#128 The Top 10 Causes of Weight Gain

October 25th, 2015 by

The Top 10 Causes of Weight Gain

The average American gains 1 to 2 pounds a year.  That is as little as 10 extra calories a day–less than one bite of food.  This weight gain is so subtle that most people don’t even know it is happening until one day they tune in and discover that they have gained 20 to 30 pounds since high school.

The famous 5th century B.C. Chinese General, Sun Zi, said in the book The Art of War, “If you know the enemy and yourself, you need not fear…If you know neither the enemy nor yourself, you will lose every battle.”

In this article, I am going to help you better know the enemy and share with you the top 10 causes of weight gain.  It is only by knowing the enemy and yourself that you can enjoy the weight that works best for you.

My High School Weight

While not especially lean, I weighed a respectable 180 pounds in high school.  My first year away at college, rather than “The Freshman 15,” I actually added “The Freshman 25” and hit a peak weight of 205 pounds during my first nine months away from home.

Fortunately, I started exercising again after my freshman year of college, which helped prevent further weight gain. However, it did not allow me to lose all of the weight I had gained.  I carried that extra weight around for two more decades until my 40s when I was forced to change my diet and lifestyle due to other health problems.

The Best Study on Weight Gain

To better know the enemy, most of the scientific data I am going to share with you is from a seminal Harvard study published in the most prestigious medical journal, the New England Journal of Medicine.  This study involved 120,877 U.S. men and women and the lead author was my former classmate, and fellow cardiologist, Dr. Dariush Mozaffarian.

What surprised me most about this Harvard study was that it wasn’t just one thing that cause people to gain weight.  Rather, it was a cluster of bad habits and lifestyle choices that led to 1 or 2 extra pounds each year.  Unfortunately, as the weight goes up so do chronic medical problems as well as the need to take lifelong medications and make appointments with the cardiologist or other doctors.

I should also point out that these top 10 causes of weight gain have also been seen in other studies.  Also, the Harvard study did not show causation but rather correlation.  In other words, weight gain was observed to happen in people who reported doing these 10 things–whether or not this was the actual cause of their weight gain cannot be determined from this Harvard study.

The Top 10 Causes of Weight Gain

1. Can’t Find Time to Exercise: 0.44 pounds/year (0.2 kg/yr)

It should come as no surprise that not exercising was the number one cause of weight gain.  While a weight gain of just 0.44 pounds per year (0.2 kg/yr) may not sound like too much of a price to pay for not exercising, this adds up to a total weight gain of 21 pounds (9.4 kg) from high school to retirement at age 65.

While many people mistakingly feel that you can exercise off a bad diet, the research just doesn’t support this.  Exercise is for maintaining not losing weight.  Even during my marathon running years, when I was running 20 or more miles a day, I never seemed to burn off the extra weight I gained from my freshman year of college.

2. French Fries and Potato Chips: 0.42 pounds/year (0.19 kg/yr)

The number two cause of weight gain caught me by surprise.  While I knew French fries and potato chips caused people to gain weight, I would never have predicted that this effect would be stronger than sugary drinks.

Even more surprising was that the average person in this study only ate French fries or potato chips one time per week at most.  I suspect the reason why fries and chips are so dangerous to your waistline is because these processed potatoes are instantly converted to sugar in the body, they contain high amounts of unhealthy oils, and the same people who eat fries are more likely to eat other junk food as well.

As with a lack of exercise, this gradual weight gain from fries and chips, on average, adds up to a grand total of 20 extra pounds (9.1 kg) by retirement.

3. Trans Fat from Processed and Fried Foods: 0.36 pounds/year (0.16 kg/yr)

Number three in this Harvard study also came as a surprise to me.  While I was well aware of the ultra artery clogging effects of trans fat, I had no idea this toxic fat also causes people to pack on the weight.

When it comes to trans fat in the diet, most of my patients mistakingly believe this is no longer a problem as all of their packaged food labels read “zero” for trans fat.  What they don’t understand is that, based on lax reporting guidelines, processed food companies can create such unrealistically small portion sizes so that the trans fat content in a “microscopic serving” is below the required reporting level of 0.5 grams.

To keep your arteries clean and your weight in check, if you see “partially hydrogenated oil” anywhere on the ingredient list then this is something that you should never eat.  When it comes to trans fat, there is no safe amount you can eat.

In addition to processed foods, the worst trans fat offenders are fried foods, microwave popcorn, and store bought bakery items.  If you give in and eat processed or fried foods you can count on gaining an average of 17 pounds (7.7 kg) and a likely visit to a cardiologist by retirement age.

4. Sugary Drinks: 0.25 pounds/year (0.11 kg/yr)

While falling much lower on this list than I would have expected, sugary drinks are still an important cause of weight gain.  In addition to sugary drinks, other forms of sugar like desserts, refined grains, and fruit juice combined also added up to an additional 0.25 pounds/year (0.11 kg/yr).  By refined grains, I am referring to the typical grocery store breads, pastas, cereals, crackers, etc.

Thus, if you do sugary drinks, desserts, refined grains, and fruit juice you can expect to gain 0.5 pounds/yr (0.22 kg/year) from your sweet tooth–an even greater effect than not exercising.

It is interesting that fruit juice did not cause as much weight gain as sugar sweetened beverages like Gatorade or soda pop.  The lead author of the Harvard study, Dr. Dariush Mozaffarian, was also surprised and explained that the reason was likely because they found that most people seem to drink sugary beverages in much greater quantities than fruit juice.

Once again, it did not take much to increase weight.  The average person in this study only had a little more than 1 sugary drink per week and 1.3 servings of dessert and 1.2 servings of refined grains each day.

Regardless, doing all forms of sugar namely sugary drinks, desserts, refined grains, and fruit juice, even in very small amounts, can add up to a hefty 23.5 pound (10.7 kg) average weight gain by retirement.

5. Red Meat: 0.24 pounds/year (0.11 kg/yr)

For those who follow a dietary regimen that advocates meat, I’m sure the number five cause of weight gain in the Harvard study comes as a surprise.  I should point out that all meats are not raised and processed equally, and that most of the 120 thousand plus people in this study were eating the typical grocery store or prepared forms of meat which come from antibiotic and hormone treated animals.

Equally as strong as red meat for weight gain in this study were processed meats.  By processed meats I mean meats like bacon, hot dogs, sausage, and deli meats.  If you eat processed meats you can expect to gain an additional 0.23 pounds each year.  Thus, eating both red and processed meats will cause you to gain, on average, 0.47 pounds per year or 22 pounds (10 kg) by retirement.

I should point out that the people in this study did not eat much red or processed meats.  Indeed, the average person had less than one serving daily of red and processed meats combined.

If you are a meat eater, and don’t want to gain weight, then the Harvard study would suggest giving up red meats as well as processed meats and instead focus on poultry or fish.

6. Stress: 0.15 pounds/year (0.07 kg/yr)

Most of us also know that we naturally crave junk food when we are feeling stressed.  Stress causes changes to the hormones that regulate hunger.  According to the study I use to calculate the damage from stress, you can also count on gaining an average of 7 extra pounds (3.2 kg) if you are under a lot of stress.

7. Sleep Deprivation, 0.14 pounds/year (0.06 kg/yr)

Most people intuitively know that they also crave junk food when they are tired.  I know this is a weakness of mine after I have been up all night in the hospital taking care of patients.  Sleep deprivation is a well known cause of activating our hunger hormones in a way that causes weight gain.

What most people don’t understand is that when it comes to weight gain, over sleeping seems to be just as dangerous as under sleeping.  In a separate study I use to calculate the weight gain risks associated with sleep duration, it shows that sleeping under 5 hours or over 9 hours a night puts you at risk of weight gain.

Based on these definitions, if you under or over sleep you can count on gaining an average 7 extra pounds (3.5 kg) from high school to retirement.

8. Butter: 0.12 pounds/year (0.05 kg/yr)

In the 1980s and 90s a, few people would have been surprised to see butter on this list.  Yes, it is true that butter is much healthier for you than the trans fat containing products, like margarine, from the 1980s and 1990s.

While butter made the top 10 based on the data from the Harvard study, I should point out that dairy had mixed effects when it came to weight gain or loss over time.  For example, the Harvard study showed that cheese also caused weight gain but milk was neutral and yogurt even caused significant weight loss over time.

Thus, the type of dairy seems to be important in determining whether or not you gain or lose weight with dairy.  For the worst dairy offender, butter, it can cause you to gain an average of 6 pounds (2.7 kg) from high school to retirement.

9. Alcohol: 0.1 pounds/year (0.05 kg/yr)

As with dairy, the data on alcohol and weight gain are mixed.  Heavy beer drinkers seem to show the highest weight gains from alcohol.  In the Harvard study, alcohol drinkers can expect to gain an average 0.1 pounds per year or 5 pounds (2.3 kg) by retirement.

10. Electronic Devices: 0.08 pounds/year (0.04 kg/yr)

Rounding out the top 10 list are electronic devices. When this Harvard study looked at television watchers, they found that just 36 minutes a day contributes to an average four extra pounds (1.7 kg) by retirement.

Final Thoughts

So there you have it, the scientifically proven 10 best ways to gain weight as an adult.  When it comes to changing any bad habit, the first step is awareness.

As the 5th century B.C. famous Chinese general, Sun Zi taught us in The Art of War, the key to wining any battle is to know the enemy and yourself.  Now that we have identified our top 10 enemies in weight gain, it is time to become aware and create an environment that helps us to conquer these enemies.

What is your number one weight gain enemy?  What has helped you to battle this enemy?

#031 Listen to Your Body and Make Exercise Work for You

September 1st, 2014 by

“That candy bar you ate from your kid’s Halloween bag is stuck right there in your thigh! Squeeze harder! Get it out! Come on, you know you ate more than you should. We all have our favorite jeans that we want to fit into! Keep lifting!”

So we did. We all lifted our leg higher at the “counsel” of our Pilates instructor.

What was the message offered to us that day?

External appearances are more important than our internal well-being?

We’re not good enough as we are?

We can’t trust our body to tell us what it needs?

The tragedy here is that we may take in and even look for these types of external cues to tell us how we’re doing.  These external cues abound in our modern society.

Productive Movement in China’s Longevity Village vs. Our Typical Gym Experience

During our most recent trip to China’s Longevity Village, as I worked along side Mrs. Huang and her neighbor in the fields one morning, I couldn’t help but reflect on the stark contrast between my gym classes which are designed to mimic the real motions utilized in real work and real work itself.

I noticed the strong steady rhythm at which Mrs. Huang and her friend worked. With seeming ease, they carried the packs that held the substantial fruits of their efforts; their faces expressed both contentment and determination.  Side by side, they conversed about the issues in their families and community, identifying possible solutions as they went. At the end of the day, they would prepare their harvested food and partake with their families of multiple generations in one home.

There I was outside working with these women and with the earth, thinking about what a strange phenomena it is, by contrast, that I hop in my car and drive to a building so that I can stand on a machine or in a room, with others doing the same–to move.

As these women work in their fields, their focus is on harvesting the fruits of the earth.

By contrast, as my friends and I work out in the gym, our focus is on the mirror in front of us and the images that are reflected back to us.  We focus on the external appearance of ourselves and others, as instructors call out our next move, telling us what we need to be doing.

In this way, our cues come from an external voice while our focus is on an external image.

Similar to my Pilates instructor, who encouraged us to squeeze the candy bars out of our thighs, my cycle instructor admonished us as Thanksgiving approached:

“Who is planning to eat pie?  Are you going to be naughty?  Pedal faster!”

We pedaled faster then we got in our cars and drove home.

Now, don’t get me wrong, I have loved the gym since I was old enough to join one.  I still love it.  For some of us, the gym may be the only way we can work in physical activity, and is a vital component of our well-being.

However, for our ultimate well-being and enjoyment, we need to learn to identify and confront the external messages that can override the messages our body will most definitely give us to tell us what it really needs.

Making the Shift from External to Internal Cues

I used to exercise to compensate for the junk food I ate and measure my exercise status by the number of calories burned, the maximum heart rate achieved or the minutes spent on a particular machine. I exercised primarily alone with the sole focus of “getting in shape.”

Today, gratefully, I move simply because it feels good. I get outside more. I join with friends and family more. Together, we produce more.

Our family is always looking for new and creative ways to get out and enjoy nature together. One of our favorites that we just discovered is, instead of driving all the way to grandma’s and grandpa’s, parking and riding our bikes the rest of the way.

I feel so much better and can accomplish so much more than I did when I was trying so hard to do the exercise thing according to the rules I thought I was supposed to be following.

What great freedom I experience with this shift from focusing on the external to honoring the internal!

By observing with compassion, I can now identify and confront these messages that sometimes exist at the gym and elsewhere that tell me that how I look on the outside is more important than how I am taking care of myself on the inside, that I am not good enough and should do something to compensate, and that I need to look outside myself for the answers.

Challenge for the Week

Here is your physical activity challenge for the week:

1. Make it natural.

2. Make it social.

3. Make it productive.

4. Make it enjoyable.

5. Do what feels good to your body.

6. Politely dismiss any external cues that may suggest you do otherwise.

Listen, honor, and let us know what you discover by leaving a comment below!

#028 How to Prevent Weight Gain After Eating a Big Meal or Junk Food

August 18th, 2014 by

How to Prevent Weight Gain After Eating a Big Meal or Junk Food

What should you do if you just ate way too much? Most of us follow this unhealthy behavior with yet another unhealthy behavior: sitting. In our western culture, we were often taught to rest after a meal to allow the body a chance to digest the food.  Could this be the wrong advice? How can you prevent weight gain after eating a big meal or the wrong carbs?

The Chinese have a famous saying, “Take 100 steps after eating and live to 99” or 饭后百步走,活到九十九 (Fan hou bai bu zou, huo dao jiu shi jiu).  This concept of going for a walk after eating is part of Chinese culture and helps to explain why obesity rates are so much lower in Asia.

My study of the Chinese language and travel to China for cardiac conference lectures, over the last 32 years, finally led me to discover China’s Longevity Village where people are living exceptionally long, healthy lives.  In this village, we noticed that people regularly took walks after eating.  Seeing the Chinese walk after meals prompted my curiosity about the potential health benefits, and I began to research the science behind it.

The Glucose and Insulin Spikes

One of the primary hormones involved in hunger and weight gain is insulin.  When we eat the simple carbs, such as “healthy” whole wheat bread, processed foods, cereals, pasta, crackers, white rice, fruit juice, sports drinks, soda pop, pastries, sugar, etc., it causes a spike in our blood glucose.  The blood sugar spike from these simple carbs, or what I like to call the “hunger carbs,” then leads to a spike in insulin.

Simple Carbs –> High blood glucose –> High insulin –> Hunger and weight gain

When high insulin levels are coursing through our blood from overeating or eating the hunger carbs (i.e., junk food), it then causes our fat cells to grow and multiply by taking up all of the excess glucose.  Insulin is what causes our cells to pull the glucose out of the blood.  Once this happens, blood glucose levels drop, and we are hungry again.

If you ask someone you know with diabetes taking insulin they will likely tell you that they gained weight after going on insulin.  Insulin is the critical hormone for making fat (weight gain) and plays a dominant role in driving us to eat more.  The goal is to naturally keep our glucose and insulin levels as low as possible without any drugs.

Good Carbs vs. Bad Carbs

Of course, the best way to prevent this in the first place is not to overeat or eat the hunger carbs.  While “carbs” have been demonized recently in popular health books, healthy carbs such as those found in fruits, vegetables, nuts, seeds, beans, and lentils are an essential part of a healthy diet and in preventing diseases.  These healthy carbs or filling carbs don’t result in a significant sugar rise as they are slowly digested, from all of the fiber they contain, in the gut.

Also, some intact whole grains such as quinoa and brown rice can also be a good source of healthy carbs in our diet.  The primary problem with carbohydrates is flour.  Flour is nothing more than sugar to our bodies.

If you enjoy bread, as I do, try eating bread like Ezekiel, Trader Joe’s flourless bread, or Paleo Bread from Whole Foods.  Flourless or almond bread is slowly absorbed and doesn’t result in the big sugar and insulin surges.

What should I overeat or eat the hunger carbs?

If you slip up and overeat or give into junk food, which is normal, I recommend following the advice of the Chinese and go for a nice walk as soon as you finish eating.  This can help to minimize the damage.

What is the physiologic basis to walking after a meal?

After a big meal or eating junk food we get a big surge of glucose or sugar in our blood.  When this happens we can either wait for our body to bring down these toxic levels of blood sugar with insulin or we can quickly drop our blood sugar levels ourselves with exercise.

Our muscles need glucose to function.  When we exercise or go for a walk, the large muscles in our legs quickly extract the sugar from our blood stream.  When this happens, it prevents the insulin spikes and steals the sugar from going into the fat cells.

Glucose Storage in Muscle

Glucose is stored in muscle as glycogen.  As we need glucose when exercising, the body can store about 90 minutes of exercise fuel (glycogen) in the muscles.  This roughly translates to about 2,000 calories.

When our glycogen fuel tanks are full, the excess glucose has to go somewhere else.  However, if we can deplete these glycogen fuel tanks right after a meal then there is a place, other than making body fat, for any excess glucose from a meal to go.

Does Taking a Walk After Eating Really Work?

In a fascinating study, Dr. Loretta DiPietro from George Washington University showed that in a group of diabetic patients, a brisk 15-minute walk after each meal could prevent blood glucose spikes.  Moreover, these three 15-minute walks after each meal were shown to be much more impactful than a single 45-minute walk.

The principle is the same for us.  Walk after a meal to prevent blood glucose and insulin rises.  If we can keep our blood sugar and insulin as low as possible naturally, without any medications, we can prevent insulin from causing weight gain.  We can put the excess glucose from a big meal or junk food into our muscles instead of into our belly fat.

Timing of Meals and Exercise to Weight Gain

The concept of taking a walk after eating brings up another question.  Does it matter when we eat or exercise with respect to weight gain?

If you are like me, you were probably taught to never eat before working out.  While most of us have probably experienced the stomach cramps that come with exercising on a full stomach, could it be possible to moderately eat before exercising as a way to keep your weight in check?  After all, elite endurance athletes eat during all day long endurance competitions without problems.

One attractive feature to exercising after eating is that you can prevent the glucose/insulin spike.  Without the glucose/insulin spike we can help to prevent our fat cells from growing.

While there is not much data on this approach in humans, recent studies in rats suggest that exercising after eating can have a powerful weight loss effect.  Not only did the animals who exercised after eating lose weight but they also gained more muscle mass.  Could exercising after we eat grow our muscles rather than our bellies?

Practical Tips

Certainly, exercising or going for a walk after eating is not a license to eat whatever you want.  Unfortunately, it just does not work that way.  You simply cannot out train a bad diet.  In the end, for most people a bad diet will eventually wreck your health, regardless of how much you exercise, just like it did to me.

Based on these data and the teachings of the Chinese, I now try to walk or do something physical after most meals.  Could the Chinese be right after all?  Could a walk after eating be just what you need to prevent weight gain?

What one habit will you change to help you get moving more after you eat? Write it down. Try it for one week and document how you feel.  Together, we can lift one another in our quest to navigate the challenges of this society and take back our power to live well.

#027 Do You Have Any of These 12 Magnesium Deficiency Symptoms?

August 11th, 2014 by

Do you have any of these 12 magnesium deficiency symptoms?

You probably have no idea that you are currently suffering from magnesium deficiency. Indeed, studies show that up to 89% of Americans are magnesium deficient.  Read on to see if you have any of these 12 magnesium deficiency symptoms.

Jill’s Experience

Jill was a 45-year-old woman suffering from a heart condition known as atrial fibrillation. It made no sense why someone so young should develop this heart condition as she didn’t have any of the usual atrial fibrillation risk factors.

The only tip-off as to the cause of her atrial fibrillation was that she was taking Prilosec for acid reflux, Lasix occasionally for leg swelling, and she was eating the “Standard American Diet.” Even though her magnesium levels came back normal on her blood test, I suspected a magnesium deficiency as the cause of her heart problem.

Interestingly, once I convinced her to replace all added sugars and processed foods with real foods which included a massive salad every day, she immediately lost 20 pounds without even trying. In no time at all her acid reflux was gone and she was off the Prilosec. Also, with no added sugars or processed foods, her legs no longer swelled so there was no further need of diuretics.

Best of all, she felt better than she had ever felt and her atrial fibrillation went away. As she made many lifestyle changes, it was impossible to know what exactly drove her atrial fibrillation into remission.

However, in my mind, I’m sure replacing her magnesium stores played a role. Continue reading to figure out how she boosted her magnesium stores.

Can you test for magnesium deficiency?

While you can test for magnesium deficiency, you probably don’t want the test your doctor orders. The reason for this is because the standard magnesium test only measures the magnesium in your blood.

As 99% of your magnesium is not freely floating around in your blood but rather is inside of your cells and bones, you need a better test for magnesium deficiency. Of the various ways to test for magnesium deficiency, probably the best is the RBC magnesium test. The RBC magnesium test measures the amount of magnesium inside of your red blood cells.

Who is at risk for magnesium deficiency?

Many things contribute to magnesium deficiency. For example, if you are under a lot of stress, you likely are not absorbing much magnesium from your food.  Those who love drinking filtered or bottled water also aren’t getting much magnesium. And processed foods are notorious for being completely absent of magnesium.

Other conditions contributing to magnesium deficiency include being overweight, diabetic, or over age 60. Likewise, many prescription medications like diuretics or acid-blocking medications are also keeping your magnesium levels dangerously low.

Do you have any of these 12 magnesium deficiency symptoms?

1. Weight Gain/Diabetes

When you don’t get enough magnesium in your food and water, it can cause glucose and insulin levels to rise.  When insulin levels are high, you may suffer from food cravings.  Unfortunately, these food cravings are generally for sugar or processed carbohydrates which lead to further weight gain.

2. Fatigue and Muscle Weakness

Magnesium is a critical component of energy production in the body.  In fact, the body’s energy molecule, ATP, is created through magnesium dependent chemical reactions.

If you are tired all the time, you are probably magnesium deficient.  Likewise, if your muscles are weak, you may also not be getting enough magnesium.

3. Anxiety

People under high levels of mental or physical stress, poorly absorb magnesium from the gastrointestinal tract. Contributing to a downward spiral, magnesium deficiency is a significant cause of anxiety.  Fortunately, studies show that restoring the magnesium may help in the treatment of anxiety.

4. Insomnia

Having enough magnesium balances out your stress hormones.  Magnesium also helps the body maintain sufficient melatonin and other sleep hormones.  Indeed, magnesium supplementation has been shown to help with sleep.

5. Depression

Magnesium deficiency and depression go hand in hand.  Low magnesium stores lead to depression and people suffering from depression are more likely to eat a diet low in magnesium.

6. Dental Cavities or Osteoporosis

Dental cavities and osteoporosis are two more signs of magnesium deficiency.  Magnesium affects vitamin D metabolism and osteocalcin which play a vital role in bone turnover and formation.

Ironically, if you are taking calcium supplements for osteoporosis, you may be making matters worse. Calcium supplementation can throw off your calcium/magnesium balance.

7. Constipation

If you suffer from constipation you probably are magnesium deficient.  Magnesium in any form is an excellent laxative.

8. Muscle Cramps or Migraine Headaches

Do you suffer from leg cramps, eye twitches, or muscle spasms?  Do you get frequent headaches? These may all be magnesium deficiency symptoms.

9. Inflammation, Arthritis, or Autoimmune Diseases

If you suffer from chronic inflammatory conditions, such as arthritis or autoimmune diseases, you may be magnesium deficient.  Studies have linked magnesium deficiency to arthritis and elevated C-reactive protein (CRP) blood tests.

10. Palpitations, Heart Attacks, Heart Failure, or Cardiac Arrest

Most forms of heart disease are linked to magnesium deficiency.  This mineral is critical to optimal cardiac function.

11. Thyroid Problems

Thyroid problems are widespread in the U.S.  Research suggests that many thyroid issues may be due to magnesium deficiency.

12. Cancer

Cancer may be a wake-up call that magnesium levels are low. Magnesium is a critical nutrient for many DNA repair mechanisms.   As new cancer cells are created every day in your body, you need your DNA repair mechanism functioning optimally.

Magnesium in Our Water

Our ancestors used to get large amounts of magnesium just from their drinking water.  Mountain spring water is naturally high in magnesium.  Unfortunately, many municipalities remove magnesium as part of their water treatment process.

If you want to see how much magnesium is in your drinking water, click here.  In general, the “harder” your water, the more magnesium you are getting.

Interestingly, drinking hard water may lower your risk of heart disease.  If you happen to live in a city with naturally hard water, you can get up to 30% of the magnesium you need each day from water.

Unfortunately, water softeners, water filters, reverse osmosis devices, and bottled water are generally all depleted of magnesium.  If you drink any of these magnesium depleted water types, you have to get 100% of your magnesium from food.

Magnesium in Our Food

Once upon a time, our soil contained much more magnesium.  Unfortunately, modern agriculture has stripped this essential mineral from the ground.  Processed foods are even worse when it comes to magnesium content.

Fortunately, organically grown produce has been shown to have up to 29% more magnesium.  To get enough magnesium in your diet, make sure you eat plenty of green leafy vegetables, especially spinach, nuts, seeds, and legumes every day.  To see a breakdown of which foods contain the most magnesium click here.

Can you get too much magnesium?

In general, it is very tough to get too much magnesium from your food and water unless you have kidney disease.  Certainly, it is possible to get too much magnesium if you are taking supplements.

How much magnesium do you need each day?

The recommended daily amount of magnesium varies depending on your gender and age. Assuming there are no problems with magnesium absorption, you need about 400 mg of magnesium each day. If you can get at least 400 mg of magnesium daily from your water and food, you can start to enjoy the health benefits of magnesium.

Magnesium in China’s Longevity Village

As you know, we have been studying the residents of China’s Longevity Village for many years.  We have found that these people do not suffer from magnesium deficiency symptoms.

The mountain spring water they drink is extremely hard and packed full of essential minerals.  Researchers suggest that these people get up to 50% of their magnesium just from the water.

Also, modern agriculture has yet to put a stake in the ground in this rural area of China.  Thus, the soil is extremely high in magnesium and other minerals.

Their diet, which is very high in vegetables, nuts, seeds, and beans, only further augments the magnesium they are getting every day.  We suspect that the magnesium in their food and water may be a major reason why heart disease is very uncommon, and people live to old ages free of chronic medical conditions.

To learn more about why China’s Longevity Village has the highest known concentration of centenarians in the world, please be sure to pick up a copy of our new book, The Longevity Plan.

How can you correct magnesium deficiency?

Let me give you five simple steps to correct magnesium deficiency.

1. Drink hard or mineral water.

2. Eat a heaping salad with spinach, nuts, seeds, and legumes daily. 

3. Embrace the stress in your life.

4. Talk with your doctor about magnesium supplements.

5. Talk with your doctor about medications that may be contributing to your magnesium deficiency like diuretics, acid reducing medications, or calcium supplements.

Practical Tips

As 89% of Americans are magnesium deficient, there is a high likelihood that you may be one of them. Fortunately, magnesium deficiency is easy to correct.

I know I used to be one of these people. Before my health transformation, I required Prilosec daily for acid reflux, ate the Standard American Diet, and was always stressed. These three things alone probably put me also into a state of magnesium deficiency.

Now, in addition to eating a diet very high in magnesium, I have found that taking a magnesium supplement before bed helps me to sleep. Indeed, medical studies show that magnesium supplementation is an effective treatment for insomnia.

If you suspect you may have a magnesium deficiency as well, correct anything that can be fixed to boost your magnesium stores. Also, speak with your physician about whether a magnesium supplement might be right for you.

If you enjoyed this article, please be sure to subscribe to our free weekly newsletter and podcast. Also, to learn the secret to fantastic health at any age, please be sure to read our new book, The Longevity Plan.

#026 Life’s Clutter: Six Steps to Reclaim Your Power

August 11th, 2014 by

My typical reaction upon entering my children’s rooms has often been, “This place is such a mess! You guys have got to clean this up! Now!” And so many times, with such a sense of urgency, I meant now. I would quickly work with them to get some layer of clutter cleared before I could commence with whatever it was that I had come in there for in the first place.

It was the same around the house where people kept leaving their dirty socks, games, dishes, etc. around. I felt like I was constantly after them: “Guys! Remember, dirty socks belong in the laundry bin, not the floor…..Please put each game away after you play, so they aren’t all out at the same time with mixed up pieces….and….It saves you time to do your dishes before you leave the kitchen because no one has to call you back….”

We are still working on this, but something has changed.

A Shift in Focus, A New Outcome

It occurred to me that while there were areas of the house where I had less control over other’s actions, at the same time, there existed areas that I could control, and that by changing these, I could positively influence my dilemma of clutter in the house. I decided to start with my bathroom drawer, figuring that this would give me an immediate and achievable win. I couldn’t wait to get started.

As soon as the kids were in bed, I headed straight for that drawer and got to work. I cleared out bottles of stuff–some of which had been in there more than a decade.  (I am one who tends to hang onto things, thinking, “What if I need this someday?”) The image of that clean drawer gave me a lift each time I thought about it. The next night, I tackled the bathroom cupboard.This starting-projects-late-at-night habit is something else I’m working on, but that’s another topic for another day.

What happened when I shifted my focus to areas under my control? My need to fix other people’s clutter lessened, and the clutter itself lessened. I had taken back my power, and with it, came a greater sense of peace.

I found myself walking into my kids’ room, being unaffected by the clutter and being able to focus on the person with whom I came to interact, instead of the mess. And when I did ask my children to clean their rooms, the request came free of the sense of desperation that previously accompanied such “requests.”

My children sensed this shift and their resistance seemed to melt away to the same place my anxiety vanished. They now found the mental and physical space to move forward on their own, and the results were astounding.  They actually took initiative to clean their own desks one night instead of going to bed.  (I know what you’re thinking.  They’re following my bad example of staying up late to start a project.  We’ll have to tackle that issue separately.  I promise I’ll work on this and let you know how it goes!)

Giving Away My Power and Taking it Back

The point I want to make here is that in blaming an external factor, I gave my power away, when all along I had the power within to change my situation.

It sounded something like this:

Giving Away My Power: “I just can’t keep on top of all the clutter in the house because my kids leave their stuff everywhere.”

Taking Back My Power: “I can organize my own areas, which is changing the clutter situation in my home as well as my reaction to it.” Despite the existence of factors beyond my control, when I put the focus back on me, and the things that are within my control, I can change my situation.

Confront Your Excuses and Reclaim Your Power

Where are you giving away power that is actually yours to use?  Here are a couple of common excuses that you may have heard from others or even, possibly, yourself.

Giving Away Your Power in health: “I have diabetes, high blood pressure, high cholesterol, or this ______________(fill in the blank) condition, because it runs in my family.

Taking Back Your Power in health: “My lifestyle choices have an even greater impact than my genes do on whether or not I develop conditions, even genetic ones. I can make some small lifestyle changes, knowing that most conditions are reversible or preventable and that I can turn genes on or off  through my lifestyle choices.”

Giving Away Your Power in exercise: “I’m so busy with work and family that I don’t have time to exercise.”

Taking Back Your Power in exercise: “By making exercise a priority, I gain back time during my day, and over my lifespan. Studies show that exercise promotes energy, alertness, and concentration, increasing the productivity and quality of the remainder of my hours in the day.”

Seven Steps to Take Back Your Power

Here’s my challenge for you this week.  Follow these seven steps to take back your power:

1. Get Curious: As you go through the week, observe yourself with curiosity: What situations do you wish could be different?  Where are you blaming factors or people outside of yourself for this situation? Write it down.

2. Focus: Pick one, only one, situation for now. Write it down.

3. Identify: Get creative and pinpoint one thing within your control, not dependent upon outside factors or people, that you can do differently in this one situation. Write it down.

4. Experiment: Do that one new thing.

5. Assess: How does this one new approach change your situation and your feelings about your situation? Write it down.

6. Repeat. Introduce one more change in the same situation, or identify one new situation in which you can make one new change.

It’s time to confront your excuses and reclaim your power.  By doing so, what new reality can you make possible in your life? Let us know how it goes! You can leave a comment by clicking here.

#022 Can the Cookie You Just Ate Cause Your Unborn Child to Become Overweight? Behaviors are Contagious and We Can Change Our Genes

July 28th, 2014 by

There was a time when I could not imagine a day without a chocolate chip cookie or a donut. Who doesn’t love a fresh warm chocolate chip cookie?

As a cardiologist, I would generally go to the hospital cafeteria during off hours, when I knew not many people would be there, to buy my cheeseburger, fries and cookie.

I hated it when people would look at my white lab coat stating “cardiologist” and then the tray of food and sarcastically jab, “that’s a healthy meal for a cardiologist.” It’s like they somehow expected me to be able to resist because I was a doctor, but I’m no different than anyone else.

The scary thing is that the only person I thought I was hurting with my “sweet tooth” addiction was me.  At the time, I had no idea that behaviors are contagious or that my poor food choices could cause my children to inherit a gene for, say, diabetes or obesity.

Even though it has been more than three years since I have had a cheeseburger, fries, cookie or donut, I still crave these items. What has helped me to stay strong? Not only does what I eat make me feel better, but studies now show that what I eat can change my genes and can also affect the health of the generations that follow me.  This gives me the purpose and resolve to shift my habits to healthier ones for myself and for my posterity.

The Obesity Numbers

How has the obesity rate gone from approximately 10% in 1970 to 36% in 2010?  That is nearly a four-fold increase!  Now, more than 2 in 3 Americans is overweight or obese (69% of the U.S. population).   For men it is even worse, as 3 in 4 adult men in the U.S. are overweight or obese.

What is Driving Everyone to Gain So Much Weight?

Why are we eating 500 more calories each day now than what we ate in 1970?  Traditional wisdom, based on Darwinian evolution theories, tells us it is impossible for our genes to have changed that much in the last 40 years.  Thus, it must be our lack of willpower that is driving most of us to gain the weight.

Behaviors Are Contagious

Could gaining weight be as contagious as catching the common cold?  Indeed, this is the argument set forth in a landmark study published in the most prestigious medical journal in 2007.

In this study, researchers from Harvard and U.C. San Diego evaluated 12,067 people from 1971 to 2003 living in Framingham, Massachusetts as part of the Framingham Heart Study.

These researchers found the following:

1. If your friend gains weight, you are 57% more likely to gain weight too

2. If your sibling gains weight, you are 40% more likely to gain weight too

3. If your spouse gains weight, you are 37% more likely to gain weight too

How can this be?  The argument is that we tend to follow the behaviors we see around us.  The good news is that these same researchers found that if a friend or family member “gets healthy” you will probably “get healthy” as well.

One easy solution to take advantage of these scientific findings?  Identify and start hanging out with people who strive to live healthy lifestyles.    It just might be what finally enables you to more effortlessly lose weight, enjoy exercising more regularly, and feel better.  Experiment and see if you find that it is possible to catch this contagious “healthy bug.”

Genetic Predestination?

Just this past week I had several patients tell me that they were “destined” to be overweight, diabetic, and have heart disease because that is what happens to everyone in their family.  One patient even went on to tell me, “we all get the same gene and there is nothing we can do about it.”

When I heard this I was so saddened.  He felt he was a victim and with this thought process he too had become overweight, diabetic, and had a heart condition.

Could it be that this was a learned behavior and had nothing to do with his genes at all?  Or could it be possible that even if it was “genetics,” we can change our genes through our lifestyle choices?

According to the exciting new science of epigenetics, the encouraging news is that, yes, we can change our genes.


“Epi” means outside or on top of.  Thus, epigenetics refers to the science of how “tags” are put on the outer portion of our genes.  What we eat and how we live determines which of our genes are turned on or off based on these “tags” or our epigenome.

Healthy Lifestyles Change Our Own Genes

It is not just us that will benefit from us modifying our own genes but our posterity will benefit as well.  In the groundbreaking research of Dr. Dean Ornish of men with early prostate cancer, he found that a healthy lifestyle consisting of the following resulted in over 500 positive gene changes.

1. Plant-based diet

2. Daily exercise

3. Daily stress reducing activities

4. Weekly support groups

Depending on how you look at it, epigenetics could be really exciting or really scary.  If we eat real foods and live a healthy lifestyle, this can put tags on our genes which turn off bad genes and turn on good genes.  This can benefit us now and reverse chronic medical conditions.

In some cases, these new genetic tags, can be passed on to our children and grandchildren.  Thus, your healthy lifestyle can give you and your children and grandchildren a genetic advantage for generations to come.  Alternatively, your bad habits can genetically handicap you, your children and grandchildren.

So, getting back to the question, why then has there been nearly a four-fold rise in diabetes and obesity in the last 40 years?  Could learned behavior and epigenetics explain this rapid rise?

Can Foods Change the Genes We Pass to Our Children?

Not only are our kids and grandchildren “destined” by the behaviors they see in us but it is also possible that we are passing on new genes that can predestine them to being overweight and diabetic.

Parent Diets and Children/Grandchildren Health

There was a fascinating study showing this phenomenon in action.  The northern most point of Sweden, Norrbotten, is a very isolated cold corner of the world.  During winters when food was scarce, people were very lean.  Conversely, during years of plenty, people ate much more food than was needed.

Surprisingly, researchers found that children born during famine years, when their parents did not overeat, were not only healthier but also lived 32 years longer.  Not only did these famine year children enjoy remarkable health but their grandchildren did as well.  Conversely, children born during “plenty years,” when people overate, had more health problems and died much younger.

Dr. Randy Jirtle from Duke University pioneered this groundbreaking research.  From his research, he found that what types of foods mice mothers were fed prior to conception could genetically play a large role as to whether her babies would have diabetes or obesity.  He followed up this research in humans by showing that if a man was overweight at the time of conception it was likely that his child would genetically have the “obesity gene” turned on.

The science of epigenetics completely overturns the concept of Darwinian Evolution.  In other words, species slowly evolve over time.  Rather, with epigenetics, species can change rapidly when exposed to certain environmental factors.

Parental Guilt

Naturally, one downside of epigenetics could be more parental guilt.  I know this is the case for me.

I was overweight and ate my fair share of processed, chemical-laden, sugary foods when each of my three children was born and I suffered myself with many unnecessary medical conditions.

Jane and I are now doing our best to model healthier food behaviors while our kids are still young.  I now live free of several medical conditions and medications that previously held me back. With the right supportive environment, perhaps any epigenetic tags that I may have passed on to our children could be reversed.

We are emphasizing real food first in our home.  In other words, we encourage our children to eat real food first at every meal (vegetables, fruit, healthy fat, and a healthy protein) before they eat anything else.  The goal here is that they will be satisfied after eating the real foods and desire fewer “hunger carbs” like sweets. I am seeing this approach work wonders for my patients and colleagues. Time will tell, and we’ll let you know how it goes with our kids!

What do you think?  Are healthy or unhealthy behaviors contagious?  Through our lifestyle choices, can we impact the helpful or harmful genes we pass on to our children and grandchildren? You can leave a comment by clicking here.


#017 The 10 Best Excuses Not to Exercise

July 7th, 2014 by

We all recently saw the headlines, too much sitting increases our risk of cancer by up to 66%! Sitting really is the new smoking. If you figure that sitting to watch TV for one hour shortens your life by 22 minutes and smoking one cigarette takes 11 minutes off your life then sitting down to watch that one hour TV show tonight is the equivalence of smoking 2 cigarettes.

We all know we need to get moving more. Not only do we need to exercise each day but we also need to keep moving all day long. Sitting on our butts the entire day after a grueling one hour work out in the gym will undo any benefit we may have achieved in the gym. Our bodies were designed to move!

We all need to get moving. Based on objective pedometer data, less than 1 in 20 American adults actually moves enough during the day.

Every day I encourage my patients to get moving. Often when I make these suggestions, they have excuses. Let’s face it, we all have excuses why we would rather not move.

I thought that in this article I would compile the top 10 excuses I hear every day why people can’t get active. I know most of them not just because I’ve heard them from my patients, but because I used them myself. Here are some of the top excuses my patients offer when I encourage them to be physically active on a daily basis:

Excuse #1: “I don’t have time to exercise”

Fact: Physical activity creates time.

Being physically active will not only add years to your life, but will make the years you have vastly more productive. Exercise promotes energy, alertness, and concentration, increasing the productivity and quality of the time you spend at work and with your loved ones. A recent study in a prestigious medical journal found that if people could be physically active for as little as 15 minutes per day, that would improve their longevity by 3 years. That works out to be an extra 19 hours of life for every hour of physical activity.

Even if you are not concerned with extra time later, how can you squeeze it in now? I get it. I am a busy cardiologist, serve as in coming president of a large international medical society, have church and community responsibilities, a family with three small children, and I am writing a book with my wife, Jane.

I can only find time to exercise on my off days. What about the other days? As I have analyzed my time, I find that I spend two to three hours each day on a computer. With my treadmill desks and my bike desk I can now convert this “computer time” to “exercise time”.

At my home we have an old treadmill that we purchased shortly after Jane and I were married 20+ years ago. It was a treadmill that was gathering dust and the incline button did not even work. With some old furniture we were not using, an old nightstand on top of an end table, we now had a perfect treadmill desk. The cost? Free. I have included a photo of my “poor man’s” treadmill desk at the end of this article.

At the hospital it was a bit more challenging. I made a strong case and even offered to pay for a treadmill desk. Fortunately my employer, Intermountain Heathcare, agreed to buy the entire treadmill desk for me. If your employer is not in a position to help you with a treadmill desk, could you use a “box” marked for the recycle bin as your new standing desk? That is what I did prior to my treadmill desk. Studies show that even just standing while working can burn an extra 50 calories an hour and strengthen your leg muscles over the course of the day!

To help mix things up at home, I took an old mountain bike that I was no longer using and with a bike trainer and some bricks, wood, and barrels we had in our basement was able to build a bike desk. Cost? Free. I have included a photo of my “poor man’s” bicycle desk as well at the end of this article.

What if you don’t spend part of your day on the computer? Two of my patients, took their Lazy boy chairs out of their front room and replaced them with a treadmill and stationary bike. Now, when they “sit down” to watch TV or a movie at night they now exercise together instead. Is it any wonder why together they were able to lose close to 100 pounds and put their heart disease into remission?

Excuse #2: “My knees or my (fill in the blank) hurt too much”

Fact: The right physical activity is physical therapy.

If your body is injured, it will hurt more if you don’t use those muscles, tendons and joints. There is something every one of us can do to stay active throughout the day. Be creative! If your knees hurt, try swimming, water aerobics, riding a bike or cross country skiing. The right physical activity will strengthen whatever ails you and help you heal faster.

This is exactly what I was doing before I made drastic changes in my own life. Little by little I was withdrawing from all physical activity because it hurt. Somehow I thought that if I just rested my (fill in the blank) that I would start feeling better.

I sat all day for my surgeries. This only made things worse for me. Paradoxically, by standing to do my surgeries all day long, along with other changes, allowed my joints and back to heal.

Find something you can do, cross train, do physical therapy, something until your injury resolves. Many of my patients with severe joint problems and obesity have found swimming, water aerobics or even walking in a pool against the current to be very therapeutic. Do something. Your life depends on it!

Excuse #3: “I can’t afford to exercise”

Fact: Physical activity can be free or even save you money.

You do not have to pay for a gym membership or buy any equipment to begin being physically active. There are many things you can do for free. It does not cost anything to go for a nice walk. It may even be healthier to be physically active outside. All you need is a good pair of shoes to start today.

Be creative. You may even be able to save money by exercising. Can you bike to work? Many of my patients bike to work from April through October. Depending on your gas mileage, most of my patients save over $2,000 a year. What if you could eliminate one car in your household? Better yet, biking to work could give you 60 minutes of exercise time while only “costing” you 20 more minutes than what you would have spent driving your car. Imagine that, a 60-minute work out with only a 20 minute time investment!

Excuse #4: “I don’t have a babysitter”

Fact: Physical activity is vital for children too.

We have three young kids so we understand it can be a challenge to find any/enough time for yourself. Try taking turns with someone else, watching the kids while the other engages in physical activity. Better yet, try getting your kids involved. It will help them build healthy habits and it can be fun. If they are really young, push them in a jogger stroller or pull them behind your bike. Just last night we biked as a family to Grandma’s House. Go for a walk or a hike together as a family. I ski with my kids every week during the winter and spring. Plan physically active family vacations.

Excuse #5: “I am too tired to exercise”

Fact: Physical activity will give you more energy.

Do you feel too tired after a long day at work to be physically active? Do you just want to relax? It can be difficult to get off the couch when you are feeling drained, but within a short time, you will feel more energized and alive physically, emotionally, and mentally. Studies show that the best energy “pill” we have is to be physically active all day long.

Put your work out clothes and exercise gear out ahead of time. Schedule a time to exercise with a friend. Not wanting to have to put your clothes or exercise gear away for nothing or let your friend down, you will be energized in the end.

Excuse #6: “I am not losing any weight”

Fact: Physical activity will tip the scale in your favor.

Regular physical activity will increase your metabolism so you will burn more calories even while at rest. Most people naturally start to make healthier food choices once they begin exercising.

Unfortunately, others, like me in the past, believe they can eat anything they crave as long as they burn off the calories. The trouble is that exercise rarely works alone. Unfortunately, exercise increases your appetite. An energy drink and a big unhealthy meal following your workout will completely undo any benefit you may have achieved. You also cannot look at exercising as “punishment” for unhealthy eating. You have to eat right and move your body. The two work together.

While physical activity decreases most people’s desire to eat junk, in some people physical activity can trigger the desire to eat the junk. Perhaps this was due to years of conditioning from playing little league sports where we routinely reward our children with donuts and fruit juice following their workouts. Remember, that sports drink and what ever other junk you go for after your work out will undo any benefit you may have achieved. Physical activity is not a free ticket to eat junk.

Staying active may be enough to maintain a healthy weight when you are younger, but as you grow older, you may find it increasingly difficult to lose weight. It may take more time for all the benefits of your new routine to develop. Be patient and think of physical activity as a lifelong plan.

Excuse #7: “I don’t want anyone to see me”

Fact: Physical activity will enhance your self-esteem.

Do you feel intimidated to go to a gym or exercise in your neighborhood? If you worry about not having the “right” clothes or the “right” body to fit into the gym culture or be out in your neighborhood, please consider that this is the time to honor and take care of yourself, rather than being held back by fears of what others may or may not think. Also, you don’t need to box yourself into going to a gym if it doesn’t work for you.

There are plenty of activities you can choose in lots of different locations. Be creative and be willing to experiment. You deserve to feel great and exercising is one of the best ways to feel more comfortable and confident about your body.

Excuse #8: “I just can’t do what I used to do”

Fact: You can be physically fit at any age.

If you have never been active, you now have a chance to get in the best shape of your life. You may not be as fast or as flexible as you once were. It is natural for our bodies to change over time. You simply need to redefine what it means to be physically fit at each stage of your life and go for it!

My patient, Mary, could barely even walk without becoming short of breath. She did not let this stop her. With encouragement and tracking her daily results, she was able to build up to seven miles a day within 3 months! It is never too late to change!

Excuse #9: “Exercise is Too Boring”

Fact: There has to be something you enjoy doing.

I think the problem here is that most people equate exercise to going to the gym. I get it. If exercise meant that I had to go to the gym I would hate it as well. I hate the gym and have not been to a gym in years. For me, I have to be outside or in the mountains for physical activity to be fun.

When my patients ask me what type of exercise should they do I always answer, do something you enjoy. If you enjoy it you will stick to it. There has to be something you enjoy. Do something every day.

Do you like dancing? Go dancing.

Do you like golf? Then golf and carry your own clubs. Stay away from the cart at all costs.

Do you like gardening? Then please garden as this is an incredibly beneficial activity with many health benefits.

Excuse #10: “I am afraid to exercise”

Fact: Except in rare cases, being physically active is one of the best things you can do for your body.

When I encourage patients to be more physically active, I often hear the excuse that they are afraid they might hurt their heart or even die. I am saddened by these fears they share with me nearly every day that I am in the clinic.

If you have experienced any of the following symptoms, please talk to your physician before becoming physically active again: extended period without physical activity, pre-existing cardiac condition, shortness of breath or chest discomfort. Except in very rare cases, being physically active is one of the very best things you can do for your heart.

Amazingly, study after study shows that for patients surviving a heart attack or even living with heart failure, one of the best things they can do to improve their health, wellness, and longevity is to be very physically active. Just days after a heart attack, we get our patients into an exercise program. Try to be honest with yourself: your excuses may be unnecessarily limiting your life.

These excuses are common. Odds are you’ll see yourself somewhere in this list. Even my wife, Jane, and I have used some of these excuses from time to time. The bottom line is that despite whatever limitations you may be facing, there’s always something you can do. Be creative and remain open. Studies show that every effort you make will increase rather than decrease your capabilities over time.

What do you think? What do you do to stay active? Please let me know.  You can leave a comment by clicking here.

Treadmill         Bicycle

#014 Eliminate Stress in Seven Steps

June 23rd, 2014 by

Eliminate Stress in Seven Steps

I recently performed an ablation for a patient who was suffering from atrial fibrillation following the recent death of her husband of 50 years.  She and her husband did everything together.  It was the kind of marriage that everyone dreams about.

Unfortunately, last summer her husband died suddenly.  She was left heart broken.  She was so devastated she could not leave her home for months until she became too short of breath to even walk inside her home.

Her daughters brought her to the emergency room where she was diagnosed with Takotsubo cardiomyopathy or congestive heart failure from the Broken Heart Syndrome.   After she was treated with the appropriate medications, her heart failure improved. However, it was not until she was no longer grieving her husband that her heart failure completely resolved.  Unfortunately, she was left with atrial fibrillation…

Takotsubo Cardiomyopathy or the Broken Heart Syndrome in My Practice

This is something that I have seen many times in my career.  While it is often from the death of a loved one, I have also seen it from other forms of stress such as family conflict, natural disaster, a lawsuit, losing a job, losing a house, etc. Fortunately, most cases resolve once people are able to manage their stressful experience.

Stress and Our Health

Stress is everywhere!  In fact, 83% of Americans are stressed out at work according to Everest College’s 2012 study. Another study showed that chronic stress has a similar damaging effect on the body as smoking 5 cigarettes a day  Even just thinking you are “stressed” is enough to increase your risk of a heart attack by 27%.

Stress shortens our lives and leads to premature aging.  The stress we are feeling now predicts our health 10 years down the road.  Stress is part of the human experience.  We cannot avoid it.  The key is how do we process and manage stress?

Eliminate Stress

What are the effects of stress on the cardiovascular system?  

For years, I have seen how people with high anxiety levels seem to be very prone to a dangerous heart rhythm abnormality called atrial fibrillation or Afib.  It always seems that when these people are most stressed they have an episode of Afib.  In addition to Afib, stress can trigger may other cardiovascular problems.  If you want to read more just click on each condition.

1. Stress can trigger arrhythmias

2. Stress can cause strokes

3. Just one episode of mental stress can cause heart cells to die. (here is a more layperson’s report of this study)

4. When we are stressed out we eat heart damaging foods.

What can we do?

Unfortunately, studies have shown that we can even inherit stress from our parents.  But, like everything else we have learned, our DNA is not our destiny.  We can change our lives and change the lives of those who will follow us.

7 Ways to Manage Stress and Avoid the Broken Heart Syndrome

1. Keep a Gratitude Journal

Be grateful for whatever you have.  Studies show that if we have an “attitude of gratitude” stress becomes much more manageable.

2. Get Enough Sleep

When it gets dark at night it is time to start winding down our day.  If we are sleep deprived we cannot manage anything very well.  Get your sleep and your stress will be much easier to manage.

3. Keep Physically Active

Physical activity allows us to diffuse the toxic stress hormones, cortisol and adrenalin.  If you are stressed, go on a long strenuous walk.  Exercise really does reduce stress!

4. Eat Right

If we eat the right foods, especially fruits and vegetables  it gives our bodies the right nutrients to keep everything working properly.

5. Meditate

Meditation can quiet the mind and reduce stress.  Meditation can come in many different forms.  For some it can be prayer for others it could mean yoga.

6. Connect With Others

Too often, when we are stressed, we turn inward.  This is especially true for men.  When we are stressed out is when we need to reach out to others the most.  We need to find ways to help others when we are stressed the most.  It seems counter intuitive but when we focus on others rather than ourselves our stress will magically resolve.

7. Accept What You Cannot Change

At the end of the day, there are just things that are beyond our control. We simply can’t fix everything.

What do you think?  Is stress affecting your health? You can leave a comment by clicking here.

#010 Six Reasons Why You Need a Vacation Now

June 2nd, 2014 by

Did you know that taking regular vacations can help you to prevent a heart attack? While it seems strange, most Americans do not take their full vacation time. I was the same way once. It really makes no sense at all.

Is stress crushing you?

According to the 2013 Work Stress Survey, 83% of Americans reported being stress out at work. Where are you right now in your life? Are you buried at work? Is stress crushing you?

Do you need a vacation?

The problem is that as Americans we just do not take many vacations. While Europeans get up to 30 days of paid vacation each year, we just get 14 days. Even with these 14 days of vacation, the average American only takes 10 days off.

I get this. I used to be the same way. I would never take any time off. I would let my vacation time go unused so that I could work more. Seems strange doesn’t it?

I’m really not sure what was going on in my head at the time. I think I was trying to work hard and not spend any money in hopes for an earlier retirement. That is if I still had my health by the time I hit retirement age…

It was not until I hit my own health crisis a few years ago that I started taking vacations. Now I know that vacations are absolutely critical to our health, happiness, and longevity!

Let me give you 6 Reasons Why You Need a Vacation Now!

1. Less Stress

We just do not do a good job of dealing with stress in our modern lives. 70% of all doctor visits are due to stress or illnesses brought on or made worse by stress. I see this every day in my medical practice. In fact In a study of 1500 women in Wisconsin, those who rarely took vacations were 90% more stressed out than those who regularly took vacations.

2. More Happiness

While we have always been taught money cannot buy you happiness, that is not always the case. Studies have shown that spending money on life experiences, such as vacations, actually improve happiness.

Interestingly, in a study of 1,530 Dutch people, vacations seem to boost their pre-trip happiness the most. Somehow, just thinking about your upcoming vacation makes you happier. I know this is the case for our family. For the last 20+ years our annual family vacation has been on my parent’s houseboat at Lake Powell. If we even bring up Lake Powell our kids instantly become joyous! Now that I am thinking about this vacation, I can already feel my spirits lifting!

3. More Energy

Yes, vacations can give you more energy! Perhaps it is because they give you a new perspective on life or a chance just to de-stress. Regardless, from the Wisconsin study cited above, women who rarely took vacations were 67% more tired and fatigued than those who regularly took vacations.

4. Better Marriage Satisfaction

Can you really improve your marriage just by taking a vacation? Yes, according to the results of this Wisconsin study. In this study, women who regularly took vacations reported 55% more satisfaction with their marriage. Vacations give us a chance to reconnect with those that are most important in our lives free from all of the stressors of everyday life.

5. Protect Your Heart

Yes, a vacation will help to save you from ever developing heart disease! In fact, from over 12,000 men followed for 9 years in the MRFIT Trial, those who regularly took vacations were 29% less likely to die from a heart attack. Studies of women have shown the same heart protective effects of vacation. Vacationing is indeed good for your heart!

6. Live Longer

If all of the above benefits were not enough, those who regularly take vacations live longer than those who do not. Based on the MRFIT Study above, regular vacationers were 17% less likely to die over the 9 years of the study.

What if I can’t afford a vacation?

You may be thinking, yeah that all sounds great Dr. Day but my wife and I just cannot afford a vacation right now. Vacations do not have to be expensive. In fact, you could even do a “stay’cation”.

Stay’cations, if done right, can yield the exact same health benefits. Of course, a stay’cation does not mean stay home and do chores around the house. It means to get out and explore the area around where you live!

What can I do today?

My challenge to each of you is to take some time and plan a vacation with your family or friends today. There is no better time than the present. It just might make you happier!

How have vacations helped you in your life? What was your best vacation? You can leave a comment by clicking here.

#003 (UPDATED) Can Too Much Exercise be Bad for You?

May 24th, 2014 by

Can Too Much Exercise be Bad for You?

The modern day marathon was inspired after Pheidippides, a long distance running courier in ancient Greece. During two days he ran a total of 175 miles. On the last leg of his run, a 25 mile distance from the battlefield near Marathon to Athens, he died suddenly.

Can the same thing happen to us if we run too much?

Recent Headlines: Too Much Running is Dangerous

Did you see the recent news reports that too much running is dangerous?  What is the science behind these headlines?

These headlines came from a recent study published in the Journal of the American College of Cardiology.  In this study, researchers from Copenhagen reported their findings of 5,048 joggers and non-joggers who they had followed for 12 years.

Results of the The Copenhagen City Heart Study

Here are the key findings of this study which caught the attention of the news media:

1. The most intense runners had the same risk of dying as the coach potatoes.

2. Light joggers who jogged between 1 and 2.4 hours each week, for no more than 3 times each week, at a slow to moderate pace were the least likely to die.

3. Moderate joggers did not survive as well as the light joggers.

4. Running faster than 7 mph, jogging for 2.5 hours or more each week, or jogging more than 3 times per week increased the risk of premature death in this study.

Can we believe the results of the Copenhagen City Heart Study?

For the runners reading this article, like me, our first question is how reliable are these data?  And, just what is the optimal dose of running?

Like most medical studies, this study was definitely not perfect.  For example, there were only 47 joggers in the group that jogged the most (more than 4 hours a week).

In this small group of 47 joggers in this study who ran more than 4 hours a week there was only one death.  Had that one person not have died during the study then the results would have been completely different.

Interestingly, this study did not even report what this one runner even died from.  For all we know he could have died in a car crash that had nothing to do with his love of running.

While we can certainly poke holes in the conclusion of this study, this study is in line with a growing body of research that shows that extreme levels of exercise may be dangerous to our health.  The only difference between this study and the other studies is that this study reported that even low levels of exercise (jogging for more than 2.5 hours per week) conferred an added risk of death.

Can what happened to Pheidippides happen today?

For better or worse, too much exercise is something that 99% of the American public never needs to worry about. In fact, knowing that less than 5% of Americans even get enough exercise according to pedometer studies I hesitated even writing this article.

I recently read the epic masterpiece by Christopher McDougall entitled “Born to Run” (affiliate link) which reignited within me my passion for marathon running.  A number of years ago during my health crisis I had to give up running due to severe knee pain.  Since completely changing my lifestyle I was able to reverse my knee pain in addition to many other medical conditions.

Prior to becoming a cardiologist, I had run 5 marathons including the legendary New York City Marathon twice. You will notice the photo of my 1992 New York City Marathon finish.

Yes, I am the totally depleted guy without a shirt at the finish line. I remember as a child running in our neighborhood and dreaming of winning the Olympic Marathon for USA, however, from my marathon time you will notice that I never quite qualified…

Now that I have completely regained my health and am able to run again I would love to train for another marathon.  However, as a cardiologist, I have to question if marathon running, or any ultra endurance event, is really the best thing for my health. Outside of the wear and tear on our joints from marathon running, just what is happening to the heart?

Phidippides Cardiomyopathy

Interestingly, there is now a cardiac condition called Phidippides Cardiomyopathy. In this condition, the heart enlarges, weakens, and becomes very susceptible to a cardiac arrest after extreme levels of exercise.

Indeed, studies have shown that marathon runners experience transient enlargement of their hearts after a marathon.  Other studies have shown that 13% of marathon runners permanently “scar” their hearts.

It is not just marathon runners who are at risk. Studies have also shown endurance cyclists and cross-country skiers are also at risk of cardiac complications.  For example, endurance athletes often have cardiac enzymes, from cardiac cell death, in their blood following an endurance race.  It should be pointed out that cardiac enzymes in the blood is an ominous finding and is one of the ways we diagnose a heart attack when anyone, usually non-athletes, when they present to the emergency room with chest discomfort.

Fortunately, the vast majority of these cases of Phidippides Cardiomyopathy completely resolve. However, in a small subset of people they actually go on to develop heart failure. In addition to Phidippides Cardiomyopathy, endurance athletes also appear to be predisposed to developing a dangerous arrhythmia called atrial fibrillation.

Tragically, one of the key characters in Christopher McDougall’s book, Caballo Blanco, an ultra marathoner, died of a cardiac arrest while running just 3 years after the book was published.  At autopsy he was found to have an enlarged heart and likely also developed Phidippides Cardiomyopathy after a life-time of ultra marathoning.

They Don’t “Exercise” in China’s Longevity VillagePeasants on their way to work in the morning in the village of Poyue

When we discussed the concept of exercise to the residents of China’s Longevity Village on our last visit, they found the whole Western concept of exercise quite strange.  In fact, if you ask them they will tell you that they “never exercise.”

How can they escape most of the Western diseases like heart disease, dementia, diabetes, obesity, etc. and yet never exercise?  The answer is really quite simple.  They are physically active all day, every day farming by hand.  They do experience short periods of high intensity training like when they need to carry a 50-70 pound basket of produce on their backs while walking up the side of a mountain.

Their form of “exercise” is very gentle and does not stress the joints.  Could this be why none of them had undergone joint replacement surgery but yet could walk without a limp even at an age of more than 100 years old?

How Much Should We Exercise?

Just how much exercise should we aim for?  Let me share with you four simple strategies that I recommend for my patients.

1. Make it a daily habit.

Commit to 30 minutes of moderate intensity exercise or 15 minutes of high intensity exercise each day.  If you think about it, 15 minutes over the course of a day really is not much time.  Even the busiest of people can carve 15 minutes out of the day to protect their health.

2. Find an exercise you enjoy.

It doesn’t matter what you do for exercise as long as you enjoy it. Unfortunately, half of all people who start an exercise program quit within 6 months.

The key, therefore, to making exercise stick is to find something that you enjoy.  Exercise does not mean just going to the gym.  Personally, I hate the gym and have not spent anytime in a gym for years.

Rather, exercise could be dancing, walking, skiing, hiking, or just about anything that moves your body.  Even better is to mix up your exercise routine to minimize the risk of injury and work different muscle groups.

3. Have a Work Out Partner or Track Your Work Outs

Studies show that those who exercise with others are more likely to be successful.  If you don’t have anyone you can exercise with then track your work outs.  Studies show that either approach will increase your chances of making daily exercise a lifelong habit.

4. 10,000 Steps

In addition to exercise, it is also just as important to remain physically active throughout the day. Studies have shown that people who sit for most of the day (i.e. desk jobs), cannot reverse the ill effects of sitting all day even if they exercise vigorously each day.

For example, if you sit more for more than 3 hours a day then you lose 2 years of life according to this study.  When we sit our large muscle groups are at rest which leads to changes in our body’s metabolism and how we process glucose.

10,000 steps represent the equivalent of walking approximately 5 miles.  I have found that even my elderly patients can log 10,000 steps a day.  Just the act of tracking your steps causes you to take an extra 2,000 steps (1 extra mile) without even knowing it.

With thoughts of the Copenhagen City Heart Study and Phidippides Cardiomyopathy in my mind, I think I will hold off on training for any more marathons. Do you agree?

What is your preferred form of exercise?

Please note that this article was revised and updated on February 6, 2015.