increase your fiber intake over time to avoid any gastric distress.

1. With the exception of fish, wild meats or eggs, try to make everything you eat be high in fiber.

2. I encourage my patients to get 9 servings of fruits and vegetables each day (20-25 grams of fiber).

3. I encourage my patients to get at least 1 serving of legumes each day (10-20 grams of fiber).

4. I encourage my patients to get at least 1 serving of nuts or seeds each day (2-7 grams of fiber).

5. Only eat real whole grains such as quinoa, brown rice, or coarse “flourless” wheat if you are not gluten sensitive, etc. (10-20 grams of fiber)

6. Track your fiber with an app like Lose It!

Disclaimer

As with all of my articles, do not self diagnose or treat based on anything that you have read.  Always discuss health changes with your physician first.

 

 

#076 Do You See Everything? Inattentional Blindness

February 15th, 2015 by

Do You See Everything? Inattentional Blindness

I was very worried about Jeff’s shortness of breath. He had difficulties even walking across the street. I was so concerned about his condition that I ordered a chest CT scan to evaluate his lungs.

I specifically told the radiologist that I wanted him to look at his lungs, specifically his pulmonary veins, very closely. To my initial relief, his chest CT report came back with no significant abnormal findings.

As I was still worried about his breathing I also ordered an ultrasound of his heart (echocardiogram). On his ultrasound I noticed that the main artery coming off of his heart, the aorta, was severely enlarged. This was an urgent surgical condition.

How Can the Obvious Be Missed?

An aortic aneurysm is a threatening complication as the aorta could rupture or dissect at anytime causing instant death. This is what happened to John Ritter from the famed TV show “Three’s Company.”

This made me wonder, why didn’t the radiologist see the severely enlarged aorta when a chest CT is a much better way to view the aorta than an echocardiogram. The aorta is a large structure in the center of the CT scan images. Why was nothing mentioned of the aorta on the report?

I picked up the phone and called the radiologist. This time he clearly saw the severely enlarged aortic aneurysm and quickly amended the report.

Fortunately, there was no delay in the diagnosis and Jeff did well.

Inattentional Blindness

This experience is what is often referred to by researchers as inattentional blindness. In other words, we may become blind to the obvious in front of us when our attention is compromised or we are distracted by something else. In this case, the radiologist was likely distracted by me asking him to focus on the lungs.

Test Yourself to See if You Also Suffer from Inattentional Blindness

In a famous study on inattentional blindness, researchers asked people to watch this video.

 

To test yourself to see if you also suffer from inattentional blindness, please stop reading this article and watch the video link above before continuing on with this article. Did you count the correct number of passes? The bigger question is, did you see the gorilla?

Interestingly, 50% of all people who take this test miss the gorilla. Half of all people become so distracted trying to count the passes that they completely miss the big gorilla in the center of the screen.

83% of Radiologists Suffer from Inattentional Blindness

It is extremely competitive for a U.S. medical student to obtain residency training in radiology. Radiology has historically been a highly sought after medical specialty. Thus, given how hard it is to get into radiology, let alone to get into a U.S. medical school, radiologists represent some of the brightest people in the country.

Interestingly, when radiologists are shown this CT scan and are asked to find the “cancer”, fully 83% of them miss the gorilla hiding in the CT scan. The problem is that they become so distracted trying to find the cancer their brains completely “tune out” the unexpected gorilla on the CT scan.

Did you see the gorilla in this CT scan?

We All Suffer from Inattentional Blindness

It is not just radiologists that suffer from inattentional blindness. There are classic reports of airplane crashes where pilots missed an instrument, right in front of them, telling them that their plane was losing altitude and would soon be crashing into the ground.

The same can happen to us. Have you ever missed your exit on the freeway while talking on the phone? Have you ever wondered if you locked the door of your house after you left? Have you missed what your child was trying to tell you while you were busy with a work project, trying to make dinner, or just playing with your phone?

How much more effective would we be at work or at home if we simply paid attention to everything going on around us?

5 Ways to Overcome Inattentional Blindness

In order to battle against inattentional blindness and become fully aware of what is really happening around us, we need to know when it is most likely to occur. The following are common situations of when inattentional blindness is likely to happen:

1. Don’t Multitask

Multitasking is really the art of messing up several things at once. Focus on one task at a time and you will be less likely to be distracted. Tune into your significant other or your child when they are trying to talk to you.

2. Don’t Spread Yourself Too Thin

If you are tired or feel overwhelmed then you are more likely to miss the obvious. Our brains can become tired and frazzled if we don’t take the time to care for ourselves and manage stress.

3. Expect the Unexpected

If something appears that is completely unexpected then your brain may subconsciously dismiss it as “noise.” This is what happened in the gorilla radiologist study.

Your spouse, coworker, customer, or even your child may be trying to tell you something important. If your brain subconsciously tunes out the subtle physical cues, you may completely miss the warning signs of impending challenges.

4. Have a Checklist

Radiologists and pilots have to have a check list or a systematic way of doing what they do every day. If not, something will be missed.

The same is true for us. Every time we drive, prepare a presentation, or just spend time with our families we should have a mental checklist as well to make sure nothing is missed. For example, I have a checklist that helps me to connect with each family member and coworker daily. This helps me to stay connected to the people most important in my life.

5. Make a Mental Note of What You See

If we are not careful we will suddenly wake up on our death bed and realize that we missed most of the really important things in life. Carefully note the flowers or the leaves when you go on a walk. Remember the smile of your child. Savor the warm embrace of a loved one.

It is not too late to see the really important and obvious things in life! Start today! Put down the smart phone or iPad and tune in to what life has given you.

How do you make sure you “tune in” to life?

#075 Does Cholesterol Still Matter? The New Nutrition Guidelines

February 15th, 2015 by

Does Cholesterol Still Matter? The New Nutrition Guidelines

Did you see the latest headlines that it is OK to eat cholesterol according to the new nutritional guidelines?  Are eggs now officially considered “healthy” again and how can we make sense of these ever shifting nutritional guidelines?

The New Nutrition Guidelines

To begin with, the guidelines have not officially changed yet.  We are still stuck with the last set of guidelines from 5 years ago.  It should be noted that we get new national nutritional guidelines every 5 years.

All of the stir in the media is because of a leaked report from the nation’s top nutrition advisory panel that will soon be going to the Department of Health and Human Services and the Department of Agriculture.  The official new dietary guidelines are not expected out until the end of the year.

As there are many powerful lobbyists in Washington DC, not all of these recommendations from the Dietary Guidelines Advisory Committee will make it into the final draft of the national nutrition guidelines.  These guidelines are very important as school lunches, how doctors counsel their patients, and how food companies advertise their products are all based on these guidelines.

Is it OK to eat cholesterol again?bigstock-Cholesterol-Level-Conceptual-M-51872137

Probably the biggest news leaked from this report is that “cholesterol is no longer important.”  To many this may seem like nutrition guidelines are flip-flopping yet again.

First of all, the cholesterol story is very complicated. Here is what we do know:

1. The plaque that builds up within the arteries of our heart is often comprised of cholesterol.

2. High levels of LDL (bad cholesterol) as well as triglycerides significantly increase your risk of a heart attack.

3. The cholesterol that we eat does not significantly influence cholesterol levels for about 75% of people.

The major cardiology groups in the U.S. dropped the importance of dietary cholesterol in their 2013 guidelines.  The American Heart Association and the American College of Cardiology both stated that there were not any strong data to recommend cutting dietary cholesterol for most people.  It is expected that the official U.S. nutritional guidelines will do the same.

People Sensitive to Dietary Cholesterol

Does this mean we can now eat as many eggs as we want?  Not quite so fast.  We do know that in about a quarter of people that eating cholesterol rich foods will raise their cholesterol levels.  Also, for people who have already had a heart attack they may want to continue to limit the cholesterol in their foods.

How do you know if you are part of the 25% of people that are sensitive to dietary cholesterol?  Probably the easiest way to check is to have your doctor repeat a fasting lipid panel (blood test) if you choose to eat more cholesterol rich foods.  Dietary cholesterol is only found in animal products like meat and dairy.

Why is my cholesterol high?

You may be wondering what is causing your cholesterol to be high if cholesterol in foods does not matter for most people.  Here are the big causes of why your cholesterol may be too high.

1. Trans fats.

The goal for trans fats in our diets should be zero.  These are man-made fats.IMG_8083

For trans fats you cannot trust labels on your favorite foods.  As long as there is less than 0.5 mg of trans fat then food manufacturers may report “zero.”  This is very deceptive but yet is allowed by food manufacturers under U.S. law.  To help protect you and your family, avoid products that say anything “hydrogenated” or “partially hydrogenated” on the ingredient list.

Most Americans eat about 3 grams of this toxic fat each day.  If you eat fried food, fast food, pastries, processed foods, or use the unhealthy vegetable oils you are getting this deadly trans fat.

Any trans fat in the diet can dramatically raise cholesterol levels.

2. Saturated fats

The bad saturated fats are another cause of high cholesterol for many people.  This is why lean animal meats have been recommended for quite some time.

This is another area where new research may change future recommendations.  We still do not fully understand which saturated fats are “bad” and which ones are “good.”  Certainly, the saturated fats in nuts and seeds seem to be cardiac protective.  Stay tuned on this one.

3. You are not getting enough exercise

Exercise can have a profound effect on cholesterol levels. Exercise can raise our good cholesterol (HDL) and lower our bad cholesterol (LDL).

4. You are eating sugar or foods that behave like sugar

As your total cholesterol is also based on triglycerides levels, any sugar or foods that behave like sugar in your body (think refined grains), will raise your triglycerides.  If you want to lower your total cholesterol and triglycerides then avoid added sugars, fruit juices (real whole fruit is very healthy), and simple carbohydrates (99% of breads, pastas, crackers, etc.).

5. You are part of the 25% that are sensitive to dietary cholesterol.

As mentioned above, you might just be one of those people that cannot eat much cholesterol in your diet without significantly bumping your cholesterol levels.

6. Bad genes

While most people feel there is nothing we can do about “bad genes” quite the opposite is true.  Through a healthy lifestyle we can “turn off” bad genes and “turn on” good genes.  Just because you were born with bad cholesterol genes doesn’t mean you have to take a “statin” cholesterol lowering drug for the rest of your life.

What other changes are expected in the new U.S. Nutritional Guidelines?

1. Salt Guidelines May Loosenbigstock-Sea-Salt-In-Wooden-Spoon-57830636

Our last nutritional guidelines stated that we should keep our daily sodium intake to below 2,300 mg.  However, recent science has challenged this and the Institute of Medicine recently stated that there are no strong data that we should keep salt below 2,300 mg.  It will be interesting to see if the salt guidelines loosen.

2. Lobby Groups Will Oppose Recommendations to Eat Less Animal Meat (Especially Red and Processed Meats)

While the Dietary Guidelines Advisory Committee is recommending more of a plant-based diet with less red meat and processed meats it is expected that lobbyist groups will kill these recommendations in the final guidelines.

The big industrial meat farms are not helping our health or the environment.  Thus, we will likely continue to see wording encouraging us to eat a lot of animal meat in the U.S.

3. We may have our first sugar guidelines

Due to powerful lobby groups, our government has never set official sugar recommendations.  With mounting evidence building ever higher, our government may be finally forced to create some sort of a sugar guideline.

With the average American child now consuming 250 pounds of sugar each year, sugar guidelines are long overdue.  Bucking intense political pressure from lobbyist groups, the World Health Organization (WHO) recently recommended keeping our added sugars below 5% of our daily caloric intake.

4. “My Plate” Probably Won’t Change

The “My Plate” push from the last set of guidelines isn’t expected to change much.  In some ways this is good as our government will continue to encourage us to eat more fruits and vegetables.

However, the other half of “My Plate” will continue to remain very controversial.  Our government is expected to continue to recommend whole grains, low-fat dairy, and lean animal meats.  Emerging scientific data will continue to challenge these later recommendations.

My Views of the New Nutritional Guidelinesbigstock-Fresh-fruits-and-vegetables-ov-14753480

While our government is making some progress on the nutritional front, they are still way behind the scientific data.  Over the course of human kind, we have been very good at adapting and thriving from many different cultural diets.

For example, the Mediterranean people have thrived on the traditional Mediterranean Diet.  Asians have thrived on the traditional Asian Diet.  The Tarahumara Native Americans have thrived on their traditional diet.  This list goes on and on.

The only diet that our health suffers from is the “Standard American Diet” (SAD).  Our bodies simply do not thrive in a processed or prepared food environment loaded with sugar, refined grains, and other “Frankenfoods.”

In my opinion, past dietary guidelines have done far more harm than good.  2 in every 3 Americans are now overweight or obese, based in large part, to bad past guidelines.  Millions of Americans now suffer tremendously from many chronic medical conditions that could prevented or even reversed with a “traditional diet.”

The real enemy isn’t the mg of sodium or cholesterol in our diets but rather processed foods, prepared foods, sugar, refined grains, and other “Frankenfoods and Frankenmeats.”

Let this be my call to return to eating real foods!

Please share with me your views on the new nutritional guidelines.

Disclaimer

If you suffer from high cholesterol or are at risk for cardiovascular disease please discuss what diet you should be eating with your physician first before considering any changes based on the content of this article.

#074 Can Wine and Grape Juice Really Burn Fat?

February 9th, 2015 by

Can Wine and Grape Juice Really Burn Fat?

Did you see the latest news headlines that drinking wine or red grape juice can help to burn fat?  A red wine and grape juice diet seems too good to be true, right?

Would you be surprised to learn that there actually just may be some truth to this media headline?  This news story comes from a new scientific study exploring the effects of ellagic acid.

Just what is ellagic acid, is there a better way to get it, and is this something I want more of in my diet?

Red Grapes

In writing this article, I have a disclosure to make.  Red grapes are my favorite fruit.  This publicly professed love of red grapes does have its draw backs though.

This past week I had a full-day of medical society meetings in Washington DC.  Spying the fruit plate I saw one last remaining bunch of red grapes.  I tried taking just a portion of the grapes but they weren’t separating.  Not wanting to make a scene or spill fruit all over my suit, I made the only logical decision in my mind at the time and took the one remaining bunch of red grapes.

Later, a colleague and fellow reader of this blog, approached me on a break and mentioned, “I noticed you took all of the red grapes.”  I was caught and had to confess.  With this article I may be watched even more closely…

What is Ellagic Acid?

Ellagic acid is a potent natural antioxidant that can be found in many different fruits and vegetables.  Ellagic acid has also been shown to inhibit the proliferation of cancer cells in the test tube.

It is for this later effect that many supplement companies have come under FDA scrutiny for falsely advertising that ellagic acid supplements cure cancer.  In fact, ellagic acid is even listed as one of the FDA’s 187 fake cancer “cures” consumers should avoid.

While ellagic acid has not yet been shown to prevent cancer in humans, it should be noted that the effects of ellagic acid on tumor cells is different than resveratrol, which is also found in grapes and was recently discussed in one of my articles.  In this article, we will explore the possible effects of ellagic acid on fat cells and cholesterol levels.

What did this latest study actually show?

Headlines aside, what does the actual science from this study teach us?  In this study from the University of Florida and Nebraska, researchers gave overweight and sedentary mice a muscadine grape phytochemical powder which is packed full of ellagic acid.

The key findings of this mouse study are as follows:

1. Ellagic acid stopped the formation of new fat cells and burned existing fat cells in the liver.

2. Ellagic acid blocked cells from taking up lipids and from forming new lipid particles.

3. Ellagic acid lowered the triglyceride levels of mice.

4. Ellagic acid helped to keep blood sugar levels normal.

These 4 findings suggest that ellagic acid may help mice to stay lean and free of diabetes as well as preventing fatty liver and keeping their cholesterol levels under control.  Could these same fat burning and cholesterol lowering effects be true in humans as well?

What dose of ellagic acid do I need?

If you trying to replicate the effects of this study, you need to know how much ellagic acid was used.  Fortunately, the ellagic acid dose used in this study was a very reasonable amount.

According to the study’s lead author, Dr. Neil Shay, it was the “human equivalent” of eating a cup and a half of grapes each day.  This was just about the amount of red grapes that I was caught taking this past week in Washington DC.

Before we get to enthusiastic about the results of this study, I need to point out the obvious.  This study was done in mice and we are not mice.  As is so common in medicine, benefits seen in a mouse often cannot be translated to a human.  To date, there are no convincing data that the same findings seen in this study can be replicated in humans.

Do we have to drink red wine or grape juice to get these effects?

As you have undoubtedly gleaned from this article thus far, the answer is no.  In this study, mice were given a muscadine grape supplement.

After reading the report that came out this past week that 79% of supplements are a scam according to DNA analysis, I would not recommend obtaining ellagic acid from the supplement form.  Even more frightening is that these supplements did not come from some overseas shady internet site but rather from large chain drug stores like Target, Wal-mart, GNC, and Walgreens.  Indeed, based in part on this report, New York’s attorney general, Eric Schneiderman, is now going after these supplement sellers.

If the supplement form is not a good way to get ellagic acid then red wine and grape juice, like mentioned in news headlines, could be another alternative form.  My concern is that getting ellagic acid from red wine or grape juice could lead to unnecessary weight gain or other undesirable effects.

As mentioned, the amount of muscadine grape supplement given to mice in this study is the equivalent of a cup and a half of red grapes for humans.  This is something that is very doable for most red grape lovers like me.  What should you do if you don’t like red grapes?  Are there other food options for ellagic acid?

The 6 Best Food Sources of Ellagic Acid

If you want to boost your ellagic acid, here are the foods that contain the highest amount of this molecule:

1. Red grapes

2. Berries including blackberries, raspberries, and strawberries

3. Nuts such as pecans and walnuts

4. Peaches

5. Cranberries

6. Pomegranates

Fortunately, these are all foods that are very healthy food choices.  Based on this list it seems like it should be very easy for most of us to get all of the ellagic acid our bodies need.

How do you get your ellagic acid?

Disclaimer

As there are no convincing studies demonstrating the benefits of ellagic acid yet in humans, please discuss this article with your physician before trying to increase your intake of ellagic acid.

#073 What Dogs Teach Us About Health and Nutrition

February 9th, 2015 by

What Dogs Teach Us About Health and Nutrition

Why do 95% of diets fail?  Why is it that most people who start an exercise program quit within 6 months?  Why is it just so hard to live healthy?

If you have ever struggled with eating healthy or getting enough exercise this article is just for you.  Dogs really can teach us a lot about how to maintain a healthy lifestyle.

Our Dog AndiIMG_0131

In March of 2010, after years of intense lobbying by our children, we finally gave in and decided to adopt a family dog.  Our selection criteria were really quite simple.  We wanted a mature dog that was already house trained, one that did not bark much, and one without separation anxiety.  These criteria were all based on our previous dog which caused us much grief.

With these criteria in mind, we packed the entire family in the car and drove off to our local Humane Society to adopt a new family dog.  As soon as we entered, all of the dogs were barking intensely but one.  The only dog not barking was an old and depressed appearing yellow lab lying in a corner kennel.

We asked the employee about the lifeless old yellow lab.  She replied, “the dog’s name is Andi.  She was dropped off after a messy  divorce.  She has already been here a month and will be put to sleep soon unless someone IMG_0991adopts her.”

“Why hasn’t she been adopted yet,” I asked.

“No one wants an old dog,” the employee went on to tell us.  “Most families just want a puppy.”

“Our needs are different,” I replied.  As Andi was the only dog that was not barking, we asked if we could take Andi out for a walk.

Andi slowly stood up and appeared to be in a lot of pain.  She walked with a definite limp, a clear indication of hip dysplasia which is so common in larger dogs.

Andi was an overweight dog and the extra weight was putting a significant strain on her hips.  Despite these limitations, our children quickly fell in love with the old yellow lab on the walk.  When we brought Andi back to her kennel she dejectedly went back in with no signs of separation anxiety.

Our kids begged us to take Andi home but Jane and I needed more time to think about this big commitment.  We also wanted to make sure the children were 100% committed to caring for this sweet old dog.

For days we debated as a family whether or not we should take the plunge and adopt Andi.  Finally, we gave in to the promises of our children that they would indeed care for Andi.

When we finally called the Humane Society they told us that Andi had already been put to sleep.  Our children were in tears.  What should we now do as parents?  We obviously waited too long deliberating this decision.

We decided to return to the Humane Society to look for a different dog.  As soon as we reentered the kennel our children once again spotted the old yellow lab sleeping in the corner kennel.  Fortunately, she was still alive and available for adoption.  We immediately adopted her.

We gave Andi love, put her on a healthy diet, and exercised her daily.  Within a couple of months she lost 20 pounds, her arthritis resolved, and she once again became an energetic dog.

To this day my wife, Jane, still regularly climbs mountains with Andi.  Each day Andi walks with the children to and from the local elementary school.  Today, she is 12 years old and remains in the best physical condition of her life.  She is growing “younger” year by year.

IMG_0660What are the lessons of this story?

In the right environment this old yellow lab, who was struggling with depression, obesity, and arthritis could be transformed into a much younger dog that was lean, happy, and energetic.

Why has Andi been so successful in maintaining her healthy lifestyle when most dogs in the U.S. suffer from obesity and physical inactivity?  It all comes down to having the right supportive community.

With the right supportive community we too can effortlessly maintain a healthy weight, eat the right foods, and get enough physical activity.  The key to health and nutrition is not willpower but rather in creating the right supportive environment.

Dogs Are Not Immune from the Obesity Epidemic

One hundred years ago you would never have seen an obese dog.  Now, according to this CNN report, 55% of all dogs in the U.S. are obese.  How can our obesity epidemic also strike dogs?

It should be so simple to prevent your dog from becoming overweight as the dog’s guardian has 100% control of the dog’s diet.  Perhaps this is the challenge.  Being overweight is now viewed as the norm for dogs just like in humans.

It is not as if our dogs consciously make the decision to eat junk food and gain weight.  They are just like us.  If you surround them with excess quantities of food or unhealthy food choices they will willingly partake just like us.

Dog’s have very limited willpower.  For a dog to live a healthy life they are 100% dependent on the right supportive community or home.  If they have the right home their diet will be healthy and they will never miss the extra meals and unhealthy food choices.

The same is true for us.

Most Dogs Are Now Sedentary

Dogs, like us, were built to move.  Unfortunately, most dogs are now also very sedentary.  Dogs need a reason to be physically active.  If not they tend to sleep most of the day.

Dogs will not just spontaneously start running up and down the stairs to exercise in your home if they don’t get enough exercise opportunities outside from their guardians. Like us, they need the right environment to thrive physically.

Why do diets and exercise programs fail?

I have often pondered why 95% of diets fail and why most people quit their exercise program within 6 months.  Is it because we are weak willed?

Absolutely not.  The reason is that for most people it is extremely hard to swim upstream when everyone else is floating with the downstream current.  In other words, if most people are eating the Standard American Diet (SAD) and junk food is everywhere around you then chances are that you will partake.  To make a healthy lifestyle “stick,” you must be in an environment where everyone else is living the same way.

My Culture Shock in Taiwan at Age 21: No Junk Food!

I grew up a junk food junkie.  I lived the American lifestyle.  I loved my soda pop, pastries, sugar cereals and just about any other simple carb I could find.

At the age of 21 I suddenly found myself all alone without access to junk food in Taipei, Taiwan.  This was my first trip out of the U.S.  I spoke Chinese fluently and was looking to immerse myself in the language and the culture.  A Chinese family willingly welcomed me into their home for the summer.  I thought I was ready for this experience.

The thing I was not ready for was the complete absence of junk food.  There was absolutely no junk food in the home of the Chinese family I was living with.  In 1988 the Chinese just did not have the junk food habit that we had already developed in the U.S.

It was a difficult experience for me.  I went through severe sugar withdrawals.  I was not prepared for this sudden and unexpected “sugar detox.”  I had severe cravings, dizziness, and was irritable for days.

I searched Taipei for Western food stores that catered to foreigners to get my sugar fix.  I did find these stores but on a student’s budget I could not afford the junk food. I had no choice but to detox.

Amazingly, after a couple of weeks I had completely lost my sweet tooth.  As no one around me was eating junk food I never missed it at all.  There was no “new year’s resolution.”  I just lost weight without even trying and it did not take any willpower at all.

The old adage, out of sight out of mind was definitely true in my case.  It was so easy. There was no willpower required.  I thought I was forever cured of my sweet tooth.  Perhaps this is how our dog, Andi, feels living in our home.

Unfortunately, at the end of the summer I returned back to the U.S. to resume my college studies.  Within a week or two of seeing all of my old college friends gorging themselves on junk food the cravings returned.  I was hooked again.

China’s Longevity Village

When we have stayed in China’s Longevity Village over the years, we too, temporarily lost our cravings for junk food.  Why is this the case?  It is because we didn’t see it anywhere.  There was no one to tempt us.

When I give lectures and presentations on the amazing health and longevity of the people living in China’s Longevity Village, I am often asked how is it that the Chinese in this village have so much self-control to eat right and stay physically fit.

The are so surprised to hear that they do not have any more willpower than we do.  They are just like us.  In fact, as soon as these rural Chinese migrate to the big cities in China or to the U.S. they soon adopt our Western ways.

Indeed, they key to their success is the same as with our dog, Andi.  Unless you are part of the 5% of people with superhuman willpower, they key to health, nutrition, and physical activity is the right environment.  Willpower is a finite resource.

Change Your Environment, Change Your Life in 8 Easy Steps

You simply cannot swim upstream when everyone around you is blindly floating downstream for long.  Yes, you can muster enough will power to do this for a few months but not for a lifetime.

Living like this is also miserable.  You may even feel “deprived.”  There is an easier way.  It is the way of our dog Andi or the residents of China’s Longevity Village.  Here are my 8 easy steps to change your environment and change your life.

1. Junk Food Free Home

You cannot control the junk food your coworkers bring in to the office or what is served at the church or community social event.  However, you do have 100% control over what is brought into your home.

Willpower is limited and can be depleted.  Make your home a sanctuary from the world.  You don’t need to battle food cravings within the walls of your own home.

Commit now to never bring junk food into your home again!

2. Find an Accountability Partner

You need to find someone that will hold you 100% responsible.  For many, this could be a personal trainer, exercise partner, or anyone that is not afraid of holding you accountable to your goals.  If there is no one in your life that can fulfill this role you could even look to an online app or a virtual group of people all trying to accomplish the same goal.

If you have to report back to someone you will not want to let them down.  For example, I found that 92% of my overweight patients suffering from a serious cardiac condition were able to maintain an incredibly healthy lifestyle when they were accountable to me by a daily email and a weekly face to face meeting.

3. Avoid the “Bar”

Can an alcoholic stay sober when they enter a bar?  Of course, the answer is “no.”  The same is true for us.

For me, my “bar” is my hospital’s cafeteria.  There, the sirens call of pizza and Diet Coke often seems to deplete my willpower.  For me the only thing that seems to help is to never set foot in my hospital’s cafeteria.

I have found that when I pack a healthy lunch I never miss the pizza or the Diet Coke at all.  My willpower stays strong and I feel much better in the afternoon.

What is your “bar?”  Identify these danger spots and avoid them.IMG_8785

4. Change the Furniture in Your Home

Does the TV contribute to an unhealthy lifestyle for you?  Can you replace the sofa in your front room with a treadmill or exercise bike?  Perhaps you need to get rid of the TV?

Do you have a place to exercise in your home when the weather is not good for exercising outdoors or you don’t have enough time to run to the gym?  Make it easy to exercise.  Dedicate a room or corner of your home to exercise when you are in a bind.

IMG_8787For me, I need time to write articles like this or the book we are working on with Harper Collins.  To help me meet all of my needs, I have a treadmill desk as well as a bike desk in an unused room of our basement as seen here.

5. Pick the Right Friends

Did your Mom tell you the importance of picking the right friends when you were young?  Why is this advice so important?  Studies show that you become the person you spend the most time with.

It has often been said that you become the sum of the 5 people you spend the most time with.  I bet that I can probably predict your healthy just by looking at the 5 people you are closest to.

If you spend time with people who eat junk food and sit most of the day you cannot help but to do the same.  Studies show that your friends and family members will subconsciously determine how healthy and vibrant you are.

Spend time with people that you want to become more like and you will naturally adopt their healthy habits.  Become friends with someone healthy today!

6. Make it Easy to Eat Right

To succeed with a healthy lifestyle you need to make it the path of least resistance.  Always have healthy snacks with you.  Put fruits and veggies on the top shelf of your refrigerator where you will see it easily.  Have the right cooking tools and ingredients on hand to quickly prepare a healthy meal.

7. Have a Clutter Free Bedroom

Sleep is critical to a healthy lifestyle.  Keep your bedroom clutter free.  Never bring electronic devices into the bedroom.  Keep it simple, clean, cool, and dark at night for sleeping.  If you are well rested then it will aid you in your quest for health.

8. Have a Daily Stress Plan

Stress is a given in our modern life.  Stress is everywhere.  The key is to have a plan to manage stress every day.  If you don’t manage stress it will manage you.

Stress management could take on many different forms.  It could be yoga, meditation, a walk in nature, or even spending time with family or friends.  Identify what works for you and make it part of your daily stress management plan.

Closing Thoughts

At the end of the day, dogs are just like us.  They will eat whatever they have access to.  Likewise, they’ll go outside and exercise whenever someone takes them out.

Do you have the right supportive environment for health?  If you have enjoyed this article please share it with a friend!

#072 5 Ways to Heal Yourself with the Power of Your Mind

February 2nd, 2015 by

5 Ways to Heal Yourself with the Power of Your Mind

Did you see the recent worldwide headlines which boldly proclaimed that an “expensive placebo” could reverse the neurologically crippling Parkinson’s Disease?  This was not just an isolated medical study.  Indeed, countless other studies have shown that up to 62% of people can be cured of whatever medical condition they have from just a “dummy pill” or a placebo.

What do these studies teach us?  Namely, that if we can tap into the power of the mind we can literally cure our physical bodies.  In this article we will explore the science behind the power of the mind to cure the body.  I will also share with you five ways to heal yourself with the power of your mind.  These are approaches that I have personally seen transform the lives of my patients in my cardiology practice.

What is the Placebo Effect?

A placebo is a dummy pill or a sham procedure intended to convince the patient that they are receiving treatment for their condition.  The placebo effect occurs when the patient miraculously gets better even though they are not actually receiving any “real” treatment.

This is used all the time in clinical studies.  For example, whenever you test a new medication or medical procedure you must test it against a placebo or a sham procedure.  The reason for this is so that you can know the true healing effects of a medication or a procedure.  As a large percentage of patients “get better” on a dummy pill or by a sham procedure you really have to know what the true effect of the medication or procedure is.

The Nocebo Effect

I recently saw John in my cardiology clinic.  He was experiencing severe headaches, fatigue, and nausea after starting a “new medicine” in a clinical study.  The side effects were so bad that he had to stop the medication.  As soon as he stopped the “new medicine” his side effects immediately went away.

Interestingly, at the end of the study we discovered that John had been randomized to a “dummy pill” in this study.  His headaches, fatigue, and nausea from the “new medicine” were in reality created by the power of his mind.

This is the nocebo effect in action.  The nocebo effect describes a condition where patients have a bad reaction to a dummy pill or a sham procedure.  The nocebo effect can be just as powerful as the placebo effect but just in the opposite direction.

John’s case is not unique.  I have seen many patients who experience severe side effects from a dummy pill while participating in a clinical study.  Fortunately, in clinical studies we see the placebo effect much more commonly than the nocebo effect.  Our mind can really change our reality for the better or for the worse.

If you stop for a moment and think about it, the placebo and nocebo effects are really quite remarkable.  The only explanation is that the mind really can heal or hurt our physical conditions.

Reverse Parkinson’s Disease with an Expensive Placebo

Does the cost of a “placebo” determine just how well the placebo will work?

In this study, researchers told 12 patients with Parkinson’s Disease that they were testing two “new medications.”  The first was a “cheap” new medicine (placebo) and the second was an “expensive” new medicine (the same placebo).

These patients were told that the cheaper new medicine cost $100 per dose and that the expensive new medicine cost $1,500 a dose.  What the patients did not know was that the placebo was in reality the exact same injection of saline or salt water into their veins which really costs just a few pennies.

Parkinson’s Disease is characterized by severe tremors, slow movement, shaking, and ultimately dementia.  Remarkably, these symptoms just seemed to vanish when they were given a placebo (plain saline injection).  Even more astounding is that their functional MRI brain scans also remarkably improved as well.  What set this study apart was that the “expensive placebo” had much more of a healing effect than the “cheap placebo.”

In what seems almost as an act of cruelty, at the end of the study all 12 patients with Parkinson’s Disease were told that they really just received a placebo.  As you can imagine, the patients could not believe this was true.  I suspect that as soon as they were told this news their Parkinson’s Disease likely degenerated and that they lost any clinical benefit from participating in this study.

Redefine What is Possible

I used to get depressed on the long days of being the cardiologist on call at my hospital.  I don’t mind the hard work the problem is that on these days I am generally unable to “exercise” in the traditional sense of the word.  These days are long and as soon as I finish my last surgery and see my last patient I want to hurry home to see my family.

Even though I am not “exercising” on these days, my job as a cardiologist is very physically demanding.  I am on my feet all day long in surgery wearing a 20-30 pound lead suit to shield me from x-ray radiation.  I often walk miles on these days going up and down stairs consulting on patients with cardiac problems throughout the hospital.

Could the reason why I am not getting any of the health benefits from all of this physical activity be because of my definition of what the word exercise means?

The Hotel Maid Study: Placebo Effect in Action

In an equally fascinating study, how we define our lives in our mind can determine our health.  In 2007 the brilliant Harvard psychologist, Ellen Langer, also known as the “Mother of Mindfulness” based on her bestselling book Mindfulness (affiliate link), asked this same question to 84 hotel maids.  The results of this landmark study have had profound effects on our understanding of the mind to heal us.

Langer started the study by asking these hotel maids if they “exercised.”  Most of these hotel maids (67%) reported that they did not exercise.  This response really surprised her as she could see just how physically demanding their jobs really were.

Even though these hotel maids had very physically demanding jobs and clearly exceeded the recommended guidelines for “exercise” you would never know it by looking at them.  These women were not getting any of the health benefits of “exercising” all day long at work every day.  She wondered if the reason why they did not gain any benefit from exercise was because of their perception of what exercise was.

To explore this question, she then took these 84 maids and divided them into two groups.  In the first group she told them how much “exercising” they were doing each day and how many calories they were burning each hour.  For the second group of hotel maids she did not give them any of this information.

Quite unbelievably, for the first group that was told how many calories they were burning and just how much exercising they were doing their health immediately improved.  Even without changing their daily routine or how many calories they ate at all, in just four short weeks their blood pressure dropped and they lost a significant amount of weight.  The second group that was not given any of this information did not experience any beneficial changes.

This study shows us that just having the hotel maids imagine that they were “exercising” during their work day caused their health to dramatically improve.  The same can be true for us.

I personally have tried this approach on my long call days at the hospital with equal success.  By imagining that I am exercising all day long on these grueling physical days has helped me tremendously.  Our mind can really change our reality and our health.

The Mind Cannot Always Heal

Unfortunately, the mind cannot always heal us of everything.  This was certainly the case with the legendary Steve Jobs.

In October of 2003 at the peak of the iPod craze that was sweeping the world, the Apple icon was quite unexpectedly diagnosed with a rare form of pancreatic cancer. His doctors urged him to have this cancer surgically removed immediately.  For 9 months Jobs rejected this advice instead focussing on diet, alternative therapies, and spiritual healers to rid him of this tumor.

Unfortunately, his cancer surgery was delayed 9 months.  This was a decision that he would regret to his death.  By giving his tumor 9 more months to grow many medical experts publicly stated that this delay caused his early death.

Jobs undoubtedly believed he could be healed.  Unfortunately, the tumor proved to be too powerful for his mind alone.

5 Ways to Heal Yourself with the Power of Your Mind

How can we tap into the healing powers of our minds without having to be tricked from a clinical study?  This is something that each of us can do.  I know these 5 strategies work as I have seen them in action many times in my cardiology practice.

1. Believe that You Can Be Healed

Believing that you will get better is probably the most important step.  You need to be able to visualize a life without the medical conditions you are currently battling.  Tell yourself that you are getting healthier every day.

If you are not full of optimism your future health will suffer and it will be difficult for you to overcome your current physical condition.  Every study I have reviewed has showed the same thing.  Optimists enjoy far better health than the pessimists.  To learn how to become and optimist and live up to 8 years longer according to medical studies, please read my article on the topic.

2. Have a Purpose to Your Life

Do you have a reason that gets you out of bed energized and excited each morning?  Do you know what your mission is in this life?

I have seen in my cardiology practice that those patients who have a mission to their lives rarely seem to be held back by their heart conditions.  They seem to just bounce right back up.

Studies have shown that those people with a strong purpose to their life can avoid heart disease, Alzheimer’s Disease, and many other conditions.  To learn how you can develop a purpose or “why” to your life, please read this article I wrote on having a purpose to your life.

3. Trust Your Care Team

If you are going to tap into your mind’s healing powers it is critical that you trust your care team.  Find a doctor or healthcare provider that you can fully trust.  This may require getting a second opinion.

One of the critical reasons why the Parkinson’s Disease patients got better is because they trusted their physicians “expensive” new treatment even though it was in reality just a saline injection or a placebo.

4. Keep a 5 Minute Gratitude Journal

Why is gratitude on this list?  I have seen time and time again that patients who are grateful for what they do have are more likely to recover from their heart condition.

We all have blessings in our lives that we can be thankful for.  Take just 5 minutes at the first of each morning to quickly record your gratitude thoughts in a notebook or even electronically on your phone.

Gratitude can also allow us to redefine the meaning we attach to life’s events.  For example, redefining what “exercise” means is what allowed the hotel maids to suddenly start enjoying all of the benefits of exercise.

5. Understand Your Body Through Meditation

It is too easy to become frazzled and stressed out with our fast-paced modern life.  Indeed, studies have shown that stress plays a role in more than 70% of doctor visits.

If we truly desire better health we need to be in tune with our bodies.  We need to calm our minds and our anxieties.  I have reviewed countless medical studies which show that meditation in various forms can help to heal us.

Meditation can take on a variety of different forms.  It can be yoga, a walk in nature, prayer, or whatever allows you to calm your mind and listen to your body.

Do you believe in the power of the mind to cure?

Disclaimer

While the mind can help to heal us, we cannot rely entirely on our mind alone.  We must trust our care team, including our physicians and other care providers.  This is likely what caused Steve Jobs to die at such a young age from pancreatic cancer.

Of course, physicians and other care providers are not always correct in their diagnosis or treatment plans.  It is always best to get a second opinion for more serious medical conditions.  Find a physician or care provider that you can trust and stick with them.

#071 Do You Really Need 8 Glasses of Water Daily?

February 2nd, 2015 by

Do You Really Need 8 Glasses of Water Daily?

Your mother probably told you to drink 8 glasses of water each day. Many health “experts” also recommend getting at least 8 glasses (64 ounces or about 2 liters) of water each day.

Are you wondering if there’s actually any science backing up this advice?  Just how much water should we be drinking to lose weight and maintain optimal brain and heart function?

What the Science Tells Us about 8 Glasses of Water

You might be surprised to learn that there are actually no medical studies backing up the practice of drinking 8 glasses of water each day.  While there have been studies done on this subject, none of these studies to date have shown any significant benefit.

If there are no data supporting the medical need to drink 8 glasses of water each day then the question naturally arises, how much water should you drink?  The simple answer is, it depends.  In this article we will explore possible reasons why you may want to increase your water intake depending on your weight, brain, and heart goals.

How much water should you drink to stay hydrated?

It appears that the amount really depends on the individual person, where they live, and how active they are. Adults who live in an average climate and are moderately active can likely maintain their health drinking less than 8 glasses per day.  This doesn’t mean that you want to skimp on drinking your water however.

In contrast, those people who exercise frequently or live in very hot climates can lose up to 4 liters of fluid in just one hour of intense exercise on a hot day.  For these people, staying hydrated during a work out is critical for their health and to prevent a heat stroke.  These people could easily drink far more than 2 liters of water in a day.

Why is water so healthy?

Did you know that water makes up about 70% of your body?  Water helps to flush toxins from your bloodstream and cells, allowing your body to experience a daily “detox.”

Staying hydrated is also important for maintaining your energy, getting a good night’s sleep, and keeping your mood up.  If you want to appear young, water can also play an important role.  For example, if you are not drinking enough water, you may appear aged and can suffer from rough or cracked skin, bloating, or puffiness.

Can you really tell the difference between hunger and thirst?

Strangely, medical studies have shown us that we often cannot tell the difference between hunger and thirst. Unfortunately, most of us end up eating something when we really may just be thirsty.

Water helps us to feel full because it takes up a lot of volume in our stomachs.  Sometimes we may think we are hungry, and may even experience hunger pains, but in fact it may be that we are just experiencing mild dehydration.

When we don’t stay hydrated, we don’t feel the best that we could.  We tire easily, feel moody, get headaches, and we don’t function well overall. These uncomfortable feelings make us crave food because we are looking to food for more energy when all we really need is more water.

Water can help us to eat less at meal times as well. Try drinking 2 glasses of water right before you eat a meal and you may find you eat less since your stomach will feel partially full and you won’t be confusing thirst for hunger at all.

Why do water drinkers stay thin?

Have you ever noticed that people who carry a water bottle around with them seem to appear healthier and slimmer than most people?  What is the science behind water drinking and maintaining a healthy weight?

Besides not confusing hunger for thirst, the obvious answer is that if you are drinking a lot of water you probably are not drinking soda pop, fruit juice, or other sugary drinks.  This alone could cause significant weight loss.  I commonly see patients lose more than 20 pounds just by giving up all soda, fruit juice, sports drinks, and other sugary drinks.

Even diet soda may cause significant weight gain in many studies!  Studies show that even though you are not getting any “calories” from diet sodas, the aspartame in diet sodas is feeding your bad gut bacteria which, in turn, may cause weight gain.

Water also causes a significant calorie burn through the process of cold thermogenesis.  If you want to learn more about how to boost your metabolism through cold thermogenesis, I recently wrote an article on this subject (blog #68).

Studies have shown that by drinking 8 glasses (2 liters) of cold water, your body can be forced to burn an extra 400 calories!  Researchers report that most of this 400 calorie weight loss was due to the energy required by the body to heat the cold water up to body temperature.  If you do the math, drinking 2 liters per day of cold water, without increasing your food intake, would burn 42 extra pounds per year.

Since there is no risk in drinking more water for most people (see disclaimer at the bottom of this article), and you might even feel more energetic thereby increasing your work out routine, why not start drinking more water today?

Boost Cognition and Memory with Water

Could helping your child score well on the SAT or ACT college entrance tests be as simple as drinking more water?  Studies have consistently shown that children do better on tests when they are hydrated.  Even adults, based on medical studies, do better on cognition tests when they are well hydrated with water.

Other studies have shown that dehydration, or even relative mild dehydration like not drinking enough water during the day, can impair brain function.  Studies have even shown that fighter pilots don’t fly their planes as well if they are not drinking enough water.  Thus, if you want optimal brain and memory function learn to love water.

How much water should you drink to prevent heart disease?

If your goal is to prevent heart disease and never see a cardiologist, like me, then there are actually some data supporting how much water you should drink.

The Seventh Day Adventists are one of the healthiest groups of people in the world.  The Adventists have been extensively studied and have even been featured in the best selling health book, Blue Zones (affiliate link).

In this study, researchers closely followed 20,297 California Adventists for 6 years.  Interestingly, they found that those Adventists drinking 5 or more glasses of water each day were 54% less likely to die from heart disease!

Just how does water protect against a heart attack?  Could the benefit from water be because they drank water rather than soda pop, fruit juice, or other sugary drinks?  Likewise, could a high water intake be a manifestation of someone who is generally more health conscientious or someone who exercises a lot?

There are some studies that suggest that relative dehydration can cause you to have “thicker blood” or a higher blood viscosity.  If you are not drinking enough water then your blood particles are more likely to clump together and form clots.  These clots could lead to a heart attack or a stroke.  Regardless of how you can prevent a heart attack by drinking more water, it seems to me that drinking at least 5 glasses of water each day is a very healthy habit which we should adopt.

Dr. Day’s 6 Water Rules

To help you maintain a healthy weight and allow your brain and heart to function at its best, let my give you my six rules when it comes to drinking water.

1. Drink water instead of soda, fruit juice, or other sugary drinks

If you want to torpedo your health and your waist line, then drinking soda in either the high fructose corn syrup or diet varieties, juice, or other sugary drinks like sports drinks is a great strategy.  On the other hand, if you want to feel energized and maintain a healthy weight learn to love water.  If water isn’t yet your thing, try adding some fresh lemon or lime to your water.

2. If you are hungry between meals drink water first

Learn to notice the difference between your body’s true hunger signals, versus thirst signals. If you feel hungry between meals, try drinking something first. Wait 30 minutes. If you still feel hungry after 30 minutes, you probably are hungry and should eat something.

3. Drink water to boost your metabolism

To keep your body’s metabolism high, stay hydrated.  As discussed in this article, you can burn a significantly high amount of calories each day by drinking 2 liters of water.

4. Stay hydrated for optimal brain performance

Our brains require plenty of water to function optimally.  Stay hydrated to boost your cognition and memory.

5. Drink at least 5 glasses of water daily for your your heart

While 8 glasses of water (2 liters) has not been shown to make you “healthier,” there are data that drinking at least 5 glasses of water each day may protect your heart.  This may keep your blood viscosity low and prevent clots from forming.

6. Keep water with you throughout the day

As it is so easy for us to become dehydrated through the day, learn to carry a glass or stainless steel water bottle.  Having the water bottle with you is a great reminder to drink more.

How much water do you drink each day?  Do you carry a water bottle with you?

Disclaimer

Please remember that if you suffer from heart failure, kidney failure, or other medical conditions you should discuss your optimal daily water intake first with your physician.

#070 Could Using This Word on Twitter Cause a Heart Attack?

January 31st, 2015 by

Could Using This Word on Twitter Cause a Heart Attack?

What you say on Facebook and Twitter better predicts your heart attack risk than smoking, diabetes, obesity, or high blood pressure based on the findings of this new study from the University of Pennsylvania.  Researchers also found that using just one word in a Tweet can predict with great accuracy who will die from a heart attack.  Just what is the most dangerous word to use in a Tweet?

Tweets and Heart Attacks

As soon as this medical study was published it instantly hit news media outlets across the world.  Many news reports, like this one, reported on the findings of this study.

In this study, researchers analyzed 140 million Tweets across the U.S. What they found is really quite alarming. In those U.S. counties where people Tweet their anger or frustrations are the same counties where people have heart attacks.  In other words, people that Tweeted negative emotions died from heart attacks.

And just what is the most dangerous word to use in a Tweet when it comes to your risk of a heart attack? Would it surprise you that the most dangerous word to Tweet, according to this study, is the word “hate?”

Other dangerous emotions to Tweet about are fatigue and anger. In contrast, places in the U.S. that Tweeted about their optimism on life and positive relationships with family and friends tended not to have heart attacks.

Dr. Day’s Take on this Study

1. Facebook or Twitter could give us a “big picture” look at the general health of a person.

We know from many studies that optimistic and grateful people can avoid heart problems. Likewise, people who dwell on the negative tend to die young and sick.  Social media posts could literally be a “window to the soul” of a person.

2. Should cardiologists now start reviewing what patients say on Facebook and Twitter?

In addition to reviewing the blood pressure logs of my patients, should I also start reviewing all of their Facebook posts and Tweets?  Would this be more helpful to me than ordering a stress test for my patients? Perhaps some clever young entrepreneur will create an iPhone or Android app that could quickly calculate a heart attack risk score by analyzing every Facebook post and Tweet from their social media accounts.

3. We should take a look at our own Facebook posts and Tweets.

This study should really be a wake up call for each of us.  I know it was for me.

What do we write about in our own Facebook posts and Tweets?  Also, the findings of this study apply not just to social media but also to what we talk about at work, home, or even on the telephone.  If we can learn to focus on the positive when interacting with others our health and our hearts will get better.

4. Interpret this study with caution.

While the findings of this study are very interesting and certainly grab media headlines, we need to be careful when interpreting the data. For example, in my cardiology practice, the people who are Tweeting are generally not the people having heart attacks.

5. This is a classic chicken vs. the egg type study.

The question I have when I read studies like this is do sick people Tweet negative emotions or do people who dwell on negative emotions in their Tweets get sick? I suspect both are probably true.

Do you keep your conversations, Facebook posts, and Tweets positive???

#069 Is Cognitive Function Determined by Occupation? 3 Secrets of Getting Kids to Eat Veggies, Fitness is More Important than Fatness, and Lose Weight by Exercising Fasted

January 29th, 2015 by

Recent Medical Studies Podcast

In this podcast, I discuss four recent medical studies.  As I discuss each of these studies, I provide simple strategies we can all implement to enjoy the health benefits from these studies.

You can listen to these podcasts directly from the website or you can subscribe through iTunes or Stitcher by clicking these links to make sure you never miss an episode!

1. Is Cognitive Function Determined by Occupation? (Links below)

News report:

Actual study:

2. Three Secrets of Getting Kids to Eat Veggies (Links below)

News report:

Actual study:

3. Fitness is More Important than Fatness (Links below)

News report:

4. Lose Weight by Exercising Fasted (Links below)

Actual study:

#068 How to Boost Metabolism: Cold Thermogenesis

January 26th, 2015 by

How to Boost Metabolism: Cold Thermogenesis

The world’s greatest swimmer, Michael Phelps, consumes 12,000 calories each day. Based on my calculations, he only burns 9,602 of these calories leaving him 2,398 extra calories each day that are simply unaccounted for.

Why doesn’t he gain any weight from overeating by the equivalent of more than 4 McDonald’s Big Macs each day (2,398 calories)?  Could these unaccounted for calories be due to cold thermogenesis? Just what is the science behind cold thermogenesis boosting metabolism and will this help me to lose or maintain a healthy weight?

Michael Phelps: The World’s Best Athlete

During the summer of 2008 the entire world was focussed on Michael Phelps at the Olympics in Beijing.  In just 8 short days he went on to win 8 gold medals and set many new world records, a feat never before accomplished at the Olympics.

With the 2012 London Olympics he has earned a total of 22 medals from three Olympics. He is arguably the greatest athlete who has ever lived.  In this inspirational video you can see him win each of these 8 memorable gold medals at the 2008 Beijing Olympics.

Michael Phelps: The World’s Biggest Eater?

While much has been written about Michael Phelps’ training schedule, one thing that is rarely mentioned is the 12,000 calories he eats each day.  Yes, he has a grueling daily work out, but no one can burn that many calories in a day long-term.  What is his secret to not gaining any weight?

As you know from my previous articles, I am a cardiologist who believes in science and I also look for the lessons that we can learn from medical outliers.  Here is my assessment of how Michael Phelps has boosted his metabolism to the point that he can eat 12,000 calories a day and yet not gain a single pound.

Michael is 6 feet 4 inches (193 cm) and weighs 194 pounds (88 kg).  According to the many published reports, he works out 6 hours a day from swimming, weight lifting, and running.  According to the Mayo Clinic, he would burn the following calories:

-A 200 pound (91 kg) man swimming vigorous laps burns 892 calories an hour.

-A 200 pound man weight lifting burns 455 calories an hour.

-A 200 pound man running very fast at 8 mph (17 kmh) burns 1,074 calories an hour.

-His basal metabolic rate or the amount of calories he burns at rest, according to the Haris-Benedict Equation, for an extremely active 200 pound man would be 3,602 calories per day.  This is an overestimate of the calories he burns as he only weighs 194 pounds and would actually burn less.

-Assuming he is burning an overly generous average of 1,000 calories an hour for 6 hours of working out plus his metab0lic rate of 3,602 calories daily (total of 9,602 calories) this leaves 2,398 calories that are completely unaccounted for.

Cold Thermogenesis and Michael Phelps

Could these unaccounted for 2,398 calories be due to cold thermogenesis? Lap swimmers usually swim at 75 degrees Fahrenheit (24 degrees Celsius). Body temperature on average is 98.6 degrees Fahrenheit or 38 degrees Celsius.

From a science perspective, heat loss is 20 times faster in water than air. The reason for this rapid heat loss from water is due to conductive heat loss. This also explains why people can suffer hypothermia in 41 degree Fahrenheit (5 degrees Celsius) water in just 10 minutes whereas you could spend hours outside at 41 degrees if you are dry.

Michael Phelps spends approximately 4 hours in the pool each day. In the cool lap pool he is losing a tremendous amount of body heat. This body heat needs to be replaced by boosting metabolism or burning more calories to stay warm. This term is called “thermogenesis” or the production of heat by the body. Thus, cold thermogenesis refers to the body’s attempt to keep the body warm in a cold environment by revving up metabolism or the burning of calories.

Brown Adipose Tissue or “Brown Fat”

You have probably seen many news articles recently about the role of brown adipose tissue or the so called “brown fat.” Brown fat is opposite the usual fat, or white fat, that we get from gaining weight.

Abundant brown fat can be found in newborns as well as animals that hibernate during the winter. For example, the polar bear has abundant brown fat which helps to keep the bear warm in the harsh arctic climate. As we age, most people lose their brown fat.

Brown fat has extensive blood vessels and burns a lot of calories to keep us warm and regulate our body temperature. Many researchers feel that if we could regain our brown fat that it just might help to reverse the obesity epidemic. Many drugs companies are even looking into creating pills that help people to develop more brown fat in order to boost metabolism and lose weight.

Interestingly, new studies have shown that people who spend a lot of time in cold environments can actually regain their brown fat that was lost as they grew older. Could the key to Michael Phelps’ incredible metabolism be that he has more brown fat than the rest of us?

How to Boost Metabolism with Cold Thermogenesis

Perhaps swimming 4 hours a day in a cold lap pool or a winter lake near your home is not your idea of a good time. The same is true for me. I have tried for years to enjoy swimming and I just can’t seem to make it work for me.

As you know, I live in Salt Lake City and love to exercise outdoors. Summer or winter you can find me on top of one of our local mountains.

I also keep my window open in the exercise room of our house where I keep my treadmill and bicycle desks. The fresh air energizes me, prevents sweating, and results in an increased energy burn. Even as I am writing this, I am in shorts on my bicycle desk with the window open. The outside air temperature right now is 20 degrees Fahrenheit or minus 7 degrees Celsius.

Even if you don’t enjoy exercising in the cold there are still ways you can enjoy the massive calorie burn that comes from cold thermogenesis. Let me give you the answer of how to boost metabolism in three simple steps with cold thermogenesis.

1. Exercise in a cool environment

Of course, exercising in a cool lap pool will boost your metabolism much more than cool air due to the much greater conductive heat loss properties of water. Regardless, even if it is cold in the morning when you get up for your run or walk at least you can tell yourself that the cool air is boosting your metabolism. While this is not an excuse to eat more, at least it can help you to maintain a healthy weight.

2. Turn the heat down in your home

Turning the heat down a few degrees in your home is a great way to save money on your energy bill and boost your metabolism. Indeed, a cooler home will require your body to burn more calories to keep you warm.

3. Drink 8 glasses of cold water daily

Eight glasses of water works out to about 64 ounces or almost 2 liters. While there is no scientific evidence that you must drink 8 glasses of water each day for optimal health, all this cold water does require your body to heat it to 98.6 degrees Fahrenheit or 38 degrees Celsius. This is also cold thermogenesis in action as calories must be burned to heat 2 liters of cold water to a much warmer body temperature.

According to this study, drinking 8 glasses or 2 liters of water burns 96 calories each day. If you do the math, drinking 2 liters of cold water each day without increasing your food intake would burn an extra 10 pounds each year.

The Downside of Cold Thermogenesis: Increased Hunger

By this point you may be thinking that cold thermogenesis is the key to boosting your metabolism and maintaining a healthy weight. While that may be the case, it comes at a significant price. The price is that cold thermogenesis dramatically increases hunger for most people.

I have found that if I am not careful, I tend to eat significantly more food after exercising in the cold.  Studies have also confirmed that cold thermogenesis can increase our appetite . What helps me is to realize this ahead of time so as to avoid mindless eating after exercising in the cold.

I realize that I am not burning as many calories per hour from cold thermogenesis as Michael Phelps as it is cold air rather than a cold lap pool for me. However, I love to start my morning work-outs with 1.5 liters of water. I will then go on to drink another liter or so of water over the rest of the day to keep myself hydrated and keep cold thermogenesis going.

If you can’t control the post-exercise hunger from cold thermogenesis then it could backfire on you and you may end up gaining weight in the process. Knowing how hungry you will be after a cold thermogenesis work out could help to prepare you to find ways to prevent mindless eating afterwards.

Sweating or Evaporative Cooling to Boost Metabolism

Perhaps the hunger that follows cold thermogenesis is too much for you. There is an alternative along the same principle and that is sweating or evaporative cooling to boost metabolism.

In this study, exercising in the heat causes much less hunger afterwards than exercising in the cold. Indeed, if the end result is weight loss and you don’t do well battling hunger then heat may be better for you than the cold. Remember, that if you are in a warm environment you will need much more water to stay hydrated. Does this get us back to cold thermogenesis again?

When it comes to how to boost metabolism it appears that either cold or heat could help you to accomplish this goal. The only difference is the level of hunger that you may experience afterwards.

Cold Thermogenesis Disclaimer

Cold thermogenesis or even exercising in the heat is definitely something that you should not try on your own at home. Likewise, drinking 2 liters of water each day could also be dangerous with some medical conditions like heart or kidney failure. If you are interested in exploring cold thermogenesis further, please work under the supervision of your physician.

Do you prefer exercising in the cold or the heat? How do you manage the hunger pains after exercising in the cold?

#067 Does Bad Luck Cause Cancer? Volunteer to Prevent Depression, Weights Beat Cardio for Fat Loss, and BPA Free Plastics May Cause Brain Damage

January 23rd, 2015 by

In this podcast episode I discuss these four recent studies and what they mean for us.   Here are the links to these four studies:

1. Does Bad Luck Cause Cancer?

News report

Actual study

2. Volunteer to Prevent Depression

Study

3. Weights Beat Cardio for Fat Loss

News report

Actual study

4. BPA Free Plastics May Cause Brain Damage

News report

Actual study

If you enjoy this podcast, please try subscribing to it on iTunes or Stitcher by clicking the links.  Now you can listen to these great podcasts while you are driving, exercising, or just about anywhere.


#066 7 Ways to Extend Life and Prevent Cancer with IGF-1

January 19th, 2015 by

7 Ways to Extend Life and Prevent Cancer with IGF-1

NFL football players typically die in their 50s from heart disease or cancer.  In contrast, Laron Dwarfs from Ecuador live incredibly long lives without ever getting heart disease or cancer.  Could too much or too little IGF-1 be the reason?  In this article I will teach you how to optimize your IGF-1 levels to maintain muscle mass, extend life, and prevent cancer.

1986 Superbowl

On January 26, 1986 all of America was glued to the TV screen as they watched the Super Bowl XX match up between the Chicago Bears and the New England Patriots.  Favorite among Americans was the massive rookie defensive tackle of the Chicago Bears, William “The Refrigerator” Perry.

Perry seemed to have it all.  He was one of the biggest and fastest players to ever play the game.  He started the season at 380 pounds.  Not only was he formidable on defense but he was also a powerful secret weapon on offense as well in the role of a running back.  Perry represented the modern NFL player built much bigger and stronger than previous generations of NFL players.

In the third quarter of the Superbowl game with the ball on the 1-yard line the call was made to give the ball to “The Refrigerator” Perry.  On one of the most famous NFL plays of all time, “The Refrigerator” Perry scored the touchdown run as scene in this video of the event helping the Chicago Bears to go on to win their first Super Bowl.

What is IGF-1?

Insulin-like growth factor 1 (IGF-1) is a hormone similar in structure to insulin.  IGF-1 is one of the most potent hormones stimulating growth.  IGF-1 levels are highest during the childhood growth periods and continue to play a role in growth and muscle development even in adults.

NFL football players and body builders likely have the highest circulating levels of natural IGF-1 due to their lifestyles.  For some NFL players they still wanted even higher levels of IGF-1 through performance enhancing drugs.  For example, IGF-1 was suddenly thrust into the spotlight during the 2013 Superbowl game when it was revealed that Baltimore Ravens star Ray Lewis was doping with IGF-1 from deer-antler pills.  Deer-antlers contain high levels of IGF-1 as IGF-1 is what causes the antlers to grow so fast each year in the life of a deer.

On first blush it seems like IGF-1 is something all of us want.  Who wouldn’t want to possess super human size and strength?  Is it any wonder New York Yankees baseball legend, A-Rod or Alex Rodriguez lied under oath that he did not use performance enhancing IGF-1 despite evidence to the contrary?

The Laron Dwarfs: People with Genetically Low Levels of IGF-1

At the same time “The Refrigerator” Perry was dominating the NFL, far away to the South, Dr. Guevara-Aguirre discovered the Laron Dwarfs in Ecuador in 1987.   Dr. Guevara-Aguirre was interested in these three to four foot dwarfs as legend had it that they lived very long lives free from cancer or diabetes.

At the time no one believed Dr. Dr. Guevara-Aguirre’s findings.  It was impossible that there were no reported cases of cancer or diabetes in any group of people.

Currently, there are about 300 known people in the world with the Laron-type Dwarfism.  Of these 300 people, most reside in Ecuador.  Researchers have reported that most of these dwarfs could probably live much longer if it were not for their high rates of alcoholism and accidents likely from their short stature.

The reason why Laron Dwarfs don’t develop cancer is really quite simple.  IGF-1 stimulates growth.  If growth is not stimulated then cancerous cells do not grow and multiply.  Likewise, with low levels of IGF-1 their blood glucose levels remain low even if they become obese.

Aside from their short stature, the other challenge Laron Dwarfs face is that of a decreased intelligence.  In addition to growth and muscles, IGF-1 also enhances cognitive performance.

Interestingly, if you inject IGF-1 into these Laron Dwarfs, like A-Rod, during their adolescent growth periods they will grow to a normal size.  However, if IGF-1 is given after puberty then they will remain as dwarfs.  Clearly, IGF-1 administration has to be critically timed to reverse their dwarfism.

Acromegaly and Excessive IGF-1

On the other end of the spectrum from the Laron Dwarfs is acromegaly.  Acromegaly is a condition where people continue to grow due to a pituitary gland abnormality.  As opposed to the Laron Dwarfs, these people are giants and have very high levels of IGF-1.  Unfortunately, these giants tend to die very young.

One of my favorite Hollywood movie stars growing up was André the Giant who reportedly stood at 7 feet 4 inches (224 cm) and starred in the classic movie The Princess Bride (affiliate link).  Unfortunately, André the Giant suffered from acromegaly and died at the young age of 46 due to complications from this condition.

Dog Size, IGF-1, and Longevity

Elizabeth with Andi

We love our dog Andi.  We rescued this golden lab at the age of 7.  Currently, she is 11 years old.

Even though her health is excellent, we all know that, in general, bigger dogs don’t live as long as smaller dogs.  Given how attached our children are to Andi, we know they will be devastated when this happens.

Why is this the case?  Could the same IGF-1 link hold true in dogs as well?

Recent studies in dogs have shown a similar outcome when it comes to IGF-1 levels and survival.  Larger dog breeds tend to have higher levels of IGF-1.  Consequently, they don’t live as long as the smaller breeds with lower levels of IGF-1.

Unfortunately for me (my height is 6′ 2″ or 189 cm), taller humans have also been shown to not live as long based on IGF-1 levels.  It seems that at least in some studies there is a trade off based on height versus longevity.

Centenarians, Genetics, Cognition, and IGF-1 Levels

Interestingly, studies of centenarians and their offspring have consistently shown lower levels of IGF-1 in those who live the longest.  This link is not just confined to certain ethnic groups.  As we have been very fascinated with the long-term health and longevity of people living in China’s Longevity Village, the same finding holds true with the Chinese.  Chinese living into their ninth or tenth decades of life consistently show lower levels of IGF-1.  These studies seem to suggest that at least in long lived families, there may be a genetic component to IGF-1 and longevity.

While in the extreme cases, like Laron Dwarfs, extremely low levels of IGF-1 are associated with cognitive impairment.  However, in healthy adults like the centenarians mentioned above, IGF-1 levels are not associated with cognitive performance.

7 Ways to Optimize Our IGF-1 levels?

Is there some middle ground between the muscle bound hulking NFL lineman and the diminutive Ecuadorian dwarf?  What is the goal IGF-1 level for optimal muscle strength, cognitive function, longevity, and freedom from cancer and diabetes?

From this article it could appear that there is a trade off when it comes to IGF-1.  On one end of the spectrum you have muscles and strength with high levels of IGF-1 (growth) while on the end you have longevity with freedom from cancer or diabetes with low levels of IGF-1 (repair).  Is there a way to have the best of both worlds?  Can we have both growth and repair going on simultaneously?

Like with most things, there is a healthy range.  For example, when it comes to the heart there is definitely an IGF-1 sweet spot.  Studies have shown that when IGF-1 levels are too high or too low the risk of heart disease is increased.

While in clinical studies or specialized clinics you can test your IGF-1 levels, for most people these lab tests are not available.  However, there are things we can do to keep our IGF-1 levels in the optimal range.

1. Maintain a Normal Vitamin D Level

IGF-1 and vitamin D levels often go hand in hand.  People who have low levels of vitamin D tend to have low levels of IGF-1 as well.  Vitamin D supplementation for people who are low in this hormone tends to normalize IGF-1 levels.

2. Avoid Excessive Animal Meat and Cow Milk

Excessive animal meat and dairy may raise your IGF-1 levels too high.  In contrast, vegans who eat plant-based proteins tend to have low levels of IGF-1.  Could this be one reason why vegans may have a lower risk of cancer and may also live longer?

3. Minimize Simple Carbs

A diet high in the simple carbs has also been shown to raise IGF-1 levels.  Could this explain the reason why a diet high in the simple carbs also leads to an increased risk of cancer and diabetes?

4. Avoid Isolated Soy Protein

Isolated soy protein significantly raises IGF-1 levels.  If you enjoy soy then it should be eaten how it has traditionally been eaten in Asia where they eat a non-GMO variety in the whole bean form.

5. Exercise Regularly

There have been many studies done on the effect of exercise to IGF-1 levels.  The results seem to be mixed.  My research on this topic suggests that regular moderate levels of exercise seems to optimize IGF-1 levels.

In contrast, extreme levels of exercise or excessive weight lifting can significantly raise IGF-1 levels.  Could the excessive animal meat and simple carbs in conjunction with extreme levels of exercise and weight lifting result in very high IGF-1 levels for NFL football players?

6. Maintain a Healthy Weight

Diabetes, obesity, cancer, and premature death all seem to run together.  Researchers feel that there may be a link with IGF-1.  If we want to maintain healthy levels of IGF-1 we also need to maintain a healthy weight.

7. Intermittent Fasting

Studies have shown that intermittent fasting can help to normalize levels of IGF-1.  Could this explain why intermittently fasting may increase longevity? Certainly, excessive fasting or extreme caloric restriction can be dangerous and could drive IGF-1 levels too low for optimal health.

Epilogue: “The Refrigerator” Perry Today

You may be wondering what happened to “The Refrigerator” Perry.  Unfortunately, his post-NFL football career has not turned out well.  Contrary to internet and Twitter rumors, he is still alive at age 52 but his health is extremely poor.  According to this report, he can barely walk, he weighs 450 lbs (205 kg), and he has spent considerable time in the hospital over the last few years.

What are you doing to optimize your IGF-1 levels?

#065 Is Resveratrol the Fountain of Youth?

January 18th, 2015 by

Is Resveratrol the Fountain of Youth?

At the age of 122, the French woman, Jeanne Calment was still as mentally sharp as ever.  A woman who had met Vincent Van Gogh when he still had two ears while she was a young woman in Arles, Jeanne had become an international celebrity for being the oldest documented person to have ever lived.

At the age of 90, the woman who would one day go on to be the oldest person to have ever lived according to documented records, Jeanne Calment, found herself without any direct heirs and dangerously running out of money.  In such a dire situation, a French lawyer made a deal with Jeanne to pay her the equivalent of $500 USD a month if she would sign over her home to him upon her death.

It probably seemed like a good deal for the lawyer.   The only catch was that he had to wait until she passed away.  Perhaps given her advanced age, he thought it would just be a short period before he would have the home free and clear.

As fate would have it, this woman ended up outliving the lawyer.  Not only that, the lawyer ended up paying her more than twice the value of her home.  This stroke of fate allowed Jeanne to live the rest of her life without any further money worries.

Perhaps this deal is what allowed Jeanne to support her 2.2 pounds of chocolate that she ate each week and her red wine.  When she was later asked how the lawyer must have felt about this deal, Jeanne simply replied, “it happens in life that we make bad deals.”

When asked about her secret to a long life during an interview in 1997 just before her death, she credited her longevity to red wine and chocolate, among other things.

For decades, researchers have been intrigued by the potential link between the ingredient found in both red wine and chocolate–resveratrol–and longevity.

Discovery of Resveratrol

In 1939 an obscure Japanese researcher, Michio Takaoka and his students, were doing experiments on veratrum grandiflorum, a plant found on the northern most island of Japan, Hokkaido.  By chance, they isolated resveratrol crystals and shared their findings in a Japanese medical journal unknown to the rest of the world.

His finding had faded away into obscurity until modern scientists once again discovered resveratrol, this time when red grapes made the compound when infected by a fungus.  Further research concluded that resveratrol was a protective effect of red grapes to environmental stressors like weather, bacteria, or fungus.

Now large pharmaceutical and supplement companies have jumped into the resveratrol quest.  Consequently, many studies have been published on the potential benefits of this anti-oxidant, anti-aging, and anti-cancer compound.

Could Resveratrol Explain the French Paradox?

The French Paradox has baffled scientists for generations.  How could the French eat the “wrong” foods and not exercise more than anyone else, yet consistently have the lowest rates of heart disease in the world?  Indeed, based on World Health Organization data, the risk of a heart attack in France is nearly 3 times lower than in the U.S.!

One of the possible theories for the French Paradox is that while enjoying their red wine, the French benefit from the resveratrol in the red wine which can help protect against heart disease.

Possible Health Benefits of Resveratrol

You may be wondering what the science says about resveratrol.  Can you really live to 122 on a diet that includes red wine and chocolate?

1. Resveratrol Slows the Aging Process

Amazingly, when resveratrol is given to worms, fruit flies, bees, and mice they can live up to 38% longer.  Researchers feel that the life extending benefits of resveratrol may come from activation of the SIRT1 gene.  This gene has the same effect to the body as caloric restriction in extending life.

Unfortunately, as we age our DNA slowly degrades with time.  When this happens it can lead to disease, suffering, and ultimately death.  Fortunately, the SIRT1 gene has also been shown to enhance DNA repair which can also lengthen lifespans.  Other research has shown that the life extending benefits of resveratrol may come from activation of mTOR proteins.

Regardless of which mechanism of longevity may be at play, the French remain one of the longest lived people.  In fact, the French live, on average, several years longer than we do in the U.S.

2. Resveratrol Prevents Cancer

In the laboratory setting, resveratrol has been shown to be highly effective in killing many different types of cancer cells.  However, what happens in a test tube and what happens in real life are often two different things.

In living animals and humans these cancer preventing effects of resveratrol have not been as pronounced.  Currently, there are many ongoing studies looking at the effect of resveratrol in both preventing and reversing cancer.

3. Resveratrol Prevents Heart Disease

With regards to the heart, there are many possible explanations as to why resveratrol may prevent heart disease.  In addition to being an anti-oxidant and anti-inflammatory agent, resveratrol has also been shown to have many heart protective effects including the following:

-Prevention of cholesterol from being oxidized in our arteries

-Prevention of blood clots from platelet aggregation

-Improved blood flow within the heart

Whether or not it is the red wine, the French have the lowest rate of heart disease in the world where there are reliable data.  Is it the resveratrol or something else that seems to protect the French hearts?

4. Improves Cognitive Function

Jeanne Calment was mentally sharp right up until her last day of life at age 122.  With humor, when asked about her remarkable longevity, she was quoted as saying “I’ve been forgotten by God.”

Was this due to good genes or the brain protective effects of resveratrol?

In studies done with fish, resveratrol has been shown to protect against age-related cognitive decline.  Additionally, studies in mice and rats have shown that resveratrol can improve brain function by reversing traumatic brain injuryParkinson’s Disease, and Alzheimer’s Disease.

While most of the research on resveratrol and cognitive function has occurred in animals, there are studies in humans showing that resveratrol may improve memory.  In other words, not only may resveratrol increase lifespan but many studies have shown that it can also help to protect the brain with this increased lifespan.

5. Reduces Appetite

As researchers have been busy trying to increase the lifespan of mice with resveratrol, they noticed a very strange thing.  Not only did the mice live longer but they also stayed very lean and would not always eat all of their food.

Over time, this finding has been seen in other animals as well.  Resveratrol seems to cause decreased food intake.  This decreased appetite effect of resveratrol was not anticipated at all.  This effect is now also felt due to activation of the SIRT1 gene which has the same effect on the body as caloric restriction.

Could the resveratrol in the French diet possibly explain their much lower obesity levels than what we see here in the U.S.?  Specifically, Americans are nearly three times more likely to be obese than the French.

This too is also part of the French Paradox.  How can they stay slim on the French diet which would cause many to gain weight?  Indeed, the low rates of obesity in France has prompted a number of popular books like French Women Don’t Get Fat (affiliate link).

Natural Sources of Resveratrol

By now you are probably wondering how can you naturally increase your resveratrol intake.  The primary sources of resveratrol come from red wine or red grapes as resveratrol is most highly concentrated in the skins of red grapes.  There are also other natural sources of resveratrol which include blueberries, cranberries, peanuts, and dark chocolate.  Fortunately for me, these are all some of my favorite foods.

Should I Take a Resveratrol Supplement?

If you believe the the French Paradox then it can’t be from resveratrol supplements as most French do not take these supplements.  Jeanne Calmen never took resveratrol supplements as she got all of her resveratrol naturally from her beloved red wine and chocolate.

Perhaps the biggest challenge with resveratrol supplements is that the bioavailability of resveratrol is extremely low. Even worse, what little resveratrol that it usable by the body may have detrimental effects.  For example, one recent study suggested that resveratrol appeared to negate the benefits from exercise.

My Approach to Resveratrol

At the young age of 100, Jeanne Calment was still riding her bicycle.  I, too, love riding my bicycle and do so in some form on most days year round.  While I don’t drink red wine, my favorite fruit, which I eat in large quantities, is red grapes.  Also, my only sugar vice, dark chocolate covered almonds, also has resveratrol.

While there has been a lot of hype in the media about the many anti-aging and other properties of resveratrol, there still are no convincing studies that it is beneficial yet in humans.  Thus, until further scientific data emerge I don’t think resveratrol is our fountain of youth.

Given this lack of data on resveratrol, I cannot recommend resveratrol supplements.  Likewise, if you don’t drink alcohol I cannot recommend that you start drinking red wine just for the potential health benefits of resveratrol.

However, if you love resveratrol rich foods, like me, then at least you can feel good about eating red grapes, blueberries, cranberries, peanuts, and dark chocolate.  As with Jeanne Calment, perhaps these foods will allow you to stay young, smart, and thin while protecting you from heart disease and cancer.

Do you try to get resveratrol in your diet?

#064 Children and Fast Food, Zen of Yoga, and Dangers of Diet Pills

January 17th, 2015 by

Children and Fast Food, Zen of Yoga, and Dangers of Diet Pills

In this podcast I cover the following medical articles and studies:

1. Children and Fast Food

News report: http://www.medicalnewstoday.com/articles/287414.php

Actual study: http://cpj.sagepub.com/content/early/2014/12/04/0009922814561742.abstract

2. Zen of Yoga

News report: http://www.bbc.com/news/health-30475999

Actual study: http://cpr.sagepub.com/content/early/2014/12/02/2047487314562741.abstract

3. Dangers of Diet Pills

News report: http://www.consumerreports.org/cro/news/2014/12/taking-diet-pills-don-t-waste-your-money/index.htm

#063 Benefits of Almonds, Turning Medical Challenges into Blessings, Avocados Lower Cholesterol, Longevity with Real Whole Grains, and Best and Worst Diets

January 17th, 2015 by

Benefits of Almonds, Turning Medical Challenges into Blessings, Avocados Lower Cholesterol, Longevity with Real Whole Grains, and Best and Worst Diets

In this podcast I cover the following recent medical studies and articles:

1. Benefits of Almonds

News report

Actual study

2. Turning Medical Challenges into Blessings

News report

3. Avocados Lower Cholesterol

News report

Actual study

4. Longevity and Real Whole Grains

News report

Actual study

5. Best and Worst Diets

News report

To make sure you never miss a podcast from me, please subscribe through iTunes or Stitcher by clicking the links.

 

#062 The Four Personality Secrets of Centenarians

January 12th, 2015 by

The Four Personality Secrets of Centenarians

Do You Have the Right Personality to Live to 100?

Only one in every 4,400 people in the US lives to be 100 years old. For many of us, thriving to 100 sounds like almost an unattainable goal, but I’m here to tell you that that’s actually not the case. In fact, there are plenty of ways you can work towards having “a healthy personality” that will help to keep your health intact well into old age.

While most people assume that living to 100 years old must be determined by “lucky” genes, there are plenty of studies that demonstrate the opposite to be true. Take the landmark study that looked at 2,872 Danish Twins born from 1870 to 1900; this study showed us that only 25% of our longevity is determined by genes.

This means that the vast majority, 75%, of our longevity is up to the lifestyle choices we make. Of course our lifestyle is affected by the personality that we choose to put forward into the world each day, because our personality establishes our priorities, stress levels, mindset, relationships, and more. So how do you develop the right personality traits to keep time on your side?

The Four Personality Secrets of Centenarians

According to research from four large centenarian studies (Georgia Centenarian Study, Jewish Centenarian Study, Tokyo Centenarian Study, Swedish Centenarian Study) there are four key personality traits that are common among those who are able to thrive until reaching the 100 year mark. These four traits are as follows:

1. Easygoing

2. Optimistic

3. Love to Laugh

4. Outgoing

These traits are believed to be partly due to genes, but also highly influenced by everyday actions and choices in life that can positively shape your personality.

Assessing Your Own Personality

How do you know if you have the right personality to thrive to the age of 100?  I have taken several online longevity tests using calculators like the ones found on this website. This is where you will find “The Living to 100 Calculator,” put together by researcher Dr. Thomas Perls. Another website I used and recommend is the “Blue Zone Longevity Calculator.”  These free online assessments will give you a rough idea of your projected longevity and where you can improve.

How Does My Personality Stack Up?

According to the results of calculations produced by these sites, I am predicted to live to 96 and 97 years old, respectively. While that’s a very admirable number, these online assessments show that I may not have the perfect personality to make it to 100.

Why am I coming up short, according to these calculations?

For starters, I am not necessarily an easygoing person and I could probably afford to laugh more often. I tend to be very “driven” to the point where it may be a fault of mine. In high school I was very easy going, loved to laugh, and did not seem to have a care in the world.

Perhaps it was the stress and focus required to get me into medical school that started to change the way I reacted to the world. And of course the incredible stress of an extremely high work load once I got into Johns Hopkins Medical School, or even my internship, residency, and fellowships at Stanford University, all likely contributed to “changing” me as well.

Knowing that the four personality traits I listed above are the ideal to strive for based on centenarian studies, I am making improvements wherever I can and taking note of what’s working.

My children are teaching me to laugh more.  For example, they love to play board games, so I am learning to slow down and play board games with them.  They also love comedies and encourage me to watch some with them.

I do have something in my favor.  Fortunately, I am an extremely optimistic person. I believe that things always seem to work out for the better over time, so I often can avoid unnecessary anxiety and worries by keeping this in mind.

While it appears otherwise, I am not naturally outgoing. If I am not expected to be “outgoing” in a social situation, my natural tendency is to be shy. What has helped me overcome this, to some degree, is that I’ve read in studies that 90% of people experience general shyness, so I feel less alone. Since 90% of us feel “shy” and hope that someone else will reach out to us, I choose to play the outgoing role and to reach out and connect with others.

Perhaps if I work on these personality traits more, I too just might live to 100?

How do these personality traits allow us to live longer?

Let’s take a closer look at how these personality traits favor living to be 100 years old:

1. Being Easygoing

Studies have shown that, not surprisingly, easygoing people have lower levels of anxiety.  As you probably know, stress and anxiety really age us. According to certain studies, people with high levels of perceived stress are actually able to age their telomeres 10 years compared to those who regularly experienced less stress. Telomeres are the caps of our DNA that protect DNA from damage, so when they become shortened due to ongoing anxiety, we are prone to chronic disease and an earlier death. Therefore being more laid back is associated with healthier DNA and a better chance of longevity.

2. Being Optimistic

Studies show that optimists live longer than pessimists. Optimists are more likely to eat right and to regularly exercise, as they believe that they will be around for longer and ought to take care of themselves. Some studies have shown that optimists live up to 8 years longer.

3. Laughing Often

According to studies, laughter has many health benefits. Research concludes that “laughter has shown physiological, psychological, social, spiritual, and quality-of-life benefits.”  Additionally, there is evidence that people who regularly laugh are at a lower risk of having a heart attack according to certain studies. Who knew that simply laughing more could solve so many problems?

4. Being Outgoing

People who are outgoing are more able to make friends and therefore to form meaningful relationships, which is very important in keeping your mood elevated and stress levels lower. One study even reported that outgoing people are happier in general than those who are more shy.

Eight Strategies to Develop the Right Personality to Thrive to 100

How can you work on adopting these personality traits more in order to live a long and healthy life?  Let me share with you the eight things I am working on right now to make it to 100.

1. The 10 Year Perspective (to be more easygoing)

I try to approach each challenge I face with a 10 year perspective in mind.  I ask myself, will this really matter 10 years from now?  If the answer is “no”, then I do my best to let it go.

2. Eliminate the Clutter (to be more easygoing)

My biggest struggle is that I take on too many things thus creating too much “clutter” in my life. The book Essentialism: The Disciplined Pursuit of Less (affiliate link) has had a profound effect on me.  Both Jane and I have read it and it has changed our lives.

We are learning to say no to many good, but non-essential, things in life. It is important to realize that when we say “yes” to something we are really saying “no” to something else in our lives.

As we have started to do less, it has actually allowed us to be more easygoing and feel less stressed. It makes sense if you think about it.  The less things you have “on your plate” the less overwhelmed or frazzled you feel.

3. Five Minute Gratitude Journal (to maintain optimism)

Studies show that consciously practicing gratitude is linked with better well-being, less stress, and likely the ability to become more optimistic too. To make an effort to “practice” gratitude in my life more often, I have started doing a “5 Minute Gratitude Journal” on most days of the week.

As I journal what I am grateful for each day, it makes me more optimistic about what the future holds. If I’m having a bad week, practicing being grateful for what I do currently have- the things that are going right– reinforces the idea that there will better times to come.

4. Daily Physical Activity (to maintain optimism)

Moving more throughout the day often results in a better overall mood and sleeping better at night too.  I have found that if I can get in some form of exercise during the day, and then get a good night’s sleep as a consequence, the world looks a lot better.

Studies show that exercise is correlated with increased levels of happiness and reduced stress. Exercise boosts “feel good” hormones and endorphins in our brain, like serotonin and dopamine. These improve our sense of well-being, help to relax us, and give us a sense of accomplishment and personal power.

For even more tips on being more optimistic check out my article, How to Be An Optimist and Live Eight Years Longer.

 5. Spend More Time with Children (to laugh more)

As mentioned, I don’t naturally find myself laughing very much.  I used to laugh a whole lot when I was younger, but along the way I just got too serious as I became older and more focused. The best thing for me to do in order to boost my laugher is to spend more time with my children in “silly play”.

6. Watch Comedies (to laugh more)

My children love their comedies, and like most people, they laugh very often. Their favorite show right now is Studio C, which is clean, family humor. I am now learning to enjoy them with my kids.

How can you learn to laugh more? Ask yourself what kinds of situations bring laugher out in you naturally, and make an effort to do those activates more. Maybe it’s watching favorite funny movies, playing with children, or even playing with your pet that brings out the laughter in you.

7. Remember 90% of People Feel Shy Too (to be more outgoing)

Like I mentioned earlier, about 90% of people report feeling shy.  I use this to my advantage by keeping in mind that I am not alone in my natural tendency towards shyness, and that it is not “just me.”  This helps me to reach out to others in social situations because instead of feeling self-conscious, I tell myself that I am stepping up to the plate and taking the first step towards making a meaningful connection.

8. Make a New Friend Each Day (to be more outgoing)

I try to consciously make a new friend each day if I can. While this is often not possible, having this as a goal changes my outlook on life.

Every time you go somewhere, try to consider it an opportunity to meet someone new and interesting. Really listen to what others are saying, see if you find a connection to your own life, and do what you can to make a new “friend”.

Another great way to meet new friends is to volunteer. This will put you in touch with other like-minded people who share the same values as you, and can also boost your happiness according to studies.

Take a close look at your own life and personality.  What can you do to be more like the centenarians that share these four personality characteristics?  If you can find ways to be more easygoing, optimistic, laugh more, and be more outgoing then you just may be able to thrive to 100 as well.

What personalities are you working on right now?

#061 How to Bulletproof Your Heart: The Roseto Effect

January 12th, 2015 by

How to Bulletproof Your Heart: The Roseto Effect

More than four in 10 Americans will die from a heart attack or other heart problems.  Not only is heart disease still the number one killer for both men and women but the same people who suffer from heart problems are also the ones more likely to suffer from Alzheimer’s Disease, strokes, and poor brain function later in life.

Is it possible to bulletproof your heart so that regardless of your diet or how much you exercise you won’t suffer from heart or brain problems later in life?

What I Was Taught at Johns Hopkins Medical School

When I was a medical student at Johns Hopkins in the early 1990s we were all taught the risk factors for heart disease.  Namely, if you don’t smoke, you don’t have diabetes, your cholesterol and blood pressure are in check, and there is no family history of heart disease then it would be very unlikely for you to have a heart attack.

As I have progressed further in my career and research I have come to learn that there are far more factors at play.  Indeed, these “other factors” may be just as important as the big five I was taught in medical school.   Let’s explore this concept further.  Welcome to a small mysterious town in Pennsylvania where people seemed to magically be protected from heart problems despite a poor diet, high rates of smoking, high cholesterol, and a lack of exercise.

Roseto, Pennsylvania: The Village of “Bulletproof Hearts”

In 1961, at the height of the heart disease epidemic in the U.S., a local Roseto doctor happened to mention to Dr. Stewart Wolf from the University of Oklahoma  that heart disease was virtually nonexistent in Roseto.  From this chance conversation, outside researchers quickly converged on this small town.

With the blessing of the mayor of Roseto, everyone in the village was studied.  They collected blood samples, monitored what they ate, and basically how they lived their lives.  Researchers poured over every death certificate and interviewed everyone.  After spending several years in this small town they had their answer.

As reported in the prestigious Journal of the American Medical Association in 1964, and later by Malcolm Gladwell in his bestselling book Outliers (affiliate link), Roseto was a small community where people ate all of the wrong foods and had high rates of obesity and smoking, had high cholesterol, breathed toxic fumes from working in the slate quarries, and yet somehow were protected against heart disease.  Indeed, the risk of a heart attack in this small Italian village in Pennsylvania was just half as much as the five surrounding towns.

How can this be?  How can you do everything apparently “wrong” for your heart and yet be protected from a heart attack?  There had to be an explanation for this paradox.

At the time, Roseto was a small tightly knit community of Italian immigrants living about 75 miles west of New York City.  This village was settled in 1882 by Italian immigrants from Roseto Valfortore in Italy.  When they immigrated to the New World they kept their exact same social structure as they did in Italy.

This was a socially isolated village.  They only married within the community, kept to themselves, spoke Italian, worshiped God, only shopped at their own local small stores, and lived as three generational families under the same roof.  The worked at the numerous local slate quarries and lived the “old” Italian way even though the rest of the country had already gone through rapid changes in the years following World War II.

The Roseto Mystery Explained

You may be wondering, how can you eat all of the wrong foods, gain weight, smoke, and have a high cholesterol but yet not develop any heart problems?  Let me outline the key factors as to why a heart attack was an incredibly rare event in Roseto.  If we can maintain a healthy lifestyle, unlike the Rosetans, and incorporate these additional four factors then we can truly “bulletproof” our hearts.

1. Family Centered Life

For the Rosetans, family was everything.  Families were close and multiple generations all lived within the same home. Families were self sufficient and took care of their own.

Indeed, there have been countless studies in the medical literature supporting the fact that strong marriage and family relationships can protect us from heart attacks.  As the quality of our family relationships has such a profound effect on our heart health the question is what can we do to strengthen these relationships?

For me, what has helped the most is to put the needs of my family ahead of my own.  As I give of myself it always seems that in the end my needs are met as well.

Also, given my busy lifestyle, I have found that what gets scheduled gets done.  In other words, the calendar on my iPhone is also filled with many family events including scheduled one on one time with family members.

2. Spirituality and Religious Ties

On Sundays, everyone in Roseto went to church.  It was a God fearing community.  They had strong Christian values and were very spiritual people.  They cared for their neighbors and looked after each other.

As with strong family relationships, many studies have shown that religion and spirituality can protect us not only from heart disease but many other chronic medical conditions as well.  Even if you are not religious, taking time to care for your spiritual needs can be very therapeutic.

In our family, we worship together at church each Sunday.  Even if it is a boring sermon at least you can tell yourself that, based on medical studies, you are getting healthier each time you go to church.

3. Strong Community

From a socioeconomic standpoint, you did not know in Roseto who was rich or poor.  There was no keeping up with your neighbors.  Even if you were wealthy it was socially taboo to display your wealth.

The community cared for everyone.  If a neighbor was in need, everyone came to help.  They were all “brothers” and “sisters” in the community.

Once again, there is a vast body of scientific data that socioeconomic disparities or even perceived disparities can lead to heart attacks.  Trying to keep up with your neighbors or peer group will drive you crazy and cause undo stress on your heart.  At the end of the day, all we really need to be happy is a safe home with enough food and loving relationships.

4. Low Stress

Despite difficult working environments at the slate quarries, Rosetans perceived very low levels of stress.  They put their worries into God’s hands and knew that whatever happened in life their family and community would always be there to help.  Crime was nonexistent in this village.

Based on all of the studies published to date, it goes without question that perceived stress is a powerful predictor of who will get a heart attack.  Much has been said about stress and I have published many blog articles on the subject as well.

For me, the three most important things in keeping my stress levels in check are to live as healthy as possible, always plan to arrive or be ready 15 minutes early, and to always look for ways to simplify my life.  As we can eliminate the “clutter” in our lives and focus on that which is truly essential we can minimize our perceived stress.

Roseto Today

By now you are probably considering moving to Roseto, PA and living a utopian life free of heart disease, stress, and worries.  Indeed, this is where Malcolm Gladwell left off in his book Outliers (affiliate link).

I wish this is where the story ended but unfortunately there was an unravelling of the Roseto Effect.  Today, Rosetans no longer have “bulletproof” hearts.  Let me now share with you what happened in the late 1960s.

By the time the late 196os rolled around, the American way of life had infiltrated the village.  They still ate poorly, smoked, and failed to exercise.  However, now they began intermarrying, families started to split up, religion was no longer the glue to the community, and the pursuit of wealth and materialism was in full swing.

Indeed, by the 1970s Roseto was no different than the neighboring towns and their heart attack risk became the same as everyone else as well.  They were no longer bulletproof.

What is the lesson of the Roseto Effect?

In medical circles, the term “Roseto Effect” has come to describe how a close-knit community can escape the risks of heart attacks.  When Rosetans lost the Roseto Effect they then fell victim to the consequences of their unhealthy lifestyles.

While the Roseto Effect is NOT an excuse to live an unhealthy lifestyle, it does show that by having close family relationships, living a spiritual life, caring for neighbors, and minimizing the effect of stress in our lives, we can escape many of the unnecessary chronic medical conditions like heart disease.

Do you have the Roseto Effect working in your life?  Is your heart bulletproof?

#060 7 Surprising Reasons Why You Need Capsaicin

January 4th, 2015 by

7 Surprising Reasons Why You Need Capsaicin

Are you gaining weight because your metabolism is too slow?  Perhaps you suffer from chronic pain or just have high cholesterol?

Could one solution to these medical problems be as simple as chili peppers?  Indeed, capsaicin, one of the key natural ingredients in chili peppers, has been shown to have many health benefits.

My Experience with Chili Peppers

Growing up, I steered clear of spicy foods.  As a child I even believed the old wives tales I heard that a spicy food, like chili peppers, could cause stomach ulcers.

As my food tastes became more mature as I grew older I started liking spicy foods.  While living among the Chinese in Taiwan during college I fell in love with spicy Szechuan Chinese food.  Later, I learned to love spicy Indian, Mexican, and Thai food as well.  I now enjoy the intense spice and health benefits that come from capsaicin.

What if you don’t like chili peppers?

While our two older children love spicy chili peppers, our youngest child will not eat anything “spicy.”  Fortunately, capsaicin is not just found in chili peppers, it is even present in sweet peppers.  Fortunately, all of our children love eating sweet peppers.  We often cut up sweet peppers as snacks at home or to eat while driving in the car.

7 Surprising Reasons Why You Need Capsaicin

Let me now share with you seven surprising reasons why you need capsaicin.  Of course, like everything I share on this website, always discuss any general information I share with your doctor or healthcare provider first before considering any changes you might make in your own diet or lifestyle.

1. Capsaicin Boosts Your Metabolism

When we think of “burning calories” we usually think of exercise.  However, a much bigger source of “calorie burning” comes from our basal metabolic rate or the energy required to keep our body warm and the millions of chemical reactions happening every minute in our body working properly.  If this metabolic rate, or our metabolism, could be turned up a notch or two then we could burn a tremendous number of calories.

Fortunately, our metabolism can get a significant boost from capsaicin.  For example, in just a few minutes after eating capsaicin your metabolism is quickly boosted by 20% for as long as 30 minutes according to this study.

Not only does capsaicin boost your metabolism but other studies have shown that it can also enhance fat burning and decrease your appetite.  If you like to eat chili or sweet peppers throughout the day then this could be a great way to help you lose or maintain a healthy weight.

2. Capsaicin is a Potent Pain Reliever

Do you suffer from arthritis or neuropathy pain?  If so, topical capsaicin could be a great natural pain reliever to help avoid the disabling and addictive effects of opiates.

Many studies have shown that capsaicin, through the skin, can offer tremendous relief for people who suffer from arthritis.  Nerve pain, or neuropathic pain, can be one of the most difficult forms of pain to treat.  Fortunately, capsaicin has also shown great benefit in clinical studies for this condition as well.

3.  Capsaicin Protects You from Oxidized Cholesterol

Cholesterol, in and of itself, is not dangerous to our cardiovascular system.  The risk comes from when bad cholesterol, or LDL cholesterol, is oxidized or reacts with free radicals inside our arteries.

Fortunately, capsaicin has been shown in this study to help stabilize our bad cholesterol so that it does not cause damage to our arteries.  If the bad cholesterol is not oxidized then it does not cause atherosclerosis or inflammation within our arteries.

4. Capsaicin May Help to Prevent Cancer

Given the many effects of capsaicin, researchers have long looked at the potential anti-cancer role of capsaicin.  Some early small studies with impure forms of capsaicin suggested that capsaicin could increase the cancer risk.  More recent larger studies, using a more purified form of capsaicin, have shown that it can prevent cancer.  The data for prostate cancer prevention with capsaicin appears to be the strongest.

5. Capsaicin Can Prevent Stomach Ulcers

Contrary to what we may have heard when we were young, capsaicin or chili peppers can actually help to prevent stomach ulcers.  Capsaicin protects the gastric mucosa or the cells lining the stomach.  Indeed, capsaicin can be very effective in treating peptic ulcer disease.

6. Capsaicin Can Prevent Diabetes

Nearly half of all Americans have diabetes or pre-diabetes.  The scary thing is that most people with pre-diabetes are completely unaware that they even have this condition.

To help combat diabetes, capsaicin has shown tremendous benefits.  For example, in this study capsaicin significantly improved blood sugar and insulin release following a meal.

 7. Chili Peppers Have Many Key Nutrients

In addition to the myriad of benefits already covered in this article, chili peppers are also a very low calorie food packed with many vitamins including vitamins E, K, A, and the B vitamins.  To see the many vitamins and minerals contained in chili peppers, here is an excellent resource.

Do you like spicy foods?  Do you prefer to get your capsaicin from chili or sweet peppers?

#059 Lemon Juice and Vinegar, 2000 Calories, Hugs, and eBooks

December 31st, 2014 by

Dear Podcast Listeners,

Here are the topics and links to the articles and studies discussed on my latest podcast.  If you are not yet a subscriber, please subscribe to my podcast by clicking this link to iTunes.

1. Lemon Juice and Vinegar can help to lower the glycemic effect of foods which could help in weight loss.

2. What does 2,000 calories look like?  Here is the link to the New York Times article.

3. Hugs can prevent the common cold.  Here is the PBS news story on this study.  Here is a link to the abstract of this published study.

4. eBooks at night can harm our sleep and our health.  Here is the link to the news report of this study.  Here is a link to the actual study.

#058 How to Prevent Cancer: The Anti-Cancer Diet

December 28th, 2014 by

How to Prevent Cancer: The Anti-Cancer Diet

As hard to believe and sad as this may sound, today it’s estimated that 1 in 2 men and 1 in 3 women in the US will get cancer at some point in their lives (1).

While genes do play a role in cancer development, the good news is that it has been estimated that 90-95% of cases are caused by lifestyle and environmental factors.   This means you do have a lot of control over whether or not you develop cancer at one point in your life. Some researchers now feel that by following a healthy lifestyle, roughly 75-80% of cancer cases would be prevented (2).

Cancer Can Strike Anyone

I have personally always feared cancer, feeling powerless against this enemy. I am blessed that cancer does not run in my family, but I know that certainly does not make me immune. I want to believe that if we do everything right we will be protected from all health tragedies, but deep down I know that is not the case.

My dear colleague and friend just recently began chemotherapy for metastatic lung cancer; he has never smoked a day in his life, has no family history of cancer, has been running marathons his entire life, and eats a healthy diet. It just does not seem fair, someone who has always lived a healthy life developing stage 4 lung cancer at a young age.

What causes cancer?

According to studies, 25–30% of cancer cases are due to tobacco use, 30–35% are linked to a poor diet, and 15–20% are due to infections.  The remaining percentage are due to environmental factors including alcohol, radiation, stress, lack of physical activity, environmental pollutants, etc. (2)

What can I eat to prevent cancer?

I am often asked this question so I want to summarize what I’ve learned after reviewing many medical studies on the “anti-cancer” diet topic. First and foremost, focus on eating a diet that is filled with protective fruits and vegetables and low in inflammation causing foods and preparation methods.

This type of diet will help you to reach and maintain a healthy weight, which studies have shown us is a protectant against cancer development. Obesity increases the risk for developing cancer due to the on-going stress and inflammation it puts on the body, therefore a diet that is very high in nutrients, but overall low in calories, is the best kind for protecting against cancer (3).

Here is how to go about adopting an anti-cancer diet:

1. Make fruits and vegetables the star of your meals-

According to numerous credible studies, all fruits and vegetables seem protective against cancer. This is because fruits and vegetables contain vital antioxidants and phytochemicals.

Antioxidants fight something called “free radicals” within the body. Free radicals are really a by-product of living a normal life; they are produced by our everyday actions like walking and eating, however when they become outnumbered due to their counterpart antioxidants being too low within the body, they can cause all kinds of harm.

Some studies have shown that more than 25,000 different phytochemicals are in fruits and vegetables. Phytochemicals are the plant chemicals that nourish us and help to keep us healthy and free of cancer (4).

Fruits and vegetables have been shown to help protect us against almost all forms of cancer. Interestingly, certain studies show that fruits and vegetables are especially helpful in preventing breast cancer in women who are not physically active (5). While eating a diet high in fruits and vegetables is not an excuse NOT to exercise, it is interesting that a healthy diet high in phytochemicals and antioxidants from fruits and vegetables could be protective against cancer even for people who are unable to exercise regularly, perhaps when they are healing from an injury or another physical condition.

This is just one more reason why an anti-cancer diet is so important. A wide variety of fruits seem to be best for optimal cancer protection. For example, the rockstar of fruits, blueberries, have been shown to help prevent breast cancer (6). In addition, all types of citrus fruits, oranges, grapefruit, lemon and lime juice for example, are also correlated with a decreased risk of developing breast cancer (7).

A wide variety of vegetables can help to prevent cancer, including all leafy greens like spinach and kale, mushrooms, onions, tomatoes, broccoli, cauliflower, and many more. In fact, there are basically zero vegetables that do not contribute at least something towards preventing cancer (8).

2. Consume cruciferous vegetables regularly-

Data are especially strong for the cancer-preventative properties of all cruciferous vegetables. Cruciferous vegetables include broccoli, cauliflower, brussel sprouts, kale, bok choy, and various types of cabbage.

While fruits and veggies in general are very potent anti-cancer agents, cruciferous vegetables seem to be some of the strongest, thanks to their potent sulfur-containing phytochemicals. The compounds found in cruciferous vegetables can knock out cancer carcinogens before they even start turning ordinary harmless cells into cancerous ones. It’s best to ideally consume some sort of cruciferous vegetables everyday if you can, but if not, aim to have them as often as possible.

Try buying the organic varieties of fruits and vegetables whenever you have access to them, so that you limit pesticide exposure. And consume the freshest cruciferous vegetables that you can, since they begin losing nutrients quickly after being harvested. One great option is to buy frozen vegetables, since these are often picked at their peak of freshness and come in organic varieties that can still be bought at good prices. For much more information on cruciferous vegetables, you can refer to my article here.

3. Consume the right kinds of carbohydrates-

Studies have shown that sugary processed foods (also called simple carbs) increase the risk of breast cancer. The types of sweets to avoid include: soda, sweetened juices and sports drinks, cookies, cake, flavored yogurts, ice cream, candy, sweetened cereals, and so on (9).

In studies, women who ate diets high in sugar and simple carbohydrates were at a 35% increased risk of breast cancer, especially if they were also overweight. While simple sugars are a risk factor for cancer, 100% real, whole grains can be a protector. Whole grains including barley, sorghum, millet, rye, and oats contain important antioxidants, vitamins, minerals, and fiber- so these are a good addition to any diet, as long as they are not refined and stripped of their beneficial nutrients (10).

4. Consider eating a plant-based diet more often-

Studies show that a plant-based diet is often one of the best ways to prevent cancer. Contrary to popular belief in the U.S., animal products are not the only source of protein-legumes, nuts, seeds, 100% whole grains, and even many vegetables contain plenty of protein too, in addition to many other nutrients like fiber and trace minerals (11).

I personally eat legumes, nuts, and seeds daily as a great source of plant-based protein and fiber. The American Heart Association recommends eating both legumes and nuts on most days of the week because they are good for the heart and for cancer prevention.

5. Make sure to eat a high amount of dietary fiber-

The average American eats roughly 15 grams of fiber daily, while the daily recommended amount according to nutrition experts is around 30 grams daily. If you aren’t eating a diet high in fruits and vegetables already, and you aren’t normally a “plant-based” eater who consumes legumes, nuts, and seeds then chances are you’re not getting enough dietary fiber.

In studies, fiber is correlated with preventing colon cancer because a high fiber diet results in a faster gut transit time for your food (12). Fiber helps to pull toxins, waste, and heavy metals out of your gut, leaving you with a healthier gut flora. It’s an excellent way to prevent constipation and it also helps to make you feel fuller, so you are less likely to snack on junk foods throughout the day and can stick to a healthy diet.

If you don’t know how much fiber you eat each day, there are many excellent apps now that can help you to track this. Personally, I track my nutrient intake via the app “Lose It” and “Health” on my iPhone.  I average 68 grams of fiber daily!

6. Include nuts and seeds in your diet often-

Nuts have been shown to help prevent cancer according to studies. Due to their high amount of antioxidants and trace minerals. Nuts, like all essential healthy fats, also help to make you feel satisfied after eating so you can go longer without snacking and minimize overeating.

Focus on consuming nuts and seeds like almonds, chia seeds, flax seeds, and walnuts to get plenty of healthy plant-based fats and omega-3 fatty acids which are protective against cancer (13). Minimize saturated fats from animal products and refined, hydrogenated oils that are used in many store-bought packaged foods.

7. Limit the amount of red and processed meats you consume-

There are significant data linking red and processed meats with cancer. For example, bladder cancer has been shown to increase as more red and processed meats are included in the diet (14). According to studies, red meat also increases the risk for lung, prostate, and breast cancers too (15), (16), (17).

Until recently we have not known why red meat is consistently linked to an increase risk of cancer.  In a recent study published in Proceedings of the National Academy of Sciences, Dr. Ajit Varki identified the possible link between red meat and cancer.  This link is from a sugar molecule, Neu5Gc, which is found in red meat but not in poultry or fish.  While Neu5Gc is found in other animals, this molecule is foreign to humans and appears to trigger an immune reaction which may then lead to cancer.

Perhaps this risk could be avoided with wild or organic red meats but there are not much data as of now that tell us whether or not this is the case. So in the meantime, regularly consume plant sources of protein like beans, real whole grains, nuts, and seeds, and consume less low-quality meat products.

When you do include meat in your diet, treat it like it is a condiment- added to your meal to add a bit of extra flavor- but not the main dish. I learned this from when I lived in Asia in the 1980s; I was surprised to see that meat was just used to flavor the dishes rather than being the star of the main course, as it is in the U.S.

It is important to remember that meat is not the only source of protein.  We should eat 1 gram of protein per 1 kilogram of body weight.  Very active people may need a higher amount, but there are many non-meat protein options such as legumes, nuts, and seeds.

Fish and organic, cage-free poultry are better options for cancer prevention according to studies (18). The American Heart Association recommends fish twice weekly.  This could be the best cancer preventing source of animal protein there is, especially if it is a wild oily fish. My personal favorite is Wild Alaskan Salmon; you can read more about how I include salmon and other fish in my diet here.

8. Prepare your food in the healthiest ways possible-

Some cooking methods preserve more nutrients in your food and release less toxins than others. When cooking meat, be careful not to burn it or cook it at very high temperatures at this can release toxins and carcinogens into the food (19). The safest way to cook meat is to boil or steam it, but try to minimize using a BBQ.  Also choose fresh cuts of meat rather than smoked, cured, or preserved meats

Another toxic group of foods to avoid is oxidized oils, meaning oils that turn rancid or lose their health benefits when they are cooked at high temperatures. Oils to avoid cooking at high heat- meaning frying, BBQing, or even roasting with them- include soybean oil, safflower oil, canola ice, corn oil, sunflower oil, and other vegetable oils. Even olive oil, which normally healthy, does not have a “high smoke point” and cannot withstand very high heat cooking. Try using coconut oil for high heat cooking instead, since it has a higher smoke point before turning rancid.

When cooking, try using cancer-preventative fresh herbs and spices to naturally flavor fresh food yourself, rather than buying pre-flavored packaged foods which likely contain artificial ingredients, sodium, sugar and preservatives. Try using curry, ginger, garlic, thyme, oregano, and basil which all have antioxidant abilities and other anti-cancer benefits (20).

The Big Picture

Cancer often starts developing many, many years before it ever manifests. While potentially cancerous cells are formed inside of our bodies all the time, fortunately our immune system normally takes care of killing these dangerous cells.

In the end we are all mortal and something will fail us at some point in our lives.

The key is to live as healthy as we can to avoid any unnecessary suffering. However, when tragedy does unfortunately strike, we need to find meaning in our health challenges. I am praying that my friend quickly recovers from his struggles with lung cancer. And I also hope that you can use the information in this article to begin eating a powerful anti-cancer diet that will help protect you and your family from disease as much as possible.

If you have a history of cancer or want to learn more, you will want to be sure to speak with your doctor about what diet is right for you and can best help to protect you against cancer.

What changes have you made in your diet to help protect you from cancer?

#057 How to End Insomnia and Weight Gain

December 27th, 2014 by

How to End Insomnia and Weight Gain

Do you suffer from fatigue, stress, depression, anxiety, brain fog, high cholesterol, or a raging appetite?  If so, there is a good chance you are one of 70 million Americans who also have difficulties sleeping.

Could the dramatically rising rates of sleep deprivation over the last 50 years be responsible for why most people are gaining weight?

The Dangers of Sleep Deprivation

A recently published study showed that sleeping an average of just 5.7 hours a night for one week changed the expression of 711 genes in the body!  Many of these genes are the very same genes that cause obesity, heart disease, and dementia.  Is it any wonder that insomniacs are 55% more likely to die from heart disease.

Even as little as one night of severe sleep deprivation can cause the same injury to the brain as a concussion. If you are part of the 10% of Americans who even occasionally take a sleeping pill like Benadryl or an antihistamine, your risk of premature death is 3 times higher!

My Struggles

I have battled with insomnia for most of my adult life.  It started in college and has been with me ever since.  I suspect much of my battles with insomnia are due to stress, travel, and disrupted sleep from being on call for the hospital at night.

I have found that when I am sleep deprived from stress, travel, or being on call for my hospital that I tend to have a ravenous appetite.  In a previous blog post, I shared my 10 strategies to better sleep.

The topic of this article is how can we channel our increased appetite from sleep deprivation into better sleep?  In other words, how can we eat our way to better sleep and weight loss?

How a Lack of Sleep Changes Our Hormones and Metabolism

1. It Increases the Stress Hormones (Cortisol and Adrenalin)

When we are sleep deprived it increases our stress hormones cortisol and adrenalin.  With regards to weight gain, cortisol is particularly troublesome.  As anyone who has ever taken cortisol, in the form of Prednisone or a short course of steroids, will tell you that while they took this drug their appetite was intense and they gained weight.

2. It Increases the Hunger Hormones (Low Leptin and High Ghrelin)

Have you ever felt yourself craving sugar after a bad night of sleep?  Why is this the case?

When we are sleep deprived our leptin levels are low and our ghrelin levels are high.  Leptin is the hunger hormone that tells our brain we are full.  Ghrelin is the hunger hormone that tells us it is time to eat.

When these hormones are particularly out of sync, we tend to crave the high sugar and fatty foods.  Unfortunately, the fatty foods we tend to crave in this hormonally disrupted state are the unhealthy fats like those found in french fries or processed foods.

With low levels of leptin our brains never get the signal we are full.  Likewise, with surging levels of ghrelin we feel compelled to eat even when we have already eaten.

3. It Raises Our Blood Sugar

Our blood sugar levels tend to be high when we are sleep deprived.  There are many reasons why this happens.  Some of these include the decreased use of glucose by the brain, insulin resistance, and from the high levels of cortisol.

When our blood sugars run high, the body compensates by releasing more insulin.  Insulin not only can stimulate hunger, as any diabetic quickly finds out when they start taking insulin shots, but it also drops blood glucose.  When our blood sugar levels bottom out from insulin it triggers the hunger hormones which again tell us we are hungry and it is time to eat.

How to End Insomnia and Weight Gain in 7 Steps

As we have now covered how sleep deprivation changes our hormones and metabolism to eat more, I now want to discuss how we can reverse this process.  Yes, it is very possible to channel our increased appetite from sleep deprivation into eating our way to better sleep and weight loss.  Here are my best 7 strategies to end insomnia and weight gain.

1. Shut the Kitchen Down at 7 pm

Eating late at night not only leads to weight gain but compromised sleep as well.  Indeed, in this study researchers found that late night eaters had worse sleep quality.

Late night eating is an important cause of acid reflux.  Acid reflux is a well-known cause of poor sleep at night.  Even if you don’t get the typical chest pain that often comes from acid reflux it can still disrupt your sleep.

In addition, there is a growing body of evidence that intermittent fasting or time restricted feeding can reverse obesity.  In this recently published study in mice, researchers found that just by timing when mice ate determined whether they were lean or obese even though they ate the same number of calories.

The best way to make intermittent fasting or time restricted feeding work for you is to stop eating early in the evening.  By the time breakfast arrives, at least 12 hours will have passed and you will have accomplished intermittent fasting or time restricted feeding without even trying!

2. Have “Tryptophan Nuts and Seeds” for Dinner

Have you ever felt tired after a big turkey dinner at Thanksgiving?  Odds are that the sleepiness was due to high levels of tryptophan from the turkey.  Tryptophan is a sleep promoting amino acid that helps your body to produce melatonin.

Nuts and seeds are the perfect dinner time food for sleep and weight loss.  They are packed full of protein, healthy fats, and fiber which means they will keep you full until morning so you won’t be tempted for a bedtime snack.

In addition to the perfect trifecta to staying full (protein, fat, fiber), the tryptophan nuts and seeds will help to put you to sleep.  The nuts and seeds high in tryptophan include walnuts, cashews, and sesame seeds.

3. Eat a High Magnesium Dinner

Magnesium is a mineral that 60% of Americans are deficient in.  Magnesium relaxes muscles and our nervous system.  Magnesium has even been shown in clinical trials to improve sleep.

Some excellent choices to increase your magnesium levels would be pumpkin seeds, spinach, sesame seeds, sunflower seeds, almonds, or pecans.  Not only will more magnesium help to improve your sleep but  it can also help with anxiety.  Anxiety robs many of my patients from blissful sleep.  To learn more about the many health benefits of magnesium, here is a link to an article I wrote on magnesium.

4. Have “Lettuce Opium” for Dinner

From as far back as the ancient Egyptians, the milky fluid part of lettuce has long been known to produce opium like effects.  Not only does lettuce taste great in a salad but it can also reduce pain and promote sleep.  This is especially helpful as I have found that so many of my patients are kept up at night from chronic pain.

Studies have now been done to prove what humans have known for thousands of years, namely that lettuce has sleep inducing qualities.

5. Eat a High Calcium Dinner

Like magnesium, calcium also relaxes muscles and the nervous system.  Although the data are somewhat limited, there is some evidence that calcium with magnesium may help to promote sleep.  In addition, calcium can help the brain to better utilize tryptophan in the production of melatonin.

While dairy is certainly a good choice for obtaining calcium, often overlooked options for calcium include tofu, sardines, sesame seeds, spinach, or kale.  To learn more about what foods contain calcium here is a good link.

6. Eat Vitamin B6 Foods for Dinner

Vitamin B6 plays many different roles in the body.  One of these include regulation of tryptophan and serotonin which are important for healthy sleep.

Some excellent foods that are high in vitamin B6 include tuna, salmon, sweet potatoes, sunflower seeds, spinach, or a banana.  It is best to get vitamin B6 at night from foods rather than supplements as vitamin B6 supplements taken at night may cause vivid dreams.  When you are sleep deprived state the last thing in the world you want is to be awakened from an intense dream.

7. Eat Cherries to Boost Melatonin

In one study, cherry juice was shown to boost natural melatonin levels and improve sleep quality.  While drinking your calories is not a good option for weight loss, the same sleep promoting benefit could be obtained by eating whole cherries.

Putting it All Together: The Perfect Dinner for Sleep

I realize that I just shared many different strategies to eat your way to better sleep and weight loss.  How do we put it all together?

Let me share with you my perfect dinner for when I need a good night of sleep.  Have the following before 7 pm at night for best results.  This simple dinner will cover all 7 strategies discussed in this article.

Eat a lettuce and spinach salad loaded with sunflower seeds, pumpkin seeds, walnuts, and almonds.  By loading your salad with nuts and seeds it will keep you very full until morning.  For a sleep enhancing dressing try a healthy cherry vinaigrette dressing made with dried tart cherries or a tart cherry juice instead of orange juice in this recipe. Although this recipe does not call for a blender I would suggest using one for the optimal consistency of this dressing.

What do you eat for dinner when you need a good night of sleep?

#056 Should I Take Vitamins and Supplements?

December 22nd, 2014 by

Should I Take Vitamins and Supplements?

With recent articles like “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements” appearing in prestigious medical journals, many people are now reconsidering their daily vitamins and other supplements.  Yet, half of all Americans still take vitamins and supplements.

When you look at who is taking supplements in the U.S., it is generally women, older Americans, and those who are more educated and better off financially.  Should you still take your vitamins and supplements?

My Vitamin and Supplement Disclosure

Before we get too far into this article, I should disclose that I do take vitamins and supplements.  In the past, I used to take a multivitamin and fish oil.  However, given the potential risks of each individual component in the multivitamin, I try to get all of the nutrients I need from real food and I now only take the following:

1. I take a vitamin D supplement from November 1 through March 31 as I live in Salt Lake City which is too far north (above the 37th latitude) for natural vitamin D from the sun during the winter months.  While I do get some vitamin D from fish and eggs, I have tested my levels in the winter and they are low from fish and eggs alone.

2. I take iodine, in the form of whole kelp, several days a week as I rarely eat dairy, my salt is not iodized, and I cannot get enough iodine in my diet from eating wild salmon and strawberries several times a week.

3. I take a biologically active sublingual form of vitamin B12 weekly to ensure that I am getting enough of this vitamin as I generally only eat meat on the weekends (wild salmon) and may only have eggs once a week.  It is very possible that I am getting enough vitamin B12 from the fish and eggs alone.  At some point in the near future I will test myself to see if this is indeed the case.

The Concern with Vitamins and Supplements

Why are prestigious medical journals attacking the powerful 30 billion dollar supplement industry?  It is because most vitamins and supplements have not been shown to prevent chronic disease or premature death.  Moreover, vitamins and supplements may potentially even increase your risk of certain diseases, cancer, or premature death.

Clearly, there is a role for vitamins and supplements when people have known deficiencies.  Also, while people may be eating all of the right foods they may not be fully absorbing key nutrients in their gut.

Potential Risks of Specific Vitamins and Supplements

It seems like each year there is a new study documenting the potential dangerous effects of certain vitamins and supplements.  Here is a review of the life-threatening potential risks of the most popular vitamins and supplements.

1. Vitamin A and Beta-Carotene Supplements

It seems like a paradox, and one that will play out over and over in this article, a diet high in vitamin A and beta-carotene from real foods (fruits and vegetables) decreases the risk of cancer.  However, in well designed clinical trials, vitamin A/beta-carotene supplements had the opposite effect.  When taken as a supplement the risk of cancer was increased!

Fortunately, it is very easy to get all the vitamin A we need from a diet high in fruits and vegetables (here is a list of the vitamin A containing foods).  Clearly we do not understand the myriad of effects of the thousands of different molecules in real food versus an isolated single molecule in a supplement.  Thus far, scientists have not been able to replicate the health benefits of real food in a supplement form.

2. Vitamin E Supplements

Unfortunately, there is an increasing body of data that vitamin E supplements may increase the risk of cancer.  Other studies have shown that vitamin E supplements may cause premature death.  We don’t yet know what dose of vitamin E increases our risk of cancer or premature death.  As vitamin E is in most multivitamins, this does cause me some concern.

Vitamin E is an important antioxidant and can prevent many chronic diseases when eaten in the form of real food. Fortunately, for those eating a healthy diet with plenty of nuts, seeds, fruits, and vegetables it should be easy to get all of the vitamin E your body needs from real food.  To learn which foods contain vitamin E, here is an excellent reference.

3. Selenium Supplements

Once again, while selenium is a powerful antioxidant and can help to decrease your risk of heart disease and cancer, taking too much of this through supplements may increase the risk of cancer.  Selenium is an easy nutrient to get from real foods.  Just one Brazil nut each day is all you need to get enough of this important mineral in a real food form.

4. Folic Acid Supplements

In an effort to reduce the risk of neural tube defects and other folate deficiencies, folic acid is now regularly supplemented in refined grains and processed foods.  If you eat processed foods and also take a multivitamin you are probably getting too much folic acid.

While high dietary intake of folic acid has been consistently associated with lower cardiovascular disease and cancer, taking it in the supplement form has shown no benefit in preventing heart disease or cancer. Even worse, research is emerging that folic acid supplementation may increase the risk of cancer and cause premature death.

Once again, it is easy to get enough folate in your diet particularly if you eat your greens and legumes each day.  To see which foods contain folate, here is an excellent reference.

5. Magnesium, Zinc, Copper, and Iron Supplements

Magnesium, zinc, copper, and iron are considered a “must have” in most multivitamins.  However, some data have linked these minerals, when taken as a supplement, to an increased risk of premature death.

The data implicating these minerals as potentially dangerous is tenuous at best.  Correlation does not mean causation.  It is possible that “sicker” people gravitated to supplements as a way to start feeling better.

Regardless, it does cause some pause for concern.  Especially that in most cases, these minerals can be easily obtained as part of a healthy balanced diet of real foods.  Follow these links to find out what foods contain magnesium, zinc, copper, and iron.

6. Calcium Supplements

While calcium supplements are commonly taken by older women as a means to prevent osteoporosis, could it be possible that calcium is actually causing harm?  Yes, according to this study.  Calcium supplements increase the risk of a heart attack by 31% in this study.

There are certainly other ways to ensure healthy bones.  For example, daily exercise, including strength training, and plenty of vitamins K and D as well as calcium through a healthy diet and lifestyle can do wonders for our bone health.  For a list of foods high in vitamins K, D, and calcium click on these links.

7. Fish Oil Supplements

A few years ago cardiologists were enthusiastic about giving fish oil supplements to most cardiac patients.  I even took fish oil supplements for a period of time.  As fish has long been known to be very heart healthy, it was just typical human thinking to think that we could get all of the benefits of fish in a simple little fish oil pill.  Indeed, early studies even supported the health benefit of a fish oil pill.

Now, there are more and more studies coming out about the potential cancer risk of fish oil supplements.  Once again, we can get all of the cardiovascular benefits from fish by eating real fish at least twice weekly as recommended by the American Heart Association.  For me, I generally have wild salmon each Saturday and Sunday.

Should I Take a Vitamin D Supplement in the Winter?

Low vitamin D levels have been linked to most chronic diseases and even premature death.  Certainly, the best way to get vitamin D is in a sun-smart way so that your risk of skin cancer is not increased.

Unfortunately, if you live above the 37th latitude in the Northern Hemisphere (north of Los Angeles) or below the 37th latitude in the Southern Hemisphere, much of the year it will be difficult for you to get the vitamin D your body needs from the sun.  Here is a map to see where the 37th latitude runs in the U.S.

Fortunately, there are now great apps for smart phones that can even calculate your daily vitamin D intake from the sun and food.  Here is the free iPhone app that I have started using.  For a list of foods high in vitamin D you can click on this link.

Who is Regulating the 30 Billion Dollar Vitamin and Supplement Industry?

Would it surprise you to hear that the answer is no one?  While prescription medications are highly regulated by the FDA, no one is making sure our supplements are free of contaminants or even contain the amount of the supplement listed on the label.  To make sure you are even taking what you think you are taking, make sure that any vitamins or supplements you take are USP or GMP certified.

Vitamin and Supplement Use in China’s Longevity Village

From our research of the centenarians in China’s Longevity Village (links to a video and news report) it was readily apparent that none of them took any vitamins or supplements.  They obtained all of their needed nutrients from their food, water, and sunlight.  The same can be true for us.

Should I Take Vitamins and Supplements?

Returning back now to our original question, should I take vitamins and supplements.  The simple answer is, it depends.  If you have a documented nutritional deficiency, that cannot be corrected with real foods, then you would be a good candidate for vitamins or supplements.

Here are my four thoughts on vitamins and supplements.

1. Vitamins and supplements are very helpful if you have a documented deficiency.

If you have been tested and are low in certain vitamins or minerals, that cannot be corrected by eating real foods, then vitamins and supplements can be very beneficial.  Work with your physician and get tested to make sure you do not have any vitamin or mineral deficiencies.

2. Vitamins and supplements are like pharmaceutical medications.

They have potential benefits and possible risks.  Make sure you discuss the risks and benefits of any vitamins or supplements with your physician before you start taking them.

3. Vitamins and supplements may be contaminated or not even contain what they claim to contain.

There are many reports of people harmed by tainted vitamins or supplements.  Make sure that if you do choose to take vitamins or supplements that they are USP or GMP certified.

4. Supplements cannot replace the nutrients that we can get from real foods.

With a healthy diet it is possible for most people to get all the nutrients that they need from real food sources.  The World’s Healthiest Foods website is a reference that I frequently check to make sure I am getting all of my key nutrients from food.

#055 7 Warning Signs You May Have BPA Toxicity

December 15th, 2014 by

7 Warning Signs You May Have BPA Toxicity

While the FDA continues to assert that BPA is safe, millions of Americans continue to suffer from more and more chronic medical conditions.   Fully 93% of all Americans have BPA in their body according to one study.  France has now banned BPA.  Could BPA be one reason why so many of us are developing chronic medical conditions?

 What is BPA?

BPA, or Bisphenol Ais a chemical often used to make plastic, food and beverage cans, the thermal paper used with cash register receipts, and sometimes the liner in water pipes.  BPA has been used since 1957 which, interestingly, seems to coincide with the timeframe of the obesity epidemic in the U.S.

BPA leaches into our food and water from BPA lined cans and plastic bottles.  When plastic is heated or cleaned, like in a microwave or a dishwasher, even more BPA leaches into our food.  BPA is also absorbed from our skin whenever we handle the thermal paper from cash register receipts.

While the FDA did ban BPA in baby bottles in 2012, they did nothing to protect babies from BPA in cans and jars of baby formula or other drinks and foods.

Seven Warning Signs You May Have BPA Toxicity

Aside from having your urine tested for BPA levels, how can you know if you may be suffering from BPA toxicity?  If you have any of the following seven medical conditions you may be exposed to excessive levels of BPA.

1. You Are Overweight

Historically, the concept of obesity was one of “calories in, calories out.”  Now, based on a myriad of new data, whether or not someone is overweight is more of a function of hormonal and metabolic changes rather than just “calories in, calories out.”

Based on this new paradigm of obesity, powerful hormonal disrupters, like BPA, have been implicated as a possible cause in the obesity epidemic.  Many studies, like this one, have shown that BPA is associated with weight gain.

To date, the data are not yet conclusive that BPA causes weight gain.  However, given the increasing data of a link between weight gain and BPA, as well as for the others reasons that follow, we try to avoid BPA in our home.

2. Early Puberty

BPA disrupts our hormones.  It has an estrogen-like effect that can alter many hormonal pathways.  For example, it has been well described in the medical literature that BPA exposure can cause early puberty in both animals and humans.  Could BPA be one of the reasons why most girls in the U.S. are now entering puberty now before age 10? 15% of girls enter puberty at age seven in the U.S. About 100 years ago, the average age of puberty for girls was 14 years.

3. Erectile Dysfunction

How does this estrogen-like effect impact men?  In this study, researchers identified 230 factory workers in China who were exposed to high levels of BPA at work and then compared them to a similar number of men of the same age and other characteristics in the same city who were not exposed to BPA at work.  Interestingly, men exposed to BPA at work were four times more likely to have erectile dysfunction.

4. Your Blood Pressure is Too High

In a study published last week in the prestigious medical journal, Hypertension, researchers concluded that even small amounts of BPA from a canned beverage can shoot our blood pressure up for a few hours. In this well designed study, researchers enrolled 60 people and had them drink the same beverage from either a glass container or the standard BPA lined container and then measured their blood pressure and BPA levels in their urine two hours later.

Not surprisingly, the BPA levels in the urine two hours after the drink were more than 16 times higher from the usual BPA-lined container versus the glass container.  Interestingly, the systolic blood pressure was 5 mmHg higher following the drink in the standard BPA-lined container.  Even just 1 mmHg rise in blood pressure is enough to increase your risk of a heart attack over time.

While your doctor has probably told you to cut back on your salt if you have high blood pressure, one of the causes might be BPA.  For my own health, I would much rather reduce my exposure to BPA than eat bland food or take a drug for high blood pressure.

5. You Have ADHD

Unfortunately, the hormonal effects of BPA seem to go well beyond our reproductive health.  Researchers are increasingly identifying that BPA may affect the brain to cause anxiety and hyperactivity disorders in both animals and humans.  In this study of 292 children, researchers found that BPA levels in moms during pregnancy and then later in the child at age five seemed to predict whether or not they developed ADHD.

6. You Have Heart Disease

Many studies have now linked BPA to heart disease.  Studies show that BPA may be a cause of plaque build up in the arteries of the heart, arrhythmias, and even heart attacks.  One large study showed that people with the highest BPA exposure had a three-fold increased risk of heart disease.

7. You Have Breast or Prostate Cancer

It seems possible, then, that if you are exposed to high amounts of the estrogen disruptor BPA in your food and water, that cancer cells could arise in the breast or prostate.  Indeed, many studies have now linked BPA to breast cancer and prostate cancer.

BPA in China’s Longevity Village

As most of you are aware, my wife and I have been studying the factors involved in the longevity and health of China’s centenarians residing in the remote Bapan Village of Southwest China.  In this village where people are often still working in the fields until their 80s, 90s, or even 100s free from medications and the chronic medical conditions we see in the West, historically there was no exposure to BPA.

In this village, the people eat the produce on the day it is picked.  Produce is not stored in any plastic containers.  For millennia they have drunk from the clean mountain springs around their village, once again, free from plastic water containers.  Any fish they catch from the river running through the village is eaten on the day it is caught and never comes into contact with plastic.

Certainly there is a lesson we can learn from these people.  The less our food and water comes in contact with plastics and other chemicals the better.  There is a lot we can do to ensure that what we eat and drink does not touch plastic or other potentially toxic chemicals.

What Can We Do to Protect Our Families from BPA?

Fortunately, for the most part we have a lot of control how much BPA we are exposed to.  With careful attention, we can be part of the 7% of Americans who do not have any detectable levels of BPA in our urine.  Here are my four strategies to rid our bodies of BPA and other potentially toxic chemicals.

1. Only drink from high grade glass or stainless steel containers.

Even if your plastic water bottle states that it is BPA free, I wonder about what other chemicals they use in the plastic to replace the BPA.  Will these chemicals be found to cause problems for our health in the future?

2. Only Use BPA Free Cans

If you like your soda pop then you are probably going to also get a big dose of BPA unless you can find it in an old-fashioned glass container.  Some canned foods, like beans, can be very healthy.  When selecting canned foods make sure you only use BPA free cans.

3. Do Not Touch Receipts

Unfortunately, a large percentage of receipts are printed on BPA lined paper.  Also, you can absorb a significant amount of BPA through the skin.

What should you do?  This may sound a little extreme, but you could say no, thank you to the receipt, or wash your hands if you handled the receipt.  If you need the receipt for business purposes, you could bring an envelope for it.  If you work as a cashier, you could work with your employer to switch to BPA free receipt paper.

4. Avoid Letting Your Food Touch Any Plastic Product

There is so much we can do to avoid letting our food touch plastic.  For example, we use glass containers in our house.  We don’t overfill the glass containers so that the plastic lid does not touch the food.

The same goes for plastic utensils. We should be very wary of heating TV dinners in the microwave as they often come in plastic containers.

Also, at the grocery store, we avoid most packaged or prepared foods in favor of fresh produce.  When we select our fresh produce at the grocery store we generally do not use the free plastic bags they provide.  We just put the produce directly into paper bags and then wash the produce thoroughly before using.

What can you do in your home to minimize your exposure to BPA and other potentially toxic chemicals?

#054 Sugar, Indoor Plants, Winter Blues and HFCS

December 14th, 2014 by

Sugar, Indoor Plants, Winter Blues and High Fructose Corn Syrup

In this podcast episode I discuss the following four recent studies:

1. Is Sugar the Cause of My High Blood Pressure?

2. Will Indoor Plants Purify My Air and Reverse Asthma?

3. Am I Suffering from Seasonal Affective Disorder (Winter Blues)?

4. Does High Fructose Corn Syrup (HFCS) Just Make Me Hungrier?

To make sure you never miss another podcast, subscribe to my podcast on iTunes.  Please click on this link here to subscribe.

#053 Sense of Time Urgency and Heart Attack Risk

December 7th, 2014 by

Sense of Time Urgency and Heart Attack Risk

Do any of these statements describe you?

1. I usually feel pressed for time.
2. I eat too quickly.
3. I get upset if I have to wait.

If any of these statements describe you then your risk of a heart attack is four times higher according to the results of this study.

Time Urgency and Risk of Heart Attack Study

In this study, researchers evaluated 680 people. Of these 680 people, 340 had suffered a heart attack and 340 had not. These researchers found that those people who had suffered a heart attack were much more likely to identify with these three statements.

The Stress Response

What makes someone who answered “yes” to these three statements more at risk for a heart attack? I suspect that it is due to the stress response.

People who are experiencing chronic stress have much higher levels of cortisol and adrenalin. While these stress hormones can be beneficial during short periods of stress, the problem is that if the stress never goes away these same stress hormones can wear out the heart and the body.

My Three Strategies to Answer “No” to These Three Statements

How can we turn a “yes” to the three statements above into a “no?” Let me share with you the three things that I have found to help me control my sense of time urgency and impatience.

1. Try to Arrive 15 Minutes Early

I admit that I am guilty of racing the clock or a sense of time urgency. I have found that if I try to arrive somewhere 15 minutes early then my stress levels are much lower and I can be “in the moment.”

This extra 15 minutes allows for unexpected things that may arise.  It buffers in extra time if traffic is slow or your child cannot find where they placed their shoes.

2. Engage in Meaningful Conversation While Eating

Once again, if I am not careful I can literally inhale my food. Eating fast is not only bad for our heart but also leads to overeating, which creates a myriad of health problems.

To help me slow down I try to engage in meaningful conversation. I try to engage colleagues while eating at work and my family while eating at home.

3. Always Bring Something to Do

If we always have something with us that we can do, then if an unexpected delay arises, we won’t mind waiting.  It always amazes me that most of my patients who come to see me in clinic don’t bring something to do.  I would like to think this is because they know I am always running on time but I know this is not the case.

Always bring along a good book or even your iPad or a laptop. You might actually enjoy an extra minute or two to yourself while waiting.

What will you do to help you answer “no” to these three statements?

1. I usually feel pressed for time.

2. I eat too quickly.

3. I get upset if I have to wait.

How is slowing down and reducing your sense of time urgency helping you?